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Rereading Arrowsmith in the COVID-19 Pandemic

Educational Objective
To understand how Arrowsmith can encourage optimism within times of great struggle and stress
1 Credit CME

You should read Arrowsmith,” I have long told aspiring clinician-scientists I interview, as a way of getting them to think about which of the 2 career tracks drives them more. That recommendation is even more timely and broadly relevant now in the midst of the novel coronavirus disease 2019 (COVID-19) pandemic.

The 1925 novel by Nobel Laureate Sinclair Lewis tells the story of Martin Arrowsmith, an ambitious early-career physician who finds himself drawn to research but gathers no moss as he tries out roles as a clinician, scientist, and public health specialist, seeking models and mentors at each turn and finding them all unworthy of his ideals. He finally finds a home as a researcher at a well-funded private institute in New York when a novel bacteriophage treatment he has developed seems like it might be the cure for a fictional bubonic plague outbreak ravaging a Caribbean island. In the face of the deadly epidemic, his principled commitment to maintaining a control group to prove the efficacy of his therapy is barely sturdier than the sense of superiority he has carried his entire life, and the widespread death he encounters on the island forces him to choose between his ideals and identity as a scientist (studying the treatment first) and as a humanitarian and clinician (treating everyone). It takes what may be the only fate worse than dying in a pandemic to shock him into a direction, and it is left to readers to judge the merits of his choice, which in the end disappoints even Arrowsmith himself.

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Article Information

Corresponding Author: David J. Eisenman, MD, Department of Otorhinolaryngology–Head and Neck Surgery, 16 S Eutaw St, Frenkil Bldg, Ste 500, Baltimore, MD 21201 (deisenman@som.umaryland.edu).

Published Online: June 26, 2020. doi:10.1001/jama.2020.11489

Conflict of Interest Disclosures: None reported.

References
1.
Manson  K . Virologist behind “Contagion” film criticises leaders’ slow responses. Financial Times. April 19, 2020:FT Weekend page 3.
2.
Kalil  AC .  Treating COVID-19–off-label drug use, compassionate use, and randomized clinical trials during pandemics.   JAMA. Published online March 24, 2020. doi:10.1001/jama.2020.4742PubMedGoogle Scholar
3.
Angus  DC .  Optimizing the trade-off between learning and doing in a pandemic.   JAMA. Published online March 30, 2020. doi:10.1001/jama.2020.4984PubMedGoogle Scholar
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