Literature and Medicine II

11 Slater’s reply left her critics in the strange position of having to defend themselves for taking her seriously, for crossing the science/culture divide. “It is a value judgment as to whether possibly fabricated data in a popular press book should be the basis of a report in the scientific literature,” Mark Zimmerman, the reviewer for The Journal of Nervous and Mental Disease, writes (741). Spitzer and his colleagues initially defended their report by noting the potential influence of Slater’s work:

Some readers may harbor the view that our findings are much ado about nothing. After all, they might contend, Slater’s results were not peer-reviewed and can safely be ignored by the scientific community. In our view, this response would be misguided. Because Slater’s book was undoubtedly read by thousands of individuals in the general public, it is probably more likely to shape the laypersons’ impressions of diagnostic and prescription practices of psychiatrists than are peer-reviewed publications. Mental health researchers ignore popular perceptions of psychiatry and psychology at their peril [...] and must remain vigilant about correcting potential distortions and misrepresentations of scientific findings that are promulgated to the general public. (“Rosenhan Revisited” 738)

This conversation exists at the uneasy intersection of the concerns of “scientific community” and the “general public,” which is in part why it is such a difficult and heated exchange. Slater has emphasized the cultural differences between the language and practices of the scientific community and those of the laity: “honey, let’s experiment with this recipe.” However, as Zimmerman notes, the divide between science and popular culture is not so pronounced as to be unbridgeable, and Slater clearly has knowledge of both realms: “It is disingenuous for Slater to now try to hide behind a cloak of a nonscientific writing style. It is clear that she understood the impact, importance, and implications of Rosenhan’s study and her own study” (Zimmerman 741). It is perhaps disingenuous of Slater to respond this way, but it is also in keeping with her past work to be deliberately obscure, and to purposefully raise more questions than she will answer. In “A Response to a Nonresponse to Criticisms of a Nonstudy: One Humorous and One Serious Rejoinder to Slater,” Spitzer and his colleagues eventually recognize the futility of engaging with Slater on their terms: in the end, they are quoting comedian Gilda Radner (“Never mind!”) and are just as sarcastic as Slater herself. They are left with lingering doubts:

Slater’s response suggests another question: did she even perform her study in the first place? She does not provide readers with evidence that it ever took place. By “nonstudy,” does she mean only that her hospital observations were unsystematic or unscientific? Or does she also mean that the events she described were fictional? (Lilienfeld 745)

It is perhaps fitting that this exchange ends with questions like these, which involve the fuzzy boundaries of truth and imagination in creative nonfiction and the unique blend of medical fact and personal observation that is typical in much of Slater’s writing.

12 The relationship between fact and fiction in psychiatry is of particular interest to Slater, and Rosenhan’s experiment lends itself to examining possible manipulations in the power structure of clinical encounters. Rosenhan’s original experiment was, after all, based on fictional symptoms: the auditory hallucinations that the pseudopatients feigned in their admission interviews. Rosenhan’s experiment began with a strategic violation of the contract of the clinical encounter between doctor and patient, in which the patient presents symptoms to the doctor who in turn reads those symptoms in order to diagnose and treat. In his experiment, which is based on an initial misreading—a failure to distinguish malingering (fiction) from a truly experienced symptom (fact) during admissions—staff and doctors continued to misread some behaviors of the pseudopatients as pathological during their hospitalization. Although Rosenhan’s primary objective might have been to cast doubt on the validity of psychiatric diagnoses, the experiment also illustrates just how dynamic the clinical encounter can be: patients have potential power over how they present (they can manipulate their readers/doctors), and doctors themselves can become test subjects (the objects of examination).

Lauren Slater’s Lying

13 Lauren Slater’s memoir of growing up with epilepsy, Lying: A Metaphorical Memoir, similarly foregrounds and manipulates the expectations of the reader in order to transgress the conventions of the illness narrative. She writes:

[…] despite the huge proliferation of authoritative illness memoirs in recent years, memoirs that talk about people’s personal experiences with Tourette’s and postpartum depression and manic depression, memoirs that are often rooted in the latest scientific “evidence,” something is amiss. For me, the authority is illusory, the etiologies constructed. When all is said and done, there is only one kind of illness memoir I can see to write, and that’s a slippery, playful, impish exasperating text, shaped, if it could be, like a question mark. (Lying 221)

The text itself begins with a fake introduction written by a fictional philosophy professor.[5]For a description of reviewers’ attempts to track down the fictional Professor Hayward Krieger, see Richard Ingram’s “Life Plagiarizing Illness: Lauren Slater’s Lying.” Chapter one consists of two words: “I exaggerate” (3).

14 While Slater’s text is ostensibly about epilepsy, she makes it clear from the very beginning that her account is not the typical illness narrative, and her epilepsy is a literary, not a literal, illness:

I have epilepsy. Or I feel I have epilepsy. Or I wish I had epilepsy, so I could find a way of explaining the dirty, spastic glittering place I had in my mother’s heart. Epilepsy is a fascinating disease because some epileptics are liars, exaggerators, makers of myths and high-flying stories. […] when I opened my mouth [...] all my words seemed colored, and I don’t know where this is my mother or where this is my illness, or whether, like her, I am just confusing fact with fiction, and there is no epilepsy, just a clenched metaphor, a way of telling you what I have to tell you: my tale. (5-6)

Slater’ strategy in Lying is problematic on several levels. Traditionally, a memoir writer has an implicit contract with her readers to base her story in fact, not fiction or metaphor, and some readers are unwilling to permit Slater’s sweeping alterations in the terms of that contract.

15 A quite different objection to Slater’s conceit comes from the field of disability studies. As G. Thomas Couser writes: “[…] the ethical crux of Lying is not that Slater may be lying about having epilepsy, but that in exercising prose license she commits herself to an essentializing and mystifying characterization of a still stigmatic disability” (141). In other words, Slater’s memoir stigmatizes real people who live with epilepsy. Margaret Price voices similar objections:

[…] in the choice to appropriate another disability to stand in metaphorically for her own, Slater is on risky ground. I do not wish to defend her choice, which I find problematic for a variety of reasons. For one thing, it risks playing into the accusations of “malingering” so often leveled at disabled persons—especially those of us who have no objective evidence to offer, but only reports of what is happening inside our minds. And yet, perhaps in its very shamelessness lies its value. With this lurid gesture of untruth, the narrator of Lying refuses to become the exposed, confessing narrator of conventional disability autobiography. (20)

The politics of personal representation are vital to disability studies, a civil rights movement characterized by the slogan “Nothing about us without us.” In this context. Slater’s manipulation of autobiography is dangerous, but also potentially liberating. Lying complicates a genre that has been too easily packaged and consumed in the recent past.