In The Scarlet Letter (1850), Nathaniel Hawthorne describes the physician Roger Chillingworth as he evaluates his patient, the Reverend Arthur Dimmesdale. His approach is a model for health care professionals who seek to help patients understand and cope with hidden stresses.
“Thus Roger Chillingworth scrutinized his patient carefully, both as he saw him in his ordinary life, keeping an accustomed pathway in the range of thoughts familiar to him, and as he appeared when thrown amidst other moral scenery, the novelty of which might call out something new to the surface of his character. He deemed it essential, it would seem, to know the man, before attempting to do him good. Wherever there is a heart and an intellect, the diseases of the physical frame are tinged with the peculiarities of these. In Arthur Dimmesdale, thought and imagination were so active, and sensibility so intense, that the bodily infirmity would be likely to have its groundwork there. So Roger Chillingworth – the man of skill, the kind and friendly physician – strove to go deep into his patient’s bosom, delving among his principles, prying into his recollections, and probing everything with a cautious touch, like a treasure-seeker in a dark cavern. Few secrets can escape an investigator, who has opportunity and license to undertake such a quest and skill to follow it up. A man burdened with a secret should especially avoid the intimacy of his physician. If the latter possess native sagacity and a nameless something more, – let us call it intuition; if he show no intrusive egotism, nor disagreeably prominent characteristics of his own; if he have the power which must be born with him to bring his mind into such affinity with his patient’s, that this last shall unawares have spoken what he imagines himself only to have thought; if such relations be received without tumult, and acknowledged not so often by an uttered sympathy as by silence, an inarticulate breath and here and there a word, to indicate that all is understood; if to these qualifications of a confidante be joined the advantage afforded by his recognized character as a physician, – then, at some inevitable moment will the soul of the sufferer be dissolved and flow forth in a dark but transparent stream, bringing all its mysteries into the daylight.”
Ironically and shockingly, Dr Chillingworth is seeking revenge, using his seemingly compassionate technique to uncover a secret that tortures both him and his patient. His cold, calculating nature is reflected in the name the author gives him. All of which illustrates that a good thing can sometimes be used for evil purposes. However, when coupled with benign intent, the approach is worthy of emulation.
Tags: Hawthorne, medical interview, Scarlet Letter
