- The Illness Memoir
To the burgeoning field of studies in medical culture, Lisa Diedrich has made a useful contribution with Treatments: Language, Politics, and the Culture of Illness. In the most general sense, the field of studies in medical belongs to cultural studies: various interdisciplinary culture belongs to cultural studies: various interdisciplinary approaches are applied to the medical landscape, which may include anatomy and autopsy, surgery and plastic surgery, ill and healthy bodies, disability, doctor-patient relations, pharmaceuticals, and so on, as well as the various venues that represent these topics (art, film, television, drama, narrative). Early in the development of the field, Michel Foucault and Susan Sontag made seminal contributions with The Birth of the Clinic: An Archaeology of Medical Perception (1973) and Illness as Metaphor (1978). More recent studies include Elaine Scarry's The Body in Pain: The Making and Unmaking of the World (1985) and Jonathan Sawday's The Body Emblazoned: Dissection and the Human Body in Renaissance Culture (1995).
Within this context, Treatments falls into the subfield of illness narrative while converging with another subfield, studies in disability. Such subject matter tends to be personal and patient-driven and has to do with issues of subjectivity, changes to or loss of the self, reconfigurations of the body (say, from abled to disabled), and how the body is (personally) known. Diedrich's book charts the rise of the illness narrative, or more precisely, the illness memoir, from its advent in the mid twentieth century to its full-blown materialization today. [End Page 307] Moreover, the illness memoir Diedrich examines is itself a special case: the authors are ill with a potentially terminal disease like cancer or AIDS, or the authors are caretakers (loved one or doctor) of someone who is. And, too, because several of the authors are dying, the narrative is often doubled, including not only the patient memoir but also the caretaker memoir which "finishes" the story. Diedrich is certainly to be commended for shouldering such a heart-wrenching genre and for her perseverance in researching the many illness memoirs that underlie the book.
In the introduction, Diedrich writes that Treatments is essentially about "bodies, language, and death" and how various academic and medical discourses are established in the object under study, the illness narrative (vii). The theories she identifies as foundational for the book—poststructuralism, phenomenology, and psychoanalysis—seem to date the approach at the theoretical heyday of the late twentieth century. While it owes a great debt to Foucault, the field has also moved far beyond such early work as that found in The Birth of the Clinic. Despite an acknowledgment that Foucault-as-model does not always lend itself to the illness memoir (xviii), Diedrich relies too much on Foucauldian methodology, especially in the first several chapters. Given her depth of knowledge and analytical deftness, I would have liked to see her provide both a contextualization and critique of Foucault's work along the lines of her excellent analysis of Sontag's Illness as Metaphor and Aids and Its Metaphors (1989), found in chapter 2. Perhaps there could even have been a way to read the end of Foucault's life as an illness "memoir."
Diedrich begins Treatments with a helpful discussion of the memoir itself, a genre that is open to denigration by critics who tend to distrust works that deal with personal experience, viewing them as no more than self-indulgent whining on the part of a victim. Diedrich counters this position by showing that the memoir, rather than being a simplified and degenerate literature, is worthy of attention for its enabling of questions about the subject, culture, and nation and its institutions. With respect to the illness narrative, the memoir has not only provided a powerful form for rendering the experience of illness but has also been constitutive: "The ways in which we are able to think and do illness come into being through the narratives and practices that already structure the experience and event of illness" (xvi). [End Page 308]
Though most of the...