Reading Response 1 – Arthur Kleinman from Katy Meier

Utilizing his knowledge as both a psychiatrist and anthropologist, Arthur Kleinman details distinct definitions for the following terms: “illness”, “disease” and “sickness”. These definitions are specific yet overlapping at the same time. “Illness” involves the unique and personal experience of an individual suffering. An example of “illness” as the subjective lived experience of a disorder include the incomprehensible pain of losing an arm and being unable to express oneself through art ever again. Kleiman states that, “Illness problems are the principal difficulties that symptoms and disability create in our lives”. He continues by giving a multitude of examples, “We may become demoralized and lose our hope of getting better, or we may be depressed by our fear of death, or of becoming an invalid. We grieve over lost health, altered body image, and dangerously declining self-esteem” (4). Kleiman’s examples involve the non-standardized aspects of a disorder that are rarely addressed publicly. I find it interesting that as Kleinman lists these examples, he uses the plural pronoun “we”, including both himself and the reader. I think his intentions for doing this were to emphasize that illness problems are experienced by all yet no one experiences them in the same way.

The distinct definitions between, “illness”, “disease” and “sickness” are important because recognizing these differences allows us to better understand the meanings behind disorders both in our own culture and cross-culturally. Furthermore, it enables us to better address and relieve suffering. By confining the term “disease” to biomedical usage and using “illness” to address the condition holistically, instead of the two synonymously, empowers the individual suffering. Kleiman refers to disease as “radically materialist” meaning that it focuses solely on the testable and irrefutable science of a pathogen. As Kleinman specifies later in the chapter, he says that disease refers to the “technical quest for the control of symptoms” (9). Using this specific language, Kleiman gives a narrow definition to disease.

 

Work Cited

Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human 

               Condition. Basic Books, Inc, 1998.

Nancy Mairs’ Use of Crippled

Nancy Mairs’ essay “On Being a Cripple” reveals the raw emotions and truths of suffering from an illness, specifically multiple sclerosis. One of the most powerful sections in Mairs’ essay describes semantics and her choice to call herself a cripple, rather than disabled or handicapped (1). Mairs explains how such euphemisms broaden “the gap between word and reality” of her illness (1). Identifying as a cripple better captures Mairs’ experience with MS, but it also symbolizes her resistance to the societal delicacies concerning sickness.

Mairs’ self-conscious point of view allows her to explain how she addresses her illness and why the “verbal garbage” society uses is not sufficient to describe her “calamitous disease” (1-2). Mairs recognizes her differences from others and acknowledges her losses, refusing to employ language, such as “differently abled” that misconstrue the reality of her suffering (1). In denying these euphemisms, Mairs is working towards reclaiming her illness story as her own. She disregards the fragility of others who choose to shadow the authentic experience of MS with comfortable language that merely serves to reassure themselves.

Mairs explains that “society is no readier accept crippledness than to accept death…” (2). It is easy to assume that those who suffer from an illness would prefer more inclusive language. However, we oftentimes fail to acknowledge that this same language diminishes an individual’s experience with illness and confines their narratives to what society deems acceptable. Mairs wants people to know that she “can face the brutal truth of her existence,” which ultimately gives her more agency and ownership of her illness (1). Mairs, along with others who experience suffering, deserve the right to define it completely and without reservations, and how they choose to do so should influence the language we use when discussing illnesses.

Mairs, Nancy. “On Being a Cripple.” University of Arizona Press, 1986, 1-10.

The Wounded Storyteller:The Quest Narrative

Arthur Frank’s analysis of the quest narrative makes it an asset of the storyteller’s journey in which the illness is to be “conquered” in a sense of overcoming its biological deterrents and turning them into tools of liberation. In the journey from a wretched state of being to indemnification, Frank attempts to explain that while transformation interrupts the self-story, the interruption also pushes the storyteller to rise to the occasion and recognize themselves as a moral agent, whom of which dissociates from their disease by seeking to self-reinvent.

However, Frank’s development of such a quest draws upon help from Campbell’s three phases of storytelling which help to set up the framework of one’s illness journey. In the definitions of departure, initiation, and return there lies an underground force that is able to influence how each phase works-the concept of seeing one’s self as a hero. “The paradigmatic hero is not some Hercules wrestling and slugging his way through opponents, but the Bodhisattva, the compassionate being who vows return to earth to share her enlightenment with others. What the myths are about is agony. The hero’s moral status derives from being initiated through agony to atonement: the realization of oneness of himself with the world, and oneness of the world with its principle of creation. Suffering is integral to this principle and learning the integrity of suffering is central to the boon” (Frank 119). The hero is any storyteller who steps out of the boundaries of what confines them physically and consequently mentally and places them in a situation where they are not only the dynamic character, but they are able to metamorphose their suffering into something to be shared and a reformation of an imminent pitfall into the contingent body’s source of productivity.

The storyteller becomes their own hero, in which their conquering of the somatic transcends into the inner physique. While the manifesto and the memoir are quest stories that exemplify overcoming battles, the automythology is set in a space in which one must overcome and continue to revitalize. In the case of Oliver Sacks “A Leg to Stand On”, the usage of an automythology best highlights the hero as it is the job of the hero to reform from their own ashes. The setting for such a story is never set in stone as the different markers of change in the person become the “locations” that the story is formed around. Succeeding Sacks incident with the bull, a need to regain the ability to walk is an identification of the need to not let the event define his sense of self but rather rearrange what has left him in constraints. In an account that reflects the quest most profoundly Sacks comments that “a destiny of experience neither given to, nor desired by most men: but one which, having happened would refashion and direct me” (Frank 124). Arthur Frank uses these experiences to interweave the bigger concept of reinvention into an understanding of growth-mindsets being more powerful than illness.

Work Cited:

Frank, Arthur. The Wounded Storyteller: The Quest Narrative-Illness and the Communicative Body.  University of Chicago Press, 1995, pp.119-124.

The Doctor’s Failure

 

Passage taken from A Fortunate Man: The Story of a Country Doctor

“Her asthma continued and caused structural deterioration of the lungs. She now survives on steroids. Her face is moon shaped. The expression of her large eyes is placid. But her brows and eyelids and the skin pulled tight over her cheek bones twitch at every moment and sound which might constitute a warning of the unexpected. She looks after her mother, but very seldom leaves the cottage. When she sees the doctor, she smiles at him now as she would probably smile at the solider of the Salvation Army.”

Before, the water was deep. Then the torrent of God and the man. And afterwards the shallows, clear but constantly disturbed, endlessly irritated by their very shallowness as though by an allergy. There is a bend in the river which often reminds the doctor of his failure” (Berger and Mohr 23).

In A Fortunate Man: The Story of a Country Doctor, John Berger and Jean Mohr create a story detailing the relationship between a doctor and a young girl in a village in rural England. At the beginning of the passage, words such as “structural deterioration” and “steroids” which are associated with disease, “an alteration in biological structure or functioning,” are used to describe the girl’s condition (Kleinman 5). In the middle of the passage, words that describe the patient’s specific features such as her “placid” eyes and “cheekbones” twitching signify the doctor’s transition into also recognizing her symptoms of illness, or “the innately human experience of symptoms and suffering” which he realizes two years later (Kleinman 3).

Towards the end of the passage, Berger describes a body of water which is likened to the girl’s personality. Prior to the assault, the girl is characterized as “deep” where she is willing to put a deep trust in those around her. Then, there is a “torrent” when her trust is shattered by her sexual assault and the doctor’s inability to understand her anxiousness. Given her trust has been diminished, her personality is likened to the “shallows” in her maintenance of a superficial relationship to those around her.

Through word choice and metaphor, Berger and Mohr ultimately reveal the deterioration and destruction of the doctor-patient relationship that can arise when doctors only consider symptoms of disease and are unable to earn their patients’ trust. The doctor has failed to recognize symptoms of illness in the girl’s facial expressions and nonverbal actions by merely questioning her instead of trying to recognize her actions, thereby losing her trust. The doctor’s failure is clearly seen in her smile towards him as how “she would probably smile at the soldier of the Salvation Army,” a superficial smile signifying a lack of trust which he cannot earn back.

 

Works Cited

Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human Condition. Basic Books, A Member of the Perseus Books Group, 2007.

Berger, John, and Jean Mohr. A Fortunate Man: The Story of a Country Doctor. Canongate, 2016.

Follow this blog

Get every new post delivered right to your inbox.