Next time you see a patient with insomnia, rather than prescribe a hypnotic recommend that he or she writes a book. The result might be sleep for the author and a masterpiece. Henry James gave that advice to Axel Munthe; it worked, and we now have an exquisite book, The Story of San Michele , that has been translated into 45 languages and was once required reading for medical students. The book is a mixture of autobiography and fantasy, with the boundaries between the two delightfully blurred. Most autobiographies are largely fantasy anyway, but few are so clear about it.

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Nor was it a transient phenomenon — more copies were sold of the seventy-fifth printing than of all the editions in the year it was first published. It has been published in at least forty-five languages, and a bestseller in most of them; at least one translation, into German, sold over a million copies itself — I assume the same is true of French, Italian and Swedish at the least, but I can find no figures on a cursory search of the internet.

Certainly, it is probably one of the most read books of the 20th century. My copy is from the early s, and is from the 81st printing. It has enjoyed impressive success — for a book that was archaic in style and content even when it was first written. Although he disliked the description, San Michele is the memoirs of a doctor — the youngest doctor in modern French medical history, in fact, being fully qualified at the age of In later life, Munthe was a minor celebrity himself, as a writer, philanthropist, friend and host to the famous, and personal physician to the Queen of Sweden — but his memoirs focus primarily on his life in the late 19th century, when he worked as a fashionable doctor in Paris and Rome.

Munthe tells us, in essence, a long series of anecdotes — but they are the anecdotes that he wishes to tell. The Queen of Sweden is only mentioned once or twice, and only elliptically.

He served in the Red Cross during the First World War; there is one throwaway mention of the horrors of Verdun, and another about treating maimed soldiers who had been heaped into a pile in a room. He was married twice; no wife is ever mentioned, nor even any but the briefest of romances. He abandoned his own honeymoon to treat a typhus epidemic on Capri — I think the existence of the epidemic is mentioned in one sentence, but not his role in it, nor his honeymoon.

His second wife was English; he moved to England, and became a naturalized British citizen; his citizenship is mentioned in a preface, but there is no account of his decades living here. He had two children by his second wife, but they are not mentioned. Munthe clearly is not writing a confessional, and feels no duty to be complete.

These omissions are possible because the book is not an autobiography, but only a collection of memoirs. There is no set timeline — events late in the book as a general rule occurred later than those early on, but as between neighbouring chapters there is no way to say which precedes which, or whether they are simultaneous.

A servant is dismissed in one chapter, only to be mentioned again in the next, still employed. One chapter may span several years — only for the next to return to the beginning. Frequently, the author seems to have intentionally defied the reality of time: the events of ten years are compressed into a single turning of the seasons, while a week may seem like years. Each chapter generally has one or sometimes two themes, and, at least at first, deals almost entirely with that theme — if he is talking about his demonic housekeeper, he does not divert into discussing his work, and if he is talking about a particular patient he will not digress into discussing his friends.

This patchwork technique allows many things — even two marriages and two children — to simply disappear into the cracks without trace or indication.

Later in the novel, he gains more confidence, and chapters twist in unexpected directions, generally following only thematic, rather than chronological, principles. The reader may not notice his omissions at first reading; what they will notice is the reverse, when unmentioned things float suddenly into view.

When a story requires him to have solitude on a train, he reluctantly and off-handedly admits to us that was at the time the doctor of one of the Rothschilds, who happened to own the railway company.

If we pay attention to a certain string of names, we happen to notice his friendship with August Strindberg. Munthe does not boast of his associations — he seems instead to be ashamed of them. Certainly he does not view them as interesting. The habit of concealing things from us, added to a tendency to mention things in passing as though known to us, even when they only feature later in the novel for instance, there are casually cryptic allusions to Mamsell Agata many chapters before she is actually employed — or else the events of the two chapters have simply been inverted; it is impossible to say , creates a curiously oceanic, almost nauseous, disconnection from time and causality.

We are left entirely in the hands of the author, to guide us in the appropriate direction, as we have no way of knowing for ourselves which things will prove important and which will not. Unfortunately for us, this requisite trust is not without complications: Munthe is not a reliable narrator.

He admits openly that he has made omissions, and distorted his account in places to make himself appear more admirable though this is easy to forget, faced with his continual air of almost vain humility. He even enjoins us to accept the conceit that because only parts of the book were written by hand, and others only by typewriter, that only the former sections are really his responsibility, while the latter can be partly blamed on the collusion of the Corona Typewriting Company.

He does not say which passages are which, but he is interested to know whether we can tell the difference — he has set out to play games with us, even if he would never admit it. This duality of pen and typewriter is only one part of the systematic plurality of authorship — the man who acts and speaks, the man who remembers, and the man who is writing down those reminiscences are all given to us as distinct narrative figures, and yet their voices are not distinct.

If we cannot trust the man, should we trust him when he tells us he is not to be trusted? Some instances of this unreliability are unknown to us as readers — only through external accounts could we learn that his acquaintance with Charcot was probably not nearly so close as it appears in the novel.

Other examples we cannot but suspect, particularly regarding women. He is vague about his relationship with one of his patients and what exactly happened on a moonlit walk, and though he protests his innocence he does it with such knowing coyness that he seems to be trying to tell us something different from what he says.

At another time, he is expelled by Charcot, when it is found that he has hypnotised a vulnerable young girl into going to his own house for, it is assumed, nefarious purposes; he, of course, presents his own perfectly reasonable explanation for why he hypnotised her and gave her those commands, but do we really believe him? On the other hand, if, as it seems, Charcot barely knew him, should we even take this sensationalist little story at face value? With Munthe, it is clear that he often writes himself in a better light than he deserves; yet, at the same time, we cannot discount the possibility that he is also making himself look worse than he is.

And yet it is hard to believe that he is simply inventing these episodes, if only because, from the preface to the finale, he is unwavering in counterposing his own honest experience to the ignorant fictions of other.

His apparent untrustworthiness almost seems designed to make us doubt his undoubtable virtues. Partly, this is because Munthe seems to take a perverse joy in confusing us. Repeatedly, he says one thing and we believe another — only to see that he intended himself to be disbelieved. Again and again, we see the enormous vanity and arrogance of the character — only for he himself, or another character, to mock him for it, or, worse, to undermine our reasons for thinking him arrogant.

At one point he gives himself an almost appalling speech about the inferiority of women — only to have himself undermine his own argument.

He is arrogant — and yet he often seems to have a strain of self-contempt. That, however, is not enough for him — looking back with hindsight, he mocks both his vanity and his self-loathing, to the point where it is impossible to tell whether he is acting entirely sincerely or entirely ironically, and whether an action is from self-love or self-hate, and we cannot but suspect that many of his flaws have been inserted to make himself look better. He has an insatiable pity, and a love for all those who are weak, powerless, isolated or condemned.

He likes and cares for nobody more than for prostitutes. This pity drives what we would normally consider incredible philanthropy — which is such a matter of record that we cannot doubt it: he risks his life fighting cholera in Naples, typhus on Capri; saving lives in the trenches of WWI, and in the shattered and polluted ruins of Messina after the great earthquake which, for modern readers unfamiliar with the event, killed up to ,, including 70, in Messina alone ; he spends his spare time working for free in the slums, fighting diphtheria epidemics almost single-handed, operating on kitchen tables; he helps the vets at the Parisian zoo; he volunteers to work with dangerous rabies patients, helping Pasteur develop a cure, and frequently with violent lunatics; he forces the women who rely on him for medical help to donate toys and clothes that he distributes to the poor.

His home on Capri, he made into a refuge for abandoned pets including two tortoises, an owl, a baboon, and a mongoose , and he gave up other land to make a bird sanctuary. He made a fortune through his career, and gave almost all of it to charity. And yet this is not philanthropy at all. When he refuses to send bills to his patients, and instead demands the clothes off their backs, it is just as much to humiliate them as to help the children.

He admits that he cares far more for animals than he does for humans — it seems that humanity in general he treats with hatred and contempt. He is a misanthrope, and he includes himself in the contempt. And yet, for him, this misanthropy is a double-edged thing. He seems to operate an inverse hierarchy: the weaker and more miserable a thing is, the more he loves it. This is why he prefers animals to humans, women to men, prostitutes to respectable women, and the poor to the rich.

This explains the bizarre contradictions between word and deed: why, for instance, he happily opines that women are inherently inferior to men, and that the chief desire of women is to be dominated by men, and yet throughout the novel undoubtedly admires the female characters more than the male — for him, being inferior is something praise-worthy.

Inferiority exonerates — if women sin, he says, it is usually because they have been forced to by a man. Those who are controlled are freed from guilt: guilt resides at the top of the hierarchy, and in the institution of the hierarchy itself.

Regarding sex, there is also something of a double standard when it comes to gender: he tends to condemn men, including himself, for their crude sexual impulses, yet appreciate the same things in women — because for women it is taking something of their own from their relationships, while for men, who are generally in the position of power, it is connected too greatly to exploitation. I think that he thinks it admirable when the exploited are able to find some happiness in their exploitation, but terrible that the exploitation exists at all.

It is at the lowest, most primitive point of humanity — whether naturally among the native Lapps of his own country, or forced upon the shattered people suffering after Messina, that Munthe, it seems, believes humanity is reduced to the level of animals, which is to say, from his perspective, elevated to the status of the divine.

The most pitiable human being of all the book may be the poor Sicilian peasant who has lost her home and her family to the earthquake, suckling two babies by the side of the road — and it is she who in the imagination of Munthe becomes one with the highest deity, the Mother Earth itself. Whenever he does diverge into theorizing, it is plain to see that he is mocking himself.

Throughout the novel, he expresses disdain for the way he treated women as a younger man — not because of any error of theory regarding them, but as a weakness in himself. It is hard not to wonder whether he puts his misogynist views into his own mouth to further degrade himself, to make even clearer how even he has been inveigled into the structure of domination and exploitation.

Certainly he does not try to hide it: his main method of treatment is to bring women under his control, through bullying and occasional hypnosis; this is justified because most of his patients are hysterical hypochondriacs, and need nothing more than discipline and a good hobby. It is plain he despises them as a group — and yet every one of them is described in sympathetic terms. As with mankind in general, he has contempt for the species, but affection for the individual — because as he gets to know the individual, he discovers their flaws, and their flaws are what make them attractive to him.

This is why his misanthropy is double-edged: by viewing people as contemptible, he views them as pitiable. He loves the weak and hates the strong, but by revealing the hateable flaws of the strong, he shows how they are really weak. Those who are cruel and controlling are driven by flaws fear, lust, greed that are painful and demeaning to them, and that often result in their own downfall. One example he gives is of Guy de Maupassant, who is portrayed extremely negatively — degenerate, drugged, a serial abuser of vulnerable young girls whom he seduces and abandons — and yet it is clear that Munthe has affection for him.

With most authors, this would be a puzzling inconsistency, but with Munthe it makes perfect sense: it is because he is flawed that Munthe pities him. This is why Munthe was his friend: Munthe simultaneously could look down upon him, not only for his actions, but for his sniveling pessimism, and yet at the same time admire the bold and unapologetic acceptance of inadequacy, which he seems never to have been able to achieve himself: Munthe clearly is infected with a strong love of life, and had no time for whiners, including himself.

This, perhaps, is why he portrays himself in a negative light: as a way of praising himself by making himself seem pathetic. Or, to see it the other way, perhaps he is condemning himself by making himself seem vain. Does he unabashedly show us his vanity in order to display his inadequacy, or is he so vain that he even want to show off his powers of self-criticism? And that forces us to ask the question: should we believe his self-criticism any more than his self-praise?

The book seems underlain by the pathological paradox that I have set out — but was Munthe really pathological, or is he just making himself seem that way? It almost seems at times that he is an entirely healthy, even joyful, man who is merely affecting this distorted self-perception. He admires the English greatly for it, yet he admits that he is not very English himself. Another paradox to hide the first…. This bizarre combination of vanity and humility is seen most explicitly in a passage where, in a letter to the Swedish Consulate, he flippantly rejects the award of the Messina Medal, on the paradoxical grounds that his policy has always been to accept only honours he has done nothing to deserve hence his vast array of them , and that as he did a great deal to deserve this honour, accepting it would be a risky endeavour that would likely introduce confusion into his philosophy.

And yet he accepts the humbug wholesale when he defends his decision to keep it by admitting that he had done hardly anything to merit it.

And yet he undermines that defence by listing some of the things he did — which, he is quick to retort, was nothing compared to what was done by the real heroes of the earthquake, and in most cases was nothing more than anybody else would have done. Except that, as we know but he does not remind us, most doctors would not have rushed to the disaster site at the first opportunity, and lodged each night with murderers and looters.

Let it not be thought, however, that this book is full of self-obsessed reflection. Indeed, part of the confusion is that it is almost entirely absent. Indeed, there is almost nothing about Munthe at all. This, perhaps, is why his wives and children are not mentioned: they would be too close to him, reveal too much about himself. It is an appealing thought — and yet the essence of Axel Munthe, is so immanently present in every page, so seemingly real, so simple and unitary, that it is hard to accept the theory, even as it is hard to remember the inconsistencies and pluralities.

I have said a lot, without saying very much.


The Story of San Michele

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This 'dream-laden and spooked' Marina Warner, London Review of Books story is to many one of the best-loved books of the twentieth century. Munthe spent many years working as a doctor in Southern Italy, labouring unstintingly during typhus, cholera and earthquake disasters. It was during this period that he came across the ruined Tiberian villa of San Michele, perched high above the glittering Bay of Naples on Capri. With the help of Mastro Nicola and his three sons, and with only a charcoal sketch roughly drawn on a garden wall to guide them, Munthe devoted himself to rebuilding the house and chapel. Over five long summers they toiled under a sapphire-blue sky, their mad-cap project leading them to buried skeletons and ancient coins, and to hilarious encounters with a rich cast of vividly-drawn villagers. The Story of San Michele reverberates with the mesmerising hum of a long, hot Italian summer.


Written in English, it was a bestseller in numerous languages and has been republished constantly in the nine decades since its original release. Munthe grew up in Sweden. At the age of seventeen, he was on a sailing trip which included a brief visit to the Italian island of Capri. Hiking up the Phoenician steps to the village of Anacapri , Munthe came across a ruined chapel owned by a nearby resident, Maestro Vincenzo, and fantasized owning and restoring the property. The chapel, dedicated to San Michele, had been built on some of the ruins of Roman Emperor Tiberius ' villa.

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