RIDGEON: We’re not a profession: we’re a conspiracy.
SIR PATRICK: All professions are conspiracies against the laity.

‘The Doctor’s Dilemma’ is a play by George Bernard Shaw, first staged in 1906 and published in 1909. It’s usually described as a ‘problem play’ but in fact it tackles two distinct dilemmas related to medical practice:

1. the moral dilemmas created by limited medical resources i.e. who do you treat and who do you leave to be sick or die?
2. the conflict between medicine as a vocation (to heal the sick) and a business (to make a packet)

Cast

• Sir Colenso Ridgeon (‘Colly’) – just been knighted for his work in vaccination for tuberculosis and typhoid and plague, specifically for discovering the role of opsonin in maximising the effect of vaccination
• Redpenny – his assistant
• Emmy – his housekeeper

The doctors

• Leo Schutzmacher – a Jewish physician recently retired from a modest practice in the Midlands
• Sir Patrick Cullen (‘Paddy’) – 20 years older than Ridgeon, a bluff, gruff dismisser of all inventions and innovations
• Mr Cutler Walpole – an energetic, confident surgeon, convinced every ailment is caused by blood-poisoning and can be cured by cutting out the ‘nuciform sac’ which all his colleagues think doesn’t even exist
• Sir Ralph Bloomfield Bonington (B.B.) – thinks the cure for everything is to ‘stimulate the phagocytes’
• Dr. Blenkinsop – a shabby unsuccessful doctor, cheaply fed and cheaply clothed

The Dubedats

• Jennifer Dubedat – ‘an arrestingly good-looking young woman’, wife of…
• Louis Dubedat – the artist, a slim young dazzlingly amoral man of 23
• Minnie Tinwell – forlorn waitress at the Star and Garter who claims to be Louis’s real wife

Act 1. Dr Ridgeon’s consulting room

Act 1 is in three parts or scenes:

Scene 1

In the consulting room of Dr Colenso Ridgeon, his ancient housekeeper, Emmy, informs his keen young assistant, Redpenny, that Ridgeon has just been awarded a knighthood.

Scene 2

A succession of fellow doctors call by to congratulate their friend and provide a gallery of ages and types of physician, each with their perspective, views and hobby horses about the profession. They are, in order of appearance:

1. Leo Schutzmacher who they used to call ‘Loony’ Schutzmacher. Shaw singles out his Jewishness in a manner which I think is not malicious but makes us uncomfortable today.

His combination of soft manners and responsive kindliness, with a certain unseizable reserve and a familiar yet foreign chiselling of feature, reveal the Jew: in this instance the handsome gentlemanly Jew, gone a little pigeon-breasted and stale after thirty, as handsome young Jews often do, but still decidedly good-looking.

Shaw makes the same kind of ‘racial’ generalisations about Sir Patrick Cullen being Irish.

Schutmacher has recently retired after working a very modest practice in the Midlands for decades. For all that time his business success rested on a sign in the shop window reading ‘Cure Guaranteed’. That a giving more or less everyone the same patent medicine:

SCHUTZMACHER: You see, most people get well all right if they are careful and you give them a little sensible advice. And the medicine really did them good. Parrish’s Chemical Food: phosphates, you know. One tablespoonful to a twelve-ounce bottle of water: nothing better, no matter what the case is.

2. Sir Patrick Cullen is a big, bluff, no-nonsense man, twenty years older than Ridgeon, gruff common sense, communicates mostly in grunts. Insists there’s nothing new under the sun and that all these inventions were first made 50 years ago.

SIR PATRICK: Look at your great discovery! Look at all the great discoveries! Where are they leading to? Why, right back to my poor dear old father’s ideas and discoveries.

a) It’s during their conversation that we discover precisely what Ridgeon’s knighthood is for, the discovery of a way to boost the effects of vaccination, namely accompany it with an injection of the substance he’s discovered and named opsonin.

RIDGEON: Opsonin is what you butter the disease germs with to make your white blood corpuscles eat them… [But] the phagocytes wont eat the microbes unless the microbes are nicely buttered for them. Well, the patient manufactures the butter for himself all right; but my discovery is that the manufacture of that butter, which I call opsonin, goes on in the system by ups and downs – Nature being always rhythmical, you know – and that what the inoculation does is to stimulate the ups or downs, as the case may be… I call the up-grade the positive phase and the down-grade the negative phase. Everything depends on your inoculating at the right moment. Inoculate when the patient is in the negative phase and you kill: inoculate when the patient is in the positive phase and you cure.

Sir Patrick refuses to be impressed or think any of this is new. b) Their conversation is also notable because Ridgeon tells him he’s been feeling unwell:

RIDGEON. There’s nothing wrong with any of the organs: nothing special, anyhow. But I have a curious aching: I don’t know where: I can’t localize it. Sometimes I think it’s my heart: sometimes I suspect my spine. It doesn’t exactly hurt me; but it unsettles me completely. I feel that something is going to happen. And there are other symptoms. Scraps of tunes come into my head that seem to me very pretty, though they’re quite commonplace.

He doesn’t hear voices, so he’s not going mad and Sir Patrick, true to form, dismisses it as nothing. They are interrupted by the arrival of:

3. Mr Cutler Walpole, an energetic, unhesitating surgeon of forty with ‘a general air of the well-to-do sportsman about him’, never at a loss, never in doubt. Walpole’s idée fixe is that almost all medical cases are caused by blood-poisoning and the knife is the only effective remedy.

Sir Patrick makes a general comment about Walpole’s family

SIR PATRICK. I know your Cutler Walpoles and their like. They’ve found out that a man’s body’s full of bits and scraps of old organs he has no mortal use for. Thanks to chloroform, you can cut half a dozen of them out without leaving him any the worse, except for the illness and the guineas it costs him. I knew the Walpoles well fifteen years ago. The father used to snip off the ends of people’s uvulas for fifty guineas, and paint throats with caustic every day for a year at two guineas a time. His brother-in-law extirpated tonsils for two hundred guineas until he took up women’s cases at double the fees. Cutler himself worked hard at anatomy to find something fresh to operate on; and at last he got hold of something he calls the nuciform sac, which he’s made quite the fashion. People pay him five hundred guineas to cut it out. They might as well get their hair cut for all the difference it makes; but I suppose they feel important after it. You can’t go out to dinner now without your neighbour bragging to you of some useless operation or other.

4. Sir Ralph Bloomfield Bonington (B.B.) – a tall man, with a head like a tall and slender egg and a marvellously healing voice. His obsession is the belief that the cure for everything is stimulating the phagocytes. He deprecates chemists and pharmacists, believing all drugs are the same.

BB: Believe me, Paddy, the world would be healthier if every chemist’s shop in England were demolished. Look at the papers! full of scandalous advertisements of patent medicines! a huge commercial system of quackery and poison.

5. Dr. Blenkinsop – a poor doctor, unsuccessful, cheaply fed and cheaply clothed.

After all these doctors have aired their views and effectively trashed their own profession, they congratulate Ridgeon one more time and leave.

Scene 3

All this time the serving woman, Emmy, has been nagging Ridgeon that a woman is waiting for him in the waiting room, who is everso worried about her husband who has tuberculosis. Finally, after all the doctors have left, this woman, Mrs Dubedat, forces her way into the see the doctor.

She explains that her husband is ill with tuberculosis but is a great artist and must be saved. Ridgeon predictably poo-poos this until Mrs D shows him some pieces from her husband’s portfolio, at which point he is very impressed. But all this leads up to formulations of the Doctor’s Dilemma. His hospital TB ward is already full with ten patients. As it is, he’s had to turn 30 others away to select these ten. Now she’s asking him to turf one of these ten out to make way for her husband.

RIDGEON: The dilemma: In every single one of those ten cases I have had to consider, not only whether the man could be saved, but whether he was worth saving. There were fifty cases to choose from; and forty had to be condemned to death. Some of the forty had young wives and helpless children. If the hardness of their cases could have saved them they would have been saved ten times over.
MRS DUBEDAT: I am asking you to save the life of a great man.
RIDGEON: You are asking me to kill another man for his sake; for as surely as I undertake another case, I shall have to hand back one of the old ones to the ordinary treatment. Well, I don’t shrink from that. I have had to do it before; and I will do it again if you can convince me that his life is more important than the worst life I am now saving. But you must convince me first.

The husband’s drawings are outstanding and Ridgeon, a bachelor, is not immune to Mrs Dubedat’s striking beauty. And so all this resolves itself into Ridgeon’s suggestion that she brings her husband along to a dinner to celebrate his knighthood to which he’s invited all the doctors we’ve seen earlier in the act. She and her husband can discuss his case with all of them.

(Small note: we learn that the wife’s name is Jennifer, which Ridgeon takes to be an unusual name, one he’s never heard before. Mrs D explains it’s a Cornish version of Guinevere.)

Act 2. The terrace of the Star and Garter, Richmond

The dinner is over and the doctors are scattered about the table or standing on the terrace admiring the view. The husband (whose name is Louis) is off showing Blenkinsop how to use a telephone so Jennifer is able to canvas the other doctors’ opinions of him. They think he’s a fine chap and his drawings are outstanding. But the key point is Ridgeon agrees to bump one of his other patents out the ward and take on Louis, to Jennifer’s immense relief.

When Louis reappears they all praise him, though it is now late in the evening so they recommend he should go home before the damp air exacerbates his TB. Then there is comedy. One by one the doctors admit that Louis touched them for a loan, and they were all so sympathetic to the charming chap that they coughed up like lambs.

• Walpole – £20
• BB – £10
• Blenkinsop – half a crown (2 shillings and sixpence)

Only Schutzmacher didn’t lend him anything, despite Louis going out of his way to flatter Jews and their knowledge of art i.e. buttering him up, before asking him for a £50 loan. For some reason this leads into another extended passage about Jews, this time Schutzmacher speaking, which made me uncomfortable:

SCHUTZMACHER: Personally, I like Englishmen better than Jews, and always associate with them. That’s only natural, because, as I am a Jew, there’s nothing interesting in a Jew to me, whereas there is always something interesting and foreign in an Englishman. But in money matters it’s quite different. You see, when an Englishman borrows, all he knows or cares is that he wants money and he’ll sign anything to get it, without in the least understanding it, or intending to carry out the agreement if it turns out badly for him. In fact, he thinks you a cad if you ask him to carry it out under such circumstances. Just like the Merchant of Venice, you know. But if a Jew makes an agreement, he means to keep it and expects you to keep it. If he wants money for a time, he borrows it and knows he must pay it at the end of the time. If he knows he can’t pay, he begs it as a gift.
RIDGEON: Come, Loony! do you mean to say that Jews are never rogues and thieves?
SCHUTZMACHER: Oh, not at all. But I was not talking of criminals. I was comparing honest Englishmen with honest Jews.

At which point this puzzling disquisition is cut off because one of the hotel’s maids approaches. Without much ado she drops the bombshell that she is Louis’s real wife. Her name is Minnie Tinwell and she tells them she and Louis got married, burned through the little money they had, Louis went off to London to try and further his career, and that’s the last she heard of him till she saw him this evening.

The doctors all hear this amazing revelation and are astounded but also interested and amused. It’s at this point that Walpole remembers he lent his gold cigarette case to Louis and the blighter never returned it. The common view starts to be that Louis is a bigamist and a thief.

Now the doctors make a great fuss of all saying good night to each other, but it’s during this that Blenkinsop, the poor failure among them, reveals that he is a bit touched with tuberculosis, in one lung. the others are all the picture of concern and Walpole says he’ll drive him home.

Leaving Ridgeon and old Sir Patrick. I thought the doctor’s dilemma was whether Ridgeon should take Louis and kick one of his current ten patients out of hospital. Now, with the news that Blenkinsop has TB as well, the dilemma has come much closer. It is: Louis the artistic crook or Blenkinsop the not very productive or effective good man.

SIR PATRICK. Well, Mr Saviour of Lives: which is it to be? that honest decent man Blenkinsop, or that rotten blackguard of an artist, eh?… It would be simpler still if Dubedat had some of Blenkinsop’s honesty. The world isn’t going to be made simple for you, my lad: you must take it as it is. You’ve to hold the scales between Blenkinsop and Dubedat.
RIDGEON: It’s not an easy case to judge, is it? Blenkinsop’s an honest decent man; but is he any use? Dubedat’s a rotten blackguard; but he’s a genuine source of pretty and pleasant and good things.

They discuss the relative merits of a good man against good pictures for a while, before Ridgeon says there’s an extra aspect which is that if he doesn’t treat Dubedat and he dies, Ridgeon intends to set his cap at winning the lovely Jennifer i.e. people might think he did it deliberately.

The obvious thing to me is that the whole thing is predicated on the notion that Ridgeon possesses a uniquely effective cure for tuberculosis which he of course didn’t. And it is (deliberately) melodramatic to say that if he doesn’t take Louis as a patient he is killing him. Of course he isn’t killing him. He would just be handing him over to one of the other eminent quacks we’ve been introduced to.

Act 3. Louis Dubedat’s studio

Louis is painting Jennifer. In their dialogue we quickly learn that he is not consciously a con-man, he just doesn’t like touching Jennifer for money and hates the whole sordid subject. In particular he rebels against patrons who hassle him for the portraits they’ve paid for, and dislikes the ones who’ve insisted they’ll only pay on delivery. Obviously his reputation has got around.

Then we learn that all the doctors have invited themselves round. Louis and Jennifer innocently think it’s to hold a joint consultation, not realising how much Louis’ borrowing and stealing has set them against him.

Ridgeon is first to arrive and Jennifer goes into another room, leaving Louis to embarrassedly apologise for the state of the place, explain that he doesn’t like to sponge off Jennifer and then ask Ridgeon for the loan of £150, going on to propose a complicated scam including post-dated checks which Ridgeon indignantly refuses, before asking Ridgeon if he will promote him (Louis) to his patients.

The other doctors arrive. Walpole discovers Louis has pawned the gold cigarette case he took from him. He is quite hopeless at money but charmingly heedless of any criticism, deploying his ‘dazzling cheek’.

When they confront him with Minnie’s story he freely says she was just a little serving girl at a seaside hotel. He seduced her, they got married and ran through her life savings, plus what else he could cadge and borrow, in three short weeks, at which point he kissed her, said I’ve given you unforgettable memories and left. The doctors are staggered by his lack of remorse or what they think of as morality.

Louis – and Shaw – baits them with all being narrow conventional moralists, all too ready to jump to moralising conclusions about bigamy, and next thought about the police.

LOUIS. Oh bigamy! bigamy! bigamy! What a fascination anything connected with the police has for you all, you moralists!

Louis scandalises them even more by telling them that Jennifer is already married. She married the steward on a liner who cleared out and left her. She thinks that 3 years of no contact with a spouse makes you divorced, and so was happy to marry Louis. So Louis is immensely pleased to tell the stuff doctors that they’re both bigamists.

When they ask why he didn’t tell Jennifer he was married, he says he wanted to spare her feelings, plus make her feel respectable, as any gentleman would. The entire scene, in fact the whole character of Louis is the latest version of Shaw twitting his bourgeois Edwardian audience for their narrow morality.

LOUIS: Oh, go and do whatever the devil you please. Put Minnie in prison. Put me in prison. Kill Jennifer with the disgrace of it all. And then, when you’ve done all the mischief you can, go to church and feel good about it.

When one of them suggests turning them over to the police, Shaw has gruff old Sir Patrick deliver one of Shaw’s favourite hobby horses, which is the immorality and uselessness of prison.

SIR PATRICK. The criminal law is no use to decent people. It only helps blackguards to blackmail their families. It’ll punish not only him but everybody connected with him, innocent and guilty alike. It’ll throw his board and lodging on our rates and taxes for a couple of years, and then turn him loose on us a more dangerous blackguard than ever. It’ll put the girl in prison and ruin her: It’ll lay his wife’s life waste. You may put the criminal law out of your head once for all: it’s only fit for fools and savages.

All their threats Louis turns back on his accusers with almost Wildean delight in paradox:

LOUIS. Well, I didn’t begin it: you chaps did. It’s always the way with the inartistic professions: when they’re beaten in argument they fall back on intimidation. I never knew a lawyer who didn’t threaten to put me in prison sooner or later. I never knew a parson who didn’t threaten me with damnation. And now you threaten me with death. With all your talk you’ve only one real trump in your hand, and that’s Intimidation. Well, I’m not a coward; so it’s no use with me.

Before Louis makes the extraordinary declaration that he is a disciple of none other than George Bernard Shaw.

LOUIS: Well, you’re on the wrong tack altogether. I’m not a criminal. All your moralisings have no value for me. I don’t believe in morality. I’m a disciple of Bernard Shaw.
SIR PATRICK [puzzled]: Eh?
B.B. [waving his hand as if the subject was now disposed of]: That’s enough, I wish to hear no more.
LOUIS: Of course I haven’t the ridiculous vanity to set up to be exactly a Superman; but still, it’s an ideal that I strive towards just as any other man strives towards his ideal.
B. B. [intolerant]: Don’t trouble to explain. I now understand you perfectly. Say no more, please. When a man pretends to discuss science, morals, and religion, and then avows himself a follower of a notorious and avowed anti-vaccinationist, there is nothing more to be said…
SIR PATRICK: Bernard Shaw? I never heard of him. He’s a Methodist preacher, I suppose.
LOUIS [scandalized]: No, no. He’s the most advanced man now living…

Presumably the theatre audience of the day would have found this self-referentiality amusing and we post-moderns are impressed by the narrative’s meta-something-ness, but my main impression is of Shaw’s amazing arrogance and self-centredness. It’s not enough that his plays overflow with his obsessions and spill over into long rambling prefaces, but he has to appear in his own plays as well!

But the practical upshot of all this is that Ridgeon washes his hands of Louis and refuses to treat him. He hands Louis over to Walpole who, predictably enough, decides that Louis is suffering from blood-poisoning which will require the removal of his nuciform sac. But he is dumbfounded when Louis, counter-intuitively, asks how much Walpole will pay him for the fun of cutting him open.

LOUIS: Well, you don’t expect me to let you cut me up for nothing, do you?

which has the flavour of counter-intuitive Wildean paradox. If Walpole rejects him there’s only one doctor left, Sir Ralph Bloomfield Bonington. BB now makes a contribution to the debate which is thin and silly. The best he can come up with is that, when you consider many of his patients, no matter how much they pay in fees, frankly a lot of them would be better off dead. This isn’t a position of moral philosophy or practical guidance, more after-dinner gossip. Instead he says he’ll treat Louis simply because he made a promise to his wife to do so, even though he thinks he’s ‘a vicious and ignorant young man’.

The joke is that through all these pompous speeches Louis has been doing a sketch of Sir Patrick and triggers the doctors into a bidding war for it. He manages to get the bidding up to twelve guineas, for which price BB buys it and presents it as a gift to Sir Patrick.

At this point Louis proposes to invite Jennifer back into the room and asks the doctors to behave like gentlemen. This leads to a lot of comic irony because, as gentlemen, they cannot speak openly about that they’ve learned of the couple’s bigamy, nor their low opinion of Louis, so are limited to conventional compliments and vagueness, leaving Jennifer quite puzzled.

Still, she is puzzled when Sir Patrick and Walpole hasten to leave and then appalled when BB says he will be taking on the case. She had hoped Sir Colenso… but BB is so vainly full of himself that he takes her dismay for embarrassment at securing such a magnificent physician. Maybe pomposity, and puncturing it, are the most enduring subjects of comedy. BB exits.

This leaves Ridgeon alone with Jennifer and coping with her real upset that he’s abandoned her. he tactfully says the place he had assigned to Louis must be taken by his colleague Blenkinsop.

The dialogue takes a turn when Jennifer angrily blames him. She says people are always turning against Louis and it can only be because he is so superior to them, he is an artist etc. Ridgeon has to tactfully agree because, as a gentleman, he cannot reveal what a low ‘reptile’ he and the doctors have come to think Louis. So there is comic irony in the audience knowing what a plight Ridgeon is in.

She asks him to sit by her and launches into a great speech about what a good man Louis is: oh, sometimes he’s forgetful about money but he’s promised her he will never again borrow any; and his wild talk about morality makes the narrow-minded think he is wicked; and he is a little susceptible to women but only because they throw themselves at him so – piling on multiple layers of irony because Ridgeon and the audience know how comprehensively Louis is deceiving her, and breaking all his promises.

Things take a more pathetic turn when she goes on to describe her childhood in Cornwall, an only child with very little contact with other people (which explains, to Ridgeon, he naivety and gullibility). And take a potentially tragic turn, when Jennifer explains that she has devoted her life to his career and so, if she ever lost faith in him, she would ‘it would mean the wreck and failure of my life’. She would go back to Cornwall and throw herself off a cliff. She assures him she could show him the very cliff she has in mind.

So this is the real doctor’s dilemma: should Ridgeon tell Jennifer the truth about her husband, destroy her image of him, and trigger her suicide? or should he break his own moral rules and blatantly and massively lie about her husband’s character?

Once again Jennifer begs him to take Louis on but Ridgeon replies with the deepest sincerity that the only way to preserve her hero, in her eyes, is to let Sir Ralph (BB) treat him.

RIDGEON: You must believe me when I tell you that the one chance of preserving the hero lies in Louis being in the care of Sir Ralph.

On this promise the act ends and I was initially puzzled. Did he want to hand Louis over to BB because having BB treat him means Ridgeon will avoid in future excruciating tests like this, where he was tested within an inch to spilling the beans and telling her what her husband is really like? But when I read the opening of Act 4 I realised it’s because Ridgeon knows for a certainty that BB’s quack mistreatment will quickly kill off Louis, preserve Jennifer’s illusions, and so stop her committing suicide.

The choice is not between Louis and poor Blenkinsop, it is between Louis and his wife, and the wife wins. You can rationalise Ridgeon’s decision because he has seen how Louis, despite the superficial attractiveness of his devil-may-care attitude, has actually used and exploited a naive gullible young woman. He deserves what he’s going to get.

Act 4. Louis Dubedat’s studio, three day later

Louis is ill. The doctors arrive, Ridgeon last of all. Sir Patrick tells him that Louis is at death’s door. He’s gone through three months of galloping consumption in just three days. Sir Patrick thinks he won’t last the afternoon. The doctors squabble among themselves, BB wondering if he over-stimulated the phagocytes, Walpole accuses him of killing the patient by ignoring the obvious diagnosis of blood poisoning.

Through their bickering we realise an unpleasant fact. BB administered Ridgeon’s discovery, opsonin but without taking notice of whether the patient was in an up phase or down phase. Remember Ridgeon explaining that the timing was crucial: administer it in an up phase and the patient will recover, but in a down phase and the patient will die. Ridgeon handed Louis over to BB in a down phase, more or less certain the injection of his vaccine would kill him.

Jennifer is wearing a nurse’s apron and distraught. Into this difficult scene comes a journalist who has asked to interview the artist. Shaw gives his opinion of journalists in no uncertain terms:

a cheerful, affable young man who is disabled for ordinary business pursuits by a congenital erroneousness which renders him incapable of describing accurately anything he sees, or understanding or reporting accurately anything he hears. As the only employment in which these defects do not matter is journalism (for a newspaper, not having to act on its description and reports, but only to sell them to idly curious people, has nothing but honour to lose by inaccuracy and unveracity), he has perforce become a journalist, and has to keep up an air of high spirits through a daily struggle with his own illiteracy and the precariousness of his employment.

And Walpole is wonderfully abusive and condescending towards him, too. Louis is wheeled into the studio in an invalid’s chair. There follows a long colloquy between the dying man and Jennifer in which he makes her promise to wear lovely clothes and marry again and preserve his memory. Ridgeon cynically observes that Louis is playing the part of The Dying Man but that doesn’t stop him giving a command performance, including a great hymn to art. It’s hard to know how seriously this is intended but it’s not particularly enjoyable.

Eventually he dies, the doctors feel his pulse etc. Jennifer exists the room. Ridgeon adjusts the bed and says some harsh words. He was not at all reconciled to Louis. The newspaperman asks a few impertinent questions but is quickly turned out by BB. it’s difficult to see why he was ever there. The doctors make fools of themselves waxing painfully lyrical about death. BB is given a comic moment where he ridiculously misquotes Shakespeare to his fellow docs but a) you’d have to know a bit of Shakespeare to realise that’s what he’s doing and b) it isn’t really very funny.

Mrs Dubedat returns dressed up to the nines and dazzles them. She grandly announces they have all been witnesses to a great man i.e. she has preserved her illusion to the end, and Ridgeon has solved his dilemma. So what is left for the fifth act, I wondered.

Act 5. A Bond Street art gallery

It is an exhibition of Louis’s work. The scene opens with some business between Jennifer and the secretary of the gallery, Mr Danby, regarding the catalogues and some advance press reviews, Shaw throwing a few satirical barbs about art critics only attending launches if there’s a free lunch etc. There are also copies of the biography of her husband which Jennifer’s written. Jennifer pops out to chivvy the printers about the catalogues.

The point is that Ridgeon arrives, has a word with the secretary, then has a look at the pictures very carefully, using a magnifying glass. The secretary himself pops out, leaving Ridgeon the only person. Jennifer walks back in not realising Ridgeon has arrived. He backs away from a picture muttering the telling comment, ‘Clever brute!’ which Jennifer overhears and flinches. They come face to face.

Jennifer is aloofly angry. She says she bumped into Dr Blenkinsop and saw that he had made a complete recovery… unlike her husband. Ridgeon tells her to spit it out so she does. She accuses him of being cruel and callous. All patients are just brutes to him, he cannot appreciate sensitivity etc etc.

Ridgeon asks he if she realises that he killed Louis but she takes him to mean, inadvertently, and softens a little, since this amounts to a confession or admission of guilt. But Ridgeon has committed to being utterly truthful and now explains that when he uses his medicine, correctly, it cures, as with Blenkinsop. But he deliberately gave it to BB knowing he would use it incorrectly and it would kill Louis.

Ridgeon makes the extraordinary admission that he did so because he was in love with her. She thinks this is ridiculous because he’s an old man at least 20 years older than her, and this deflates Ridgeon who slumps on a sofa and loses his elan.

But Jennifer asks if he deliberately murdered her husband and he admits it. She is scornful that he murdered someone in the ludicrous belief that she could ever be his. But Ridgeon goes on to explain that he also did it to protect her. Her besotted devotion to her hero eventually exasperates Ridgeon and he breaks his own promise and bluntly tells her what all the doctors thought of her husband:

RIDGEON. What truth! Why, that Louis Dubedat, King of Men, was the most entire and perfect scoundrel, the most miraculously mean rascal, the most callously selfish blackguard that ever made a wife miserable.

Which is, of course, pointless, because she refuses to believe it. That is not the man she knew and loved. The more Ridgeon tries to indict Louis, the more she pities Ridgeon for not being able to see the truth. But it’s then that she drops the bombshell. Louis (in his long speech) said he disliked widows, and she has married again! Staggered, Ridgeon makes his farewell and walks out.

Medical knowledge

Among other things, the play points at the immense ignorance of doctors for most of human history and the utter uselessness of almost all their treatments – but comically dramatises how their ignorance about disease or most illnesses didn’t stop doctors making sweeping, ignorant generalisations and charging their parents a fortune for completely worthless treatments.

All the hundreds of nostrums recommended for tuberculosis or ‘consumption’ as it was called in the nineteenth century, were worthless compared to antibiotics which only began to be prescribed for it at the end of the Second World War.

Tuberculosis (TB) is an infectious disease that most often affects the lungs and is caused by a type of bacteria. It spreads through the air when infected people cough, sneeze or spit… Tuberculosis disease is treated with antibiotics. (WHO website)

A series of dilemmas

Initially, I thought the play was about the strictly medical dilemma of deciding whether a man should be given priority treatment because he’s a good artist, condemning one of the other patients in the hospital to being kicked out of the war. But it ends up not being at all the play I was expecting, as it moves through a whole series of problems.

Then, when Blenkinsop reveals that he too has TB, the dilemma becomes a much more acute decision about whether to treat Dubedat or Blenkinsop.

But then it becomes something a lot less interesting, which is the choice between telling the truth and wrecking a woman’s illusions, or letting a bad man die and preserving them?

And then, right at the end, it turns out to have been a sort of twisted love affair all along, one that feels hurried and contrived at the end, with the last-line-of-the-play revelation that Ridgeon’s agonised decision was all for nothing.

As to the first, more medical versions of the dilemma, the trouble with the play, as with many Shaw plays, is that it raises an interesting subject but then deals with it in such a superficial way. The passages where the doctors discuss the morality of preferring this patient over another, or how you value someone’s life, are surprisingly thin and boring. Shaw has a feel for the drama of ideas without any depth of actual thought. This is what makes so many of the plays feel entertaining but thin.

As to the second theme, the choice between exposing Louis or preserving Jennifer’s illusions, this is much more familiar territory and feels like the kind of choice which goes back to ancient Greek theatre and resonates through all literature. Close to Shaw’s time it is the same dilemma which confronts Marlow at the end of Heart of Darkness between telling a devastating truth or a saving lie.

And then, right at the end, at the last minute, it turns into a frustrated love story with Jennifer’s studied rejection of Ridgeon’s pitiful declaration of love, and the whole thing feels like it’s moved into completely new territory, utterly unconnected with the moral and ethical problems stated at the start.

Movie version

The play was turned into a 1958 movie directed by Anthony Asquith and starring Leslie Caron, Dirk Bogarde, Alastair Sim, and Robert Morley. I love all those old actors but it looks dire, doesn’t it?

Thoughts

It has its moments and you can admire the structural ideas such as the parade of obsessive doctors, or the portrait of a genuinely amoral artist – but somehow it doesn’t hang together. Despite some funny ideas, ‘The Doctor’s Dilemma’ is, in the end, boring, for a number of reasons:

1) The portrayal of the medical profession as a collection of cranks is moderately funny but also very wordy. Morley’s speech in the trailer, above, demonstrates how wordy and clotted the subject quickly becomes.

2) As discussed above, the play can’t make up its mind what it’s about. The initial dilemma only emerges slowly and I wasn’t completely sure it was the central dilemma till half way through at which point it morphs into the ‘save Jennifer’ theme, and then, at the end, turns into a quite bitter story of frustrated love and delusion. Each new manifestation of the central theme eclipses the one before until the bitter end which leaves you puzzling what it was all about.

3) Crucially, there is no one sympathetic character. Pygmalion was and is a hit because the two central leads are so strong and distinctive. No-one here has the same depth of character, least of all Sir Colenso who the play opens with and is the doctor with the supposed dilemma, but who remains a pale shadow all the way through and certainly nowhere nearly strong enough to carry the kind of emotional weight which Shaw very abruptly gives him in the short last act where he painfully reveals that he loves Jennifer only to be comprehensively rejected. The transformation from the cool, calculating medic of most of the play to the pathetic failure-in-love of the last few pages doesn’t work at all, for me.

Similarly, Jennifer never really engages our sympathy: her threat of suicide feels stagy and forced and her last-page revelation that she’s got married feels stupefyingly forced.

The amoral Louis has a bravura scene at the start of Act 3 where he dominates the stage with his devil-may-care rejection of conventional morality but he isn’t given the prominence that his character requires, he feels like a bit player in his own story, and then I couldn’t get the measure of his death scene at all, was it intended that there shouldn’t be a dry eye in the house, because he is made to be far too arch and knowing for that to work?

It’s full of juicy moments, but the Doctor’s Dilemma feels like a failure to me.

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Related links

• The Doctor’s Dilemma on Planet Gutenberg

Bernard Shaw reviews

• Arms and the Man (1894)
• Candida (1894)
• John Bull’s Other Island (1904)
• Major Barbara (1905)
• Preface to Major Barbara (1905)
• The Doctor’s Dilemma (1906)
• Pygmalion (1913)
• Heartbreak House (1919)

• More play reviews