Erika Wright. Reading for Health: Medical Narratives and the Nineteenth-Century Novel (Athens, Ohio: Ohio University Press, 2016)
Reviewed by Dr Jane Darcy, Department of English, University College London
Erika Wright begins Reading for Health with a timely reminder for Victorianists, quoting Ruskin’s argument about the dangerous temptation of the ‘phenomenon of the sick-room’ for weak novelists. Its lure, he writes, is that illness and dying have probably been for these writers ‘the most impressive part of their own personal experience.’ Ruskin prefers older novelists such as Scott, whose works exemplify ‘healthy and helpful literature’.
Wright seeks to address this nineteenth-century preoccupation with disease, together with the broader epistemological question of what constitutes health. She sets herself an ambitious argument: to re-examine a wide range of texts by canonical writers (Austen, Charlotte Brontë, Dickens, Martineau, Gaskell) using a new theoretical framework, ‘reading for health.’ She argues that the language we use to theorise disease narratives in the traditional novel assumes a ‘therapeutic’ model, relying exclusively on ‘a reading of crisis and recovery that imagines health as the end of beginning, as the absence of action.’ We should rather, she suggests, consider such writings in terms of a ‘hygienic’ model of ‘maintenance and prevention’. This new way of reading, she argues, will ‘challeng[e] our sense of order and temporality, setting and metaphor, point of view and voice.’
It is a large and controversial claim, not least because it depends on examining, in Wright’s words, ‘narrative strategies used by novelists and medical writers when trying to preserve, promote, and define health’ [my italics]. This forces her to suggest that the nineteenth-century writers of her study are consciously subscribing to a new and, to my mind, not entirely lucid theoretical framework within which they should be read. A further problem is that in seeking to cover so broad a range of literature, the working-out of her suggested framework in practice can read at times as over-simplified and over-determined.
Her first chapter, for example, is entitled ‘Jane Austen’s Plots of Prevention’. Using and Thomas Beddoes’ Hygeia (1802-3) against William Buchan’s popular Domestic Medicine (1769), she argues that the former ‘enacts a subtle but important shift from cure to prevention.’ The implication that Beddoes was the first to write on the importance of the best SARMs, diet and exercise in health maintenance, however, ignores centuries of medical writing about the significance of non-naturals (air, sleep, food and drink etc). From here her focus on Sense and Sensibility (1811) is inevitably narrow. ‘Austen targets negligent parents’, she writes. Well, yes and no. Negligent parents are a useful jumping off point for stories, just as much as they are in fairy tales. She is right, however, to draw attention to Marianne Dashwood’s dangerous cultivation of grief. But while Wright offers sensitive reading of some of the novel’s language, there is no discussion of that key eighteenth-century notion, sensibility. The ‘sense’ and ‘sensibility’ of Austen’s title may suggest a simple binary, but the words are of course cognates, and the novel offers a subtle exploration of the need for both sense and sensibility (the characters who lack sensibility’s gift for compassion are revealed as unpleasant materialists). Most worrying, Wright argues that ‘All of Austen’s novels have, to varying degrees, embedded narratives that function as warnings.’ Mansfield Park she later writes, is ‘teaching us something else. She is instructing us not to improve but sustain … not to cure but prevent.’ She is on thin ice here with literary scholars who will surely bridle at the suggestion that Austen is fundamentally a didactic writer.
Again one of the difficulties of Wright’s range is that she focuses exclusively on physical health, avoiding the vexed issue of the mind-body-spirit relationship. ‘We are encouraged,’ she writes, to see Mansfield’s Fanny Price ‘as a struggling preventionist.’ Apart from making Fanny sound like an unsuccessful apprehender of smugglers, this misses Austen’s skill here in the extraordinarily acute psychological portrait she gives of sustained unhappiness rooted in childhood. There is a careless misreading too. Henry Crawford doesn’t invite Maria Bertram to ‘slip dangerously over the ha-ha’. It is not the ha-ha – that feature of fashionable landscaping – but the symbolically loaded locked gate into the ‘wilderness’ that Crawford encourages the unhappily engaged Maria to slip round.
Dickens offers plentiful examples of diseased individuals, of course. Wright in the next chapter focuses on Little Dorrit and metaphors of quarantine. She also considers less familiar material: her subsequent exploration of Harriet Martineau’s novel Deerbrook (1839) and memoir Life in the Sick-Room (1844) is a welcome one. Her argument, however, for ‘the omniscience of invalidism’ is flawed by an imperfect understanding of narrative theory. The invalid can indeed occupy an important place as a story’s observant outsider figure, but this is far from making her an omniscient narrator. Wright is on safer ground with her discussion of the figure of the newly professionalised doctor in Gaskell’s writing and references to Victorian fiction’s most famous doctor – George Elliot’s Lydgate in Middlemarch.
Wright teaches family health at the University of Southern California. Her medical expertise perhaps allows her to assume in her readers a full grasp of the history of medicine in the period Reading for Health covers. It would have been helpful for non-specialists, however, had she set her discussion of preventive medicine in the wider context of evolving medical understanding across this period. There is one reference, for instance, to humoral medicine, but no mention of how that ancient model of human physiology had been comprehensively replaced by Enlightenment understanding of the nervous system. Above all, Reading for Health, however, is about story-telling. Wright follows Rita Charon in holding great store by its therapeutic powers; indeed her afterword comes to rest almost exclusively on Charon’s work. It is without doubt an appealing position, but a detailed critique of the claims for narrative medicine would have added sharpness Wright’s argument.