What Can Narrative Theory Learn from Illness Narratives?

Rimmon-Kenan, Shlomith.

Literature and Medicine, Volume 25, Number 2, Fall 2006, pp.

241-254 (Article)

Published by The Johns Hopkins University Press

DOI: 10.1353/lm.2007.0019

For additional information about this article

http://muse.jhu.edu/journals/lm/summary/v025/25.2rimmon-kenan.html

Access Provided by University of Puerto Rico at 02/10/11 2:04AM GMT

Shlomith Rimmon-Kenan 241

What Can Narrative Theory

Learn from Illness Narratives?
Shlomith Rimmon-Kenan

This essay marks a development and a shift of emphasis in my

work on illness narratives. Until now, I have brought my tools as a
literary theorist, and more specifically a narratologist, to bear upon texts
that have been studied by medical humanists, psychologists, sociologists,
and anthropologists of medicine, each from his or her own perspective.
In this way, I hoped both to shed new light on specific texts and to
contribute to the fairly new interdisciplinary junction between medicine
and narrative theory. In the course of my research, however, I have
become increasingly aware that just as narrative theory can elucidate
illness narratives, so can illness narratives illuminate, and sometimes
problematize, central notions in narratology and narrative theory. It is
this mutual relationship that I wish to begin articulating here. More
specifically, I shall explore the complex interaction between the col-
lapse of the body and that of the narrative, the problem of narrating
the unnarratable, the author-reader relationship, and the subsequent
implications for narrative ethics.1

Order and Chaos

“Order begins with the body,” writes the medical anthropologist

Gay Becker. “That is, our understanding of ourselves and the world
begins with our reliance on the orderly functioning of our bodies.
This bodily knowledge informs what we do and say in the course of
daily life. In addition, we carry our histories with us into the present
through our bodies. The past is ‘sedimented’ in the body; that is, it
is embodied.”2
Becker thus suggests connections among the body, a sense of order,
and temporal continuity. She also adds an archeological overtone to
the geological metaphor of “sedimentation” to emphasize the effect of

Literature and Medicine 25, no. 2 (Fall 2006) 241–254

© 2007 by The Johns Hopkins University Press
242 What Can Narrative Theory Learn from Illness Narratives?

the past, of “our histories,” on the formation of our layered present.

Archeological (and geological?) sites, however, are always in danger
of crumbling. And so is the body. When this happens, the network
of connections outlined by Becker may disintegrate. What follows is
one self-conscious description of the impact of the loss of embodied
coherence in the case of illness. It is taken from a diary entry written
by Barbara Rosenblum, an American sociologist who died of breast
cancer at the age of forty-four:

When you have cancer, you have a new body each day, a body that
may or may not have a relationship to the body you had the day
before. When you have cancer, you are bombarded by sensations
from within that are not anchored in meaning. They float in a world
without words, without meanings. You don’t know from moment
to moment whether to call a particular sensation a “symptom” or a
“side effect” or a “sign.” It produces extreme anxiety to be unable
to distinguish those sensations that are caused by the disease and
those that are caused by the treatment. Words and their referents are
uncoupled, uncongealed, no longer connected. You live in a mental
world where all the information you have is locked into the present
moment. . . . Interpretation of a sensation always depends on having
at least two bodily events close enough in time to make meaning
of seemingly random events. . . . I’m hostage to the capriciousness
of my body, a body that sabotages my sense of a continuous and
taken-for-granted reality.3

Rosenblum experiences herself as locked into the present, cut off

from both past and future. In her case, the past is not “sedimented”
in the body but rather severed from it by the huge alteration of the
body as a result of cancer, sometimes making her feel a stranger to
herself. And the future is blocked. Moreover, the present itself is com-
posed of discrete, discontinuous moments in which “your body”—and
therefore your sense of yourself and the world—“may or may not have
a relationship to the body you had the day before.” The disintegration
of the body disrupts not only Rosenblum’s sense of temporal continu-
ity but also her capacity to construct causality. A sensation may be
either a symptom of her illness or a side effect of chemotherapy, and
the incapacity to tell one from the other and establish a cause-and-ef-
fect relationship produces “extreme anxiety” in her. The security of a
taken-for-granted order is replaced by randomness, destabilizing any
basis for interpretation or sense making. As a result, “[she] float[s] in
Shlomith Rimmon-Kenan 243

a world without words, without meanings.” Such a predicament may

also have a devastating effect on narrative order.
Most theoretical thinking about narrative accords a central consti-
tutive role to events and their temporal and causal organization. Since
narrative texts seldom unfold chronologically, narratologists devised a
“working hypothesis” designed to abstract from the text the temporal
and causal chain of events as they supposedly “happened.” This con-
struct, called fabula by the Russian formalists and taken up in differ-
ent ways by most narrative theories, serves the needs of intelligibility
and/or analysis. It is like a “zero degree” to which one can compare
the actual composition of the text, so as to be able to describe its
operation. Moreover, the possibility of abstracting a fabula is often seen
as “what distinguishes narrative from non-narrative texts.”4
The notion of fabula is anchored in a linear conception of time.
Other conceptions of time exist, of course—circular, reversible, poly-
chronic, for example—but linearity is the one assumed by narratology.
Thus, the fabula is a unidirectional time line, a chronological succession
of events, stretching from Earlier to Later. It is also characterized by
the fullness, i.e., the absence of “holes,” of a sequence of events that
are temporally determinate, unambiguously locatable at a given point
in the chain.5 In addition to temporal succession, events in the fabula
are also related to one another as cause and effect.6 The abstraction of
the fabula renders the narrative text “manageable.” By the same token,
however, the fabula becomes a way of regularizing the text, reduc-
ing its strangeness, perhaps also its textuality, rendering it seemingly
“natural.” The term naturalization was coined by the literary theorist
Jonathan Culler, with the awareness that what is taken to be natural
is a product of convention.7 Culler does not discuss fabula, but the
expression “conventionally natural” seems to me an adequate descrip-
tion of its status in many narrative theories.8
It is the gap between “conventional” and “natural” that embodied
disruptions like illness make palpable. Both the onset of illness and
the various phases of its trajectory are experienced—as the quotation
from Rosenblum suggests—as random, unforeseeable, uncontrollable,
the very opposite of lawlike regularity. Accidents, rather than order,
prevail. Disruption is the rule rather than the exception, says Becker.
Does this imply that texts written about illness are likely to impede an
extraction of a fabula from them? And does it follow, then, that they
are non-narrative? Or—conversely—should narrative theory be rethought
in terms of contingency, randomness, and chaos rather than order and
regularity? The latter direction is advocated by David Wellbery in a
244 What Can Narrative Theory Learn from Illness Narratives?

general theoretical context not connected with illness narratives. The

classical models, he writes, “know . . . no accidents, which is at once
their strength and their poverty.”9 By contrast, he defines an event
not as a link in a chain but “as that which destabilizes and disrupts
lawlike regularity” (237). Such a view seems to be supported by the
quotation from Rosenblum’s diary.
However, things are more complex in both Rosenblum’s and
Wellbery’s texts; there is a tension between regularity and contingency,
not simply a subordination of the latter to the former, or a subversion
of the former by the latter. Let us start with the passage I quoted
from Rosenblum: On the one hand, it thematizes the collapse of the
body, of order, of causality, “sabotaging” the possibility of narrative, at
least in its traditional acceptation. On the other hand, the whole text
lends coherence to chaos. Cancer in Two Voices is written jointly by
Barbara Rosenblum and Sandra Butler, her lesbian partner, alternating
the voices of the terminal patient and her loving caregiver. Consisting
as it does of diary entries by the two, the book’s formal composition
(labeled sjuzet by the Russian formalists) seems to be a collection of
fragments rather than a coherent narrative. But the entries are dated
chronologically, parallel to the development of the illness, and the two
writers often consecutively relate to the same events from different
perspectives. A fabula is abstractable from the text, although one may
wish to argue that the “real story” lies precisely in the spaces between
the events forming an ordered chain.
The tension between a thematization of disintegration and a writ-
ing that preserves qualities of narrative order may be a dramatization
of the struggle between an acceptance of fragmentation and the need
to overcome it by creating a coherent narrative.10 It may also reflect
the oscillation in a patient’s life, particularly that of a hospitalized
patient, between a strict order of daily routine, tests, and treatments
and an internal chaos. The ill person has limited control over both the
dictated order and the overwhelming inner disorder. Autobiographical
writing about illness may be an attempt to control the uncontrollable,
and hence it can become a battleground between the two competing
principles. But beyond illness narratives, it also suggests a coexistence
of or, better, a collision between regularity and contingency in all nar-
rative. It is here that Wellbery’s view is particularly relevant. Far from
substituting randomness for order—a move that he sees as “all-too-easy
and utterly false” (249)—Wellbery gestures toward a model that “will
set the chrono-logic of action sequences into a relation with another
order, or more precisely with a nonorder, the anachronic dimension
Shlomith Rimmon-Kenan 245

of contingency. Narrative thus appears, as does every semiotic system,

as the articulation of two noncoincident, independently organized sys-
tems” (249).
Narratology gives insightful accounts of order but has no tools
for—and no interest in—an analysis of randomness. The tension I have
discerned in Cancer in Two Voices, as well as in many other illness
autobiographies, may be a productive one informing all narrative and
inviting an opening up of closed narratological systems. In this sense,
illness narratives may be seen as an extreme test case that highlights
some limitations of narratology. Indeed, postmodern (and modern)
literature has often invited this type of interrogation, yet illness narra-
tives remain an extreme test case from the perspective of the embodied
nature of both continuity and disruption in them. Here, the bodily,
visceral level entertains intimate relations with the sufferer’s sense of
time and hence with the shaping/unshaping of narrative.11

Telling and Its Discontents

Thus far I have concentrated on the effects of bodily distress

on the collapse of the sufferer’s sense of order, but the passage from
Rosenblum also stresses the resistance of a collapsing body to verbal-
ization: “[You] float in a world without words, without meanings.”
Put differently, a disintegrating body may threaten the very possibil-
ity of narration. Like time, the act of telling is considered a defining
characteristic of narrative. Texts that struggle with its disturbance invite
both a challenge and an expansion of the category of “narration.” Such
destabilization is not exclusive to illness narratives, but they add a
dimension worth exploring.
According to Rosenblum, because words are no longer connected
to conventionally accepted (and expected) fixed meanings, they become
an inadequate medium for the expression of bodily sensations.12 In
another entry, she stresses not only the problem of self-expression but
also that of communication:

The problem: when I have sensations in my body, it’s an unshar-

able experience; I become aware of the limitations of language in
describing those sensations and thus relieving myself of their burden.
I grow increasingly aware of the illusion of the intersubjective nature
of the world. The world is shattered, language dissolves, and there
is only body and its feeling. Even a private language, such as I
246 What Can Narrative Theory Learn from Illness Narratives?

have with Sandy [her lover], is a self-contradiction. There cannot be

private language. Interactions slow down, collapse, lose their mean-
ing and integrity. I observe myself trying to talk but am isolated in
an imprisoned, solipsistic world, experiencing the terror, panic, and
isolation because we believe in common language, common culture,
common understandings.13

Paradoxically, being an implicit address to readers, the above passage

becomes an intersubjective and communicative comment about the
illusion of communication and intersubjectivity. It thus enacts, at the
level of narration, a tension similar to the one in the earlier passage
quoted from Rosenblum in relation to order and chaos.
Another aspect of the problem is addressed by Gillian Rose, a
British professor of philosophy, whose book Love’s Work: A Reckoning
with Life discusses, among many other things, the difficulty of com-
municating the experience of a colostomy.14 Rose is haunted by two
dangers: the fall into medical discourse and the escape to a view of
illness as a metaphor. Patients often try to adopt the language of
medicine, perhaps because it gives them the feeling of control and the
illusion of being able to discuss their condition with their doctors as
peers. At the same time, this language is completely dissociated from
embodied experience and it may inadvertently reinforce the appropria-
tion of the patient by the medical establishment. “Medicine and I,” says
Rose, “have dismissed each other. We do not have enough command
of each other’s language for the exchange to be fruitful.”15 The second
danger, that of metaphor—for example, interpreting cancer or AIDS
as doom, often as a doom deserved or brought upon oneself—has
already been forcefully warned against by the late Susan Sontag and
probably needs no elaboration here.16 Fully aware of these pitfalls, Rose
defines the challenge of narrating the nearly unnarratable thus: “I want
to talk about shit—the hourly transfiguration of our lovely eating of
the sun. I need to remove the discourse of shit from transgression,
sexual fetishism, from too much interest, but, equally, from coyness,
distaste and the medical textbook . . . . I need to invent colostomy
ethnography” (94).
And how does she do it? Ironically, she speaks the unspeakable
by overspeaking it.17 In other words, she describes her condition in
an extremely detailed, concrete way:

Let me make myself clear: the colostomy—stoma means “opening”—is

a surrogate rectum and anus. Tight coils of concentric, fresh, blood-
Shlomith Rimmon-Kenan 247

red flesh, 25 millimetres (one inch) in diameter, protrude a few mil-

limetres from the centre left of my abdomen, just below the waist.
Blueness would be a symptom of distress . . . .
Deep brown, burnished shit is extruded from the bright, proud
infoliation in a steady paste-like stream in front of you: uniform,
sweet-smelling fruit of the body, fertile medium, not negative sub-
stance. It hangs hot in a bag, flush with the abdomen, with the
raised temperature even of congealed life. (93–5, Rose’s italics)

The abundance of bodily details clearly emphasizes the materiality

of the physical experience, blurred by both medical and metaphoric
conceptions of illness. Rose’s language thus succeeds in rendering the
body articulate, but at the same time it endangers the desired control
over the reader.

Reading and Its Discontents

The difficulties in narrating “embodied distress” are replicated by

problems in its reception. Writing about illness is often an attempt to
share it with people who do or will suffer from the same condition
and often a testimony or an appeal for empathy. The implied reader
consequently has a central role for the writer. However, the specific
reader may find the identification with the empathic implied reader
too demanding emotionally. Whether readers have a moral obligation
to read such narratives is a complex ethical problem (the same applies
to trauma stories, holocaust narratives, etc.), but writers must be aware
that closing the book or withholding empathy is a potential reaction.
Rose’s Love’s Work confronts this problem in an original way. The
first half of the book tells—in a fairly fragmented, nonchronological
manner—about her love relationships, her family history, academic
career, friends, attitude to Judaism. Beyond the mention of suffering in
her childhood from asthma and dyslexia, the first half does not read
as an illness narrative. Then, exactly in the middle of the book, she
turns to the reader, in a self-conscious and defiant tone:

Suppose that I were now to reveal that I have AIDS, full-blown

AIDS, and have been ill during most of the course of what I have
related. I would lose you. I would lose you to knowledge, to fear
and to metaphor. Such a revelation would result in the sacrifice of
the alchemy of my art, of artistic “control” over the setting as well
as the content of your imagination. (76–7)
248 What Can Narrative Theory Learn from Illness Narratives?

Here, I skip two beautiful and teasing paragraphs for the sake of
brevity (or out of anxiety on the part of one specific reader?). Rose
then continues:

I do not have AIDS . . . . If I were now to explain that, in my

early forties, I have cancer, say, advanced ovarian cancer, which has
failed to respond to chemotherapies, and is spread throughout the
peritoneum, the serous membrane lining the cavity of the abdo-
men, and in the pleura, the serous lining of the lungs, you would
respond according to the exigencies of taxonomy, symbol and terror,
according to ignorance rather than knowledge, although there is, in
fact and in spirit, no relevant knowledge.
For you, “cancer” means, on the one hand, a lump, a species
of discrete matter with multiplying properties, on the other hand,
a judgement, a species of ineluctable condemnation.
To the bearer of this news, the term “cancer” means nothing:
it has no meaning. It merges without remainder into the horizon
within which the difficulties, the joys, the banalities, of each day
elapse. (77–8)

Rose’s provocative appeal to the reader is based on the silent contract

we tend to take for granted between writer and reader, the contract
she describes thus: “[Y]ou have given me free rein, and I have hon-
oured my share of the obligation by not using up that freedom, by
leaving large tracks of compacted equivocation at every twist in the
telling” (77). Part of the silent contract is the assumption that what
is essential for the narrative will be either told or posed—explicitly
or implicitly—as an enigma that will occupy the reader throughout,
probably to be solved at the end. In Love’s Work, however, Rose’s
cancer is not mentioned until the middle of the book. We read with-
out knowing a central component of the narrative, and we may feel
cheated when we are told, especially since the revelation is at once
heartrending and uncanny. By self-reflexively pointing this danger out,
Rose not only “diagnoses” a problem but also manipulates the reader
into continuing to read in spite of the emotional difficulty. It is as if
she says, “You can’t leave me now that you know my condition.” The
challenge is to our conventions of reading, as well as to our attitude
toward illness. This challenge, however, is also amenable to an alternate
interpretation: rather than (or together with) expressing Rose’s anxiety
about losing the reader, it may be a narrative strategy of “high risk,
high reward.” In other words, Rose may be implying that while she
Shlomith Rimmon-Kenan 249

knows she will lose some readers, she will retain those who respond
positively to her breaking of convention, and these—though potentially
few—are her preferred audience. The deferral of the illness narrative
has an additional function. It dramatizes Rose’s philosophy, according
to which illness is not something to be singled out, but an integral
part of the joys and sorrows, the banalities and dramas that constitute
the process of living. “I must return to my life affair,” she says at a
later point (103), and the book she writes is, appropriately, a life story,
an autobiography, not a “pathography.”18 Moreover, the delayed telling
about her illness performatively repeats that philosophy, putting the
reader in a position where he or she has no choice but to experience
illness as part of life.
The problematization of the writer-reader relationship in Love’s
Work joins similar doubts in literary theory, at least since the advent of
reader-response criticism, and in literature itself throughout its history.
The delicate balance between having to “create” the reader and know-
ing that he or she has the freedom both to comply and to resist, the
knowledge that the reading contract cannot be taken for granted, nor
is it made once and for all, and the awareness of its being inhabited
by risk, in need of constant renewal and change, are not new. Think,
for example, of Laurence Sterne’s Tristram Shandy, the late novels of
Henry James, the work of Franz Kafka, of Alain Robbe-Grillet, of many
postmodernists. Every writer whose work resists interpretation risks
losing the reader for different reasons and different purposes. In all,
I think, the difficulty also draws attention to the medium of written
language, preventing a reading as if through a transparent glass. In
Love’s Work, and in many other illness narratives, attention is drawn not
primarily to the medium (although this too should not be dismissed)
but to the body. Illness narratives may deter readers because they
force them to encounter embodied experience, and this is, perhaps,
their special contribution to the age-old problem (and challenge) of
narrating the unnarratable.

One Reader’s Response

In order to suggest that the reception of illness narratives is at

least double-edged, I would like to devote the last part of this essay
to an incident in which I myself was split between the positions of
reader and read. It concerns a recent book by the British novelist
Christine Brooke-Rose, author of Between (1968), Thru (1975), Amal-
250 What Can Narrative Theory Learn from Illness Narratives?

gamemnon (1984), Next (1998), and Subscript (1999)—to mention only

some of her titles. Brooke-Rose is not only a writer of fiction but also
a critic, theoretician, and narratologist. Her fictional work often reflects
on problems of narrative and its strategies. The title of her most recent
book is Life, End of.
Before broaching the issue of reading, I would like to relate Brooke-
Rose’s book to those discussed so far. Like Butler’s and Rosenblum’s
diaries, like Rose’s narrative, Brooke-Rose’s text is self-conscious and
self-reflexive. This is perhaps the place to say that not all illness narra-
tives meditate on questions of writing, but those that do acutely invite
an explicit rethinking about narrative and narrative theory. Unlike the
openly autobiographical nature of Cancer in Two Voices and Love’s Work,
Brooke-Rose’s text blurs the border between direct and fictionalized
autobiography. The autobiographical elements are clear to anyone who
knows the author, and at some point she explicitly declares the same-
ness of author and protagonist: “The author places himself inside the
character. The author is a she. It so happens that the author here is
very close to the character, even over-identifying with the two pillars
of fire for feet and legs that jerk flinch wince and stagger but with
the brain so far intact.”19 However, the names of the minor characters
are fictional, and the protagonist remains unnamed, “the invalid,” “the
slowly dying cripple” (33). In the text itself, Brooke-Rose defines its
genre thus: “But this isn’t a scenario. Or a novel. Or an autobio. It’s
a dying diary, undated except indirectly because the sense of time is
lost” (87).
The emphasis on the destructive effect of illness on the sufferer’s
sense of time also allows the association of Life, End of with Cancer
in Two Voices. If Rosenblum characterizes her mental world as “locked
into the present moment,” Brooke-Rose speaks about old age as “a
mirror of childhood but childhood not for one second reflected in
the present-bound, floor-bound eyes” (13, italics added). If Rosenblum
feels the present to be severed from the past by the huge alteration
of the body, Brooke-Rose—who also dwells on physical limitations
and changes—experiences her past and present as two separate lives:
“As if this second life [her past] were separate and gone elsewhere,
since all these ailments hit” (63). And just as the future is blocked
for Rosenblum, so “[t]he time, the time for everything is gone” for
Brooke-Rose (113). Interestingly, the blocking of future-oriented con-
tinuity makes Brooke-Rose describe the process of dying in terms
of space rather than time: “House to flat to room to bed to coffin
to urn” (95; a recurrent sentence in the text). Thus, an analysis of
Shlomith Rimmon-Kenan 251

Brooke-Rose’s text could reinforce my earlier reconsideration—based

on Butler and Rosenblum—of the narratological notion of linear time.
It could, perhaps, take it further by rethinking the relations between
time and space in certain types of narrative. However, as the title of
this subsection suggests, I have decided to foreground another aspect
of Life, End of so as to elaborate on the problematics of reading, this
time implicating myself as a reader.
A central theme in Brooke-Rose’s text is the deleterious effect of
bodily disintegration on the relations between the ill person and the
(seemingly) healthy others. A succession of friends’ visits to “the inval-
id’s” house in Provence is dramatized, almost invariably with a sense
of disappointment and alienation. The narration of one of these events
identifies the visitors thus: “Dan and Rebekah are here for forty-eight
hours, all the way from Jerusalem for what all three accept tacitly as
a last reunion with the slowly dying cripple” (33). The visit, rendered
from the perspective of the disabled author-narrator-character, is fraught
with tension, culminating in what she experiences as an insight:

Then suddenly, it all drops into place. Or misplace?

For forty-eight hours Dan has been trying to ring a friend
on a mobile lent by his daughter. . . . Said this morning:
Is it a friend? I’m not vain enough to think you’ve come
all this way just for me. Rebekah once combined me with a
conference.
Of course not, we chose to come just for you.
Forcefully, from Rebekah. . . .
But why the elaborate lie? White lies shouldn’t need to be
so laboured. (42)

Dan and Rebekah are my husband and myself, and—I might add—we
did come to Provence with the sole purpose of visiting our ailing friend
Christine Brooke-Rose. The repeated unsuccessful phone calls were to
our daughter, who was away on a school trip. I was extremely hurt
when I realized that our visit, undertaken in spite of many difficulties,
was not appreciated for what it was. Time has passed, and I am bring-
ing the incident up here because it adds an ethical dimension to the
reconsideration of narrative techniques. The ethical problem concerns
the clash between the requirements of lived reality and the integrity
of narrative strategies in texts where a flesh-and-blood reader is also a
(fictional?) character. It also concerns the destabilization of the implicit
claim to authenticity by misinterpretations and erasures, caused by pain
and vulnerability, in both the act of narration and that of reception.
252 What Can Narrative Theory Learn from Illness Narratives?

In a longish metatextual section of Life, End of, the author compares

her narrative method, developed over several recent novels, with that
of other writers, characterizing hers as using “the present tense, but
without the first person” (67). The tense chosen is clearly appropriate
for the dramatization of the temporal constriction thematized in the
text. But the present is also used in other novels by Brooke-Rose, and
in Life, End of she explains the intended effect of this narrative method
in her writing: “It creates characters who must be constructed by the
reader entirely out of what they see hear feel think or say, that is,
without any help from the author” (67).
Some help from the author, however, is given in the first line
of the passage quoted above. “Or misplace?” suggests that the bio-
graphical Brooke-Rose later realized that we had come for her, perhaps
even partly suspected this at the time of the visit. When I read the
typescript, however, my hurt sensibility was completely oblivious to
this question, confined—like the bulk of Brooke-Rose’s narration—to
what the ailing character perceived-thought-felt in the present of the
experience. Moreover, in the published version of the book, Brooke-Rose
added another brief sign of awareness. It appears within a segment I
omitted from the quotation and reads: “Annoyed? No, paranoid” (42).
Although it is followed by further doubt, it enables a reinterpretation
of the suspicion as an indication of the ill person’s low self-esteem,
her incapacity to believe that “they’ve come all that way for forty-
eight hours with an invalid as asserted, when it would be so much
more normal to combine it with a longer rest from the permanent
terror-time in Jerusalem” (33). The incredulity may also be construed
as a dramatization of an all-too-frequent side effect of severe, chronic,
progressive, isolating illnesses.
How could I—a narratologist, an interpreter of other texts by
Brooke-Rose, a person with a chronic illness studying illness narra-
tives—have disregarded the self-imposed constraints of Brooke-Rose’s
narrative method, as well as her hints at a recognition? How could I
have let my personal hurt blind me to her narrative performance and
inhibit my own professional competence? And how could I have ignored
her pain? Because of my pain, caused by her disbelief, would be the
personal answer. But beyond the personal, a few questions pertaining
to “narrative ethics” emerge. When author, narrator, and protagonist are
identical, and minor characters are potential readers of the text, is there
not a danger that a strategy exclusively enacting the perception of the
protagonist would do injustice to the other characters and, consequently,
to actual people who read it? Or is this an irrelevant concern, a bit
Shlomith Rimmon-Kenan 253

like Jessie Chambers, the real-life Miriam of D. H. Lawrence’s Sons

and Lovers, complaining that Lawrence misrepresented the relationship
between them? Are nonfictional autobiographies different from fictional
ones in this respect? Is there a clear-cut distinction between the two
types? These questions are often discussed in present-day narrative
theory and can be sharpened from the perspective of illness narra-
tives like Brooke-Rose’s. Do illness autobiographies have a privileged
access to authenticity? Or, conversely, is the status of the reliability of
the narrator-protagonist particularly fragile in them? On a conceptual
level, these are questions I can only ask, not answer, at the present
stage of my study. However, I suggest that such narratives bring into
bold relief problems that also appear, in a less salient form perhaps,
in numerous other works—which is why they potentially constitute a
rich corpus for a reconsideration of narrative theory.

NOTES

1. This study is part of a larger project I have embarked on with my col-

league Dr. Ruth Ginsburg, and I am grateful to her for our constantly stimulating
dialogue. I am also grateful to Bill Daleski, Elizabeth Freund, James Phelan, and
the second, anonymous, reader for Literature and Medicine for perceptive comments
that led me to several important revisions.
2. Becker, Disrupted Lives, 12.
3. Butler and Rosenblum, Cancer in Two Voices, 138.
4. Rimmon-Kenan, Narrative Fiction, 15. In accordance with the Anglo-American
tradition, my book uses the term story rather than fabula (although it mentions the
latter), but I thought this might be confusing for readers from other disciplines, for
whom story may be, commonsensically, a synonym for narrative.
5. See Herman, Story Logic, 212.
6. Some researchers see causality as an effect of temporality, suggesting that
the reader projects the former on the latter even when the latter is not specified.
7. See Culler, Structuralist Poetics, 131–52.
8. Culler, 148.
9. Wellbery, “Contingency,” 242. Subsequent references are cited parentheti-
cally in the text.
10. See Rimmon-Kenan, “The Story of ‘I.’”
11. Ibid.
12. Note that she invokes the Saussurean distinction between “signifiers”
and “signifieds” but substitutes “referents” for “signifieds,” perhaps because of her
desire to emphasize the physical body, not the body image or a mental conception
of the body.
13. Butler and Rosenblum, 106–7.
14. I am grateful to Einat Avrahami, whose PhD dissertation, “Illness Autobi-
ographies: The Invading of the Body,” made me aware of this text. My discussion
has probably internalized some of the insights in that dissertation.
15. Rose, Love’s Work, 102. Subsequent references are cited parenthetically in
the text.
16. See Sontag, Illness as Metaphor.
254 What Can Narrative Theory Learn from Illness Narratives?

17. She herself uses the terms underspoken and overspoken for a different purpose
(see 76–7), but these terms gave me an insight into her writing practice.
18. Pathography is a term coined by Anne Hunsaker Hawkins in her book
Reconstructing Illness. I find this medical-sounding term alienating.
19. Brook-Rose, Life, End of, 69. Subsequent references are cited parentheti-
cally in the text.

BIBLIOGRAPHY

Avrahami, Einat. “Illness Autobiographies: The Invading of the Body.” PhD diss.
Bar-Ilan University, 2002.
Becker, Gay. Disrupted Lives: How People Create Meaning in a Chaotic World. Berkeley:
University of California Press, 1999.
Brooke-Rose, Christine. Life, End of. Manchester: Carcanet, 2006.
Butler, Sandra and Barbara Rosenblum. Cancer in Two Voices. San Francisco: Spinsters
Book Company, 1991.
Culler, Jonathan. Structuralist Poetics: Structuralism, Linguistics and the Study of Litera-
ture. Ithaca, NY: Cornell University Press, 1975.
Hawkins, Anne Hunsaker. Reconstructing Illness: Studies in Pathography. West Lafayette,
IN: Purdue University Press, 1993.
Herman, David. Story Logic: Problems and Possibilities of Narrative. Lincoln: University
of Nebraska Press, 2002.
Rimmon-Kenan, Shlomith. Narrative Fiction: Contemporary Poetics. London: Routledge,
2002.
———. “The Story of ‘I’: Illness and Narrative Identity.” Narrative 10 (2002): 9–27.
Rose, Gillian. Love’s Work: A Reckoning with Life. London: Chatto and Windus,
1995.
Sontag, Susan. Illness as Metaphor. New York: Farrar, Straus and Giroux, 1978.
Wellbery, David. “Contingency.” In Neverending Stories, edited by Ann Fehn, In-
geborg Hoesterey, and Maria Tatar, 237–57. Princeton: Princeton University
Press, 1992.