Abstract
Gygax and Locher’s Narrative Matters aims to show the importance of narrative practices to health, advocating for a central position for narratives within the medical humanities. Containing contributions from 15 authors from the fields of linguistics, literary and cultural studies, clinical psychology, psychiatry and medicine, the volume pursues an interdisciplinary dialogue on topics ranging from narrative texts and practices to the relation between narratives and medical humanities and dealing with texts as diverse as autobiographies, graphic novels, medical treatises and reports, short stories, reflective writing, online narratives and creative writing.
Narrative may be either written or spoken to be practised for specific purposes. In Part I, written narrative texts on illness and medicine are approached from a literary and cultural studies perspective. Chapter 2 focuses on representations of autism in selected American autobiographies, where perseverance and success have begun to replace notions of disability and defect. Chapter 3 argues that since language is the means to express absence/loss, autothanatographies tend to become actual life writing texts as omnipresent representations of dying and death. A third important form of written narrative, historical accounts, is covered in Chapter 4; here, different types of pox accounts are analysed to demonstrate that the narrative form offers the patients a way to make sense of their suffering.
After having demonstrated the significance of narratives, Part II shifts to narrative practices in health contexts from the perspectives of psychiatry, psychology and linguistics. Illness narratives in the psychotherapeutic session are analysed before prototypical patterns of narrative self-thematisation can be identified in the context of illness, suffering and deficiency (Chapter 5). Chapter 6 uses extracts from transcribed interviews and video clips placed online to show how the patient’s voice has been given space, and thus other patients can share it as a transient ‘third space’ that allows them to explore new subject positions in their narratives. Narratives in computer-mediated contexts are analysed in Chapter 7 to demonstrate how interactants engage in metadiscourse about doctor–patient interaction and co-construct the narrative through intertextual strategies. Chapter 8 addresses a special form of communication: reflective writing focused on encounters with memorable patients, which is found to be a valuable tool for students to become aware of their clinical communication skills and the narrative core on which such skills are based.
The history of the medical humanities presented in Part III shows that compassion tends to overshadow the need for a structural analysis of medicine and medical care and that critical medical studies and interdisciplinary theory integration should be encouraged (Chapter 9). Chapter 10 argues, however, that present-day medical students are quite ambivalent about incorporating narrative into medical practice, having uncritically accepted the dominant paradigm of biomedicine.
The ‘narrative turn’ which began in the past century has resulted in numerous findings, but with various definitions of narrative no consensus has by far been reached on many key issues. Usually narrative is taken as one of the key constituents of human identity, self-representation and cultural transmission, being embedded in larger discourses. Sociolinguists and discourse researchers now raise questions about the role of narrative in communication, and many regard storytelling as a fundamental ‘discourse unit’ that is acquired in the process of socialisation. Through a variety of approaches, this collection shows the richness and scope of the concept of narrative and its significance for discourse studies.
Recent work on how narrators position themselves and others in the storyworlds has led to the study of identity construction and positioning theory, focusing on materials such as life stories and small stories. Such narratives are pervasive in medicine, not only in patients’ presentation of their medical problems, but also as a crucial part of professional work. By demonstrating how narratives in medical contexts inspire and expand theoretical research in different disciplines, this collection deepens discourse analysis in the medical contexts. Foregrounding the narrative construction of illness, and looking into how illness narratives can be understood and analysed, the book helps open perspectives to see how narratives shape people’s experience in medical contexts and in other texts as a useful communicative means. Two significant insights out of these perspectives are prominent: empowerment is usually evoked whether narratives are experienced by the suffering autobiographer, the patient, the practitioner, the medical student or the reader; readers may become aware of the many different angles from which narratives can be analysed and understood, and benefit from the variety and multivocality of narratives on the experience of illness.
One shortcoming, if any, is some imbalance in author and participant backgrounds, which weakens one of the two aims of this volume: to advocate a central position of narratives in medical humanities. Most authors work in areas other than medicine, none of the three authors of studies in medical humanities is a medical professional, and only two studies employed medical students as participants. Although it may be difficult to persuade medical professionals to join in discourse research, such a collaboration should prove a worthwhile endeavour for this strand of research.