The Summing Up

W. Somerset Maugham knew he wanted to be a writer even before he became a medical student at St. Thomas’s Hospital in London.

We do not write because we want to; we write because we have to.

His years in medicine, rather than being a cul de sac for his creativity, were in fact a boon to his future career.

I saw how men died. I saw how they bore pain. I saw what hope looked like, fear and relief…

In his memoir, ‘The Summing Up‘, he wrote of the impact of his medical training on his writing. According to Maugham, It was during these years that he came to an understanding of human nature:

I do not know a better training for a writer than to spend some years in the medical profession. I suppose you can learn a good deal about human nature in a solicitor’s office; but there on the whole you have to deal with men in full control of themselves. They lie perhaps as much as they lie to the doctor, but they lie more consistently, and it may be for the solicitor it is not so necessary to know the truth. The interests he deals with, besides, are usually material. He sees human nature from a specialised standpoint. But the doctor, especially the hospital doctor, sees it bare. Reticences can generally be undermined; very often there are none. Fear for the most part will shatter every defence; even vanity is unnerved by it. Most people have a furious itch to talk about themselves and are restrained only by the disinclination of others to listen. Reserve is an artificial quality that is developed in most of us but as the result of innumerable rebuffs. The doctor is discreet. It is his business to listen and no details are too intimate for his ears.

But of course human nature may be displayed before you and if you have not the eyes to see you will learn nothing. If you are hidebound with prejudice, if your temper is sentimental, you can go through the wards of a hospital and be as ignorant of man at the end as you were at the beginning. If you want to get any benefit from such an experience you must have an open mind and an interest in human beings.

W. Somerset Maugham, The Summing Up

Maugham was born in 1875, at the peak of British Imperial power, and died in 1965 when the Empire was but a memory. I wonder if he wished he’d taken his own advice:

Death is a very dull, dreary affair, and my advice to you is to have nothing whatsoever to do with it.

W. Somerset Maugham
Trailer for ‘The Painted Veil’, based on the book by W. Somerset Maugham

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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