Book review The Wounded Storyteller by Arthur W. Frank

1. Book reviewThe Wounded Storyteller by Arthur W. Frank By Tim Tran

2. What’s it about? • Spectrum of illness • Patients who have illness have stories to be told • These are important • Define who they are • Attempts to analyse this in a series of sociological/personal theories of classification

3. Remission Society • Sontag’s metaphor: remission society • Illness vs. health • Dual citizenship • Visa status – constant periodic renewal • People who would have been dead to enjoy the living world but always subject to expulsion

4. “Fear comes and goes as a breast cancer survivor, but twice a year, at check up time it’s ferocious” • Lack of permanent citizenship • Frank believes we belittle the diversity of suffering by reducing it to a unifying general view • Sufferers suspicious of this ‘medical reduction’

5. “When admitted to hospital or visiting a doctor, we stop being people and start being patients. We relinquish our identity as people who live in their hospitals”.

6. Reconstructive surgery to face – article doesn’t mention name although pictures of patient shown • They need us but they don’t acknowledge that • In post modern times pressures on clinical practice, including cost of physician’s time, greater use of technologies, mean less time for patients to speak

7. People still need their specific professionals, but professions as a group are regarded with increasing cynicism • Author sounds bitter and angry

8. One of our most difficult duties as human beings is to listen to the voices of those who suffer • Ill voices are easy to ignore because they are often faltering in tone and mixed in message • These voices bespeak conditions of embodiment that most of us would rather forget as it reveals our own vulnerability

9. Review • Tries to identify people with illness have stories that need to be told, but that doctors do not hear or want to hear • Thick veil of sociological jargon and excess literacy that makes this difficult to read but easy to publish • Professional in sociology venturing into medicine/illness trying to quantify/qualitative analysis of sickness

10. Tries to take back perceived ownership of the illness experience from professionals • Tries to express medicine posing it’s own language on people, but then imposes own sociological language • Condescending/confrontational, but maybe not everyone else has such a benevolent approach

11. Maybe seeing the patient’s perspective doesn’t come easy to all doctors • Maybe he’s just a wounded patient? • Later divulges his diagnosis of testicular cancer successfully treated • Different slant from this viewpoint • But does this give him the right to take ownership of advocacy?

12. Author seems to have had turbulent contact with medical professionals – sounds bitter sometimes considering limited resources/time to treat the many at the expense of treatment to individuals • Ideal is to have unlimited time and resources to give individual patients maximally optimised care. • Not always possible

13. My thesis is that different bodies have “elective affinities” to different illness narratives • Theories don’t stand up next to real stories

14. Very occasionally Frank includes illness stories • Desire • Pt dying of leukaemia “maybe at sixty it’s a good time to bow out” • Lacking desire • Why buy shoes? Why have dental work done? • Diagnostic shock…….to living with cancer

15. Taking up tap dancing lessons as something he always wanted to do, but also to keep falling out of love with yourself as illness attempts to diminish or disfigure you • It is not dying we fear, but the diminished self

16. Trying to demonstrate a principle called the ‘disciplined body’ • Pt with breast cancer “relief” finally being punished and paying price for being bad mother • Feels she deserves this • Self pride • Returns to work soon after mastectomy

17. Recurrence undergoes chemotherapy • Makes informed decision to stop chemotherapy sooner than advised • Despite medical pressure, accepts advice and makes her own decision • She makes peace with her aging body • Far from interpreting as punishment sees her experience has made her more of a person for having survived • Humbling passage about a person’s journey with cancer

18. And all these people in pain…all these people with aches and all these people suffering. We walk in different dimensions. We have access to different experiences, different knowledges. And there are so many of us too. We could help the normals and whitecoats both. We could help them see that they’re wasting the precious moments of their lives. Sick people know what health is. They know it by it’s very loss…. • Live as if it really mattered, don’t waste precious moments

19. None of the theories are evidence based • Author’s perogative? • Who is intended audience? Other sociologists? Not patients not doctors • Would I recommend this book?