In 1768 the young, feeble-minded King Christian VII of Denmark sets off on a prolonged tour of European capitals. His "handlers" determine that he needs to have a doctor along to help fend off, and to treat, the King’s frequent bouts of "agitation." Therefore, they appoint Johann Friedrich Struensee, a German physician from Altona, as the Royal Physician. Christian and Struensee develop a close bond; when the trip is over, the Royal Physician stays with the King and becomes a permanent fixture at the Danish court.

Christian is unstable and childlike. He enjoys playing games, but is totally uninterested in his beautiful young English wife, Caroline Mathilde. She becomes pregnant the first time he visits her, but he never sleeps with her again. Meanwhile, the King’s ministers actually run the government, even though he is theoretically an absolute monarch.

When Struensee, who is an Enlightenment intellectual, enters this ménage, he decides to reform the State by getting King Christian to agree to a series of enlightened new laws. Having won the King’s ear, the Royal Physician proceeds to rule Denmark for several years and to institute many of the reforms proposed by Voltaire and the other Enlightenment philosophers. Struensee also begins a tender, prolonged, and obvious love affair with the queen, who subsequently bears him a daughter.

The end of this story is not difficult to predict. Aggrieved members of the aristocracy manipulate the king to strip Dr. Struensee of his power and have him executed for adultery with Queen Caroline. She and the baby girl are shipped back to her home in England. The new Prime Minister retracts all of the reforms enacted by Struensee. And the demented king lives on in the fiction of his absolute power.


This novel, based on historical characters and events, presents Johann Friedrich Struensee (1737-1772) as an Enlightenment intellectual who capitalizes on his ability to dominate the king and institutes governmental reforms, including freedom of the press, reduction of peasant labor service, creation of a unitary judiciary, and reform of Copenhagen’s municipal government.

However, Struensee’s role as a physician provides an added dimension to his social consciousness. Early in the novel (p. 91), Dr. Struensee’s old friend attempts to recruit him to become the royal physician by emphasizing how much good he could do in that role. The doctor replies that he is already doing good work in medicine and public health, "I keep statistics on all the medical problems in Altona. I inspect the three dispensaries . . . I help the wounded and those who fall victim to accidents. I supervise the treatment of the insane. I observe and assist with the autopsies . . . I attend to the sick in the women’s prison . . . " Nonetheless, he later succumbs to the concept of taking on the state itself as his "patient" and attempting to "cure" the state of the "illness" of injustice and exploitation. Thus, he manipulates the feeble-minded king to allow him to institute Enlightenment reforms.

While social responsibility and political action are aspects of medical professionalism, effectiveness in these roles requires skills that Dr. Struensee apparently lacked; for example, the ability to assess others’ motivations, to negotiate, to compromise, and to cover one’s back.


Translated by Tiina Nunnally. Published in Sweden in 1999.


Washington Square

Place Published

New York



Page Count