Many of the books by Robert Louis Stevenson (RLS) were on the reading list for English when I was at school. Treasure Island, Kidnapped, and The Strange Case of Dr Jekyll and Mr Hyde among others. Not surprisingly, there were many links between the 151 works he published in life (with a further 80 posthumous works) involving jeopardy, adventure and the high seas, and the 100 lighthouses the wider Stevenson dynasty built around the British Isles and Japan.
Fast forward a few decades and having looked out to sea both literally and metaphorically from my working life in Dundee, Shetland, Edinburgh and our holiday cottage on the East Lothian coast, many of the ‘Stevenson’ lighthouses and RLS stories have resonated more deeply with me. My time as Dean and Vice-President (Dental) reignited my curiosity about Robert Louis Stevenson’s life. As a child, I was unaware of his interactions with the medical and fledgling dental professions in Edinburgh and that the inspiration for some of his most famous works lies close to our College in Edinburgh. I thought I would share these as a blog.
Robert Louis Stevenson was born into relative comfort in 1850 in the Edinburgh ‘New Town’ and grew up living between the contrasting halves of the city. He became one of the key literary characters within the Edinburgh literature scene and counted many writers among his friends. Stevenson described Edinburgh as “a dream in masonry and living rock,” characterising Edinburgh as a city spanning the elegant and organised New Town contrasting against the frenetic, densely populated and sometimes disreputable Old Town in his days. Times move on, and our College has witnessed many phases of the evolution of Old Town Edinburgh life.
Stevenson found the darker and complex workings of the Old Town more alluring for both his Bohemian lifestyle and as a subject for his writings when compared to the gentile nature of the Georgian New Town. The vibrant yet slightly chaotic lives of the Old Town peoples going about their daily business through the narrow streets and in the various watering holes provided the catalyst for many of his stories including The Strange Case of Dr Jekyll and Mr Hyde, The Lamplighter, St Ives, Kidnapped and The Misadventures of John Nicholson.
The taverns of the Old Town in Stevenson’s era were not simply rowdy pubs, but rather, a key part of social cohesion. They were the social stage and places where the city workers, students, and by-passers would congregate and interact. Stories and gossip would be exchanged, and with the influence of high spirits, social boundaries would flex. Stevenson and other writers of the time found such locations to be the perfect vantage point for social observation. Picture RLS walking through the Old Town streets as day turned to night, with the gas streetlights flickering and the day’s outdoor business coming to a close. RLS would then pop into a tavern to spectate. Quietly listening. Watching. Taking notes of interactions and the multiplicity of voices and conversations. Energetic discussions would sometimes lead to inconsistencies in stories, whilst others would be downright rogues. Stevenson was a respectable citizen who kept his own voice hidden but communicated effectively through ink. He catalogued his observations for his social commentary on the characters of the day. Many of the real-life people were to appear in the stories he subsequently wrote throughout his life, where through his lens, he helps the reader appreciate the vibrancy of their personality.
Old Town Edinburgh shaped much of Stevenson’s work, and although he had initially enrolled at Edinburgh University to study engineering, he switched to law as his father disagreed with his preferred career choice “in letters”. The human condition clearly fascinated him, and as a sick child and as a weak and sickly adult, he endured an ongoing battle with respiratory disease throughout life. Speculation has often suggested that he suffered from one of many pulmonary conditions throughout his life, with tuberculosis and bronchiectasis being the most likely. Perhaps this stimulated his interest in learning about anatomy and physiology, with clinical observation and medical deduction complementing his legal and writing mind.
Like many others of his time, Stevenson frequently attended medical lectures which were open to all during this era at our College. Furthermore, Stevenson’s formative years were characterised by Edinburgh being one of the leading medical centres in the world. The extramural medical school attracted students from Europe, North America, and many other countries across the world. It was an exciting time for our College with advancements in surgery through dissection and anatomical training exceeding that which the University could offer. Indeed, the Anatomy Act of 1832 not only regulated the craft but led to more widely available classes.
Dental surgery began to emerge as a separate discipline with the first regular course in clinical dentistry being delivered by John Smith in 1856 and the Royal Odonto-Chirugical Society of Scotland being formed in 1867. The Dentists Act of 1878 led to our College offering a Licentiate in Dental Surgery examination in 1878. Medically, the Scottish Triple Qualification cemented the non-university route to GMC registration from 1884. This intellectual environment of the Edinburgh medical community, particularly in the Old Town, is likely to have imprinted Stevenson’s imagination for future works.
Many other interesting connections also exist between Stevenson, our College and medical developments of the time. Stevenson became close friends with Walter Grindlay Simpson, the son of Sir James Young Simpson (who became an RCSEd Licentiate at age 19). Their friendship developed while they both studied Law and Stevenson was no stranger at the Simpson household in the New Town. They enjoyed several adventures together in Belgium and France with one particular trip sparking Stevenson’s first book An Inland Voyage.
Edinburgh Dental Dispensary began operating in 1860 at 1 Drummond Street, next door to one of Stevenson’s favourite haunts, Rutherford’s Bar (established in 1834). It was affectionately known as The Pump and in an 1888 letter, Stevenson commented “as I pickled about Rutherford’s in the rain and the east wind”. Arthur Conan Doyle was also known to frequent Rutherford’s, and while there is no known record of their interactions in Rutherford’s, they were friends. In 1893, Stevenson penned a letter to Doyle congratulating him on his new literary character, Sherlock Holmes. “Only one thing troubles me, can this be my old friend Joe [Joseph] Bell?”.
A plaque now adorns the corner of Drummond Street, honouring Stevenson as a “son and student of Edinburgh”. Rutherford’s later became La Hispaniola and is now part of Ciao Roma, a frequently visited Italian restaurant for many associated with our College. Ciao Roma has a clever ‘Jekyll and Hyde’ layout with the chic Italian café downstairs and the now pirate themed upstairs section on Drummond Street resembling a scene from Treasure Island with the fixtures and fittings giving a feel for the schooner Hispaniola. Captain Alexander Smollet could easily be at the helm while Long John Silver cooks up a mutiny down below.
One of Stevenson’s most famous works is The Strange Case of Dr Jekyll and Mr Hyde (1886), a gothic horror novella, which has a strong flavour of Edinburgh medical culture with the hypocrisy of Deacon Brodie running through the whole story. The themes of scientific experimentation, moral duty within the medical profession and the duality of human identity were all lively debates in the 19th century with rapid medical advances taking place in anaesthesia due to Sir James Young Simpson, James Syme’s pioneering surgical techniques, and antiseptic surgery through Joseph Lister.
With our College being central to setting standards for these innovative practices, Stevenson used his observation skills to the utmost, transforming the inherent tensions into a remarkable act of fiction set in hidden Old Town doorways, winter fog and thin lamplight. Whilst the Burke and Hare affair was history (1828) by Stevenson’s time, it inevitably cast a long shadow over medical ethics and it is conceivable that this further influenced RLS as he grappled with the themes of body and identity, and the boundary between life and death.
The story is however even more complex. Eugène Chantrelle was hanged for murdering his wife, Elizabeth in 1878. He was known to Stevenson as a frequent visitor to various taverns and interestingly the Chantrelle family lived in George Street nor far from the Simpson household. The story and trial are therefore likely to have been of interest to him as his story developed. Sir Henry Duncan Littlejohn, the city’s Police Surgeon, Medical Officer of Health and RCSEd President 1875-1876 was called in as a notable forensic expert at the trial. Among the evidence Littlejohn presented to the court were the traces of opium found on Elizabeth’s nightclothes, and that Chantrelle had recently taken out a large life insurance policy on his wife. Furthermore, Littlejohn and Dr Joseph Bell were colleagues and friends, jointly working on police investigations over two decades with Arthur Conan Doyle serving as outpatient clerk to Bell and being taught by Littlejohn. It is therefore plausible that Bell was a contributor to the forensic evidence gathered by Littlejohn. Furthermore, is said that Chantrelle’s final words on the gallows were “Give my compliments to Joe Bell. He did a good job in bringing me to the scaffold”. Stevenson most likely followed the harrowing story taking careful notes for The Strange Case of Dr Jekyll and Mr Hyde.
As noted above, Robert Loius Stevenson did not enjoy good health throughout his life and spent long days and nights in bed as a child with his father telling him all sorts of imaginary tales of ship captains and the more mundane aspects of life, which inevitably fuelled a vivid imagination. Stevenson’s mother also suffered from tuberculosis, and in the 19th century, 25% of sufferers perished. The family travelled extensively in search of purer, healthier air, the only known treatment. England, France, Belgium, Switzerland, the east and west of the United States, Hawaii, Tahiti, New Zealand, the Gilbert Islands and his final resting place, Samoa, were all on his travelogue.
Having travelled between the United Kingdom and the United States on various occasions, Stevenson found the dry air of California provided not only respite for his pulmonary function, but it was also the place to rekindle his relationship with Fanny Vandegrift Osbourne, who he eventually married. On this occasion, Stevenson took a passage alone to the east coast of the United States suffering from multiple pulmonary exacerbations while on board. His subsequent overland travel was interrupted on various occasions while he recuperated and regained strength.
Stevenson’s primary connection to dental surgery was however, as a patient. Little is known of his dental health until he reached the point where his teeth were “rotten” and a dentist, “The famous Russell Cool of East Oakland,” across the bay from San Francisco undertook a dental clearance in 1879, and provided immediate dentures, which were later replaced by a dentist in Marseilles in 1883. Not only did Stevenson’s health improve dramatically following his dental clearance, but the dentures also improved the appearance of his mouth and profile.
Stevenson later undertook three Pacific voyages and settled with his family, including his mother (as his father had passed by this point), in Samoa. He continued to write, with a parallel politically active career developing during his time in Samoa until he succumbed to a stroke in 1894, aged 44. The South Sea Letters, later published as a book, In the South Seas, chronicle his Pacific voyages and unsurprisingly provide detailed observations of island life and anthropological history. Perhaps these voyages allowed him to live out his Treasure Island fantasy which is thought to have been inspired by the island of Fidra, located in the Firth of Forth with the final setting being the Norman island in the West Indies. There is however no mention of either mutiny or success in finding any buried treasure on any of the pacific islands he visited.
Robert Louis Stevenson was neither a medical doctor nor a dentist, but undeniably, his character and writings were significantly influenced by the medical culture of his time in Edinburgh’s Old Town, with our College having played a central role. RLS stories are rich with the concepts of ethics, duality, and the human condition, which equally occupied those within our College at the same time. He provides a glimpse into an interesting period of RCSEd and some of the key individuals in the 19th century by intertwining storytelling and medical science.
Next time you are walking to or from The Royal College of Surgeons of Edinburgh, why not stop as you cross Drummond Street and read the plaque on the wall at Number 1. It is well worth a few minutes of contemplation.
I am keen to hear from any of our Members and Fellows, so please feel free to get in touch at dental@rcsed.ac.uk.