Toward a Reciprocity of Systems

-S^Toward a Reciprocity of Systems* Suzanne Poirier I dont beUeve in other people's reading of riddles. ... [It is l]ike a person delivering judgment when only half the facts are there. ... I mean its so barren; so easy; giving advice on a system. . . . What a discovery that would be—a system that did not shut out.1 Virginia Woolf wrote these words in 1932, reacting against what she considered to be the "preaching" of D. H. Lawrence in his novels. Although Woolf was talking about the writers and readers of fiction, her criticisms of judging from "only half the facts" and the exclusionary nature of a "system" are particularly relevant to the field of Uterature and medicine today. The relevance of these words is vividly demonstrated by volume 5 of Literature and Medicine, Use and Abuse of Literary Concepts in Medicine.'1 At first glance it is a widely diverse issue that includes articles on the short stories of WilUam Carlos Williams and the poetry of Emily Dickinson, the clinical biographies of A. R. Luria and cUnical tales of OUver Sacks, imaginative writing for medical students, and the extended case history. Readers of these articles in 1986 were challenged, directly and indirectly, to consider the relationships that hold these genres together and justify their claim as a discipUne, the appropriate uses for these forms and analyses of examples, and the possibility of formulating a theory—and thence a methodology—to guide a discipline of literature and medicine. It was an ambitious challenge, embracing, as it did, connections that were still intuitive in the minds of many of the people who had become a part of this interdisciplinary exercise. To classify such a collection of forms as literature, however, is not without precedent. Teachers of literature have *An earlier draft of this paper was presented to members of the Kaiser Narrativein -Medicine Circle in June 1990.1 owe a special thanks to its members for their comments and encouragement. Literature and Medicine 10 (1991) 66-79 © 1991 by The Johns Hopkins University Press Suzanne Poirier 67 always used the term broadly, and literature courses have taught fiction, poetry, drama, treatises, biography and autobiography, diaries, personal essays, and sermons and other forms of public address. Under the influence of semiotics, feminism, and other recent critical perspectives, Uterature has accommodated even more "nontraditional" texts—such as advertising and oral history—within its purview. Recently, as Joanne Trautmann Banks notes in her introduction to volume 5, discipUnes such as history, theology, and anthropology have come to talk about story, text, or narrative. Nevertheless, the wider adoption of a vocabulary that, formerly, was used primarily (and often loosely) by scholars of Uterature entails a greater need for care and deUberateness in choosing the words that classify uterature and Uterary forms and a greater need for understanding what those terms mean to the variety of people who use them. When a historian, a rhetorician, and an anthropologist speak of a siory, do they mean the same thing? The significance of this question is even greater in an aspiring field such as literature and medicine. Many of the articles in volume 5 of Literature and Medicine turn, in fact, on definitions of Uterature or üterary forms. For example, it was as a piece of "fiction" that the editor, Joanne Trautmann Banks, asked Eric Rabkin to consider David Barnard's "A Case of Amyotrophic Lateral Sclerosis ." "If I believed this were fiction . . ." Rabkin's response begins in "A Case of Self Defense" (p. 43), and he proceeds to base his analysis of the account upon his knowledge that it is not fiction. In "WilUams's Force," David B. Morris charges that "it is the doctor who gains entry, but the poet who grabs the paper" (p. 135). In "Clinical Tales," OUver Sacks writes, "I myself have no 'literary' aspirations whatever, and if I write 'CUnical Tales' it is because I am forced to; because they do not seem to me a gratuitous or arbitrary compound of two forms, but an elemental form which is indispensable for medical understanding, practice, and communication " (p. 16). Finally, in "Esthetics and Anesthetics: Mimesis, Hermeneutics , and Treatment in Literature and Medicine...