Reviews Soundings

Axel Munthe and The Story of San Michele

BMJ 2006; 332 doi: (Published 02 March 2006) Cite this as: BMJ 2006;332:557
  1. George Dunea, attending physician
  1. Cook County Hospital, Chicago, USA

    He loved birds, flowers, and especially dogs, which he thought were easier to understand and to love than men. He travelled widely, from Lapland in his native Sweden to Italy, where he built the villa of San Michele at Anacapri on the ruins of Tiberius's palace. In Naples he witnessed the dying gathered in heaps and thrown into cholera mass graves dead or alive. In Messina he saw people crushed to death during a horrific earthquake. He tended patients dying from typhoid and children suffocating from diphtheria. He often saw young patients with consumption: fever, wasting, “ominous crackles in the top of the lung,” then the fatal haemorrhage. He saw others, some in prominent positions, develop the expansive insanity of the general paretic. But in Paris, and later in Rome, he was incredibly successful with the neurotic or hysterical women who had chronic “appendicitis” or “colitis.” This success he ascribed to his ability to inspire confidence, a gift he thought was granted by birthright to one doctor but denied to another, one so magic that “the doctor who possesses this gift can almost raise the dead.”

    In Paris he knew Henry and William James, Guy de Maupassant, Somerset Maugham. He remembers Louis Pasteur, pale and worn, helpless at the bedside of the Russian peasants bitten by rabid wolves. He accompanied the body of a young Swede to Stockholm but then discovered that the caskets had been switched and that he had brought the body of an ancient Russian general.

    Not always politically correct, he attributed women's historic lack of achievement in the arts and sciences to intrinsic differences rather than to lack of opportunities. For criminals he favoured short sentences with severe floggings for first offenders, execution for recidivists. He thought doctors should keep aloof of their patients or their prestige would suffer, and so should authors, as shown by the medieval monks who would “think little of a man's writings if they had even once seen him.” Books, including his own, would need successive generations of readers and reviewers to fix their value. But in 1928 he wrote The Story of San Michele, which became a best seller in 25 languages and is still read today.

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