A Fortunate Man by John Berger

First published: 1967

Type of work: Cultural criticism

Time of work: The 1960’s

Locale: Rural England

Principal Personage:

• John Sassall, a doctor in a small English village

Form and Content

John Berger’s extended essay A Fortunate Man is only minimally biographical. John Sassall, the country doctor whose career serves as the focus of Berger’s book, is more a type of existential hero of the atomic age than the particularized subject of a life narrative. This small deception is in keeping with Berger’s initial observation in the essay—that the landscape acts as a curtain behind which the drama of life and lives is played. Concealment, then, or at least hidden fears, desires, and motives, forms the structure of the village life portrayed. It is the rural society in which Sassall practices medicine and not Sassall’s life itself that concerns Berger, and it is the exquisite depiction of the relationship between the individual (in this case a physician) and his social environment which engages the reader.

A Fortunate Man begins with six vignettes showing Sassall treating and counseling various patients. A woodsman, for example, has his leg crushed by a falling tree. The doctor is summoned and must drive swiftly through the mist-shrouded countryside to relieve the victim’s agony and assure his comrades that all will be well. A depressed teenager is solaced by the prospect that Sassall will help her find a meaningful job. A dying woman and her family are visited by the doctor, who can offer only understanding. These and the other vignettes are related without sentiment or authorial comment. They seem united by no thematic cord, except for Sassall’s presence at scenes of unhappiness. Yet in a haunting way they establish the mood and set the scene for the rest of Berger’s essay. The reader notes that the doctor’s practice is conducted in a depressed rural community and that it involves few cures but much talk. The meaning of the vignettes becomes clear only after the entire book is digested.

A Fortunate Man is a brief book, a mere 158 pages. With about seventy black-and-white photographs, the work of Jean Mohr, the text is only some eighty pages long. The introductory vignettes take up perhaps one-fifth of those pages, so the essay proper constitutes about four-fifths of the actual text. The photographs are stark portraits of Sassall’s patients, of the doctor giving treatment, and of the grim country in which he lives and works. Like the vignettes, these portraits emphasize the dour environment in which Sassall and the villagers must function. Thus, A Fortunate Man gives the appearance of being a documentary or photographic essay, but again this is deceptive. For it is in the essay proper that the book’s essence and density lie.

As the essay proper begins, Berger dispenses with objectivity and freely interjects his opinions and interpretations into the examination of Sassall’s medical practice and methods, what he gives and what he gets by working in the kind of locale and among the kind of people he does. This examination may be divided into four segments. The first deals with the development of Sassall’s method of treating the whole personality rather than merely the disease. Berger contends that the villagers require “recognition” before their maladies can be correctly diagnosed and remedied. This recognition of them as discrete individuals enables Sassall in turn to achieve his ambition to become a universal man.

The second segment of the essay delineates the doctor’s public role. Berger discusses the inability of the culturally deprived to articulate their hopes and fears. He notes their ignorance of history and of their place in the world beyond the village. Sassall must be their voice, their “clerk of records,” as Berger writes. This public persona affords Sassall a privileged position among the villagers, and this position encourages his unique (among them) way of thinking.

The third part of the essay treats Sassall’s sense of inadequacy, the price he pays to be a country doctor. Berger contends that the psychic proximity Sassall’s method enforces renders him vulnerable to the depression and emptiness so many of his patients reflect both in their illnesses and in their everyday lives. The author remarks, however, that the very source of Sassall’s anxieties serves as their cure.

A Fortunate Man concludes with a critique of a society which denies its members the opportunities to develop to their fullest potentials. Berger reserves judgment about whether John Sassall is a successful doctor, remarking instead that a culturally deprived society has no standards by which to make either judgments or choices and, worse, no sense of the value of life itself.

Critical Context

Famed as an art critic, screenwriter, and novelist, John Berger departs from traditional literary forms with A Fortunate Man. The coupling of a free-floating essay with uncaptioned photographs, which provide their own silent commentary on the essay’s subject, emphasizes Berger’s view, presented in Ways of Seeing (1972), that images precede words and that words, in turn, are necessary for thought. The essay style employed by Berger in both books permits him to delve into cultural criticism and use anthropological, psychological, sociological, economic, political, and aesthetic approaches to a single subject. This freedom allows Berger himself to act as the universal man and, in fact, he seems equally comfortable discussing the tribal antecedents of doctors, the nature of time, and the social retardation of an English village.

Such eclecticism has troubled several reviewers of A Fortunate Man. Some are disappointed not to know more about Sassall; some find Berger’s method abstruse, his argument hard to follow. These readers were expecting, one supposes, only the story of a country doctor—a genre that has produced a number of entries, most idealized and sentimental. This is not the kind of book Berger has written, however, and A Fortunate Man can be difficult if one mistakes the subject of the essay. While Berger uses medicine and John Sassall in particular as the background for his book, he is writing in reality about cultural deprivation and existential survival.

Further, many critics find his Marxist views intolerable. His disparagement of capitalism, which he considers exploitative—an argument made very clear in his discussion of advertising in Ways of Seeing—runs counter to the prevailing liberal idea that social adjustment constitutes progress. Berger’s view that man himself must change puts the onus on each individual. While that idea may be palatable in conservative circles, his charge that the institutions of capitalistic power systematically suppress the individual self-awareness necessary for change is not.

Ultimately, the best context for judging A Fortunate Man is the one Berger himself provides—contemporary health care. It should be noted that physicians who have reviewed the book have praised it. Perhaps it touches a nerve in its portrayal of Sassall’s holistic, personal approach to doctoring. After all, the medical care with which most readers are familiar depersonalizes both doctor and patient with its technology, its fragmentary treatment, its specialization. As an institution it is overwhelmingly venal. What young doctor committed to an ideal of human service would not feel betrayed by such an institution?

Clearly, Berger’s response to such an alienating construct is not Luddite. He accepts technology and scientific knowledge as a given. His concern is simply for the place of the individual amid the social construct: Can either doctor or patient feel fulfilled, or even human, when neither knows or is allowed to know who he is? A Fortunate Man specifically contemplates a personalized, holistic approach to medical care. On the whole, however, Berger challenges all people to move toward self-awareness and moral choice or else be stricken down by the diseases of ignorance and dependence, ill beyond all cure.

Bibliography

Balint, Michael. The Doctor, His Patient, and the Illness, 1964.

Cassell, Eric. The Healer’s Art: A New Approach to the Doctor-Patient Relationship, 1976.

Gott, Peter. No House Calls: Irreverent Notes on the Practice of Medicine, 1986.

Jaco, E. Gartly, ed. Patients, Physicians, and Illness: A Sourcebook in Behavioral Science and Health, 1972.

Kaufmann, Walter, ed. Existentialism from Dostoevsky to Sartre, 1956.

Lane, Kenneth. Diary of a Medical Nobody, 1987.

Sigerist, Henry. “The Physician and His Environment” and “The Special Position of the Sick,” in Henry Sigerist on the Sociology of Medicine, 1960. Edited by Milton Roemer.

Thomas, Lewis. The Youngest Science: Notes of a Medicine-Watcher, 1983.