{"id":36746,"date":"2016-05-26T15:23:38","date_gmt":"2016-05-26T14:23:38","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=36746"},"modified":"2017-08-22T20:18:09","modified_gmt":"2017-08-22T19:18:09","slug":"claire-mcdaniel-and-daniel-marchalik-considering-patient-stories-through-adam-johnsons-the-orphan-masters-son","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2016\/05\/26\/claire-mcdaniel-and-daniel-marchalik-considering-patient-stories-through-adam-johnsons-the-orphan-masters-son\/","title":{"rendered":"Claire McDaniel and Daniel Marchalik: Considering patients&#8217; stories through Adam Johnson\u2019s The Orphan Master\u2019s Son"},"content":{"rendered":"<p><a href=\"http:\/\/bmj.co\/doctors_book_club\"><strong>The Doctors\u2019 Book Club<\/strong><\/a><br \/>\n<strong><u>Adam Johnson\u00a0<em>The Orphan Master\u2019s Son<\/em><\/u><\/strong><\/p>\n<p>After her son was arrested by the secret police, <a href=\"https:\/\/en.wikipedia.org\/wiki\/Anna_Akhmatova\">Anna Akhmatova<\/a> spent seventeen months waiting outside the Leningrad prisons for news of his wellbeing. Standing next to scores of other women similarly hoping to hear that their loved ones were alive, Akhmatova composed \u201cRequiem,\u201d a lyrical poem that explores the helplessness of living in a totalitarian state:<\/p>\n<p><em>I\u2019ve cried for seventeen long months,<\/em><br \/>\n<em>I\u2019ve called you for your home, <\/em><br \/>\n<em>I fell at hangmen\u2019 feet\u2014not once, <\/em><br \/>\n<em>My womb and hell you\u2019re from.<\/em><!--more--><\/p>\n<p>The absurdity and powerlessness of life in oppressive regimes is explored in Adam Johnson\u2019s <em>The Orphan Master\u2019s Son<\/em>. The novel chronicles the life of a North Korean named Jun Do beginning with his childhood in an orphanage. His life takes a series of strange turns as he begins work in the underground military tunnels, then as a professional kidnapper, and a naval spy. He travels to Texas on a mission to gather intelligence and acquire thousands of DVDs for the Dear Leader. Then without explanation, he is sent to a remote labor camp. As he struggles to survive in the horrible conditions, his life takes another unexpected shift as he serendipitously switches places with a national hero. Though the vicissitude of events may seem fantastical, the novel maintains a clear devotion to realism and the exploration of the human condition.<\/p>\n<p>The narrative structure that interweaves storytelling and propaganda ultimately forces readers to question the nature and purpose of \u201ctruth.\u201d The novel opens with the voice of the loudspeaker in the form of constant \u201cevening propaganda broadcasts coming over the apartment\u2019s hardwired loudspeaker\u201d of which \u201cthere\u2019s one in every apartment and factory floor in Pyongyang.\u201d Johnson makes clear that this world is nothing like the world we know, and immediately frames the coming narrative within the confines of an official party point of view.<\/p>\n<p>There are several functions to this voice. It enables us to see the North Korean world through the same lens that is offered to its citizens (the voice of the loudspeaker reads very similarly to the official North Korean memos released to the public). At the same time, the multiple points of view crafted by the voice of Jun Do, the loudspeaker, and a party interrogator, help create a cross-section of life across Pyongyang, portraying the same event from a multitude of viewpoints. Truth, we learn, is a constantly moving target.<\/p>\n<p>This phenomenon is familiar to those exposed to hospital culture. When a patient is seen in the hospital, his story emerges out of several different narratives\u2014 other physicians\u2019 notes, the laboratory and radiologic findings, the patient\u2019s narrative, and our own observations. In isolation, each story represents a part of a whole. But together, they help paint a complete picture. But does that bring us any closer to the truth?<\/p>\n<p>In Johnson\u2019s world, the concept of truth is difficult to pin down. For example, should we believe that Jun Do\u2019s story is factually true? After all, the sequence of events that leads to the story\u2019s climax are hardly believable: Jun Do, working in the mines of a remote labor camp, kills the North Korean national taekwondo champion (and minister of the mines) in hand-to-hand combat after which he effortlessly slips in his place and begins living alongside his wife and children. Perhaps in a world as strange as North Korea, such an event could, indeed, be true. As Jun Do learns, \u201cif a farmer is declared a music virtuoso by the state, everyone had better start calling him maestro. And secretly, he&#8217;d be wise to start practising the piano. For us, the story is more important than the person. If a man and his story are in conflict, it is the man who must change.\u201d Yet Johnson also seems to suggest that the verifiability of a story is not its most important trait. What matters is that we understand the complexity a North Korean citizen\u2019s life, regardless of the facts involved.<\/p>\n<p>In this way, Johnson\u2019s story pushes readers to confront their own narratives. Do we tell stories for their facts of for their message? And can that idea be extended to our interpretation of patient stories? Could our habit of truth-seeking stand in our way of understanding? After all, stories of pain and suffering are seldom neat. As Johnson notes in an interview, \u201cTrauma narratives are hallmarked by fragmentation, broken chronology, changing perspectives, shifts in tone, and absented moments.\u201d<\/p>\n<p>We invite your personal reflections on truth and narratives in the healthcare setting. What is the role of truth in a clinical context, especially in patients\u2019 stories? Are \u2018truth\u2019 and \u2018fact\u2019 inextricably linked in clinical encounters? Do you have a story of a patient whose narrative may not have been factually correct but nevertheless \u201chonest\u201d? Please post it below!<\/p>\n<p><span style=\"text-decoration: underline\">Next Month:<\/span><br \/>\nWe will discuss <em>All The Light We Cannot See<\/em>, by Anthony Doerr.<\/p>\n<p><span style=\"text-decoration: underline\">Questions to consider:<\/span><br \/>\n-How does Doerr portray blindness in this work?<br \/>\n-Is it clich\u00e9 or quite nuanced?<br \/>\n-What are Doerr\u2019s positions on choice and free will (do Marie Laure or Werner have a choice or are they cast into their futures by circumstance?)<br \/>\n-What do we make of the legend of the Sea of Flame and Sergeant Major Reinhold von -Rumpel\u2019s quest to find it in order to treat his terminal cancer?<br \/>\n-What does von Rumpel\u2019s belief in extraordinary healing powers of a gem suggest about the way people approach illness?<br \/>\n-Does Doerr\u2019s portrayal of von Rumpel\u2019s disease help excuse his motivations?<\/p>\n<p><a href=\"http:\/\/bmj.co\/doctors_book_club\">More articles in this series<\/a><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/04\/20\/claire-mcdaniel-and-daniel-marchalik-haruki-murakamis-the-colorless-tsuluru-tazaki-and-the-complexity-of-grief\/daniel_marchalik3\/\" rel=\"attachment wp-att-36528\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-36528\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2016\/04\/daniel_marchalik3.jpg\" alt=\"daniel_marchalik3\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2016\/04\/daniel_marchalik3.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2016\/04\/daniel_marchalik3-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a><em><strong>Daniel Marchalik<\/strong> is completing his urologic surgery residency in Washington, D.C. He writes a monthly column for <\/em>The Lancet<em> and directs the <a href=\"http:\/\/www.georgetownliteratureandmedicine.com\/\">Literature and Medicine Track<\/a> at the Georgetown University School of Medicine.<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/11\/claire_McDaniel.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-35599 \" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/11\/claire_McDaniel.jpg\" alt=\"claire_McDaniel\" width=\"168\" height=\"220\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/11\/claire_McDaniel.jpg 601w, https:\/\/blogs.bmj.com\/bmj\/files\/2015\/11\/claire_McDaniel-229x300.jpg 229w\" sizes=\"auto, (max-width: 168px) 100vw, 168px\" \/><\/a><\/p>\n<p><em><strong>Claire McDaniel<\/strong> is a second year medical student at Georgetown University School of Medicine in Washington, DC, participating in the school&#8217;s Literature and Medicine Track. Additionally, she is an MBA candidate at Georgetown University McDonough School of Business.<\/em><\/p>\n<p><em><strong>Competing interests:<\/strong> None declared.\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Doctors\u2019 Book Club Adam Johnson\u00a0The Orphan Master\u2019s Son After her son was arrested by the secret police, Anna Akhmatova spent seventeen months waiting outside the Leningrad prisons for news [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/05\/26\/claire-mcdaniel-and-daniel-marchalik-considering-patient-stories-through-adam-johnsons-the-orphan-masters-son\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[765],"tags":[],"class_list":["post-36746","post","type-post","status-publish","format-standard","hentry","category-literature-and-medicine"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Claire McDaniel and Daniel Marchalik: Considering patients&#039; 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