‘Modernism and Physical Illness’: Book Review

Fraser Riddell reviews Peter Fifield’s Modernism and Physical Illness: Sick Books (Oxford: 2020).

Modernism and Physical Illness explores how modernist texts present the experience of illness as something which strikingly transforms the everyday, ‘bracketing the habitual, transparent relationship with the world and replacing it with a troubled, compromised, but crucially visible one’ (8). It examines the works of five writers—ranging from canonical to less familiar figures—with each chapter offering a detailed examination of their respective engagement with aspects of physical illness. Fifield’s fascinating study shows us how D. H. Lawrence develops an intense language of sensory acuity to capture bodily sickness; it demonstrates Virginia Woolf’s keen interest in the ways in which illness transforms perception, and reveals T. S. Eliot’s fascination with broken and disfigured skins. Sections on Dorothy Richardson and Winifred Holtby place the focus on how forms of caregiving are shaped by both individuals and institutions, and remind us of the ways in which certain literary genres privilege some modes of care over others. While the study will predominantly be of interest to specialist scholars of English literary modernism, it also contains a diverse range of fascinating material relating to health and illness at the first half of the twentieth century that will appeal to medical humanities scholars working in other areas (e.g. on tropical illnesses, dermatology, dentistry, state healthcare provision, liberalism and health, illness in middle-brow literature, and medicine in women’s writing).

D.H. Lawrence by Lady Ottoline Morrell (29 November 1915)
The opening chapter traces two particular aspects of Lawrence’s representation of illness. Firstly, the manner in which ill health becomes the site or cause for a failed connection with one’s own body and the bodies of others. Secondly, the capacity of illness to act as an ‘intensifier of emotional and bodily integration’ (33). These he deftly explores through a broad-ranging account that extends from the rich sensory description prevalent in Lawrence’s letters to the metaphorical treatment of tropes of disease in Lawrence’s critical writings. Fifield convincingly situates Lawrence’s non-fictional writings, such as Fantasia of the Unconscious(1922), as looking back to the nineteenth-century tradition of ‘pathological critique’, in which writers such as Max Nordau presented bodies rendered sick by a degenerate culture, whilst also responding to more recent developments, such as Freudian psychoanalysis. A particular strength of Modernism and Physical Illness is the skill with which it integrates biographical detail into broader discussion of literary texts. This approach pays rich dividends in the context of discussion of Lawrence’s own lung disease, demonstrating how such experiences informed representations of illness and disability in Sons and Lovers (1913) and The Rainbow (1915).

Virginia Woolf by Francis Dodd (1908)

The second section turns to the works of Virginia Woolf, with a particular focus on the representation of Rachel Vinrace’s fever in The Voyage Out (1915) and the haunting traces of the Spanish Flu’ which punctuate Mrs Dalloway (1925). In his discussion of the former, Fifield is keenly aware of the manner in which Woolf’s representation of illness responds to the text’s generic forebears—specifically, the tropical adventure novel. This nicely brings into focus Woolf’s shifting sense of Rachel’s precarity as shaped by both the pressure of the external environment and an internal consciousness that often drifts away from the material world. Close attention to Woolf’s depiction of Rachel’s delirium reveals an novel which ‘gives a striking phenomenological analysis of illness not as a particular activity of sensation […] but as an event that modifies the very texture of that experience’ (92). While illness in The Voyage Out is presented as terrifyingly isolating and alienating in its apparent privacy, Mrs Dalloway is more immediately concerned with illness as it relates to transmission and visibility. Fifield teaches us to read for the traces of a pandemic not only on the surface of physical bodies—Clarissa Dalloway ‘grown very white since her illness’—but also as manifested in the networks that extend across the modern metropolis, whether crowds of people or airplane advertising slogans.

    T.S. Eliot; Virginia Woolf by Lady Ottoline Morrell (June 1924)
    T. S. Eliot’s sensitive skins form the focus of Modernism and Physical Illness’s third section—extending from Vivien Eliot’s dermatological problems to the problems of the ‘young man carbuncular’ in The Waste Land (1922). This material is situated in a broader consideration of Eliot’s ‘embodied composition’—the surprising place of the sick body and its relationship with writing in the works of a poet who notoriously insisted in ‘Traditional and the Individual Talent’ (1919) on the ‘impersonality’ of the artist. Eliot’s peeling and blistered skins emerge in an impressive reading of ‘Gerontion’ (1920) as ‘objectionable boundaries on the point of pathological collapse’ (123), bespeaking a wider refusal of interiority. This leads us to the variously failing and disgusting bodies of The Waste Land—from acne to syphilis, irritated skin stands as a marker of infectiousness. Fifield’s wonderfully detailed account of 1920s dermatological medicine is a refreshing reminder of this as a text that responds as vividly to the aetiology of boils and carbuncles as to the shored fragments of high culture. A final brief consideration of Eliot’s Four Quartets(1941) shows how Eliot’s relationship with bodily suffering was profoundly reshaped by his later engagement with Christianity—‘The sharp compassion of the healer’s art/ Resolving the enigma of the fever chart’.


The healer’s art in Dorothy Richardson’s Pilgrimage sequence (1915–1946) is one that is closely bound up with dynamics of the medical institution—specifically the dental surgery. Fifield brings into focus the ways in which Richardson portrays the distinctive forms of sociality that sustain networks of care-giving in these texts. This analysis is grounded in a wealth of historical detail, extending from Richardson’s journalistic writing for the Dental Record to consideration of the new conceptions of state healthcare provision that emerged from the National Insurance Act in 1911. Fifield shows us how Richardson’s text responds to contemporary concerns about the impact of state involvement in healthcare, from the place of inter-personal sympathy in a care system that apparently privileges the collective over the individual to the limitations of sociological methods for understanding public health. This comes into focus with a discussion of the respective views of Miriam and Miss Dear on health and welfare provision, through which Richardson presents a ‘wish to be an independent agent of generosity’ as bound up with the sometimes damaging consequences of ‘individualism’s […] emphasis on personal responsibility’ (181).


The final chapter—and in many respects the most illuminating—investigates the representation of illness in so-called ‘middlebrow’ fiction, looking in particular at Winifred Holtby’s South Riding (1938). Fifield sees this genre as sustaining a Victorian tradition of ‘civic fiction’—following Elizabeth Gaskell and George Eliot—which pursues ‘practical political and social form’ (185) in a broadly realist mode. The concern of these texts with the domestic reality of women’s lives—especially as nurses and caregivers—mean that they provide access to accounts of experiences of health and illness that are otherwise overlooked in canonical ‘highbrow’ modernism. Fifield skilfully traces this line of argument through Woolf’s essay on ‘Middlebrow’ and Holtby’s own book-length critical study of Woolf. This leads to a fascinating discussion of these authors respective attitudes towards cinema and its exterior perspective on the suffering body.  Placing Holtby centre stage also allows Fifield to consider the place of humour in modernist accounts of illness—here in the context of Holtby’s journalism, such as her regular book reviews for Good Housekeeping.

Modernism and Physical Illness is a welcome contribution to our understanding of how illness takes form in English literary modernism. Fifield’s interests here are predominantly literary-historical—his analyses are grounded in impressive archival work, a keen interest in biographical detail, granular attention to text, and a welcome curiosity about formal detail. The project is underpinned by a clear sense of broader methodological questions pertinent to work in the medical humanities—phenomenological vs. naturalistic accounts of illness, the problems of mind-body dualism, the usefulness (or otherwise) of literary texts in medical education. He draws confidently from a range of theoretical materials—Claudia Benthien on skin, for instance—whilst wearing his theoretical sophistication lightly. A significant achievement of this study is to teach us a certain scepticism about the way in which experiences of illness are categorized. Indeed, Fifield’s choice of texts demonstrates the messy materiality of the body as a site of resistance to biomedical control. These texts’ narrative voices—whether aggressively self-assertive, fatally estranged, or warmly attentive—insist that there cannot be a single or unified perspective on the nature of bodily illness. Here, at least, the enigma of the fever chart remains unresolved.

Dr Fraser Riddell is Lecturer in English and Medical Humanities at Durham University. He is a specialist in Victorian and early-twentieth century literature, with particular interests in music, the senses, theories of embodiment and queer theory. His monograph Music and the Queer Body in English Literature at the Fin de Siècle is forthcoming from Cambridge University Press. Recent publications include articles on John Addington Symonds and the Victorian chorister in Victorian Literature and Cultureand on queer musical geographies in Decadent literature in the Journal of Victorian Culture. His chapter on the queer materiality of breath in the works A. E. Housman and other late-nineteenth century writers is included in The Life of Breath in Literature, Culture, and Medicine (Palgrave: 2021). Fraser can be followed on Twitter @fraser_riddell.

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