Title

Examining the fiction of J. M. Coetzee as a means to prepare medical students and medical trainees of narrative practive.

Date of Award

5-1-2016

Document Type

Dissertation

School

Caspersen School of Graduate Studies

Degree Name

Doctor of Medical Humanities

Abstract

Underscoring the extent to which narrative plays a part in how patients come to integrate their illnesses, and also underscoring the extent to which narrative fluency bears upon the physician-patient interaction, Rita Charon proposed the practice of narrative medicine. Charon defines narrative practice as medicine practiced with the narrative skills of "recognizing, absorbing, interpreting, and being moved by the stories of illness." To this end, several medical schools now incorporate literary studies into their curricula as a means to promote ethical, compassionate, and holistic care. This dissertation advocates the use of J. M. Coetzee's fiction as one means through which medical students and trainees can achieve the skills advocated by Charon, skills necessary for entering into the practice of narrative medicine. By guiding medical students and trainees through a careful examination of Coetzee's works instructors can help students to: 1) gain narrative fluency, 2) increase awareness of the themes facing ill, dis/abled, or aging patients, and 3) more compassionately inhabit the plights of those who present for care. Coetzee's fictional novels are particularly suited to such study. He utilizes a wide array of narrative structures. Inside his works, embedded meta-fictional elements are discovered vis-a-vis close reading, and such a discovery process becomes a means for building the clinical skills of close listening and attention. Furthermore, Coetzee's fictions are detailed and incisive, meticulously elaborating the experiences of his varied characters. Through indirection, Coetzee provides vicarious experiences of illness and suffering to developing physicians, experiences that become transferable to their future interactions with patients. Additionally, Coetzee's stories resist moralizing; rather, by entraining readers into the plights of his protagonists, he raises questions about the construction of self-story, the ethics of care, and innumerable motifs surrounding the condition of suffering. Finally, as students traverse Coetzee's texts, opportunities arise to experience a bird's-eye view of the effect of "narrative wreckage" on protagonists. These opportunities will mimic those encountered in clinical practice as developing physicians interact with patients whose lives are changed by the advent of illness. By affording medical students and trainees these lessons, Coetzee's stories become a foundation from which competent, holistic, narrative practice can develop.