Official Interview: Elliott B. Martin, Jr.

[kandscreeley]

Today's Chat with Sarah features Elliott B. Martin, Jr. author of The Virtuous Physician.

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1. What do you do when you aren't writing?

When not writing, I work full-time as a psychiatrist. I wear several different hats as a doctor. I am the director of psychiatric consultation and emergency services at a general hospital in the Boston area. I am the interim medical director of our outpatient substance use clinic. I am also the consulting psychiatrist for an educational-vocational residential school for kids with severe neurodevelopmental disorders and intellectual disabilities. I also do regular forensics evaluations for the Boston Public Defenders Office. I am also a professor of psychiatry at Tufts University School of Medicine. Otherwise, I enjoy spending time with my family. And I'm always reading, at least three or four books at a time.

2. Who has been most influential in your life?

There are so many people, both good and bad influences. If I had to narrow it down, it would be a 'gang of three'. When I was a resident at Yale, I started a discussion group, the Yale Philosophy and Psychiatry Group, a group that went on to publish several influential papers. In so doing I gathered together three senior faculty mentors, Jim Phillips, Don Mender, and Mel Woody, two psychiatrists and a professional philosopher. Sort of like My Three Dads, these guys, with humor and intelligence, opened my eyes to the world as a whole. And like any philosopher worth his salt, under their tutelage, I became a failed critical theorist. But that failure is what has made me a (hopefully) good psychiatrist and (again, hopefully) a better human being. I also like to think I re-sparked the creative energies in those guys as well.

3. Let's discuss your book The Virtuous Physician. Can you give us a short synopsis?

The Virtuous Physician: A Brief Medical History of Moral Inquiry from Hippocrates to COVID-19 traces the origin and development of moral inquiry as viewed through a lens of medical history. The cornerstone of the book is a translation of, and commentary on, the second-century BC pseudo-Hippocratic Greek text, Precepts, a work not translated into English since 1921, which first introduced the idea of the 'virtuous physician', and first makes mention of the 'art' of medicine. Precepts describe the ideal way of being a physician and offer a pragmatic, very modern (very much superior to the Hippocratic) code of ethics.

In addition, through the examination of other early and more modern texts, the book locates the physician as really a seminal figure in ancient society, first with religious significance, and later with increasingly philosophical and intellectual meaning. In the book, this inquiry is eventually put to the modern test as applied to the existential threat and crisis of the COVID-19 pandemic.

4. What made you decide to write a book of this nature?

Before going to medical school, I had actually had a previous career as a failed academic. I was a graduate student in the Department of Neat Eastern Languages and Cultures at UCLA, all-but-dissertated. I was an ancient language specialist. I had passed any number of doctoral exams in any number of dead languages once spoken in the Near and Middle East and Ancient Mediterranean, including Greek (the language of the Oath of Hippocrates).

So, as a classics scholar, and physician, the Oath of Hippocrates has always bugged me. It has really become more of a cultural bugaboo than a professional code. There are so many iterations, depending on one's politics, and although we all raise our right hand and recite some lines we (wrongly) attribute to Hippocrates, no one in medical school has any idea what it's all about (including me until I did more research). Mostly, I wanted to give the medical community an update.

The book expanded, however, as books do, once the process started, and as a historian, and first-hand witness to the recent pandemic, I decided to follow this thread of moral and ethical inquiry more broadly to our current era, more to explore how contemporary, and relevant, many of these ancient ideas are.

Overall, the work allowed me to create a concise history of medicine and psychiatry in a (hopefully) more entertaining fashion.

5. This is a detailed book that discusses the history of medicine. How much research did you do for this book?

The research, especially for the translation, was quite extensive. I spent many days and nights at libraries both at Yale and Harvard going through both primary and secondary sources, all kinds of obscure dictionaries open before me, making sure I had everything just right. The translation was actually peer-reviewed by several classical scholars as it was published separately in an Italian journal first, the interdisciplinary Journal of the International History of Ideas.

6. What was the most difficult part of the writing and publishing process for you? What was most rewarding?

For me, writing is relatively easy, and once I have my thoughts in order, the words just come. The hard part is the revision process. Every time I read over something I have written I always find something I want to change, and it is hard to finally pull back and let the thing breathe on its own.

Finding a publisher can be laborious. In this case, I was looking more for an academic-style press, and given the subject matter, it was relatively straightforward. Editing a book to appease a publisher or editor can also be trying, but not so much in this case.

What is most rewarding for me is having people read my work and get what I am trying to say. I don't necessarily seek out 5-star reviews, or agreement, but more than that, I seek to get people thinking and re-thinking, considering and reconsidering. If I can turn a layperson on to the history of medicine with a book like this, then I feel richly rewarded.

7. What do you think is the biggest problem with healthcare today?

That's a tough one. Right now, especially given that I work primarily for a gargantuan, monopolistic healthcare megalith that controls the healthcare in my current city, I would say it's the problem of gargantuan, monopolistic healthcare megaliths taking over healthcare. The fact that we are now an "industry" is quite troubling. In these scenarios, you, me, the patient, really are nothing more than data points as medicine becomes increasingly standardized and algorithmized. Hospitals have become giant nursing homes, and the strange bedfellows of Big Insura, Big Pharma, and Big Academia have very little concern for any individual datum point.

8. What's next for you? Any more books in the works?

I have recently published two other books, companion volumes, through another academic style press, Reconceptualizing Mental Illness in the Digital Age: Ghosts in the Machine and Reconceptualizing Mental Illness in the Viral Age: Souls in the Machine. Although these focus on the state of psychiatry and medicine in the context of the Digital Age, I do bring a fair amount of historical background to my arguments as well. Currently, I am completing a book that collects some of my own personal stories and anecdotes as an emergency psychiatrist in New Haven and Boston. Tentatively titled The (Dis)order of Things, or The Myth of Mental Wellness, it is aimed at a more popular audience and has been fun to write.

I like to end with lighter questions.

9. Which fictional doctor would you want to treat you?

I would say either Dr. Samuel Loomis from the Halloween movies (either Donald Pleasance or Malcolm McDowell would be fine), or Dr. Lecter (provided he wears his mask). I would have said Harley Quinn, but I believe she is actually a psychologist.

10. When you were young, what did you want to be when you grew up?

A veterinarian. Don't know what happened.

11. What is your biggest life accomplishment?

As a physician, rising to a leadership position in a major healthcare system. As an academic, gaining a faculty appointment at a major university. As a writer, having my books published. And as a person, having anything to do with the success of my recently teenaged daughter.

12. What is your biggest fear?

Becoming useless. Especially as I grow older. Especially in this hyper-rapid digital era. The thought of having nothing left to offer is terrifying.

[Carole Kendall]

I really enjoyed this interview and your sense of humor peeking through. I am a retired Clinical Psychologist and have worked in many of the same settings you mentioned. However, I worked in one or two at a time not all simultaneously as you are doing.I don’t know how you squeezed in writing books with the other demands on your time. I would really like to know how you got from wanting to be a veterinarian to where you are today.

[Blessed Hope]

You were asked a question on healthcare and the point of hospitals becoming a giant nursing home is quite true because many people are complaining about services they encounter at hospitals. On the point of Big Insurance, Big Pharmaceuticals and Big Academia having little concern for any individual is quite true. This is because, they would have already come up with affordable healthcare for all
Healthcare is very very expensive particularly for the poorest of the poor across the globe.
Can you come up with a formula that can be funded from taxpayers money to fund the poor while being financial sustainable and not relying on donors and debts? Please, your expertise is highly required