Article Text

Book review
Illness as Narrative
  1. Kathy Behrendt
  1. Correspondence to Dr Kathy Behrendt, Department of Philosophy, Wilfrid Laurier University, 75 University Avenue West, Waterloo, Ontario, Canada N2L 3C5; kbehrendt{at}

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Ann Jurecic. Published by University of Pittsburgh Press, 2012, paperback, 192 pages. ISBN 978-8229-6190-1, £21.50.

With Illness as Narrative, Ann Jurecic seeks to reclaim the validity of illness narratives from the still dominant ‘hermeneutics of suspicion’ in literary criticism and its allies. That widespread faction, when not ignoring illness narratives entirely, tends to dismiss them for their earnestness, naïveté, subjectivity and affectivity. Illness narratives are pragmatic and not theoretical. Like much life writing, they disregard the social, political and cultural powers that shape discourse, and therefore, they simply fall out of the jurisdiction of legitimate scholarly consideration. Or so the criticisms go. Jurecic does not wish to discount the established critical climate, but to expose its inadequacies, in particular, its neglect of our ordinary motives for writing and reading illness narratives. It is these motives that she thinks must be brought to bear in any serious critical treatment. She looks first at the history of personal accounts of illness, and then devotes separate chapters to risk narratives, narratives about pain, Susan Sontag's seismic shift from theory to fiction, the changes that have occurred in theory, and the prospects for reforming how illness narratives are read. Throughout, Jurecic supplies important lessons for readers of these texts, be they theorists, educators in the medical humanities, or the general public.

Many well-chosen examples of illness narratives illustrate her case, including novels, journalism, ethnography, memoirs (‘misery’ and otherwise), conventional tales of struggle and recovery, genre-busting experimental works, and the narratives of some who would normally be most comfortable on the theoretical side of any theoretical/pragmatic divide (eg, Foucault, Stephen Jay Gould, Sontag, Bruno Latour). Jurecic is exceptionally sensitive to the individual character of each of her chosen texts. She accepts that not all live up to the expectations of conventional narrative, while others exploit those conventions in such a fashion as to undermine their own insights. Her relation to narrative is complex and occasionally ambivalent, and that it is so makes her book stimulating and worthwhile.

Jurecic's probing gaze is not confined to writers and their texts; she also takes readers to task. She cites the case of Stephen Jay Gould's ‘The Median Isn't the Message’—an essay that concerns how a sophisticated understanding of statistics and probability allowed him (correctly) to surmise that his odds of surviving cancer were considerably higher than average. This piece is often read as a general message of hope, rather than a specialised analysis of a particular and rare case (and, perhaps, a general warning about statistical analysis). A similar observation is made of Jean-Dominique Bauby's The Diving Bell and the Butterfly; again, there is a gulf between the actual content and tenor of the text, and its public reception—in the latter we find hyperbolic descriptors such as ‘triumphant’, whereas the work itself is riddled with an irony that often scarcely manages to hold distress at bay. The sensitive reader will recognise that even the ‘reparative writing’ of illness narratives can be complex and equivocal. This salient lesson is extended to other difficult texts that Jurecic discusses, such as those attempting to convey the putatively indescribable experience of severe or chronic pain, or those involving cross-cultural rifts in comprehending subjects’ actions and explanations (Anne Fadiman's The Spirit Catches You and You Fall Down is the notorious case in point here). Jurecic implies that the alleged shortcomings of such works may be partly a product of how they are read. ‘Writers’, she notes, ‘are pressed by circumstances to address how the experience of illness causes fixed ideas and narratives to fall away’ (109). The corollary to this is that readers must be attuned to these complexities if they are to extract the true value of these works; the critical community should reconsider rather than merely retreat to its established categories, and the everyday reader should also recalibrate her narrative assumptions and expectations.

Jurecic's own sensitivity to the differing techniques of illness narratives comes to the fore on several occasions, including her treatment of closure. She singles out David Rieff's Swimming in a Sea of Death as noteworthy (like Gould's article) for what it does not tell us, that is, for its vehement rejection of narrative resolution through emotional closure. And she is critical of unearned closure when it occurs in memoir (Susanne Antonetta's Body Toxic) and in fiction (Ian McEwan's Saturday). But despite her incisive critical assessments, Jurecic takes all these works to involve ‘necessary fictions’, providing structure for meaning that statistics cannot. This notion is drawn out in her discussion of one of the most vivid shifts from a potentially open-ended to an explanatorily closed work: Darwin's infamous revision of the final paragraph of On the Origin of Species for the second edition. With the simple addition of a reference to the creator, Darwin turns the complex story of evolution into a simplistic one. Of this, Jurecic writes, ‘… post-Darwinian writers of risk narratives will always share the double bind the scientist finds himself in at the end of Origin of Species. They must balance the responsibility to remain true to a scientific view of the world with the desire to give meaning to lives lived in uncertainty. The narratives they create will be imperfect but necessary fictions’ (42).

This championing of ‘necessary fictions’ consciously borrows from Joan Didion's popular philosophy of narrative: ‘we tell ourselves stories in order to live’. But there is some risk of non-falsifiability with this thesis, given its power to absorb even texts like Rieff's. If the only alternative is a purely scientific analysis, it is no wonder that so much gets consigned to the opposing category of meaning-conferring narrative. The dichotomy, however, is questionable. Jurecic is evidently open to questioning it when she acknowledges some texts’ difficulties, failures, or active resistance to conforming to narrative tropes and expectations (and, perhaps worse, the depreciation of certain texts when they do so conform). But she closes off such questioning when she takes all these vastly different texts to, at base, support the same narrative impulse. It would be good, ultimately, to see a finer-grained taxonomy of that impulse. It can be difficult to accept that those who go out of their way to seek causal-erotetic closure where it is not to be had (eg, Antonetta), those who, after searching, bitterly renounce emotional comfort or resolution (eg, Rieff), and those who actively resist sympathy and empathy (eg, Sarah Manguso, in her memoir, Two Kinds of Decay), are each, at bottom, engaged in the same exercise.

This point, however, does not hamper the value and urgency of Jurecic's larger project to push back, on behalf of illness narratives, against the resistance of theory. She shows how the theoretical grip can become a stranglehold, citing the case of Stephen Greenblatt's epilogue to his book Renaissance Self-Fashioning, where he recounts an incident in which a man asked him for help in devising a means for communicating with a suicidal son. Greenblatt refused for (according to his retrospective analysis) reasons that conformed to and confirmed his own scholarly thesis about self-fashioning. Neither Greenblatt nor the critics who discuss the epilogue mention the human elements and ethical implications of this incident. It is simply exploited as an opportunity to analyse the theory. It is a small but striking example of the power of theory to displace human concerns, illustrating the possible extent of the divide between theory and pragmatics, along with the imperative to find means to bridge it. Jurecic ends her book on a hopeful note, demonstrating, in the final chapters, that criticism has shown itself capable of pluralism and compassion. Reparative writing and reading can exist alongside the paranoid practices of the hermeneutics of suspicion. We are entitled, as critics or simply as intelligent readers, not to take the content of illness narratives entirely at face value. At the same time, we should recognise that theory alone cannot capture or compensate for what can be gained from attentiveness to any individual tale of suffering, pain or illness.

Jurecic is surely correct that people's motives for writing and reading illness narratives are not reflected in, and not satisfied through, the hermeneutics of suspicion; neither are they always reflected in, or satisfied by, the examples she herself provides. Many readers do not want Rieff or Manguso. Others, in the very face of Gould and Bauby's own careful and reticent words, can extract, as if by magic, an unalloyed message of hope and redemption. And some writers will succumb to such expectations even while others stringently resist them. When we focus on the motivations of writers and readers, we come up against the sheer variety and complexity of such motives. Jurecic's choice of texts, their range, and her astute analysis of them, outruns the relative straightforwardness of her initial thesis, complicating the questions of why we write and read illness narratives, and how we might read them better. It also lays the foundation for this important discussion to continue.

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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