Chapter 5 Speaking For, Not With
No matter how committed health professionals are to treating patients with empathy and to respecting them as people, as individuals who have identities and lives beyond their health conditions and who have their own complex and powerful stories, interactions with patients often do not go as planned. In In- ferno: A Doctor’s Ebola Story (2017), Dr. Steven Hatch recognizes that despite his best efforts to be a “sensitive and caring physician” in the eyes of Josephine, a young girl who died of Ebola four days after being diagnosed, he was “a monster – her own personal monster.” Hatch also believes that by separating mother and daughter, as he had no choice but to do to prevent Ebola from spreading further, he “facilitated a horror from which Josephine’s mother will never fully recover” (2017: 145). Hatch had done his best to ease Josephine’s transition from the “suspect ward” to the “confirmed [Ebola] ward,” having first “reviewed [to myself] all the lessons I have ever taught my students about how to make a connection with patients,” including trying to make them feel as comfortable as possible being conscious of nonverbal signals; speaking with them slowly, gently, and at eye level; and holding their hands (144). But Jose- phine would have none of this, instead recoiling into her mother’s arms, a per- fectly understandable reaction considering both her age and Hatch’s protec- tive gear, which made him look like “a monster, a faceless creature in yellow whose eyes were the only part visible, and barely so, hidden behind the mist of the goggles” (144). Hatch admits that his misplaced smugness regarding his ability to communicate with his patients and earn their trust continues to gnaw at him years later. Similarly, the sixth part of Serbian writer Zoran Živković’s (Зоран Живковић, 1948–) mosaic novel Sedam dodira glazbe (Seven Touches of Music, 2001) de- scribes a physician, Dr. Dean, doing his best to care for a hospitalized terminal patient, whom the narrative identifies only as “the professor” (profesor). Dean stops by his patient’s room every evening near midnight after his regular shift, and he does his best to appear relaxed and cheerful, to make his patient feel at ease, even though both he and the professor know the end is near. One stormy night, speaking to his patient, Dean tells the professor how fortunate he is to be in bed already, while Dean still needs to travel home in inclement weather and then attend to a list of obligations before he can go to bed himself. Dean im- mediately recognizes his mistake: “He had intended to cheer the professor up, to give him some hope, even if unfounded, but it seemed he had inadvertently
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1 Seven Touches of Music contrasts Dean with the nurse Mrs. Roszel, who also cares for the professor “not only conscientiously but with affection” (2001: 119). Roszel is depicted as hav- ing a better sense of the professor’s needs than does the physician, but she too is said to avoid looking at him. 2 This tendency is exacerbated by the fact that the notes of health professionals, which until recently have generally not been accessible to patients, frequently become the patient’s story, even when the patient speaks eloquently. Writing on the occasion of the death of writer and neurologist Oliver Sacks, Christine Montross laments the falling out of favor of the case study, which has been replaced by data and the accompanying “precise biological and bio- chemical explanations of illness, evidence-based practices, and standardized approaches to patient care,” which do not always suffice, much less tell the most important parts of the story, at least from the patient’s perspective (2015: B10–12). Another factor contributing to the decline of the case study is concern over privacy. Montross ties these developments to the “voicelessness of so many who suffer from mental illness.” Exceptions include Ameri- can clinical psychologist and writer Kay Redfield Jamison’s (1946–) An Unquiet Mind (1995), American writer and professor of clinical psychology Andrew Solomon’s (1963–) The Noon- day Demon: An Atlas of Depression (2001), and American writer and law professor Elyn R. Saks’s (1955–) The Center Cannot Hold: My Journey through Madness (2007). In truth, Mon- tross cautions, physicians need to bear witness. Case histories do not necessarily trump a patient’s own narrative. Frequently, they give voice to those who cannot speak.
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3 An important example from the United States is Margaret Edson’s (1961–) award-winning play Wit, which was first produced in 1995 and eventually adapted into an Emmy-award win- ning film; the play has been translated into dozens of languages and performed worldwide. Wit centers on Vivian Bearing, a celebrated professor of English and a John Donne (1572–1631) specialist, who has been diagnosed with terminal ovarian cancer. The disease quickly over- powers her preferred rational, logical, and academic approach toward life, with Vivian com- menting, “The young doctor, like the senior scholar, prefers research to humanity. At the same time the senior scholar, in her pathetic state as a simpering victim, wishes the young doctor would take more interest in personal contact…. Now I suppose we shall see … how the senior scholar ruthlessly denied her simpering students the touch of human kindness she now seeks” (1999: 58). Later, Vivian observes, “Now is not the time for verbal swordplay, for unlikely flights of imagination and wildly shifting perspectives, for metaphysical conceit, for wit. And nothing would be worse than a detailed scholarly analysis. Erudition. Interpreta- tion. Complication. (Slowly) Now is a time for simplicity. Now is a time for, dare I say it, kind- ness” (69). Vivian’s oncologist Harvey Kelekian is not unkind, but he speaks past his patient (see especially pp. 8–9 and 36–37); and Vivian’s primary nurse Susie Monahan must fight to have health professionals honor Vivian’s do-not-resuscitate order.
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1 Stories Dismissed
Friends or family members who cannot bear to watch a loved one suffer fre- quently create an alternative narrative to what that person tells them about their illness simply to give themselves space to come to terms with the new reality.4 More disturbing is when patients tell or attempt to tell stories of self and illness to health professionals only to have those stories heavily edited, if not dismissed entirely and replaced by discourse that better meets the as- sumptions and expectations of healthcare personnel. A fundamental part of person-focused care is honoring the patient’s stories of illness.5 But many fac- tors impede a health professional from truly listening to a patient and acting
4 I speak more on this phenomenon in Part 3. 5 The phrase “honoring the stories of illness” is from the title of Charon’s 2006 volume on nar- rative medicine.
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6 Coetzee has frequently been criticized for not speaking more explicitly of apartheid in Life and Times. Some critics read this novel as taking place in the 1970s or early 1980s and some in the late 1980s (Clarkson 2009: 133). For more on South Africa’s book and reading cultures in light of apartheid, see Archie Dick, who argues that “Coetzee mixed prejudiced views with respectable scientific views, and was guilty of intellectual fraud and conceptual laundering. It was politics parading as science” (2012: 92). South African writer Damon Galgut’s (1963–) award-winning novel The Good Doctor (2003), which takes place in rural post-apartheid South Africa, provides an important contrast with Life and Times. Galgut spent much of his childhood battling cancer and later reflected on his experiences in the short-story collection Small Circle of Beings (1988). 7 Cleft lip and cleft palate are two of the most common orofacial deformities and visible birth defects. See Loh and Ascoli (2011) for a cross-cultural study of attitudes and perceptions to- ward cleft lip and palate deformities among Africans, Chinese, and Indians. Writing in the early 1950s, about the time of Michael K’s childhood, Penn et al. reveal that nearly half of the
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After losing his job as a gardener in Cape Town, Michael K leaves that violence- plagued city with his ailing mother for her home in the village of Prince Albert; recently released from the hospital, his mother is too weak for the journey and perishes en route.8 Michael spends the next months alternatively living off the land, hiding in the mountains, confined in resettlement and rehabilitation camps, and in the medical ward of a prison camp. The end of the novel finds him back in Cape Town, having escaped and relishing his freedom. Life and Times draws disturbing parallels between the dehumanization of Michael in society writ large and how he is treated by healthcare personnel inside the prison camp. The camp healthcare workers are focused on Michael, their pa- tient, and are eager to learn more about him. But mocking the essence of per- son-focused care and refusing to respect their patient, they insist that the story he tells about his life and his health conditions is false, and they attempt to create a new story for him. The novel never makes clear precisely why the camp healthcare workers are so intent on dismissing the story Michael K tells them about himself. The narrator never explains the reasons behind their idée fixe of what his story should be. But the silence on their motivation intensifies the novel’s parody of health professionals supposing to know the stories of their patients better than the patients themselves and reveals just how falla- cious their assumptions can be.
five hundred South African cases of cleft lip and palate they examined for their article had “been the victims of incorrect operations, causing disability as well as physical and psycho- logical suffering,” and they plead with authorities to “ensure not only that doctors are ade- quately trained to carry out these services, but also that only fully trained personnel be per- mitted to treat children with cleft lip and palate deformities in the major provincial hospitals in the Union” (1952: 484–488). Since 2006, the ngo Operation Smile has worked in South Africa to remove the stigmas surrounding cleft lip, cleft palate, and other facial abnormalities by providing free surgeries to correct these conditions; many continue to believe that chil- dren with cleft lip or cleft palate are cursed. In China, nearly thirty thousand children are born each year with an oral cleft. Ignorance and fear continue to surround this condition; some believe oral clefts to be a sign that the family has been immoral or uncharitable. Oral clefts are stigmatized more than other con- genital anomalies because of communication difficulties. In 2015, a grandfather made head- lines for murdering his newborn grandson because of his cleft lip (Ni 2016). 8 The narrator says virtually nothing about Michael K’s race, although he does note that when imprisoned, Michael K is listed as “Michael Visagie – CM – 40 – nfa – Unemployed” (70). CM stands for “Coloured Male” and nfa for “No Fixed Abode” (Poyner 2009: 69). Under apart- heid, “Coloured” referred to South Africans of mixed descent. Discussions of Life and Times often examine the relationship between Michael K and his namesake, Franz Kafka’s (1883– 1924) Joseph K from Der Process (The Trial, 1925); Joseph K is arrested and prosecuted without ever being informed of his crime (Poyner 2009: 69–90; Attridge 2004: 51).
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As with much of Coetzee’s oeuvre, Life and Times has been translated into more than thirty languages. Shortly after its release in English in South Africa by the anti-apartheid Ravan Press (1983), the novel was reissued in English in New York (1984) and elsewhere, and then it appeared in more than a dozen other languages, including Japanese, by the end of the 1980s.9 Many of these translations have since been reprinted.10 Translations into additional Asian languages appeared around the turn of the twenty-first century, with two into Chinese (2000; 2004) and one into Korean (2003), as well as one each into Ma- layalam, Tamil, Thai, Urdu, and Vietnamese.11 Although Life and Times does not speak explicitly of apartheid, something for which it has been criticized, much of its international appeal has come from its insights into life in the na- tion known best for its violence and racial segregation and from Coetzee’s reputation for challenging political and social oppression.12 Indeed, in the
9 Ravan Press had also published Dusklands (1974), Coetzee’s first book, which discusses relationships among the colonizer, historian, and fiction writer (Jolly 1996: 111). Ravan Press likewise published Coetzee’s In the Heart of the Country (1978) and Waiting for the Barbarians (1981), the latter of which, in Jolly’s words, “examines the implementation of Manichean allegory in the field of imperialist power politics” (1996: 124). In the Heart of the Country was initially published by Harper and Row in New York as From the Heart of the Country (1977); the 1978 Ravan publication was a local version, including as it did long passages of dialogue in Afrikaans not present in the New York version. For a compari- son of the South African and British/United States versions of this novel, see van der Vlies (2012). Life and Times was the first of Coetzee’s novels to be translated into Japanese; transla- tions and studies of Coetzee continue to appear frequently in Japan. See, for instance, writings by Tajiri (2006; 2008). In “Hitobito no seikatsu ni hairikomi, nichijō o kanjitotta Nihon hōmon no ni shūkan” (Inserting Oneself into the Lives of the Locals, Taking in the Everyday in a Two-Week Visit to Japan, 2008) Coetzee speaks of his travels to six cities in Japan in 2007, including Nagasaki, which interests him on account both of the atomic bomb and of the long Dutch presence there, as Coetzee is of Dutch heritage. Coetzee also visited Tokyo in 2013 for the Tokyo International Literary Festival, where he read an ex- cerpt from his then-yet-unpublished Childhood of Jesus (2013). Thank you to Manuel Azuaje-Alamo for this insight. 10 For instance, the 1989 Japanese translation by Kubota Nozomi was reissued in 2006 by the same publisher, Tokyo’s Chikuma Shobō. 11 Cheng Zhenjia’s Chinese version is titled Maike K de shengming yu shidai (Michael K’s Life and Time) and was published in Taiwan in 2000 by Tianxia Wenhua Chuban Gongsi. Zou Hailun’s Chinese translation is titled Maikeer K de shenghuo he shidai (Michael’s K’s Life and Time) and was published in Hangzhou, China in 2004 by Zhejiang Wenyi Chubanshe. Although Chinese translations of Coetzee took off after he won the Nobel Prize in 2003, his reception in China has been mixed, with writers such as Wang Anyi openly critical (Wang Jinghui 2008: 52–54). 12 As discussed in Chapter 2, Coetzee also has been criticized for failing in later work to talk about other South African crises. Disgrace does, however, deal with sexual violence in
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afterword to the second edition of the novel’s Japanese version, the translator Kubota Nozomi writes first about his initial encounter with Life and Times and then about Coetzee’s background and his numerous writings, both critical and creative. The translator – identifying himself as having been committed to the Japanese anti-apartheid movement – notes that when the novel was written in the early 1980s, censorship was severe and the end of apartheid was not yet in sight. Even in 1989, when the first edition of the Japanese version was published, the “exit [from apartheid] was not yet visible” (出口はまだ見えなかった; 1989: 244).13 Kubota speaks of the importance of this novel to a nation (Japan) whose people knew precious little about South Africa but whose business community flouted international sanctions against South Africa to become its top trading partner in the late 1980s.14
post-apartheid South Africa. The protagonist David Lurie, a professor of English fired from his position for having an affair with one of his students, and his daughter are at- tacked by a group of young black men; David is violently beaten, and Lucy is brutally raped and impregnated. Yet, as Palumbo-Liu comments regarding Lucy’s and David’s re- fusals to press charges against their attackers, “For [Lucy], the rape becomes purely a ‘pri- vate matter’ precisely because the historical moment has changed … For both David and Lucy, there is a gradual yet final realization that history has brought a profound and irre- versible change to South Africa, and no ‘normal’ remedy or action is possible” (2011: 63–64). For more on the importance of storytelling as a means of reconciliation in South Afri- can fiction see Knapp (2006) and Hunter-Gault (2012). 13 Likewise, in “J·M·Kuttsē shi no sairainichi ni yosete,” Tajiri Yoshiki describes the novel as “talking about the wanderings of a man utterly discriminated against and overpowered … in South Africa’s chaos” (2008: 62–63). In “Yakusha atogaki,” his afterword to the 1989 Japa- nese translation, Kubota first describes Coetzee’s family, linguistic, educational, and liter- ary background, then includes a section titled “Shinjōteki ‘burakku’ to shite no hakujin bungaku” (White Literature That Is Emotionally Black), which discusses racial politics and apartheid in South Africa (1989: 243–247). Kubota wraps up his discussion of Coe- tzee, however, by commenting on its universal appeal (251). Japanese interest in South African writers and apartheid goes back decades. An early favorite was the South African poet Mazisi Kunene (1930–2006), best known for Emperor Shaka the Great (1979; Japanese trans. September–October 1979) (Takeuchi 1970). The Japanese press published numerous translations and studies of the anti-apartheid activist and writer Alan Paton (1903–1988); Nobel Prize-winner Nadine Gordimer (1923–2014), whose work taught international readers about the “human effects of the ‘color bar’ and the punishing laws that systematically sealed off each avenue of contact among races” (Verongos 2014); and Bessie Head (1937–1986), also an anti-apartheid activist born in South Africa to a black man and a white woman. Head was declared mentally ill but fled to Botswana in 1964; her writings are largely autobiographical (Ōike 1999). For more on intellectual responsibility in South Africa see Sanders (2003). 14 As Osada notes, “Japan was criticized domestically and internationally for its trade rela- tions with the apartheid regime and for accepting the ‘honorary white’ treatment” (2002: 4). Although officially Japan condemned apartheid and imposed sanctions on South
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Inequities in medical treatment were a hallmark of apartheid.15 As Ato Quayson argues, “Michael K has a harelip [and] is inarticulate … because he is an underclass colored person in apartheid South Africa…. The inarticulacy and disability of [Coetzee’s] nonwhite characters performs an insistent invitation to interpret while frustrating the possibility for interpretation” (2007: 149).16 Although Life and Times does not say so explicitly, the fact that Michael K’s cleft lip was not repaired when he was a child, when, as the novel informs us, all that was required was a simple operation, likely was a result of discrimina- tion in the delivery of healthcare under apartheid.17 In its opening pages Life and Times exposes how swiftly disfigurement (for Michael K) and illness (for Anna K) can isolate individuals from family and community. The narrator’s early positing of storytelling as a luxury compli- cates the novel’s later discourse on the importance of the act of telling one’s story. Coetzee’s text begins with background on Michael K – most notably his cleft lip, which resulted in difficulty eating, rejection by his mother, a lonely childhood and institutionalization, and preference for solitude as an adult. The first thing mentioned about Michael K is the first thing that the midwife
Africa, trade between the two countries increased 500 percent in the 1960s and more than 3,000 percent between 1960 and 1985. And in 1986 (the year the U.S. Congress passed its landmark Comprehensive Anti-Apartheid Act imposing sanctions against South Africa) as well as in 1987 Japan was South Africa’s “largest trading partner” (ibid.). The Japanese media reported on apartheid but were criticized for portraying it as “barbarism which happens in a remote country that has nothing to do with us”; as recently as 1998 a Japa- nese photographer in South Africa noted that many Japanese believed it to be “a remote country where fierce animals roam around the airport and racial discrimination still pre- vails” (Sawano 1998). For more on Japan and apartheid, see also Kusuhara (1988). Despite good ties with Taiwan, with which it established diplomatic relations in 1962 and relations at the ambassadorial level in 1976, South Africa sought contacts with China in the 1980s. Formal diplomatic relations between the two countries were established in 1998. Dedicated to reforming the current global political and economic order, and in par- ticular to eliminating inequities of global governance, the two nations now are creating new forms of what has been called “South-South” cooperation (Shelton 2008), although opinions differ on whether China is actually part of the so-called Global South. 15 See, for instance, Jurjus (2015: 13–14). 16 Quayson also reads Coetzee’s Life and Times as “a literary representation of a person with autism” (2007: 163), although there is some question as to the extent of Michael K’s actual cognitive impairment. 17 South African actor and comedian Trevor Noah’s (1984–) memoir Born a Crime: Stories from a South African Childhood (2016) is only one of many volumes that reveal the ex- treme prejudices against black and mixed race individuals in South Africa. Noah, whose own birth was a crime in South Africa, where relations between whites and blacks were long prohibited, calls apartheid “the most advanced system of racial oppression known to man” (19).
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18 Even more extreme is the reaction of Sanaubar in Afghani American physician-writer Khaled Hosseini’s international bestseller The Kite Runner (2003), who upon giving birth to a child (Hassan) with this condition in 1964, barks bitterly to her husband Ali, whom she despises, “There … now you have your own idiot child to do all your smiling for you!” (10). She refuses to hold Hassan and five days later disappears; she runs off soon thereafter with a band of singers and dancers (210). Sanaubar returns years later, extremely apolo- getic. When Hassan’s wife gives birth in 1990, it is Sanaubar who delivers her grandson, and soon she and the child are inseparable, with Sanaubar attempting to make up for lost time. 19 The narrator states only, “Because of his face K did not have women friends” (4). The sim- plest interpretation of this line is that women are repulsed by his face and so will not as- sociate with him; many individuals in South Africa and elsewhere with cleft lips, cleft palates, and other physical disfigurements are utterly ostracized from their communities.
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Michael’s apparently sluggish intelligence is innate or whether it developed as a result of early isolation and has been reinforced by society’s reactions to his physical disfigurement. Yet Michael K is not as incoherent as many claim. In- deed, he often appears to be playing at being rather than actually being a simpleton. Notably, the early pages of the Chinese, Japanese, and Korean versions of Life and Times define Michael K even more by his cleft lip than does the English source. Kubota’s Japanese translation – titled simply Maikeru K (マイケル·K, Michael K) – shortens considerably Coetzee’s opening sentence, transform- ing, “The first thing the midwife noticed about Michael K when she helped him out of his mother into the world was that he had a hare lip” (1984: 3) into “Maikeru K wa kōshinretsu datta” (マイケル·Kは口唇裂だった; Michael K had a cleft lip, 7). The Japanese version draws immediate attention to Michael K’s physical condition, even before stating who Michael K is. It is only in the second sentence that the Japanese version observes that the cleft lip is the “first thing the midwife noted” – saisho ni kizuita no wa sono koto datta (最 初に気づいたのはそのことだった, 7). In contrast, Cheng Zhenjia’s Chinese- language version of Life and Times – titled Maike K de shengming yu shidai (麥可·K 的生命與時代, lit. Michael K’s Life and Times) – translates much more literally the opening sentences: 產婆把麥可·K接生出來的時候，她 第一個注意到的就是他的兔唇 (2000: 3). But on its preceding page, as an epigraph to the first part of the novel (omitted in the English version), the Chi- nese translation adds lines that are repeated in the narrative proper two pages later, including, “Michael’s face made it so that he didn’t have female friends, he was most at ease when he was alone” (2). For its part the Korean translation speaks not of the “first thing” but the “first distinguishing characteristic/dis- tinctive feature”: 첫번째특징은 (2003b: 9). All three East Asian translations give even more prominence to Michael’s physical disfigurement and isolation than the English version, drawing attention to his marginalization from society. The third page of Life and Times turns to the plight of Anna K: the woman who could not accept her son has fallen ill and now is grateful that he has come to liberate her from nearly a week in the purgatory that is Somerset Hospital. As David Babcock has commented, “The moment that Anna K falls ill, the wel- fare state becomes a Kafkaesque labyrinth of bureaucratic obstacles” (2012: 894). Coetzee’s narrator explains how Anna K had suffered for months with a swollen stomach, arms, and legs, and how she had been admitted to Somerset unable to walk and barely able to breathe. But far from being cared for, she
But given surrounding discourse, this sentence also suggests that it is because Michael K has never learned how to socialize that he does not have (female) friends.
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instead is “neglected by nurses who had no time to spend cheering up an old woman when there were young men dying spectacular deaths all about” (1984: 5). Her pleas to be sent home are ignored, and her nights among the dy- ing bring home to her “how indifferent the world could be to an old woman with an unsightly illness in time of war” (7). This apathy is brought home to Michael K when he pleads repeatedly with officials for leniency on travel re- strictions, only to find that “his mother’s health did not constitute special grounds … on the contrary … [he was told that he should not] mention her condition at all” (9). Exhausted from their journey, Anna K is admitted to an- other hospital, where again little is done for her, and she soon passes away. There is no indication that anyone in either hospital cares about her wellbeing or her story; the novel mentions her symptoms and their history, as well as what she undergoes while hospitalized, not from her conversations with oth- ers but instead from the narrator, who simply describes her condition.20 To be sure, the emphasis here is less on the absence of respectful person- focused care than on the surfeit of dead and dying bodies in times of war. Many of Michael K’s demands on behalf of his mother in fact come across as mis- placed, given the circumstances. The hospital staff is greatly overextended, one of the nurses remonstrating to Michael K that she is “just one person. Not two, not three – one. Do you understand that, or is it too difficult to understand?” (28). Also important to remember is that while the “young men dying spec- tacular deaths all about” receive more attention as a group from professional caregivers than does Anna K, they do not garner much notice as individuals. Their lives are truncated with little warning, and there is no sign that they have the opportunity to share their individual stories. Moreover, the narrator’s com- ment that soldiers are “dying spectacular deaths” suggests that many of them are not breathing their last in the hospital but instead are perishing on the battlefield, without having had the chance to speak at all. The contrast with Michael’s own experiences in the medical ward is strik- ing; far from a luxury, storytelling is expected of him, but the script has been predetermined. Michael K’s medical officer – the narrator of Part 2 – is not only very concerned with the health of his patient, he is desperate to learn more about him.21 Still, the officer does not recognize what Michael K recounts
20 Of course, not everyone is entirely apathetic regarding Anna K: the Buhrmanns (her em- ployers) take care of her before her condition worsens and she needs to be admitted to the hospital, while Michael does his best to look out for her. But even these individuals are not depicted as having any interest in what she herself is going through. 21 As Attridge points out, the narrative style of Michael K not only avoids the first person with the exception of this section. It also uses free indirect discourse only sparingly. Al- though we learn much about Michael K’s thought processes and emotions, we “never feel
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that we have assimilated them to our own” (2004: 51). See also Clarkson for more on this novel’s twists on free indirect discourse (2009: 30–33). 22 The relationship between Michael K and the medical officer who recounts his story is one of the most important in the novel. Cf. Marais (1989).
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23 Michael K’s malnutrition is a result not of his cleft lip, which can make eating difficult, but instead first of an absence of sustenance and then of his subsequent loss of interest in food. Although the narrator comments at the very beginning of the novel on the difficul- ties Michael K’s mother had getting him to nurse, subsequent discourse indicates that as he grew to adulthood, lack of food was his principal problem. For instance, the narrator writes, “As a child K had been hungry, like all the children of Huis Norenius [the boarding school to which he was confined]. Hunger had turned them into animals…. Then he had grown older and stopped wanting. Whatever the nature of the beast that had howled in- side him, it was starved into stillness” (68). Later, when he works in the fields and has seemingly unlimited access to food, he still does not eat, the narrator noting, “As he tend- ed the seeds and watched and waited for the earth to bear food, his own need for food grew slighter and slighter. Hunger was a sensation he did not feel and barely remembered. If he ate … it was because he had not yet shaken off the belief that bodies that do not eat die. What food he ate meant nothing to him” (101). Michael K believes that he will recover his appetite “when food comes out of this earth” (101), and this does happen, but his joy is short-lived (113–114).
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24 Michael K’s refusal of treatment is not unlike that of the character Animal in Indian writ- er Indra Sinha’s (1950–) novel Animal’s People (2007). This international sensation is set in Khaufpur, a fictionalized Bhopal (the site of the 1984 Union Carbide disaster). It focuses on the experiences of Animal, a young man who was born shortly before the disaster and whose exposure to toxic gas twisted his spine to such an extent that he can walk only on all fours and considers himself less than human. Animal’s People concludes with Animal declaring, “I reckon that if I have this operation, I will be upright, true, but to walk I will need the help of sticks. I might have a wheelchair, but how far will that get me in the gul- lies of Khaufpur? Right now I can run and hop and carry kids on my back, I can climb hard trees, I’ve gone up mountains, roamed in jungles. Is life so bad? If I’m an upright human, I would be one of millions, not even a healthy one at that. Stay four-foot, I’m the one and only Animal…. We are the people of the Apokalis. Tomorrow there will be more of us” (366). On the other hand, while a simple surgery could cure Michael K completely, the operation offered Animal would leave him in a wheelchair; it is possible that if surgery allowed Animal to walk without aids, he might be tempted to go under the knife. In addition to writing novels, Sinha has translated ancient Sanskrit texts. He also has been active in securing funds and medical treatment for survivors of Bhopal and is a vocal critic of Dow Chemical Company, now the parent company of Union Carbide. In articles written on Bhopal, Sinha has criticized the Indian government’s lethargic response to this disaster.
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Where is your stake in the future? Do you want the story to end with you? That would make it a sad story, don’t you think? … We brought you here to talk, Michaels….We give you a nice bed and lots of food, you can lie in comfort all day and watch the birds fly past in the sky, but we expect something in return…. You’ve got a story to tell and we want to hear it. Start anywhere. Tell us about your mother. Tell us about your father. Tell us your views on life. Or if you don’t want to tell us about your mother and your father and your views on life, tell us about your recent agricultural enterprise and the friends in the mountains … Tell us what we want to know, then we will leave you alone. (140)
Paradoxically, as intent as he is to learn more about his patient, the medical officer persists in referring to him as Michaels, rather than Michael. More im- portantly, Michael K has already told the narrator about his mother, how she “worked all her life long … but when she was old and sick they forgot her” (136). Yet the medical officer immediately dismisses that narrative, asserting, “as for your mother, I am sure you have not told the full story and I am sure you know that” (136). There is a particular narrative that the medical officer and his col- leagues want to hear, and they promise Michael K that they will leave him alone, but only after they hear this expected story. It is less that Michael K “can- not tell a coherent story of his own,” as Michael Bérubé has argued (2016: 69), than that the stories Michael K tells do not conform to what is envisaged.25
25 Bérubé rightly notes that when Michael K attempts to tell his story to himself, “The words were eaten up, the gap remained. His was always a story with a hole in it: a wrong story,
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Recognizing that he is getting nowhere, the medical officer urges the official charged with recording Michael K’s story to fabricate a story, since “truly there is no story to be had,” at least not from Michael K himself. In fact, the medical officer goes so far as to claim: “It’s not a lie, Noël. There’s probably more truth in the story I told you [that an insurgent gang had visited Michael K’s farm ev- ery month or so] than you would ever get out of Michaels if you used thumb- screws on him” (1984: 141). This, notably, is not the first time that the medical officer has created a story for Michael; earlier in Part 2 he points out, “One tries to imagine him running a staging post for insurgents and one’s mind boggles. More likely someone came along and offered him a drink and asked him to look after a gun and he was too stupid or too innocent to refuse” (130). The pa- tient’s story cannot be told, will not be told, by the patient. Equally important is how tangential Michael’s health is to the actual story the medical officer longs to hear. The narrator wants to learn more about his patient not so that he can focus on healing him physically or psychologically, not so that he can im- prove his patient’s wellbeing, but so that he can submit the needed paperwork to the authorities. Michael K escapes the ward not long after the medical officer and his col- leagues settle on his, or rather their story for Michael. To be sure, Michael K’s own narratives are not completely lost; the medical officer reveals this when several days later, he remonstrates with the duty officer for not exempting Mi- chael from physical exercise. The duty officer chastises him for believing “all the stories these buggers tell you,” and the medical officer himself admits that “perhaps I do indeed believe too many of his stories” – but no, these told but un-narrated stories prove to be true. Two days later, Michael K is brought back to the medical ward, unconscious; he had refused to do what he was told, was ordered to squat and jump as punishment, and then collapsed. Just as at the beginning of Part 2, the indifference of the guards is here contrasted with the concern of the medical officer; he upbraids the guards for not taking Michael’s physical condition into account when meting out punishment. In the next section the medical officer documents his attempt to help Mi- chael K, and it here becomes clear how little he cares about the health and wellbeing of his patient. Michael K refuses to eat, stating that what they offer him is “not my kind of food.” This sends the medical officer into a tirade, de- manding to know why Michael will not eat. The narrator claims that he and his colleague Felicity are the only people in the world who care enough to help Michael. When Michael croaks out, “I never asked for special treatment,” the
always wrong” (2016: 110). This does not mean, however, that Michael K has no story or even that his story is not at all coherent.
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26 The same is true of the Japanese translation. To give one example, Noël’s claim that what is written in the register is “the story of Michaels” is changed to “the background [経歴, keireki] of Michaels” (191). Keireki can be translated “background information” or simply “background.” For its part, the Korean translation replaces the initial reference to “the story” in Part 2 with somun (소문, rumor/news/gossip, 171) and, as with the Japanese, changes Noël’s claim to “the personal history [전력, chŏnryŏk] of Michaels” (173). Not long thereafter, the Korean version transforms the narrator’s critique of Michael K, that
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The final part of Coetzee’s novel finds its protagonist back in Prince Albert, where unable to sleep one night, he begins to think about stories and storytell- ing. The irony of what he has been asked to do, and how little preparation he has had, does not escape him:
From the children they expected only a stammer of thanks in return. From me they want more, because I have been in the world longer. They want me to open my heart and tell them the story of a life lived in cages. They want to hear about all the cages I have lived in, as if I were a budgie or a white mouse or a monkey. And if I had learned storytelling at Huis Norenius … if they had made me practice the story of my life every day, standing over me with a cane till I could perform without stumbling, I might have known how to please them. I would have told the story of a life passed in prisons where I stood day after day, year after year … dream- ing of experiences I would never have … When my story was finished, people would have shaken their heads and been sorry and angry and plied me with food and drink; women would have taken me into their beds and mothered me in the dark … At least I have not been clever, and come back to Sea Point full of stories of how they beat me in the camps till I was thin as a rake and simple in the head. I was mute and stupid in the beginning, I will be mute and stupid in the end. (1984: 181–182)
Michael K reveals himself as having been clever in his seeming lack of clever- ness. The desired story referred to here is different from the story for which the medical officer of Part 2 is searching, but the principle is the same: people de- sire to hear from Michael K a particular narrative, a story that is not spontane- ous but one that is scripted and needs to be practiced under duress. And it is only via this story that succor – food, drink, mothering, sex – is possible. Sig- nificantly, despite the fact that Michael K has just been in a medical ward, nothing is said of the care he receives, indicating just how low a priority this is. While Cheng Zhenjia’s Chinese version and Wang Ŭnch’ŏl’s Korean version maintain the repetition of the word story (Chn. 故事; Kr. 얘기) in their trans- lations of the lengthy passage on stories and storytelling, Kubota’s Japanese translation in places substitutes “telling” for “story.” In other words, “they want … me to tell them the story of a life lived in cages” becomes: 檻のなかの暮ら しについて話すようにせがまれる (lit. I was pestered to speak about life in a cage; 1989: 265). Likewise, “the story of a life spent in prisons” becomes: 刑務所
he has not “told the full story of his mother” to “you have not told everything about your mother” (180).
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で過ごした生活について…話してやれる (telling them what my life was like in prison, 266). Words are spoken, but they do not constitute a coherent story. As in Parts 1 and 2, Cheng Zhenjia’s Chinese translation adds an epigraph to the third part of Life and Times:
The true truth is [真正的真相是] I have been a gardener, first for the city council, then for myself, and gardeners spend their time buried in the earth [在埋 首于泥土當中的]. ······ I’m more like an earthworm, he thought, which is also a kind of gardener: or a mole, also a gardener, only it cannot tell stories [只是牠不會說故 事], because it always moves in silence. (2000: 274)
Not only does the Chinese translation change “the truth is that” (181) to “the true truth is,” emphasizing the veracity of what follows. This version also re- writes “that does not tell stories” (182) as “only it cannot tell stories,” distin- guishing the mole and possibly earthworm from the gardener and emphasiz- ing the silence of both the animal(s) and Michael K. The irony is, of course, that Michael K has been far less silent than he is made out to be by either of his narrators.27 In telling his story – his life and times – they too have not heard much of what he has said. Coetzee’s novel wraps up with Michael K seemingly at peace and moving beyond pondering the stories told and untold about his own life and the hu- man story more generally. He wonders, “Is that the moral of it all … the moral of the whole story: that there is time enough for everything?” (1984: 183). In contrast, neither the Japanese nor the Chinese translation adheres to the no- tion of the “whole story.” Instead, the Japanese states simply, ようするに、それ
27 Parry notes that although Michael K likens himself to a silent mole, silence is “privileged as enabling the euphoria of desire unmediated by words” (1998: 154–155). On the other hand, Michael K’s social isolation is very real, and his “retreat” to gardening has been criti- cized by many, including the South African novelist Nadine Gordimer, who in her 1984 review of Life and Times argued that “the novel’s pastoral impulse amounted, at best, to an ethical orientation that was out of place and time during the interregnum in South Africa” (Graham 2010: 194–195). For more on Gordimer and Michael K see Babcock (2012) and Wang Ŭnch’ŏl (2003: 247–248). Cf. Coetzee’s The Lives of Animals (1999), a prequel to his novel Elizabeth Costello but also “a foundational text for postcolonial ecocriticism … and critical animal studies” (Carruth 2011: 201).
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がモラルなのか? … すべてに通じるモラル、つまり何をするにも時間は たっぷりあるということが? (lit. In short, was that the moral? … The moral per- vading everything, namely that there is, too, enough time to do whatever one wants to do?; 1989: 268); while the Chinese comments: 難道這就是一切的寓 意嗎 … 難道這就是整件事的寓意所在嗎 – 就是説，縂有足夠的時 間來做任何一件事嗎 (lit. Could it be that this was the moral of it all? … Could it be that this was where the moral of the whole thing is? That is to say, that there is always sufficient time to do anything?; 2000: 295). In the Japanese version, “the whole story” becomes “everything” (すべて) while in the Chi- nese, “the whole story” becomes “the whole thing” (整件事).28 Removing the novel’s final reference to “story,” these East Asian translations implicitly rele- gate “story” to just a part of an individual’s life, including that of Michael K, including the very text Life and Times itself. Ironic, of course, is that the final lines of Coetzee’s story echo strongly those of the celebrated Japanese novelist Abé Kōbō’s (1924–1993) Suna no onna (砂 の女, Woman in the Dunes, 1962), translated into English in 1964.29 At the end of this novel, Abé’s protagonist, Niki Junpei, is surprised to discover that his crow trap “Hope” is in fact a very effective water-collecting device, allowing him to put off indefinitely the return to the city from the sand dunes that he has been plotting for much of the novel. Similarly, Coetzee’s Michael K, as though imagining himself Niki Junpei, envisions that if asked what would be done about water, he would simply “produce a teaspoon from his pocket … and a long role of string … bend the handle of the teaspoon in a loop and tie the string to it … lower it down the shaft deep into the earth, and when he brought it up there would be water in the bowl of the spoon; and in that way, he would say, one can live” (1984: 184). Envisioning his future in this manner, he works to confirm that there is “time enough for everything.” Time enough for every- thing, that is, except to tell one’s story and have it understood and respected.
28 In contrast, the Korean translation of Michael K retains the phrase “whole story” (모든 이야기). On the other hand, while the English version speaks of “the moral of it all,” “the moral of the whole story,” and “time enough for everything,” moving among “all,” “whole,” and “everything” to emphasize totality, the Korean version repeats 모든 (modŭn, all/ whole/every) as a modifier for “things” (것들, recurring twice) and “story” (이야기): 모 든 것들을 위한 시간이 충분히 있다는 것, 바로 이것이 모든 것들의 교훈 이며 모든 이야기의 교훈일까? (2003b: 240). The repetition of modŭn further blurs distinctions between “story” and “everything” – the story is everything, and everything is the story. 29 Abé Kōbō’s Woman in the Dunes is one of Japan’s most celebrated avant-garde novels. Teshigahara Hiroshi (勅使河原宏, 1927–2001) adapted this novel into a prize-winning, surrealistic film.
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Life and Times mocks the assumptions society makes about individuals and especially how readily healthcare personnel can take for granted that they know their patients’ stories better than their patients themselves. The novel reveals how obsessing over an individual’s story, far from allowing one to be- come more focused on that person, can fictionalize the story and can intensify suffering and obstruct healing. For their part, from their opening pages, the Chinese, Japanese, and Korean translations of Life and Times accentuate Mi- chael K’s isolation from society, and the flexible translations of the word story give more nuance to the types of narratives swirling around the novel’s pro- tagonist, few if any of which are his own.
2 Stories without Words
Coetzee’s Life and Times mocks the readiness with which some healthcare per- sonnel, however eager they are to hear from their patients, dismiss and replace the discourse of their patients, dehumanizing them even when they believe them to have a story. In contrast, British-Pakistani writer and journalist Mo- hammed Hanif’s celebrated Our Lady of Alice Bhatti (2011) and prolific Japanese writer Ogawa Yōko’s bestselling and globally translated Equations the Professor Loved (2003) mock the assumptions professional caregivers sometimes make about patients who cannot speak about themselves or their illnesses.30 In so doing, Hanif’s and Ogawa’s novels underline just how little is known about some conditions, much less the impact of these conditions on people’s lives, and how nothing should be taken for granted. A key part of humanizing treat- ment and embracing person-focused care is muting assumptions and listening attentively to patients. But what happens when patients do not communicate verbally about their illnesses? Novels such as Our Lady and Equations feature professional caregivers who are compassionate with their patients, even against incredible odds, yet who continue to make assumptions about those patients without engaging with them closely. These narratives caution that while per- son-focused care is by definition compassionate, compassionate care is not necessarily person-focused and can readily overlook the needs of the patient. Conditions are brutal for both patients and healthcare personnel at Sacred Heart Hospital for All Ailments in Karachi, Pakistan, the hospital at the center
30 Within Japan, Equations was one of the major Japanese publisher Shinchōsha’s fastest selling paperbacks.
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31 Hanif, who was born and raised in Pakistan and is one of that nation’s most popular Eng- lish-language writers, is best known for the comic novel A Case of Exploding Mangoes (2008), which draws on the 1988 plane crash that killed former president of Pakistan General Muhammad Zia ul-Haq ( , 1924–1988). 32 Alice Bhatti fights back, including physically. Before working at the hospital as a junior nurse, she had been imprisoned for fourteen months in the Borstal Jail for Women and Children for having attacked with a marble flowerpot a senior surgeon who had made her his scapegoat for his negligence. Early in Our Lady, Alice Bhatti cuts with a razor the geni- tals of a man who molests her in the vip ward, with his mother on her deathbed. Sus- pended for two weeks, she tells her supervisor, “So basically I am being punished for re- sisting an armed assault” (114).
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The narrator contrasts Bhatti’s gentle demeanor and devotion toward Zainab with the brusqueness of an oncologist from Houston who is visiting the Sacred Heart Hospital on a “charitable visit.” This physician shows so little respect for his patients that he does not even speak with them. Instead, he simply stops by the dying Zainab’s bed, looks at her medical chart, and declares – unaware that the hospital is in fact her home – “Six weeks. I think you should probably take her home” (2012: 222). The physician sees no possibility of a cure at this late date, and he is to be credited for not subjecting Zainab to a prolonged hospital death, but his brusque manner reveals his dismissive attitude toward his pa- tients, whom he sees as only barely human. Bhatti then quickly escorts the foreign oncologist to the next patient, over whose bedside he coos, “What an interesting case, what a rare strain of non- Hodgkin’s.” This man sees diseases, not people. Disgusted, Alice Bhatti tries to reassure Noor by discrediting this insufferable man: “Who does he thinks he is? A TV doctor? Did you see his teeth? So white?” (222). In addition to revealing the oncologist’s lack of respect and compassion for his patients, as well as his seeming obliviousness to the importance of treating his patients as people, Hanif’s novel significantly does not ascribe the physician’s manner to his na- tionality and does not contrast the practice of medicine in the United States with that in Pakistan.33 Instead, the focus is on the failings of biomedicine more generally. Indeed, the local physicians at Sacred Heart Hospital are little
33 In contrast, much literature highlights the disrespect of foreign physicians for local popu- lations. American writer Thom Jones’s (1945–2016) short story “Way Down Deep in the Jungle” (1995) for instance, includes the tale of an American doctor in Africa who “didn’t believe in the [local] superstitions, and in the course of things he humiliated a traditional doctor.” The local doctor curses the American, who proceeds to step on a snake, and has to be rushed to a facility in Johannesburg. A year later, on his second day on the job, he is bitten by a rabid animal and although receiving the full rabies vaccine protocol, contracts the disease (1995: 62–63). Nigerian writer Obi Egbuna’s (1938–2014) short story “The Medics” (1970) also features the power of a traditional healer (Okwologu) and a British physician, Dr. Williams, who has lived in Africa for decades and is challenged by the newly arrived foreign medical student, Dick Gooderick, who declares a moratorium on “witch-doctoring” and accuses Okwologu of being a fraud. Gooderick urges Okwologu to retire, so he is no longer a “dan- ger” to his people, including his son, who has a contagious infection that puts the entire community at risk for an epidemic. Gooderick also encourages Okwologu to permit his son to attend medical school in England; Okwologu refuses, accusing Gooderick of believ- ing “in the wisdoms of the land of your upbringing but [denying] others the right to be- lieve in their own” (1970: 77). The irony, as Williams reveals, is that in reality Okwologu does not even have a son; he has fooled the foreign medical student into believing that he does. “The Medics” concludes with Williams instructing Gooderick to “respect genius wherever you find it, even in an African witch doctor” (87). Also noteworthy are Scottish writer Aminatta Forna’s (1964–) The Memory of Love (2011), which reveals the inability of Western treatments to address the traumas in Sierra Leone, and Quartey’s Wife of the Gods
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(2009), in which a foreign medical student is killed in rural Ghana, where scientific ap- proaches to hiv/aids are in conflict with those of traditional healers. Other writings emphasize the necessity of straddling two worlds, in the words of Sindiwe Magona’s To My Children’s Children (1990), the world of school and “civilization” and the world of “ancestor worship, witchdoctors, and traditional rites” (1990: 54). The importance of integrating different forms of medicine is underscored in such works as Native American writers Leslie Marmon Silko’s (1948–) novel Ceremony (1977) and Louise Erdrich’s (1954–) novel Love Medicine (1984), Memorial Sloan Kettering cancer physician Sidney J. Winawer’s memoir Healing Lessons (1999), and Chinese writer Bi Shumin’s novel Save the Breast (2003). Such integration received renewed attention after Chinese re- searcher and pharmaceutical chemist Tu Youyou (屠呦呦, 1930–) received the 2015 No- bel Prize in Medicine, the nation’s first in science. Tu Youyou received the Nobel Prize for extracting the malaria-fighting compound Artemisinin from Artemisia annua. 34 Until quite recently there was very little palliative care available in Pakistan. 35 There is only one reference in Hanif’s novel to Zainab speaking to Alice Bhatti, to advise her that “if a woman can’t drag her man to the middle of the square and thrash him once in a while, the marriage is doomed” (227). Our Lady includes several scenes where Noor dotes on his mother, but only once does Zainab speak to him, and then only to admonish her son for telling her in a loud voice about Alice Bhatti’s recent marriage to Teddy, given,
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Zainab says, that she is not deaf and that she knows all about marriage, having been mar- ried once herself (225). Otherwise, Noor listens to Zainab murmur in her sleep. 36 Noor’s obsession with Alice Bhatti resonates throughout much of Our Lady. 37 Alice Bhatti perceives the episode with the newborn to be not a “miracle” but instead a “freak incident.” She knows that the other “so-called miracles are mostly the result of a non-literal implementation of the working nurse’s manual” (275).
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relationship with Noor – pours half a liter of sulfuric acid on her face, killing her, but leading any number to believe that they saw her “ascend with [our Holy Mother] to the heavens” (339) and appearing to trigger a variety of other mysterious events. Given how the petition for his daughter’s sainthood has been denied on numerous seemingly facetious grounds, Joseph Bhatti con- cludes his letter to the Vatican by arguing, “There is only one thing left to do, and that is to tell the complete story of Alice Bhatti…. And since Sister Alice Bhatti’s story can’t be told without telling the story of her time at the Sacred, why not start the story when Alice Bhatti came to the Sacred, looking for a job” (339). These lines at once conclude Our Lady and return the novel to its begin- ning. The repetition of the word story, however, four times in seven lines, is a reminder both of Alice Bhatti’s being deprived of the opportunity to tell her own story and of the stories that are not heard in Our Lady, most notably the story of Zainab but also the stories of the countless individuals who have been terrorized by violence.38 Bhatti’s compassion is laudable, but she does not give Zainab the person-focused care this woman deserves.
38 Providing an intriguing counterpart to Our Lady is the controversial Cambodian human rights advocate Somaly Mam’s (1970/71–) French-language Le silence de l’innocence (Si- lence of Innocence, 2005), published as a memoir but later revealed to be a fictionaliza- tion of her experiences with and struggles against sex slavery. Mam has made a career of enabling girls and young women to speak of their experiences with sex slavery, and Si- lence of Innocence gives these individuals a platform to break at least some of the silences surrounding their trauma, both in their conversations with Mam, recorded at various points throughout the text, and more directly in the book’s final chapter – “Deux té- moignages” (Two Testimonies). This chapter consists of an opening paragraph followed by the testimonies of two young women. Yet the stories quoted are so tidy and concise as to appear to have been heavily edited as they were translated from Khmer to French. Moreover, Mam introduces these two women’s narratives with the curious comment: “J’ai envie de vous emmener encore un peu plus loin dans la réalité de mon pays, dans ma ré- alité quotidienne, en laissant la parole à deux adolescents cambodgiennes, vendues et prostituées dès leur enfance” (I want to take you a little further into the reality of my country, into my daily reality, in letting speak two Cambodian adolescents, sold and pros- tituted from childhood; 2005: 200). In other words, the focus remains on her. Further- more, she follows this sentence with the comment that providing the stories of two young women – Srey Peuve and Chan Ry – tells more not about their personal experiences but about Cambodian experiences: “Leur histoire est celle de milliers de petites filles cam- bodgiennes” (Their story is that of thousands of young Cambodian girls, 200). The asser- tion that these two stories are those of thousands of Cambodian girls raises additional questions about storytelling. Are stories really that interchangeable? Can two really stand in for thousands? And if they can, then what to do about the disconnect between two imperatives: the importance of every girl and young woman breaking the silence infiltrat- ing her individual experience by creating a narrative – the need for millions of stories to be told, a story by every one of the millions who experienced abuse similar to that de- scribed in Silence of Innocence, and the presumed need for a single, coherent narrative
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3 Stories without Memories
Although Equations is set in a far more privileged space – 1990s Japan as op- posed to contemporary Pakistan – parts of Ogawa Yōko’s novel resonate strong- ly with Our Lady. Equations is narrated by a woman who looks back at her time as housekeeper and caregiver for a mathematics professor in his sixties who twenty years earlier, in 1975, sustained a traumatic brain injury (tbi) in a traffic accident.39 The professor’s memory of events before the accident is intact, but he has only eighty minutes of short-term memory.40 Eventually, even these eighty minutes disappear as the professor loses his short-term memory alto- gether. The final few pages of Equations cover the professor’s last decade, which he spends in a long-term care facility, visited frequently by the narrator and her son. Ogawa’s novel probes the dynamic not of professional caregivers dismissing their patients’ stories of illness, nor of caregivers sidestepping these stories, as is common in many works about illness, including tbi.41 Instead, it examines attempts to care for an individual living with tbi whose combination of mem- ory loss and intrinsic reticence for topics beyond mathematics and baseball
that can alert the world to one of Southeast Asia’s major health crises? Although Srey Peuve’s and Chan Ry’s stories share much in common, they also are quite distinct, reveal- ing the two young women as not so swappable after all. Strikingly, these testimonies are not included in the Korean and English adaptations of Silence of Innocence. For more on Somaly Mam’s narrative and its translations see Thornber (2013a). Telling one’s story and hearing stories of others with similar experiences aid individual recovery, or so Mam states repeatedly in Silence of Innocence. But also vital is creating more opportunities for individual healing, not to mention transforming societies to pro- tect children and young adults from needing such outlets in the first place. 39 The leading causes of traumatic brain injury are falls, vehicle-related collisions, violence, sports injuries, and explosive blasts and other combat injuries. At particular risk are members of the armed forces, athletes, and the elderly, but tbi can happen to anyone (Mayo Clinic 2019). Approximately 10 million people are affected each year, with the who predicting that road accidents will follow only heart disease and depression as the leading contributor to the global burden of disease and disability (Humphreys et al. 2013). In- creasingly, those who do not themselves live with brain disorders are close to someone who does. 40 For instance, at 2:00 p.m. on Saturday, May 16, 1992, the professor could not remember anything between 1975 and 12:40 p.m. on that day. 41 See, for instance, Australian writer Sarah Vallance’s Prognosis: A Memoir of My Brain (2019), where she addresses the pervasive stigmas physicians harbor against individuals with traumatic brain injuries, commenting, “It’s a scary thought: you turn up in the emer- gency room after a bad knock to the head, and your treatment is compromised because the doctor who sees you assumes you were foolhardy and responsible for any injury you have sustained” (58).
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42 The narrator depicts the professor as extremely reticent about his condition; he tells her only that he has just eighty minutes of short-term memory. Although everyone in the novel claims that the professor’s pre-1975 memory is intact, the only evidence offered is that the professor is still able to talk about and do mathematics. In addition to mathemat- ics and baseball, the professor also speaks of the wellbeing of the narrator’s son. 43 The discussion of Equations below is from Thornber (2017b). 44 In 2006, the novel was adapted into a feature film of the same title that received a Japa- nese Academy Award. 45 See, for instance, the case of the Urdu-language publisher Mashal Books, which has trans- lated numerous works of non-Western literature into Urdu via the English translations of these works. Prominent among literary texts translated by Mashal are East Asian novels
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Just as important, the many differences in how the translations of Equations describe the professor’s overall memory, how his short-term memory func- tions, the condition of his mind and brain, and his lived experience cannot readily be attributed to cultural differences regarding treatment of tbi or brain disorders more generally. In other words, to give one example, the differences between the German and the Korean versions of Ogawa’s novel do not stem from differences between German and Korean attitudes toward brain disor- ders. Instead, taken together, the differences among the translations of Equa- tions underscore the fundamental subjectivities and even capriciousness at play in labeling and describing people and health conditions. The differences reinforce our continued lack of understanding about brain disorders and the experiences of those who live with them. Ogawa’s novel suggests, and its many translations emphasize, that more caution is needed in speaking about these conditions, and that more care must be given to grasping what patients most want and need from their professional caregivers and from society at large. The following pages draw on eight translations of the Japanese-language version of Equations – two in Chinese and one each in English, French, Ger- man, Italian, Korean, and Spanish. I pay particular attention to how these translations grapple with describing both the professor’s health condition and his experiences with this condition.46 So doing brings to the forefront one of the great challenges of person-focused care: an individual’s health condition and how experiences with this condition can be interpreted (i.e., translated) in many different ways, particularly when the individual cannot speak about their condition, making it exceptionally difficult for a professional caregiver truly to alleviate suffering and promote healing. All versions of Equations agree that the professor’s memory of events before his car accident in 1975 remains intact but that he has only eighty minutes of short-term memory, a condition brought on by a tbi suffered in the crash. Yet the translations vary in their in- terpretations of the implications of this condition; the fact that these diver- gences do not seem to stem from cultural differences, despite the fact that much of medicine is highly culturally based, further highlights the arbitrari- ness of how conditions, and people, are categorized. To begin with, there is the state of the professor’s overall memory: given his eighty-minute short-term memory, is his overall memory to be understood simply as having “problems,” is it actually impaired, or does it not work at all? The first thing the professor’s sister-in-law tells the narrator as the narrator is
that grapple with illness and health, including Yi Ch’ŏngjun’s novel Your Paradise, dis- cussed in Chapter 1. For more on this phenomenon see also Thornber (2016f, 2016g, 2018). 46 I also refer briefly to the Hebrew translation.
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But almost immediately thereafter, she likens the professor’s memory to an eighty-minute videotape that appears automatically and smoothly to record new memories over old memories. Ultimately, neither image fully captures the professor’s reality for the previous seventeen years, given that he also retains his long-term (pre-accident) memory. Because the professor is described as having both a long-term memory that is very much intact and an incessantly changing/collapsing eighty-minute tape/tower, it is no surprise that as the nar- rator is wrapping up her interview with the professor’s sister-in-law, she de- clares that her previous work experiences will be of little use to her here. Translations of Equations have tackled this passage in a variety of ways. They tend to follow the Japanese version in likening the professor’s memory to a videotape that every eighty minutes records over the previous eighty min- utes. And some, like the Korean version, maintain the idea of memories at- tempting to accumulate only to collapse at once (금방 무너져 내려요; 2004b: 11), but the English, German, and Spanish versions – even as they speak of the professor as having a single, eighty-minute videotape inside his head – decline the opportunity to refer to both accumulating and collapsing edifices of memory. The English reads only, “Since then [the accident], he has been unable to remember anything new. His memory stops in 1975” (2009: 5). The German version likewise deletes references to collecting memories: “Vor siebzehn Jahren hat er sich bei einem Autounfall eine schwere Kopfverletzung zugezogen und leidet seitdem an Gedächtnisverlust. Seit 1975 funktioniert sein Kurzzeitgedächtnis nun schon nicht mehr” (Seventeen years ago he incurred a serious head injury in a car crash and since then has suffered from memory loss. His short-term memory hasn’t worked since 1975; 2012: 11). By retaining the comparison to a videotape yet omitting the reference to an unsuccessful strug- gle to pile up memories, the English and German versions mitigate the profes- sor’s struggles with his memory. Other versions of Equations speak of the professor as attempting to accu- mulate memories but say only that he cannot do so or that these memories rapidly disappear, as opposed to the Japanese version’s claim that they “quickly collapse.” Wang Yunjie’s 2004 Chinese translation, for instance, states that the professor’s memory “lasts only until 1975 [記憶只到一九七五年為止]. After that, even though he wanted to accumulate new memories, this was a futile effort [即使想要累積新的記憶也徒勞無功]” (2004a: 8). Li Jianyun’s 2005 Chinese version claims that before the accident there was a “stockpiling move- ment of the professor’s memory storehouse” (记忆库的存储活动), but “after that, even though he wanted again to accumulate new memories, new memo- ries immediately disappeared” (即使再想积累新的记忆，新的记忆也将 马上消失; 2005: 6). Li’s translation draws more attention to the professor’s
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presenting many different impressions of the professor and life with very lim- ited short-term memory. Given the professor’s difficulties with memory, how then can the condition of his mind, his brain, be described? Immediately after telling the narrator that the professor’s memory is impaired, the professor’s sister-in-law declares, as if to reassure her potential employee, “His mind hasn’t gone soft” (惚けているの ではありません; 2003a: 8). The two Chinese versions of Equations are less subtle, leaving open the possibility of a slightly more serious condition; they state only, “He’s not senile” (没有癡呆; 不是癡呆), as do the English, German, and Korean versions, using the words senile, senil, and 노망, respectively. Tak- ing a similar approach are the French (gâteux, doddering), Italian (ido, men- tally gone), and Spanish (demente, demented, insane) translations.47 The different translations of Equations agree that the professor’s mind is not decrepit, but they follow this statement with diverging impressions on the con- dition of his brain. The Japanese version insists, “On the whole, his brain cells are working in complete health” (全体として脳細胞は健全に働いているの です; 2003a: 8). The Chinese, French, and Italian versions downgrade “com- plete health” to “good health”: “On the whole, his brain cells are in good health/ function normally,” while the Korean version omits the modifier “on the whole” (全体として), stating without caveat, “his brain cells are functioning health- fully” (뇌 세포는 건강하게 움직이고 있으니까요; 2004b: 11). Given that the Korean translation had just declared that the professor’s memory “didn’t work,” this text accentuates even more than other versions of Equations the disparity between the health of an individual’s brain cells, at least in the mind of a non-specialist, and the actual function of their memory. For their part, the English and German versions delete mention of brain cells altogether, following the assurance that the professor is not senile with “his brain works well” and “seine Geisteskraft ist unvermindert groß” (His mental vigor remains strong, 11), the latter especially an apparent contradiction with earlier declara- tions that the professor’s memory is leaving him in the lurch. Internal contra- dictions in each version of Equations are multiplied by the novel’s multiple translations – as family members and translators alike struggle to shed light on a mind so far out of their reach. Paradoxically, at the same time that references to healthy, functioning brain cells can provide deeper assurances of health, they also skirt the issue of whether the professor’s mind/brain works well as a whole.
47 The Japanese version could be translated as “he is not senile,” but the phrase 惚けている のではありません is somewhat subtler.
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What then about the lived experience of the professor? What impact does the inscrutability of his condition have on those around him and on the quality of his care? Somewhat surprisingly, considering the sister-in-law’s description, the professor bonds quickly with the narrator and her son, whom the professor nicknames Root. The professor listens carefully to Root, even correcting him gently when his table manners leave something to be desired and encouraging him to eat larger portions so that he will grow stronger. Although the professor dislikes being disturbed while working, he emerges from his study the moment Root returns home, eager to converse with the boy. To be sure, as with most children, Root prefers playing baseball with his friends to studying mathemat- ics, but the professor is a gifted and patient teacher, always full of praise for his young pupil, even when Root is making little progress on his homework. The two grow so close, in fact, that the narrator feels excluded when they are to- gether, but she allows the relationship to blossom, recognizing how good it is for her son to have the professor in his life. Many of her conversations with the professor similarly revolve around mathematics, equations filling the air and the pages of Equations; the narrator claims that she had detested mathematics as a child, but thanks to the professor, she has become fascinated with the sub- ject and eventually sees prime numbers and equations everywhere around her. Yet the relationship between the professor and his caregiver is not without its challenges. Kind and compassionate, the narrator respects the professor’s desire to limit their conversations to numbers and baseball and to refrain from talking about the professor himself. But as a result, she learns very little about the accident’s impact on the professor beyond what she had been told during her initial interview with his sister-in-law. Her care is person-focused in that she honors the wishes of her patient to avoid discussing himself, and in so do- ing does not exacerbate his suffering, but her care is anything but person-fo- cused when it comes to the professor’s other needs. Early in the novel, the narrator comments on the relative ease of her new position from the perspective of a housekeeper: the professor lives in a small cottage, never has visitors, and shows little interest in food, leaving her ample time to clean. But as his caregiver, she laments that she has great difficulty understanding how the professor’s memory actually works and the effect his truncated memory has on him. She recalls his sister-in-law’s comment that the professor’s memory stopped in 1975 but regrets that she still does not compre- hend, “for example, what yesterday meant to him, or whether he could think ahead to tomorrow, and the extent of the anguish [苦痛] brought about by his impairment/inconvenience [不自由さ]”(2003a: 30). In contrast with the pro- fessor’s sister-in-law, the narrator reveals her own attempts to understand not just the nature of the professor’s memory loss but also how he lives, and suf- fers, because of it.
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Translations of Equations replicate the narrator’s uncertainty concerning the degree to which the professor suffers from his condition, but the varying ways these texts label the condition again reveal diagnostic instability, how differently the same symptoms can be interpreted. The narrator in the Japa- nese version echoes the professor’s sister-in-law by depicting the professor as afflicted by an “impairment” or “inconvenience” (不自由さ). This sentiment is replicated in the Korean version and in Li Jianyun’s Chinese translation (2005), where the terms 부자유 스러움이 and 不便 are used, respectively; it also is repeated in the German version, which speaks of the professor as suffering from “Einschränkung” (restrictions, 2012: 35). But the idea of impairment/in- convenience is adapted slightly in Wang Yunjie’s Chinese translation: “不知道 這穜記憶障礙會給他带來多大的痛苦” (I didn’t know how much suffering these kinds of memory impediments had brought him; 2004a: 29), where the narrator speaks of “memory impediments” rather than of “impairments” or “inconveniences.” In contrast, the French, Italian, and Spanish translations speak explicitly of the professor’s “handicap,” while the English states merely “I had no idea … how much he suffered” (2009: 22), refusing to attach any label to the professor’s condition.48 Ultimately, the different versions of Ogawa’s novel are unclear both internally and among themselves as to whether his condition is a handicap, an impairment, a problem, or just something from which he suffers. However, while in the Japanese version the narrator speaks in this passage of the professor’s “impairment” or “inconvenience,” later in the novel, she won- ders how much the professor understands of his “illness” (病気, 2003a: 64), a term that – unlike “impairments” or “inconveniences” – is closely replicated in the Chinese (自己生的病, 2004a: 63; 病况, 2005: 53), French (maladie, 2003b: 70), Italian (malattia, 2008a: 56), Korean (병, 2004b: 68), and Spanish (enfer- medad, 2008b: 80) versions of Equations. For its part, the English moves from refraining to label the professor’s condition to speaking of his “memory prob- lem” (2009: 47), whereas the German moves from referring to “restrictions” on the professor’s life to speaking only of the professor understanding how his memory is ordered (sein Gedächtnis bestellt war; 2012: 70–71). The narrator strives to do right by the professor, who does not remember her from one day to the next or even at different points during the same day, if she is away from him for more than eighty minutes. She comments that she is
48 The French, Italian, and Spanish translations use the word handicap (handicap, 37; handi- cap, 31; minusvalía, 42). The Japanese term 不自由さ can be translated as “handicap,” but it has a wider range of meaning and a softer edge than the English word “handi- capped” and its European equivalents, which are more frequently rendered in Japanese as 障害 or, more recently, しょう害 (disabled).
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always afraid she will say the wrong thing, and she reveals that in retrospect, she felt terrible suggesting that they should purchase a television to watch the 1992 Barcelona Olympics when the last Olympics he remembered were the 1972 Olympics in Munich. But she also confesses that the professor himself did not appeared bothered by such comments, noting “When the conversation went off in a direction that he couldn’t follow, he wouldn’t get angry, or impa- tient, but instead would simply wait until it returned to something he could talk about” (2003a: 31). The narrator can only surmise what the professor is thinking and why he is so garrulous on some topics and so reticent on others. She guesses that it likely is not pride that prevents him from asking for help but instead aversion to trou- bling “people in the normal world of normal memory that we take for granted” (ごく当たり前の記憶の世界に生きる人々; 2003a: 64). This being the case, the narrator decides to say as little as possible to her charge. Noteworthy here is the separation the narrator makes not only between herself and the profes- sor but also between the professor and the world of “normal memory.” Further isolating the professor from his surroundings, the English translation rewrites “people living in the world of normal memory” – repeated in the Chinese ver- sions (2004a: 63; 2005: 54) – as “those of us who lived in the normal world” (2009: 47).49 In other words, both the Japanese and the English versions of Equations posit the professor as living in a world that is different from that of most people, but while in the Japanese and Spanish versions the professor is separated only from the world of “normal memory,” the English version has him isolated from the “normal world” itself. So too does the German transla- tion, which likewise speaks of the professor as separate from the “normal world” (normalen Welt, 2012: 71). Taking a middle ground, the Italian transla- tion refers to the “normal world of memory” (normalissimo mondo della me- moria, 2008a: 56), leaving open the possibility that while the professor does not inhabit this “normal world” of memory, there are other “normal worlds” still open to him, as evidenced by how he has adapted to his new life. In contrast, the French translation omits the reference to “world” altogether, speaking of the professor as reluctant to disturb “ceux qui vivaient avec une mémoire tout à fait normale” (those who lived with a totally normal memory; 2003b: 70). Likewise, the Korean version speaks only of “people who remember the past as
49 The Hebrew translation takes this one step further with “those of us who lived in the real/ true world” (53–54). The Hebrew version of Equations is a translation not of the Japanese but of the English version and translates closely the passages examined in this chapter. The one major change is in the title, which the Hebrew translation gives as Matnat ha- misparim (Gift of Numbers, 2010), in contrast with the English The Housekeeper and the Professor. Thank you to Sunny Yudkoff for this information.
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description of visits to the professor gives no indication that he fails to recog- nize them. Condensing the final eleven years of the professor’s life into the last few pages of Equations, the narrator instead speaks of gentle games of catch between Root and the professor, records a conversation they had on prime numbers during their last visit, and shares the professor’s delight at the news that Root is preparing for a career as a middle-school teacher. As before, she sidesteps the deterioration of the professor’s mind, focusing instead on his weakening physical body, as well as the apparent joy he derives from sharing math problems with her and her son. As its Japanese title suggests, Equations the Professor Loved highlights what the professor continues to cherish – mathematics and especially equations, which are scattered throughout the Japanese narrative and duplicated in the many translations of this spatially and linguistically mobile text. In contrast, the novel’s descriptions of the professor’s overall memory, how his short-term memory functions, and the condition of his mind and brain, as well as his lived experience with a brain disorder, vary within and across versions, underscor- ing the arbitrariness with which labels are attached and conditions are under- stood, particularly health conditions that prevent individuals for whatever rea- sons from expressing their own explicit illness narratives. In a recent article on his brief episode of anterograde amnesia, American journalist Trip Gabriel asks, “Without our memories, who are we?” Gabriel goes on to comment, “The ability of the mind to hold short-term recollections, and to retrieve longer-term memories and the feelings they evoke, is essential to being human” (2016).50 In contrast, Equations depicts life continuing mean- ingfully and productively, albeit with great difficulty, after traumatic brain in- jury.51 Ogawa’s novel and its translations throughout the world highlight the
50 Gabriel references the film Memento (2000), which features Leonard Shelby, who also has anterograde amnesia, as well as the Pixar animated film Inside Out (2015), which takes place in the head of an eleven-year-old girl. Gabriel argues that the latter film portrays memories as the bedrock of personality. 51 In this the professor is very different from Patient H.M. American journalist Luke Dit- trich’s Patient H.M.: A Story of Memory, Madness, and Family Secrets (2016) tells the story of one of the world’s most famous memory disorder patients – Henry Gustav Molaison (1926–2008) – who was given a bilateral medial temporal lobectomy in 1953 to control his debilitating epilepsy, which had been triggered by a bicycle accident some twenty years earlier. In the words of his surgeon, Molaison had “very grave, recent memory loss, so se- vere as to prevent the patient from remembering the locations of the rooms in which he lives, the names of his close associates, or even the way to toilet or urinal.” Molaison be- came “the most studied individual in the history of neuroscience” (2016: 8), every part of his brain examined and reexamined the remainder of his life and well after his death, revolutionizing the field. Interestingly, neuropsychologist Brenda Milner (1918–), who
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4 Differences Denied
Just as vulnerable as Coetzee’s Michael K, Hanif’s Zainab, and Ogawa’s profes- sor is the patient who is a child, who is only infrequently consulted about her care, and about whom assumptions are regularly made. Lenny, a member of the Parsi diaspora in colonial Lahore and the first-person narrator of Pakistani American novelist Bapsi Sidhwa’s Ice-Candy-Man (1988), is precisely such an individual.52 Although Ice-Candy-Man is primarily an exposé of the horrific violence of the 1947 partition of India from a Parsi perspective, Lenny begins the novel by talking about reactions to her limp, a result of polio.53 Especially
worked extensively with Molaison, told Dittrich about a decade ago, “You can imagine that he [Molaison] did not really have a very good life [before the surgery] with all the medication and all the seizures and the isolation. And since the surgery, since he is so amiable, and since he really likes doing tests, he likes doing something for science” (233). But it is not at all certain that Molaison actually liked much less knowingly consented to “doing something for science.” As Dittrich writes, “My grandfather’s operation had made Henry neurologically predisposed to consent to anything” (328), and he describes in Pa- tient H.M. how little control Molaison had over what happened to him. 52 Ice-Candy-Man was later published as Cracking India (1991). Sidhwa was born in Karachi and lived in Pakistan until 1985, when she moved to the United States (Didur 2006: 70). 53 The Parsis are a minority community in India. Paromita Deb (2011) discusses Lenny’s identity as a Parsi and the impact of the Partition on this community, while Cara N. Cilano focuses on the impact of Lenny’s differently aged narrative voices (2017: 34–41). Lenny’s experiences with polio and with Dr. Bharucha pale in comparison to the trau- mas and terrors described in the hundreds of first-person polio narratives produced worldwide. Polio is an ancient disease for which there has been a vaccine for more than six decades (Jonas Salk’s [1914–1995] polio vaccine was introduced in 1955) but for which there is still no cure or even effective treatment. Moreover, as Marc Shell observes in Polio and Its Aftermath, “The victory over polio [i.e., the Salk vaccine] obscured just how much polio was still affecting key aspects of our culture – literature, cinema, music, and the media and health businesses,” not to mention the daily lives even of those who had been
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“cured” (2005: 2, 4). Shell references hundreds of first-person polio narratives from all the world’s continents (although not Sidhwa’s novel), many of which were not catalogued anywhere. His study reveals not only the terrors and traumas to which those with this disease were subjected but also the extent to which polio has been neglected in scholarly discourse. Shell emphasizes how those who have had the disease are marked as such throughout their lives.
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When it comes time to remove the cast, she describes herself as “unable to bear the thought of an able-bodied future” (13). But once again, the patient is not consulted. Moreover, Bharucha cares not at all about Lenny’s fears; he does not even hear her, much less listen to her. And he becomes impatient with her parents for not undressing her quickly enough in the examination room. Lenny trembles “from the thunder of her an- gry roars.” He orders her to “Lie still!” and she is petrified by his tone. But when the cast comes off, she is relieved at what she sees; her right leg “looks dead … [it] looks functional but it remains gratifyingly abnormal – and far from ba- nal” (15). The physician warns that she still needs care, but he reassures her mother that “by the time she grows up she’ll be quite normal” (15). Again, the emphasis is on making Lenny “normal,” not on ensuring her wellbeing. Rather, wellbeing is erroneously equated with normality, not with what Lenny actually desires. When Lenny’s father asks Bharucha about his daughter’s education, the physician responds, “She’s doing fine without school, isn’t she? … Don’t pressure her…. her nerves could be affected. She doesn’t need to become a professor” (15). Bharucha then rather unusually – given his previous failures to interact with his patient – turns to Lenny and asks her whether she wants to become a professor. Not surprisingly, given that she is still quite young, Lenny shakes her head “no,” to which Bharucha responds, “She’ll marry – have children – lead a carefree, happy life. No need to strain her with studies and exams” (15). In other words, Lenny’s parents can rest assured that she will be- come a “normal” woman. Even as a child, however, Lenny believes such a response to be “sealing my fate” (15). As Clare Barker has argued, “Medical intervention (or interference) is figuratively aligned with the imposition of arbitrary borders on the shape of the nation, and Lenny’s fear of dismemberment is as much a comment on ideas of normalization that require bodies to conform to a gendered, sexual- ized and ableist norm as it is on restrictive state policies in Pakistan that eschew diversity in favor of an Islamic religious identity” (2011: 111–112). Moreover, Barker continues, Sidhwa’s novel “acknowledges the impossible and undesirable nature of ‘cure’ with regard to the body and the nation. Instead, it ultimately gestures towards a politics of healing that, in Sidhwa’s terms, in- volves a continuing alertness to the effects of representation and an attempt to achieve an empathetic engagement with difference” (126).54 Lenny is never completely freed of her limp, and even though as a young child she had commented on the “compatible and sanguine nature of my
54 Barker examines the pervasive disabled child-nation motif through Sidhwa’s novel and a range of other postcolonial texts.
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relationship with my disease” (Sidhwa 1988: 17), as she grows older, knowing what she does about her society, she begins to worry that she will never find a husband (217). Yet unlike her physician and her mother, she does not obsess over being cured.55 To be sure, Sidhwa’s Ice-Candy-Man does not suggest that cure should not be pursued. But it does reveal how rapidly the patient’s voice can be lost in such a pursuit. … Patient voices and stories are frequently dismissed, if they are even acknowl- edged at all, and especially if they are not articulated coherently, regardless of the devotion of practitioners to those under their care. Global literature such as Coetzee’s Life and Times, Hanif’s Alice Bhatti, Ogawa’s Equations, and Sidh- wa’s Ice-Candy-Man counter this disregard, both by exposing some of the un- expected means by which this neglect occurs and by underlining the need to listen to and speak with patients as people. Sometimes so doing is a matter of life or death, or at least of unbearable suffering or welcome relief. But just as often, person-focused care is a matter of not adding unnecessarily to the chal- lenges people already face physically, psychologically, and socially as a result of their health conditions and instead providing them with means of healing and improving wellbeing. Indeed, greater emphasis on healing and wellbeing, even in the case of chronic conditions, is just as central to humanizing healthcare as listening to and speaking with patients as people. This emphasis is the topic of the following chapter.
55 Late in the novel, singing the praises of the homeopath Mr. Phailbus, Lenny’s mother commands her daughter to demonstrate her walk for the Phailbuses and Bharucha’s re- placement, Dr. Selzer. And so, Lenny reports, “like a performing poodle I parade up and down before the Phailbuses, taking care to place my awkward heel on the floor.” Watching her daughter, Lenny’s mother exclaims triumphantly, “He’s cured her limp!” (270). Per- haps having been convinced that her daughter is “cured” will ease her mother’s heart, and she will cease obsessing over cure.
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