Framing the Conversation on Speechlessness, Testimony, and Indifference

Part of literature and medicine's growth in the past few years has occurred in the area of bearing witness to suffering. Private and public, individual and cultural, the giving of testimony and bearing witness to it have occupied clinicians, activists, scholars, teachers, and writers who are coming gradually to see the urgency of telling and the difficulty of listening in the face of trauma and loss. Whatever memory might end up to be, it seems critical to respect its needs and recognize its bounty by stoking it or nourishing it with language, and language that must be heard in order to be uttered.

It seems a natural gesture for our doubled field to perform textual acts as a direct response to others' suffering. We listen, we attend, we perceive, we take in the multiple meanings of the recounted experiences of the survivor of catastrophic trauma—rape, war, September 11, the Holocaust—and of uncatastrophic trauma—migraines, heart attacks, depression. Because we are writers or literarily driven clinicians, we represent that which we behold in some form that tries for an authentic record of the testimony—a videotape, an oral history transcript, a documentary account of what was heard, a medical note faithful to as many dimensions of suffering as can be captured in the clinical genre. The urgent question is whether, in fact, such attention and representation matter to the teller and, secondarily, to the listener. We think it does, for both, and may lead to a sturdy and healing affiliation.

Practitioners of literature and medicine and narrative medicine have found themselves inviting college students to write of illness as a method to metabolize or comprehend their past experiences. Some have started writing programs for health-care professionals with the aim of increasing reflective practice. Some have sought training as oral historians or chaplains in an effort to develop the particular skills of bearing witness to suffering without the felt or enacted need to try to fix anything materially. Some have guided patients to write of their own experiences of illness and have discovered the direct therapeutics of narrative. Through our deep work in writing and healing in all its manifestations, we have been accruing conceptual and pedagogic skill in methods of midwiving storied accounts of suffering. Our composition students, medical students, doctors, nurses, social workers, and patients who write of their personal histories and clinical practices discover that they know more than they knew they did, and they make these discoveries by virtue of conferring literary form on erstwhile formless (and therefore chaotic and even threatening) experiences.

Last June, we at Columbia University hosted Geoffrey Hartman and Dori Laub, the visionary founders and codirectors of the Fortunoff Video Archive for Holocaust Testimonies at Yale University, at a public lecture and an intensive seminar with faculty and staff from clinical disciplines and humanities departments. We came quickly to understand the overlaps and transparencies between their work and ours, for example, the work of a psychiatrist in AIDS clinics in Africa, a qualitative researcher studying "root shock" among the displaced persons of New York's so-called urban renewal projects, a literary scholar who studies the stories a culture tells itself about outbreaks of horrible infections, and a feminist scholar who writes on autobiographical theory and how the textual memory might work. Our contact with Hartman and Laub helped us to articulate and probe the witnessing dimensions of ordinary doctoring and nursing and the clinical dimensions of ordinary listening and writing.

In the following pair of essays, psychiatrist Dori Laub and oral historian Mary Marshall Clark develop these ideas and describe these practices. Laub's essay flows from his testimony work with chronically ill psychiatric patients in Jerusalem who are Holocaust survivors. The essay proposes radical reenvisionings of the processes of historiography, exposing the personal uses to which historians or interviewers must allow themselves to be put in the acts of hearing and registering accounts of trauma. We realize that this paper, as an empirical study of a clinical intervention among seriously ill hospitalized patients, may seem like a stretch for this...