Tag Archives: Arthur Frank

Week 2: Diagnosing Illness Narratives

It’s one thing to be sitting in a classroom discussion as a student– its something entirely different to be leading the discussion as an instructor. I’ve enjoyed teaching scientific facts and promoting inquiry-based learning in science, but it’s a new  experience for me to be leading discussions rooted in my literary interests.

It really makes a difference to have an enthusiastic group of students and a classroom where we can sit in a circle. I taught about the history of illness narratives, which I’m simultaneously writing about for my thesis. It was a strange experience to be crafting  leading questions by voice that I have also been trying to ask in my writing.

I think one of my teaching goals for the semester is to get better at tackling silences. There’s an art to teaching in silence, to allowing quiet to linger for just long enough for thought generation, without letting this surpass into daydreams and uncomfortable, awkward silences. I’m working on it.

It was a thought-provoking first discussion class, and I’m looking forward to keeping the conversations going. Up next: excerpts from Sylvia Plath’s The Bell Jar and her poems Lady Lazarus and Tulips.

Lesson Plan Week 2: Diagnosing Illness Narratives

Presentation: Illness Narratives — A Brief History

Worksheet: Diagnosing Illness Narrative with Frank’s Illness Narrative Types

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Concluding Ideas about Frank and Conway

In the second half of Illness and the Limits of Expression, Conway explores the literary methods of metaphor, narrative form, and endings. While Sontag critiques metaphor as something that confines individuals within stereotypes, others see metaphors as necessary to come as close to an accurate representation of the illness experience as possible.Narrative form often strives for linearity, a beginning, middle, and end; individuals seek to construct this sense of coherence but also to expose the interruptions and interjections caused by illness.

Conway discusses the complexity of the ending, and how there is often a desire to end on a happy note. Some authors feel themselves gravitating towards this triumphant conclusion, but they catch themselves in time to adopt an ending that is better suited with the rest of their narrative.

After laying out a basic foundation of illness narratives, Frank delves into his three types of illness narratives: the restitution narrative, the chaos narrative, and the quest narrative. He argues that illness narratives often contain elements and moments of each of these perspectives, and he explores the defining characteristics of each [see table].

The restitution narrative focuses on the conclusion of illness, the ultimate victory over illness, an individual’s reintegration into society and return to the normalcy of everyday life. The chaos narrative claims that “chaos is told in the silences that speech cannot penetrate or illuminate”; thus, the chaos narrative is an anti-narrative that highlights the interruptions caused by illness (101). The quest narrative focuses on the temporal enactment of the illness experience and an individual’s transformation over time.

Frank explains how these narratives coexist and intermingle to compose the illness experience. He toys with the idea of patients as witnesses to illness and illness narratives as a kind of testimony. The concluding chapter explores suffering, for “all illness stories share a common root in suffering as ‘an existential universal of human conditions’” (170). He relates suffering to illness narratives by showing how both telling and hearing stories has the power to heal.

This table outlines the 3 types of illness narratives. Click to enlarge!

Types of Narratives

Discussion Questions:

1. What literary characteristics of an illness narrative can hint at a shift in the type of narrative? For example, what syntax, diction, etc.?

2. How does classifying the narrative type affect the analysis of an illness narrative?

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Revelations of an Impaired Listener

Frank presents a number of fascinating ideas that have exceeded my expectations by showing how interesting illness narratives are. He outlines how the evolution of illness from premodern to modern to postmodern times. Illness was initially alienated from the disease, which Kleinman defines as the pathological component, because medical terminology existed in isolation as a sort of foreign language. Modern times involved an acknowledgement of illness as a component that was equally as important as disease, while postmodern times have taken this a step further to empower illness with a voice that now echoes through illness narratives.

A fundamental idea that Frank presents is as follows: “The mystery of illness stories is their expression of the body: in the silences between words, the tissues speak.” This situates illness narratives in an in-between state; they transform physical experiences of the body into emotional experiences of the mind, and then translate them into language. Because I’m fascinated about ideas regarding the mind and the body, I wonder how illness narratives fit into this divide and how these aspects of an individual influence this form of communication. According to Frank, illness narratives include four problems with the body: “control, body-relatedness, other-relatedness, and desire” (29). He also categorizes depictions of the body into four different types: “the disciplined body, the mirroring body, the dominating body, and the communicative body” (29).

Perhaps what I found to be most compelling was the idea that there really is no such thing as a singular illness narrative for an individual. Each individual shares multiple illness narratives, largely shaped by the audience and the purpose of its telling. This traps individuals within a multilingual “narrative wreck,” so to speak, a heterglossic discourse. As a result, there are multiple ontologies to illness, and each narrative shapes illness into a different entity. Despite the multiplicity of illness narratives and illnesses themselves, I find it slightly paradoxical that these all originate within a single body.

Realizing that narratives are told in variations has changed the way that I listen. It’s fascinating to see how conversations unfold based on those involved. As I was volunteering at Mott’s Children’s Hospital, I couldn’t help but hear dialogues differently. Conversations with different individuals illuminated different aspects of an illness, depending on the listener: a doctor, a nurse, a child life specialist, a family member, a friend. Just as illness narratives can empower individuals with a voice, exploring them can also provide listeners with the power to hear.

Discussion Questions:

1. Metaphor is common in illness stories. When is it appropriate to find symbolism in illness, and where does the boundary lie? (57)

2. How do illness narratives exist temporally? What transformations do they initiate, especially with regards to individual identity and the multiple ontologies of an illness in the past, present, and future? (60)

3. How does narrative truth function in narrative illnesses, and what is its importance? Frank claims that “in illness stories, truth may be selective, but it remains self-conscious” (62). What does he mean by this, and how can this be seen in present illness narratives?

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