Hektoen International

A Journal of Medical Humanities

Saul Bellow’s Doctor Adler: The achieving medical father and his non-achieving son

Solomon Posen
Sydney, Australia


“I’ve learned,” old Doctor Adler lectures his oversized, untidy and bankrupt son, “to keep my sympathy for the real ailments” (42). Saul Bellow’s 1956 novella Seize the Day, arguably his finest work, is the story of a prodigal son (Tommy Wilhelm) who returns to his father, craving love as well as financial aid.1 Unlike the biblical father, the old man rejects Tommy and tells him to get out of his sight. “It’s torture for me to look at you, you slob” (110).

Numerous critical essays on Seize the Day have focused on Tommy, the “Holy Fool” and his marginalization in a society with distorted, materialistic values (Opdahl 1967, Rodrigues 1979, Fuchs 1984, Pifer 1990, Kramer 1998, and Eichelberger 1999). This paper concerns itself with the portrayal of the father who, significantly, is not a share broker or a real estate agent but a prominent and highly respected retired internist whose unsympathetic behavior is due, at least in part, to his medical background (Norris 1969).

In contrast to Tommy, who is a chronic loser, Doctor Adler can look back on a career that can only be described as an unqualified success (11-12). Despite his Jewish background and his own father’s occupation (“My old man sold dry goods in Williamsburg,” 50), he not only made it into medical school but subsequently became renowned as one of the most distinguished internists in New York. He had been awarded an academic title by one of the universities (11-12) and had established an enormous practice. Now retired, he still looks “clean and immaculate” (12) with only his hearing aid (38) to indicate that he is almost eighty years old.  His face, reflecting the doctor’s youth and vigor, “had a wholesome reddish and almost translucent color, like a ripe apricot” (38).
During his working days the doctor had amassed a “considerable fortune” (11) so that he can now afford to live, on a permanent basis, if not at the “Ansonia Hotel” at least at the “Gloriana,” which specializes in accommodating retirees (4-5). Here the old widower is the star guest (11-12), pampered by the staff who point him out to visitors as a living treasure. Doctor Adler, who has always been a vain man, basks in this meaningless adulation, which no doubt takes him back to his practicing days when patients would come up with compliments like “Doctor, you are so kind.”

The afterglow of Doctor Adler’s professional and financial achievements is darkened by his two non-achieving children. He does not like them; he sees their lack of worldly success as detracting from his own standing, and he resorts to exaggeration and lies to hide their blemishes. His daughter, Catherine/Philippa, who is married to an impoverished court reporter (32), wants to be a painter, but public recognition of her talents has thus far not been forthcoming. When discussing her with his elderly friends, the doctor boasts that at one stage, before her marriage, she held “an important position” at Mount Sinai Hospital.” (She had been a medical technologist, 32).

Tommy Wilhelm’s problems are worse. Doctor Adler knows that Tommy is unemployed and that job-offers are non-existent, but he nevertheless describes him as a “sales executive” with a large salary. “He didn’t have the patience to finish school. But he does all right for himself” (13). Tommy finds it amusing that his father should act somewhat like a salesman and boast about his unsuccessful offspring as well as about himself.

The old people at the Gloriana claim that Doctor Adler “still has all his buttons. You can discuss any subject with him” (12). In fact, the doctor displays no such conversational powers. He talks about himself, about his children as an extension of himself; he vaguely mentions the effect of caffeine on the respiratory center (34), and he informs Tommy that Mr. Perls from the fifteenth floor suffers from “a bone condition, which is gradually breaking him up” (42).2 Adler has become obsessed with his own health (44) and spends a good deal of time on the massage table or in the hydrotherapy pool. He does not discuss medical topics, let alone ethical problems or poetry. Unlike Tamkin, the bogus doctor in Seize the Day, who swindles Tommy out of his savings, Adler, the “real” doctor, is no versatile scholar (Posen 2006).

Doctor Adler’s greatest failing is his inability to relate to his family. He refuses to help Catherine/Philippa who wants to rent a gallery to exhibit her paintings. “I was glad enough to buy crayons for her when she was four. But now she’s a woman of forty and too old to be encouraged in her delusions. She’s no painter” (46).

Doctor Adler’s late wife may not have taken a great deal of interest in sexual activities (51), but she was a loyal helpmate (49), Tommy muses, with “sensitive feelings, a soft heart . . . and a tendency to be confused under pressure” (25), presumably Doctor Adler’s pressure. Despite his otherwise unimpaired memory, Doctor Adler is unable to recall the year of her death (27) and refuses to repair the broken bench at her grave (34).

The negative attitude of Doctor Adler towards his son, Tommy, constitutes the central theme of the story. Bellow repeatedly stresses Tommy’s status as a captive animal (Norris 1969). He is described as a “hippopotamus” and a “bear” (23), affectionate, bumbling, huge and pigeon-toed, trapped and chained by cruel hunters. At other times he is described as an overgrown, trusting child, full of helpless, well-meaning and unreciprocated love, ready to take any sort of dishonest advice and to make a series of disastrous moves (Norris 1969).

In a world governed by a concept of “success” as measured in terms of money and status, Tommy is a total failure. He lacks formal education. He is unable to function as a minor film actor, as a husband, as a furniture salesman or as a speculator in commodities (lard). He loses at cards (7). On the “Day of Reckoning” (85) when he asks his father for a loan, he is about to default on his alimony payments and has no money left for his accommodation. Predictably, his love and admiration for his father are not appreciated. “His father . . . [is] ashamed of him” (14).

Over the years, Doctor Adler tries, ineffectually, to prevent Tommy’s decline. While he does not join his wife in encouraging medical school ambitions in their ungainly and unscholarly son (16), a letter from the college authorities asking about Tommy’s whereabouts (22) must have caused him an unpleasant surprise. He advises against a trip to Hollywood (23), against marriage to Margaret (48) and, more recently, against an association with a con man (10) who subsequently “borrows” Tommy’s last few dollars. “I don’t know how many times you have to be burned in order to learn something,” the doctor castigates his son. “The same mistakes over and over” (109).

During his undistinguished career, including service as a hospital orderly (24), as a trench digger for the WPA (38), and as an unheroic GI during the Second World War (54), Tommy has acquired a number of disgusting personal habits. He now lives in a filthy, stinking room (36). His car is littered with Coca-Cola bottles, papers and cigarette butts (33). He is a glutton (42), a chain smoker (33), a heavy drinker (36), and he is addicted to a variety of sedative and stimulant pills (34). He fidgets constantly, “hoisting his pants up and down by the pockets or jittering with his feet” (28). From his days as a failed Hollywood actor he retains a taste for histrionics (48). He is a compulsive liar (111). All this so irritates the fastidious and abstemious old doctor-father that it makes communication between the two men almost impossible.

Doctor Adler stresses repeatedly that he keeps his sympathy for “real ailments” (42) . . . “fatal sickness, accidents” (45). Although he disapproves of Tommy’s joining the army, (54) he considers the war a genuine problem and sends Tommy’s wife Margaret a check each month. If Tommy had arrived suffering from a bronchial carcinoma or a myocardial infarct, or if one of Tommy’s sons had been injured in a car accident, the doctor would most likely have dealt with the situation efficiently and sympathetically. Tommy’s actual problems, on the other hand, are regarded as self-inflicted and incurable.

Doctor Adler may be dismissed as an egotistical, intolerant, and miserly old fop (38) who has turned his back on his dysfunctional family. He is the embodiment of a corrupt society, which despises losers like Tommy. However, Bellow constantly reverts to Doctor Adler’s medical background and repeatedly suggests that the old man’s failure as a father and a human being is linked to his clinical training.

There is the complaint, common in twentieth century fictional literature (Posen 2006), about the doctor’s inability or unwillingness to spend sufficient time with his family. “Dad never was a pal to me when I was young,” he reflected. “He was at the office, or the hospital or lecturing” (14).

Doctor Adler “behaved towards his son as he had formerly done towards his patients” (17), presumably his more “difficult” patients (Groves 1978), who made a career of suffering (45). He scrutinizes Tommy’s “history” so as to disentangle genuine observations from opinions, half-truths and falsehoods, and to determine whether these observations might fit his own hypotheses.

This technique, which works well when a physician is gathering evidence concerning a patient, is both inappropriate and ineffective in the setting of a father interrogating his son. Instead of maintaining a “bedside manner” which, despite its pejorative overtones (Posen 2005), at least implies an element of civility, Doctor Adler reverts to the role of the judgmental parent reprimanding his child and he becomes abusive. “You’re lying . . . Since you have to talk and can’t let it alone, tell the truth” (51).

The old doctor cannot believe that Tommy would have acted like a petulant child, leaving his job because his “feelings were hurt” (56); he suspects, instead, a sex scandal. When Tommy denies any involvement with women, Doctor Adler asks, quite inappropriately, “Maybe it was a man then?” This question can only be interpreted as an insult, implying, “You’re such a jerk, I wouldn’t put anything past you” (51).

Tommy is dimly aware of the incongruity of Doctor Adler’s line of questioning, which reflects a grotesque mixture of paternal and medical attitudes. Why all these questions about factual details if the final decision is unfavorable? “What do you want to know about my problems for . . . if you’re not going to help me?” (53).

The doctor’s powers of observation, sharpened by thousands of physical examinations, remain acute; he notes with distaste that Tommy’s fingers are so dirty that “a faint grime was left . . . on the white of the egg after he had picked away the shell” (36). He advises fewer pills, less alcohol and more exercise (45). He even hints that the best course for Tommy would be to persuade his former employers to reinstate him, to return home to his scheming wife and put up with any “bed-trouble” (51) that might be awaiting him. But there is no compassion for Tommy and certainly no money.

Most significant is Doctor Adler’s attempt at “detachment.” While the term is at present politically incorrect, the concept is tacitly and widely accepted in the medical profession (Konner 1987). If a doctor becomes too involved emotionally in his patient’s suffering, his efficiency as a healer declines. The classical detachment question, after a patient has poured out his anger, his anguish and his disappointment, is “What would you like me to do?” with the word “me” lightly or heavily accented as the situation demands.

After hearing the litany of Tommy’s misfortunes, Doctor Adler asks his son this very question: “What do you want from me? What do you expect?” Unlike former patients who may have muttered at this point that there was nothing the doctor could do, Tommy cries out “I expect help!” (53). Help is not forthcoming, and Tommy slinks out, leaving behind his doctor-father whose failure as a parent is due, in part, to the inappropriate use of his medical training.

What little joy Doctor Adler may have felt at seeing Tommy again is tempered by forebodings about the future. No amount of financial support will bring about a life-style change in this improvident 44-year-old son who will return for further hand-outs for the rest of the doctor’s life. The phrase “seize the day,” with its hint of spontaneous celebrations, is quite alien to the old physician, who has been trained to make prognoses—to forecast what will happen the day after a father deals with a prodigal, a point on which the Bible and Saul Bellow are deliberately silent.

Like Henry James’ earlier successful fictional physician,3 Bellow’s Doctor Adler analyses his child’s problem correctly from the clinical point of view, but in the process, he destroys the remnants of his family life (James 1881). Clinical skills and affectionate spontaneity may be essentially incompatible, and neither Henry James nor Saul Bellow offers a resolution to this particular “Doctor’s Dilemma.”



  1. Saul Bellow (1915-2005) was awarded the Nobel Prize for Literature in 1976. He died on April 5, 2005. All references to Seize the Day are given in parentheses and refer to the Penguin edition (New York, 1996).
  2. Mr. Perls wears a large built-up shoe and “thrusts” with a heavy cane. He is a tall man with an extremely wrinkled face (32), and his teeth have been replaced by multiple pointed crowns. His “progressive bone condition” is more likely hypogonadal osteoporosis with a badly healed hip fracture before the days of joint replacements than polyostotic fibrous dysplasia. Neither condition provides an explanation for his bad teeth.
  3. In Henry James’ Washington Square, Dr. Austin Sloper’s daughter, also called Catherine, falls in love with an adventurer who promptly decamps when informed that the doctor will disinherit her if the engagement takes place. Sloper, whose appraisal of the would-be fiancé is entirely appropriate, saves Catherine from a miserable marriage, but his attitude and his sarcasm break her spirit (James 1881).



  1. Bellow, S. 1956. Seize the Day (New York: Penguin Books, 1996.) – All page numbers are indicated in parentheses in the text and refer to this edition.
  2. Eichelberger, J. 1999. “Renouncing ‘The World’s Business’ in Seize the Day.” In Prophets of Recognition: Ideology and the Individual in Novels by Ralph Ellison, Toni Morrison, Saul Bellow, and Eudora Welty (Baton Rouge: Louisiana State University Press): 95-126.
  3. Fuchs, D. 1984. Saul Bellow: Vision and Revision (Durham, NC: Duke University Press): 78-97.
  4. Groves, JE. 1978. “Taking Care of the Hateful Patient” N. Eng. J. Med. 298: 883-7.
  5. James, H. 1881. Washington Square (New York: Bantam Books, 1959).
  6. Konner, M. 1987. Becoming a Doctor (New York: Viking).
  7. Kramer, MP (Ed.). 1998. New Essays on Seize the Day (Cambridge: Cambridge University Press).
  8. Norris, CB. 1969. The Image of the Physician in Modern American Literature Ph.D. Dissertation, University of Maryland: 321-33.
  9. Opdahl, KM. 1967. The Novels of Saul Bellow: An Introduction (University Park, PA: Pennsylvania State University Press): 106-117.
  10. Pifer, E. 1990. Saul Bellow against the Grain (Philadelphia: University of Pennsylvania Press): 79-95.
  11. Posen, S. 2006. The Doctor in Literature Volume 2 – Private Life (Oxford: Radcliffe Publishing): 45-49 and 139-66.
    —-. 2005. The Doctor in Literature Volume 1 – Satisfaction or Resentment? (Oxford: Radcliffe Publishing): 71-97.
  12. Rodrigues, E. 1979. “Reichianism in Seize the Day.” In Trachtenberg, S., Critical Essays on Saul Bellow (Boston: G.K. Hall): 89-100.

I am indebted to Dr. Carolyn B. Norris for making available a full copy of her Ph.D. dissertation and for all her helpful comments.



SOLOMON POSEN, MD, is an emeritus professor of medicine at the University of Sydney, majored in English before obtaining his medical degrees (M.B. B.S., M.D.) at the University of Adelaide, Australia. He is a Fellow of the Royal Australasian College of Physicians, a Fellow of the Royal College of Physicians, London, and a past president of the Endocrine Society of Australia. Dr. Posen taught General Medicine and Endocrinology at Sydney University for almost 30 years. He served on the Editorial Boards of several medical journals; he is the author of some 130 scientific papers (mainly in the field of calcium metabolism) and a coauthor of a book on Alkaline Phosphatase. He is the author of a projected four-volume work titled The Doctor in Literature. The first volume, (“Satisfaction or Resentment”) was published by Radcliffe in 2005. The second volume (“Private Life”) appeared in 2006. Dr. Posen is married with three adult children and seven grandchildren. He lives in Sydney, Australia.


Highlighted in Frontispiece Spring 2009- Volume 1, Issue 3
Spring 2009  |  Sections  |  Books & Reviews

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