The book contains considerable social commentary on the state and prospects of medicine in the United States in the 1920s. Arrowsmith is a progressive, even something of a rebel, and often challenges the existing state of affairs when he finds it wanting.
This novel has been inspirational for several generations of pre-medical and medical students. There is much agonizing along the way concerning career and life decisions. While detailing Arrowsmith's pursuit of the noble ideals of medical research for the benefit of mankind and of selfless devotion to the care of patients, Lewis throws many less noble temptations and self-deceptions in Arrowsmith's path. The attractions of financial security, recognition, even wealth and power, lure Arrowsmith away from following the footsteps of his first mentor, the brilliant but abrasive bacteriologist Max Gottlieb.
In the course of the novel Lewis describes many aspects of medical training, medical practice, scientific research, scientific fraud, medical ethics, public health, and personal/professional conflicts that are still relevant today. Professional jealousy, institutional pressures, greed, stupidity, and negligence are all satirically depicted, and Arrowsmith himself is exasperatingly self-involved. But there is also tireless dedication, and respect for the scientific method and intellectual honesty.
Martin Arrowsmith shares some biographical elements with Félix d'Herelle, who is identified in the novel as a co-discoverer of the bacteriophage and represented as having beaten Arrowsmith into publication with his results.
Because of its detailed and gripping portrayal of experimental laboratory research as a practice, a profession, an ideology, a worldview, and a “prominent strand in modern culture, a way of life”,[2] Arrowsmith is generally acknowledged as a classic 'science novel', focusing on moral dilemmas bio-medical researchers may encounter.[3] Educator and school founder Lisa VanDamme describes using the ethical challenges and world outlook presented in Arrowsmith: “…I might give one class about the idealistic characters and in what way they are doomed to suffering in the world, another about those who abandon their ideals and achieve practical ‘success,’ another about the basic moral-practical dichotomy this implies, and another contrasting this view with that of…[other novelists].”[4]
Arrowsmith has been compared with The Citadel, published in 1937 by A. J. Cronin, which also deals with the experiences of a young idealistic doctor who tries to challenge and improve the existing system of medical practice.
Sinclair’s scientific collaborator Paul de Kruif drew inspiration for locations and characters in Arrowsmith from specific sources. The laboratory work and experimental process of Max Gottlieb was based on the careers of Frederick George Novy and Jacques Loeb. Loeb and De Kruif both worked at the Rockefeller Institute for Medical Research in New York, and Novy was De Kruif's longtime mentor.[5]
A writer in Public Health Reports commented in 2001 that the novel predicted many of the successes and problems affecting today's medical profession, such as the competing needs and goals of clinicians and medical scientists; commercial interests of pharmaceutical companies developing new medications and vaccines versus the need to seek for scientific truth; political and social difficulties in developing programs for protecting a community's public health; and the doctor's evolving role in American society.[6]
Scholars have found eerie parallels to the COVID-19 crisis in the 1925 novel, and the many ethical dilemmas and challenges it presents.[7]
