On Trusting Science: Review of Arrowsmith by Sinclair Lewis

As a youth, Martin Arrowsmith, the fictional protagonist of the novel Arrowsmith, by Nobel Prize-winning author Sinclair Lewis (1925), is hooked when he has the opportunity to observe medicine — as practiced by an old country doctor in his tiny Midwestern hometown — and he decides to become a physician. Martin grows up to become a normal, decent human being – but, as do so many of us, he conducts his life according to a confusion of incompatible standards: for instance, as a pre-med student in 1904, he experiences two crushes – dual infatuations with girls and with pure Science — and he becomes engaged to two girls at the same time. And, although Martin often falls in love, he is not able to focus on a human relationship for any significant length of time:

“He raced home in adoration. As he lay in his narrow upper bunk at midnight, he saw her eyes, now impertinent, now reproving, now warm with trust in him. ‘I love her! I love her! I’ll ‘phone her—Wonder if I dare call her up as early as eight in the morning?’ But at eight he was too busy studying the lacrimal apparatus to think of ladies’ eyes.” (Lewis, Project Gutenberg)

Indifferent when it comes to studying philosophy and the liberal arts, Martin is yet a thinking man; and, usually, he attempts to do the right thing. But sometimes he has difficulty determining what the right thing is — and sometimes he knowingly does wrong. As a medical student, he faces an ethical conundrum: he finds that he must doubt the wisdom of pursuing his intellectual passion for pure science, because he believes that, were science ever to succeed in immunizing every person against every known pathogen, the triumph of humanity would be short-lived – for, the newly immuno-depleted human race would be altogether eradicated by the next germ to emerge. In the end, Martin believes, science cannot protect humanity from infections entirely.

As a new doctor, while Martin takes his duty to heal seriously, he makes honest mistakes from time to time. Some of his mistakes are the result of faulty reasoning and bad guesses, but often he commits blunders out of his personal weaknesses. Many of the regrettable decisions he makes — in both his personal life and in his practice of medicine — are the result of his anxiety over the opinions of other people. He yearns for the esteem and social position which are seldom the rewards of researchers unseen in laboratories, and seldom the rewards of scrupulous honesty.

Eventually, Lewis’s well-intentioned and very fallible protagonist is initiated into the political dimensions of public health, the profit motives of pharmaceutical research (i.e., the patenting of life-saving drugs, rather than the free sharing of the formulae), the manipulation of statistics by officials and corporations, bribery and kickbacks, and the “Old-Boy” professional network – all of which threaten the honest, disinterested delivery of health care. Repeatedly, Martin finds himself faced with deciding between a right and a wrong course; and he does, at times, rise briefly to the level of heroism. He does this – not by always making the right decision – but by rejecting rationalization and submitting to honest self-examination, and owning up to his shortcomings. But he is not always honest with either himself or others. Martin’s life is characterized by his constant vacillation between his love of pure science — which is less remunerative than practicing medicine — and his desire for affluence and esteem.

The climax of the novel is the arrival of the Bubonic Plague on St. Hubert’s Island. Dr. Arrowsmith is sent to conduct an experiment funded by the pharmaceutical sector. The chief component of the study was to have been the inoculation of only half the population of the island with Martin’s experimental phage-vaccine, in order to compare the rates of infection and survival in the two control groups, and thus to objectively prove the efficacy of the vaccine he has discovered. Martin chooses, instead, to inoculate everyone, in order to save more lives, abandoning his experiment. He is hailed as a hero by government and the pharmaceutical industry – but he considers himself a failure:

“The more they shouted his glory, the more he thought about what unknown, tight-minded scientists in distant laboratories would say of a man who had had his chance and cast it away. The more they called him the giver of life, the more he felt himself disgraced and a traitor; and as he looked at Stokes he saw in his regard a pity worse than condemnation.” (Lewis, Project Gutenberg)

He regrets the loss to Science more than he regrets the loss of his first wife, who succumbs to the plague — a direct result of his neglect of her. In the end, Martin abandons his second wife, son, and friends, too, to go to the woods, in pursuit of a monastic life devoted to the god of Science:

“Martin worried as much over what he considered his treachery to Clif Clawson as over his desertion of Joyce and John, but this worrying he did only when he could not sleep. Regularly, at three in the morning, he brought both Joyce and honest Clif to Birdies’ Rest; and regularly, at six, when he was frying bacon, he forgot them.” (Lewis, Project Gutenberg)

Thus, Martin chooses his desire for knowledge over his connection with humanity. In Arrowsmith, the Scientist is the madly obsessive scientist, who considers social distractions mortal sins against the pure pursuit of Truth.

It seems to me that today’s reader can substitute the WHO, CDC, Presidents Trump and Biden, Dr. Fauci, et al., for Lewis’s characters and see our own situation played out a century ago. In the present time, when the refrain chanted so often by institutional authorities – “Trust Science” – is resounded ad nauseum every place one turns, Arrowsmith provides the reader with a poignant reminder that the members of the scientific community and of the medical profession, are as fallibly human and self-interested as the rest of us. Ultimately, trusting science is simply trusting people; and Arrowsmith prescribes a healthy dose of skepticism toward demagogues in lab coats.

Sinclair Lewis regarded humans and human institutions with an informed cynicism. He refused the Nobel Prize for Arrowsmith, claiming that the prize was awarded more for the political correctness of an author than for the intrinsic literary or intellectual merit of the work under consideration (another historical perspective which is readily applicable to our present cultural circumstances). In Lewis’s words:

“I wish to acknowledge your choice of my novel Arrowsmith for the Pulitzer Prize. That prize I must refuse, and my refusal would be meaningless unless I explained the reasons.

“All prizes, like all titles, are dangerous. The seekers for prizes tend to labor not for inherent excellence but for alien rewards; they tend to write this, or timorously to avoid writing that, in order to tickle the prejudices of a haphazard committee. And the Pulitzer Prize for Novels is peculiarly objectionable because the terms of it have been constantly and grievously misrepresented.

“Those terms are that the prize shall be given ‘for the American novel published during the year which shall best present the wholesome atmosphere of American life, and the highest standard of American manners and manhood.’ This phrase, if it means anything whatsoever, would appear to mean that the appraisal of the novels shall be made not according to their actual literary merit but in obedience to whatever code of Good Form may chance to be popular at the moment.” (Arrowsmith, Wikipedia)

In times of uncertainty and fear, people tend to look to government and other social institutions (such as public health and religion) for salvation. Arrowsmith reminds us that the institutions are made up of people much like ourselves.