Session 3: Narrative, Self and Health, Illness and Disease
Chair: Louise Penner
From Narrative to Rhetoric in the Doctor-Patient Relationship
Carlann Fox Scholl
Department of English, Utica College, Utica, New York, USA
The argument of this presentation is that medical narratives serve as a heuristic for a medical rhetoric that has not yet been identified as such.
In Health and the Rhetoric of Medicine, Judy Segal categorizes contemporary stories of people suffering from an illness, which she labels pathographies, as epideictic discourse. Because such stories are epideictic (discourses about values), critics of the biomedical model of medicine in clinical practice use these stories in several ways. Here are some examples:
1. Pathographies sometimes illustrate how disease affects a patients’ life world.
2. Pathographies sometimes illustrate how patients’ are active meaning makers.
3. Pathographies sometimes illustrate how patients’ stories affect the physician.
However the stories are employed, critics such as Arthur Kleinman, Eric Cassell, Lucy Candib, and Arthur Frank argue that such patient narratives should become part of the doctor-patient relationship, which would result in a change in the biomedical model of medical care. That is, the doctor as knower and fixer of the body-machine, who delivers truths about the body as machine in the doctor-patient encounter, becomes one who allows the patient to have agency and also to be a knower about the illness experience. In so doing, the patient becomes more than a body-machine, and the doctor-patient relationship becomes dialogic. In such a dialogic rhetoric of relationship-centered care, the physician is hailed as hospitable and empowering and the patient as active knower and sufferer.
Self, Narrative and Illness as Creative Invention
Goldsmiths College, University of London, United Kingdom
This paper draws on research in psychosomatic medicine (particularly the work of Luis Chiozza and Viktor Von Weizsaecker) to critically revise some key themes in the literature on narrative and illness. Analyses of illness narratives have tended to present the event of illness as one of ‘disruption’, a ‘loss of self’, the ‘wreckage’ of a previous experience of biographical – and hence, narrative – continuity and coherence. The narrative that is triggered by illness has been described as biographical work that reconstructs and renegotiates identity. In contrast to this line of analysis, this paper examines the implications of clinical observations and interpretations based on the use of a ‘pathobiographical’ method for a range of medical conditions. This is an approach that stresses the continuity between the event of illness and narratives of the self, such that illness itself may be seen as lending coherence and meaning to an individual’s life. From this perspective, the (apparent) disruption of meaning occasioned by illness would appear part of a vital and creative effort on the part of the organism to heal its self. The event of illness, and that of healing, can thus be seen as instances of creative invention rather than as in terms of deviation from (or restoration to) a norm of ‘health’. The paper further argues that the understanding of health and illness in terms of creative invention has profound implications for our understanding of the sick role
The Everyday Body and Illness
University of New South Wales, Sydney, Australia
My paper foregrounds the affective body in relation to illness, interspersing creative writing with theories of embodiment and subjectivity. It describes the process of researching my own illness and writing my experiences into my existing PhD thesis after being diagnosed with cancer. The dissertation incorporates medical research on cancer with autobiographical writing that locates the body within everyday life and its relations to everyday life institutions, including medical discourse. This work is an exploration of how writing attempts to make meaning of the experience of illness and considers questions such as the corporeality of illness and the body’s encounters with the medical system, the impact of illness on the family, and the physical impacts on the body as it moves from illness to health.
The body is investigated as always in excess of knowing, as perceptive and intuitive, and as a reactive or disruptive site that challenges existing practices, creating spaces for the discernment of differences. The paper describes, after the diagnosis of secondary cancer, the importance of researching the condition and the pursuit of alternative medical treatment that enables informed engagement with therapy options. An important area for me, as a dancer, is both the impact of illness on the dancing body and conceiving of the body as capable of movement in its own right against the institution of dance. Contrasting the metaphor of movement with the static nature of illness, the writing recounts both the grief of the body’s reduced physicality for periods of time and the body’s capacity to heal and return to dance.
This process of writing where creative and critical or theoretical works are merged as an intersubjective and experimental space, in Australia is known as fictocriticism.