Medication

WE ARE PRESENTED to Wellington Yueh, as we are to many physicians, through his credentials. He wears a diamond on his forehead and a ring in his hair, both symbols of his training at the venerable Suk Medical School. In the Dunes universe, the school is known for psychologically conditioning its graduates into a posture of non-maleficence, that antiquated imperative to do no harm. Amid the high stakes of Imperial politics, where the Great Houses find reason to employ spies and assassins alongside their private physicians, the value of a Suk physician rests much more on ironclad ethics than specific clinical expertise.

Still, Yueh’s primary role in the story is that of an agent of evil. Admittedly, there is an element of coercion to this – he is tricked into betraying House Atreides by his sworn enemies, the Harkonnens, who pull the necessary psychological strings by convincing Yueh that his wife’s life is at stake. Secondary actions, however – providing an escape route for Duke Leto’s partner Jessica and her son Paul, and arming the Duke with a prosthetic tooth that doubles as a kamikaze weapon – the doctor suggests he doesn’t has perhaps not lost its moral compass so much as awakened to a larger moral calculation. Betraying a patient to save his own wife is one thing, but what about betraying a patient to save his family? Or kill a monster? Or to prevent a war?

It is assumed that Suk Medical School offers at least graduate level courses on dealing with these inevitable cart-like problems. Then again, perhaps a radically simplified professional creed renders these questions moot. When I was a medical student, I don’t recall my ethics training being particularly strong, despite regularly witnessing end-of-life cardiopulmonary floggings or uninsured hospital discharges. with a wad of unrefillable prescriptions. Biomedicine offers its practitioners the privilege of compartmentalizing, detaching the body from its external circumstances and repairing it in a vacuum. Accompanied by a dream of total precision, this approach lends credence to an ethical framework in which healers could absolve themselves entirely from the prospect of collateral damage.

In Essential ecologies (2007), historian Linda Nash opposes this mechanical understanding to a much older view of the body, which she describes as “ecological”. This view accords with ancient Greek ideas of health arising from the compatibility between an individual’s temperament and the surrounding soil, or the idea persisting until the end of the 19th century that malaria appeared after having crossed the “bad air”. It is also consistent with some contemporary models of chronic disease, of the type studied by historian Michelle Murphy in Sick building syndrome and the problem of uncertainty (2006), who again locate the disease just outside the body, at its interface with the environment. We also feel the first puffs of it in the Villeneuve Duneswhen Yueh lays a diagnostic hand on Paul, disoriented after his first exposure to the spice-laden desert, and says with some surprise, “you seem to be sensitive.”

Nash and Murphy don’t necessarily dwell on the bioethical implications of ecological bodies, but in the face of such intrinsic complexity, it’s hard to imagine clinicians sustaining the hubris necessary to uphold an ideal of perfect nonmaleficence. The notion may seem as flimsy as the Fremkits that Paul and his mother find stowed in their getaway vehicle. Wrapped with a handwritten note from Yueh, they seem insufficient in the face of the sandstorm — at first glance. The kits are one more harm reduction effort from the renegade doctor, a second skin who may or may not protect his former patients from a harsh new environment. However, subtle processes of physical change are already underway, transforming the surviving members of the Atreides family into blue-eyed sand walkers. This transfiguration is wrought by the elements, and it also bears the signature of Yueh.

In a 1969 interview, Frank Herbert made explicit his interest in certain tensions. Referring to the novel’s planetary ecologist, for example, the fact that he “sees all these things happening to him as mechanical things doesn’t take away from the fact that he’s still part of this system, because he’s observing it. . ” Later, he characterizes the journey of Paul in Dunes as “an exercise in showing, one might say, the fallacy of absolutism”. Yueh embodies similar tensions—between the rigidity of professional duty and the contingency of private motivations; between the order of the royal residence and the unstable landscape in which it bursts; between the infinitely readable bodies of the future and the madly fluid bodies of the past.

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Art by Kenneth Mills.

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Nitin K. Ahuja is an assistant professor in the Division of Gastroenterology and Hepatology at the University of Pennsylvania. His writings have appeared in The Yale Review, The Washington Post, infinite time, Slate, The New England Journal of Medicineand elsewhere.