The illness of Charles Darwin

Abstract

From The Institute for the Medical Humanities and Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas. Requests for reprints should be addressed to Dr. William B. Bean, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas 77550. Manuscript accepted May 18, 1978. The relationship between health and creativity is a subject of intense interest. Concern with it has given rise to a miscellany of notions, delusions and, sometimes, tolerably accurate beliefs. It has been believed widely that artistic creation of many kinds has its genesis in neurosis. It was thought that the artist has to keep a neurosis simmering actively in order that his creative productivity remain actively boiling and bubbling. One of the important examples of the way ideas often illustrate the mysterious viability of the false is the 19th century conviction that inspiration and genius were frequently associated with and presumably engendered by consumption or, as we say now, tuberculosis. A strong countercurrent to this view was developed by the late Lawrence Kubie in an illuminating volume entitled “Neurotic Distortion of the Creative Process.” Whether or not we use the constructs of psychoanalytic theory, most of us realize that something which is called the unconscious is a subsurface system in which memory traces are corralled to keep them out of sight or to keep them from disturbing the neighbors by disrupting our conduct. Seen or unseen, hidden flywheels and gyroscopes constrain our actions by clearly felt but invisible lines of force. Somewhere, not quite in limbo between the conscious and the unconscious Kubie placed ‘I. . . an intermediate form of mentation to express at least by implication the neurosis of thought and feeling, those collateral and emotional references which cluster around the central core of meaning. Here every coded signal has many overlapping meanings; and every item of data from the world of experience has many coded representatives.” This is the form of coded language which is essential for all creative thinking, whether in art or science. In technical jargon, this second type of symbolic process is called preconscious. In every moment of maturing or mature human life the unconscious, the preconscious and the conscious are in action concurrently. Well or sick, busy or quiet, everything we do, say, think or feel is thought to be a kind of composite of hidden vectors. The preconscious, when it dominates, gives freer swing to man’s creativity and is not checkreined into immobility by an overactive conscience, nor is it deflected into futility, nor deranged into disease by a dominance of the unconscious. In one of the most exciting literary detective excursions we have, John Livingstone Lowe% in “The Road to Xanadu,” by a searching study of everything Coleridge had read, written and almost what he had said, found every idea and many sentences or fragments which comprised Kubla Khan and the Ancient Mariner. He did not like psy-