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Beneath the Bandages: Conceptualizing surgery in patient narrative

Magdalene Lugowski, MD. Memorial University of Newfoundland

Introduction: Patients often turn to narrative to grapple with the meaning of illness. Technology such as social media encourages such activity on a large scale. However, narratives of surgery are complex to construct and commonly incorporate information from multiple sources. It is worth considering the ways in which patients reconstruct their surgical experiences to understand what information patients seek out and how surgeons can be of help.

Methods: This analysis offers a close reading and considers the narrative techniques used in two accounts of surgery written by patients two hundred years apart. Frances Burney’s account of her mastectomy, completed without anaesthesia, was composed as a letter to her sister Esther Burney. The second text, Brain on Fire, was originally written as an article for the New York Post by Susannah Cahalan, and later expanded into a book, which has, in turn, inspired a movie by the same title. She too recounts her surgery, but twice removed from her lived experience, by both madness and modern anaesthesia.

Results: Though their circumstances differ greatly, Burney and Cahalan deploy some of the same techniques to narrate their surgical experience. Subverting genre expectations regarding the directness of their chosen methods of communication – letter, memoir – the authors create carefully crafted texts, in which they assume the medical gaze for their own use, mingling this with their own voices to reclaim the experience. The effect differs however, as Burney’s account contains the vivid recollection of truly living through surgery unanaesthetized, while Cahalan must fall back on her professional persona, and rely on her medical record and the voices of others, as her own memories (if they exist) are largely inaccessible. In adopting the medical gaze, both authors engage to an extent with the experience of their surgeons. The construction of each narrative and the various literary techniques employed by each author raise questions about the extent to which anyone can narrate their own surgery coherently and invite readers to contend with the complexity of trying to capture such an experience.

Conclusion: The texts considered here were written by women who were writers before they became patients, and they employ their pre-existing narrative skills to produce these accounts, using similar techniques. Exploring the ways in which patients narrate surgical experience can allow clinicians to develop effective partnerships with patients that support this process of seeking meaning in illness.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95222

Program Number: P620

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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