Perspectives
Book The lives of stories, or the body of words “When my daughter was about seven years old, she asked me one day what I did at work. I told her I worked at the college—that my job was to teach people how to draw. She stared at me, incredulous, and said, ‘You mean they forget?’” Howard Ikemoto, painter and art teacher
Letting Stories Breathe: A Socio-Narratology Arthur W Frank. University of Chicago Press, 2011. Pp 209. US$25·00. ISBN 9780226260136
2170
Telling and listening to stories is something that all human beings grow up doing, seemingly without having to be taught how. Yet medicine seems in need of a “story teacher” to reteach to us a skill that has somehow leached out of our human equipment, subdued or overstruck by skills of diagnostic reasoning and reductive analysis. Patients say they need to express their experiences, to “story” their ordeals, that they need us to listen to these accounts once they find the means to express them, and that we don’t always encourage them to do so. Sociologist Alan Radley’s Works of Illness: Narrative, Picturing and the Social Response to Serious Disease details for us what patients can and must convey to themselves and to us about their illness experiences through writing or art; poet Rachel Hadas’s Strange Relation: A Memoir of Marriage, Dementia, and Poetry demonstrates how powerfully words and craft can convey the loss and rage and grief of sickness’s losses. With great appetite did I read Arthur Frank’s Letting Stories Breathe: A Socio-Narratology. Known by physicians and medical educators for his pioneering works on medical narrative, The Wounded Storyteller and A Renewal of Generosity, sociologist and critical theorist Frank has made a life-work of reading and writing illness narratives, helping doctors and patients to learn that which can only be learned from first-person accounts of illness. From Frank, we have learned to “think with stories, not about stories”. Under his rigorous tutelage, we have matured
into close readers of illness narratives, able to parse a patient’s account of illness not only into different categories but, more usefully, into singular voices and moods and plots and desires.
“Differences aside, this book is a weighty contribution to medicine’s determined and inspired search for increasing our powers of recognition, interpretation, and attention to what patients tell us.“ For its first half at least, this book is not about medicine. Instead, Frank takes pains to establish his position as a narrative scholar. Christening his métier “socio-narratology”, Frank creates a chimera of literary studies and social sciences. He examines the dynamic processes of story-telling, proposing that the meanings of narratives are achieved in the intersubjective relation between the teller and the listener or the writer and the reader. “No one ever thinks a story alone”, he suggests, rendering both the formative and the relational aspects of narrative’s actions on their participants. He brings the reader slowly to realise that stories form the foundations for culture, religion, family, nationhood, true love, and selfhood and that envisioning any story’s meaning cannot but be done dialogically, collectively, within our interpretive communities. He reminds us that stories can have destructive as well as beneficial sequelae. Similar ideas have been articulated powerfully in literary studies, recently by J Hillis Miller in Literature as Conduct, a study of how the novels of Henry James influence their reader to arrive at meaning. As a sociologist assuming the work of a literary critic, Frank lives out what it means, literally, to be curious about a fresh corner of the world. Like our little girl who knows that all of us can draw
until we forget how, Frank knows that we all inhabit stories and are guided by them and swap them and live by their precepts. Sometimes, he overstates this basic claim. To say that “humans live their lives getting themselves into stories” might diminish the force of action. When I make a medical mistake, I am not only getting myself into a story. I am getting myself and my patient into trouble. I am committing an act with consequences to others and to myself. I diminish the event to reduce it to the creation of a story. Stories may be one part of what results from our world-making, but there are also Frank Lloyd Wright’s houses and Guarneri’s violins and Cézanne’s paintings of Mont Saint-Victoire. I think Frank is trying hard not to lower representation to a simple report of a reality that exists unchanged before and after representation, and this is laudable, but to call everything a story erodes the power of thinking about stories altogether. Differences aside, this book is a weighty contribution to medicine’s determined and inspired search for increasing our powers of recognition, interpretation, and attention to what patients tell us. Fortunately, medical educators are developing means to equip students and clinicians with the wherewithal to enter story-worlds and to join with their tellers in the search for meaning stories offer. Like Hillis Miller’s book, do our patients not plead, “Read me”? With what equipment might we answer that plea? Through narrative training, Frank suggests, perhaps we can develop these ways of knowing, these curiosities, these skills in inhabiting narrative worlds of others so as to join them in finding out what the stories mean. That way, we don’t forget.
Rita Charon
[email protected]
www.thelancet.com Vol 377 June 25, 2011