Imagine Captain Ahab -- that fiery-eyed, vengeance-goaded mariner -- faced with a choice: Chase a great big whale or swallow an itty-bitty pill.
If he picks the latter, you can forget about "Moby-Dick."
Yet if he sticks with the mad pursuit and eschews medication, he's a goner.
Ahab is fictional, but here's a fact: Last month marked the 20th anniversary of Prozac, the most widely prescribed antidepressant in history. The story of Prozac, however, is not simply the chronicle of a drug that changed lives, made billions for its maker, Eli Lilly & Co., and upped the ante in the long-running debate over the neurological or sociological components of serious depression. It is also a case study of a product that quickly acquired a profound and pervasive cultural identity. The word "Prozac" can stand alone. Nobody asks, "What's that?"
They don't ask because they already know -- whether or not they have ever taken Prozac. They know it from books such as Elizabeth Wurtzel's memoir, "Prozac Nation" (1994), which became the 2001 film of the same name starring Christina Ricci, or "Prozac Diary" (1998) by Lauren Slater. They know it from a song such as "Is It Peace or Is it Prozac?" (1993) by folk singer Cheryl Wheeler: "When the moon is full and the world's too close / I just keep my smile and I up my dose."
When authors want to set up a battle between psychiatry and other forms of emotional rescue, they use the term "Prozac" to be the bad guy in books such as Lou Marinoff's "Plato, Not Prozac! Applying Eternal Wisdom to Everyday Problems" (1999) and Kathleen DesMaisons' "Potatoes Not Prozac: Solutions for Sugar Sensitivity" (1998, revised 2008).
But Prozac is more than a metaphor. The debates initiated by its widespread use bloom into a larger cultural question: If art depends on an engagement with the world as it is, with a world of pain and loss and sorrow and frustration, what happens when that engagement is routinely mediated by a drug that alters brain chemistry? If melancholy can be headed off by medicine, what emotions will be left, out of which to make art?
For all of the artists or writers who may fear the effects of Prozac and its ilk on their creativity, there are others who credit such medications with enabling them to function at all, much less flourish as artists. Among the latter is Wurtzel, who wrote in "Prozac Nation" that her depression was so severe it made her feel as if her life was "just awful, not worth living, a horror and a black blot on the white terrain of human existence."
Virginia Woolf suffered debilitating bouts of mental illness and committed suicide in 1941. Had Prozac been available, would she have taken it? What if she had believed it might blunt her heightened emotional response to life and thus weaken the power of her writing? Woolf, after all, believed that "the greatest release" is the "freedom to think of things in themselves," as she stated in a 1928 lecture later published as the extended essay "A Room of One's Own."
The argument over Prozac's efficacy belongs to other venues: neuroscience, medical ethics, public policy. What is still in play for cultural commentators is the question of the drug's influence on literary trends. Have two decades of pharmacological intervention in the moods of vast numbers of people -- Prozac now is prescribed to almost 54 million people around the world -- seeped into themes and plots and character development?
Literature has moved from the lumbering, cumbersome social novels of the late 19th and early 20th centuries -- written by the likes of Frank Norris and Upton Sinclair -- to the shorter, quicker, nervier works of contemporary novelists such as Zadie Smith and Jonathan Lethem. (Naturally, there are exceptions; Jonathan Franzen's 2001 novel "The Corrections", was a throwback to the dense, high-carb tales of yesteryear, while the briefer novels of Willa Cather seem to belong to 2007, not 1927.)
Gore Vidal detected this change in an essay he wrote half a century ago: Novels, he believed, were moving toward "a purer, more private expression" and might soon become "like poetry, a cloistered avocation." That increasing insularity also troubled critic Alfred Kazin, as he explained in his crucial 1971 study of the American novel, "Bright Book of Life": "We never get away from the particular case, the haunted self, some central bat in the belfry."
Was any of this the result of Prozac? No, but the ubiquity of Prozac has arisen alongside the unmistakable trend toward fictions that worry more about individual emotions than large-scale issues. Prozac didn't cause the shift; the symbolism of Prozac as a cultural force, though, is its perfect escort.