Texts as Symptoms: Workshop Report

On arrival at the first of a series of workshops for Dr Maria Vaccarella’s new research project on fictitious illness narratives, we were encouraged to share our reasons for attending. As someone who works on anxiety in contemporary American literature, I’m always fascinated to hear people’s thoughts on the slippery boundary lines between fiction and non-fiction – an interest shared by many researchers at the workshop. Others were keen to hone their skills of textual analysis in the context of the medical humanities, and to explore the narrativisation of symptoms, the relationship between psychoanalysis and the literary field, and how the day’s themes might map on to visual fictions.

The morning began with a paper from Professor Sue Vice on Tristan Szente’s self-published illness memoir Becoming Me (…Again) (2016), which details the aftermath of a motorbike accident, and subsequently, a mysterious brain virus. Sue considered how texts such as this often only truly come into being once their falsity is exposed, and how symptoms are used almost as excuses to account for discrepancies and contradictions in-text. She raised some particularly interesting questions about the gendered response to illness narratives, and how memoirs written by women are more likely to be questioned and distrusted, while also examining our motives for interest in narratives of illness and victimhood, which offer an existential appeal through tales of miraculous recovery and saintly cures. She concluded with thoughts that recurred throughout the day on the distinction between accounts of illness that are posted online and those that are published, particularly in relation to how these different forms are received.

Next up was Katrina Longhurst, who presented on Lauren Slater’s Lying: A Metaphorical Memoir (2000), a puzzling text which is self-conscious about the reader’s expectations of truth, opening with the words “I exaggerate.” Katrina thought through how the text operates as a form of counter-diagnosis, with language subverting diagnostic urges and embracing the sense of confusion and disjointedness illness may cause. Indeed, she also reflected on how this is a book which shifts and distracts itself; its narrative is repeatedly caveated, and, in Katrina’s words, stretches the autobiographical pact to breaking point. In this sense, she argued that Slater invites us as readers to enter the confusion of diagnosis with her – to face the multiple truths and voices of mental illness communally. This paper raised fascinating questions about the author-reader (and narrator-reader) relationship in illness narratives, while also contemplating on our reliance on diagnosis as truth, and what, if anything, a ‘true’ or ‘accurate’ illness narrative looks like.

This was followed by a paper from Dr. Maria Vaccarella, who provided an overview of her project and the questions that prompted it: what counts as an illness narrative today? Are they always artistic or performative, and if not, what else might they be? And why do we like them? In particular, Maria’s work is examining false accounts of illness, asking what cultural work is being done by these accounts, and what drives them, beyond narcissism and a desire for fame. Celebrity patients such as Belle Gibson, who wrote a cookbook and developed an app detailing her cancer diagnosis and subsequent health journey, have contributed to Marc D. Feldman’s concept of Munchausen’s by Internet – lying about one’s health online. Maria also reflected on the difficulties this can cause while researching, as many accounts of illness that are posted online and proved to be false are subsequently deleted very promptly. One notable trend throughout the morning’s papers was that writers who created false illness narratives often drew very heavily on the work of their idols – Sue’s paper considered how James Frey’s A Million Little Pieces (2003) borrowed scenes and phrases from Charles Bukowski’s Ham on Rye (1982), and Maria noted how Gibson drew her approaches from a real cancer patient and wellness writer called Jessica Ainscough. This points to the implicit intertextuality of false illness narratives, which model themselves on the accounts of real patients, taking the reader along for the journey of emotions that follow when this falsity is exposed. Maria referred to the complex relationship between online accounts and health promotion as the new melodrama of social media autofictional storytelling, which is also at the heart of her new work.

These papers prompted a wide-ranging discussion on medical charlatans, models of miracle cures, reader responses to the exposure of illness narratives as fake, ethical questions as to when crime begins in the creation of false illness narratives, and, perhaps most interestingly, the remedicalisation of such texts, where they are recuperated as symptomatic of real conditions such as factitious disorder. In turn, this moved us into a brilliant Fact or Fiction exercise, where we were asked to identify whether passages of writing were fictional or non-fictional (at least when initially marketed!). In doing so, we were able to further discuss our expectations of accounts of illness – are there clear markers of falsity in-text? How might language and narration differ when comparing fictional and non-fictional accounts of illness? This was followed by a ‘new title’ activity, where we were asked to think about whether, and how, we would rename autobiographical texts that are revealed to be false, which again raised questions of how readers react to discovering a text is not what it seems.

To close the day, we came together in groups to analyse extracts from fictional and non-fictional accounts of illness, including some non-fictional writing that was revealed to be false. Drawing on Anne Hawkins’s Reconstructing Illness and Arthur Frank’s The Wounded Storyteller, we reflected on some common genres or narrative trajectories within illness narratives, from the idea of rebirth (illness as an occasion for spiritual growth) to quest and chaos narratives, which respectively frame illness as a journey of discovery, and as anti-narrative, with bodily confusion reflected in a text’s plot. During these discussions, I was interested by the way in which we as readers tend to introduce personal anecdotes into our analysis of illness narratives – it’s as though we feel some compulsion to relate these stories to our own experiences, deepening both the author-reader relationship, and the sense of deception when their stories are revealed to be fake – all food for thought for our next session!


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