This is a first installment in an exploratory series on storytelling in medicine, science, life. Drop a line if this interests you.
“We tell ourselves stories in order to live...”
Joan Didion’s quote is ubiquitous, shoehorned into Canva-quote boxes, plastered across the internet. Less often included is the context, from The White Album: “We look for the sermon in the suicide, for the social or moral lesson in the murder of five. We interpret what we see, select the most workable of the multiple choices. We live entirely, especially if we are writers, by the imposition of a narrative line upon disparate images, by the ‘ideas’ with which we have learned to freeze the shifting phantasmagoria which is our actual experience.”
Even less often included, is the last line of the essay: “writing has not yet helped me to see what it means.”
from Bookforum (rip, sob)
Didion, queen of the California Gothic, was the masterful storyteller of late American empire. She cut through the dazzle and power into a sordid, decadent heart. She observed from her elegant Hollywood home the grotesque cult murderers in the desert. She is not merely observing the necessity of story for survival, she is warning…or perhaps lamenting. We tell ourselves story to live – it is an act of desperation to make sense of the nonsensical. An act that often falls short.
Do you remember when everyone was a Storyteller? There was a 2010s Obama-era moment: when the Moth Story Hour reigned, the personal essay boomed, and Ted talks still enchanted. Sure, storytelling qua storytelling, is an old thing: the novel is entering its third century and Aristotle’s millenia-old description of 3-act dramatic structure still dominates tv sitcoms. There was, however, a specific quality to the meta-story ascendant in the 2010s, that perfused journalism and shaped our self-conception. Something that followed from the Chicken Soup for the Soul empire, This American Life, proliferation of memoir; with creative nonfiction as a genre and Narrative Medicine launching at Columbia.
from Reddit, the author’s 2012 vibes, when she endured the peplum reign of terror. Thanks for coming to my tedtalk.
My fixation on this era is biased: it is when I came of age in the sequestered world of medical training. I was finishing school, where medicine was about scientific research, literature, art, economics, policy—then moved deep into the bowels of hospitals. There, the only relevant intellectual work was what was immediately useful at 3am: sodium concentrations for fluid replacement, correlate EKG spikes to heart rhythms, and which homeless shelters would accept a complex discharge. There was no space for the imposition of narrative, or even ethical questions (why is there no housing for this patient?) Shortly after, I plunged into parenting, a world even more alienated from larger culture (an invisibility that is by design), that is even more consuming, repetitive, concrete.
My ability to navigate the mismatch between reality and expectations collapsed. We had had the game show president. Then pandemic, George Floyd’s murder and its reckoning; endless articles on the crumbling childcare infrastructure, a stark contrast between the workers who could stay home and those who could not, between science and its public reception, the brazen contempt for care work paired with the overturning of abortion protections. As the news came fast and hard, so did platitudes, insistent shaping of events into season-long arcs, from clueless middle-class narrators (the ones who stayed home, popping off on mask policy from homogenous neighborhoods).
Why did I think what I thought? Who made these stories? Is it for me to live or someone else? Why did I buy them? Do I need them? Why don’t they cohere? Coca cola and Bill Cosby, despite segregation and predation; Sunday church and Walter Cronkite, while Kissinger incited genocides. Be a good worker and sacrifice, while Fox News rouses the mobs against you. Not just double consciousness, but triple, quintuple, a fracturing, a self with no there there. I thought I was a Main Character in a meritocratic climb, doing the right thing. But here I am, another cog in a larger machine to whom things happened, another midlife crisis in late capitalism. The only thing worse than losing the story is cliché.
“The Son of Man” Renee Margritte, 1946
“Why is this happening? And: What can we do to change it?,” writes Paul Gleason in his review, “But Didion regarded answers to these questions with skepticism, bordering on contempt. At the heart of grand narratives about who we are and where we are heading, she saw self-deception in the face of meaningless disorder.”
Listen, I, like everyone, had been advised to work this all out in therapy—privately and medicalized (as long as I have insurance) (just kidding, nobody takes insurance anymore, bring cash) (if you can find time off or childcare). So here we are.
The Narrative Takeover of Society—Not everything is a story
Amid all this re-assembling of self- and grand narrative, I stumbled into Peter Brooks on the “Narrative Takeover of Society.” Brooks had been arguing since the 1970s that storytelling and narratives were the key to self and society. “This was not at all common wisdom at the time,” he notes, “but rather a kind of anthropological take on narrative largely inspired by French structural linguists, anthropologists, and literary theorists.”
narrative imposition, unknown source
Narrative interpretation, with the help of scholars like Brooks, (in parallel to Didion) spread from French academic theory to Anglo-American psychology, philosophy, medicine, and economics. And it was a compelling framework!
“Stories (unlike poems) can be translated,” says Brooks, “they can be transposed to other media, they can be summarized, they can be retold ‘in other words’ and yet still be recognizably the same story. Narrative, which the human child appears to discover before age three, is fundamental to our sense of reality and how it is ordered. We don’t simply arrange random facts into narratives; our sense of the way stories go together, how life is made meaningful as narrative, presides at our choice of facts as well, and the ways we present them. Our daily lives, our daydreams, our sense of self are all constructed as stories.”
This is convincing! Intuitive even (now). It is notable, though, that the attractive thing Brooks identifies about story is that it is an abstract-able form, it can be taken out of its local context and medium, propagated via mimesis, a standardization of parts, a formula that allows for industrial scale reproduction.
After seeing the finale of Game of Thrones, Professor Brooks was as hilariously irked as the rest of us. Specifically, he was startled by Tyrion Lannister’s declaration at the end of 8 seasons: “There's nothing in the world more powerful than a good story. Nothing can stop it. No enemy can defeat it.”
Yes, that is how it ends.
What Brooks saw as an illuminating understudied tool had become absurdly reductionist: “The claim that story brings you to world dominance seems by now so banal that it’s common wisdom. Narrative seems to have become accepted as the only form of knowledge and speech that regulates human affairs” Damn, HBO. “Gradually we learned that we were part of a larger movement to understand the uses of the narratives that surround us, from the everyday to the transcendent. But we never envisaged nor hoped for the kind of narrative takeover of reality we appear to be witnessing in the early 21st c, where even public civic discourse supposedly dedicated to reasoned analysis seems to have been taken hostage.”
Listen, there is something to the endurance of the Storytelling Moment. People tell stories. Myths, fairy tales, proverbs are ubiquitous. We steep our children in stories. Stories keep us warm around campfires, are shared over bread, channel our ancestors, comfort us after hard days with sitcoms. We use stories to connect, to challenge, show off, communicate, seduce, comfort, explain, sell, obscure all the corners of our lives. Storytelling taps into our deepest formative pleasures: the laps of grandmothers, the screen glow of Disney, shooting the shit with friends.
Stories organize the collective with a shared lexicon, but they also divide. This was recognized even before ideological news bubbles and the Tiktok algorithm. Brooks references the French philosopher Jean-François Lyotard from 1984 (also the year of the first TED conference): “in our postmodernist moment the ‘grand narratives’ that sustained whole societies, the narrative of emancipation especially, have lost their force. We are left with many mini-narratives everywhere, individual or collective and, in many cases, dominantly narcissistic and self-serving.”
(Did postmodernism predict the algorithm or inspire it? Were those grand narratives actually sustaining or did they suppress the truth of slavery, colonialism, exploitation to justify the powerful? This is a contention about the story of stories)
“First rule of postmodernism: you do not define postmodernism” - the internet
Brooks, like Didion, made his living with storytelling. But the professor and the craftswoman both recognize (more than most) the power and limitation of their tools. Perhaps what Brooks is getting at is the statistical adage “all models are wrong, some models are useful.” Storytelling is a simplified pattern that is illuminating, but it is not actually everything.
This “narrative Fundamentalism” –that everything is reducible to story—makes no sense. Story is not reality. Also, many things interpret reality that are not story: metaphor, concepts, argument, claim, pitch, proofs, description, riddles, theories, hypothesis, questions, incantations, spectacle, games, poems. These can overlap with or incorporate story but are not reducible to a shared sequence of connected events. Furthermore, the “Tyrion Lannister corollary” –that story is the the single most powerful thing—is also absurd. “History is written by victors,” is a thing because ok sure, maybe you have a good story about the crusades or liberation or the evils of communism, but usually that story is compelling because it’s paired with the other end of a weapon.
[the best novel that elegantly lays bare the relationship between force and the tellers of history is Naomi Alderman’s The Power]
Finally, at the risk of further revealing myself to be the pedant that I am, it is worth remembering story are not necessarily true. Sure, fiction can capture something true about the human experience, but it isn’t beholden to facts. Stories contrast with what Brooks called “reasoned analysis.” There is a Truth, that processes and disciplines like science and rigorous journalism attempt to access, in a way that is different from story. These approaches may use story to communicate findings or guide interpretation, but fundamentally their output and process are not story.
In fact these processes—science, law, journalism, philosophy—are messy, contentious, prone to revision. This can be confusing! During the pandemic, the public hungered for a version of familiar expertise: reassuring storytellers to guide us, a digestible TED talk. That is not the reality of a messy, conflicting, changing world of clinical science or public health crisis interventions. The seduction of simplicity, of charismatic leaders and their certainty, is what Hannah Arendt warns us about.
Shoe-horning Arendt into a Canva-quote box
As a science communicator, a clinician, and even as a mother, I spent much of the last several years saying: we don’t know what will happen, but we are here with you. It was not always well received, even (especially) to myself. The fundamental human discomfort with uncertainty, especially when stakes are high, that gap between reality and desire, is exploitable for people to advance their agenda, whatever that agenda. Cherry-picking data, undermining trustworthiness, outright fabrication are all what Arendt saw as fertile groundwork for authoritarianism, or what Socrates called sophistry.
Not everything is a story, nor should it be.
Not all stories are the same: Alas here we are at Joseph Campbell
Sure, ok, not everything is not a story, but stories are still powerful. Another hazardous blindspot besides “narrative fundamentalism,” is “narrative chauvinism”: there are many kinds of stories, yet often we only know one type of story.
I found that if you google “storytelling,” there is a consistent description, especially in screenwriting or marketing. Screenwriting sites repeat advice like: “A good story features a main character, or protagonist, who confronts a strong moral choice… As the story progresses, the hero confronts other characters and situations that support, negate, and challenge his ability to overcome the odds and achieve his goal.” A marketing site says “A good story is basic. Good guys, bad guys, triumph over adversity, morals and social good, happy endings...and maybe a little romance. The same storytelling basics apply to business brands.”
This is all describing a very specific story: the Hero’s Journey, formulated by Joseph Campbell in 1949, in the book Hero with a Thousand Faces. He claimed this structure as the monomyth, the single structure that underlies all myths. An ordinary person heeds the Call to Action, endures the Ordeal/Initiation, a nadir in the Third Act, and the Return, fundamentally altered. This is the story of Star Wars…and Harry Potter, Finding Nemo, and so many Disney, Pixar, and Marvel movies (conveniently, all within a single conglomerate). Films may resist or play with the monomyth, but it is taken for granted that this is the ur-format of story.
But who’s the bad guy?! - Frozen II takes on colonialism
Why is this the dominant form of our most influential/profitable story tellers? Campbell’s Hero’s Journey ran into criticism immediately from the folklore scholars, psychologists and anthropologists of the time. They pointed out many folktales do not conform to this structure at all. They accuse Campbell of cherry-picking examples to fit his thesis.
Even famous examples, like the Epic of Gilgamesh from 2700 BC, fall short. Screenwriter Sean Hood points out, “Gilgamesh is our hero, but he is also a tyrant, a rapist, an egomaniac and a coward in the face of death.” The original hero was an antihero all along. Or note the famed distance between the Disney version (Sleeping Beauty is reached by Prince Journey, a hero who awakens her with a kiss) and the dark af source material (sleeping beauty was raped while she slept, abandoned by the prince, awakened by the twins she birthed).
Gilgamesh: Tony Soprano’s a pussy, come at me bro
Campbell claiming that he is describing a “universal” structure is false. But—claiming that Hero’s Journey is universal was itself delicious storytelling. A story, whatever its truth, that would find a ready audience in the ascendant affluent post-war, Communist-wary American 1950s, open to the myth of individualism.
As Sara E. Bond and Joel Christen review in LARB, Campbell did more than his contemporaries to include non-European stories, but he categorically ignores everything that doesn’t fit his model, whatever its source. His work “plucked at will from global traditions and was definitely crafted for Western consumption.” They argue “Campbell sold the public on a vision of the individual hero, unfettered from community or history. He gave a postwar readership a seemingly timeless archetype for America’s unique brand of ‘rugged individualism.’” The Hero’s Journey became the monomyth of our time because of Campbell and a specific culture receptive to his version (readily amplified by Hollywood).
So we arrive to The Main Character Syndrome. Bored teens had been narrating their lives during lockdown on Tiktok as if they were the hero in a story. It was a creative way to cope with upturned lives, boredom and isolation. It spawned endless think pieces lambasting social media, Gen Z or Millennials for narcissistic excess (e.g.). But the teens were just riffing on the narcissism already baked into the concept of Main Character and decades of storytelling convention.
Bond and Christen: “The Monomyth encourages audiences to see themselves as protagonists in a great struggle and all others as either helping or hindering their journey. The use of the Monomyth is in a way nearly perfectly narcissistic. It invites audiences to focus on just one character, to see the world as serving the interests of one singular point of view. In the stories themselves, all other characters are helpers, objects or obstacles in a hero’s tale.”
The hero’s journey obscures everything outside the hero and the journey. It is a very narrow conception of hero: The hero is a colonist, a frontiersman, a savior. A hero is Odysseus, not Penelope waiting at home, nor the suitors in his way.
There are some well-trod consequences to this, specifically the Savior Narrative
Decades of film critics have pointed out that the Hero’s Journey is a seductive brew for the Savior Narrative, which strips complex social phenomena into individualistic drama. Rather than a complex adventure like Gilgamesh, a hero saves a damsel-in-distress or the community-in-distress.
The virtuostic Mahershala Ali as Don Shirley in The Green Book
In this excellent analysis of “allies” in film by F.D Signifer, he examines the savior trope in 2019 Oscar Best Picture The Green Book. Savior movies cannot capture structural racism, white supremacy or colonialism—their focus is foremost the benevolent hero. Such big productions center White audiences (even if the audience is heterogenous). The only way to tell stories set anywhere in America’s vast history of racism (say) using the Hero’s Journey is then through the target audience’s proxy—the White Savior. F.D Signifier’s summary (italics are mine):
“This is actually…what makes this trope so powerful and so hard to get rid of because it makes for good stories. What most people see when they see these characters or films is: allies, usually White people, putting it all on the line, risking their livelihood, their social status and their interpersonal relationships and their reputation for the sake of marginalized people. In isolation this sounds great, right? This sounds like exactly what is needed for marginalized communities.
“However, the main problem with saviors, is that for the most part, their benevolent actions are almost never really about the communities that they are trying to help. In reality these relationships are almost always paternalistic and one-sided and the pain and suffering of the marginalized groups is used to give meaning to the saviors life, as opposed to improving the person or party they are supposed to save…This is why the savior movie is so bad but so effective: they’re entertaining movies because they provide viewers with excellently written scripts and character arcs that are engaging and they always end in this cathartic moment of clarity.
“But this is a big part of the problem because racial justice and equity is not something that will be solved by bombastic acts of selflessness or big moments of worthy of a movie. The problem is that most savior movies and thus the characters only engage with the realities of the people they’re saving just enough to create drama for the character and thus the audience. They never fully engage with the reality of how these problems come into play or why they keep happening. The movies are about the savior going through an arc and learning often through vicarious struggle of the people with the most at stake.”
Now, what happens to the targets of the savior, those made to play damsels-in-distresss or masses to be saved? There is a dehumanizing price to becoming the Empathetic Victim awaiting salvation, stripped of being a Main Character in one’s own reality. Yasmin Naire addresses this in her essay “The Perils of Trauma Feminism” starts with this blazing line: “For too long, women of color and other marginalized people have vomited out their tales of trauma and woe. The time has come to stop telling our stories, to stop asking for empathy, and simply demand systemic changes.”
Naire is reviewing two books: Rafia Zakaria’s Against White Feminism: Notes on Disruption and Kyla Schuller’s The Trouble with White Women: A Counterhistory of Feminism. The first author, Zakaria, is a Pakistan-born human rights lawyer and activist. Zakaria opens her book with an anecdote. She realizes too late that she had been invited to a fundraiser by the organizers (predominantly White, global North feminists) not to speak from her deep political expertise, but instead to perform as a silent, token Pakistani woman. She is admonished for not wearing “traditional” clothing and asked to sell totchkas for the event. In the rest of her book, Zakaria provides piercing analysis of what she calls the colonialist NGO-driven “White Savior Industrial Complex” and its deeply harmful impact on global human rights. Like the savior in films, the IRL global development saviors also create a one-sided relationship that erases those who they purport to help, relegating whole populations to play the role of the damsel-in-distress for the savior to shine upon. Such organizations heap interventions that are unhelpful and unasked for, focused on their own priorities and egos, ignoring both what communities actually want and deeper structural injustices.
Naire has even deeper questions about the way Zakaria makes her case, the way her “reasoned analysis” is interwoven with personal anecdotes like that at the fundraiser. “Why is it that a brown Pakistani woman with years of analytic experience as a lawyer and activist must first reveal to the reader her supposedly authentic, private self, her trauma, and her life as a domestic violence survivor? Is such a demand made of white authors?”
Was this another way Zakaria is performing vulnerability, as she was asked to perform her tokenized otherness at the fundraiser? I have not read Zakaria’s book so I cannot say how the anecdotes relate to the analysis and how they are used. Journalists are often encouraged to use storytelling leads and first-person narratives in their reporting, as are politicians in their advocacy. That is its own expansive topic. Naire is asking why Zakaria, her editors and publishers thought this might be effective and how it impacts the book’s argument.
Specifically, Naire contrasts this with Schuller’s book, which has no personal anecdotes from the author. Instead, the structure of Schuller’s book is to pair stories: one of a famous White cisgendered feminist to contrast with a “forgotten” feminist with a marginalized identity. This book, unlike Zakaria’s, is completely devoid of critique of power structures. The simplistic binaries “present the lives of the women she writes about as easily digestible Lessons for Today’s Feminists (a TED Talk title if ever there was one) and herself as the Grand Teller of Tales.” This becomes an act of erasure that replicates the saviorism – Schuller centers the stories of trauma for her “forgotten” feminist and erases their significant expertise, complexity and agency.
For example, Schuller’s “counterhistory” of Zitkala-Ša, a Yankton Dakota writer, centers memories of childhood and the grievous state-sponsored separation from her mother. “Schuller is drawing from Zitkala-Ša’s various accounts of her life, but she is also crafting a story that relies on the stereotypical image of the Native American child running free in nature. Zitkala-Ša may have been that, but she was also possessed of unconventional views and practices on and around marriage, for instance. She studied violin at the New England Conservatory of Music and even wrote an opera, the first by a Native American. She was a woman with multiple talents and a fiery and contentious spirit, but all that is made secondary to her essentialized identity and, worse, Schuller renders her a forgotten woman.” Zitkala-Ša is not at all forgotten, she was celebrated by the National Women’s History Project, had a Google doodle, and there is both a park in Arlington County and crater on Venus named after her.
Why this erasure? Naire points out multiple examples of Schuller’s flattening her POC, global South and trans feminists to serve the purpose of contrasting. Schuller is portraying individuals in a way that they perform their marginality, their trauma, and sadness to make her case, as Zakaria was asked to do at the fundraiser. Schuller also excludes grappling with how the variables of gender, race, class, education, nationality, disability complicate the binary story of oppressor and oppressed (Heros and Victims require Bad Guys, not intersectional analysis).
Zitkala-Ša, the multifaceted Sioux activist, writer, violinist and composer, from
So why does this matter
None of this is new, despite the fact that we got to 2023 with a whole ass second Avatar movie. Campbell and Hollywood did not invent the White savior, it has been the official front of multiple centuries of European imperialism. But our popular stories continue to repeat it, upholding a marginalizing status quo.
So can we correct for the narrowness of the Hero’s Journey by expanding representation? Do we just need to fix who gets to tell the stories, from what point of view, for what audience? There was certainly a lot of post-2020 Discourse in academia, Hollywood, publishing, etc. And a whole lot of it was performative, minimal, tokenized. But if done in earnest, increasing representation, especially in the decision-making, in popular storytelling could be powerful.
If we did that, perhaps we would even have better stories, instead of the same boring, repetitive formulas. We won’t get something like the 2015 movie Stonewall, erasing the true stories of POC and genderqueer community (replaced with a fictional, palatable proxy). We may instead get at the much longer, richer oral history of gay liberation. Again F.D. Salinger on Green Book: “We spend more time with Italian tough guy Frank, a stock character we’ve seen in a million other movies, versus Don Shirley, a queer Black musical genius with 2 PhD’s, a litany of accolades—like when I found out this dude’s real story, I could not believe that they didn’t make the movie just about him. He literally takes a back seat to his own story.”
Stonewall Inn, July 2, 1969
But I really suspect that this will not be enough. First, there is a whole lot of “intuition” to unlearn in a century+ legacy of storytelling culture. “The hero with a thousand faces turns out to have a depressingly constant appearance,” say Bond and Christen. “He projects a toxically masculine, heteronormative point of view that often marginalizes other voices and bodies. Despite some heroes of color in recent years, Campbell’s narrative offspring have generally been white and male. When we make heroes of women, we often sidestep or mute their sexuality and capacity to give birth (as in the case of Buffy the Vampire Slayer) and render them essentially masculine.”
This isn’t something that can be rectified by more diverse casting, as the narrowness is part of the structure. “When we cast Black stars as classic or new heroes, audience rage and rejection [e.g.] show that racism is a feature and not a bug of the heroic game…Campbell’s hero is ruggedly individual; it uses weaker people as instruments; and it has no room for collective action, for families, or for bodies that fail to conform: the aged, the disabled, the sick.”
Moses Ingram as Reva Sevander in the new Obi-Wan series. She is among many POC cast in Star Wars franchise that face relentless online backlash for not being a white dude. George Lucas is credited for popularizing Joseph Campbell, especially among screenwriters.
Even if you get educate internet bros over time to stop losing their shit, there’s something fundamentally limiting to the kind of story telling the Hero’s Journey is. I am not sure you can correct for it. In 1990, the psychotherapist Maureen Murdock described the Heroine’s Journey to better approximate story telling in women’s lives. Campbell himself explicitly excluded women as heroes, they could be the target (Sleeping Beauty) or the obstacle (the evil queen). Murdock described woman protagonists as more likely to take an internal journey rather than external. This binary already sucks, limiting both the emotional-spiritual quests of men and excluding physical, external adventures for women. Instead of conquest, the heroine starts in a place of imbalance and seeks to achieve balance. Which ok! I don’t know. Arguably this can better capture stories conventionally marketed to women, like romantic comedies. In these stories, the heroine has already achieved “masculine” conquest in the world, which may even be the source of her imbalance, which is ultimately restored by…a man. Like, sure this is maybe a part of some human existence, but it still leaves out a lot!
Maria Tatar is a folklorist who more recently writes about the Heroine’s Journey as a type of testimony. She acknowledges that the story of conflict and conquest fails women’s experience. Instead, “Telling your story, revealing injuries inflicted and harm done—has come to be invested with unprecedented weight.” Again, this is an important part of storytelling—but we are back to Yasmin Naire’s critique that women, especially of color, are narrowly constrained to stories of victimness.
If the dominant storytelling form only can make sense of Saviors, Victims and Villains, what is lost?
What Story can capture Care?
I think the biggest issue with the Campbellian narrative and its variations is that it cannot capture care work. Care, maintenance, repair—none of this is something heroes do or heroines can restore. This kind of activity is repetitive, it aims to keep things the same or cyclical. If we can only conceive of story as transformation, discovery, conquest, production, then this type of activity is not legible in storytelling. And that matters when it comes to perceiving what work is valued and respected. In an interview the late, great anthropologist David Graeber discussed our narrow conception of work (which I think is related to both our stories and material power):
“We think of work primarily as making things—each sector is defined by its ‘productivity,’ even real estate!—when in fact, even a moment’s reflection should show that most work isn’t making anything. It’s cleaning and polishing, watching and tending to, helping and nurturing and fixing and otherwise taking care of things. You make a cup once. You wash it a thousand times. This is what most working-class work has always been too—there were always more nannies and bootblacks and gardeners and chimneysweeps and sex workers and dustmen and scullery maids and so on that factory workers. And yes, even transit workers, who might seem to have nothing to do now that the ticket booths have been automated, are really there in case children get lost, or someone’s sick, or to talk down some drunk guy who’s bothering people.”
In her book How to Do Nothing, the artist Jenny Odell also talks about how the work of maintenance is often rendered as “nothing,” as unseen. Mierle Laderman Ukeles is an the artist who wrote the Maintenance Manifesto. One of Ukeles pieces is Touch Sanitation, in which she personally shook the hands and thanked the 5800 sanitation men who worked in New York City, as well as following and documenting their work. Ukeles cites her inspiration in motherhood: “Being a mother entails an enormous amount of repetitive tasks. I became a maintenance worker. I felt completely abandoned by my culture because it didn’t have a way to incorporate sustaining work.”
Ukeles, “Wash: Washing, Tracks, Maintenance—Outside and Inside,” July 22, 1973
There are real consequences in rendering care work invisible in stories. Take a narrow example, in my world of medicine. What is lost when healthcare workers are heroes? Then only individual heroic effort with individual gripping dramatics are legible. Not the repetitive carework/maintenance that cumulatively saves far more lives, bears witness, prevents the drama: primary care, nursing, pharmacists, lab techs, public health prevention, antibiotic stewardship. What happens when workers do not comply with sacrificing hero role, and instead ask for hazard pay, adequate protective gear, for rest and support—as did the medical residents of NYU Langone medical center? (They were shamed by the CEO and subsequently unionized). What happens when patients do not play compliant damsels-in-distress for the Hero’s efforts, advocate for themselves, are “difficult”? What happens when healthcare workers and patients both see themselves as antagonists in opposing Main Character arcs? What happens when yes, workers and patients have a messy intersection of class, race, gender, ability and weaponize it against each other when feeling vulnerable?
Artists like Ukeles, nonfiction writers like Odell, and anthropologists like Graeber can communicate this. Can story capture this huge reality of human life that is care work? In medicine, for example, subdiscipline like narrative medicine or medical humanities target burnout or empathy with storytelling, but cannot grapple with the systemic issues like squeezed workers doing more with less, or patients’ lack of access to care. We implore and train students in empathy but do not discuss the resources that go into supporting empathy—time, adequate pay, space to perceive their truth.
Didion writes of the late 1960s as “a time when I began to doubt the premises of all the stories I had ever told myself…I was supposed to have a script, and had mislaid it. I was supposed to hear cues, and no longer did. I was meant to know the plot, but all I knew was what I saw: flash pictures in variable sequence, images with no ‘meaning’ beyond their temporary arrangement, not a movie but a cutting room experience.”
Something about story leaves huge scraps of our reality on the cutting room floor and I am uncertain if it is capable of otherwise. There has been exciting work in speculative fiction as a way to imagine a more viable future. Can story be made as expansive as this future?
Links, News, Notes
(1) Book Club: I’ll be reading Peter Brooks new book on the topic Seduced by Story: the Use and Abuse of Narrative, if you want to join forces. I will also be exploring speculative fiction as activism, via adrienne maree brown; and implications for medicine and carework, reading recs welcome!
(2) Me in the press: I got to talk to a reporter on what it takes to support pregnant workers in Quartz
(3) Do you want me to write, speak, teach, analyze stuff for you? lmk, I am especially interested in the intersections of cultural criticism, carework and healthcare.