Illness and the Limits of Expression (review)

At the very beginning of her 1997 illness memoir, Ordinary Life, Kathlyn Conway tells her reader that she “feel[s] like a modern phenomenon—a forty-seven-year-old woman with one husband, two children, and three cancers.”¹ What makes her a “modern phenomenon” is not just that she has been diagnosed with, treated for, and survived three cancers (Hodgkin’s, breast, and lymphoma), but that she feels compelled to write about the experience and event of those cancers within the context of an “ordinary life,” signaled here by the one husband and two children. Although the motivation to write her latest book, Illness and the Limits of Expression, is again her own experience of cancer, this time the object of her analysis is not (or not only) her own experience, but the experiences described in the published illness narratives of others.

Conway also opens Ordinary Life with the assertion that, “the experience of cancer is without redeeming value,” distinguishing her story of cancer from the dominant tradition in American illness narratives, which tends to emphasize triumph over adversity, overcoming over failure.² In Illness and the Limits of Expression, Conway takes on that tradition once more by discussing the far less ubiquitous counternarratives of illness that “suggest a different cultural conception of serious illness and disability. In contemporary American culture, where a denial of illness and an unwillingness to face death is pervasive, [counter-narratives of illness] suggest not just a better technique for managing illness but a place outside of technique where author and reader alike can simply reflect on these very human experiences” (3). I am in complete sympathy with Conway’s challenge to the triumph narrative; I appreciate her annoyance with texts like Andrew Weil’s Spontaneous Healing and Bernie Siegel’s Love, Medicine and Miracles; and I admire many of the illness narratives she lauds here, including Audre Lorde’s The Cancer Journals, Nancy Mairs’s Waist-High in the World, Jean-Dominique Bauby’s The Diving Bell and the Butterfly, and Joan Didion’s The Year of Magical Thinking, among others. What I am more skeptical about is Conway’s suggestion that there is “a place outside of technique where author and reader alike can simply reflect on these very human experiences” (3). In this sentence, and in the rest of Illness and the Limits of Expression, Conway seems to be making claims about “technique” and “experience” that I want to counter, if only because I am afraid I lack her faith in the goodness of simply reflecting.

Illness and the Limits of Expression is the most recent title in the Conversations in Medicine and Society series from the University of Michigan Press, a series dedicated to publishing works that “focus on the historical, social, and cultural dimensions of health and sickness, public policy, medical professionalization, and subjective experiences of illness,” according to the book’s front matter. Conway’s work emphasizes the last area—subjective experiences of illness—and is organized around chapters that investigate character types and model plots in illness narratives as well as the struggle to find a language and narrative form that can adequately capture something of the subjective experience of illness and suffering.

Conway does an impressive job demonstrating the pervasiveness of the triumph narrative in contemporary American culture, and she makes a convincing argument for the necessity of a more complex understanding of the experience of illness in illness narratives. Yet, in her own challenge to the universalizing narrative of triumph, Conway also has a tendency to universalize the experience of illness. In her introduction, she admits that she does not focus on “distinctions between different illnesses and disabilities” because she hopes “to define a broader and more collective experience of illness” (14). And, at the beginning of Chapter Two, entitled “Character: The Damaged Self,” Conway explains that, “while the nature and degree of damage in different illnesses and disabilities vary widely, all serious illness and disability share this fundamental characteristic: damage...