Saturday, February 21, 2009

The Subjectivity of Sickness

In his Preface to The Man Who Mistook His Wife for a Hat, Oliver Sacks wrote that "animals get diseases, but only man falls radically into sickness." I take this to mean that, while any study of the nature of disease may be consigned to a canton of the objective world, the experience of sickness is very much a phenomenon of at least the subjective world and possibly the social world. I suppose I was first aware of this when I was diagnosed with prostate cancer, for which my urologist recommended a radical prostatectomy. He provided me with an abundance of background reading, which both my wife and I found very helpful, but far more valuable was the knowledge that the husband of one of my colleagues had experienced this surgery. This knowledge led to several conversations, along with the opportunity to read the diary he kept associated with the whole surgical experience. I read this after our initial conversation, which allowed me to read it for "voice," rather than just information; and it was that "sense of voice" that was missing in the reading matter provided and recommended by my urologist.

These days, when it comes to sickness, there appears to be no shortage of "voice" on the Internet (nor, for that matter, is there a shortage of more objective information). Indeed, the critical observations of Dr. Aric Sigman, which I recently cited, may have much to do with the extent to which such "voice" is present in the virtual world in reality or only in appearance. Since the BBC story I cited only summarized one of Sigman's professional publications, I cannot use it to assess fairly any thoughts Sigman may have about "voice." However, anyone who reads fiction has no trouble recognizing that "voice" is a "constructed reality," which almost always has more to do with constructions by the reader, rather than the writer. Thus, in the course of some preliminary text analysis research based on the content of message boards maintained by, I had little trouble in endowing most of what I read with "voice" and keeping that "voice" consistent across contributions by the same user. Still, my analysis required my own detachment from the text, regardless of whether that text was making Goffman-like "moves" in the objective, subjective, or social world.

I am now, once again, confronted with my own sickness. After several years of a negligible presence of the prostate specific antigen (PSA) in my blood (indicating the absence of prostate cancer after the surgery), that PSA number has escalated; and I have begun conversing again within my own social network. My friend who kept the diary asked if I would be blogging about my condition and the likelihood that I would now be undergoing radiation therapy. My initial reaction was that I would not do so. My explanation was that I view these posts as invitations for conversation extended to a potentially wide audience consisting almost entirely of people I do not know. While I have no trouble doing this in areas like the performing arts, politics, and philosophy, my personal health is another matter; and I think the distinction has to do with my restricting my "author's voice" to readers already familiar with my speaking voice. Whether or not this is a rational decision (or even whether I hold to it, since this post is already stretching it) remains to be seen. My guess is that however much my experiences over the next few months inform me about sickness, they will probably inform me about my own writing practices.

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