J Med Humanit (2013) 34:77–79 DOI 10.1007/s10912-012-9181-9

Ann Jurecic’s Illness as Narrative Book Review (University of Pittsburgh Press 2012, ISBN 978-0-8229-6190-1, $24.95, 178 pp. Paper) Arthur W. Frank

Published online: 28 August 2012 # Springer Science+Business Media, LLC 2012

Illness as Narrative makes its case more by demonstration than by theorized argument, and that case is quite specific. Jurecic writes that “accounts of illness have become central to the literary branch of medical humanities” (2). She eloquently and concisely describes the medical humanities interest in illness narratives as: “how narratives about suffering sustain individuals and communities … how autobiographical illness narratives reclaim patients’ voices … how literary, popular, and medical narratives report and construct the experience of illness…”(3). Then comes the focus of Jurecic’s argument: “Such an approach to personal narrative is, however, out of step with mainstream literary criticism, which has not, by and large, recognized the significance of the work performed by such texts” (3). Illness as Narrative seeks to fill the “gap between the pragmatic work done by medical humanities in professional schools and the theoretical projects of scholars in the academy” (3). Before proceeding to details of how Jurecic understands this gap, two points of disclosure are necessary. First, Jurecic is book review editor of Literature and Medicine, of which I am a Contributing Editor, and over the last years she has commissioned the reviews I have written in that journal. Second, I am one of those whom Jurecic cites to exemplify the medical humanities stance, along with Howard Brody, Rita Charon, Thomas Couser, Anne Hunsaker Hawkins, Arthur Kleinman, and David Morris, among others. Situated as I am on one side of the gap between “pragmatic work” and “theoretical projects,” I am not sure whether I underestimate this gap, not seeing it as a problem, or overestimate it, treating certain literary critics as Others. Who feels affected or constrained by this gap, with what effects on their work, is an open question. Jurecic argues that “mainstream literary criticism” is dominated by “practices that are based in what Paul Ricoeur called the hermeneutics of suspicion” (3, original emphases), but with a twist. Ricoeur’s original formulation balanced “the willingness to suspect” with “the willingness to listen” (3). Citing literary critic Eve Kosofsky Sedgwick, Jurecic asserts that suspicion has displaced listening. “For scholars trained in such habits of reading, the idea of trusting a narrative to provide access to the experience of another person indicates a naive understanding of how such texts function” (3). A. W. Frank (*) University of Calgary, Calgary, Canada e-mail: [email protected]

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Medical humanities scholars would not understand a narrative’s access to experience as being unmediated, but access to experience is a goal, with individual colleagues qualifying differently what counts as experience. Jurecic’s primary concern, however, is not addressing her medical humanities colleagues. Instead, Illness as Narrative is directed to what she calls “mainstream literary criticism.” Jurecic’s goal is to offer such critics “other options, interpretive approaches that enable them to assemble meanings in the face of life’s fragility” (4). The primary option is what Sedgwick calls “reparative readings” (104–5), but more of that later. Jurecic’s question is: “What alternatives to suspicion are available as readers, especially critics, seek to understand narratives of illness that are overtly cathartic, therapeutic, or personal?” (11). Jurecic’s main example of suspicion dominating critical instincts (among only two examples, the other being Lauren Berlant) is Arlene Croce’s famous/infamous 1995 manifesto against what she called “victim art” (12 ff.). Jurecic summarizes “the critical stakes” neatly: “on one side stands the dispassionate critic who is suspicious of art that elicits sympathy or empathy; on the other is the empathic critic who seeks to acknowledge the suffering bodies at the center of art” (13). My own gloss is that Croce wants to defend the power of the critic to evaluate without feeling constrained to acknowledge the life circumstances of the artist or the “real lives” of those depicted in or performing the art work. Jurecic correctly notes that Croce sees herself as a critic of power and is suspicious of how claims of sympathy can mask operations of power. Ironically, I see Croce defending her own power as a critic, specifically the power to proclaim judgments. Jurecic herself asserts critical judgments throughout the book, both negative and positive; for example: Susanne Antonetta’s literary experiments “do not always succeed” (33); the ending of an Ian McEwan novel has an “overtly manufactured quality” (38); and Susan Sontag’s The Volcano Lover is judged to be “an achievement” (80). As Jurecic recognizes, such pronouncements are not the objective of medical humanities writing. The term “victim art” certainly has passed into common usage, but Jurecic does not assess how many critics agree with Croce and what influence they have. Nor need she, on my reading. Against Jurecic’s primary goal, I read her work in terms of what it adds to medical humanities. The value of Illness as Narrative depends on what insights Jurecic brings to the illness narratives that she proceeds to discuss. The limitation of this review is my inability to speculate whether literary critics will be influenced by the “other options” that Jurecic seeks to exemplify. The book’s chapters are cumulative in their effect, if independent in their respective analyses. Chapter 2 opens with the sociologist Ulrich Beck’s much cited idea of risk society. Jurecic poses the question: “What kinds of stories emerge and flourish in such conditions?” (19), a formulation that is classic sociology of literature. She discusses a diverse array of texts on the topics of living “in prognosis” with the risk of a life-threatening but yet latent disease, living with genetic risk, and “literary risk” which is how literary authors make risk a topic. Chapter 3 takes up the problem of representing others’ pain and the tension between representation and response. Jurecic’s main foil in this discussion is Elaine Scarry’s influential The Body in Pain. On my reading, one of the two major contributions of Illness as Narrative is to question how correct Scarry’s thesis is: does pain “unmake” the body’s capacity for language? Jurecic takes the side of literary scholar Martha Stoddard Holmes, who writes that “her own body in pain has been ‘a site not of language erosion but language generation’” (55). The discussion of Scarry is too nuanced to allow brief summary, but the upshot is a very useful reframing of what ought to be fundamental in analyzing representations of pain: “The question is not how to find words for pain, but rather, who will listen and what will they hear?” (44). If the critique and reframing of Scarry’s work is one of Jurecic’s singular contributions, the other is her reading of the career of Susan Sontag, morphing from Sontag’s life-long engagement with representations of suffering to representations of Sontag’s own recurrences

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of cancer, including the controversial photographs taken by Annie Leibovitz and the memoir by Sontag’s son, David Rieff. This chapter is the most successful for me because it is structured by the chronology of Sontag’s changing ideas and the tension of Sontag’s reversal of expressive practice. Her early work is suspicious of stories, which she groups with photographic images of suffering. The early Sontag argued “that repeated exposure to images of horror threatens both ‘conscience and the ability to be compassionate’” (72). She believed in “the superiority of the critical essay over personal narrative” (72) and avoided any references to her own cancer in her landmark Illness as Metaphor. Although many people talk about this book as if it were a personal narrative, Illness as Metaphor is an anti-personal narrative. Sontag may not have changed her opinion of photographs, but she came to believe that “Narratives can make us understand” (82). More important, she became a storyteller: “I thought I was a ruminator … And then I discovered that I liked to tell stories and make people cry” (76). Jurecic’s discussion of The Volcano Lover did not make me cry, but it does bring together the diffuse stands of Sontag’s project and display both her changes of literary practice and consistency of purpose. To adopt the prose of critical pronouncement myself, the chapter is an achievement of intellectual summation. Chapter 5 attempts to knit together an autobiographical story from Stephen Greenblatt, the (possibly) dying reflections of Michel Foucault, and Sedgwick’s reparative reading, which is then applied to Jean-Dominique Bauby’s The Diving Bell and the Butterfly. Exactly what distinguishes reparative reading remains unclear to me, which may be my problem. What makes most sense to me is Sedgwick’s statement of her goal: “to assemble and confer plenitude on an object that will then have resources to offer to an inchoate self” (106, 108). I could write that about my own work, so perhaps I am projecting my interests onto an elliptical formulation that is open to multiple interpretations. If I missed exactly how reparative reading makes possible a distinctive understanding of Bauby, the point may be for a literary critic to be able to read Bauby at all, rather than dismissing his work as victim art. The final chapter also seeks to exemplify reparative reading, now focused on Anne Fadiman’s The Spirit Catches You and You Fall Down, which has become one of the most influential narratives in American medical education. The tension of the chapter is provided by the anthropologist Janelle Taylor’s criticism of how Fadiman’s work is understood and used by medical educators. Taylor’s critique sets up Jurecic’s final demonstration of reparative reading. Those who read Fadiman expecting some form of authority are mistaken. Instead, reparative reading notes how Fadiman continually unsettles how the story is told and what counts as knowledge both among those in the story and among Fadiman’s readers. The Spirit Catches You is a reparative text because it works by progressive complication on multiple levels. Predictably, Fadiman’s mode of telling has a problem with its ending. Closure risks imposing some final form or message that would solidify what Fadiman has worked to keep open and in process. Jurecic has the same problem. She makes no attempt at conclusion, but simply leaves her final textual discussion to resonate in readers’ critical awareness. Full-length studies of illness narratives remain rare, and Jurecic’s work is a welcome contribution. The basic dictionary definitions of reparative are, first, to make amends, and secondarily, to repair. Jurecic makes amends for past critical neglect of illness narratives, and she repairs several misunderstandings, especially about Scarry and Sontag. Whether and how Illness as Narrative will change anyone’s critical practice is not for me to predict. The book is filled with insights about the nature and goals of narrative, and its specific readings of fictional and non-fictional texts nicely fulfill Sedgwick’s goal of making these available as resources for selves whose feeling of being inchoate is both a result and cause of suffering.