Notes
189 notes Preface 1. Throughout this book I use the terms psychiatry and psychiatrists; however, much of this material will be relevant for mental health workers more broadly. I welcome readers from outside psychiatry to consider these ideas. 2. Cultural studies of psychiatry may be seen as part of a larger genre, which Davis and Morris call “biocultures.” See Davis and Morris 2007 for an articulation of the larger genre. For a review of this material, see Lewis 2009. Chapter One: Listening to Chekhov 1. Many argue that the chemical imbalance model is a distortion of contemporary biopsychiatry (Lacasse and Leo 2005). But even if we accept this argument , it does not change the underlying disease logics at the core of biological psychiatry. See Helen Mayberg’s discussion of limbic-cortical disregulation for an updated and sophisticated version of the neuropathology of depression (Mayberg 2004). 2. These numbers were calculated using drug sales data from IMS Health by Graham Aldred for the Alliance for Human Research Protection (AHRP) (www .arhp.org). AHRP is a well-known citizens’ watchdog organization that brings public attention to human rights issues associated with biotech research and usage. For the details of Aldred’s analysis, see Aldred 2004. 3. Breggin 1991; Caplan 1995; Farber 1993; Valenstein 1998. 4. Useful resources for understanding Chekhov’s life and background include Chekhov 1997, 2004; Coope 1997; Finke 2005; Hingley 1976; and Rayfield 1997. 5. Because of the uniqueness of Chekhov’s multiple positions, William Carlos Williams (also a master of literature and medicine) was correct when he told a young medical student looking for advice in understanding the subtleties of medicine to “read Chekhov, read story after story of his” (Coles 2002, xii). Contemporary physician Robert Norman says much the same thing when he tells fellow doctors, “I recommend you dive in [to Chekhov’s writings] with abandon, soak 190 Notes to Pages 4–11 up the visions of Chekhov, and you will emerge the better person” (Norman 2005). 6. For a review of these portrayals from a medical perspective, see Coope 1997, chap. 2. 7. Although Kramer does not mention examples, it is certainly true that others in the medical humanities community interpret Ivanov in a similar way. Both Coope and Callahan also see Ivanov as clinically or biologically depressed. See Coope 1997, 34–38, and Coulehan 1997. 8. For an extended version of this argument, see Kramer 2005. Here, Kramer follows suit with his Ivanov review, using strategic polemic to claim that depression must be seen as a medical disease. He catalogs an array of contemporary scientific research that shows how depression disrupts brain functioning, damages the heart, and alters personal perspective. Kramer minimizes any complications of this interpretation to make the extreme claim that contemporary medical research demands that there be no alternative perspective on depression beyond a disease model. 9. See also Friedland 1964, 130. 10. For an excellent discussion of Bakhtin’s concepts of “voice” and “polyphony ” as applied to Chekhov and medicine, see Puustinen 1999, 2000. See also Kathy Popkin’s discussion of Chekhov’s frequent strategy of staging an incident and then providing two separate perspectives on it,“one that regards the incident as utterly trivial, barely worth mentioning, while the other discerns the maximal degree of catastrophe in the same event” (Popkin 1993, 38). 11. Subsequent references are cited parenthetically in the text with act, scene, and line numbers. 12. There is some evidence that Chekhov himself was not disposed to an environmental interpretation. Indeed, Chekhov explains in a letter that one of his early motivations for the play was to demolish all talk of Russia’s superfluous men—the very Ivanov types that were so common in Russian literature at the time and who were generally understood to be suffering from a kind of social paralysis (see Chekhov 2004, 175). Gilman argues, however, that Chekhov’s motivations may have changed in the course of writing the play. Although he at first wished to dispose of environmental explanations for Russia’s “superfluous men,” during the process of writing the play“he steadily transformed it into something much richer and far less thematically local” (Gilman 1995, 40). This interpretation would account for Chekhov’s inclusion of general anomie in Ivanov’s setting, and it would account for including Sasha’s outburst that diagnoses all the men in the area. 13. For a discussion of “dogmatism” in contemporary psychiatry, see Ghaemi 2003. Ghaemi concludes, based on an analysis of psychiatric practice, that...
OR
Buy This Book in Print