Medicine and Literature

John Updike once wrote, “Life is a very strange thing, in a way, compared to life in a novel. People in novels rather rarely eat; their health is not often of concern to them; earning money isn’t nearly as important to them as it is to those of us in the real world.”

Virginia Woolf also expresses this view in her well-known essay “Short of Breath” that has been reprinted as a slim volume On Being Ill. It begins with a memorable paragraph.

“Considering how common illness is, how tremendous, the spiritual change that is brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to view, what precipices and lawns sprinkled with bright flowers a little rise of temperature reveals, …when we think of this, as we are so frequently forced to think of it, it becomes strange indeed, that illness has not taken its place with love and battle and jealousy among the prime themes of literature.”

Even though she spent most of her life battling depression and debilitating physical symptoms, she never wrote about them. She wonders why illness has not been as popular a subject for literature as love. Why has the “daily drama of the body” not been recognized by writers?

She admits it might simply be due to the poverty of language. “English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache.” Her essay was written in 1926; in the eighty-four years since then, much has changed.

Late last year the first Wellcome Trust book prize was awarded for “outstanding works of fiction and non-fiction on the theme of health, illness or medicine.” The winning book was Keeper, Andrea Gillies memoir of caring for a relative with Alzheimer’s that apparently had not been publically reviewed. In writing about this award Chris Powers discusses other works of literature that treat medical themes.

He discusses Ken Kesey’s One Flew Over the Cuckoo’s Nest and Thomas Mann’s The Magic Mountain, Oliver Sacks The Man Who Mistook His Wife for a Hat, and Ian McEwan’s Saturday. He mentions writers who were trained as doctors—Chekhov, William Carlos Williams, Somerset Maugham, Walker Percy, a topic about which I have previously blogged.

I think of books I’ve read about individuals with Alzheimer’s, a topic that is being written about with increasing frequency these days. There is Still Alice by Lisa Genova a novel that describes the experience from the point of view of an individual diagnosed with early onset Alzheimer’s. Much earlier there was Elegy for Iris, John Bayley’s moving account his wife, Iris Murdock’s, descent into Alzheimer’s.

…Iris’s inability to summon the words she seemed to want. Her delivery had always been slow and thoughtful and a little hesitant, and at first I was not perturbed, sure that she would recover in a few minutes, when she got the feel of the gather. It was hard to say how conscious she was of her own difficulty, but the effect soon became paralyzing, for the listener as well as for her.

Alzheimer’s is, in fact, like an insidious fog, barely noticeable until everything around has disappeared. After that, it is no longer possible to believe that a world outside fog exists. First, we saw our own friendly, harassed GP, who asked Iris who the prime minister was. She had no idea but said to him with a smile that it surely didn’t matter.

More and more fiction and non-fiction books are being written about old age and the infirmities of growing old. I think of Jean-Dominique Bauby’s The Diving Bell and the Butterfly, a memoir that documents the author’s struggle to cope with the effects of a massive stroke that left him totally paralyzed with the exception of his left eye-lid that allowed him to communicate. I think David Rieff’s Swimming in a Sea of Death about his mother, Susan Sontag that portrays her persistent, but always painful, struggles to overcome three bouts of cancer. And then there are two recent works of Philip Roth, Everyman and Exist Ghost that depict in agonizing detail the “massacre” that is old age.

It is clearly no longer correct to say, as Virginia Woolf and John Updike did, that literature has ignored illness and matters of health. To the contrary, it now appears we are being inundated with more and more volumes of literary works that treat these issues in considerable detail. I sense we have only seen the beginning.