This article examines John Buchan’s experience of gastric illness, dyspepsia and duodenal ulcers within the medical context of his life during the first half of the twentieth century. In tracing some of the different and changing approaches to gastric illness over the intervening decades, it compares the medical knowledge and practices of that period with medical knowledge and treatment today. The article’s low key empirical intersectional examination, too, touches on both ethics and justice. Its importance lies not only in its discussion on past and present medicine, but also in its scrutiny of Buchan’s extraordinarily dutiful approach to his active and varied careers, often marred for him by sudden onsets of illness. Buchan’s coping mechanisms, including mental and physical endurance, are spotlighted in his life and in some of his works, frequently written when he was in pain, or recuperating from illness. Both his fiction and non-fiction had multiple purposes: to support his extended family; to help his country; to help his fellow countrymen escape into adventure during war; and to help himself escape from pain.