Bladders and Brobdingnag

BMJ 2000; 320 doi: (Published 20 May 2000) Cite this as: BMJ 2000;320:1379
  1. Kevin J Turner, research fellow in urology
  1. Oxford

    Generations of children will have read abridged versions of Jonathan Swift's Gulliver's Travels (1767). Sadly, if familiarity prevents rereading then much of the richness in this masterpiece will be missed. For example, few will be aware that Gulliver was a surgeon. Educated at Cambridge, Gulliver studied surgery for four years in London, and then studied medicine for two further years. The story of his adventures is peppered with surgical references. In Brobdingnag (a land populated by giants), Gulliver encounters a woman with a fungating carcinoma of the breast, a man with a wen (sebaceous cyst) on his neck “the size of five woolpacks,” and a bilateral amputee with “a couple of wooden legs each about 20 feet high.” Gulliver was no stranger to the pressures that characterise modern surgical practice: he worked long hours— “till I was half dead with weariness and vexation”—and he was sued and almost ruined but won his case. In the Academy of Lagado, Gulliver experienced surgical research first hand, narrowly avoiding colonic insufflation for “a small fit of colic.” A canine subject was not so fortunate and suffered the fatal consequences. It is, however, matters urological that concern Swift the most. Gulliver's prodigious flow rate saved the life of the Lilliputian queen when fire threatened to engulf the royal household. Unfortunately, his undoing proved to be his undoing; peeing in the palace was tantamount to treason and a rapid escape was required. Swift also recounts the Lilliputians' fascination with our hero's genitalia: the combination of Gulliver's threadbare trousers and the Lilliputians' diminutive stature afforded ample opportunity for surreptitious examination. Finally, the easily distracted Laputians could converse only if a servant constantly held their attention by “flapping” their mouths and ears with an inflated bladder, containing a few calculi, and fastened to a stick. Sixteen years of travel changed Gulliver forever. On his return to England he could not tolerate the company of fellow humans. While not told explicitly, the reader can only conclude that he did not practise surgery again. If Swift were writing today few in the public eye would be spared his brilliant satire. You wonder if his hero would still be a surgeon. Probably. But a urologist? Why not?

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