In Sophocles’s Oedipus Rex, a plague ravages Thebes as divine punishment for an unpunished crime—the murder of the eponymous king’s predecessor.

Two and a half millennia later, illness remains a metaphor in Robert Icke’s buzzy retelling of the Freud-genic tragedy, now on Broadway after a West End run last fall. Susan Sontag, who cautioned that portraying disease as a symbol of social decay can stigmatize patients, would likely disapprove. (Perhaps, apotheosized on Mount Olympus, she cursed Lesley Manville, who plays Oedipus’s wife and—spoiler alert—mother Jocasta, with an illness; Denise Cormier filled in when I saw the production.)

At curtain rise, on a stage-wide video screen, Oedipus (a charismatic and commanding Mark Strong)—reimagined as a politician on the cusp of electoral victory—tells a throng of eager reporters and supporters: “The civic body is ill. And that isn’t… chemicals in lakes—it’s us; we’re sick… The water got poisoned, and we got used to the taste.”

Economic inequality and xenophobia abound, as do rumors surrounding the death of Laius, the former ruler and Jocasta’s former husband. And so Oedipus promises to open an investigation. This off-script announcement exasperates his campaign manager and brother-in-law Creon (John Carroll Lynch), but Oedipus is steadfast in determining what happened. In Icke’s adaptation, probing the metaphorical plague is less a divine mandate and more a political act of narrative control. And, as Oedipus doubles down on transparency, what he uncovers about a fateful crossroads unravels his sense of self.

The truth of Oedipus’s identity is old news for most viewers, and we know that he is going to win. Yet Hildegard Bechtler’s set—an office with a hodgepodge of furniture, TV screens, and a clock counting down until the release of the election results—cultivates a palpable sense of uncertainty.

The successful set embodies Mikhail Bakhtin’s notion of the chronotope, or the inextricable fusion of time and space in literature. The literary theorist cites the road as one example of a chronotope. Social divisions such as class, nationality, and religion collapse, and time unfolds unpredictably through chance encounters rather than routine.

In Oedipus, as election night comes to a close, movers strip the campaign headquarters bare, transforming the space into a chronotope that mirrors how our hero is stripped of everything he once believed about himself. The ticking clock heightens the temporal pressure, heralding the landslide victory while portending the inexorable revelation that Oedipus did what every little boy dreams: killed Dad and married Mom.

Bakhtin also argues that chronotopes allow abstract ideas about philosophy, society, and cause and effect—say, the limits of free will and the illusion of power—to “take on flesh and blood.” Oedipus highlights the vital role chronotopes play in narratives, even if the coda transports us to the start of the campaign, undoing everything.

And even if much of the script doesn’t sparkle. For instance, Jocasta telling Oedipus “You’ll be the death of me” and calling him “baby boy” feels heavy-handed. Modern updates to Oedipus’s family dynamic have mixed success. The parts of adoptive mother Merope (Anne Reid) and daughter Antigone (Olivia Reis) are a welcome addition and expansion, respectively, bringing understated humor and wisdom. On the other hand, Icke casts one of Oedipus’s sons, Polyneices (James Wilbraham), as gay and the other, Eteocles (Jordan Scowen), as unfaithful. This framing raises an uneasy question: Are we meant to read queerness as a moral transgression on par with infidelity or incest? (Sontag, who was bisexual, probably wouldn’t be thrilled by this either.)

Icke’s greatest writing, however, is Jocasta’s hesitatingly revealed, harrowing backstory: She was only 13 when Laius raped her and forced her to abandon the resulting child. Jocasta recalls the delivery in visceral detail: the fluorescent lights of the hospital, the newborn Oedipus’s mucus-slick body. But she is denied the opportunity to share her traumatic account on her own terms; in his relentless quest for answers, Oedipus forces her long-hidden narrative, precipitating the discovery of their true relationship.

Narrative medicine emphasizes that this kind of listening can be destructive to both patient and listener. Indeed, Jocasta kills herself, and Oedipus gouges out his eyes with her heels. (Not very healing.)

Some narrative humility would have served Oedipus well. As Sayantani DasGupta writes, “narrative humility acknowledges that our patients’ stories are not objects that we can comprehend or master, but rather dynamic entities that we can approach and engage with, while simultaneously… engaging in constant self-evaluation and self-critique about issues such as our own role in the story.” With greater narrative humility, Oedipus might have better seen Jocasta—and himself.

Icke’s Oedipus teaches us that listening must be humble, ethical, and emotionally attuned; had it been so, perhaps the drama’s seemingly inevitable ending could have been averted.

Oedipus, through Feb. 8 at Studio 54 in New York; oedipustheplay.com.

Bakhtin, Mikhail. “Forms of Time and of the Chronotope in the Novel: Notes toward a Historical Poetics.” The Dialogic Imagination: Four Essays by M.M. Bakhtin, edited by Michael Holquist, translated by Caryl Emerson and Michael Holquist, University of Texas Press, 1981, pp. 84-258.

DasGupta, Sayantani. “Narrative Humility.” The Lancet, vol. 371, no. 9617, 2008, pp. 980-981. thelancet.com/journals/lancet/article/PIIS0140-6736%2808%2960440-7/fulltext

Web image from Sonia Friedman Productions Limited.

The latter decision unarguably constitutes a significant setback in the struggle for reproductive rights for American women, but the history of access to abortion—and a sense of what the future might hold—may best be understood by taking the long view, across cultures. In Pushback: The 2,500-Year Fight to Thwart Women by Restricting Abortion, historian Mary Fissell does just that. Starting with the story of an enslaved woman in ancient Greece who becomes pregnant after being hired out as a prostitute by her enslaver, Fissell presents a series of case studies. Each one illustrates how women continued to have abortions through the centuries despite changing mores, laws, the influence of the church, and the irregular availability of experienced or qualified providers. The stories also demonstrate a pattern: as women gained more social and economic freedoms, the laws governing abortion became more restrictive, with the pendulum eventually swinging back in the opposite direction to a more liberal stance on abortion.

The enslaved woman in ancient Greece would likely have faced no moral sanction for seeking an abortion—her value lies in her continued availability as a sex worker, and, in her case, a singer. Documents suggest that women in her position would have had the knowledge to end her pregnancy, most likely with an herbal abortifacient, though squatting, jumping and sneezing were also recommended methods of preventing pregnancy immediately after sex. In ancient Rome, the focus on controlling fertility was somewhat different; Roman women had greater freedoms than their Greek sisters, raising concerns about adultery, which Augustus declared as a criminal offense. With  a focus on increasing the number of upper-class Romans who would rule the growing empire, controlling the fertility of elite married women was one way to achieve this end.

Leaving antiquity behind, Fissell nimbly guides us through the Middle Ages. In an era where Christianity is on the rise, and the issue of ensoulment is linked to the experience of quickening (when the pregnant woman first feels the fetus moving), the story of Brigid of Kildare was recorded. Brigid, a holy woman whose historical existence cannot be confirmed, was said to have helped a young woman miraculously end her unwanted pregnancy (a subsequent miracle attributed to Brigid helped a woman preserve her chastity).  The Church’s codified position on abortion was still more than 500 years away and for many of these early Christians, discussions of ensoulment notwithstanding, concerns around abortion as a means of covering up illicit sex appear to have weighed more heavily than any harm to the fetus.

In early modern Europe, in some parts of the continent, abortion had become a capital crime punishable by execution, a development that reflected “a larger cultural shift that sought to control female sexuality in the interests of Church and state.”  The story of Anna Harding who went on trial in 1618 was a case in point. Against the background of a witchcraft panic, Harding  admitted to providing both married and unmarried women with herbal and floral preparations to end their pregnancies. A “confession” under torture to having consorted with a demon led to Harding’s conviction and being burned at the stake. 

Indeed, herbal preparations to end unwanted pregnancies were common to societies as disparate as enslaved women in the Caribbean, who used abortions as an act of resistance, to Victorian women of all classes who sought abortions for many of the same reasons as women do today. Use of one of the herbs best known to induce abortion, pennyroyal, persisted up through the early 20^th century, although not without risk to the pregnant woman.

By this time, the idea that life begins at conception had gained a greater hold in the United States. Hugh Hodge, a professor of medicine at the University of Pennsylvania, argued this “scientifically-based” premise as early as 1839, while the Pope’s 1869 declaration that life begins at conception would have been presented as divine revelation, though Fissell posits that concern on the part of European monarchs in Catholic countries worrying about depopulation and “degeneration” may well have influenced the pronouncement.

The story of Beatrice J, a Baltimore woman, who safely achieved two self-managed abortions in the 1940s through the aid of a catheter and ergot pills to induce uterine contractions, serves as a more modern example of women who had ended a pregnancy going on to administer abortions to others. In Beatrice’s case, after her trusted pharmacist helped set her up as an abortion provider, an undercover police operation exposed her practice. A trial followed, but charges were ultimately dismissed by a progressive judge on the basis that the “client”  who visited Beatrice was not actually pregnant.

In addition, Fissell points out this was not an isolated example by any means. Even in the most restrictive settings and time periods, there appears to have been a fair amount of  tacit acceptance.  In the U.S., for example, “Physicians performed legal abortions for a variety of indications, and the rest, so-called criminal abortions, went largely unremarked. In the 1920s and ‘30s, abortion providers were rarely prosecuted, whether physicians or not, and the former were at risk only if a woman died.” Moreover, once antibiotics and blood transfusions became available in the 1930s and 1940s, the morbidity and mortality associated with these procedures would have been reduced.

The presence of abortion providers who practiced under the radar persisted throughout the ‘30s and early ‘40s, albeit with some providers using their own judgement as to who was morally deserving of their covert services.  But the 1940s and 1950s also brought a more punitive attitude toward abortion in the United States. With an increasing number of arrests of providers administering safe abortions, dangerous practices became more widespread, as did abuses by practitioners, including sexual assault on clients. In turn, these tragic stories led to the underground movement of women and their allies who supported those in need, including the Jane Collective in Chicago, a group of women who risked criminal prosecution to help others obtain safe abortions. 

While the individual stories of women seeking abortions constitute the throughline of Pushback, Fissell consistently addresses the broader factors that affected access in each of the societies she describes, including eugenics, racism, nativism, and concerns about fidelity and heredity. Enslavement and labor demands, the appropriation by physicians in the 19^th century of care that was formerly the domain of midwives, and superstitions linking women’s fertility to fertility of livestock and crops, also come under scrutiny, as does the relatively recent shift of emphasis from the importance of the life of the mother to that of the fetus.

Readers might also consider the role of medical advances as factors that have altered our understanding of pregnancy, development of the fetus, and access to abortion. Among them was the development of simple urine tests that eliminate the uncertainty surrounding pregnancy, a means of confirmation light-years away from those early societies where pregnancy was confirmed by quickening. Sophisticated imaging of the fetus via ultrasound not only confirms pregnancy at an early stage, but packs an emotional punch. Moreover, the availability of medication through pharmacies and online sources for self-managed abortions, while under threat, has created a new landscape for pregnant women. This last means of obtaining an abortion, though formulated in a laboratory, suggests a new iteration of the herbal abortifacients used by so many generations past.

Pushback succeeds at being both highly readable and meticulously researched—the volume includes an extensive list of notes and references for each chapter. Fissell, who is the Inaugural J. Mario Molina Professor in the History of Medicine at Johns Hopkins University, also writes the Substack A is for Abortion: Snapshots from the Past. As a pre-modern historian of the 17^th century, she particularly enjoys the kind of “detective work” that accompanies that study. But she was also pleasantly surprised by how much she enjoyed researching and writing on the modern period, where sources are more readily available, including data she found through Ancestry.com.

Fissell completed her manuscript before the start of the second Trump administration and aside from allusions to Roe v. Wade and Dobbs v. Jackson, Pushback does not explore the ways in which abortion became a flashpoint in our most recent national elections. (A description of politically motivated anti-vice campaigns that targeted abortion practitioners and pregnant women in the late 1940s and 1950s is included in the chapter dealing with that time period.)

But in a discussion with this writer, Fissell weighed in on current data that shows more American women than ever are having abortions despite the 2022 Dobbs ruling. “Restriction has an impact and makes abortion much more difficult and dangerous to access,” she said. “But it never stamps it out.” She also cited data that suggests roughly 66% of Americans think abortion is a decision that should be made between a woman and her doctor.  

Interestingly, Fissell did wonder at the onset of her research for Pushback whether she might change her mind on the issue. In the end, she describes holding the same views as when she started.  “Given that abortion was often shameful and secret if not [completely] illegal, I was amazed by how much I was able find out.” Her appreciation for insights from the reproductive justice movement deepened considerably as well, as it informed her understanding of women in earlier societies and the use of the term “choice,” then and now, for women in untenable circumstances.

“[Choice is] something a white woman with money can afford to have,” Fissell said. “Choice [does not apply to] a struggling waitress in a small Southern town who was raped and has two kids at home, and her wages won’t even cover their care…Casting the decision as choice means we don’t understand many women’s experiences.”     

Pushback by Mary Fissell was published by Seal Press (2025).
Web image by Medhum.org.

Literature mirrors the general culture. There has been a recent explosion of books in which AI is the central plot device moving the narrative forward to endings that range from a utopian fulfillment of human destiny to the catastrophic collapse of civilization and the annihilation of humankind. But AI infiltrated the literary space several decades ago. Philip Dick imagined a world in Do Androids Dream of Electric Sheep? where cyborgs were being hunted down because of fear that they might take over the world. In 2001: A Space Odyssey by Arthur C. Clarke, a robot named Hal murders nearly all the crew of a spaceship on a planetary mission because of a programming error. 

Speak by Louisa Hall is more recent addition to the AI library. But it was published several years before large language models became a routine tool to plan a vacation or write a letter of recommendation. Is it still worth reading in 2025? 

The novel is a composite narrative centered around five interwoven stories spanning the time period from 1663 to 2040. In the first narrative, a young Puritan girl who finds herself in an unwanted marriage, records her thoughts in a diary that she is writing on a treacherous ocean voyage to America. Fast forward to the 20^th century and we meet Alan Turing who is writing letters to the mother of young man to whom he was emotionally attached and who died prematurely. He is troubled by his inability at times to communicate with people. A decade later we meet Karl and Ruth Dettman, a couple whose families escaped Nazi Germany but under vastly different circumstances. The husband, Karl, is a computer scientist who has developed a program named MARY to enable computers to interact with humans. Ruth, his wife, is a historian who has built a career centered on the publication of old diaries like the one written by the young woman traveling to America. She is trying to convince Karl to expand the memory of his computer program and enrich it with more human material, but Karl stubbornly refuses because he is concerned about the power of his program to overwhelm its users if its database is expanded. Finally, we jump ahead to 2040, and we read the transcripts of the trial of Stephen Chinn, a man who is being prosecuted for the production of robots that are too life-like. Chinn is being accused of causing physical and psychological harm to the people who have used his robots and of weakening normal relationships between people. A young adolescent named Gaby, who was given a doll powered by a version of MARY, is one of his alleged victims. His own personal recollections are folded into the trial proceedings, as he tries to describe his intentions, justify his actions, and make amends for where they may have gone awry. 

Taking stock of our world today, there is clear evidence that AI can improve the day-to-day lot of people, make life more convenient and efficient, and promote better health outcomes. However, much of the current angst that permeates discussions of AI is focused on the potential economic and sociopolitical consequences. There is fear that systematic adoption of AI will lead to widespread loss of jobs and financial distress for people left behind. The generation of false data and uncontrolled dissemination of unfiltered information may, it is feared, foster social unrest and destabilize democratic institutions.  

All of these predictions, for good or for bad, center on the word “intelligence.” If it is defined as the creative use of information towards a specific goal– my definition, to be sure — then it exists along a gradient and there is not an opposing term. In that case, the mixed picture about the future of AI seems accurate. Humans can process information to both noble and destructive ends. If machines are provided information by humans, then it is likely that there will be worthy and flawed outcomes. It is not a reflection of the logical structures or neural networks that are built into us as humans or artificially placed into machines. It simply is the nature of intelligence. Information is agnostic and it can be processed in a limitless number of ways; there is no guarantee of what will happen when it is processed. 

On the other hand, if we center our predictions on the word “artificial,” there is an opposing term, namely “genuine.” Speak looks beyond AI as intelligence and forces us to think about its impact on interpersonal communication and interactions. The design of the robots that are being created in fiction and in our world of 2025 is steadily improving. The voices become more lifelike, the reactions more emotionally appropriate, the reactions more convincing. They display keen intelligence and manifest seeming empathy with their handlers. Like the artificial friend in Klara and the Sun by Kazuo Ishigura, the robots may even appear to have more feelings and awareness of the ever-changing psychological state of their owners than family members and friends. But it will always remain artificial. Speak forces us to ponder whether interactions between human beings have an element that cannot be programmed, that is not simply manipulation of information. It is that piece that accounts for the genuine nature of relationships between people and it is that component that is vital for human growth and maturation. The interconnected stories in Speak raise the concern that reliance on AI, in whatever embodied form it takes, to provide support and companionship may inevitably fail and leave damaged humans in its mechanical wake. The intelligence of AI may not be sufficient for humans to thrive. It remains difficult to put into words exactly what to call this additional component of human interaction. Thankfully, there is literature, and creative novels like Speak, to help us grapple with what it might be and to help us steer a course where AI is developed thoughtfully with full awareness of its limitations and potential for good and harm. 

SPEAK  
Louisa Hall 
EccoPress, New York 2016, 356 pp 
Web image by Medhum.org

A medical student, Mayer, and an art student, Rybnikov, take their friend Vasilyev, a law student, out for a night on the town, visiting a few brothels on S. Street. After being fortified with a couple of glasses of vodka, they go to the first brothel, where Vasilyev is repulsed by “How cheap and stupid it all is!” After mixing with the women a bit, they go on to a second brothel, and then a third, and finally a fourth. Vasilyev is increasingly disgusted and begs to go home, but his friends dissuade him. At the last brothel, Vasilyev engages one of the whores in conversation: Why doesn’t she leave? Why doesn’t she better herself? But she yawns, obviously disinterested. A commotion ensues when one of the men slaps a whore, and Vasilyev runs out into the snowy street. His friends lead him home, while Vasilyev harangues them about the evils of prostitution. During the night, he has a “nervous breakdown” and in the morning his friends find him disoriented and incoherent. They take him to a psychiatrist, who agrees that prostitution is evil, but his attitude seems to be, “So what, don’t let it bother you. It’s just a natural part of society.”  

Vasilyev is shaken to the core by his encounter with prostitution. He finds it morally repulsive and wants to “save” the women who practice it. Yet everyone else—his friends, the cab drivers, the psychiatrist, even the whores themselves—seems to accept prostitution as a normal aspect of society. Mayer, the medical student, even provides some statistics that indicate there are more whorehouses in London than in Moscow. Vasilyev doesn’t have the resilience to accommodate this moral dissonance in his worldview. Thus, he has a breakdown. Ironically, the psychiatrist is unable to even visualize the moral problem that Vasilyev is experiencing. 

The Party and Other Stories
Anton Chekhov
London, Penguin Books, 1985. 
Originally Published 1889 

A previous version of this review was published in the NYU Literature, Arts, and Medicine Database (Litmed).
Web image by Alex Plesovskich 

Reviews of Chekhov’s Stories

Cold Eye, Warm Heart: Medicine and Anton Chekhov  

Jack CoulehanAug 6, 2025

An Awkward Business by Anton Chekhov 

Jack CoulehanJun 11, 2025

The Grasshopper by Anton Chekhov

Jack CoulehanMay 11, 2025

Ionych by Anton Chekhov 

Jack CoulehanMar 11, 2025

A Doctor’s Visit  by Anton Chekhov 

Jack CoulehanMar 11, 2025

Ward No. 6 by Anton Chekhov

Jack CoulehanMar 11, 2025

A Nervous Breakdown by Anton Chekhov 

Jack CoulehanFeb 11, 2025

Enemies by Anton Chekhov

Jack CoulehanJan 11, 2025