We are delighted to reproduce with permission Keir Waddington and Martin Willis’s introduction to a special issue of the Journal of Literature and Science on “Rethinking Approaches to Illness Narratives.” The special issue in part arose from Off Sick: Narratives of Illness Past and Present, a project coordinated by the wonderfully named CISSMI (Collaborative Interdisciplinary Study of Science, Medicine and the Imagination Research Group). Angela Woods launched the Off Sick series in October 2010 and her article ‘Rethinking “Patient Testimony” in the Medical Humanities: The Case of Schizophrenia Bulletin‘s First Person Accounts’ is included in this special issue. To access individual articles, visit the Journal of Literature and Science web site, or download the full special issue here.
All of the articles in this issue attempt, whilst doing many different things, to do one thing in common: consider how illness narratives can be approached in new ways. Whilst scholarship in the Medical Humanities frequently presents its approach to illness narrative as essentially interdisciplinary in nature, there are a significant number of perspectives yet to be properly used to elucidate narratives of health. Largely, this is a result of a very limited set of influential critics (and works of critical insight) whose own specialisms are not those of the humanities but instead come from the sociological and health disciplines. Notwithstanding the upsurge in interest in the literary possibilities of illness over the last two decades, their conception of narrative understandably reflects their subject expertise. If this scholarship acknowledges that illness narrative is a social and cultural phenomenon, narratives are either ‘data’ to be mined for information-giving patterns or ‘life stories’ which require some form of generic categorisation or typologies as a way of humanising medicine or thinking about ‘narrative medicine,’ while they tend to frame the rise of biomedical approaches in particular ways that both accept a narrative of medicalization as inevitable and positive and lament the loss of the patient’s voice in this process. There are, of course, critical works that deal with illness narratives from decidedly humanities perspectives: any study of the range of articles in the journal Literature and Medicine or an examination of recent scholarship in the history of psychiatry for example, will testify to that. There are, too, critics who have not only led the way with their own humanities’ focussed research but who have also used their position to call for further work in a similar vein. Catherine Belling exemplifies this critical stance, as does one of the contributors here, Angela Woods, who has written previously about the limitations and opportunities of illness narrative research. However, and as both Belling and Woods would agree, the limited range of methods presently employed unnecessarily restricts what illness narratives might be allowed to mean, and even what they might look like.
For example, narratives of illness, in the present critical consensus, are restricted to narratives of a certain type: the linear, progressive, story framed with the context of biomedicine and the doctor-patient encounter. Surely it is possible to acknowledge, as literary critics have, that narratives need not be linear, they need not be structured as traditional story-telling forms (as dramas, poetries, and prose), nor need they offer logic, coherence, or temporal movement. Yet literary postmodernity – as an intellectual position or set of theories most capable of posing questions of the meaning and nature of narrative – has had little involvement in illness narrative research and therefore has made no impression upon the potential research opportunities on the structures and philosophical insights of different forms of narrative. Even this is an excessive case. More traditional literary methods – of close reading and textual analysis – are, with exceptions, rarely put to work on illness narratives in any methodological way. On a larger scale, the historical dimension and situatedness of these narratives has also been left in the cold, especially as scholarship in the Medical Humanities tends to concentrate on those narratives produced after 1950. Despite medical historians’ increasing sensitivity to the patient’s voice and work on early modern medicine and in the history of psychiatry that seeks to examine medical history ‘from below,’ in the Medical Humanities illness narratives are largely read in presentist contexts as narratives of the now rather than as narratives with a past. Such adherence to contemporaneity leaves history as an absence in illness narrative research. This is to the detriment of illness narrative research on two fronts. First, it disallows contemporary narratives the opportunity to be placed within a properly understood historical context of writing about illness. Second, it delimits illness narratives as narratives written only in the present period when in fact they have been written for as long as illness has been felt and then mediated through some form of lasting communicative act.
The contributors to this issue – Alysa Levine and Kevin Siena, Hazel Morrison, Angela Woods, and Martin Willis, Keir Waddington and Richard Marsden – all attend to one or more of the absences in illness narrative research. Their collective aim is to highlight possibilities whilst placing a check on current practice. Their work emerges from different disciplines: Levine and Siena are social historians of early modern medicine, while Morrison’s research focuses on the history of twentieth-century asylums. Woods is a Medical Humanities scholar working in interdisciplinary ways at the boundaries between literary theory, medicine, and philosophy. Willis is a scholar in the field of literature and science, emerging from a background as a literary and cultural critic, while his collaborators Waddington and Marsden are historians, with Waddington’s work focusing on how medical institutions can be read as ‘social’ institutions. Their work, taken together as a group of linked scholarly articles that aim to intervene in current illness narrative research, offers unique literary-historical interpretations of a range of illness narratives found in disparate locations and periods across both history and culture. In rethinking the ways that scholarship might approach narratives of illness they have uncovered unusual and distinctive historical narratives, revealed ways in which multiple narratives come into conflict with one another, questioned assumptions about narrative legitimacy and authority, and deconstructed contemporary narrative practices to reveal underpinning historical precedence. Their work is suggestive, interrogatory, and self-consciously aslant from existing illness narrative research. By cutting across present scholarship they aim to open avenues to new research methods and provide opportunities for an increasingly sophisticated and inclusive humanities approach to narratives of illness.