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COMPANIONS IN THIS AGE: A STUDY OF PAIN IN CANADIAN LITERATURE COMPANIONS IN THIS AGE: A STUDY OF PAIN IN CANADIAN LITERATURE By SHANE NEILSON, BSc MD MFA MA A Dissertation Submitted to the School of Graduate Studies in Partial Fulfillment of the Requirements for the Degree of Doctor of English McMaster University © by Shane Neilson, Nov 2018 McMaster University. DOCTOR OF PHILOSOPHY (2018) Hamilton, ON (English) TITLE: Companions in this Age: A Study of Pain in Canadian Literature. AUTHOR: Shane Neilson, BSc MD MFA MA. SUPERVISOR: Professor Lorraine York. NUMBER OF PAGES: 294. ii I shout love at petals peeled open by stern nurse fusion-bomb sun, terribly like an adhesive bandage, for love and pain, love and pain are companions in this age - Milton Acorn Practically everything should be seen as itself pure and simple, so far as we can comfortably see it, and at the same time not as itself, so far as we can comfortably see it, and then the two views should be combined, so far as we can comfortably combine then. If we cannot comfortably combine them, we should think of something else. - Samuel Butler Yes for a time they held as well Together, as the criss-cross’d shelly cup Sucks close the acorn: as the hand and glove: As water moulded to the duct it runs in: As keel locks close to kelson – Let me now Jolt Shake and unset your morticed metaphors - Gerard Manley Hopkins iii TABLE OF CONTENTS Epigraph iii Introduction: Provocations for the Canadian Medical Humanities 1 Chapter 1. Fielding: Humanities Frameworks for Medicine and Canadian Literature 33 Levinas and Pain 33 Metaphor and Pain 39 Narrative Medicine, Indigenous Story Medicine, and Pain 61 Disability Studies and Pain 85 Putting These Contexts in Relation 92 Chapter 2. Pain and Early Canadian Literature 96 Chapter 3. Pain and Modern Canadian Literature 126 Chapter 4. Pain, Settler Literature, and Indigenous Literature 183 Chapter 5: Between Bodies: A Poetics of Pain 230 Conclusion 269 Works Cited 276 iv Ph.D Thesis – S. Neilson; McMaster University – Dept. Of English and Cultural Studies INTRODUCTION: PROVOCATIONS FOR THE CANADIAN MEDICAL HUMANITIES In addition to being a practising physician with a focus on adolescent and adult mental health, I am also a practising poet interested in representing affective disability for a constructive purpose in society. Switching between these two hats, I have daily truck with the restorative powers of narrative and poetic representations of recovery and loss. My third hat – that of a scholar interested in representations of medicine in Canadian literature as well as the pedagogical use of narrative within Canadian medicine – creates a complex set of interrelated interests and entanglements that are uniquely suited to conceptualize the problems people have when seeking to describe and ameliorate painful experience. These problems become ones physicians encounter daily in their clinics, but usually on biomedicine’s terms. I want to change that, and this dissertation tries to encourage a reorientation towards other kinds of knowledge and knowing, especially in the case of pain. A negative biomedical definition locks pain into a corresponding negative register of expression. It is no surprise that this definition tracks exactly with the medical model of disability in which impairment is placed in the body of the disabled person and their life can only be conceived of as a deviation from an able norm. But what would happen if not necessarily negative representations of pain experience could be developed? Would they alleviate suffering in the real world by freeing pain experience from obligatory suffering? Metaphors structure our experience. By extension, metaphors either serve to reinforce or disrupt normativity. The creation of not necessarily negative metaphors both 1 Ph.D Thesis – S. Neilson; McMaster University – Dept. Of English and Cultural Studies based within and without the body could act to alleviate suffering structured by the present hegemonic metaphorical regime. To resist the power of biomedicine and possibly improve the plight of persons in pain, I will engage in – to borrow a term from biomedicine – a “multivariate analysis” that considers metaphor, disability studies, intersubjectivity/witness studies, and Indigenous knowledges as its interdependent variables. I will conduct a performative, as opposed to representational, analysis of canonical and contemporary Canadian poetry and fiction using terms and concepts from the aforementioned fields. This performative strategy is meant to follow in Shoshana Felman and Dori Laub’s footsteps, attempting to add to a theory of a nonrepresentational but performative relationship between art and culture. Perhaps this theory is one that can make key insights between pain and intersubjectivity beyond those of the linear, representational kind. Settler-Indigenous relations are a key instance of intersubjectivity theorized in this dissertation for good reason. In “Learning to See Relationally,” a chapter in Robert Ross’s Indigenous Healing: Exploring Traditional Paths, Ross describes an encounter with an Anishinaabe grandmother, writing that “[t]o her, the real essence of Creation lay in what was going on between things” (italics preserved, 8). Ross’s book (mentioned in more detail later in the dissertation) is cheering to me because it seems as if there is a possibility of understanding that is building on the settler side in Canada. Indigenous Knowledge is derived from the land. But so is metaphor, as Steven Pinker has posited: “the methodical use of metaphor in science shows that metaphor is a 2 Ph.D Thesis – S. Neilson; McMaster University – Dept. Of English and Cultural Studies way of adapting language to reality, not the other way around, and that it can capture laws in the world, not just project comfortable images upon it” (qtd. in Donaldson 14). Is the distance between pain, land, and literary studies too far? If it seems so to the reader of this dissertation, perhaps someone who has already experienced pain and who will be treated for pain in the future, then that very distance shows why a humanities- based aesthetic approach is important. Telling the story of the etymology of the words “pain” and “aesthetics” is to enact the argument I make about pain: that it can be theorized and treated by literature by turning away from medical discourse. As Rob Boddice explains in his wide-ranging Pain: A Very Short Introduction, “Modern English has separated out pain (a physical feeling of hurt) from suffering, with all of the latter’s emotional connotations” yet in the ancient world, there was no “clear distinction between pains of the body and pains of what we might call an emotional nature” (6). After explaining some of the Greek and Latin terms from antiquity that combine physical and emotional dimensions of pain, Boddice clarifies his point by admitting that vernacular English, too, preserves the linkage of emotion and pain, but that the medical and philosophical project of biomedicine has been to insist and enforce a dualism of mind and body to our collective detriment, resulting in a medical discourse that separates sensation from suffering as a means to isolate consciousness from physiology. This is as odd as would be separating the “concepts and speech and thought” from “logos” (6). It is on this exact point that I make this dissertation’s stand against biomedicine, already rightly critiqued by so many already in terms of its responsibility for the current plight of persons in pain. But whereas Boddice calls the language to express pain a mere “epiphenomenon” 3 Ph.D Thesis – S. Neilson; McMaster University – Dept. Of English and Cultural Studies of pain experience (108), I maintain that the language we have to express pain is not only a representation of the problem of pain but a key part of the problem that needs to change. We have a long way to walk pain back, for the etymology of the English word “pain” is poena, Latin for punishment. The Greeks linked medicine to aesthetics, or aisthetikos, which means “aesthetic, sensitive, sentient,” making the word for the study of art linked to both sensation and consciousness. Furthermore, the antecedent form is aisthanomai, which means “I perceive, feel, sense.” Thus, how we interpret art – and pain – connects with our larger ways of being in the world. Pain is in need of an aesthetic approach for not only treatment but also the purposes of interpretation and definition. These three different processes inform one another and allow pain to be wrested from ineffectual, unproven, and even harmful conventional treatments, definitions, and practices. When defined as pain lasting for more than three months, chronic pain is common (Harstall and Ospina 1). A review in 2012 suggested that 15-29% of the Canadian population experiences chronic pain (Fischer and Argento 192). Unfortunately, the outcomes for pain management are poor (Kamper et al. 1). Medical management of chronic pain may even be worsening the problem: globally, Canada is the second-highest per-capita consumer of opioids (UNODC 30); Ontario has seen a 250% increase in opioid-related emergency department (ED) visits from 2005-2011 (The Way Forward 10); and some First Nations in Canada have declared a community crisis owing to the prevalence of the harms associated with prescription drugs (Graveland n. pag.). Another problem of pain management’s lack of efficacy is economic: chronic pain costs the 4 Ph.D Thesis – S. Neilson; McMaster University – Dept. Of English and Cultural Studies Canadian economy in the tens of billions a year in lost productivity (Phillips and Schopflocher 44). Why is Canadian society’s prescription drug problem escalating? Why is the benefit experienced by patients in medical pain management regimes so modest? Part of the explanation lies in the fact that the responsibility for pain management in Canada largely rests with physicians who overwhelmingly approach illness from a biomedical perspective.

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