Conference Programme, Abstracts & Papers

Session 4A - Wounded Storytellers: Patient and Provider Perspectives
Chair: Rob Fisher

Emotions and the Heart in Nineteenth-Century England: The Framing of Angina Pectoris
Fay Bound Alberti
Wellcome Unit for the History of Medicine, University of Manchester, Manchester, United Kingdom

No abstract is presently available

Cool, Calm and Collected: Narratives of Gay Men's Self-Harm
Andrew Estefan
School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia

Self-harm, broadly defined as any act intended to harm one’s body, is a complex and contested phenomenon that is associated with identity and sense of self.  Previously marginalised in social and clinical inquiry, a recent rise in awareness has made self-harm the focus of much interest by health researchers and practitioners. The need to understand and respond to self-harm behaviours is recognised as urgent.  Health professionals who encounter self-harm remain anxious about patients, principally because they are constrained by understanding self-harm as a problem that must be diagnosed and contained.
This paper reports the early findings of a narrative study of gay men who self-harm. Gay men’s self-harm has not been previously explored.  Gay identity can be unstable.  Gay men exist as subjects of discourses that construct a dialectical tension between sense of self and deviance.  This discursive subject seems to self-harm differently to previously studied populations. 
Two narrative segments are presented in this paper.  These narratives reveal some of the ways gay men use self harm.  The first narrative features a calculating, precisely timed act that makes strategic use of the body to effect and sustain social change.  Such a body-practice transcends pejorative notions of manipulation and risk. The second narrative highlights how self-harm can be eroticised and commodified.  In both narratives risk is displaced to a position around and within the community, rather than within the individual who self-harms.
Utilising this research, a new perspective of self-harm emerges as the pursuit of self-damage as a moral and social practice of marginal bodies. Reframed in this way, self-harm reflects physical and emotional strength and robustness.  It challenges the construction of the person who self-harms as risky, chaotic and manipulative, advances understanding of the complexities of the phenomenon, and opens up new possibilities for caring health practices.

'The Wounded storyteller': Practitioner as Patient Postmodern Analysis of Life-Writing
Jennifer Driscoll
Department of English, Yeshiva University, New York, New York, USA

Using the growing body of work that surrounds bioethics, narrative, and medicine, this paper will examine the transforming ethical realization that occurs in the art of storytelling when illness strikes the practitioner, rendering the practitioner both doctor and patient.  Theories of Arthur Frank, medical anthropologist Arthur Klienman, and practitioner and literary critic Rita Charon will provide an interdisciplinary lens with which to consider how the practitioner's illness provides an opportunity to reconsider the moral imperative in the 'scripting' of illness.  These theories will be applied to the life-writing of Kay Redfield Jamison and David Biro to argue that the practitioner as patient becomes "wounded storyteller" whose narrative of illness emerges as a postmodern event.  For the practitioner as patient, the scope of modernist medicine, aligned with doctors associated with medical school curricula, no longer suffices and the doctor/patient embodies the breakdown between subjects and amongst subjectivities. Disease, no longer other related, becomes associated with the self and in this act bioethics (or what David Morris calls the biocultural model of illness meanings) emerges as a narrative practice of understanding the patient whose illness  is configured within a complicated life trajectory, informed by internal and external demands placed upon the body/self. This paper make an argument for bioethics (the ethics of life) in storytelling as a universal search for authentic communication and an effort for the ill body to create meaning, an effort particularly challenged by the practitioner as patient's multiple subjectivities.

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