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^Literature and Medicine: Towards a Simultaneity of Theory and Practice C. S. Rousseau . . . theory cannot be developed or tested widiout critique, and critique must involve the direct identification of alternative positions in a polemical manner. If one cares about ideas, it is difficult to write about error (or imputed error) widiout a certain sharpness of tone. I hope I have always argued with reasons. — E. P. Thompson, The Poverty of Theory, p. 403 I. Introductory Premises My reason for beginning with a brilliant quotation about die essential nature of theoretical discourse is not to exalt sharpness or point to Marxist affiliation, but to show diat I have been attentive to the tropes in which my theoretical discussion is necessarily generated. In fact, I have been self-reflective about language throughout diis essay. My thesis here —unlike die more primitive thesis of an earlier paper1 — is that the dieory and practice of Literature and Medicine cannot be split at dûs stage. The field is too young; we (I mean those who cultivate it) need to have a better sense of how it can develop. This attachment to practice should not imply diat dieory is not embedded in my "practical" statements: theory is always present in research even when the researcher remains silent about it, or when it appears in confused fashion. The more pressing matter for Literature and Medicine is not a dichotomy between theory and practice but the sense of the field harbored by those who work in it today. This is the matter to be addressed, as a consequence of which I abjure any artifidal split between dieory and practice and invite my colleagues to discuss the mediods they would like to see used. My six sections are generated in the name of method rather dian theory for this reason. To some, this position may seem evasive; some may prefer a statement at the Literature and Medicine 5 (1986) 152-181 β 1986 by The Johns Hopkins University Press G. S. Rousseau 153 outset of my own relation to contemporary theory. My attitude remains, first, that there is not room here and, secondly, that contemporary literary theory is less urgent than the approach I call method. The reasons have to do with a potential for utility built into Literature and Medicine. I hope diis attitude will not imply diat a developing subject can afford to overlook theory — unequivocally it cannot. But the matter is rather that the fundamental issues about theory in relation to Literature and Medicine are specific in the way diey (the issues) relate to the developing traditions of medicine; and diey (die issues) cannot be summarily reduced to "laws" described in a few paragraphs. The result is diat my discussion of mediod implies a dieoretical dimension; and by adopting diis approach I hope I am not evading theory at all. My emphasis on a method of inter-relationship as a fundamental procedure is directed toward this theoretical end. There remains ideology, which is also always embedded in theory and practice. The question I ask is primitive: what is die ideological content of die two terms — "literature" and "medicine" — used throughout diis essay to identify a "field" as yet dieoretically incoherent? My belief is that Literature and Medicine ought not to continue widiout self-awareness of the dieoretical status of die basic terms used to designate the field. But bodi the terms and their practices have altered over time; their ideological content remains in a terrific state of flux today. Contemporary discussion involves die use and application of die terms "literature" and "medicine" to earlier historical periods when the (dien) contemporary meanings neidier coindded with, or even approximated, the reality. Theory insures that we continue to know what we are discussing when exploring the reciprodties of these domains. Theory forces upon us the making of basic, working definitions. Throughout my discussion I am troubled by a utilitarianism I fail to disguise. My hunger is that literature should prove itself useful to the medical profession in the healing process. But even this craving embeds "practical" issues containing "dieoretical" underpinnings; and I would need another essay to explain how I arrived at dûs belief. But the methodological consequence...

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