“Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan: Summary and Critique

Introduction: “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan

“Literature and Medicine: Narratives of Physical Illness” by M. Faith McLellan first appeared in The Lancet in 1997, offering a seminal exploration of the intersection between storytelling and illness experiences. McLellan examines how illness narratives, whether autobiographical or biographical, shape personal and cultural understandings of disease, suffering, and healing. The article emphasizes the thematic structures of these narratives, including restitution, chaos, and quest stories, illustrating how patients and caregivers use storytelling to reclaim agency and impose meaning on experiences of illness. The discussion highlights historical and contemporary examples, such as John Donne’s Devotions upon Emergent Occasions, which portrays illness as a spiritual rebirth, and contemporary memoirs like Reynolds Price’s A Whole New Life, which reflects on the transformative power of chronic illness. McLellan also explores the role of metaphor, particularly the military imagery frequently used to describe disease as a battle, shaping both medical discourse and patient perception. Additionally, the article recognizes the emergence of electronic narratives—multiauthored online forums where individuals collectively construct and modify stories of illness, creating a new genre of patient-driven storytelling. This work is significant in literary theory and medical humanities because it situates illness narratives as crucial texts that contribute to autobiography, ethical discourse, and medical education, providing both personal catharsis and broader societal impact.

Summary of “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan

Theoretical Terms/Concepts in “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan

Term/Concept	Definition	Example from the Article
Illness Narrative	A personal account of illness, typically autobiographical or biographical, used to convey experiences of suffering, treatment, and recovery.	Lucy Grealy’s Autobiography of a Face details her journey with Ewing’s sarcoma (McLellan, 1997, p. 1619).
Restitution Narrative	A story where the ill person seeks to return to their previous state of health, often structured around medical intervention leading to recovery.	Common in many illness stories where patients expect a cure or improvement (p. 1619).
Chaos Narrative	A narrative that expresses the overwhelming, often incoherent experience of illness, where suffering dominates and hope for improvement is uncertain.	Gilda Radner’s It’s Always Something about her ovarian cancer attempts to make sense of the chaos (p. 1619).
Quest Narrative	A story in which the illness journey is framed as a transformative experience, often leading to newfound wisdom or insight.	Reynolds Price’s A Whole New Life explores his gratitude for continued literary productivity despite his spinal tumor (p. 1619).
Military Metaphor	The framing of illness in terms of battle, where the body fights against disease, treatments are weapons, and survival is victory.	Heartsounds by Martha Weinman Lear uses war imagery to describe her husband’s heart disease (p. 1618).
Pathography	A biography or autobiography centered on a person’s illness and medical experiences.	Often used to describe illness narratives such as John Gunther’s Death Be Not Proud (p. 1619).
Dual Narration	A narrative structure where both the patient and a close observer (e.g., family member or caregiver) contribute to the story.	Cancer in Two Voices presents illness from both patient and partner perspectives (p. 1619).
Electronic Narrative	Illness stories shared through digital platforms, often co-authored by multiple contributors, allowing real-time interaction and support.	Phil Catalfo’s online journal about his son’s leukemia fosters collective storytelling (p. 1619).
Therapeutic Writing	Writing as a means of coping with illness, used to process emotions, gain control over one’s experience, or find meaning.	Many first-person illness narratives function as cathartic exercises for the author (p. 1619).
Narrative Ethics	The use of storytelling in medical and ethical discussions to enhance understanding of patient experiences and improve healthcare.	Physicians gain insight into patient struggles through online illness narratives, influencing medical decisions (p. 1620).
Victim Art	A critical term used to describe illness narratives that focus intensely on suffering, sometimes seen as self-indulgent or overly personal.	Some critiques argue that illness narratives are driven by self-absorption rather than literary merit (p. 1620).
Autopathography	A form of autobiographical writing focused on illness and medical encounters, often used as an alternative to traditional autobiography.	The Diving Bell and the Butterfly by Jean-Dominique Bauby, written using eye blinks, exemplifies this form (p. 1619).
Embodied Experience	The lived, subjective experience of illness as it affects both physical and psychological states.	The uncertainty of daily life with multiple sclerosis, as described by Nancy Mairs, highlights this concept (p. 1620).

Contribution of “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan to Literary Theory/Theories

1. Narrative Theory

• Examines how illness stories are structured and classified into restitution, chaos, and quest narratives (McLellan, 1997, p. 1619).
• Highlights the role of first-person narration and dual narration in shaping the reader’s understanding of illness experiences.
• Emphasizes how electronic narratives on the internet have introduced multi-authored storytelling, altering traditional narrative structures (p. 1619).

2. Autobiographical Theory

• Positions illness narratives within the broader genre of autobiography and pathography, demonstrating how they serve both self-representation and public engagement (p. 1618).
• Discusses how the first-person account of illness functions as a form of self-therapy and identity reconstruction (p. 1619).
• Explores the constraints and possibilities of autobiographical illness narratives, noting that chronic illnesses provide time for self-reflection and storytelling, unlike acute diseases (p. 1619).

3. Medical Humanities and Narrative Medicine

• Establishes the role of storytelling in enhancing doctor-patient relationships and medical ethics (p. 1620).
• Shows how illness narratives provide insight into patient suffering, influencing medical practice and policies (p. 1620).
• Identifies how narratives help patients reclaim agency, moving beyond clinical definitions of disease to personal meaning-making (p. 1620).

4. Psychoanalytic Literary Theory

• Illness narratives function as cathartic texts, allowing patients to process trauma and regain control over their experiences (p. 1619).
• Suggests that storytelling mitigates feelings of chaos and fear, helping patients impose structure on their suffering (p. 1620).
• Examines how suppressed emotions and fears surface in narratives, particularly in chaos stories where meaning is elusive (p. 1619).

5. Postmodernism and Fragmentation

• Discusses how chaos narratives resist linearity and coherence, reflecting the fragmented nature of illness experiences (p. 1619).
• Electronic narratives challenge traditional authorial authority, as multiple contributors alter the original story’s meaning (p. 1619).
• Online illness narratives blur the boundaries between personal and collective storytelling, embodying a postmodern, decentralized form of literature (p. 1619).

6. Metaphor and Symbolism in Literary Theory

• Analyzes the prevalence of military metaphors in illness narratives and critiques their limitations (p. 1618).
• Highlights how mythic structures, such as the hero’s journey, shape quest narratives of illness (p. 1619).
• Explores the symbolic use of illness as a transformative force, where suffering leads to insight and personal growth (p. 1619).

7. Reader-Response Theory

• Suggests that illness narratives shape reader empathy, fostering a deeper connection with the lived experience of disease (p. 1620).
• Encourages interpretation from multiple perspectives, as both physicians and general readers engage with these texts differently (p. 1620).
• Examines how interactive digital narratives allow readers to become co-authors, altering the meaning of the story through discussion and contribution (p. 1619).

8. Feminist Literary Theory

• Highlights how women’s illness narratives challenge traditional gender roles, bringing attention to the experience of illness from a female perspective (p. 1619).
• Explores the marginalization of female patient voices, particularly in medical settings, and how personal narratives counteract this (p. 1619).
• Recognizes the gendered aspects of caregiving, with many illness narratives written by or about women who care for sick loved ones (p. 1619).

Examples of Critiques Through “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan

Literary Work & Type of Narrative	McLellan’s Thematic Critique	Key Concepts & Theoretical Lens
John Donne – Devotions upon Emergent Occasions (Spiritual Illness Narrative, Rebirth & Reflection on Suffering)	McLellan identifies Donne’s work as an early illness narrative structured around meditation, expostulation, and prayer. It portrays illness as a spiritual trial and a transformative experience rather than just a medical event (McLellan, 1997, p. 1618).	– Religious and spiritual framing of illness – Rebirth metaphor – Historical pathography
Martha Weinman Lear – Heartsounds (Military Metaphor in Illness, Heart Disease as a Battle)	Critiqued for reinforcing the “war” metaphor, which frames illness as a battle. McLellan argues that while emotionally compelling, such metaphors oversimplify suffering and impose pressure on patients to “fight” their disease (p. 1618).	– Military metaphor critique – Metaphorical burden on patients – Emotional vs. clinical realism
Gilda Radner – It’s Always Something (Chaos Narrative, Ovarian Cancer)	McLellan describes Radner’s memoir as a chaos narrative, highlighting the disruption illness causes to identity and meaning. Radner’s attempt to document chemotherapy sessions reflects an effort to regain control over a disorienting experience (p. 1619).	– Loss of narrative control – Illness as identity crisis – Emotional disarray in storytelling
Reynolds Price – A Whole New Life (Quest Narrative, Spinal Cord Tumor as a Transformative Journey)	Price’s memoir embodies the quest narrative, where illness becomes a journey of self-discovery. McLellan notes that despite his suffering, Price finds artistic and intellectual renewal, illustrating illness as a transformative force (p. 1619).	– Illness as a journey – Transformative suffering – Autopathography and resilience

Criticism Against “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan

Representative Quotations from “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan with Explanation

Quotation	Explanation
“They have been called stories of sickness, pathographies, and narratives of illness.” (p. 1618)	This statement highlights the evolving terminology surrounding illness narratives, emphasizing their growing recognition in both literature and medical humanities. The various terms reflect different perspectives—personal, clinical, and literary—on how illness is experienced and communicated.
“Despite substantial critique of their appropriateness and usefulness, military metaphors are ubiquitous in illness narratives.” (p. 1618)	McLellan critiques the common use of military metaphors in medical discourse, such as referring to disease as an “enemy” and treatment as a “battle.” This metaphorical framing can place an emotional burden on patients, making illness seem like a failure if one does not “win” the fight.
“Stories of sickness have also been described as narratives of restitution, chaos, and quest.” (p. 1619)	This classification system, based on Arthur Frank’s typology, provides a framework for understanding how illness is structured in storytelling. The restitution narrative seeks recovery, the chaos narrative represents disorientation and suffering, while the quest narrative frames illness as a transformative journey.
“The chaos story focuses on what is most untellable about sickness: the nearly incomprehensible nature of loss and suffering.” (p. 1619)	This reflects the existential and psychological dimensions of illness. Chaos narratives resist neat resolutions, often mirroring the actual experience of chronic or terminal illness, where clarity and recovery are not always possible.
“The quest narrative depicts illness as a mythical journey, in which the hero undergoes a series of trials before being granted upon his return a boon—if not health, perhaps empathy, insight, a special sensitivity, or a deepened awareness of life’s transience and value.” (p. 1619)	The comparison of illness to mythic storytelling highlights how patients often find meaning in their suffering, transforming pain into personal growth. This perspective can offer comfort and a sense of purpose to individuals experiencing long-term illness.
“When the patient is unable to relate his own story, someone close to him may become the narrator, either in whole or in part.” (p. 1619)	This acknowledges the role of caregivers, family members, and friends in preserving and conveying illness narratives, especially when the patient is unable to do so. This highlights the collaborative and communal nature of storytelling in illness experiences.
“Multiple narrators are a hallmark of a new form of illness narrative that is being created on the Internet, in discussion groups or on Web pages.” (p. 1619)	McLellan emphasizes how digital platforms have transformed illness storytelling. Online narratives allow for shared authorship, interactivity, and collective meaning-making, demonstrating the democratization of illness experiences in the digital age.
“Writers’ motivations for telling stories of illness have bright and dark features.” (p. 1620)	Illness narratives are often cathartic and therapeutic, helping authors process trauma. However, McLellan acknowledges the potential pitfalls, including emotional overindulgence, lack of literary refinement, and the challenge of balancing personal experience with artistic expression.
“One important value of illness narratives is their capacity to bring about change that improves the lives of patients, families, and caregivers.” (p. 1620)	This underscores the practical impact of illness narratives. By sharing experiences, patients can influence medical policies, improve doctor-patient relationships, and foster empathy among healthcare providers.
“Narratives of illness provide eloquent proof, for patients and practitioners, that ‘when the lights of health go down,’ one’s own story can be illumination enough.” (p. 1620)	This poetic statement captures the central thesis of McLellan’s argument: storytelling is a powerful tool for making sense of illness, offering both individual solace and broader cultural insight.

Suggested Readings: “Literature And Medicine: Narratives Of Physical Illness” by M. Faith McLellan

1. McLellan, M. Faith. “Literature and medicine: narratives of physical illness.” The Lancet 349.9065 (1997): 1618-1620.
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 8 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 8 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 8 Feb. 2025.
5. HOLLOWAY, MARGUERITE. “When Medicine Meets Literature.” Scientific American, vol. 292, no. 5, 2005, pp. 38–39. JSTOR, http://www.jstor.org/stable/26060992. Accessed 8 Feb. 2025.