BEDSIDE SHOWDOWNS

The High Stakes of Medical Practice


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When Galen argues with his fellow doctors, the stakes are high: a patient is sick, a group of physicians have gathered at the bedside, and the household and friends are watching. Today, medical debates take place in the pages of specialized journals using objective scientific language at a remove from everyday practice. In the Roman era, however, medicine was a social affair; the sickroom was a site of fierce conflict in an urgent moment. Galen’s case histories describe scenes of rivalry and confrontation, usually with a group of anonymous doctors, occasionally with a specific physician. By the end of the story, Galen’s adversaries are shown to be incompetent. If these scenes evoke a public debate or sporting competition, it is because the narratives were modeled on such spectacles. Rivals would issue challenges, mock, brag, boast, insult, laugh at, and even threaten one another. Here is Galen:

“They [my rival physicians] became paler and colder than the patient himself, and were considering some method of escape; anticipating that, I ordered the entrance door to be closed.”

Galen’s descriptions are macho and his attitude toward his peers antagonistic or hostile; often, the stories hinge on a life-or-death cure.

A page with a colored illustration of seven figures in white robes, sitting in a circle. Enclosing the scene is an elaborate rectangular border in red, blue, yellow, and black. The page’s top left corner is missing.

Seven physicians with Galen enthroned at the center. Pigment on parchment. From De materia medica (Vienna Dioscorides; Byzantine, ca. 512 CE), fol. 3v. Österreichische Nationalbibliothek: Cod. Med. gr. 1. Photo: © ÖNB Vienna.

The dramatic setup and public nature of medical care provide Galen with an opportunity to showcase his superiority in multiple ways: by presenting a stunning diagnosis and prognosis (for Galen, these were the same), by displaying his impressive erudition and debating skills, or by ultimately healing the patient. Galen records the reactions of those present—the patient, his or her friends and family, or the other doctors—highlighting their astonishment at his performance:

“[My patient] Eudemus was amazed and proclaimed my predictions to all those who visited him.”

The witnesses are key to these narratives, acting as impartial guarantors of Galen’s uncommon gifts, considering he reports them himself.

Such public displays of competitiveness, erudition, and talent in pursuit of power and influence were part of Roman culture for elite men. Most of these bedside scenes follow the same sport-like arc with Galen as victor; when one of the other healers is a woman, however, his tone is quite different. In scenes featuring midwives, even when Galen is ultimately responsible for the prognosis and cure, he does not compete with female healers or attempt to prove them wrong. But it is also instructive that stories with midwives and female doctors are rare: the social life of Roman medicine was a world based on ancient masculine ideals.

A rectangular bas-relief with two female figures, one reclining and the other seated. The edges of the object are chipped, and a crack runs diagonally across the top right corner.

Relief depicting a midwife attending a birth. Roman, 2nd century CE. Wellcome Collection. Photo: Wellcome Collection. CC BY 4.0.