Institutions manage and process people. Medicine, like many institutions, tends to define people in terms of their problems – disease, drugs, mental illness. Fiction inverts this structure, seeing character as something that transcends problems. Fiction tends not to diagnose, pathologize, or moralize. And while medicine leans toward closure (a cure, death), narrative’s drive toward resolution is most satisfying, I would argue, when the questions that drive the narrative remain, to some degree, unanswered, retaining mystery.
The new field of Narrative Medicine, inaugurated at Columbia University by a team of doctors, scientists, literature and film scholars, and fiction writers, begins with the premise that medicine centrally involves a nuanced human exchange mediated by language, specifically narrative. A patient tells a story, and a practitioner interprets, retells, alters, and “concludes” it, often without doing justice to the complexity of such an exchange, the power relationships that animate it, and without recognizing the ways in which “closure” eludes us. Institutions are designed to solve problems, not multiple them. Yet by imposing closure prematurely, science “ignores the ethical demand out of which it arises,” namely, its commitment to doubt, uncertainty and ignorance, hallmarks of scientific inquiry. The promise of narrative medicine is that literary values and techniques of interpretation can answer this ethical demand in multiple ways: by restoring attention to the ambiguity and nuance, which fruitful narrative exchanges require; increasing tolerance for uncertainty; sharpening powers of observation and reflection; developing awareness of our affect and its interference in interpretation; building cooperation and trust in relationships that are traditionally hierarchical; respecting different forms of knowledge and experience; adopting a practice of radical listening, and fostering creativity. In this course, we will study some of the most striking and innovative short stories in various linguistic traditions and periods alongside theoretical materials that will help us to better understand the elements of narrative and the principles of Narrative Medicine. By focusing on moments of ambiguity and problems of closure, we will accept the Jamesian challenge laid out in The Art of Fiction: “Try to be one of those on whom nothing is lost.” Assignments will be both interpretative and creative.
Application: Application Inside-Out Fall 2023 – Dawn Marlan CHC (1)
