I’ve always been curious about why famous writers became writers, and why they wrote what they wrote. Clearly, our life experiences shape what we write, and we as writers are always admonished to “write what you know”. As a doctor, I am fascinated by illness and disease, and I have developed a theory that many writers had their lives, and their writing, shaped in significant ways by illness. For example, Robert Lewis Stevenson was a terrible asthmatic as a child, was often in bed, and read a lot because he couldn’t go out and play. He grew up to write wonderful adventure stories; the adventures he wished he could have. George Orwell described terrible tortures inflicted on Winston Smith, his protagonist in 1984. Experts feel these were influenced by the painful surgical procedures Orwell underwent because of his chronic tuberculosis. Let’s look into my theory with another example.

We all grew up reading The Tale of Peter Rabbit, Benjamin Bunny and the other beautifully illustrated children’s stories that made Beatrix Potter so famous. The origin of those stories is integrally linked to diseases. In Beatrix’s case, it was not her own personal illnesses, but sickness in those she loved that influenced her writing. Let me tell you how.

Beatrix, born in 1866, was the child of wealthy parents, grew up educated by governesses, summered in the Lake District of England, and developed a love of nature. She and her younger brother kept numerous small wild animals (hedgehogs, mice, rabbits) in their nursery as pets and loved to observe them and draw sketches of them. She was an accomplished artist, sketching and painting as a young girl. As she grew up, she remained quite fond of her former governess Annie Moore and her family, and often wrote letters to them, especially Annie’s eight children. In 1893, Beatrix wrote a letter to five-year-old Noel Moore, who was sick with Scarlet Fever. The letter, illustrated with sketches, said, ‘I don’t know what to write to you, so I shall tell you a story about four little rabbits, whose names were Flopsy, Mopsy, Cottontail, and Peter…’.

In 1893, what would it have been like to be a five-year-old boy, sick with Scarlet Fever? Remember, this was the pre-antibiotic era, so Scarlet Fever (Strep throat with a rash) was a dreaded illness. Parents knew it could linger for weeks, and could lead to awful complications, like pneumonia, empyema, meningitis, sepsis, rheumatic heart disease, and glomerulonephritis. In fact, during that time, the death rate was as high as 30%. Terrifying! Since there was no effective treatment, parents just watched helplessly. Additionally, Noel was one of eight children; it was likely he was not the only one who became ill with Scarlet Fever. In this era, children with Scarlet Fever were immediately isolated and quarantined for up to six weeks. Sometimes entire families would be quarantined and become dependent on friends or relatives for food. Imagine keeping eight isolated children occupied in the pre-television/computer era! Beatrix’s letters and pictures must have been quite welcome.

The little boy and his sister Marjorie wanted more stories, and Beatrix complied. Noel eventually recovered, but as luck would have it, a few years later he became ill with polio. A much-feared disease, it often struck children and sometimes left paralysis in its wake. Of course, 1900, when Noel was ill, was long before the miraculous polio vaccines of the 1950s. We don’t have details about Noel’s polio, but we do know that he recovered without permanent paralysis. Beatrix’s letters continued.

Eventually, when Noel was twelve, Beatrix borrowed the letters back, compiled the stories, enhanced the sketches, and by 1901, The Tale of Peter Rabbit was published. It was instantly popular and by 1902, she had edited it, and republished it with color illustrations, the ones we are so familiar with.

Beatrix later wrote: “It is much more satisfactory to address a real live child; I often think that that was the secret of the success of Peter Rabbit, it was written to a child – not made to order!” It is clear that, without a sick child to cheer up, there might have been no Peter Rabbit!

In 1905, Beatrix was 39 years old and was already an accomplished writer and illustrator (in an era when women were rarely in business) when she became engaged to Norman Warne, her editor. His publishing house had published The Tale of Peter Rabbit a few years earlier to great acclaim, and he worked closely with Beatrix on several projects. However, within a month of their engagement, Norman returned from a trip ill, took to bed and died. Records from the time diagnosed him with pernicious anemia.

Pernicious anemia is caused by vitamin B 12 deficiency. B12 is essential for the production of red blood cells, so, slowly, fewer and fewer red cells are made. Profound anemia, heart failure as well as neurologic damage, ensue. Although described as early as 1824, it was uniformly fatal until treatments were developed in the 1920s. Alas, too late for Norman. Again, illness of a loved one struck and changed Beatrix’s life.

Beatrix, bereft, went ahead and bought Hill Top Farm, in the Lake District, a farm she and Norman had planned to buy for their retreat. And there she summered for the rest of her life, So, there were no children of her own for Beatrix. However, she continued to write and illustrate her enormously popular children’s books, eventually writing over sixty books. She did marry at the age of 47 and continued to write and study nature.

And those stories for a sick little boy? The Tale of Peter Rabbit has been reprinted many times, and after one hundred years has never gone out of print. It has been translated into thirty-six languages. Over 45 million copies have been sold, making it one of the best-selling books in history. All because of Scarlet Fever!