Neither Chaos Nor Quest: Toward a Nonnarrative Medicine

Brian Teare in The Boston Review:

In Arthur W. Frank’s foundational text for narrative medicine, The Wounded Storyteller: Body, Illness, and Ethics (1995), the ill, Frank suggests, need “to tell their stories, in order to construct new maps and new perceptions of their relationships to the world.” Frank posits three common narrative structures for the experience of illness: restitution, chaos, and quest. In restitution narratives, the healthy person becomes sick and then they become healthy again, a quick, clean plot that reifies health in ways too naïve to be meaningful. This, of course, is the arc popular culture prefers.

In chaos narratives, the unlucky ill suffer without plot, their nonnarratives untouched by restitution or even just movement toward suffering in a more agentive way. Frank seems genuinely freaked out by so-called chaos. In his account, chaos strains the limits of caregiver empathy and institutional capacity because the chaotic body is nonnarrative—which, for Frank, is in effect to be a non-self, one who cannot effectively communicate or connect with others.

In quest narratives, the plot Frank prefers, the ill person finds the strength and agency to turn their experience of illness into allegory, a journey of insight gained from suffering. As opposed to the pro forma performances of restitution and the nonnarratives of chaos, quest narratives feature a “communicative body” that models for others that patients can “accept illness and seek to use it.” So central is this narrative structure to Frank’s conception of illness that he claims, “Becoming seriously ill is a call for stories.”

Is it, though? What if serious illness doesn’t or can’t call for anything? Or if it can, it’s only the body’s call for the restoration of equilibrium?

More here.




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