Shakespeare’s Other Psychiatrist

In an earlier post, I wrote about the way that a ‘Gentleman’ in the second quarto of Hamlet was renamed a ‘Doctor’, and taken to task for his care of Ophelia, at the Royal College of Psychiatrists’ conference. In the post I mentioned another Shakespearean doctor who reports on a disordered mind, in Macbeth. I thought I might revisit that character, because, as in Hamlet, it’s striking how sketchy he is. This is not Shakespeare’s indictment of psychiatry, because it is not psychiatry at all; but it does suggest how difficult it is to deal with someone else’s thoughts. There is another thing the ‘two doctors’ share: they both have to answer to people far more powerful than they are. Diagnosis never happens in a social vacuum.

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Act 5 Scene 1 features a Doctor and a Gentlewoman observing Lady Macbeth while she sleepwalks. The Gentlewoman describes past instances of what the Doctor deems ‘a great perturbation in nature’, but she will not repeat what she heard being said. Then the Queen comes in, rubbing her hands as if washing them, and talking about a ‘spot’. The Doctor says that he will write down what she says ‘to satisfy my remembrance the more strongly’. It is clear that they realise that she is revealing terrible secrets; the Doctor says ‘you have known what you should not’. Nevertheless he remembers his therapeutic function and advises the Gentlewoman to ‘remove from her the means of all annoyance / And keep eyes upon her’. His parting words are ‘I think, but dare not speak’.
      Soon after this, in Act 5 Scene 3, which is shortly before Lady Macbeth dies offstage in what may well be a suicide, Macbeth hears the Doctor’s report:

MACBETH
How does your patient, doctor?
DOCTOR
Not so sick, my lord,
As she is troubled with thick coming ,
That keep her from her rest.
MACBETH
Cure her of that.
Canst thou not minister to a mind diseased,
Pluck from the memory a rooted sorrow,
Raze out the written troubles of the brain
And with some sweet oblivious antidote
Cleanse the stuff’d bosom of that perilous stuff
Which weighs upon the heart?
DOCTOR
Therein the patient
Must minister to .
MACBETH
Throw physic to the dogs; I’ll none of it.

There is not much more care at Macbeth’s castle than there is at Elsinore, and soon after this the Doctor expresses, in an aside, his wish to leave. Of course the Doctor cannot cleanse someone’s conscience, or someone’s state of grace. To that extent everyone ministers to themselves. And of course he cannot reveal too much to his murderous monarch. Nevertheless, it is still telling that this Doctor, in his only reappearance, is so casual about the ‘care plan’ for Lady Macbeth.
      This is very partial evidence indeed, but it seems as if Shakespeare, who is credited with a lot of insight in his portrayals of disordered minds, did not display much faith in our ability to solve their problems.

i.e. always
Faced with the King, the Doctor describes as ‘fancies’ – fantasies – things that in the previous scene struck him as revelations. They are ‘thick coming’, i.e. they assail her constantly.
The pronoun may just be a neutral one, with the ‘patient’ being spoken about in general terms. However, it seems more like the Doctor has picked up that Macbeth has turned away abruptly from his wife’s troubles (‘Cure her of that’) to consider his own.
E-mail me at rtrl100[at]cam.ac.uk

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