SickLit

Reading these three books while recovering from pneumonia, I had reason to be thankful for modern medicine and socialized healthcare. Yet I had reason to regret that in these days of quick cures and hyper-productivity, there is no culturally sanctioned place for convalescence. Although we reserve a special space for the terminally ill, we no longer value the invalid. What these three books remind us is that illness in the past, while physically traumatic, could be valued as life-transforming and spiritually improving—hence its usefulness for plot and poetry. Wayne Wild, who practiced for many years as a gastroenterologist before turning to literary-historical research, argues that in the eighteenth century illness was treated as a test of the moral qualities of both doctor and patient. While doctors thought it was the patient's moral responsibility to comply with the treatment, "for the patient, the true moral obligation was more often to be found in the spiritual experience, in the test of one's fortitude, faith, and resolutions" (25). Clark Lawlor lays emphasis less on the spiritual than the semiotic aspect of the experience of disease. Like David Shuttleton, he challenges Susan Sontag's famous demand that we cure ourselves of the idea that illness "is metaphor" (Sontag, Illness as Metaphor [1978]). Lawlor insists not only that it is inevitable that "we develop stories, patterns of expectation, plots and sequences of images and metaphors, which form our perceptions of disease, pain, the importance of suffering and so on" (3) but also that it is helpful for us to do so. The balance between the cultural construction of a disease and its physical reality is adroitly managed by Shuttleton: "To make a claim for the importance of the literary imagination in framing smallpox is not to imply that the disease was merely imagined, but does invite acts of recovery and analysis which hopefully serve to expose the historically contingent epistemic frames . . . within which the disease was encountered, interpreted and ultimately contained" (12).

The mutually illuminating relationship between literature and medicine has become an established field of inquiry, and these three works make significant contributions to our knowledge of "the historically contingent epistemic frames" (Shuttleton 12) through which literature and medicine regard each other. They help us think further about the relationships between textual and embodied selves in this period. All three authors are sensitive to the historically specific construction and experience of disease. They do not, as medical historians used to do, look through a teleological telescope to reduce a disease to its modern diagnosis or congratulate the modern age for triumphing over the superstition and ignorance of the past. Thus, John Keats and Henry Kirke White died of consumption, not of tuberculosis, which is a different cultural entity. At the same time, the authors are alert to contemporary concerns: Lawlor and Shuttleton suggest—rather unconvincingly—that their approach might help us come to terms with the modern threats of germ warfare and global pandemics. More fruitfully, each author gives significant space to issues of race, class, and gender. The danger is that these concerns can drive the study in a way that is as progressivist as the old teleological approach.

Two of the works under review are, like Roy Porter and George Rousseau's monograph on Gout (1998), or Saul Brody's on leprosy (The Disease of the Soul [1974]), studies of specific diseases. (Perhaps every disease in the medical dictionary from asthma to zoonoses will eventually benefit from its own cultural study.) Wild's book is concerned with the doctor-patient relationship more generally; he examines the changing doctor-patient relationship as it is manifest in the rhetoric of medical correspondence. He also considers the "literary applications" of...