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Reading and Writing Chronic Illness, 1990-2012: Ethics and Aesthetics at Work

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Reading and Writing Chronic Illness, 1990-2012: Ethics and Aesthetics at Work Reading and Writing Chronic Illness, 1990-2012: Ethics and Aesthetics at Work Sarah Pett Doctor of Philosophy University of York Department of English and Related Literature January 2014 Abstract This thesis is about autobiographical and fictional accounts of chronic illness professionally published between 1990 and 2012. It begins with a survey of popular and critical thinking about illness accounts, in which I show how both the medical humanities and literary studies have placed restrictions on what these accounts can mean, and thus on the kinds of cultural work they can do: restrictions that frequently belie the complexity of the aesthetics and ethics at work in many of the texts considered in this thesis. I build on this claim through close reading of a cross- section of contemporary illness accounts in which I flag up the presence of aesthetic elements distinct to the literary—including aspects of imagery, form, symbolic structure, address, and so on—, and show how these elements work not just to underscore the informative content of these illness accounts, but also to create new patterns of meaning, new networks of relation, and new modes of engagement. Though this project focuses on the contemporary, Virginia Woolf’s essay On Being Ill (1926) acts as its theoretical nucleus. In chapter 2, I show how On Being Ill provides a productive framework within which to explore the relationship between illness, literary aesthetics, and ethics. I also tease out the themes that are to define the chapters that follow, for, as Woolf demonstrates, at stake in the representation of the embodied self and the sensations it experiences are issues such as the referentiality of language and of fiction; the workings of metaphor and allegory; and the possibilities and limitations of the discursive sediment that accrues around words, images, and narrative tropes. In chapter 3, I explore this latter issue in a study of the construction of the narrative self and of the body in four autoethnographies by women academics. In chapter 4, I look at the representational experiments that Hilary Mantel and Paul West undertake in their memoirs as they seek to describe the physical and psychological effects of illness. Finally, in chapter 5 I consider how two South African fictions of illness—J. M. Coetzee’s Age of Iron (1990) and Marlene van Niekerk’s Agaat (2006)—provide a valuable case study for thinking about the relationship between illness and allegory in fiction. My conclusion draws these strands together, arguing that illness accounts can contribute not just to our understanding of the illness experience, but to our thinking about the nature of the literary and its participation in the ethical also. 2 Contents Acknowledgements………………………………………………………… 4 Author’s Declaration…………………………………………………..…… 5 Introduction……………………………………………………………….. 6 Chapter One Contested Fields: Writing and Reading Illness in the Medical Humanities and Literary Studies……………………… 29 Chapter Two Undiscovered Countries and Unexploited Mines: Woolf on Illness, Literature, and Ethics………………………………… 49 Chapter Three On Being Ill, Academic, and Female: Contemporary Autoethnographies of Illness.…..………….…………………………….. 81 Chapter Four The Devil’s Dictionary: Illness and Language in the Literary Memoir…………..……………………………………….. 108 Chapter Five: The Via Dolorosa in the Southern Hemisphere: Illness, Fiction, and the Question of Place in Two South African Novels.………………. 124 Conclusion…………………………..……………………………………… 145 Works Cited and Consulted…………………………..………………….. 158 3 Acknowledgements First and foremost, I am indebted to my supervisor Professor Derek Attridge for his consistent support of my work and his confidence in my abilities. I am also grateful to the Arts and Humanities Research Council and to the World Universities Network for funding me during this time. Additionally, I would like to thank: Mary Felstiner and Ann Oakley for their generous responses to my questions about their work. My colleagues at York and beyond for their encouragement, advice, and inspiring conversation, particularly David Attwell, Ziad Elmarsafy, Jason Edwards, Zoë Norridge, Michelle Kelly, Claire Westall, Richard Rowland, Bryan Radley, Kai Easton, Carrol Clarkson, Sam Hellmuth, and Karen Clegg. The staff at New York Public Library (Bryant Park), the Vancouver main library, the British Library, Boston Spa, Senate House, Berrick Saul Building, and the UCT Graduate Centre for their assistance. My biggest thanks go to: My family for their support and questions: Stanley Peart, Ian, Celia, and Joseph Pett. Odile Dicks-Mireaux, Rod McLean, Liz McLean, and Paul Browning for the hospitality. My friends for limitless solidarity, encouragement, tolerance, wine, spare inner tubes, spare beds, and pot luck contributions: Natasha Joseph, Sarah Wild, Thandi Welman, Erica Lombard, Hanneke Stuit, Phoebe Rose, Owen Robinson, Natalie Pollard, Ben Poore, Kate Highman, Jurate Levina, Jenny Basford, James Emmott, Kirsty Rolfe, James Fraser, Anna Bocking-Welch, and Isabelle Hesse. Finally, this thesis is dedicated to Jane Moody and Mary Bowers, two of the most brilliant women I have ever known, and who are much missed. 4 Author’s Declaration The work presented in this thesis is my own, and is the product of original research undertaken at the University of York between September 2009 and January 2014. This work has not previously been presented for an award at this, or any other, University. All sources are acknowledged as references. 5 Introduction Every era casts illness in its own image. Society, like the ultimate psychosomatic patient, matches its medical afflictions to its psychological crises; when a disease touches such a visceral chord, it is often because that chord is already resonating. Siddhartha Mukherjee (182) In the late twentieth century, there emerged a public culture of illness quite unlike any seen before: a culture in which personal experience was thrust to the fore, and first-person accounts of living with, through, and beyond illness flourished in a range of media, including life writing, fiction, film, theatre, television drama, and blogs. By the turn of the twenty-first century, the illness account had become well established as a genre—particularly in the field of life writing—and has since shown no sign of disappearing. Instead, it has continued to flourish, buoyed up by growing popular and scholarly interest in the subjective experience of illness, as well as the intersection between medicine and the arts and humanities. As Nancy Mairs—herself an author of several works on her experience of multiple sclerosis—observes, “we’re not talking about a handful of books here. Dozens have poured forth from publishers large and small in the United Kingdom as well as the States. My shelves groan under their weight” (xi).1 Of course, this culture was not spontaneously generated: accounts of illness and treatment have for a long time circulated within social networks, in the form of personal correspondence and diaries, some of which have been published posthumously or brought to a wider audience through the work of social historians of medicine. Well-known examples from the late eighteenth and early nineteenth centuries include Samuel Johnson’s reports of temporary aphasia (and other ailments) in his letters and journals,2 and Frances Burney’s account of the 1 The deluge of accounts that Mairs describes here is given quantitative impact in the second edition of Anne Hunsaker Hawkins’s Reconstructing Illness: Studies in Pathography (1999), which records that between 1993 and 1997 the number of published autobiographical illness accounts almost doubled (159). This figure has continued to increase into the present day, as a 2012 replication of Hawkins’s 1997 OCLC World Catalogue search and analysis demonstrates. 2 See, for example, Critchley (1962). 6 mastectomy she underwent—without anaesthetic—in a letter to her sister Esther.3 A more recent illustration of this kind of account can be found in Alice James’s diary, which documents her experiences of mental illness and breast cancer in the late nineteenth century.4 Sheila Rothman’s 1995 study of tuberculosis narratives in the late nineteenth and early twentieth centuries charts the beginnings of the transition from diaries and personal correspondence to more public accounts, such as those published in sanatorium newsletters, while in Illness and Narrative (2011) Ann Jurecic identifies the precursors of these accounts in professional medical journals and the popular press (Jurecic 5-6). However, though the first half of the twentieth century saw the appearance of personal narratives about illness, medicine, and healthcare in professional medical journals and the popular press, it was not until the second half of the century that first-person illness accounts began to move from the private sphere into the public in large numbers: a movement tightly bound up with cultural and technological shifts such as the democratization of autobiography, the growing influence of so-called “therapy culture,” the mass production of paperbacks, and, more recently, the digital revolution.5 What remains surprising is that, while in recent decades a substantial body of scholarly work has grown up around the burgeoning genre of published illness accounts, the principles and practices of literary studies do not occupy a central role in this scholarship.6 While valuable literary readings of life writing and fiction about illness do exist,7 in general these readings, and the approaches they represent,
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