136 RüdigerKunow
implications of such an arrangement. These complex questions do not
seemtopreoccupythefieldverymuch.^89
I would suggest therefore that as the field of narrative medicine
expands, it might profit very much from the work of Hayden White,
Paul Ricoeur, David Carr, among others. The methodological and
ideological differences of their positions aside, together they have
demonstrated that "narrative is not a neutral discursive form" but one
that "entails ontological and epistemic choices with distinct ideological
and even specifically political implications" which addresses the
temporality of human existence and its impact on self and identity
(White,Contentix, xi; Ricoeur,Time and Narrative1: 79-83). In the
perspective opened by the protagonists of the "narrative turn" of the
1980s, endowing cognitively discordant events like epidemics with a
meaning, however contrived, is an operation that is almost inescapably
appropriative in nature—making sense of something that seems to
negate sense. This means that the usual approach chosen by cultural
critique, namely to determine whether the representations of mass
disease reflect adequately the differential distribution of power and life
chances at that given moment, is not sufficient here. It needs to be
amplifiedbyananalyticswhichonemightcallstructural(withoutbeing
structuralist) and which interrogates the organizational layouts of
disease narratives and lays bare the epistemic choices guiding them. To
begin with, narratives stabilize the "discordant concordance" (Ricoeur,
Time and Narrative1: 42) produced by the intervention of epidemic
diseases.Thestabilizationachievedbytherespectivenarrativizationofa
catastrophic medical event can of course take many forms, but not as
many as one might expect. Paradoxically as it may seem, even though
mass diseases are "big news," their representations often are not. Only
very rarely do narratives about medical crises reflect their exceptional
statusintheirform.True,atcertainhistoricaljunctures,especiallyatthe
beginning of EuroAmerican modernity, epidemic diseases have
catalyzedthoseimportantinnovationsinstory-tellingthatwererecorded
(^89) Concerning the referential and formal naivité of such an approach, Karla
Holloway raises an objection that carries great weight, especially for a
materialist cultural critique: "narrative medicine's... objectification of a
patient's story fails to give constitutive weight to the cultural and historical
contextofthatexperience"(xvii).