Two Recent Articles, Expanded

Right now I’m writing several lectures that I’ll present at conferences and events this spring, so today’s blog is written by my double–my deamon voice, as Phillip Pullman would say–who will expand ideas in recently published articles.

Two articles of mine are now available in print or proto-print. One is a fairly long omnibus review, “Narrative Selves Create Memories”, published in the open access journal Narrative Works 8 (1/2), 106-126. I discuss four books published in Oxford’s Narrative Psychology series. As good as each of these books is, reading them together led me to my concluding section, “Why I am not a narrative psychologist”. Here I discuss what, on my account of selves and storytelling, the books leave out. More exactly, I ask whether the books follow through on expressions of their own best intentions; for example, Jens Brockmeier writes that “We start with a story”, but does he actually understanding stories as the starting point for experience?

To present something of that argument differently than I do in the article…. One of Jacques Lacan’s notions that has stuck with me over years since I used to read him is his description of the infant as a zero, a null entity, an empty signifier. To stick with the semiotic metaphor, I believe that stories are what that signifier comes to signify, and in that same process of learning stories, the child develops her capacity to signify. Our narrative resources–most basically, the stories we know–fill in the initial emptiness of who we are. And these resources give us the capacity to become more than who we presently are. And, some stories are better resources than others. Much of my work on Shakespeare involves making a case why his stories are better resources. It’s not exactly the content of the stories; rather, it’s how his stories are generative. They generate variations on themselves, in part because they are already variations on earlier stories. And they generate a curiosity for more stories.

For those who don’t already know Narrative Works, published at St. Thomas University in Fredericton, N.B., I hope my review essay will be an introduction to it.

My article “Does Medicine Need Universal Values?” should be available in the advance online version of Society. The print version will follow. I am part of a symposium of responses to the book Hostility to Hospitality by Michael and Tracy Balboni, in which they argue that more attention to spiritual care would help people, which is easy to agree with, but also that there should be an “equal partnership” between medicine and religion. The latter argument causes me considerable problems. Throughout my career I’ve written about spiritual aspects of illness and care. I’ll never get my thoughts straight, nor do I think it’s necessarily a good objective to do so. Writing the Society article was another step in the process.

Again to jump to the end of the article, much of the difference between how the Balbonis understand the world and how I understand it comes down to the usage of the words immanence and transcendence. In the Balbonis’s world, which they would claim as being Christian, immanence and transcendence exist in opposition to each other. They associate immanence with materialism in a reductionist sense. Their immanence is the end point in what Max Weber, whom they cite extensively but selectively, calls disenchantment. That’s not at all my understanding of immanence. Here I offer a longish quotation from David Hinton, in his Introduction to his translation of the Tao Te Ching.

“In the lexicon of early Taoist texts, heaven is a synonym for Wayheaven’s most primitive meaning is simply ‘sky.’ By extension, it also comes to mean ‘transcendence,’ for our most primal sense of transcendence may be the simple act of looking up into the sky. By association with the idea of transcendence and that which lies beyond us, heaven also comes to mean ‘fate’ or ‘destiny.’ But this unsurprising complex of ideas is transformed completely when early Taoism adds ‘nature’ or ‘natural process’ to the weave of meaning, for then heaven becomes earth, and earth heaven. Earth’s natural process is both our fate in life and our transcendence, for self is but a fleeting form taken on by earth’s process of change–born out of it, and returned to it in death. Or more precisely, never out of it: totally unborn. Our truest self, being unborn, is all and none of earth’s fleeting forms simultaneously.”

As I understand Hinton, what he says becomes a most useful interpretive gloss on what Shakespeare is getting at in Prospero’s speech following the masque he stages: “These our actors, as I foretold you, were all spirits and // Are melted into the air, into thin air” (The Tempest 4.1.161-163). We are all of Shakespeare’s characters simultaneously, all and none of earth’s fleeting forms. We materialize into life, stories are told, enacted, and reenacted, and then we melt back into the air. Funny thing is, institutional, professional medicine doesn’t believe that any more than the Balbonis do. There are multiple ways to separate immanence from transcendence. I believe the Tao is correct that all these separations lead to grief.

Or, separating immanence from transcendence leads humans to grief. Way just is. Is Shakespeare then no Taoist, because in his world there is forgiveness or not, and whether or not matters? Hinton points out that Lao Tzu was too compassionate to be consistent with his own ideas. He felt compelled to witness the grief he saw around him. Way just is, heaven and earth just are; humans care.

I’m happy to send pdf copies of these articles to anyone who doesn’t have other access, especially the article in Society. Write me at

Shakespeare’s Lessons About Care

My travelling companion during the last couple of weeks was Marianne Novy’s 1984 book Love’s Argument: Gender Relations in Shakespeare. Novy has many insights into how Shakespeare positioned men and women in the comedies and the tragedies. She is especially sensitive to moments when one character acts as the audience to another’s performance. In the comedies, “characters of both sexes can be alternatively actors and audience, cooperating in a relationship of mutuality” (83). Mutuality is Novy’s ideal for gender relations; she reads the plays as forming a continuum from mutuality achieved to failed mutuality. The failures tend to occur in the tragedies; that failure is both a cause and an effect of things turning tragic.

In the comedies, the male heroes enjoy women being actors in the dual sense of both active agents and role players. In the tragedies, “The heroes’ suspicion of female pretense darkens their view of the women, whether the women actually pretend or not. The men’s own acting–whether deed or pretense–discourages female participation….Thus, the tragic women are often confined to being audience to the hero, mediating the offstage audience’s sympathy with their own, as Ophelia does for Hamlet, Desdemona for Othello, and even Lady Macbeth for Macbeth” (82).

All this is interesting enough, but it becomes especially relevant to vulnerable reading in Novey’s later comments. She quotes Stanley Cavell’s essay on Lear, in which he writes that in both tragedy in a theatre and tragedy in actuality, “people in pain are in our presence”. What, he asks, is the difference? Cavell then makes what I consider a crucial comment on the ethics of responding to suffering: “In actuality acknowledgement is incomplete … unless we put ourselves in their presence, reveal ourselves to them” (90). That’s where I start thinking of clinical professionals responding to their patients’ pain and also family members responding. Novy’s commentary on Cavell seems to speak directly to the dilemma of response for clinicians, maybe especially hospital workers: “For the theatre audience … no self-revelation to those they see suffering is expected or possible” (90). That last phrase resonates heavily in my experience of hospital care.

Clinical professionals care, often deeply. But here’s the problem: “Many of the examples of sympathy expressed by the women discussed previously have been more like that of a theatre audience–incomplete by the standards of actuality–because they have been expressed in the hero’s absence”, Novy writes (90). Again her examples are Ophelia and Lady Macbeth. Cordelia is a significant exception, because she does express herself directly to Lear in their reconciliation scene.

Care, that most over burdened word, involves both doing and expressing. Those who are cared for often experience the expressing to be as important as the doing, and health humanities is about pulling up the expressive side of clinical practice. I remember a moment in a hospital rounds that I was invited to attend. The discussion was about a patient who was making demands that were upsetting because, in my view, everyone knew they were fully legitimate was embarrassed by not being able to admit that. At one point, someone in audience said, in a tone I heard as indignant, “Doesn’t he know how much time has been spent talking about him?” That line sticks with me because it expresses so much of what patients experience as lacking in care, and how professionals don’t get the problem. That audience member self-positioned like one of the women in a Shakespearean tragedy or the theatre audience member who can only express sympathy in the hero’s absence. The “Nothing about us, without us” thing hadn’t registered. Or in this instance, maybe it should be: nothing for us, except to us.

Ophelia and Lady Macbeth end up mad, then dead. Cordelia ends up dead, but we believe that in her last moments, she felt the redemption of being where she had chosen to be, having said what she needed to say. Getting killed is not, in itself, a tragedy.

Clinical care, especially in hospitals, is all about the duality Novy identifies between acting-as-doing and acting-as-role-playing, and I understand what she calls pretense as a neutral description of an actor’s proper work. It’s not about dropping the pretense; that’s not the goal that Novy imagines for Shakespeare’s women or I imagine for clinicians. What it’s about is achieving the mutuality in clinical care that Novy seeks in gender relations. The comedies are lessons in achieving mutuality; Novy even manages to rescue Taming of the Shrew from the oblivion of irredeemable sexism. The tragedies are cautionary tales of what happens when mutuality fails.

Performing Others’ Scripts

I continue to be fascinated by how literary criticism about Shakespeare restates issues that I have been worrying about with respect to illness and the work of healthcare professionals. My most recent example comes from Shakespeare’s Lyric Stage: Myth, Music, and Poetry in the Last Plays, by Seth Leher of the University of San Diego. I hope to return to the issue of music in a later post. For today, I want to share two of Leher’s observations.

Some of Shakespeare’s late plays, especially Henry VIII which was included in the First Folio of 1623, are clearly collaborations, and scholars argue which parts can be attributed to Shakespeare. Leher frames the issue otherwise: “I am not interested in statistical variations to determine which lines are Shakespeare’s and which are Fletcher’s,” he writes. He’s on to something more relevant to most of us who are not textualists: “What I am interested in is how the play raises authorship and individuality, collaboration and response, as themes.”

My thinking moves laterally to consider how health care involves themes of authorship and individuality, collaboration and response. In any healthcare dyad–physician/patient, nurse/patient, physician/nurse, administrator/clinician–each must collaborate with and respond to the other. Yet each engages with a particular other while keeping in mind that they are enmeshed in relationships of collaboration and response with others who are not in the room but who will hear about what happens and react to it. For patients, these others begin with their families and loved ones. For professionals, the others proliferate from colleagues down the hallway to persons in distant offices who exercise authority. What might constitute either authorship or individuality in health care is not easy to think about. Yet because the stakes on what happens are existential–what’s at issue is who a person is, as a soul that is answerable for what it does and leaves undone–questions of authorship and individuality cannot be dismissed.

Leher continues: “Characters like Ariel [the spirit who serves Prospero in The Tempest] and Autolycus [the con man who sells ballads in The Winter’s Tale] … dramatize the challenges of performing the scripts of others while attempting to take on an individual identity.” Health care is hardly the only venue that requires performing the scripts of others, but doing so seems a particular challenge in health care for at least two reasons. One, as I just said, is that the stakes are high; actions count and people remember for the rest of their lives. Another reason is that healthcare institutions are especially saturated with scripts of others, again for both professionals and patients. If I were writing a book about healthcare institutions, The Scripts of Others would make a good working title.

In my 2004 book The Renewal of Generosity I dealt with this problem at the end, when I talked about healthcare professionals as a species of artificial persons. That term was coined a generation after Shakespeare by Thomas Hobbes; it’s late Jacobean period, whereas Shakespeare was writing during the ascendency of James I. But artificial persons comes from a world that’s still recognizably Shakespearean and it remains recognizably our world. In this world, people are called upon to act in consequential ways not on their own moral judgment but according to some script of others. The physician has to follow a standard of practice or an institutional protocol. The patient feels required to do what is indicated by her family, or her religion, or her health insurer, or the medical team whom she doesn’t want to alienate. Yet as the stories of healthcare professionals and ill people eloquently testify, these people still feel an individual responsibility, as well they should.

In the first printed collection of Shakespeare’s plays, the First Folio, the last play is Cymberline. Leher discusses whether its placement reflects a considered choice by the editors or various contingencies of publication, including when the printers received the text. I love that controversy: it’s life, all over. Cymberline has one of the most convoluted plots of any of Shakespeare’s plays; every twist and confusion found in other plays is somehow reenacted in Cymberline. Leher offers a wonderfully generous interpretation, again making this confusion into the topic that the play seeks to explore. He summarizes: “Telling its own story is difficult: for us, for its history of audiences, and for its characters.” And that, again, is a concise statement of the work I’ve been doing ever since I starting struggling to tell the story of my own illnesses back in the 1980s.

Vulnerable reading offers help to those for whom telling their own story is difficult, especially because their story is always-already full of stock phrases, motives, and plots from scripts of others. When people most need to be individual, and responsible in their individuality, they find their words are not their own. Especially Shakespeare’s late plays offer the consolation of sharing that trouble with characters whose struggles are contained in ways that real life troubles are not. Their difficulty is our difficulty. What resolution those characters find does not solve our difficulties, because troubles like these do not resolve. But the solace of a story against which we can measure our own is a form of solution. With the story as a companion, we persevere not better but perhaps more content.

The Metaphor of Wind, as Chaos Narrative

I’ve measured my adult life by affiliations with a succession of French intellectuals–Camus, Barthes, Foucault, Bourdieu, Latour, and now François Jullien. Jullien is a sinologist who writes specifically about the landscape painting of the literati, among whom Shitao (1642-1707) might be the culminating figure. For these artists, poetry and painting were necessary complements; they also wrote treatises on art. One of Jullien’s titles In Praise of Blandness describes the style of these paintings. On another level, Jullien is using painting as a medium for exploring radical cultural difference and the difficulty of thinking that difference. But I want to get to a specific quotation. What I am actually writing about is research, and beyond that, the problem of writing about people living lives at some extreme, suffering.

Late in The Great Image Has No Form (the book is about how to understand that enigmatic line), Jullien quotes the painter Tang Zhiqi. He describes, as all these treatises do on Jullien’s account (which I’m in no position to question), how the goal is to depict “the very aspiration to come about” rather than “seeking to describe and represent”. So: “If you want to paint the wind passing through the landscape, Tang Zhiqi continues, you will have to keep from trying to characterize it externally–picturesquely–by making all the branches bend in the same direction.” If you do that, or only that, “You will still not feel the wind blowing.” Here we reach a crucial question about both research on suffering and clinical work: do people want to feel the wind blowing? Or, I ask myself of what I read: is this another way of “characteriz[ing] it externally” so that you won’t have to feel it?

“If you are to feel it,” Jullien continues, “the image must contain internally the ‘impossibility of facing it head on and resisting it,’ as a tension running through it and orienting it intentionally.” That’s the key phrase for me: the impossibility of facing it head on and resisting it. If I were asked what one single idea I might wish to preserve from all I’ve written, it would be the naming of the chaos narrative in The Wounded Storyteller. What I meant and mean by chaos is living with this impossibility of facing it head on and resisting it. What cannot be faced head on is the condition that has brought someone to believe that only this way of speaking can evoke her life. But to write or speak of “the condition” is already to render it external. Chaos is embodiment coming to speech and speech resolving back into the body. It is the speech/condition relation, blurring boundaries. To depict chaos is to contest the separation of one into cause and the other into effect. In English we can contest that separation, but we can never fully evade it without losing syntax, which chaos stories often do. The epistemology/ontology relation of Chinese art can prepare us for that refusal, especially as Jullien shows how Western translations of the treatises reinstate a subject/object opposition that the Chinese is all about doing without, in the sense of simply not needing it. That last idea takes a long time, at least for me.

These thoughts lead me to King Lear, because if the next question is when, in language, has the wind of suffering ever been evoked, I turn to Lear. Lear opposes the storm; he rails against it, discovering a language. But he is undone by what he faces but cannot face; he resists but cannot resist. His chaos becomes madness, flowers in his hair. He is rescued temporarily by Cordelia, and then things get worse. In the original source story, Cordelia lives and marries Edgar. Shakespeare’s refusal of that resolution, when Lear carries Cordelia’s dead body onto the stage, shocked the first audiences, literary historians tell us. Shakespeare went for an ending so without hope that for several centuries it was rewritten, because only that made the play tolerable, watchable.

The landscapes of Chinese literati painting are placid, bland, places to rest. Apparently. Shitao spent his life on the run; his royal birth made him a target for execution by those who had disposed his lineage. His is a Shakespearean story. The bland ink-wash of the scroll paintings is a form of witness to periods of horrific violence. If I can make any sense of this word resilience, it looks to those paintings, in which things are perpetually coming into being and fading back into mist, and there is no world beyond this one. King Lear is one solution to the depiction of chaos. The landscape in which all is internal tension is another.

I’m off to visit my 99-year-old father. Be back in a couple of weeks, if that is willed.

Another ‘Found’ Vulnerable Reading

This blog is about what I call vulnerable reading. But the point is not to claim to invent vulnerable reading. The point is to practice it, which includes appreciating others who express my project as well as I have. It’s reassuring that others already know what vulnerable reading is and can express it perfectly well. Not feeling alone is a significant goal.

My appreciation today is for Maura Kelly’s article published in the New York Times “Voices” series, February 6, 2019. Ms. Kelly begins with a darkly funny telling of a dialogue between herself and a crisis-line volunteer. She had called because she felt at risk of committing suicide. The volunteer is either a therapeutic genius or a lucky amateur, because after some false starts, she makes a life-saving suggestion: “Then how about, do you have something good to read?” In fact, Ms. Kelly does; it’s Anna Karenina, which she has read up to just before Anna’s suicide.

“Fear Anna’s darkening thoughts would darken my own, I’d stopped reading,” she writes. Given the way my mind works, that reminded me of reading Grimms’ tales to my daughters. A reasonable parental fear would be that taking small children through the dark forest of childhood–and often adult–fears would not be comforting to small people. But it is comforting; it has been for generations. Sensitive children listen peacefully to horrific violences (my favourite might be Snow White’s evil step-mother being put into iron shoes that had been baked in the fire, and then made to dance until she died–that didn’t make the final edit of Disney’s version). Then these children go to sleep. Nothing like a good story before bed.

“I knew Anna would kill herself by kneeling before a train,” Ms. Kelly writes, “so I urged her to stop and turn around: You poor fool! Look at all you have. Look at all the people you’ll hurt.” Then she expresses the value of vulnerable reading: “In saying that to her, I said something similar to myself: I’m not utterly alone.” Ms. Kelly does not exactly identify with Anna, although there’s an element of identification when she writes that Tolstoy “call[ed] on me to talk back to Anna, and to the Anna in myself.” That balance of identification–the “Anna in myself”–in tension with distance–“to talk back to Anna”–gets at the effect of vulnerable reading.

Ms. Kelly not only exemplifies the practice of vulnerable reading. She also offers a succinct statement of about as much theory as it may need: “A good novel is great company, less an escape from life than a different way to engage. A good novel is reassurance that other people have endured tragedies….It’s evidence I’m not alone….A good novel is a form of hope.” Nobody ever says it all, but that says enough. I especially like her phrase, “a different way to engage.” That may be, most of the time, as much as you can and possibly should offer people.

If I have any reservations about the Times article, these concern the sub-title, which I’d bet was written by a staff person, not Ms. Kelly herself. It subtly simplifies Ms. Kelly’s words: “A good novel can be a reminder that other people have endured tragedies, long ordeals, bad odd.” Except, Anna doesn’t endure. It’s in Anna’s non-endurance that Tolstoy creates an opening for Ms. Kelly to talk back to Anna, and to the part of herself that needs talking back to. A work of art becomes good when it offers characters, tragic or comic, enduring or not enduring, who can be companion-helpers to those who struggle to endure. I am being picky, but the Times subtitle emphasizes identification–novels’ characters as role models in endurance–and misses the need for distance.

Somewhere, in all those pages getting to Anna’s fatal moment, had Tolstoy been preparing his readers to be able to talk back to her? What was his implicit pedagogy that had such therapeutic force, to which Ms. Kelly is witness?

Late Style, Pending a Birthday

“Others are bright and clear: I’m dark and murky. Others are confident and effective: I’m pensive and withdrawn, uneasy as boundless seas or perennial mountain winds.”

That’s from verse 20 of the Tao Te Ching, translated by David Hinton, and it’s how I feel reading the scholarly journal articles that I’ve been working through recently. Some are on Shakespeare and some are on bioethics. They are all filled, brimming, with references to other people’s ideas, not that they don’t have plenty of ideas of their own, because they do. It’s writing I genuinely admire, but I read it and ask, couldn’t it be said more simply, and might it be more effectively said, if simpler.

Here’s another dark, murky fellow, Du Fu, known until recently as Tu Fu. “Tomorrow I leave my fortieth year//my life has started to race//downhill, toward its evening” (trans. David Young). Du Fu died at 58. In a couple of weeks I turn 73. I don’t feel I’m racing downhill. Unlike Prospero, my every third thought is not my grave. But I do ask who is going to keep doing this work. Then I remember that’s not my problem.

Six or seven years ago, in anticipation of retirement, I set before me Edward Said’s book, On Late Style. It was getting time to find my own late style, and that remains a work in progress. I ask people what late style means; I compile a list, which begins here: “And what is the use of caution//the value of constraint?” Du Fu asks, not rhetorically. Late style studies all that cautions and restrains, while–and more important–trying to model how to work without such restraints.

Last night I read a published exchange of letters between two Shakespeare scholars, one complaining about the other’s review of his book, and the other complaining about the complaint. “Let be” as Hamlet says. Each knows so much, far more than I’ll ever know, but their letters display their lower selves, in a metaphor I find useful. After so much Shakespeare in their lives, how could they not learn that? I felt cheated of all that they could have used so much energy to tell me. But the worlds in which they move make them feel they had to engage in such an exchange, writing that way. It’s their habitus, to fall back on Bourdieu once again. Which explains nothing and everything.

At this point, Du Fu would recommend getting drunk, which I gather is both a stock metaphor and literal practice among his circle. Late style gets drunk on its own simplicity; its intoxication is from stripping away. Late style defines itself by what it leaves out. Tell the stories, let the stories carry the argument, trust the stories. One of the great Taoist metaphors is uncut wood, its perfection, and what’s lost once it’s made useful by cutting it. Late style seeks to cut as little as possible. All these journal articles are so confident and effective. I am withdrawn and uneasy. Exchanging appreciations with a few friends. Just where I want to be.

Truth and Anger

After my digression in my last post, I’ll now get back to the theme of this blog which is appreciations. Last week, February 9 specifically, the New York Review Daily sent out the text of an interview with the French writer Édouard Louis, who has just published the third in his trilogy of what the NYR-D describes as having “generally been called autobiographical novels.” That qualification is serious, because Louis begins by pointing out that France doesn’t go in for genre distinctions to the extent that North America does. “We don’t have ‘nonfiction’ for example,” he says, “and we mostly use the term ‘memoir’ for autobiographies of politicians.” Given the frequency with which I refer to writers of first-person illness narratives as memoirists, Louis’ comments have the welcome effect of upsetting my categories.

Most people who think about writing realize that fiction/nonfiction distinctions work more as either claims or disclaimers (e.g., “no relation to persons alive or dead”) than they describe how much of the writing is direct reporting of what happened versus what’s called imaginative. And as others have noted, imaginations don’t just spontaneously appear in writers’ heads; they begin in real-world observations. That distinction thus blurred, Louis then offers one of the most arresting accounts of why writing in the first-person has distinct value. His point seems highly relevant in decisions about what to teach in medical humanities and narrative medicine curricula, for example. I quote:

“So when I write, I ask myself, How can I prevent people from escaping what I’m trying to show? And I think autobiography can be a tool to force people to see reality, because when you do autobiography, you say: ‘Look, this is what is happening now, this body I talk about is suffering now, while you read.” That makes me think of fairly recent books like Susan Gubar’s Memoir of a Debulked Woman or Christina Crosby’s A Body, Undone as writing that Louis describes precisely. But you could go back to Reynolds Price’s A Whole New Life. I also think of illness narratives published posthumously, which say, to paraphrase Louis, ‘Look, I spent my last months writing this book, because dying clarifies, and what I’m tell you is necessary for you and others–you need to know this.’

The issue, maybe only one of the issues but I’ll give it pride of place, is anger. Louis has also written books about Foucault and Bourdieu, and I wish my French were good enough to read them; he might have something actually new to say. “Pierre Bourdieu and Michel Foucault taught me something very important: that there is no truth without anger. That is the key to understand our world(s), that it’s maybe even the most scientific tool human beings invented.” Scientific tool–anger?–that’s worth thinking about.

Louis concludes: “Only if you are angry you understand that this violence is not normal. Anger is what allows you to take a step back and to understand the social structure you are stuck in. Bourdieu’s and Foucault’s books are full of rage, and so are my books, I hope.”

Louis does not exactly embarrass me, but he reminds me of what I continually forgot, because it’s dangerous to remember what he’s saying, if you want to get along in worlds of healthcare and medicine, to be asked to give lectures and to publish, much less to hold a job in a clinic or attract funding to a program. Healthcare is all about cooling out anger, to use Erving Goffman’s great phrase. The prose of academic journals has no allowance for expressions of anger. At most, there can be policy recommendations, but not anger. I had not put Louis’ books on my reading list. But I realize the same reasons why I don’t want to read them are why I should. I need his version of Bourdieu and Foucault, not the cooled out versions that sell better in the venues where I try to get along. I need to remember that “there is no truth without anger.”