Summary:

In Illness as Narrative, Ann Jurecic thoughtfully examines the unruly questions that personal accounts of illness pose to literary studies: What is the role of criticism in responding to literature about suffering?  Does the shared vulnerability of living in a body, which stories of illness intimately expose, justify empathic readings?   What is the place of skepticism in responding to stories of suffering?  Does whether or how we read illness narratives matter?  Jurecic's questions entice discussion at an interesting cultural moment.  The numbers of memoirs and essays about illness—and their inclusion in medical school and other humanities courses—multiplied from the later decades of the 20^th century to the present.   However, their increase, and their potential to encourage empathic readings, coincided with dominant literary theories that advocated vigorously skeptical, error-seeking responses to texts and their authors.  Jurecic reminds us that Paul Ricoeur called such responses "the hermeneutics of suspicion" (3). 

Jurecic's astutely researched, nuanced answers to those questions propose a corrective to the extreme skepticism of "disembodied criticism." Such criticism, she claims, dismisses testimonial writing from "a position of distance and privilege."  But her answers also affirm that intellectually "rigorous" responses to texts are central to the critical humanities (15).  To further her position, she offers attentive readings of accounts of illness by Virginia Woolf, Reynolds Price, and Jean-Dominique Bauby, as well as the theoretical writing of literary and other scholars.  For instance, Jurecic speculates that the condition of a reader's body aligns with his or her responses to texts.  In a chapter called "Theory's Aging Body," she observes that as skeptical scholarly readers age—Stephen Greenblatt, Michel Foucault, Judith Butler—they have turned their attention to "illness, vulnerability, and mortality" (93).  Jurecic also suggests that a function of criticism is to uncover the cultural conditions that memoirs and essays about illness respond to.  Living "at risk" is a recent one.  In stories of living with the risk of experiencing a particular illness in the future, potential patients create narratives of uncertainty to discover the "personal meaning of the impersonal statistics" that medical research now regularly delivers (18). 

 Jurecic also reflects on the ways theorists have understood the possibilities of representing and responding to pain in the varied approaches of philosophers Elaine Scarry, Martha Nussbaum, and Richard Rorty and of anthropologists Jean E. Jackson, Byron Good, and Veena Das.  In an exceptionally comprehensive and nuanced reading of Susan Sontag's theoretical, fictional, and journal writing about suffering, Jurecic uncovers Sontag's inconsistent, yet revelatory positions on the human capacity for responding to representations of pain.  The chapter on Sontag is enriched by Jurecic's reading of Annie Lebovitz's and David Reiff's responses to Sontag's suffering: in Lebovitz's controversial photographs of Sontag's final days (included in A Photographer's Life: 1990-2005) and Reiff's memoir about his mother's illnesses (Swimming in a Sea of Death). 

Illness as Narrative closes with examples of what Jurecic calls reparative writing and reading practices.  In the first instance, ill writers such as Jean-Dominique Bauby (The Diving Bell and the Butterfly) both recreate "a more coherent sense of themselves" and dislodge "fixed ideas and narratives" about illness (109).  In the second instance, Jurecic outlines the limits of two competing readings of Anne Fadiman's The Spirit Catches You and You Fall Down.  One assumes that readers will by nature empathically imagine those who are culturally different from themselves.  The other looks skeptically at the assumption that what medical educators call cultural competence can be acquired by reading a book.  Jurecic suggests that strategies for reading and teaching informed by Janelle S. Taylor, Eve Kosofsky Sedgwick, and Rita Felski can encourage more complex habits of response, such as Taylor's "'empathic curiosity'" (quoted 122).

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Dr. Jennifer White, age 64, is read her rights in a Chicago police station. But how much does the retired orthopedist who specializes in hand surgery really understand? Dr. White has Alzheimer's dementia. Her score of 19 on a mini-mental state examination (MMSE) is consistent with a moderate degree of cognitive impairment. She is questioned about the death of a neighbor, 75-year-old Amanda O'Toole, who lives 3 houses away. Amanda happens to be Dr. White's best friend and the godmother of her daughter. Amanda died at home, the result of head trauma. Four fingers of her right hand were cleanly and expertly chopped off. It seems that Dr. White is genuinely incapable of recalling whether she committed a murder or not. The physician is not charged with the crime but remains a suspect.

Dr. White's memory and mind are no longer reliable. In her lucid moments, she jots down notes in a journal. She dubs the notebook her "Bible of consciousness" [5] and it assists her in filling in the blanks of her past life. Her husband James has died. She has approximately $2.5 million of financial assets. Her two adult children - Mark and Fiona - squabble.  Throughout the course of her disease, family secrets are revealed and intimate details are exposed. Relationships fray.

Despite a slew of prescription medications (galantamine, an antipsychotic, an antidepressant, and a benzodiazepine as needed), Dr. White's mental status and behavior deteriorate. Her confusion, wandering, forgetfulness, and episodes of agitation worsen. The story is structured in four sections, based on the residence of the protagonist: First is Dr. White's time in her own home aided by a live-in caregiver, Magdalena. Next is her stay in an assisted living facility. Then she briefly escapes from that place and has a 36 hour adventure of sorts. Finally, Dr. White is incarcerated in a state mental health facility.

Ultimately, the circumstances of Amanda's death are made known. And while Dr. White did not kill her best friend, the surgeon was present at the scene with a scalpel in her hand. Another character was there too.

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A small stone island sits in the middle of a body of water. No other land is visible. Within the apparently naturally formed stonewalls that constitute the island’s perimeter, vestiges of man-made dwellings are apparent. On the left-hand embankment, the front of what appears to be a white house is visible albeit only slightly. On the other side of the island, doorways or windows have been carved out of the rock itself. Below the front most door some white paint has been added, as though to signify the fading presence of man’s creations on this island.

The center of the island opens up as a bay of sorts. In the middle of the bay and island, large vertical trees similar in appearance to Cyprus trees stretch all the way up past the stone and to the very top of the painting. Nothing of the island is visible through the dense trees. One solitary boat with two passengers makes its way into the middle of the bay. One passenger controls the oars while the other stands erect, as though a statue, and is completely white. At the front of the boat sits a box that looks like a coffin.

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On the viewer's right, in receding repetition, are narrow, numbered, blue wooden, open stalls.  Inside the stalls, and only partially visible, people are standing, dressed in street clothes, either alone or in couples, their coats still on.  In the most forward stall there are no people--only two coats that hang from coat hooks, their owners no longer "waiting."  The stalls are open at bottom and top and are illuminated by repeating fluorescent ceiling tubes.  In the lower right foreground sits a bald man dressed in a blue jacket and brown pants who looks down the narrow corridor from which the stalls branch off.  In the lower left foreground is a bench on which two men are dozing -- one man leans forward with his head tilted down, his face obscured by the hat he is wearing.  The other man has his eyes closed, his head tilted backwards.  Both are still wearing their coats.

Standing in front of the dozing men, all the way to the viewer's left, is a looming figure -- a man who stares out at the viewer, his thick glasses hiding his eyes, his mouth turned down in a suspicious frown.  He wears a dark blue coat and a brown hat.  Scraps of paper and possibly cigarette butts litter the floor in front of the sitting men. Blue is a prominent color in this painting but some of the figures wear bright red sweaters, shoes, or a dress, and a red scarf hangs from one of the hanging coats.  These individual touches of color seem to represent attempts by the sequestered people to preserve both their individuality and vitality.

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Simon Bear is a hard-charging physician; his wife Emily is a successful public relations executive, now a senior partner in her firm. Although they have a lavish house, a teen-aged daughter, and much wealth, their marriage is troubled, in large part because they have never fully mourned the death of their baby Caleb.

The title “Remedies” fits well with the long struggle for how to heal their grief. The remedies that clearly have not worked are obsessions with career, professionalism, rationalism, and the trappings of American materialism.

Simon has two obsessions about his practice. The first is that he is a rescuer, the perfect doctor who listens to his patients and gives them what they want. As a self-appointed expert on pain, he is free and easy about prescribing opiates. When his father-in-law feels no pain after a car accident, Simon is sure that a drug that the man is taking is, in fact, the Holy Grail of pain medications. Simon becomes obsessed with this “discovery,” promoting it to his patients, without a scientific study or consideration of ethical implications. When he flies to a national medical meeting to trumpet the news of this remedy, no one will listen to him.

While Simon is the point of view for Parts One, Three, and Five, Emily—structurally separated—is the voice and focus of Parts Two and Four. She is troubled by her distance from Simon and, increasingly, her 13-year-old daughter, who is sullen and rebellious. When she meets Will, a former lover, she seeks another kind of remedy in an affair with him, even prospects of marriage. Contrasting with her strategic, rational approach to life, Will is an open, easy-going man, conveniently separated from his wife.

A series of crises rock Emily, then Simon. Emily begins to understand her anger; she has a breakthrough with her daughter. Simon has several setbacks, including humiliations, but he is not crushed. Although ordinarily a secular Jew, Simon attends the Kol Nidre service the evening service before Yom Kippur, the Day of Atonement. In a powerful and moving passage, he finds healing, relief, and a new direction for his life—a true remedy.   

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In this satirical etching, a recumbent, slack-limbed man is attended by two shadow background figures (one of whom may be his wife) and his physician--a fashionably attired ass! The ass/physician is searching for the pulse of his patient, a pose that accentuates the ostentatiously large gem encircling his hoof.

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The foreground of this painting is dominated by a "pieta" type grouping. One woman hovers closely over what appears to be a dying man, while another comforts a small child. This part of the canvas is underlighted. The colors are rich earth tones. The figures are non-Caucasian.

In the background, in harsh light, is a group of identical looking starkly white men. In fact, their faces are almost skeletal. All are in suits, three are seated, with four others standing behind the seated figures. They look very much like a "tribunal."

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This striking painting seems to embody the "mania" of the morphine addict--the wild hair (particularly the unnatural upward curve of several strands); the brilliant color; the reckless glimpse of stocking; and the mixed sense of urgency and pain in the face of the young woman as she injects the drug into her thigh. The painting is a "close-up" of this desperate figure--the viewer is not offered any safe distance from her image.

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Large blue circular eyes stare up from this frontal self-portrait. The sclera is visible underneath the eyes, which reflect the same washed blue of the background. This blue is as startling as, and reminiscent of, the green background of a Van Gogh self-portrait. The visage is grimly determined and the mouth a thin-lipped line. Ears are large and the shoulders blend into the background. He is thin and somewhat haggard.

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Summary:

Unfortunately,the archive as described and annotated here is no longer available on line. The quotes, summary, and commentary below are nevertheless worth reading. Some images may be found as noted in Miscellaneous below.

Powerful series of self-portrait photographs documenting the artist’s fight against breast cancer, accompanied by a narrative describing her responses to the medical community. In early images, Spence undergoes mammography, lumpectomy, and finally, mastectomy (images 1-3, 5). These "clinical" images provide a temporal narrative of the course of Spence’s "illness," while concomitantly tracing the inter-relationship between the corporal/medical and the artistic body. In so doing, Spence calls into question medical notions of autonomy and ownership, while re-claiming her "right" to the representation of her body-parts.

In later images, Spence rejects Western medicine, in favor of alternative therapies such as acupuncture (image 4) and phototherapy (image 6). As Spence writes: "Women attending hospital with breast cancer often have to subject themselves to the scrutiny of the medical photographers as well as the consultant, medical students and visiting doctors. Once I had opted out of orthodox medicine I decided to keep a record of the changing outward condition of my body. This stopped me disavowing that I have cancer, and helped me to come to terms with something I initially found shocking and abhorrent."

Supporting text by Terry Dennett (Curator, Jo Spence Memorial Archive) at the end of the series of images provides additional excerpts from Spence’s writing, and several useful links to breast cancer awareness sites.

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