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59 The Epideictic Rhetoric of Pathography 3 The Epideictic Rhetoric of Pathography In recent years, narrative has found a place in health research, not only among social science and humanities researchers but also among some medical researchers1 as the default opposite of biomedical discourse. Biomedicine is associated with a thinness in descriptions of patient experience , a tendency to measurement and quantification, and an embrace of the mores of Michel Foucault’s clinic, where, as I note in chapter 1, the “individual in question was not so much a sick person as the endlessly reproducible pathological fact to be found in all patients suffering in a similar way” (97). Narrative is a means of balancing the scientific impulse of biomedicine with a humanistic impulse. Certainly, narrative fleshes things out. For example, in her recent work on bipolar disorder and “the measurement of moods,” Emily Martin points to patient narrative accounts of mood shifts to illustrate how people who “live under the description” of bipolar disorder may counter the regime of measurement by describing their moods discursively rather than only matching them to numbers on an eleven-point scale (“Monitoring”).2 Narrative study in health research covers a wide range of subjects, including narrative epistemology (see Kathryn Montgomery Hunter), narrative therapy (James W. Pennebaker), and narrative ethics (Hilde Lindemann Nelson). Prominent objects of narrative scholarship are personal narratives of illness—one’s own (Jean-Dominique Bauby) or someone else’s (John Bayley on Iris Murdoch). 60 The Epideictic Rhetoric of Pathography Anne Hunsaker Hawkins notes there is interest among narrative scholars in what term to use for stories of illness. “Pathography,” she says, denotes only written narrative (Reconstructing xviii). In his book on the “wounded storyteller,” Arthur Frank uses the more general term “illness narrative,” used also by Arthur Kleinman, who introduced it to describe the patient’s story as constructed by the physician. G. Thomas Couser says personal narratives pertinent to illness may include, as well as illness narratives per se, journals, essays, and “full-life narratives.” “[I]llness narrative refers to writing about the episode of one’s illness, whereas full-life narrative refers to a comprehensive account of one’s life, including the illness” (6; emphasis in original). Susan Greenhalgh would add “illness auto-ethnography,” in which the central topic is not the ill person but, rather, the illness itself and medicine, as illuminated by the study of the ill person as object by the same person as researcher.3 Hawkins describes the growth in the latter part of the twentieth century in illness narrative or pathography publication and suggests its rationale : “Pathography returns the voice of the patient to the world of medicine , a world where that voice is too rarely heard, and it does so in such a way as to assert the phenomenological, the subjective, and the experiential side of illness” (Reconstructing 12). Hawkins continues: “Pathography restores the person ignored or canceled out in the medical enterprise , and it places that person at the very center. Moreover, it gives that ill person a voice” (12). Pathography, too, is the complementary text of the medical case presentation, which, as a genre itself, is meant, according to Lorelei Lingard and Richard Haber, to include “just the relevant data,” “just the pertinent positives” (165). (An interesting question is begged here— that the case presentation is the “fact” part of illness and pathography the “value” part.) A canon of pathographies includes work by Nancy Mairs (who writes on multiple sclerosis and on depression), Gilda Radner (ovarian cancer), Anatole Broyard (prostate cancer), Audre Lorde (breast cancer), Bonnie Sherr Klein (stroke), Temple Grandin (autism), and others. There are, in addition, countless pathographies by otherwise unknown authors. In the second edition of Reconstructing Illness: Studies in Pathography, Hawkins provides a thirty-four-page selected bibliography of pathographies, organized by disease. Instances of the genre continue to multiply. In a review essay, Peter Kramer says the titles “represent niche book selling, a guide for every challenge” (“Anatomy” 27). A canon of scholarship, descriptive and classificatory, and sometimes 61 The Epideictic Rhetoric of Pathography critical, too, has developed around narratives of illness. Hawkins, Couser, and Frank are all well known for having written full-length studies of the genre.4 What work narrative does, narrative study extends. Kenneth J. Gergen says that narrative is a discipline-breaking genre, opening up social science to literary theory, hermeneutics, and phenomenology, rescuing social science from being “strangulated by empirical foundationalism.” If narrative discourse itself is the opposite of...


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