William Tucker - How People Change: The Short Story as Case History
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For most people, the quickest route to wisdom, other than experience, is through stories. Stories speak across generational lines and cultures, emphasize the universality of human experience, and offer insight into the dynamics involved in unfamiliar situations.
Freud and D.W. Winnicott were among the few psychiatrists able to write case histories emblematic of the vicissitudes of the human condition. As a rule, the technical and dry approach of the psychiatric literature is not fit to teach doctors how to connect to their patients suffering because it privileges pathological categories over experience. Tucker, therefore, turns to the drama and conflicts of fictional characters, to restore the human dimension of medicine and to entice practitioners to grasp the emotional and intellectual layers of the particular situations in which their patients are entrapped. The sixteen stories selected here are analyzed to show how they illustrate the process of change, as defined by Erik Eriksons description of the life cycle. Some of these stories include Gooseberries by Anton Chekhov, The Dead by James Joyce, and Her First Ball by Katherine Mansfield. Physicians and medical students can turn to these narratives as examples of how others have dealt with challenges and debilitating conditions, and encourage their patients to follow similar paths to bring about change in their lives.
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Ebook ISBN9781635420340
Copyright 2007 William M. Tucker
Production Editor: Robert D. Hack
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from Other Press LLC, except in the case of brief quotations in reviews for inclusion in a magazine, newspaper, or broadcast. For information write to Other Press LLC, 267 Fifth Avenue, 6th Floor, New York, NY 10016. Or visit our Web site: www.otherpress.com.
Library of Congress Cataloging-in-Publication Data
Tucker, William M.
How people change : the short story as case history / William M. Tucker p. cm.
ISBN-13: 978-1-59051-212-8 (alk. paper)
ISBN-10: 1-59051-212-X (alk. paper)
1. Psychotherapy. 2. Psychotherapy in literature. I. Title.
[DNLM: 1. Patientspsychology. 2. Literature. 3. Life
Change Events. 4. PhysicianPatient Relations. W 85 T895h 2007]
RC480.T83 2007
616.8914dc22
2006024221
v5.4
a
For Sheila,
who changed me
It was not until I was in graduate school in the humanities that I realized poems had meaning, and that poets were trying to communicate to readers or listeners what they felt, passionately, about ways of seeing or feeling. That is, poems were worth reading closely, for their content. The poet Wordsworth said they arose from emotion recollected in tranquillity. As an undergraduate all I had recognized was that their words had music to them and made for beautiful images. Much later, after medical school and fifteen years or so of clinical practice, I came back to another version of that split between life and literature, between experience and structured experience. I stumbled upon short stories as a form of poetry attenuated, revealed, and ready for use. Patients began to seem to me like characters in a handful of these stories, which were applicable to one clinical situation after another. I started teaching these stories to residents and colleagues as if they were clinical cases. Later, I began to offer them to patients as ways of looking at their own experiences. This book discusses the impact that skillful writers have on us through the plots, characters, and situations they present in their stories.
The author gratefully acknowledges permission to reprint the following material:
Grisha, Oysters, and Gooseberries from Tales of Chekhov by Anton Chekhov, translated by Constance Garnett. Published by The Ecco Press, 1984. Copyright 1917, 1944, 1972 by Macmillan Company (now in the public domain).
The Rocking-Horse Winner, copyright 1933 by the estate of D. H. Lawrence, renewed 1961 by Angelo Ravagli and C. M. Weekley, executors of the estate of Frieda Lawrence, from Complete Short Stories of D. H. Lawrence by D. H. Lawrence. Used by permission of Viking Penguin, a division of Penguin Group (USA) Inc.
Good-bye Marcus, Good-bye Rose and Sleep It Off, Lady from Jean Rhys: The Collected Short Stories, W.W. Norton & Company, Inc. New York. Copyright 1976, 1987 by Jean Rhys. Used by permission of the Wallace Literary Agency, Inc.
Araby and The Dead from Dubliners by James Joyce, copyright 1916 by B. W. Heubsch. Definitive text copyright 1967 by the estate of James Joyce. Used by permission of Viking Penguin, a division of Penguin Group (USA) Inc.
Her First Ball from The Short Stories of Katherine Mansfield by Katherine Mansfield, copyright 1923 by Alfred A. Knopf, a division of Random House, Inc. and renewed 1951 by John Middleton Murry. Used by permission of Alfred A. Knopf, a division of Random House, Inc.
The Man Who Was Almost a Man from Eight Men by Richard Wright. Copyright 1961 Richard Wright. Reprinted by permission of John Hawkins & Associates, Inc.
In Dreams Begin Responsibilities by Delmore Schwartz, from In Dreams Begin Responsibilities, copyright 1937, 1978 by New Directions Publishing. Reprinted by permission of New Directions Publishing Corporation.
My First Marriage taken from Out of India by Ruth Prawer Jhabvala. Copyright Ruth Prawer Jhabvala. Reproduced by permission of John Murray (Publishers) Limited.
Good Country People from A Good Man is Hard to Find and Other Stories, copyright 1955 by Flannery OConnor and renewed 1983 by Regina OConnor, reprinted by permission of Harcourt, Inc.
The Adulterous Woman from Exile and the Kingdom by Albert Camus, translated by Justin OBrien, copyright 1957, 1958 by Alfred A. Knopf, a division of Random House, Inc. Used by permission of Alfred A. Knopf, a division of Random House, Inc.
He from Flowering Judas and Other Stories, copyright 1930 and renewed 1958 by Katherine Anne Porter, reprinted by permission of Harcourt, Inc.
The Overcoat from The Overcoat & Other Tales of Good and Evil by Nicolai Gogol, translated by David Magarshack, copyright 1957 by David Magarshack. Used by permission of Doubleday, a division of Random House, Inc.
Colleagues too numerous to mention have contributed suggestions to the analyses of the stories presented here, doing their best to help me avoid idiosyncrasies of interpretation. Among the most persistent have been Suzanne Flater, R.N., Jane Fried, M.D., Kathleen Ibrahim, R.N., David Joseph, M.D., Clarice Kestenbaum, M.D., Randall Marshall, M.D., Lawrence Maayan, M.D., Gerald Segal, M.A., Gretchen Seirmarco, R.N., Steven Simring, M.D., Helle Thorning, Ph.D., Donna Vermes, R.N., and Joseph Youngerman, M.D.
The purpose of this book is to show practitioners and teachers of medicine how to use short stories to illustrate change at different phases of life. It draws on the richness and drama that great writers use in short stories to illustrate their insights into character, growth, and the process of change. It offers a simple, systematic way to use short stories to highlight these elements for physicians-in-training and practicing physicians who desire to expand their scope of knowledge about people and about how they change.
G OAL
The goal of this book is to encourage practitioners and teachers of medicine to use the characters in these stories and the changes they undergo to understand more fully what their patients may be experiencing. Patients expect their physicians not merely to listen to them and to be curious, but also to know what is important in life: how relationships develop, how people of different ages can change and grow, and how, given their particular strengths and weaknesses, they can do so. That is, patients expect their physicians to pass on a certain amount of wisdom. Wisdom is precisely what no amount of training in medicine confers. It comes only out of an accumulation of experience and reflection, and even then, only by chance and in fragments, and to those with a talent for picking it up. Thus, we feel at least a little fraudulent at the beginning of our medical careers, and even later on, when confronted with a patient whose problem we have not encountered, we feel similarly so. Patients tend to forget that we have our limitations when it comes to empathy and understanding, limitations that the insights and power of great writers can help us overcome.
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