Narrative Medicine in the Literature Classroom: Ethical Pedagogy and Mark Haddon's The Curious Incident of the Dog in the Night-Time

When I had the opportunity to conduct seminars in literature and medicine with second-year medical students, some of my colleagues in the English department jokingly described my work as “teaching doctors to be human beings.” Indeed, it may be easy for humanities professionals to feel a sense of smug, if silent, superiority when reading anecdotal accounts of doctors discovering truths like Arthur Kleinman’s “grand lesson . . . that it is possible to talk with patients . . . about the actual experience of illness.”¹ As professional readers of narrative, we “listen” to people, real and fictional, and strive to understand their stories as a matter of course. It’s what we do. We may even see ourselves as representatives of a field that—by offering a variety of our texts and techniques to the study of medical humanities—is responsible for having given medical education some degree of humanity. But interdisciplinary practices like those incorporated into “narrative medicine,” having created a model for ethical engagement between healthcare professionals and their patients, can also be used as a mirror for literary scholars to hold up to ourselves. In our field, teaching and learning how to “be human beings” remains taboo: such work is too soft, too subjective, too spiritual, too politically problematic. It’s irrelevant to a public university, or it’s not our job. Even in English, amidst the most profound accounts of human existence ever penned, the nobler goals of humanistic education yet take a back seat at best to “critical thinking,” to historical and cultural literacy, to theoretical play with the written word, and to intellectual rigor and systematic thinking about texts. The scientists now regularly talk about their practice in terms paradoxically foreign to the humanists: wisdom, gratitude, empathy, and ironically, the “meaning” people can make by reading and creating narrative together.

Thinkers like Wayne Booth have encouraged us to return “ethical criticism” to the study of literature, a type of reading that takes into consideration “the overall effect on the ethos, the character, of the listener . . . the very quality of the life lived” by the reader.² Far from limiting our reading pleasure and study to those texts which overtly moralize in ways we readily embrace, Booth explains that every act of reading prompts some ethical reaction, and that in fact our ethical frameworks are built, in large part, through story: “no one who has thought about it for long can deny that we are at least partially constructed, in our most fundamental moral character, by the stories we have heard, or read, or viewed . . . the stories we have really listened to.”³ It is foolish, then—even irresponsible—to ignore the ethical nature of texts, the sometimes even polemical intentions of their authors, and the often profound effects they can have on readers. According to Booth, we in literary studies can strive nobly: “when responsible readers of powerful stories engage in genuine inquiry about their ethical value, they can produce results that deserve the tricky label ‘knowledge.’”⁴

As most ethical critics note, current and future approaches to narrative ethics must be rooted in narrative theories: in other words, we must not work backward from what Daniel Schwarz has called the “theoretical revolution” of the late twentieth century.⁵ Should that still small voice that reminds us why we are moved by stories clamor at Booth’s call and desire to share with students the richly ethical components of reading, we must find a way to do so with respect to the intellectual integrity of our field.⁶ It is ironic that in medical education we find a clear, promising, and rigorous method for doing ethical criticism in our English classrooms. As they encourage conscious engagement between the reader’s ethical self and the patients, characters, or texts with which he or she engages, narrative medicine techniques (designed by and for “hard” scientists) also demand a systematic study of narrative. As a result, narrative medicine invites more muscular than pathetic readings of texts, affording those of us in...