Intended for healthcare professionals

Views & Reviews Between the Lines

Peake, Prunesquallor, and Pye

BMJ 2011; 343 doi: (Published 31 August 2011) Cite this as: BMJ 2011;343:d5468
  1. Theodore Dalrymple, writer and retired doctor

Like many a famous author, Mervyn Peake (1911-1968) had a medical father. Dr Peake was a medical missionary in China who once had to prove his prowess by operating on an official’s cataracts in public. Fortunately for him he passed the test; he might otherwise have been done to death and Mervyn would never have seen the light of day.

Dr Peake returned to England to become a general practitioner in Surrey. The young Mervyn showed artistic promise early, and studied at Chelsea Art College, where he met his wife, Maeve Gilmore, whose father was also a doctor.

One of the main characters in Peake’s Gormenghast trilogy of novels, Titus Groan (1946), Gormenghast (1950), and Titus Alone (1959), was Dr Alfred Prunesquallor. He is physician to the 76th Earl Sepulchrave: “The doctor with his hyena laugh and his bizarre and elegant body, his celluloid face. His main defects? The insufferable pitch of his voice; his maddening laugh and his affected gestures. His cardinal virtue? An undamaged brain.”

He is actually a good man, this unpromising depiction notwithstanding; but in Peake’s other novel, Mr Pye, the doctors do not come out well. Mr Pye is an evangelical who has decided to convert the fractious inhabitants of the island of Sark to sweetness and light (Peake visited the island many times, and lived there for several years, both before and after the war). Mr Pye is so unremittingly good that he begins, to his horror, to sprout angelic wings. He goes to Harley Street to consult the most eminent physicians, including Sir Daniel Thrust, as to what he should do to disembarrass himself of them. Not surprisingly, perhaps, and with great pomposity, the doctors are completely stumped. Mr Pye decides that only evil deeds will make the wings wither and disappear.

Peake’s own medical history was tragic in the extreme. During the war he had a couple of breakdowns, and did once consult a Harley Street specialist, an experience that might have been the inspiration for the Harley Street episode in Mr Pye. In his 40s, Peake began to develop symptoms of Parkinson’s disease, and then dementia. Of great charm and good humour, an accomplished draughtsman and painter, a poet and novelist, he spent the last few years of his life in institutions, unable to write, draw, or speak. (He was subjected to both electroconvulsive therapy and surgery that proved useless or worse.) His wife’s memoir, A World Away, published in 1970, is almost too painful to read.

The manner in which Peake’s doctor at the National Hospital, Queen Square, London, breaks the news of the diagnosis to Mrs Peake is an object lesson in medical insensitivity. Mrs Peake asks to meet him but is told that he is too busy at the moment; perhaps he might be able to see her on his way out if she waits in the entrance hall for him. There, in the middle of the busy hallway, he says to her, “Your husband has premature senility.” Peake was 46; she was 39.

She addresses a postscript of her memoir to Peake, describing a visit to him before his death, when he is completely immobilised by the disease: “We sit silently, and then you are restless. You want to move and cannot. You want to speak and cannot, and the silence no longer has peace in it.” Then: “When I leave you, I say ‘Goodbye,’ but goodbye was said many years ago, before we knew we were saying it.”

I have made a resolution never to complain again, but I know that I shall not keep it.


Cite this as: BMJ 2011;343:d5468

View Abstract

Log in

Log in through your institution


* For online subscription