{"id":37990,"date":"2016-12-16T14:41:12","date_gmt":"2016-12-16T13:41:12","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=37990"},"modified":"2017-08-22T16:56:04","modified_gmt":"2017-08-22T15:56:04","slug":"claire-mcdaniel-and-daniel-marchalik-the-trauma-of-survival","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2016\/12\/16\/claire-mcdaniel-and-daniel-marchalik-the-trauma-of-survival\/","title":{"rendered":"Claire McDaniel and Daniel Marchalik: The trauma of survival"},"content":{"rendered":"<p><strong><span style=\"text-decoration: underline\"><a href=\"http:\/\/bmj.co\/doctors_book_club\">The Doctor\u2019s Book Club<\/a><br \/>\n<\/span><span style=\"text-decoration: underline\">Emma Donoghue\u2019s <em>Room<\/em><\/span><\/strong><\/p>\n<p><em>And I a smiling woman. \u00a0\u00a0<\/em><\/p>\n<p><em>I am only thirty.\u00a0<\/em><\/p>\n<p><em>And like the cat I have nine times to die.<\/em><\/p>\n<p>\u2014Sylvia Plath \u201cLady Lazarus\u2019<\/p>\n<p>In 2008, a mysterious emergency room appearance of a young girl with kidney failure led to a gruesome discovery. As the Austrian investigators learned, over the span of 24 years Josef Fritzl imprisoned, tortured, and raped his daughter in the secret basement of his house; the young girl was one of 7 children fathered through this forced incestuous relationship.<\/p>\n<p>Emma Donoghue\u2019s <em>Room<\/em> (2010), loosely based on the events of the Fritzl case, explores a similarly horrific story. The novel chronicles the life a precocious 5-year-old boy named Jack and his mother, referred throughout the novel simply as Ma. Told from Jack\u2019s perspective, the book focuses on the banalities of his daily life inside Room. But as the reader quickly comes to realize, Room is not simply a child\u2019s vision of the universe; it is the entirety of Jack\u2019s world. Jack and Ma live in a tiny backyard shed where Ma has been held captive for 8 years after being kidnapped as a teenager.<!--more--><\/p>\n<p>Despite the horror of the story\u2019s events, Jack\u2019s voice colors the novel with the innocence of childhood. What Jack describes as his exciting daily routine\u2014hygiene time, \u201cscream\u201d time, adapted versions of classes such as physical education\u2014crystalize into the claustrophobic setting of the novel. After all, gym is a series of sprints around a rug-sized space that takes place beneath a small skylight, the only connection that Room has to the outside world. Yet despite the horrific circumstances, Jack appears somewhat oblivious to the reality of his world mainly due to Ma\u2019s relentless attempts to provide him with a \u201cnormal\u201d life.<\/p>\n<p>But if the first part of the novel is a story of Jack and his mother\u2019s physical captivity, the second half describes the experience of emotional imprisonment. Through a series of daring and petrifying events, Jack and Ma manage to escape. But the novel\u2019s tragedy extends far beyond the shed as the task of surviving outside of Room proves to be more difficult than inside of it. Jack\u2019s adjustment to the outside world is aided by childhood ignorance, but Ma\u2019s world is defined by a life to which she can no longer return. Life after trauma, she discovers, can never be fully restored.<\/p>\n<p>As victims of a high-profile case, Jack and Ma enter the public sphere and become the focus of both sympathy and expectation. Though Ma is continuously reminded that life should now be easier, she points out that \u201cit\u2019s actually harder\u201d since when the \u201cworld was eleven foot square it was easier to control.\u201d In the outside world, her life is no longer her own. She is judged for continuing to breastfeed Jack, for her parenting choices, or for Jack\u2019s existence altogether. Even Ma\u2019s father, visiting her in the hospital for the first time, refuses to interact with Jack simply saying, \u201cI can\u2019t be in the same room. It makes me shudder.\u201d<\/p>\n<p>Indeed, outside of Room, people\u2019s need to establish an explanation for tragedy centers on an easy target: blaming the victim herself. To make sense of the horrific events, the world quickly transforms Ma from victim to perpetrator. In a televised interview, Ma is asked by a callous host, \u201cDid you ever consider asking your captor to take Jack away\u2026 every day he needed a wider world, and the only one you could give him got narrower.\u201d This interrogation, coupled with persistent victim blaming experienced by Ma, leads her to have an emotional breakdown and ultimately attempt suicide.<\/p>\n<p>In this way, <em>Room<\/em> is an intricate study of trauma and the difficult recovery process\u2014a process often hindered by the very people who aim to help. And navigating the obstacles to surviving after trauma, Donoghue demonstrates, is a complicated and profoundly individual process. For Ma and Jack, the possibility of closure also comes in an unexpected way.<\/p>\n<p>One day, Jack asks to go back to visit Room. Despite her reticence, Ma agrees. Accompanied by the police officer who rescued them from captivity, Jack enters the shed, but \u201cit\u2019s all wrong. Smaller than Room and emptier and it smells weird\u2026 \u2018I don\u2019t think this is it,\u2019\u201d Jack says to Ma, \u201cHas it got shrunk?\u201d Walking out, Jacks looks in for the last time: \u201cIt\u2019s like a crate, a hole where something happened. Then we go out the door.\u201d<\/p>\n<p>In <em>Room,<\/em> as in life, the door out is never clearly shown. There is no prescription for how one should cope with or overcome trauma, just as there is no prescription for how one should endure it. Pain and recovery has to come on each individual\u2019s own terms.<\/p>\n<p><strong><u>Next Month:<\/u><\/strong><\/p>\n<p>We will discuss Viet Thanh Nguyen\u2019s <em>The Sympathizers<\/em><em>\u00a0<\/em><\/p>\n<p>Questions to consider:<\/p>\n<p>-What does the novel suggest about the nature of torture? Can it permanently change a person?<\/p>\n<p>-How do we interpret testimonies produced during moments of extreme pain?<\/p>\n<p>-Waking up in the hospital after a nearly fatal injury, the protagonist is told, \u201cRemember that the best medical treatment is a sense of relativism.\u201d In what way is this true? In what way is it a limited concept?<\/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\/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><em><strong>Claire McDaniel<\/strong> is a third year medical student at Georgetown University School of Medicine in Washington, DC, participating in the school\u2019s Literature and Medicine Track. Additionally, she is an MBA candidate at Georgetown University McDonough School of Business.<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><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\" \/><em><strong>Daniel Marchalik<\/strong> is a urologist at MedStar Washington Hospital Center in Washington, DC. He directs the <a href=\"https:\/\/som.georgetown.edu\/academics\/lamt\">Literature and Medicine Track<\/a> at the Georgetown University School of Medicine and writes a monthly column for <\/em><a href=\"http:\/\/www.georgetownliteratureandmedicine.com\/lancet-column\">The Lancet<\/a><em>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Doctor\u2019s Book Club Emma Donoghue\u2019s Room And I a smiling woman. \u00a0\u00a0 I am only thirty.\u00a0 And like the cat I have nine times to die. \u2014Sylvia Plath \u201cLady [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/12\/16\/claire-mcdaniel-and-daniel-marchalik-the-trauma-of-survival\/\">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-37990","post","type-post","status-publish","format-standard","hentry","category-literature-and-medicine"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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