Remembering My Hat

12th April 2011

Fiction and the cultural mediation of ageing: Part 2

Barbara Czarniawska, Univ of Gothenburg

Narrative medicine: or why doctors do not like to listen to the stories of older patients.

Narr medicine, not just about patient narratives of illness/experience, also about patients writing as part of their therapy, medics stories about patients and about themselves.

Arthur Frank ‘illness is an occasion for autobiog’ – more time, more need. [Is illness particularly an occasion for autobiography? Depends on the sort of illness. Flu is not an occasion for autobiography. Was Frank referring to chronic illness? I ought to read Frank again]

Robertson Davies 1994, The Cunning Man, another recommended book.

RD Summarizing the WHO definition of ‘health’ as ‘health is when nothing hurts very much’ [This is not the WHO definition but I quite like it as an aphorism – it’s quite realistic, workable and everyday, rather than the unachievableness of the WHO definition. And it makes it clear that disability is not ill-health. Although what about disabilities which involve chronic pain? Would someone describe themselves as healthy but in pain? Seems possible that they might. And it also falls down a bit because you may not be in pain with a blood clot that will kill you, but you’re not healthy (are you?)]

Audience comment after: this definition is also good in relation to ageing – more realistic that positive ageing agenda – ‘if your body is as much like a young person’s as possible’ [that’s my phrase/critique]

(cc) nursing pins

Was the cunning man:

–       a doctor from the past, before evidence-based medicine and standardization?

–       or from the future with the growth of holistic and alternative medicine?

–       just a patient’s dream, never existed?

Annemarie Mol (2008) The logic of care. Philosopher contrasting logic of choice (customer/citizen) v logic of care (patient, albeit active).

Audience comment: both are available to medics in care settings, they chose which one they draw on according to discursive purposes [does it make a diff if you call it a logic, rather than a discourse? I think it does. Discourse emphasizes variability, logic suggests discrete system. Interpretative repertoire, of course, is supposed to indicate even higher degree of variability]

Not everybody wants to tell stories about their experience. Shouldn’t become a new imperative (no danger of that in medicine. Might be in management)

Nurses’ handover abolished in some hosps – loss of a storytelling opportunity for nurses.

Then I chaired a panel on Fictional stategies and metaphors

Joan Walker, Loughborough

Love and relationships over 65, do comtemporary  british novels reflect the new reality?

Non-fiction since 1972 de Beauvoir Coming of Age, has known that older women have sex and relationships. Gerontology textbooks routinely acknowledge this now. But contemporary novels don’t seem to know this.

Alison Lurie ‘Foreign Affairs’ 1984 novel

Covers of novels about 65+ women’s relationships don’t show the women, have abstract design, objects, cartoons, younger woman shown.

Elena Bendien, Utrecht

A metaphor for ageing: shrinking

Dutch writer, not trans eng Inez van Dullemen ‘past is dead’ Vroeger is dood’, older woman (born 1920s?) still writing.

Metaphor of ‘shrinking’ is a key one in writing about ageing, also in policy – shrinking resources/social contact/shrinking workforce.

Is a spatial metaphor – reduction, contraction, drying out, loss of moisture and volume. Etmology [in Dutch? Or also in English?] shrinking like a snail going back into its shell – snail isn’t reduced by shrinking, just going home!

(cc) daveograve

OP’s bodies often described as shriveled, shrunken. Contracting is not about loss, it’s about making more dense. Signif for thinking about ageing.

Zoe Brennan, UWE

Fictional strategies for representing the older woman as fully human: reclaiming the everyday.

(in novels)

Make the older woman the central character

Then:

1)    inspirational, extraordinary female characters. Smash preconceptions about what older women are like e.g. Happy Ever After Jennie Diskie, has rela with much younger man, but then leaves him to go off and travel round the world. Rhode Island Blues, Fay Weldon, much quoted this conf. Challenge the idea that character is set by the time you are old. Show people developing and changing. Complex

2)    Re-evalutes the day-to-day: May Sarton Spinster, Barbara Pym – not remarkable charcters. Don’t do remarkable things, live everyday lives as you might expect for older people – visit family, cook, have hobbies. Activities not dismissed as time-filling – absorbing. (hobby as dismissive term)

3)    Angry texts, texts that rage. Bodies that don’t work. Texts about embodiment. May Sarton As we are now Frustration, society makes it worse. Ist person narrator is a powerful way of doing this, as Carrie in As we are now – can see her decline through her own journal writing. [read this! Has been on my (metaphorical) ‘novels to read’ longlist for years – move it to shortlist!]

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