At the heart of this novel is a simple love story. Dr. Bruno Sachs, a slight, stooped, and somewhat unkempt general practitioner in a French village is dedicated to his work and loved by his patients. Sachs is a solitary, self-effacing man who takes his Hippocratic duties seriously and is especially sensitive to the needs of his patients.

In addition to his private practice, Sachs works part-time at an abortion clinic, where he performs an abortion on a distraught young woman named Pauline Kasser. Soon the doctor and his patient fall in love. She moves in with him and becomes pregnant. An editor by profession, Pauline also encourages and assists Dr. Sachs in completing the book he is writing.

The story has many additional layers and dimensions. The reader views Sachs through the eyes of multiple narrators--his patients, colleagues, friends and acquaintances, all of whom write in the first person and present Bruno Sachs as "you" or "he." Thus, the reader gradually builds up a "connection" (empathy) with Sachs by synthesizing multiple glimpses of his behavior and facets of his character. At the same time, Sachs is trying to find his own voice, his own connection, by becoming a writer. At first he jots down random thoughts, then he keeps a notebook, and eventually he produces a complete manuscript.

The book has innovative structural elements that introduce other layers of meaning. For example, the 112 short chapters are organized into seven sections, corresponding with the components of a complete clinical case history: presentation (as in "chief complaint"), history, clinical examination, further investigations, diagnosis, treatment, and prognosis. Similarly, the narratives delve progressively into Sachs' "illness" and follow the "patient" through his course of "treatment."

Another structural element is the cycle of fertility and gestation. The story takes place from September through June, precisely 40 weeks, a pregnancy of nine months, during which Sachs is re-born.


The two words that best describe The Case of Dr. Sachs are revelation and mystery. For this reader the revelation results at least as much from the book's satisfying integration of story, character, and technique, as it does from any underlying meaning or message. The novel is also full of mystery. While evidence abounds in this story, and there is sufficient data to formulate a "complete" case history, each level of completeness suggests another, deeper level, so that any single formulation of The Case of Dr. Sachs is incomplete.

Bruno's need to discover his voice, to transform his experience as a doctor into a form of self-expression--perhaps to attribute meaning to the meaningless suffering he sees all around him, as well as to save himself from being submerged in that suffering--is for me the deepest and most compelling theme. Near the end of the book, Bruno reflects: "So, I think that writing, for a doctor like for anyone else, is a way to take the measure of what we don't remember, what we don't retain. You write to try to knit up the holes in evanescent reality with bits of string, tie knots in transparent veils, knowing that they're going to tear open somewhere else." (p. 425)

In 1994 Martin Winckler gave up medical practice to become a full time writer. In The Case of Dr. Sachs, the person who has been sitting in the doctor's waiting room throughout the book, patiently reading a manuscript, finally confronts Dr. Sachs on p. 430. He asks the doctor if he, in fact, is actually Martin Winckler, the man who wrote The Case of Dr. Sachs? Thus, reality breaks into fiction, and the fiction breaks into reality.

As Dr. Sachs wrote, "Medicine is a sickness that strikes all doctors, in varying ways. Some derive lasting benefits. Others decide one day to turn in their white coats, because that is the only chance of cure--at the cost of a few scars." (p. 430) Martin Winckler (and Bruno Sachs?) have chosen to seek the cure.


Martin Winckler was born Marc Zaffran in Algiers. This novel was first published in France as La Maladie de Sachs (1997) and won the Prix du Livre Inter. Translated from the French by Linda Asher.


Seven Stories

Place Published

New York



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