TheMaterialismofBiologicalEncounters 135
form. And this has remained so to the present day. So, the question
whichthischapterneedstoaddressiswhatactuallyisrepresentedwhen
disease representation takes on narrative form, what social and cultural
work is performed when narrative is the format chosen for representing
epidemicdiseases.
This is the context where the "narrative medicine" project which I
briefly touched upon in the previous chapter is also situated. The
program by that name which originated at Columbia University
proceedsfromtheassumptionthat"careofthesickunfoldsinstories...
and it acknowledges the power of narrative to change the way care is
given and received" ("Overview" n. pag.). The groundwork for this
project was laid by Rita Charon, M.D., founder and director of the
program, in a 2001 article for theJournal of the American Medical
Associationand later in her bookNarrative Medicine: Honoring the
StoriesofIllness(2008). Here, she describes the principal purpose of a
narrativeapproachto medicineasbeing"basedon complextexts which
are shaped between doctor and patient, texts that encompass words,
silences, physical findings, pictures, measurements of substances in the
body, and appearances" (110). While some critics like Arthur Frank, to
whom I will turn in a moment, tend to focus on the individual patient
andhis/herdesirestotellthestoryofillnessexperiencesothatitcanbe
heard and appreciated by significant others such as family and friends,
Charon's narrative medicine puts the emphasis on the professional
relationships between patient and physician. The aim here is that of
countermanding the anonymous, machine-centered forms in which
medicineispracticedtoday.AsCharonputsit,thefunctionofstoriesin
the contexts of diagnosis and treatment is that of "bearing witness...
and helping patients navigate the moral channels of illness" (203). For
thepurposesofthishumanisticagenda,Charonandothersinthefieldof
narrativemedicineseemtoworkwithareferentiallyandformallynaïve
concept of narrative. In other words, narrative medicine focuses on
narrative content as more or less direct, not to say mimetic,
representation of a medical condition. It seems as if the interrrogations
of narrative in High Modernism, its postmodern deconstruction, have
never happened. Another blind spot is the arrangement of the story that
circulates between patient and doctor together with the ideological