The Use Of Contrast To Critique The Field Of Medicine In Madame Bovary

In the Madam Bovary, Gustave Flaubert implements juxtaposition to reveal an industry operated by egocentricity rather than the betterment of patient to illustrate the realities of medicine and the truth behind the motifs of many medical practitioners. The dull-witted character, Charles Bovary, finds himself trapped in a futile medical career as a result of his mother’s overwhelming aspiration for his financial advancement and improved social standing. This recurrent concept is identified throughout the novel, as Charles is continually pressured by both family and counterparts to undertake difficult surgeries, despite his inadequate training and inherent aversion. Flaubert also employs the character of Emma Bovary to ridicule medicine, by fixating her affections on Charles’s medical career as opposed to his character. His attention to detail of her horrific death is conflicted with her romantic ideals of suicide, being passionate and sentimental. The role of narcissistic medical characters, Emma Bovary’s ironic and morbid self-destruction and the strain upon Charles to achieve wealth and stature all employ contrast in a variety of forms. Flaubert uses this technique to emphasize the fatuity of elusive ambitions, the superficiality and greed of the bourgeoisie, contrasting romantic illusions with harsh realities exemplified by the medical profession.

Flaubert commences his relentless attack on the medical industry with Charles’s experience at medical school, foreshadowing the future realities of his ordeal as a medical officer. Charles’s classes are assimilated to “temple-doors guarding a sacred gloom within”, referring to Charles’s entry into the medical world, his nescience of its practice and the future turmoil he will experience. The symbolic use of “sacred gloom” and Flaubert’s detailed listing of the countless classes he is required to attend, denote Charles’s dread of the impending workload associated with medical studies. This attests to the looming responsibilities and entrapment Charles perceives, emphasising the lack of freedom he feels regarding his choice of career. In contrast, Flaubert emphasises the simplicity and joy of life outside of medical school, as Charles stares out of the window during a moment of serenity. The scenery outside is described as a “fine summer evening” (pg 10), where “there was the pure and open sky”. The setting of “summer” paired with a “pure and open sky” alludes to a sense of freedom and elation unaffected by the misery and drudgery of medical study. By presenting the disparity of these two settings, Flaubert provides an initial insight into his distaste for the medical industry.

Towards the end of Charles’s studies, the novel once again takes us on a journey of contradicting imagery, reflecting on Charles’s inability to break free from his struggle against his mindless toil. He rebels by visiting a tavern recounted as a “scruffy” place where he experiences a “precious act of liberty” and “an access to forbidden pleasures”, which Flaubert presents as an antidote to the bourgeois expectations placed upon Charles and the rigid requirements of the medical training. As a result of his temporary impetuosity, Charles proceeds to “fail miserably” and is pushed by his mother to retake the exam, which he passes. Flaubert’s opening reference to his accomplishment is “what a great day for his mother!”, placing disproportionate prominence on Madame Bovary’s gratification at her son’s success and acknowledging her contribution to this outcome. By doing so, he critiques the motives of those within the bourgeoisie, who equate the medical profession to entry into the upper echelons of society, whilst being oblivious to the primary role of medicine; the care of people.

The self-serving nature of these professionals is further illustrated during the overwhelmingly graphic scene of the club-foot surgery, where the necessity for expertise was abandoned, favouring professional pretension. In the opening of the chapter, Homais, an ostentatious pharmacist, proclaims that “alleviation and rehabilitation for the patient [is] rapid and easy fame for the surgeon”. In the context of this surgery, claiming the process will be “rapid and easy” contrasts deliberately with the true outcome. This declaration accentuates the egocentricity and Homais’ need for local adulation. Flaubert’s characterisation of Homais as seemingly knowledgeable, provides credibility to his spurious claims and seduces others to follow his advice. Emma Bovary is foolishly influenced by this statement and reveals her controlling nature and ceaseless yearning for fame, when describing how she “coaxed [Charles] into taking a step that would enhance his reputation and increase his income”. The repetition of words such as “reputation” and “fortune” bolsters the underlying paradoxical nature of this tragic surgery, as incompetent Charles, “let himself be convinced” to perform a difficult surgery. By comparing the illusion of speed and ease presented to the patient with the reality of

Flaubert uses irony and extravagance to critique the precession surgery. In discussion about his surgery, Homais proclaims to patient Hippolyte “it’s for your sake! Purely from compassion!”. After lavish discussion of success, Homais convinces Hippolyte that the surgery “wouldn’t cost him a thing”, yet Flaubert’s use of irony foreshadows the exact cost of the surgery; his leg. Flaubert transitions to the realities of the surgery, which contrast heavily to the constant talk of riches. Although the surgery is initially a success and Emma Bovary “flung her arms around [Charles’s] neck” proudly, Flaubert quickly shifts the scene, with Mére Lefrançois “shouting- Help! He’s dying!”. The use of the exclamation mark and the abrupt change of tone indicates the catastrophe which has taken place where Hippolyte is described to be “pale, unshaven [and] hollow-eyed”. Flaubert focuses on the appearance of the patient intending the reader to act with horror as Hippolyte’s excruciating pain is visually demonstrated. The merciless reality of the surgery therefore stands in rigid contrast to the eloquent speeches of success, fame and fortune, making a mockery of the bourgeois physicians.

In the finale of the novel Flaubert’s portrayal of Emma Bovary’s ‘heroic and romantic’ suicide further confirms the lack of rudimentary medical understanding amongst the bourgoisie. From the beginning of the scene, Flaubert utilises pathetic fallacy with “a darkening sky” where “crows were on the wing” setting the mood for the events that follow. Flaubert also employs dramatic irony with “her chest almost bursting” to foreshadow the gruesome consequences Emma will be facing. Finally, before the event of Emma’s poisoning, he describes her feeling “a rapture of heroism which was almost joyful” with which he contrasts her romantic delusion with the horrifying realities of her impending death. The medical ignorance of the middle class is further exemplified with the ease of Emma’s access to the “blue jar” of arsenic, underlining the lack of training by Homais’ assistant in handling and dispensing of poisonous substances, as well as her foolishness of ingesting it by rather gracelessly by “stuffing it into her mouth”. Emma returns home in a state of serenity, anticipating her death to be dignified and painless. Soon after, Flaubert transitions into unsettling imagery of Emma’s “bulging eyes”, “A stifled scream [that] escaped her lips” and her crying out “Oh, my God, it's horrible!”. He employs grotesque imagery to juxtapose Emma’s ideals of a peaceful end with the reality of death by poisoning, again showcasing the pervasive medical ignorance.

In an attempt to preserve her life, Charles calls in a trained doctor named Larivière, who possesses bona fide medical certifications and experience. In order to distinguish himself amongst the medical elite, the pharmacist Homais eloquently proclaims “I wanted to perform an analysis, doctor and primo, I delicately introduced a tube…” yet Larivière calls attention to the fact that Homais instead should have “introduced your fingers into her throat”. Flaubert in this instance associates medical ignorance with eloquent language, whilst pairing medical expertise with practical discourse. This public rebuke mocks the audacity of Homais’ presumptuous medical claims and ultimately, Homais is outed for his negligence. Flaubert condemns the imperious nature of many professionals with the contrasting medical qualifications and for the first time in the work, presents a truly qualified professional.

The contrast employed by Flaubert to outline the absurdity of the bourgeoisie in the context of the medical profession is a vital aspect of this book as it echoes the ethos of the entire middle class of that time period. It helps the reader understand the disdain he feels for their ignorance, conceit and narcissism, which he showcases by reflecting on the three different types of medical professionals, the medical officer, the pharmacist and the doctor. Lack of care, education and experience are partnered with egotism, pomp and ceremony. Romantic ideals and grand notions of status and success are pushed aside by the grim realities and objective truths of middle-class lives. Whilst many of the characters have sentimental feelings and desires, Flaubert dismisses these with unfailing irony and anti-romantic narrative, as demonstrated through the mocking of medicine throughout the work. 

16 December 2021
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