Plath

Sylvia Plath and the Bell JarRick Mansfield, MD MS

Department of MedicineVeterans Affairs Medical Center, VT

Assistant Professor of MedicineDartmouth Medical School, NH

Outline Narrative Medicine: terms and definitions

Case example - Sylvia Plath: The Bell Jar

Real Life Current examples: It’s easier than you think

Conclusion: Why Narrative Medicine Matters to You

Narrative Medicine: Rita CharonWriting and humanities studies produce

better physicians…because doctors learn to coax hidden information from patients' complaints

When Medicine Meets Literature(Marguerite Holloway Scientific American Magazine -April 25, 2005.)

Narrative Medicine: Rita Charon “With narrative competence, physicians

can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care.”

(JAMA 2001; 286: 1897-1902)

Sylvia Plath: The Bell Jar – A Literary Intro into Narrative Medicine:

“…maybe doctors and writers could get along fine after all.” (P.55)

Integral Self-description

Not clear:Cliché?

+ p.1 I’m stupid…

+ P.3 I still have them

+ p.4 – girls… make me sick

+ p.9 to this day

+ p.9 I’m 5’10”…

+ p.18 walking has never phased me

+ p.19 I meditate in the bath

+ p.25 I love food…

+ p.42 I hate Technicolor…

+ P.59 If you expect…

+ P.102 people must be writing…

+ p.226 I have never … cared…

+ p.237 bell jar dream

6 5 2 TOTAL = 13

Use of Present tense in the Bell Jar

The Bell Jar: 1st Paragraph It was a queer, sultry summer, the summer they

electrocuted the Rosenbergs, and I didn’t know what I was doing in New York. I’m stupid about executions. The idea of being electrocuted makes me sick, and that’s all there was to read about in the papers –goggle-eyed headlines staring up at me on every street corner and at the fusty, peanut-smelling mouth of every subway. It had nothing to do with me, but I couldn’t help wondering what it would be like, being burned alive all along your nerves.

I thought it must be the worst thing in the world. (p.1)

1st person/past tense narrative

The Bell Jar: 1st person/present! It was a queer, sultry summer, the summer they

electrocuted the Rosenbergs, and I didn’t know what I was doing in New York. I’m stupid about executions. The idea of being electrocuted makes me sick, and that’s all there was to read about in the papers –goggle-eyed headlines staring up at me on every street corner and at the fusty, peanut-smelling mouth of every subway. It had nothing to do with me, but I couldn’t help wondering what it would be like, being burned alive all along your nerves.

I thought it must be the worst thing in the world. (p.1)

Electrocution vs. Electroconvulsive therapy.Context text

The Rosenbergs. 1950’s McCarthyism. 1st U.S. citizens to be condemned to death for espionage against the US.

Executed by electrocution.

“…down the hall between two nurses,… with dignity, like a person coolly resigned to execution.” (P.211)

ECT Therapy is the climax of the book.

One innocuous present tense paragraph tells her life:

For a long time afterward I hid them away, but later, when I was all right again, I brought them out, and I still have them around the house. I use the lipsticks now and then, and last week I cut the plastic starfish off the sunglasses case for the baby to play with. (p. 3)

For a long time afterward I hid them away, but later, when I was all right again, I brought them out, and I still have them around the house. I use the lipsticks now and then, and last week I cut the plastic starfish off the sunglasses case for the baby to play with. (p. 3)

One innocuous present tense paragraph tells her life:

Does she give away the ending? For a long time afterward I hid them away, but later,

when I was all right again, I brought them out, and I still have them around the house. I use the lipsticks now and then, and last week I cut the plastic starfish off the sunglasses case for the baby to play with. (p. 3)

The Baby? For a long time afterward I hid them away, but later,

when I was all right again, I brought them out, and I still have them around the house. I use the lipsticks now and then, and last week I cut the plastic starfish off the sunglasses case for the baby to play with. (p. 3)

How easy having babies seemed to the women around me! Why was I so unmaternal and apart?...If I had to wait on a baby all day, I would go mad. (p.222)

From Babies to Baths and Baptism Whenever I’m sad I’m going to die, or so nervous I

can’t sleep, or in love with somebody I won’t be seeing for a week, I slump down just so far and then I say: “I’ll go take a hot bath. (p.19)

I meditate in the bath…I’m never so much myself as when I’m in the hot bath…I don’t believe in baptism…but I guess I feel about a hot bath the way those religious people feel about holy water. (p. 19-20)

The longer I lay there in the clear hot water the purer I felt…I felt pure and sweet as a new baby.” (p.20)

From Babies to Baths and Baptism

There ought, I thought, to be a ritual for being born twice –patched, retreaded and approved for the road.” (p.244)

Plath’s Only Novel “Secretly, in studies and attics and

schoolrooms all over America, people must be writing.” (P. 102.)

“Then I decided that I would spend the summer writing a novel. That would fix a lot of people.” (P.121)

A feeling of tenderness filled my heart. My heroine would be myself, only in disguise. (p.120)

She would be called Elaine. Elaine. I counted the letters on my fingers. There were six letters in Esther, too. It seemed a lucky thing. (p. 120)

There are six letters in Sylvia, too. (It seems a lucky thing.)

The Bell Jar To the person in the bell jar, blank and stopped as a

dead baby, the world itself is the bad dream p. 237.

The end – is she better or not? “I felt surprisingly at peace. The bell jar hung,

suspended, a few feet above my head. I was open to the circulating air. “(P. 213)

“How did I know that someday…the bell jar with its stifling distortions wouldn’t descend again?” (P. 241.)

Read it as fiction – and she’s better.

Read it with Narrative competence – and there are several warning signs of an impending suicide.

She uses the present tense to: Compare ECT to electrocution

Discuss babies

Express her desire for new life: “baptism”

Tell what writing meant to her

Show her depression: “The Bell Jar.”

Narrative Medicine: 11/6/08 “I slept late this morning until

9:15/AM. Tested @9:24/AM 219. woke up Jesse and got him up at 9:40/AM… gave 4 Units of Novolog. Life Cereal w/milk and toast and donut +coffee at 9:58/AM”

“…read some more news to Jesse from the spectator newspaper about the central railroad roundhouse where Jesse used to work out of; and he can’t see the small print.”

Strunk and White: the Elements of Style (p. 67) “All writers, by the way they use the

language, reveal something of their spirits, their habits, their capacities, and their biases. This is inevitable as well as enjoyable. All writing is communication: creative writing is communication through revelation – it is the Self escaping into the open. No writer long remains incognito.”

http://www.amazon.com/gp/reader/020530902X/ref=sib_dp_pt

Narrative Medicine: 1/13/10 Dear Sir,

I am hoping you will let me submit one more letter …[to] be put in the record…to reflect the truth…

…This last week I tried to cut down on my medicine because of recent attempts to get healthier and to lose weight, so I tried to go down too one tablet a day and the arm pain came back in both arms it is a achy pain that goes from slight numbness in two digits and forearm skin to aching from the elbow to under my arms to pain that tightens in all of the shoulders both tops and goes up to my neck,…

The letter continued… …I just don't know what to say or do anymore. I am

confused, disoriented, disappointed, in pain I feel if I say to much people just throw up there hands.

One last thing I want to say, …

…I find myself doing this quite often, having to go back and say I want to add something all the time. I hope you will understand it's all the above and more.

This is what I wrote in the chart: “…this could just as well be a transcription of the way

he talks…series of incomplete thoughts…repetitive and disorganized. He barely takes a break.” (i.e., I am frustrated b/c I don’t understand him…and can’t tolerate him)

“…he has some insight to this. He expresses some understanding that he often can't express his ideas clearly, so he continues to say more, until people no longer want to listen to him - leaving him frustrated.” (i.e., with narrative competence, I can provide empathic care and reduce my own frustration)

The Art of Medicine

“Art is truth setting itself to work” (P.38)

Martin Heidegger (1879-1976)

The Pen is Mightier than the Sword

Conclusions: Narrative Medicine: Understanding and writing the

patient’s story, then being moved to action IS caring for the patient. (present tense!)

Narrative medicine can be reciprocally beneficial to both patient and physician. (or any interpersonal relationship)

Wield your pen with the care, clarity, and precision of a surgeon using a scalpel.

The END

Plath

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