- Arthur W. Frank (Author)
The Wounded Storyteller: Body, Illness, and Ethics. University of Chicago Press (purchase at Amazon.ca)
- Cathy Caruth (Author)
Unclaimed Experience: Trauma, Narrative, and History. Johns Hopkins University Press (purchase at Amazon.ca)
Reviewed by Judy Segal
In recent years, the relation of medicine and narrative has been explored by a number of authors. Howard Brody (Stories of Sickness) has written of "medicine as storytelling" and "storytelling as medicine," taking as one point of departure this comment by Oliver Sacks: "Each of us is a singular narrative, which is constructed continually and unconsciously by, through, and in us ...." Arthur Kleinman (The Illness Narratives) has focussed scholarly and clinical attention on the experience of suffering. Kathryn Montgomery Hunter (Doctors’ Stories: The Narrative Structure of Medical Knowledge) has written about narrative transformation—from patient’s history to doctor’s story. Anne Hunsaker Hawkins (Reconstructing Illness: Studies in Pathography) has written about the genre of the illness autobiography. A generally held
view is that illness interrupts the life story with a new story of an uncertain (or worse, certain) ending; thus illness may render a person a "narrative wreck" (Ronald Dworkin). As a construct, narrative crosses disciplinary boundaries and moves fairly easily between theory and clinical practice. In end-stage care, for example, physicians and ethicists use a metaphor of art to talk about life’s "final chapter," or about the coherence between a life’s last "scene"—the death scene—and the life as a whole. Now patients are widely known to be "storied."
Arthur Frank has, it seems, both the academic credentials (he has worked as a medical sociologist) and the experience (he has had a heart attack and cancer) to write a compelling book about illness narratives. The Wounded Storyteller: Body, Illness, and Ethics gathers a great deal of insight on illness and narrative and it republishes the powerful thoughts of well known illness narrators (Gilda Radner, Nancy Mairs, and Anatole Broyard are all quoted liberally); moreover, the book does this work in order to make some points that many readers will find helpful. Frank argues, for example, that "the ethical questions for members of the remission society are not adjudications of health care conflicts but how to live a good life while being ill." Frank says his "project in clinical ethics is to move ethicists and practitioners in the direction of thinking with stories." His book, however, disappoints.
The first problem with The Wounded Storyteller is that Frank has not successfully identified an audience for it. Frank’s stated theoretical framework and his citations would indicate that he wants to situate himself among scholarly authors he names in medical humanities (for example, Kleinman, Hunter, Hawkins) and in critical theory (for example, Lacan, Giddens, Foucault); yet the book cannot really be intended for an audience in search of any depth of scholarship. While Frank, for example, repeatedly uses the term "postmodern" to describe the project of contemporary medicine and contemporary patienthood, he allows "postmodern" to mean whatever he wants it to mean. (An endnote says his usage "is informed less by academic debates than by popular usage.") And while Frank claims access to contemporary critical theory, he quite misuses some of its important terms. "Deconstruction," he says, is what happens when "a big mystery becomes a series of little puzzles." A second problem compounds the first. Wishing, apparently, to make a contribution to theory in illness narratives, Frank offers an elaborate framework for his commentary:
In earlier writing I have proposed four general problems of embodiment;. . . Each body problem is a problem of action. . . . The ways that a body-self responds to each problem are presented as a continuum or range of possible responses; thus four problems yield four continua.. . . Within the matrix of these four continua, I generate four ideal typical bodies . . . . The language I will use to talk about bodies thus consists of these four problems of action, the four continua of responses to these problems, and the four ideal typical bodies. (29)
The problem is that the framework threatens to outstrip the commentary. (In discussions with graduate students to whom I have assigned the book for seminar presentation, I have learned that Frank’s framework can act as a decoy, diverting readers from its more interesting substance.) To his credit, Frank does not attempt to make the "really real" (a phrase he borrows from William James) fit his several categories. Instead he allows entries in minor categories loosely to inform a discussion of his most significant category. In Frank’s scheme, there are three kinds of illness narrative: the Restitution Narrative, the Chaos Narrative, and the Quest Narrative.
In Frank’s account of three kinds of illness narrative lies a third problem of the book: it is a set up. The Restitution Narrative (which Frank summarizes as "Yesterday I was healthy, today I’m sick, but tomorrow I’ll be healthy again") is a narrative delusion: the seriously ill or chronically ill person will not, Frank explains, simply be restored to a previous healthy condition. The Chaos Narrative is no more satisfying. It is the story we tell when we are unable to tell a story; it is the "anti- narrative of time without sequence, telling without mediation, and speaking about oneself without being fully able to reflect on oneself." Only the Quest Narrative, which "meet[s] suffering head on," which "acceptfs] illness and seek[s] to use it," is the good story. While Frank says he does not wish to prescribe a single kind of illness narrative, as the suffering must compose their own stories, there is no doubt that the person who can compose the Quest Narrative is the one who suffers best. The Quest Narrative is the moral and ethical story; it is the testimony of a witness to suffering. By the time Frank has described his three types of narrative, he has given himself, under the heading of Testimony, license to preach: "The body’s story requires a character, but who the character is is only created in the telling of the story. The character who is a communicative body must bear witness; witness requires voice as its medium and voice finds its responsibility in witnessing... ." The book as sermon leaves me wondering again about its audience.
"Narrative" is also a keyword in Unclaimed Experience: Trauma, Narrative, and History, but the book is part of a different tradition from that of The Wounded Storyteller and part of a different set of texts. Its more key keyword is "trauma." Caruth wishes to propose, she says, that it is "in the equally widespread and bewildering encounter with trauma—both in its occurrence and in the attempt to understand it—that we can begin to recognize the possibility of a history that is no longer straightforwardly referential (that is, no longer based on simple models of experience and reference)." Traumatic experiences are experiences "not of wholly possessed, fully grasped, or completely remembered events," but rather of events "partially unassimilated or ’missed.’" Traumatic events return repetitively and over time, because, Caruth says, the subject has not fully experienced their survival.
Caruth’s special concern is the relation between experience and representation, and she moves, to make her case, among the writings of Freud, de Man, and Lacan, especially—and Resnais and Dumas, authors of Hiroshima mon amour. I find the structure of her monograph, like her prose style, lacks discipline. Caruth’s unusual and worthwhile project deserves a better rendering. While I am loath to be one of those people who quotes tortured prose to reveal mischievous acts of postmodern writing, I wish strongly to object to sentences like this (from the chapter on Hiroshima mon amour):
And this inscription of the Japanese event into the history of the French—the inevitable self-referential reversal of the act of understanding, founded in the erasure of death—is also associated, in the dialogue, with a kind of moral betrayal within the act of sight, with, indeed, the filming of Hiroshima, which the French woman, as an actress, has come to do: . . . (29)
The back cover of Unclaimed Experience praises its author for her "wide-ranging discussion," and quotes J. Hillis Miller say- ing that each of the book’s chapters is a "classic essay on its topic." I, however, find the book unsatisfying for the very reasons for which it is praised—for its roaming focus and its failure to sustain engaging discussion of the topics it raises. Interestingly, what Caruth has marginalized in her thirty-three pages of notes constitutes some of the best explanatory and connective material of a book whose main text, at 112 pages, is not that much longer than its collection of notes.
I can’t help noticing that the subtitles of both The Wounded Storyteller and Unclaimed Experience are lists. Frank’s Body, Illness, and Ethics mirrors Caruth’s Trauma, Narrative, and History. The subtitles betray an ambivalence of purpose in the studies. Both books, I think, need better stories to tie their terms together.
- Cancer Treatment by Tanis Macdonald
Books reviewed: Bathsheba's Breast: Women, Cancer and History by James S. Olson
- Wounded Narratives by Méira Cook
Books reviewed: Fresh Wounds: Early Narratives of Holocaust Suvival by Donald L. Niewyk and Shattered Subjects: Trauma and Testimony in Women's Life-Writing by Suzette A. Henke
- Literature and Medicine by Alan Bewell
Books reviewed: Teaching Literature and Medicine by Anne Hunsaker Hawkins and Marilyn Chandler McEntyre
- Meetings of East and West by Don Randall
Books reviewed: Writing India 1757-1990: The Literature of British India by Bart Moore-Gilbert, Colonial Transactions: English Literature and India by Harish Trivedi, and Whose India? The Independence Struggle in British and Indian Fiction and History by Teresa Hubel
- Shell-Shocked Species by Dorothy F. Lane
Books reviewed: Unholy Stories by Nora Alleyn and Carole David, Kiss of the Beggar by Pierre L'Abbé, Killing Time by Hank Schachte, and Encounters by Michael Trussler
MLA: Segal, Judy. Speaking Bodies. canlit.ca. Canadian Literature, 8 Dec. 2011. Web. 26 May 2013.
This review originally appeared in Canadian Literature #161-162 (Summer/Autumn 1999), On Thomas King. (pg. 201 - 203)
***Please note that the articles and reviews from the Canadian Literature website (www.canlit.ca) may not be the final versions as they are printed in the journal, as additional editing sometimes takes place between the two versions. If you are quoting from the website, please indicate the date accessed when citing the web version of reviews and articles.