Showing 71 - 80 of 121 annotations tagged with the keyword "Literary Theory"
This is an ambitious and far-ranging book, the result of years of thinking, teaching, and working with patients. An internist at the College of Physicians and Surgeons at Columbia University, Charon sees a wide range of patients in an urban setting. Also a Ph.D. in English literature, Charon has devised a "Parallel Chart" and other means for caregivers to write personally about the dynamics between healer and patient, to read texts--narratives in particular--and, as a result, to listen better to patients, thus improving the delivery of medical care.
Charon defines narrative medicine as "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness" (4). She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.
Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon's own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.
Charon sees wider applications. As caregivers understand better concepts of attention, representation, and affiliation, they become more ethical, more community minded, and better healers to their patients. Patient interviews will be different: instead of following a grid of questions, physicians will converse with patients in an open-ended way. What is most important will emerge and emerge in ways that are most beneficial to the patient. Yes, this method will take more time but it will be more efficient in the long run. Bioethics, Charon argues, has been limited by legal approaches and philosophical principles. For her, narrative bioethics offers more human values in how people feel, experience reality, and relate to each other. Finally, there are implications for social justice: why are the poor underserved in this country and in many others?
One of the most exciting and radical formulations comes late in the book: ". . . practitioners, be they health care professionals to begin with or not, must be prepared to offer the self as a therapeutic instrument" (p. 215). This notion links up fruitfully with concepts of energy medicine (v1377v), therapeutic touch (Tiffany Field), and intentionality (Wayne W. Dyer).
Summary:Through his own studies and brilliance, a peasant servant of two students becomes an educated man. Persuaded by an army recruiter of the soldier's good life, he travels Europe before returning to his studies and becoming a licensed graduate of the law. An enamored woman inadvertently poisons him with a presumed love potion, leaving him crazy, believing he is made of glass. The Glass Graduate gains fame and fortune for his wit and wisdom, despite (because of) his folly. Cured by a cleric, his former large following rejects the now sane professional. He returns to the good life of soldiering.
Healy focuses on the social and cultural meaning of disease in Britain during the early modern period (roughly the sixteenth and seventeenth centuries). Her chapter on "The Humoral-Paracelsan Body" discusses how the humoral theory of Galen, at this time still dominant in constructing a notion of the human body and its functions, was challenged by a new Paracelsan medicine, with its emphasis on spirit and on experiment instead of book-learning, and by the emergence of syphilis. She also establishes the genre of the "regimen[t]," a text advising how to achieve personal and social order.
Her two chapters on "The Plaguy Body" review the late-medieval and Renaissance history of the plague and argue that the social meaning of the plague as a trope of violence and rebellion shifts over the course of the sixteenth century, from a judgment on Britain's "rich extortioners," careless of the welfare of the poor, to the threat represented by London's unruly urban underclass.
Healy's two chapters on "The Pocky Body" argue that the new disease of syphilis became another dominant metaphor for social disorder because it helped focus anxieties about cultural hypocrisy, corruption, and degeneration, linked to the problems of sin generally and excessive appetite in particular. Her final chapter examines "The Glutted, Unvented Body," another powerful figure of excessive appetite, threatening that the body (and its appetites) would dethrone the head (the site of reason).
Healy demonstrates the importance of debates over the glutted, headless body as a way for British writers to negotiate the problems of a trade imbalance and the tricky terrain of resistance against the intemperate Stuart monarchs, culminating in the execution of Charles I in 1649. In the book as a whole, Healy reads literary and historical texts by authors as diverse as William Bullein, Thomas Dekker, Lucretius, Erasmus, William Shakespeare (Measure for Measure and Pericles), and Milton (Comus).
This novel spans one day in the life of a London neurosurgeon, Henry Perowne. It is set on a specific day, Saturday, February 15, 2003, when mass demonstrations were held in London protesting the coming war on Iraq. This actual historical and geographical context colors the fictional narrative, told entirely from the point of view of Perowne, who wakes in the early hours of the morning to see a burning aircraft descending towards Heathrow. Although this turns out not to be a terrorist attack, as Perowne at first fears, it sets up the book's atmosphere of foreboding and the powerful contrast between dangerous world events and Perowne's essentially happy family.
The Perownes are all talented and successful and fond of each other. Henry's wife, Rosalind, is a media lawyer; their son, Theo, a blues guitarist; and their daughter, Daisy, a published poet. This Saturday's highlight is to be a family dinner, where it is expected that Daisy and her grandfather, John Grammaticus, a famous poet, will reconcile after an argument.
Henry is on the way to his morning squash game when he is involved in a minor car accident with a dubious character named Baxter. He escapes theft and a beating by realizing that Baxter suffers from Huntington's Disease. He tells Baxter the diagnosis and offers hope of a non-existent treatment, shifting the power base of the encounter from brawn to brain and humiliating Baxter in front of his cronies. (This part of the novel was published in the New Yorker as a short story, The Diagnosis. See the annotation in this database for a more detailed account.)
Henry then plays an aggressive game of squash with Jay Strauss, his American colleague, and they discuss the Middle East and the impending war. He buys seafood at the market for the evening's dinner, and he goes to the nursing home to visit his mother, Lily, who has multiple-infarct dementia. He listens to his son's band, goes home and cooks dinner. He argues with Daisy, his daughter, just come from the protest march, about the coming war.
When the family is gathered for dinner, Rosalind returns from work and Baxter and his henchmen force their way into the house. They threaten Rosalind with a knife, break Grammaticus's nose, and force Daisy to strip, at which point Perowne realizes his daughter is pregnant. Then Daisy recites poetry--Matthew Arnold's "Dover Beach"--and, unlikely as it is, the effect of the poem is to distract Baxter enough that Perowne is able to lure him upstairs with the promise of more information on treating Huntington's, and he and Theo then throw Baxter down the stairs. Baxter is taken away in an ambulance, and later Perowne is called in to operate on his brain. The novel ends with Perowne back in bed with his wife.
Physician and poet Rafael Campo sometimes gives poems to his patients, tucking them in with educational materials and prescriptions. He knows that poetry can be therapeutic for both patient and caregiver, and in this beautifully organized and executed book he tells readers why and how poetry can enhance healing.
The chapters (in which Campo ponders questions such as: Is poetry necessary for survival? How does poetry locate us inside the experience of illness? Why is poetry therapeutic?) follow the arc of illness itself. In Chapter 4, "Inklings," Campo discusses how not-yet-diagnosed symptoms of sickness may be revealed in poetry, the patient "divining" signs of illness "from the clues discernible in a sentient relationship to the world around us" (p. 52).
In following chapters ("Diagnosis," "Treatment," "Side Effects," and "End of Life"), he expertly unfolds, through brilliant poem analysis, how "At every station of the disease experience, poetry has suggested an ulterior discourse that, as it accumulates, forms a composite picture of a humane idea of wellness" (p. 127). In other chapters ("Daniel," "Clara," "Sunny," "Eduardo," and "Mrs. Twomey") he discusses how poetry has changed and informed his clinical and personal interactions with patients.
Fully aware that poetry is not a "cure" for illness and that relationships between patients and caregivers are not always ideally sympathetic, Campo demonstrates how, nonetheless, poetry can be a valid healing modality. In the "Afterword," he urges readers to imagine poetry "as a metaphor itself for the process of healing" and "to experience it through the stories and voices of real people who have themselves called upon it as they faced illness" (p. 188), and he states his wish to see "non-poet physicians use this book with their own patients and medical trainees" (p. 190). An excellent "Further Reading" appendix provides wide-ranging selections for further study.
William Carlos Williams (1883-1963) was one of this country’s premier poets, winning the Bollingen Prize for poetry in January of 1953. As a practicing physician, Williams (hereafter "WCW") incorporated many of his medical experiences into his fiction, less into his poetry. Brian A. Bremen’s book examines WCW, "a medicine man," to use Kenneth Burke’s phrase for Williams (Kenneth Burke was a lifelong friend and publisher of WCW), for whom writing was "always a form of criticism-as-diagnosis." (p.6) For Bremen, a professor of English at the University of Texas at Austin and former editor of the William Carlos Williams Review, WCW’s poetics "embrace ideas about literature, history, medicine, gender relations, politics that are currently finding expression in the contemporary critical enterprise of ’cultural studies.’ " (p. 7) Bremen’s book explores how WCW developed these ideas between "Spring and All" (1923) and Paterson, Books I-IV (1951).
After quoting a remark that Burke recalls WCW making about the nature of man, Bremen states that the quotation substantiates "the close relationship between Burke’s and Williams’s thinking" and also points out "how naturally Williams’s roles as doctor and poet combine with Burke’s closely related roles of ’Cure’ and ’Pontificate.’ If, along with this coincidence, we remember that the word ’Semiotic’ comes from the Greek meaning ’concerned with the interpretation of symptoms’ and was used by d’Alembert in his ’Tree of Knowledge’ to describe that branch of medicine concerned with diagnosis, we can begin to see how Williams’s own concern with history, culture, and the word becomes the way in which he can extend his diagnostics beyond the individual to embrace both the language and the community, providing both with cure and consolation." (p. 7)
Bremen develops his argument in four chapters: Chapter 1: "Finding the Poetry Hidden in the Prose," in which Bremen lays the groundwork for his discussion of Williams’s views on poetry and prose and introduces key figures in Williams’s thinking and/or Bremen’s analysis, e.g., Kenneth Burke, Heinz Kohut, and Ludwig Wittgenstein; Chapter 2: "The Language of Flowers," in which the author uses the psychology of Jessica Benjamin and the botany of Erasmus Darwin to demonstrate how WCW’s poetry eventually shares in a "more feminine, ’mother-based’ psychology that privileges the "narcissistic" over the "oedipal" (p. 46) while his "more modern language of flowers moves beyond these simple associations to act as ’representative anecdotes’ that embody a complex notion of ’empathy’ and ’identification,’ one that both empowers and even attempts to ’cure’ the reader." (p. 45).
Chapter 3: "Modern Medicine," is of especial interest to the readers of this bibliography, and a chapter heavily dependent on the relationship between Burke and Williams and the critical evaluation of the latter by the former. This chapter argues that "it is precisely Williams’s role as a doctor and its symbiotic--not merely complementary--relationship to his role of poet that provides the clearest model of Williams’s aspirations for his writing. Specifically it is the act of diagnosis that is at the core of both Williams’s medicine and his poetry." (p. 85).
In chapter 4, Attitudes toward History, Bremen offers a critical reading of WCW’s In the American Grain, an American history text as WCW felt history should be written and understood--a thesis Bremen successfully compares to WCW’s analogous views about poetry and prose. Chapter 5, The Radiant Gist, a chapter devoted primarily to Paterson, Books I-IV, serves as well as a coda to the book.
The now famed American poetess, Sylvia Plath (Gwyneth Paltrow) is a Fulbright scholar at Cambridge, England in 1956. Angered over a stinging review of her work by the literary roué Ted Hughes (Dennis Craig), she is then charmed by his poetry and blatantly sets out to seduce him. They marry soon after.
Sylvia had tried to commit suicide several times in her youth. Recalling one terrifying near miss, her cold-seeming mother resents Hughes, sensing the power in passionate love to harm her fragile, brilliant daughter. The initially torrid life that Ted and Sylvia share in both America and in rural Britain, grows tired through the strain of two children, her lack of joy in teaching, and his greater poetic success, all of which seem to stifle her creativity.
It ends because of his chronic infidelities, reduced in this version to a committed affair with a mutual friend, the thrice-married, Assia Wevill (Amira Casar), who becomes pregnant. Rage, jealousy, and depression become Sylvia’s muse. The more she suffers with Hughes, the more productive and poignant is her work. Unable to lure him back, she leaves buttered bread and milk for her children, seals the kitchen, and gasses herself to death.
Dr. Flaherty, a practicing neurologist, sets out to explore the act of writing and, more broadly, creativity, in the context of both neuroscience and emotion. She begins by describing several brain conditions that seem to enhance the need to write, even to the extent of obsessive hypergraphia. Next she turns to the opposite state, writer's block, looking at both psychological and neuroscientific perspectives.
Using some of the recent studies of the relationships between certain brain centers and language related phenomena, Flaherty further clarifies some of the cognitive bases for creating literature. Finally, the study turns specifically to the temporal lobe as the possible organic site of the perceived voice of the muse in religious and creative inspiration.
The author comments initially that most physicians become involved in the stories of their patients' lives--as witnesses, chroniclers, and players. He uses as an example the story of a physician's role in the death of Anton P. Chekhov. Another interesting example is the book, A Fortunate Man (see this database), the story of an English country doctor who matures in the profession and comes to recognize the task of the doctor as one to help his patients feel recognized.
Dr. Verghese believes that all patients seen by physicians are in the midst of a story that begins the moment they walk through the portals of a hospital or a clinic. He sees the challenge as engaging the patient and the family in finding an "epiphany," even if that epiphany is simply the understanding that there is nothing more that can be done medically. In his conclusion he says that as physicians we should be ministers of healing, storytellers, storymakers, and players in the stories of our patients and ourselves.
The author, Samuel Shem, opens these reflections by saying that he was a writer before he was a doctor. His early answers to questions about healing came from stories he read. "Life as it should be in addition to life as it is" became the "motor" of his writing. He loved stories that he heard from patients and the "few humane doctors" he met and decided he would be able to understand people better by writing about experiences with them.
Shem's experience as an intern spawned The House of God (see this database) and he sees writing about his training as an example of the use of resistance when he saw "something unjust, cruel, militaristic or simply not right." He recommends the following to resist the inhumanities in medicine: (1) Learn our trade in the world, (2) Beware of isolation, (3) Speak up, (4) Resist self-centeredness. He says that the healing essence of narrative is in "we," meaning the patient and the physician.