“King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz: Summary and Critique

Introduction: “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz

“King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz first appeared in Literature and Medicine in Fall 2006 (Volume 25, Number 2, pp. 189-193), published by Johns Hopkins University Press. The article explores the interdisciplinary connections between literature and medicine through the King’s Dialogues in the Humanities, a lecture series at King’s College London that invites scholars who challenge disciplinary boundaries. The 2005 lecture series, marking the launch of a master’s program in Literature and Medicine, featured discussions by renowned scholars such as Oliver Sacks, Rita Charon, and Richard Horton, who examined narrative structures in medical case histories and the social implications of medical reform. Horton’s argument that Elizabeth Gaskell’s novels represent a “literature of public health” underscores the role of fiction in shaping medical discourse: “a manifesto of dissent forming a canon of extraordinary resistance that sought to shape the public sphere by explaining how her society worked” (Vickers & Hurwitz, 2006, p. 192). The article highlights how illness narratives challenge conventional narratology, as seen in Shlomith Rimmon-Kenan’s exploration of how severe illness disrupts narrative coherence. By illustrating the narrative and rhetorical structures of medical case reports from the Hippocratic corpus to contemporary clinical descriptions, the article emphasizes the permeability between literary and medical discourses, reinforcing the broader argument that literature provides crucial insights into medical practice and human experience.

Summary of “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz

• Introduction to King’s Dialogues in the Humanities
  • The lecture series at King’s College London invites scholars to discuss interdisciplinary topics, particularly those challenging disciplinary boundaries (Vickers & Hurwitz, 2006, p. 189).
  • The 2005 theme was Literature and Medicine, marking the launch of the first master’s program in this field.
• Key Lectures and Themes
  • George Rousseau: Offered a historical perspective on the intersection of literature and medicine.
  • Oliver Sacks: Examined the case history as a narrative genre.
  • Rita Charon: Explored the poetics of house calls in medical practice.
  • Ron Britton: Investigated how psychiatry and psychoanalysis can learn from literature.
  • Richard Horton: Argued for a literature of public health, focusing on the plight of Africa (Vickers & Hurwitz, 2006, p. 190).
  • Sally Shuttleworth: Compared depictions of childhood in 19th-century psychiatry and literature.
  • Brian Hurwitz: Analyzed the representational forms of clinical case histories.
  • Shlomith Rimmon-Kenan: Examined what literary theory can learn from illness narratives.
• Public Engagement and Setting
  • The lectures were open to the public and held in a historic location—formerly the Rolls Chapel in Chancery Lane—symbolizing intellectual enfranchisement (Vickers & Hurwitz, 2006, p. 190).
• Richard Horton’s Analysis: Victorian Literature and Public Health
  • Horton described Victorian reform as a dialectic between punitive and progressive measures.
  • He linked Elizabeth Gaskell’s novels (Mary Barton, Ruth, North and South) to 19th-century medical discourse, calling them “her own personal literature of public health” (Vickers & Hurwitz, 2006, p. 192).
  • Horton contended that modern writers should emulate Gaskell’s role but focus on global health, particularly Africa.
• Shlomith Rimmon-Kenan: Illness Narratives and Narrative Time
  • Found that illness narratives disrupt traditional narratological structures by imposing a sense of present suffering, which challenges linear storytelling (Vickers & Hurwitz, 2006, p. 192).
  • Proposed illness narratives as a test ground for David Wellbery’s concept of narrative order versus chaos.
• Brian Hurwitz: The Evolution of Medical Case Writing
  • Explored the history of case writing from the Hippocratic corpus to modern medical reports.
  • Found that Galenic case histories resemble Paul Ricoeur’s concept of emplotment—a structured way of understanding illness (Vickers & Hurwitz, 2006, p. 193).
  • Argued that medical cases, particularly those written collaboratively with patients, challenge the objectivity of clinical narratives.
• Conclusion
  • The lectures illustrated the rich dialogue between literature and medicine, reinforcing the argument that literature provides crucial insights into medical discourse and human experience.
  • By publishing these lectures in Literature and Medicine, the journal continues the tradition of exploring “the literary in the medical and the medical in the literary” (Vickers & Hurwitz, 2006, p. 193).

Theoretical Terms/Concepts in “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz

Theoretical Term/Concept	Definition	Reference from the Article
Interdisciplinary Permeability	The ability of knowledge and methods to cross between disciplines, particularly literature and medicine.	“Typically, a scholar who has crossed a disciplinary boundary—often against prevailing orthodoxies—explains why he or she did so, reflecting, perhaps, on issues of interdisciplinary permeability and miscibility” (Vickers & Hurwitz, 2006, p. 189).
Narrative Genre in Medicine	The classification of medical writings as a literary genre, particularly case histories.	“Oliver Sacks discussed narrative genre and the case history” (Vickers & Hurwitz, 2006, p. 190).
Poetics of Medicine	The study of literary elements in medical practice, particularly in doctor-patient interactions.	“Rita Charon elucidated the poetics of house calls” (Vickers & Hurwitz, 2006, p. 190).
Literature of Public Health	A literary tradition that highlights social and medical reforms through fiction and non-fiction.	“Richard Horton used what he called Elizabeth Gaskell’s ‘literature of public health’ to make an impassioned plea for a contemporary counterpart” (Vickers & Hurwitz, 2006, p. 190).
Illness Narratives	Personal accounts of illness that shape medical understanding and challenge traditional narrative structures.	“Rimmon-Kenan finds that one of the constants of illness narratives written by people with severe conditions is a sense that they are locked into present suffering” (Vickers & Hurwitz, 2006, p. 192).
Narrative Time in Illness	The disruption of chronological storytelling due to the experience of illness.	“This difficult present-ness has led her to reconsider one of the foundational ideas of narratology, narrative time” (Vickers & Hurwitz, 2006, p. 192).
Case Report as a Literary Form	The historical development of medical case reports as a blend of description and storytelling.	“Hurwitz is interested in the case report as a mode of writing occupying a middle ground between description and literary representation” (Vickers & Hurwitz, 2006, p. 193).
Emplotment in Medical Cases	The structuring of medical narratives to create meaning, similar to literary storytelling.	“Galen’s cases by contrast appear to exhibit what Paul Ricoeur famously called emplotment” (Vickers & Hurwitz, 2006, p. 193).
Social Determinants of Health	The idea that literature can reveal the political and economic factors shaping public health.	“Gaskell’s masterpiece…based upon human solidarity and the common interests of all classes” (Vickers & Hurwitz, 2006, p. 192).
Medical Humanities	An interdisciplinary field that explores the relationship between medicine, literature, and the arts.	“The 2005 theme chosen was Literature and Medicine to mark the launch at King’s of what is believed to be the world’s first master’s program in the field” (Vickers & Hurwitz, 2006, p. 189).

Contribution of “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz to Literary Theory/Theories

• Narratology and Medical Storytelling
  • The article explores how medical narratives, particularly illness narratives, challenge traditional narratological structures by disrupting linear storytelling.
  • Reference: “Rimmon-Kenan finds that one of the constants of illness narratives written by people with severe conditions is a sense that they are locked into present suffering and in consequence deprived of the security and the sense of perspective that narrative gives us” (Vickers & Hurwitz, 2006, p. 192).
• Interdisciplinary Literary Theory
  • Highlights how literature and medicine intersect, promoting the permeability of disciplinary boundaries, reinforcing literature’s role in understanding human suffering and healthcare narratives.
  • Reference: “Typically, a scholar who has crossed a disciplinary boundary—often against prevailing orthodoxies—explains why he or she did so, reflecting, perhaps, on issues of interdisciplinary permeability and miscibility” (Vickers & Hurwitz, 2006, p. 189).
• New Historicism and Medical Contexts
  • The study of Victorian public health literature, such as Gaskell’s works, shows how literary texts interact with historical and medical discourses to shape public understanding of health reforms.
  • Reference: “Horton calls Elizabeth Gaskell’s three greatest novels—Mary Barton, Ruth, and North and South—’her own personal literature of public health, a manifesto of dissent forming a canon of extraordinary resistance that sought to shape the public sphere'” (Vickers & Hurwitz, 2006, p. 192).
• Structuralism and Medical Case Reports
  • Examines how case reports, from the Hippocratic corpus to modern medical texts, function as structured narratives that blend description and literary representation.
  • Reference: “Hurwitz is interested in the case report as a mode of writing occupying a middle ground between description and literary representation” (Vickers & Hurwitz, 2006, p. 193).
• Postmodernism and the Fragmentation of Medical Narratives
  • Challenges the notion of a singular, coherent narrative by showing how illness narratives often resist closure and linear progression, aligning with postmodern literary thought.
  • Reference: “Illness narratives offer a very concrete proving ground for David Wellbery’s (narratological) project of setting narrative order in relation to nonorder or chaos” (Vickers & Hurwitz, 2006, p. 192).
• Marxist Literary Criticism and Health Disparities
  • Discusses the economic and political determinants of health in literature, particularly through Gaskell’s novels, linking literature to class struggle and reform movements.
  • Reference: “Horton sees North and South, Gaskell’s masterpiece, as ‘her most ambitious project of social design, one based upon human solidarity and the common interests of all classes'” (Vickers & Hurwitz, 2006, p. 192).
• Reader-Response Theory and Patient Narratives
  • Explores how medical case reports and illness narratives are not just clinical accounts but also texts that engage readers emotionally and intellectually, shaping their perception of illness and care.
  • Reference: “Perhaps the most ingenious part of Hurwitz’s argument arises from his revisionary and highly literary readings of famous cases from our own time” (Vickers & Hurwitz, 2006, p. 193).

Examples of Critiques Through “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz

Literary Work	Critique Through “King’s Dialogues: Literature and Medicine”	Reference from the Article
Oliver Twist (1837–38) – Charles Dickens	Critiques the Poor Law Amendment Act (1834), which Dickens condemned for its dehumanizing effects on the poor. The article highlights how Victorian social and medical reforms often had unintended consequences, paralleling Dickens’ criticism.	“Charles Dickens’s outrage against the countless humiliations this piece of legislation visited on the poor can be seen in the opening chapters of Oliver Twist… He was still railing against the Poor Law in 1865 in Our Mutual Friend” (Vickers & Hurwitz, 2006, p. 191).
North and South (1854–55) – Elizabeth Gaskell	Analyzes Gaskell’s novel as a literature of public health, illustrating class struggles and social determinants of health. The text serves as an early critique of industrial conditions affecting workers’ well-being.	“Horton sees North and South, Gaskell’s masterpiece, as ‘her most ambitious project of social design, one based upon human solidarity and the common interests of all classes'” (Vickers & Hurwitz, 2006, p. 192).
Ruth (1853) – Elizabeth Gaskell	Links the novel to contemporary social issues, particularly the plight of single women in Victorian England. It argues that Gaskell’s work served as a narrative extension of public health concerns highlighted in medical journals.	“He sets the story line of Ruth (1853) against the background of a series of little-known editorials in the Lancet on the plight of some thirty-five thousand single women in London living on four pence or less a day” (Vickers & Hurwitz, 2006, p. 192).
Mary Barton (1848) – Elizabeth Gaskell	Interprets the novel as part of Gaskell’s literature of public health, showing how literature can illuminate the struggles of the working class and the necessity of health reforms.	“Horton calls Elizabeth Gaskell’s three greatest novels—Mary Barton, Ruth, and North and South—’her own personal literature of public health, a manifesto of dissent forming a canon of extraordinary resistance'” (Vickers & Hurwitz, 2006, p. 192).

Criticism Against “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz

• Limited Scope of Literary Works Discussed
  • The article heavily focuses on Victorian literature, particularly Elizabeth Gaskell’s novels, while neglecting broader literary traditions that also explore medicine and public health.
  • A more diverse selection of literary texts from different time periods and cultures could provide a more comprehensive perspective.
• Overemphasis on Public Health Over Other Medical Themes
  • While the discussion on literature of public health is insightful, it overlooks other significant medical themes, such as medical ethics, disability studies, and the doctor-patient relationship in literature.
  • The focus on public health reform might overshadow more personal, existential, or philosophical dimensions of medical narratives.
• Lack of Engagement with Contemporary Literary Criticism
  • The article does not sufficiently engage with modern literary theories, such as postcolonialism, feminist theory, or disability studies, which could offer alternative readings of literature and medicine.
  • The reliance on New Historicist and narratological approaches may limit the potential for interdisciplinary expansion.
• Medicalization of Literary Analysis
  • The emphasis on medical narratives risks reducing literature to a diagnostic tool rather than recognizing its artistic, aesthetic, and cultural dimensions.
  • By framing literature as an extension of medical discourse, the study may downplay the independent literary merit of the texts discussed.
• Limited Reflection on Ethical Concerns in Medical Narratives
  • The article discusses how medical cases are written and structured but does not critically address the ethical implications of representing illness and suffering in literature.
  • Issues such as patient autonomy, informed consent, and the ethics of storytelling in medical contexts are largely unexplored.
• Insufficient Attention to Patient Voices
  • While the discussion includes illness narratives, it does not deeply engage with patient-authored texts, memoirs, or first-person illness accounts that challenge medical authority.
  • Greater focus on how patients construct their own narratives could provide a more balanced view of literature and medicine.

Representative Quotations from “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz with Explanation

Quotation	Explanation & Context	Theoretical Perspective
“The lectures are generally given by internationally celebrated figures… reflecting, perhaps, on issues of interdisciplinary permeability and miscibility.” (Vickers & Hurwitz, 2006, p. 189)	Highlights the King’s Dialogues as an interdisciplinary initiative where scholars cross disciplinary boundaries to discuss literature and medicine.	Interdisciplinary Literary Theory – Examines the intersection between literature and medicine as a shared intellectual space.
“Richard Horton used what he called Elizabeth Gaskell’s ‘literature of public health’ to make an impassioned plea for a contemporary counterpart, a literature of global health centered on the plight of Africa.” (Vickers & Hurwitz, 2006, p. 190)	Horton links Gaskell’s social novels to public health discourse, advocating for a global literary movement that highlights modern health crises, particularly in Africa.	New Historicism – Literature as a socio-historical document influencing and reflecting public health discourses.
“Shlomith Rimmon-Kenan finds that one of the constants of illness narratives written by people with severe conditions is a sense that they are locked into present suffering and in consequence deprived of the security and the sense of perspective that narrative gives us.” (Vickers & Hurwitz, 2006, p. 192)	Discusses how illness narratives disrupt traditional narrative time by focusing on present suffering, making it difficult for patients to see their experiences within a broader life arc.	Narratology & Postmodernism – Challenges conventional linear storytelling by showing how illness disrupts narrative coherence.
“The setting was historic. All the lectures except one took place in a room that from the fourteenth through nineteenth centuries was the Rolls Chapel in Chancery Lane, where for the last hundred years the Magna Carta has been displayed.” (Vickers & Hurwitz, 2006, p. 190)	Emphasizes the symbolic importance of intellectual freedom and interdisciplinary discussion in a historic setting.	Cultural Historicism – Contextualizes the location as a site of knowledge production and political legacy.
“Horton calls Elizabeth Gaskell’s three greatest novels—Mary Barton, Ruth, and North and South—’her own personal literature of public health, a manifesto of dissent forming a canon of extraordinary resistance.'” (Vickers & Hurwitz, 2006, p. 192)	Reinterprets Gaskell’s novels as acts of social resistance, highlighting medical and health inequalities within Victorian society.	Marxist Literary Criticism – Literature as a medium for exposing class struggles and advocating reform.
“Hurwitz is interested in the case report as a mode of writing occupying a middle ground between description and literary representation.” (Vickers & Hurwitz, 2006, p. 193)	Explores how medical case reports function as a hybrid literary form, blending factual description with narrative storytelling.	Structuralism – Medical case reports as textual constructs that follow narrative conventions.
“Oliver Sacks discussed narrative genre and the case history.” (Vickers & Hurwitz, 2006, p. 190)	Sacks examines how case histories function as narrative genres, shaping medical discourse and patient experiences.	Genre Studies & Medical Humanities – Analyzes the case history as a literary subgenre that influences medical interpretation.
“Illness narratives offer a very concrete proving ground for David Wellbery’s (narratological) project of setting narrative order in relation to nonorder or chaos.” (Vickers & Hurwitz, 2006, p. 192)	Suggests that illness narratives challenge the assumption of a structured life story, aligning with postmodernist concerns about fragmentation.	Postmodernism & Narratology – Explores how illness disrupts traditional notions of plot and coherence.
“Perhaps the most ingenious part of Hurwitz’s argument arises from his revisionary and highly literary readings of famous cases from our own time.” (Vickers & Hurwitz, 2006, p. 193)	Demonstrates the role of literary analysis in interpreting contemporary medical cases, reinforcing the idea that medical writing is inherently narrative-driven.	Hermeneutics & Literary Interpretation – Medical cases are subject to literary interpretation, revealing deeper social and ethical meanings.
“In appearing now in Literature and Medicine, they are, of course, continuing in the great dialogical tradition of this journal of seeing with unusual clarity the literary in the medical and the medical in the literary.” (Vickers & Hurwitz, 2006, p. 193)	Emphasizes the bidirectional relationship between literature and medicine, where each discipline informs and enriches the other.	Dialogism (Bakhtin) & Interdisciplinary Theory – Highlights the mutual influence of literature and medicine as dialogic fields.

Suggested Readings: “King’s Dialogues: Literature and Medicine” by Neil Vickers and Brian Hurwitz

1. Vickers, Neil, and Brian Hurwitz. “King’s dialogues: Literature and medicine.” Literature and Medicine 25.2 (2006): 189-193.
2. Downie, R. S. “Literature and Medicine.” Journal of Medical Ethics, vol. 17, no. 2, 1991, pp. 93–98. JSTOR, http://www.jstor.org/stable/27717024. Accessed 11 Feb. 2025.
3. Rousseau, G. S. “Literature and Medicine: The State of the Field.” Isis, vol. 72, no. 3, 1981, pp. 406–24. JSTOR, http://www.jstor.org/stable/230258. Accessed 11 Feb. 2025.
4. Spiegel, Maura, and Rita Charon. “Editing and Interdisciplinarity: Literature, Medicine, and Narrative Medicine.” Profession, 2009, pp. 132–37. JSTOR, http://www.jstor.org/stable/25595923. Accessed 11 Feb. 2025.
5. FURST, LILLIAN R. “<span Class=”small-Caps”>Review of Janis McLarren Caldwell, Literature and Medicine in Nineteenth-Century Britain</span>.” Nineteenth-Century Literature, vol. 60, no. 2, 2005, pp. 244–47. JSTOR, https://doi.org/10.1525/ncl.2005.60.2.244. Accessed 11 Feb. 2025.