I can understand why this novel was so important at the time, for it brought out the conflicts between public and private healthcare, between discovery and commercial exploitation, and between researcher and healer.
Arrowsmith, a product of rural mid-west America, is the quintessential scientist, content to shun the pleasures and riches of the world and be sequestered in his laboratory unravelling the secrets of major epidemics. Only the love of his life, Leora, who faithfully and tragically follows him on his peregrinations to find his place in the world, and who spends hours in his laboratory compiling his tests and making notes, has him pegged: “You are not a booster. You are a lie-hunter, and a hick.” Arrowsmith’s other major influence is his research professor, Gotlieb, a renowned bacteriologist and an irascible seeker of the truth at whatever human cost.
The novel is packed with incident and chronicles our hero’s life from his youth, through his university years, to his early life as a physician in mythical mid-western towns such as Wheatsylvania (pop. 367) and Nautilus (pop. 68,000), until he gives up on the role of the healer and follows pure scientific research by joining his former mentor, Gotlieb, in New York City. Arrowsmith’s brief stints and initiatives in public healthcare draw the ire of the private healthcare establishment (many of the protesters are his former frat-buddies), making this a topical book in our modern times of Obama-care. However, the world of research, with its well-stocked labs and laissez faire approach of “tooling around until you hit on something useful, even if it takes you several years,” also starts to show its ugly underbelly when Arrowsmith’s discovery of the X Principle is usurped by another within the international research fraternity.
Arrowsmith finds his ultimate challenge when he is sent to St Hubert’s in the Caribbean to put down bubonic plague with the vaccine developed through his research. With hundreds dying by the day, he faces the test of the researcher vs. the healer: does he deliberately keep a control group without giving them the vaccine so that he can document his results accurately, or does he vaccinate everyone and save more lives? His beloved Leora shows him the answer.
From the climax in St. Hubert’s (where I thought the novel should have ended) we follow Arrowsmith a bit further to his life of luxury and privilege with a new wife, Joyce, until he faces the next existential decision: does he subside into complaisance and anonymity in Joyce’s world, or does he chuck it all up again and join a renegade research colleague, Terry, in a flea-bitten lab, extending the next frontier of medical research?
The narrative style is one of brisk storytelling laced with underlying humour; much happens in the span of a few pages. The medical community, the research community, university life, and small town life are well drawn. People in small towns have “relations” as opposed to “sex” - a word or a line of dialogue explains a lot! There is however, a lot of medical and scientific terminology that can be a bit intimidating to the uninitiated – testament to Lewis’s own life lived within a family of doctors.
Yet, despite the rationality of the researcher, Arrowsmith comes across as very human, and is governed by his emotions, making him an engaging character to take this long narrative voyage with. And like an artist, he is totally self-absorbed in his pursuits, until fate intervenes to make him pause and take stock of his humanness.