Archives for category: Empathy

I love Sebastian Barry’s writing. His prose is so lyrical and poetic, you do not want to miss a single word. Having enjoyed The Secret Scripture and On Canaan’s Side, I very much looked forward to his new novel, The Temporary Gentleman. I read it in less than 24 hours and was not disappointed.

In many ways, it reminded me of John Williams Stoner as it also tells the life story – a tragic life story – of one man and his family. It differs in many ways also, not least because The Temporary Gentleman is narrated in the first person of the main character, Jack.

We follow Jack’s story as he begins, in his 50s or so, the retrospective diary of his life. It is a sad and mostly regretful life, not least because alcohol dominated throughout. It is this that I want to focus on here, how Barry depicts the tragic effects of alcoholism. The Irish and alcohol are intimately and historically interconnected, but Barry does not default to stereotyping. The tone throughout is empathic rather than judgemental, as the situation in which Jack and his wife Mai inescapably find themselves unfolds:

‘It was as if the bricks and mortar of the house itself were saturated in alcohol.’

‘To remember drunkenness is so difficult because it is really a form of human absence, a maelstrom that blanks out the landscape.’

Behind the alcohol is the story of a couple who have lost each other, and who fleetingly regain something in the shared camaraderie of drinking. But as drink follows drink, the inebriated state again turns them into enemies:

‘But the savagery, the gear of savagery. The subtle metallic click of the machinery, when the rack is brought to the starting point, and the ropes are tied to the body.’

‘The terrifying eloquence of the barely articulate drinker. Insults, that might have done as well in the form of a knife, fashioned into a great bludgeon, for fear it would not strike home…

…Turning ourselves night after night into monsters, the creations of some failed Frankenstein…

..Nothing left at the centre but the cinder of what had been, splinters of the lost panel depicting out setting forth nearly thirty years before, in heroic guise, on this darkening journey.’

‘In the morning — nothing ever mentioned.’

The darkness is infinite and the black hole in which Jack and Mai find themselves is bottomless. But there is redemption here, of sorts. And love. The Temporary Gentleman is perhaps not an uplifting read, but a necessary one.

 

CQ

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Although long aware of the Irish author Niall Williams, I had never read any of his novels. The arrival of his current book History of the Rain prompted me to explore his earlier work.

I started with Only Say the Word, and loved it, finishing it in less that 24 hours. It feels as if every book this year reminds of another author’s work, coincidentally also Williams, John, and his novel Stoner, which I have previously spoken about here [https://sufferingandthearts.wordpress.com/2013/12/16/stoner/]. Only Say the Word and Stoner are very different, but they do share a common theme of following one man’s life, and the influences and events that impacted on the life in question. In addition, both John Williams and Niall Williams are masters of a style of prose that seduces the reader willingly and complicitly into the life of the protagonist.

Niall William’s narrative tells the story of Jim, opening with the words:

‘I do not know what to write. There have been so many words written already. So many endings and beginnings. I have lost my faith.’

We are immediately introduced to the acute cause of Jim’s sadness, which is the loss of his wife Kate, mother of his young children:

‘And so I sit here, and feel your absence and wonder how to begin to live without you.’

As Jim commits his story to the blank page, his life up to now is revealed. We learn of his childhood in Ireland, with his devout mother who seemed to exist in a haze of sadness, his kind but distant father, his genius and troubled brother, and his baby sister Louise. It is a relatively calm and untroubled childhood, until:

‘And in that same passing of time, the same even measurement in which one moment seems identical to the next but is not, our life is struck and falls apart.’

Tragedy happens, from which nobody truly recovers. Jim partly blamed himself, as children tend to do, and it was not a family where such feelings were expressed or acknowledged:

‘In our family we are each like boats slipped from the moorings, out in deep water, and utterly separate or tangled in our own nets of grief and loss. We live together in the house but are each alone.’

Jim copes by escaping, initially through books and reading, and later physically, when he leaves school.

We follow Jim’s life, and his attempt to make sense of it as he commits the telling of it to the page. Jim is a more accessible character than John William’s Stoner, yet that is not the point. Liking someone is not critical for empathy, which only demands an authentic emotional connection with the suffering of another. Jim (and in essence Niall Williams) goes a step further. By sharing his story, and in particular the redemptive possibilities of caring and of love, hope is ultimately acknowledged and embraced.

 

CQ

”She has a lump on her – her breast, like a gull’s egg.”

”Your mother has a cancer.”

‘He was silent. The whole room was full of the silence and the weight of what she had said lay upon him.’

In Black Sheep, Evie has noticed her mother-in-law Alice’s increasing fatigue and weight loss – ‘Alice looked as if the tiredness had settled in the marrow of her bones.’ Not content with her husband’s diagnosis of ‘ailing somehow’, Evie challenges Alice to share what she suspects her mother-in-law has been suffering from, and which she has hitherto been hiding:

‘The swelling was the size of an apricot, pushing against the skin.’

What particularly moves me about this passage, is how both women immediately, and silently, acknowledge the significance of the swelling. Reminiscent of Susan Sontag’s kingdoms of the ill and of the well, with a very narrow gap between the two, the chapter ends poignantly, and tenderly:

‘She put her hand on the other woman’s arm and rested it there, and so they stood, both silent, as if they were staring into the depths of the same river but from opposite banks.’

CQ

This poem, from the current issue of the The New Yorker (http://www.newyorker.com/fiction/poetry/2014/01/06/140106po_poem_twitchell), moved me:

Roadkill

I want to see things as they are

without me. Why, I don’t know.

As a kid I always looked

at roadkill close up, and poked

a stick into it. I want to look at death

with eyes like my own baby eyes,

not yet blinded by knowledge.

I told this to my friend the monk,

and he said, Want, want, want.

Chase Twichell

It reminded me of Philip Larkin, and his poem The Mower, which has a similar impact every time I read it:

The Mower

The mower stalled, twice; kneeling, I found

A hedgehog jammed against up the blades,

Killed. It had been in the long grass.

I had seen it before, and even fed it, once.

Now I had mauled its unobtrusive world,

Unmendably. Burial was no help:

Next morning I got up and it did not.

The first day after a death, the new absence

Is always the same. We should be careful

Of each other, we should be kind

While there is still time.

Philip Larkin

CQ

The medical historian, writer and poet Professor Joanna Geyer Kordesch led the research project ‘Stories and Cures: Illness and the Art of Medicine’, which was undertaken at the Scottish Storytelling Centre. The day before she was due to present the findings at the Scottish Storytelling festival, Kordesch herself suffered a serious stroke. In this video http://www.youtube.com/watch?v=uskmAr18wSs she shares her experience of the aftermath of the event, offering a unique insight into both her academic expertise on the subject of storytelling and illness, as well as her own personal experience as an illness sufferer.

The time from her near death experience to anything approaching normality has been a relatively long one for Kordesch. Along the way, no one could advise her on a recovery trajectory or a possible prognosis. The long and slow wait for return of function is a subjective experience, and one that is unique to each stroke sufferer. Thus, Kordesch stresses the word ‘individualised’ throughout the discussion: she sees her stroke as an individualised condition, and how she has endured it as an individualised experience. Although her experience has inevitably been different to those of others, for all those affected by illness and disability, Kordesch suggests a facing up to one’s symptoms, focusing on living through the condition (as opposed to trying to eliminate it), which can be in itself ultimately liberating, not only for the sufferer but also for healthcare professionals.

The complexity of influences, all of which interact, that arise from serious illness are unique to the individual, and include not just the physical but also the impact of imagination and of feelings. With her academic expertise on the experience of illness in the context of culture and philosophy, Kordesch speaks of the romantic era, pre medicalisation of psychological issues and psychiatry, when expression of one’s imagination, dreams and feelings were allowed and encouraged.

Since her stroke, her creative side – art and poetry – has become increasingly important to Kordesch, which allows her to tell her own story rather than using those of others. She stresses the importance of storytelling for one’s wellbeing, as an opportunity to explain and to experience ways of dealing with illness and disability.

Kordesch’s experience reinforces her belief that people need to be seen, particularly by doctors, as a whole rather than merely as their disabled/ill parts.

Kordesch acknowledges that her illness experience has added something to her life, and she now finds that she is more attentive to the world that she lives and recovers in.

CQ

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The poster for this conference epitomises the creativity and richly imaginative content that defined the event itself.

I have attended many ‘Medical Humanities’, ‘Health and Humanities’, ‘Medical Narrative’ and such like conferences in the past. Medicine Unboxed 2013 – with this year’s theme of Voice – stands alone as something uniquely innovative and stimulating, as well as both emotionally and intellectually challenging.

The twitter (#MU13VOICE) and facebook feeds are excellent and will give you a real sense of the diversity and substance of the content. Although I could only attend the first day, I was so very pleased to have been physically present for even 50% of the entire programme.

‘Voice’ (full programme – http://www.medicineunboxed.com/2013-voice/) was presented and discussed as the poetic voice (Jo Shapcott and Andrew Motion), the patient (Rhys Morgan), the captured voice (Fi Glover, The Listening Project), the singing voice (Birmingham Medical School Choir, Melanie and Rebecca Askew), the performed voice (Bobby Baker), and the sung voice (in terms of composition and phonetics, and music as therapy, and as an end in itself).

It is difficult to pinpoint exact reasons why I found the conference so refreshing and stimulating. The absence of medical-type presentations contributed, and Sam Guglani et al.’s creative approach to all possible aspects of ‘Voice’ in terms of health and medicine was hugely impressive.

I wonder whether the audience consisted of many non-medical/non-health-care professionals. One thing that irked me was the repeated use of the word ‘patient’. It grated. Perhaps this is because I no longer work in clinical medicine. As an ‘outsider’, ‘patient’ feels like a label that attaches an otherness to those who are ill, whereas in fact, as identified by Susan Sontag, the gap between ‘them’ and ‘us’ is very narrow…

My experience of sitting outside clinical medicine left me much to consider also following the session on the ‘Medical Voice’, in which Iona Heath, Deborah Bowman, Julian Baggini and Charlotte Blease participated. A ‘crisis in empathy’ amongst doctors was highlighted here, and there was much discussion on how medical training could be improved to address this.

I have often been critical of the lack of empathy and compassion that those who are ill have experienced during the medical consultation. I left clinical medicine a few years ago, to explore medical humanities/health and humanities (not quite sure what to call it anymore), and now work as an editor for an organisation that creates books on health and illness for children. We recently advertised for a junior doctor for the role of a medical writer. I was overwhelmed by the quantity (and quality) of the applicants – over 20 junior doctors, all disillusioned by their first years in clinical medicine. Most had no intention of ever returning to the field.

I found this sad, that the system (‘medicine’, the NHS…) had somehow failed them to the extent that just a few years working as clinical doctors made them want to walk away. We are quick to criticise doctors and how they behave, which is sometimes, but not always, justifiable. Yesterday, I found myself in the unusual position of wanting to make a plea for the ‘Medical Voice’, that it might be heard and witnessed too…

My view has inevitably been tempered by my distancing. For a perspective from a doctor within clinical medicine, do check out Jonathon Tomlinson’s response to Medicine Unboxed 2013, which truly reflects a ‘Medical Voice’ that needs to be heard: http://abetternhs.wordpress.com/2013/11/23/burden/

CQ

I was intrigued by this alternative view on Alice Munro in the London Review of Books recently (http://www.lrb.co.uk/v35/n11/christian-lorentzen/poor-rose?utm_source=newsletter&utm_medium=email&utm_campaign=3511&hq_e=el&hq_m=2528056&hq_l=13&hq_v=d9fe4d9083).

The author of the piece, Christian Lorentzen, claims to be confused by the consensus that surrounds the acclaimed short story writer Alice Munro, and how critics assert ‘her goodness, her greatness, her majorness or her bestness’ on the one hand, while at the same time encouraging us to see as virtues in her writing that which might otherwise be viewed as shortcomings:

‘So she writes only short stories, but the stories are richer than most novels.’

‘She has preternatural powers of sympathy and empathy, but she’s never sentimental.’

‘She writes about and redeems ordinary life, ordinary people…’

Lorentzen has not enjoyed reading Munro’s work:

‘Reading ten of her collections in a row has induced in me not a glow of admiration but a state of mental torpor that spread into the rest of my life.’

‘I became sad, like her characters, and like them I got sadder.’

‘I saw everyone heading towards cancer, or a case of dementia…’

I have always been drawn to stories that feel realistic and believable. True, these narratives are often ‘pathos-delivering’, as Lorentzen describes Munro’s latest collection Dear Life. But, the tales that I can relate to and connect with do not make me feel sad, or sadder, or despondent. Rather, they reassure me that out there somewhere is a story and an experience that I can connect with, on some level. Such connection makes the world a less solitary place.

There is a bigger question here too, which is why do we read. Each of us brings our own agendas and individual needs to the page, be it escapism, a need to connect, or whatever. It is good that we are all such different readers and writers.

Ultimately, my experience reading Munro’s stories has been vastly different to that of Lorentzens. Take for example the story ‘Gravel’ from Dear Life, about which Lorentzen says little, apart from the three words ‘a child drowns’, which seem heavily weighted with his negativity towards Munro’s ‘pathos-delivering tales’.

I, on the other hand, remember something quite different from the same story:

‘”The thing is to be happy,” he said. “No matter what. Just try that. You can. It gets to be easier and easier. It’s nothing to do with circumstances. You wouldn’t believe how good it is. Accept everything and tragedy disappears. Or tragedy lightens, anyway, and you’re just there, going along easy in the world.”’

CQ