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Reeher, Jennifer M 03-03-18 “The Despair of the Physician”: Centering Patient Narrative through the Writings of Charlotte Perkins Gilman A thesis presented to the faculty of the College of Arts and Sciences of Ohio University In partial fulfillment of the requirements for the degree Master of Arts Jennifer M. Reeher May 2018 © 2018 Jennifer M. Reeher. All Rights Reserved. 2 This thesis titled “The Despair of the Physician”: Centering Patient Narrative through the Writings of Charlotte Perkins Gilman by JENNIFER M. REEHER has been approved for the Department of English and the College of Arts and Sciences by Thomas Scanlan Associate Professor of English Robert Frank Dean, College of Arts and Sciences 3 ABSTRACT REEHER, JENNIFER M., M.A., May 2018, English “The Despair of the Physician”: Centering Patient Narrative through the Writings of Charlotte Perkins Gilman Director of Thesis: Thomas Scanlan Patient narrative is often an undervalued or dismissed genre of writing in the field of literary criticism, largely because the hermeneutics of suspicion leads critics to see these texts as “misery memoirs,” as Ann Jurecic suggests. In this thesis, I argue for a new approach to reading and to criticism that moves away from the hermeneutics of suspicion and instead seeks to find conversations between patient narratives, case narratives, and popular or dominant medical and scientific texts. This shift would have readers focusing not on the ways in which an author might manipulate a story but instead on what the reader might learn from intently examining the resulting conversations. In doing so, I do not argue for a switch in the hierarchy—from doctor-patient to patient-doctor—but instead argue that both patient and case narratives have value; without both texts, we cannot have a full picture of what it is like to live with illness. Making my argument through historical examination, I prove that by examining Charlotte Perkins Gilman’s patient narratives—those found in her letters, her diaries, and her autobiography as well as in “The Yellow Wallpaper”—alongside medical and scientific texts from her time, we can not only deepen and nuance current interpretations of these texts but we can also uncover motivations that may not be immediately apparent. While “The Yellow Wallpaper,” for example, has been considered as a critique of 4 patriarchal medicine, a horror story, and a liberation text—among others—it has never been explicitly examined as a patient narrative. This focus allows us to delve deeper into the conversation created between “The Yellow Wallpaper” and Gilman’s nonfiction narratives; I focus particularly on how we can see the eugenic arguments within “The Yellow Wallpaper” and how these arguments are connected to Gilman’s anxieties about marriage, motherhood, and her usefulness in society. While ignoring patient narratives makes literary critics and historians complicit in the history of silence that surrounds medical patients, I conclude that by instead recognizing the validity and the value of the patient narrative, literary critics and historians could (1) better contextualize some of the most popular and canonical texts, especially those in which illness is a significant driving factor, (2) develop a more complete understanding of what it is like to live with illness, and (3) create new frameworks through which to read patient narratives, as well as other autobiographical texts. 5 DEDICATION To my parents, Matt and Sherry Reeher Thank you for your constant and unwavering love and support. 6 ACKNOWLEDGMENTS I would first like to express profound gratitude to my thesis director Dr. Scanlan, who provided me not only with helpful comments and feedback but also with support and encouragement throughout the process of crafting this master thesis. I would also like to thank Drs. Hurley and Sheldon, the second and third readers on my thesis committee, for their insightful and prompting comments and for their keen eyes for detail. Finally, I must thank my peers in the Ohio University Graduate English Program, particularly Jeffrey Mccambridge, Devan Murphy, Megan Griffith, and Regina Yoong, all of whom actively listened to me to talk out my ideas, asked me brilliant and prompting questions, and encouraged me through every step of the thesis-writing process. Thank you. 7 TABLE OF CONTENTS Page Abstract ........................................................................................................................... 3 Dedication ....................................................................................................................... 5 Acknowledgments ........................................................................................................... 6 Introduction: A Case for the Patient Narrative Genre in Literature ................................... 9 What Is a Patient Narrative?—Defining the Terminology ........................................ 10 Patient Narrative in Medical Humanities.................................................................. 12 Patient Narrative in Literature .................................................................................. 15 Gilman, Mitchell, and American Medicine at the Turn of the 20th Century.............. 19 Chapter Overview .................................................................................................... 21 Chapter 1: Treating Nervous Conditions in Late 19th- and Early 20th-Century American Medicine ....................................................................................................................... 24 What Is Neurasthenia? ............................................................................................. 25 Causes of Neurasthenia ............................................................................................ 32 Treatments for Neurasthenic Patients ....................................................................... 39 Connecting (and Separating) Neurasthenia and Hysteria .......................................... 45 The Challenges Presented by Hysterical Patients ..................................................... 48 Neurasthenia, Hysteria, and American Anxieties ..................................................... 52 Gilman and Mitchell: In Context.............................................................................. 54 Chapter 2: The Changing Doctor-Patient Relationship and Tension in Case and Patient Narratives ...................................................................................................................... 56 The Changing Field of Medicine: Scientific Discoveries, Advancing Technologies, and Specialized Medicine ........................................................................................ 58 Changing Doctor-Patient Relationships ................................................................... 63 Case Narratives: Patient Experience in the Doctor’s Hand ....................................... 68 Chapter 3: Gilman’s Patient Narratives .......................................................................... 78 Gilman’s Letter to Mitchell...................................................................................... 79 Gilman’s Diaries...................................................................................................... 83 Gilman’s Autobiography ......................................................................................... 93 “The Yellow Wallpaper” ....................................................................................... 103 Narrative as a Window into Medical Practice and Patient Experience .................... 106 Chapter 4: Adding Patient Narrative to the Critical Conversation about Gilman .......... 108 8 “The Yellow Wallpaper” as a Horror Story ............................................................ 111 “The Yellow Wallpaper” as a Critique of the Rest Cure ......................................... 114 “The Yellow Wallpaper” as a Liberation Text ....................................................... 118 “The Yellow Wallpaper” as a Eugenic Argument .................................................. 121 “The Yellow Wallpaper” as a Patient Narrative ..................................................... 125 Conclusion: The Value of the Patient Narrative ........................................................... 130 Works Cited ................................................................................................................ 136 9 INTRODUCTION: A CASE FOR THE PATIENT NARRATIVE GENRE IN LITERATURE In 1892, Charlotte Perkins Gilman published her most well-known work, the short story “The Yellow Wallpaper.” This story draws on Gilman’s own personal experience with medicine, particularly her experience with Silas Weir Mitchell’s “Rest Cure” following her diagnoses of hysteria and neurasthenia in 1887. Since its publication, “The Yellow Wallpaper” has been interpreted as a horror story, a critique of male-dominated and sexist medicine, a liberation text, and a eugenic argument; however, this story has never been explicitly examined as a patient narrative, a text that weaves together the experiences of the individual as a patient but also as a person living a life beyond the clinically-defined boundaries of their illness. This is, in part, because the genre of patient narrative is largely underappreciated—or, at times, completely absent—in fields of literary study. By embarking on such an examination, however, we can see how Gilman’s experience—which she recorded in a variety of narratives including the
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