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It's not the Gold, it's the Journey Towards a Goal that Counts

Vincent G Valentine, MD
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vincent valentineBy perusing through all of Mark Twain's works, I am convinced of his genius (as if I am really qualified to make this bold statement) such that the more I read his material the smarter he gets (validates my ignorance). The word peruse gives us an example of the ambiguities and potential ridiculousness Twain uses as tools to teach and preach, well at least me. Let's carefully examine the word peruse, its first definition is to examine or consider with attention and in detail, and its second definition is to look over or through in a casual or cursory manner. Can we get any more ambiguous here? How would a medical student or resident respond to us when we ask them to peruse the electronic medical record of a particular patient? Anyway, Mark Twain secured immediate success with his book Innocents Abroad or The New Pilgrims' Progress published in 1869 by selling close to 100,000 copies in its first year. Today, allow me to bring to your attention a chronology of his important works in hopes that you will gain more motivation to peruse and be entertained and educated by some if not all of his works with a side effect of becoming a wordsmith.

Examining carefully or perusing his books show that he was a writer of nonfiction and fiction. His nonfiction works had their roots from his days as a newspaper correspondence to primarily as a travel writer. Among his travelogues; Innocents Abroad (1869), Roughing It (1872), A Tramp Abroad (1880), Life on the Mississippi (1883), and
Following the Equator - A journey around the world (1897). Innocents Abroad was the best-selling of all his writings during his lifetime, and it became the standard by which all his books were measured. When comparing it to John Bunyan's Pilgrims Progress, it seems Twain developed a deliberate plan with his published works.

Innocents Abroad is a prospectively written travel diary of his trip to Europe and the Holy Land in 1867. Interestingly, while this book is about traveling east to culture Americans, Roughing It originally to be published as Innocents at Home, is about traveling west into the American frontier. Roughing It is more autobiographical and retrospective. With age, Twain further regresses in time in his book and expands his imagination. By the time he publishes Life on the Mississippi where his best writing can be found, he is approaching 50 years of age. He is a more seasoned writer. The Gilded Age (1873), The Adventures of Tom Sawyer (1876), and The Prince and the Pauper (1882) were all published before Life on the Mississippi.

Life on the Mississippi, as with most of his books, is written as a first person narrative, but now he recounts his days learning the river day and night as a "cub pilot" for the steamboats on the Mississippi River ten years before he set sail for Europe on the Quaker City. It should be noted that the book Tom Sawyer was an adult narrating his childhood and his penultimate book, Huck Finn, was the innocent or ignorant boy narrating his childhood as it occurred. Taken to an extreme consider reading A Connecticut Yankee in King Arthur's Court. Twain transports the Yankee back in time and space to the "old world" of King Arthur.

By traveling to the Old World in Innocents Abroad, Twain helps American readers develop a cultural identity through the depiction of the first packaged tour group to see Europe in the mid-late 19th century. The "Pilgrims" journey across the Atlantic was comprised mostly of wealthy, respectable, churchgoing, genteel and affluent New Englanders, joined by the unrefined Mark Twain who was considerably younger than the pilgrims, hailed from middle America and the Western frontier and whose trip was paid for by a San Francisco Newspaper. The idea of a tour group traveling east back to the old world had taken hold of America's sensibilities of the well-to-do and upper crust believing that in order to complete a cultural education, a post-high school American must come face to face with the cultural movements of the old world.

Twain gives us the moral that "Travel is fatal to prejudice." It is not prejudice against but is prejudice about the old world. He dramatizes misunderstandings and misadventures of preconceived notions, biases, or assumptions with a series of new circumstances, unfamiliar realities realized on the journey. In the first person narrative, Twain uses the hapless innocent or ignorant as himself where his discomfiture becomes the basis of the readers entertainment. As a result, American readers were able to look down and laugh at the old inflated idea of Europe. An idea that by going there you were going to find more spectacular, more beautiful and more wonderful forms of life than anything the new world could offer. It was Henry James who used the genre of tragedy instead of comedy and made Americans feel inferior in Europe. Twain makes exaggerated expectations live hardly up to their promises and encourages readers to feel superior. The renaissance paintings by the old masters may have been fine once they were new, but they are not new now and no amount of his imagination can make them beautiful. To gain the "correct understanding" he "must studiously and faithfully unlearn a great many things I have somehow absorbed." Consider our biases and countless unanswered questions in the management of patients.

The proverbial advice from Horace Greeley, "go west young man and grow up with the country," is the main theme of Roughing It. In this story, Twain hits the mother lode of humor as a writer after repeated failures in the western frontier. He sets out west to "strike it rich" and learns how little he really knows. He fails miserably as a miner and learns not only all that glitters is not gold, but also nothing that glitters when prospecting for ore is gold. Through a series of misunderstandings and poor judgments this "tenderfoot" stays just as broke as he's ever been until he becomes a journalist.

Mark Twain's deepest source of power comes from the Mississippi River. Because of Life on the Mississippi, his image with a steamboat is akin to Ernest Hemingway's image with outdoor sports such as fishing and big game hunting. He brilliantly describes the sunset as the passenger. Then, he rewrites his own text and is able to describe the river as an experienced steamboat pilot. He wonders how doctors learn to read the faces of beautiful people and wonders if they can ever really admire beauty as they don't see it once mastering their profession. Experienced physicians view a series of signs that indicate much the same thing as the river indicates when technically viewed from a steamboat pilot. In time it is the inevitability of decay and death that emerges. The dangers and uncertainties that we come to know the world is full of result from the passage of time. What it tells us is that with sophistication, inside knowledge, and time pleasures vary when read interpretatively, intellectually, and critically.

Now, here's the hidden genius of Twain in Life on the Mississippi. It is not what he writes, it is what he doesn't write about and I contend, deliberately. He wrote this book after the American Civil War about when he was becoming a riverboat pilot before the Civil War. The enormous financial success of steamboating North and South on the mighty Mississippi stem from the sweat of slavery, Europe's craving for and the transportation of cotton. And he barely acknowledges the presence of black slaves except for the most important call out by the boat's leadsman's cry of "mark twain." For the record, Mark Twain was an ardent abolitionist, supporter of emancipation and an advocate of women's rights. Also, I refer you to this article:   Freed slave who penned sarcastic letter to old master after he was asked back to farm pictured for first time

Through these travels east, west and journeying north and south on the Mississippi River from his earlier days as a more innocent or ignorant with a creative imagination in full gear, we can feel Twain moving to fiction and better understanding his quote, "Truth is stranger than fiction, but it is because fiction is obliged to stick to possibilities; Truth isn't." Mark Twain is truly the first American author whose writings covered transcontinental America and quite possibly the entire globe ahead of any other writer by the time of his death. Can we recount with such grace, Olympic skill and humor of our travels to keeps us updated with the fast pace of progress in the ISHLT and our lives?

Disclosure Statement: The author has no conflicts of interest to disclose.