Cure and Care: G. Thomas Couser and the Ethics of "Pathography"

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Illness, it is said, can be an opportunity. Many of those who receive the shock of a threatening medical diagnosis respond as narrative agents, reviewing the past, reconsidering how the present and future should be lived now that the end might be closer than they had imagined and that bodily contingency seems to threaten the narrative logic of their lives. A small, generally well-educated and financially secure proportion of such people transfer this narrative activity to the page, as do some carers, family members, physicians, and others. Thus arises what is perhaps best termed "illness/disability life writing"—a genre that contains many subgenres, most notably, "autopathography" (first-person illness/disability narrative), "pathography" (illness/disability writing that is generally done in the third, sometimes the second, person), and "thanatography" (an account of death, whether in first, second, or third person).

The burgeoning field of scholarship about illness/disability life writing has produced some fine foundational work by Susan Sontag, Arthur Kleinman, Arthur Frank, Anne Hunsaker Hawkins, and others.¹ G. Thomas Couser's three books, Recovering Bodies: Illness, Disability, and Life Writing; Vulnerable Subjects: Ethics and Life Writing; and Signifying Bodies: Disability in Contemporary Life Writing,² belong in this distinguished company. These volumes are models of scholarly conscientiousness, prudent innovation, and ethical responsibility. Couser writes: "As a critic of disability life writing, I particularly value that which responds creatively and preemptively to some of the prejudicial conventions of disability representation" (SB, p. 182). And further: "What is at stake in the ethics of life writing is the representation of self and of the other, which is always at once a mimetic and a political act" (VS, p. 33). Whilst some work in this field suffers from postmodern theory's inclination to self-preening display, Couser's tone is empathetic, and unassuming: it reserves rhetorical force for the defence of well-argued principles and morally vulnerable narrative subjects. He draws judiciously on contemporary literary and cultural theory, deploying feminism's distinction between an "ethics of cure" and an "ethics of care," and on postcolonial and discourse theory accounts of power relations and their impact on representation. He writes at length about autoethnography and the place of the writing self in representations of the Other. Though he is occasionally prone to moralism, he warns that "we have to be wary of devising, in the isolation of the ivory tower, excessively fastidious or implicitly discriminatory standards" (VS, p. 55). He can be admirably direct about intellectual fashions: "Although it has recently been fashionable in the academy to treat the individual as a cultural and linguistic 'construction,' and autobiography as 'fictive,' reading accounts of illness where life is literally at stake exposes a crucial divide between fiction and non-fiction" (RB, p. 54).

Couser's slightly forbidding, coolly scientistic titles—Recovering Bodies, Vulnerable Subjects, Signifying Bodies—bespeak a sometimes uneasy rapport between compassion and the professional locutions of the academy; yet the titles do real, layered conceptual work: "recovering" means both getting well and retrieving or instating more humane representations of the body; "subjects" are both the protagonists of illness/disability narratives and, as Couser convincingly shows, subject to medical, representational, and ideological regimes; and the challenges associated with the "disabled" body apply both to third-person representations of those bodies—what such bodies conventionally "signify" in our cultures—and to the imperative that they or those who chronicle their stories resignify disability in ways that challenge existing, ideologically warped and demeaning modes of representation.

Couser's scholarly care extends to matters of genre taxonomy. The distinction quoted above between "autopathography" and "pathography" is his. While Hawkins's Reconstructing Illness performed an invaluable service in drawing attention to the range and prominence of illness...