Tuner follows Niki White (played by Leo Woodall), the apprentice of piano tuner Harry Horowitz (Dustin Hoffman), and a tragic genius. Once a gifted pianist, Niki developed hyperacusis—an increased sensitivity to sound that prevents him from playing the piano and requires him to wear hearing protection at all times. After Harry forgets the combination to his safe, Niki teaches himself to open it by listening to the lock’s subtle sounds. When Harry is later hospitalized, Niki begins cracking safes to pay off his mentor’s mounting medical debt.

By the film’s second act, Niki’s increasingly dangerous work jeopardizes both his safety and his relationship with his girlfriend Ruthie (Havana Rose Liu), leaving him to confront the consequences of his actions. When Niki makes amends in the third act, Uri (Lior Raz), the leader of the criminal group in which he has become entangled, viciously beats him. The injury costs him part of his hearing but enables his return to the piano.

Tuner is engaging, beautifully constructed, and emotionally resonant. At the same time, it turns disability into a plot device. Marking director and co-writer Daniel Roher’s fiction debut, the film fully embraces the artistic license afforded by the genre, casting hyperacusis as a superpower rather than focusing on the condition’s often debilitating effects.

To be fair, Niki mentions that, at one point, even the sound of his own voice was agonizing. He is constantly on guard against potentially harmful sounds. When confronted with barking dogs, smoke alarms, air horns, and gunshots, he winces and clutches his ringing ears.

But the impact is fleeting. In real life, exposure to noises like these can permanently worsen hyperacusis. Furthermore, the hearing disorder is not a “superhuman” tool; many individuals with hyperacusis show normal hearing thresholds. For those with milder cases, everyday sounds like a running dishwasher can cause significant discomfort. In more severe cases, even near silence can be excruciatingly painful. One wonders how Niki could tolerate the clicks, clacks, and whirs of piano keys and combination locks (another creative liberty: modern safes are designed to thwart auditory decoding).

As disability studies scholar Rebecca Garden argues, there are “tensions between the lived experience of illness… and the conventions that shape the representations of those experiences in published narratives.” [1] In other words, the demand for drama often precludes verisimilitude, instead favoring a happy ending of triumph over adversity. Niki’s liberation from his condition is narratively satisfying; another, if less commercially successful, film might depict a similar character learning to live with it.

In his seminal text The Wounded Storyteller: Body, Illness, and Ethics (2013), sociologist Arthur Frank enumerates three types of illness stories: restitution, chaos, and quest. The restitution narrative “has the basic storyline: ‘Yesterday I was healthy, today I’m sick, but tomorrow I’ll be healthy again,’” the chaos narrative “imagines life never getting better,” and the quest narrative “accept[s] illness and seek[s] to use it.”

Tuner follows a kind of restitution storyline: Yesterday Niki was a healthy prodigy, today he cannot perform because he is sick with an exploitable “superpower,” but tomorrow a thief will effectively cure him by rupturing his eardrums. The film also features aspects of the quest narrative; to quote Frank, Niki “returns as one who is no longer ill but remains marked by illness”—that is, no longer hyperacusic but partially deaf. Niki is figuratively reborn with a new purpose, embodying the film’s Spider-Mannish moral logic: “With great power comes great responsibility.”

Despite these quest elements, Niki’s story remains fundamentally a restitution narrative. Frank notes that such narratives are “culturally preferred” and calls for “an enhanced tolerance for chaos.” To that end, future films might engage more directly with the lived experience of hyperacusis. Ultimately, however, Roher’s approach is understandable and even commendable, using the possibilities of cinema to draw attention to some of the challenges of a rare, if romanticized, disability.

[1] Garden, Rebecca. “Telling Stories about Illness and Disability: The Limits and Lessons of Narrative.” Perspectives in Biology and Medicine, vol. 53, no. 1, 2010, pp. 121–135.

Photo credit: Black Bear

At age nine, first misdiagnosed and finally identified as having facial bone cancer (Ewing’s sarcoma), Lucy underwent several surgeries and more than two years of intensive chemotherapy and radiation treatments. Pain and nausea, anxiety and fear of more pain and nausea were only part of the ordeal. The young Lucy became aware of what it is to be severely, chronically ill. Her sisters behaved differently toward her: they were polite. “Suddenly I understood the term visiting. I was in one place, they were in another, and they were only pausing.” Even her father felt uncomfortable at her hospital bedside, and Lucy was relieved that he came infrequently.

But being at home was worse: in the hospital the other patients and the staff expected little from her and she felt no guilt or shame; amidst her family, she blamed herself for the tension, arguments over money, and her mother’s depression, even though these elements had existed prior to her illness. Her hair fell out and she became dimly aware that people were staring at her face. Nevertheless, “I . . . was naturally adept at protecting myself from the hurt of their insults and felt a vague superiority . . . . “

Well enough to return to school, Lucy’s disfigured face drew taunts from classmates; she understood finally that she was perceived as ugly and that she would not be loved. Only on Halloween, when she could mask her face, did she feel free and joyful, unconcerned about her appearance, “normal.” Her moods now alternated between despair, determination, and escapism. She became convinced that only facial reconstruction and a restored appearance would make life bearable.

During years of reconstructive surgery Lucy evolved complex rationalizations to give meaning to her suffering. Two anchors had stabilized her existence throughout the misery: a passionate adolescent love of horses, and an adult love of poetry. Eventually outward appearance and inner life became harmonious. “The journey back to my face was a long one.”

Unfortunately, Lucy’s story does not end here. At age 39 she committed suicide. Soon after, her close friend, writer Ann Patchett, wrote a book about their friendship, Truth & Beauty: A Friendship, published in 2003 (HarperPerennial).

Lucy Grealy Interview in 1994 (20 Min.)

Autobiography of a Face
Lucy Grealy
Houghton Mifflin 1994 Boston: 256 pages

1995 Whiting Award Winner in Nonfiction , Poetry: https://www.whiting.org/awards/winners/lucy-grealy
Web image generated from the book cover by Medhum.

A turning point comes in the fifth sestet and, to signal it, Lowell takes as his first line the famous “Una noche oscura” of St. John of the Cross, another dour poet/mystic: “One dark night”. This line begins the first of two consecutive sestets that are concerned with corporal love, bracketing a middle line that announces, to no reader’s surprise, “My mind’s not right.” The second of these sestets moves from a maudlin song refrain to a frankly depressive, almost suicidal pose: “I hear / my ill-spirit sob in each blood cell, / as if my hand were at its throat. . . .” and ends with “I myself am hell; / nobody’s here –“, which is a quotation from Satan in Book IV of Paradise Lost.

Enter the titular skunks: as a parenthetical predicate to the final line of the preceding sestet (“nobody’s here –“), the poet corrects the apparently psychological meaning of “nobody’s here –” to refer to physical presence, noting that in fact there is someone here, namely a family of skunks.

The final two sestets are among the most visually powerful images in poetry with the paradoxically high drama one would not expect from skunks. The hungry skunks “march on their soles up Main Street” in search of food with fiery red eyes as the poet, in response to their upward march, stands “on top / of our back steps” and takes a deep breath of the “rich air”, watching the mother skunk jab her head into a cup of sour cream–a mother skunk who, in a fitting yet curiously ambiguous final line, “will not scare.”

This is one of my favorite poems for a number of reasons. The honesty that eventually surfaces–the poem is after all about the self-recognition of a mind that “is not right”–is stark. It confronts the reader with the admission and dares him or her to probe into the poet’s reading of the persons and events around him. The poet’s choice of skunks as an implied comparison of his affectual state, one that feels isolated, a pariah among fellow animals, is stunning. The last lines are assertive and, one hopes for the poet’s sake, encouraging, as though the narrator finds in the skunks’ indomitable nature a source of self-reliance. As opposed to the dark “red fox stain” covering Blue Hill in the third sestet, red now promises a more optimistic interpretation, describing as it does the skunks’ defiant eyes: “moonstruck eyes’ red fire”.

As gloomy as the tone is, the poet cannot refrain from puns, another trace of his reluctance to give up poetic creativity in the face of depression. Lowell describes the Ford as a Tudor (two door). The love cars “lay together, hull to hull,” enjoying the double entendre of “lay.” The skunks “march on their soles [read “souls”] up Main Street” under the Trinitarian Church.

The economy and denseness of this poem is remarkable. Within 48 lines one encounters many of the colors of the rainbow (we have white, blue, orange, red) with a clever use of red as a focal point for a possible mood shift, with the second instance subverting the meaning of the first, as mentioned above. The puns of course add semantic value. We also have references and implicit indictments of physical love and the church as organized religion (the poet’s Ford climbs “the hill’s skull,” i.e., Golgotha, when he begins his voyeuristic watch for “love-cars”; the skunks’ “white stripes, moonstruck eyes’ red fire” contrast with “the chalk-dry and spar spire of the Trinitarian Church.”)

Much of the compressed effect derives from the force of the last lines–often spondaic–in the sestets, telegraphic lines that reinforce the gravity of the drear poetic commentary. The sequential staccato lines are: “she’s in her dotage”; “and lets them fall”; “A red fox stain covers Blue Hill”; “he’d rather marry”; “My mind’s not right”; “nobody’s here”; “of the Trinitarian Church”; “and will not scare.” The last line, “and will not scare” is reminiscent of the ending of the last line of Tennyson’s Ulysses: “[To strive to seek to find] and not to yield.” Strength and meaning are found within, in one’s self, not in the decadent civilization we see in the first four sestets.

This poem is dedicated to Lowell’s contemporary and friend, Elizabeth Bishop (1911-1979), who wrote “The Armadillo” (1957), inscribed to Robert Lowell. Both are poems about animals outré even in the animal kingdom, quadriped analogies to dissident and isolated poets, and both poets depict them as defiant and insouciant rebels worthy of human attention.

Read the Poem Online

Source Life Studies
Publisher Random House/Vintage
Edition 1959
Place Published New York
Miscellaneous The book in which this poem appeared won the National Book Award.
A previous version of this review was published in the NYU Literature, Arts, and Medicine Database. 
Web photo of Robert Lowell created from an original from Wiki Commons.

DAVID HSU: What do you think is the importance of medical humanities to you at this point? 

JACKIE DUFFIN: I think it is a very satisfying way of filling in the gaps that are generated by traditional medical training and medical experience. It invites reflection, and it invites growth, and it especially encourages criticism. And those things were certainly not there in my training. Therefore, it is comforting and inspiring, both of those things for me.  

When you say it that way, there’s a certain subversive quality to medical humanities. Am I catching your answer right?  

Yes, I guess that is exactly right. Subversiveness goes with the territory of what we do as historians as well. Everyone thinks that history is about the past, but the questions that we ask of the past are generated by the present and also the inherited wisdom that we have. And there has to be curiosity and a willingness to admit that the trajectory might not have been as straightforward as is sometimes pretended.  

How do you respond to the saying that basically history is written by the victors? 

That statement is also a reminder that what might be out there as the master narrative isn’t exactly the truth or isn’t exactly the whole story. And the losers will have their own story. And sometimes that’s worth exploring. Of course, my view of medical humanities is very much affected by the fact that I am a historian. And more than any other aspect of medical humanities … that’s what interests me the most. In fact, I don’t mind admitting that the medical humanities boom that we’ve witnessed in the last decade and a half or so has been a wonderful vehicle for enhancing the presence of history in medical schools​,​ and our visibility. I’m happy to hitch my wagon to it, but I don’t claim any expertise in all the other disciplines that participate.  

One of the things I think is useful for history with respect to ​present and ​future doctors is how history is a mirror image of the clinical process and the scientific process. And that’s something that I raise​d​ with my students all the time when I was teaching, that you begin with a question. As medical practitioners, you ​also ​have a question​;​ ​i​t is the chief complaint of the patient. What is wrong with me? Why do I feel this way? And as a doctor, you consult the patient, you explore the history, you do the physical examination, and then you touch base with the clinical wisdom that’s available to you through ​the medical ​literature. And you come up with a diagnosis, which ​​determines the direction of action. As a historian, you have the question​:​ where did this come from? Or why do we do this? Or what happened then? And with your question, you interrogate the past, looking at all of what has already been published, which is the equivalent of the medical literature, but also looking at things that have been ignored, like the stories of the losers, for example. And you come up with an interpretation. And that is a direct parallel with the ​process of ​diagnosis. You can push this even further to make an analogy with a scientific experiment where you have the hypothesis, the method, et cetera, and you come up with a conclusion. I think that demonstrating history as a discipline to healthcare professionals opens up their imaginations to seeing the practice of what they do is something that’s malleable, that’s anchored in time, that’s affected by culture and society. So, my role in the medical school was to do that. It was a privileged position. But I had no idea how successful I ever was. I have a sneaky suspicion that a lot of my faculty colleagues and maybe a large number of the students just thought I was there for comic relief and entertaining stories to be told in the meantime. That’s okay. I accept that if that gave me permission to weasel my way into the curriculum or introduce new ideas. 

Tell me a little bit about this medical humanities boom over the last 15 years. What’s going on?  

As you know, medical schools are evaluated. They’re accredited by committees. And things come along that are the flavor of the month. ​P​rior to the medical humanities boom, there was an ethics boom. Many medical schools didn’t have ethics, but they looked around and they thought, oh, we better get ethics because everyone has ethics. If they got ethics, it made them look ethical. That happened in the 90s. I saw that as a real problem for people teaching history of medicine. I got along great with our ethicist at Queen’s. It wasn’t her fault, but she was my biggest enemy. Because if the school had to devote some time to what they called ​“​soft science,​”​ they would rather have the ethicist than the historian because the ethicist got them brownie points on the accreditation. ​​ 

​​T​here was a time when the American Association for the History of Medicine was meeting in Chicago in May 2014. And we happened to be meeting at the same time as the Academy for Professionalism in Healthcare. So the brass of the American Association asked to have a meeting with their leaders to find out how they managed to convince all the medical schools they needed ethics and in particular succeeded in having questions about ethics education in the exit surveys. They did not really understand our problem. I think ethics had the media going for it and the power of a number of ​high-profile​ malpractice cases that had come along. ​It​ became obvious that patients wanted to make sure their doctors were legal and ethical, and ​t​he schools wanted to give the students tools to address these concepts. It became almost urgent. 

In fact, I did some Medline searches on this at the time. The number of articles addressing history of medicine basically tanked. And the number of articles addressing medical ethics soared. There was always an interest in medical ethics. It goes way back. Hippocrates even talks about this. And then there was codification in the 18th century. But what ​arose ​in the late 20th century was this concern that it should be transferred to the students as some kind of rubric that would help them in their future to ​educate them and help them ​behave ​ethically. ​And then that sort of plateaued and along came medical humanities. 

Accreditation saw ​​this as very good for student life. They saw it as very good for student education. If you could enhance the possibility of getting a positive accreditation of your medical school, then you would acknowledge that you should have something called medical humanities. But under that umbrella, there could be just about anything. And that’s the problem with it as a discipline. It doesn’t really have a single method. It embraces so many other sorts of​ fields​. That’s the beauty of it, but it’s also the confusion of it when it tries to make its way in a curriculum that is as rigid as a medical school structure. 

In Canada we now have a society for ​Medical Humanities, the Canadian Association for Health Humanities​. I’ve attended some of the meetings but the disappointing thing about it from my perspective is there’s almost never anything about history. 

I’m curious. If history is not emphasized as part of medical humanities what is? 

Presumably it’s ethics again and reactions to technology. I think ethics underpins a lot of it​,​ but medical ethics is a very distinct discipline​,​ as is history. We’re not the same thing. We respect each other but we’re very different. So medical humanities usually include, at the Canadian meetings at least, a lot of literature, of readings, both fiction and nonfiction. It includes the arts, music, poetry, visual imagery, trauma, drama, dance, etc. And often the papers in the meetings that I’ve attended are​ almost all​ about individual case studies​: ​e.g, “We tried this at our medical school​;​ and then we did an after​-​survey about whether it worked or not. Of course, our students loved it because it was fascinating​,​ and it wasn’t memorizing the elements in the periodic table. It was something that took them out of themselves.” Often medical students have other hobbies before they get to medical school, which are sadly neglected because there’s no time for anything else. And these activities provide an outlet for them to recover their previous selves and their identity.  

I think another agenda of ​Medical Humanities ​is to raise awareness of the differences between peoples — the difference between your patients, for example, and yourself, and to be prepared to tolerate it. So that’s a subliminal message of many of these things, causing you to see the world and other people in a different and more tolerant way. That’s basically what goes on in the medical humanities conferences. People get very excited about these opportunities, a drama presentation, a collect​ive​ reading, something that they might have done together, or artwork that medical students do based on their clinical learning and then having a show about it. That kind of thing gets reported. And then … it sort of sinks into an oblivion until the next meeting comes ​​​​along.  

So it sounds like the way you’re describing it, there’s a little bit of the study of history of medicine versus medical humanities. The two are not fully in sync in your mind.  

No, they’re not fully in sync in my mind, but I accept and welcome history being seen as part of ​ ​medical humanities. I think it’s an opportunity for us as historians to maintain our place and our credibility in medical schools.  

The presence of history in medical education has gone up and down over the centuries. There have been full-fledged chairs in History of Medicine. In a distant past, they went away​ and​ they came back. What is expected of it has probably also changed through time. But now, since it seems medical humanities is an easier way​ ​to open the door to medical schools, history can be part of it. I don’t know. It would be really interesting to find out if ethicists feel the same way as I do about it. I find that some medical humanities programs are peopled by or run by doctors who are so well-intentioned​–​ very, very well-intentioned​–​ but they really don’t have any expertise in anything but medicine. The best of them, obviously, are experienced clinicians who’ve had a lot of encounters and are thoughtful and reflective about those encounters. But there’s no method. It’s not a single discipline. It’s a quilt with a whole bunch of different patches in it.  

What do you think about medical humanities and maybe more specifically the history of medicine as a vehicle for the broader mass of people out there?  

I’ve written ​11 ​books and the most recent one to get published is this one. [She holds up a copy of ​Covid-19: A History​]. What I was doing was getting it down for everyone. It’s a history for everyone. It’s not aimed at medical students or doctors or anybody in particular. It’s aimed at Canadians basically, but it talks about the whole pandemic from a global perspective. What I want to do is remind people of the personal stories that go with the pandemic, about the dilemmas of decision-making and policy choices, about the scientific endeavors that are so easy to mock or make fun of. And ​clearly,​ I’m revealing my colors. I believe in vaccines. I believed in the public health measures. I point out in this book about the value of quarantine. When you don’t know what the pathogen is and you haven’t got a clue what the incubation time is because it’s a previously unknown pathogen, quarantine is not a stupid thing to do​,​ because you are waiting to find out how dangerous it ​might ​be and put some parameters around it. I think​–​ and again, I’m speaking only from a history perspective, not medical humanities in general​–​ I think it was important to unpack what was behind those decisions that many people got so angry about. And yet they were lifesaving decisions in many cases. Sometimes perhaps it was over the top, but it was because we didn’t know what we were confronting. 

During that book writing, I served as a volunteer contact tracer at the Kingston ​[Ontario] ​Public Health Unit. I had to phone up citizens all over our area and get them to quarantine because they’d been in contact with someone who had COVID. That was very eye-opening for me because I realized at what level you had to pitch why it was a good thing to do. And at the outset, when we didn’t know what the parameters were, we were telling people who’d been exposed to COVID to stay home for 14 days. Kingston was the only health unit to use volunteer contact tracers, but we worked really hard and Kingston had the best ​​outcomes of COVID cases in the country for a brief time. It didn’t last forever, but it was like a flagrant, on-the-spot demonstration of something that has been known for years, since at least 14^th-century plague.  

What do you make of that now that we’re in 2025 and people are so over this stuff now​,​ that​ ​there’s this feeling I get that people are saying we will never go into quarantine again? 

That’s why I wrote the book. Actually, I was invited to write it, and I had to think about whether I wanted to or not. One of the reasons I decided to write about it was that my thesis advisor, Mirko Grmek, wrote a history of AIDS right at the beginning of the pandemic. And I thought, well, I can’t write a history of COVID because it isn’t over and it may never be over. We may always have COVID. And then I remembered that Grmek had written that history of AIDS at the beginning of the AIDS epidemic. He set down where it came from. He studied the historical possibilities. He had the science too. I realized he was at the end of his life, and I’m at the end of my life. And I thought, OK, maybe this is what I need to do​,​ to accept the task of writing it as it is, right now. Now ​I’m very depressed​ by these negative attitudes. But I do hope that when the next pandemic comes-​-​and there will be another pandemic​,​ with a new pathogen that we haven’t seen before​,​ and there will be conspiracy theories about where it came from​–​ I hope that the public health agencies will remember that quarantine from 14^th-century plague worked really well​,​ and that’s what we need to do again if we don’t want to overwhelm our finite resources in hospitals and health care units to look after people. The more you implement those measures, the fewer people die. It makes a huge difference​,​ and you can actually see it. So the story is there. Whether or not it will be believed, whether or not the argument can convince the naysayers, I have no idea. All I did was set it down and hope.  

You have a historian hat, which is the critical, sometimes subversive side and then you also have the medical doctor establishment side, the scientific side. It gives you a unique lens to look at the COVID pandemic and the consequences that came afterwards.  

It’s been the story of my life. I worked in cancer care at the end of my career at Queen’s and patients would tell me really interesting things​.​ I loved talking to them and hearing what they thought about what was going on. And some of them held what I would think of as wacky ideas or they’d utter doctor​-​blaming ideas. Then the doctor in me would feel very defensive about their accusations of the mistakes or the neglect of my colleagues, even colleagues I’d never met. But when it comes to the history of medicine, I feel terribly responsible for the bad things that doctors may have done, even if it was not deliberate, but out of ignorance, because they didn’t know what was going to be discovered next​;​ or ​due to ​misplaced enthusiasm for something that turned out not to be as great as everybody thought it would be. And I’ve seen that with respect to certain drugs in my career. I’m old enough to remember thalidomide babies​;​ I was a child when that happened. But the impact of it was enormous​: ​what pills could do to us and how they might harm us. There’s a new biography out that I ​reviewed for ​Medhum of Francis Kelsey, the Canadian​-​born American health official who spared the United States from the damages of thalidomide. An amazing and courageous decision because there was great pressure on her to approve the drug and she didn’t. So we had the tragedy in Canada and they didn’t in the United States​,​ which was fascinating for me to learn at this stage of my life, because I remember being so horrified and ​thinking, ​how could doctors let us down? 

There are also other procedures that were once considered important to do that we have done away with, not because they shouldn’t ever have been used, but because something so much better came along. The most striking example of that that I remember are pneumoencephalograms. Pre-CT scans, if you thought there might be a space​-​occupying lesion in the brain, you put the patient under a sort of an anesthetic. You took out a modicum of CSF and injected the same volume of air. And then you strapped them to a chair and you ​​rotated them around, taking x-rays while the bubble of air moved all around the brain to see if there was a space​-​occupying lesion. It was brutal, painful, but it was the only way to find out if there was a space​-​occupying lesion in there. And of course, you could tell only if it was bulging on the surface of the brain. It took days for patients to recover with headache and vomiting. Every medical student in my class of​ ​1974 was required to go and witness one of these so that we would not order it frivolously. And in that same year, CAT scans were introduced and nobody would ever do a pneumoencephalogram again. Ever, ever, ever. But does that mean that all the doctors who were involved in ordering pneumoencephalograms or taking the x-rays were evildoers? I don’t think so. They were trying to help. They were trying to make a diagnosis. But it was excruciating.  

If you could fix medical education and its relationship to history, what would you want done?  

I’ve written about this for a long time. I was so lucky at Queen’s; I really was. They let me get away with a lot. From my hire in 1988 until I retired, I thought the best way to bring history into medical education was to infiltrate it. The historian has to be very tolerant and very flexible. But what you do is you introduce the history of whatever it is they’re studying at any given time. History of anatomy in anatomy if they’re doing the anatomy course. History of physiology in physiology. History of pathology (essentially is the history of disease) in pathology. The timing really is everything because it’s synergistic with what they’re learning at the same time.  

With that method, you are preceded by a guy in a white coat, and you’re followed by a guy in a white coat. It gives you credibility vicariously by the people who are around you. But it makes it seem relevant in a way that otherwise it ​wouldn’t be​. If you make ​it ​an optional, elective course, the students automatically know that it’s not important. So, I refused to teach electives when I got hired at Queens, which meant that I had to meet every department head to beg for time to do a history session. There were 25 departments at the time, and only three said yes. They were​–​ anatomy, pathology, and obstetrics; I’m forever grateful.  

Early on, faculty members of those departments would come to my inaugural class on the history of their discipline. I think they were slightly checking out how “nice” I would be to their field: the history of obstetrics, for example. But they approved the approach. The most willing departments were those units in the medical school with a lot of curriculum hours​,​ ​s​o they were able to feel generous. ​“​We will give her an hour.​”​ 

But one department head said to me, “I can’t do that. History, I love history. You’d be invited to give an ​after-dinner​ speech at our annual meeting. That would be really good. But we only have 80 hours in the curriculum. And if I gave you one of those hours, they might miss something important and kill somebody.”  

I said, “Oh, thank you​,​” ​a​nd I ​went​ back to my office feeling rejected. Only later did I think of the right reply, “If you don’t give me one of your 80 hours to make them skeptical about everything else you’re going to teach them in the other 79 hours, then they really might kill somebody.” That was the answer I should have said.  

It’s about the time constraint; you can’t offer an entire course. Medical students are not going to be historians. They’re going to be doctors. So what you want to do is sensitize them to the fact that what they see as knowledge now is something that has evolved through time, through human endeavor, something that is destined to change in the future. So history is a reminder of life-long learning. And if you time it right, then it is relevant and interesting. Not all students are going to like it, but they don’t all like pharmacology either. 

And the other thing that the medical school let me do, bless their hearts, is to grant my wish for one question on every exam.  

I remember this actually.  

It was a question of credibility; a way of forcing the medical school to commit to the idea that history was important.  

All right. To wrap up, we’ll get back to Medhum. what would you like to see us do in the months and years to come? 

I’m really a special interest voter on this because I was for 25 years involved with the Literature Arts and Medicine Database. And I contributed hundreds of annotations to that database​. ​I hope MedHum is a place where people who want to use literature–mostly literature is what I think of, but there​ are ​other things there, ​for example ​film​ reviews​–in a way that will deepen their understanding of a situation, or for enhancing education, or for whatever purpose, because that’s how the database was used, that it will be there, accessible to people who want those things.  

​​​​So for me, I get to go there when I feel like it. I get to browse. I get to pick around. I already knew some of the people and from our meetings, I’ve gotten to know new ones. I think you, people of your vintage​,​ should be deciding its purpose, in terms of determining the direction and the flavor of this entity, which hopefully will have a big reach and get to the people who need to see i​​t​. You​ ​​have a better sense. You’re closer to the users. I’m not trying to be gloomy about it. I just know that it’s entirely possible that it needs to go someplace that I can’t even imagine. 

Dr. Jacalyn Duffin was the Hannah Chair of the History of Medicine at Queen’s University from 1988 to 2017. She was also a practising hematologist. In 2020, she was awarded the Order of Canada. 

More importantly, she’s one of my favorite people in the world. Medical school wouldn’t have been the same without her gentle encouragement and unending enthusiasm. Dr. Duffin, thanks for everything. 

Web image by Medhum.org

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Lucy
Felice, first of all, can you talk a little about your background, what you were doing professionally just before and during the time you did the Database?

Felice
I was on the faculty at NYU School of Medicine. I was trained with a PhD in physiology, was hired as a physiologist, and I taught medical students physiology, but most of my life. I’ve had this dual interest in literature and in biology. And in fact, that’s from high school on, and when I started college, I had to make a decision about whether to major in English or in biology. And I decided to major in biology because I thought, well, I can do literature on my own any day, and I’ll never be able to make it a profession. Whereas, you know, I can’t do science on my own, I have to be trained. And so that was the path I took, which was a science path, but I never lost my interest in reading and thinking about literary things. And let’s see, at one point I decided to start a discussion group with the medical students and any faculty who were interested. It was a small group, and it changed from year to year, but we met once a month, and I would, initially, pick out readings. They were short readings because students don’t have much time to read non-medical stuff– poetry, short stories, essays, and that continued for several years. At the same time, and really, I have to say that without my husband’s help and interest in what I was doing none of this would have happened because he of course, was interested in the use of technology, computers in medical education, but he was also interested in what I was doing with my literary stuff. So he set up a database for me on my own computer.

Lucy
And this was in the early 1990s.

Felice 
Yes, 1993 or thereabouts; he set up a computer program for me so that I could keep track of the readings that I was doing with the students, because I didn’t want to repeat anything with the same group, essentially. And I also was kind of following the work of Joanne Trautman Banks, who was a pioneer. She really was the one who started the field. I have to give her full credit. In 1978 she published a book of annotations of literature that had to do with medicine. I don’t really remember how I found it, but it was very helpful in my own work with the students. I decided, basically, to copy what she did, with some modifications of my own, in my own database that my husband Marty Nachbar helped me to set up. So to begin with, that’s what we did. Marty’s idea was that I should recruit other people in the field who were doing this kind of teaching with their students, and who might be interested in submitting annotations to this database. And secondly, that we should make it online, so that anybody out there who has access to the internet could stumble on this thing and maybe get interested. And the idea, his idea, was that it might expand the whole field, which was, at that time, just literature and medicine.

Lucy 
I had the privilege of knowing your husband and saw how he was really ahead of his field.

Felice 
He was a visionary. Definitely not just with that, but with all kinds of stuff that had to do with tech. You know, computers in medical education.

Lucy 
He was a big help to me when I had a grant from the NIH to do a project. He really zeroed in on its strengths, its weaknesses, and helped me in a very generous way. Just to backtrack a little bit, how did you choose the work that you shared with the students? What were you looking for when you selected certain work?

Felice 
I really had a pretty broad range of what I chose, and how I looked for it. Of course, if it was something to do with doctor or resident or medical student experience with patients– that was what I was looking for. But then there was patient experience, also from the patient’s perspective, how they were interacting, and what their feelings were about their illness or disabilities. And then as I started getting interested in this, I decided I really needed more training, and I decided to get a master’s degree, not in literature, but in something that was called at that point, humanities and social thought– that was the track at NYU in one of their master’s programs. And through that, I got really interested in the social thought part and societal issues that directly or indirectly affected medical practice, patient experience, and so forth. So that really also was important for me to get that degree, because when I started recruiting other faculty from other institutions, they [thought] I was an imposter. I was coming into that field without any background other than my interest in it. And they did not think highly of my intrusion into their field, and I don’t blame them. But you know, when they got to know me and what I was doing, they sort of became more accepting. But the thing that really clinched it was when I started this degree program, because then they felt okay, she’s serious. She’s going to get some professional training that makes it more legitimate to be associated with her. But of course, it was a really great thing for me, because it did give me a lot more background for what I was doing and what I would like to have been doing.

Lucy
You were very successful in recruiting a national board of editors.

Felice
Yes–the contributors were from all different places. They were very interested in making this a national internet-based project, because they were interested in furthering the field, and they saw the potential if it was on the internet, But initially I also had two NYU medical students who helped me choose material and write annotations. And then the site, especially once it became web based, was heavily used by so many and got so many hits–about a million a year. 

Lucy
It’s clear that the users went beyond medical students and physicians. What do you think attracted the wider audience?

Felice 
Well, I would occasionally get some notes, you know– I think there was a mechanism– I don’t remember exactly, where a user could contact me or somebody who was paying attention at NYU. What I found really interesting was there were patients who were using it. I don’t know what percentage of the users were patients, but there were patients who found stuff that was helpful to what they were going through. And so that was interesting to me, and I thought it was important, you know, it wasn’t my original intent to reach out to patients. It was really more of an education-based thing, but there it was. And why not?

Lucy 
We’re all patients at some point in our lives.

Felice 
Yes, right. That’s exactly true– issues about death and dying, not necessarily for the individual person, user, but family of theirs, friends who were in serious medical situations–all of that, it makes, made sense. So the audience became very broad.

Lucy 
And also you expanded the format.

Felice 
Well, first of all, when we started in 1993 there wasn’t a worldwide web. It didn’t exist. There was an internet. But the program that allowed people to access the internet was called Gopher, G, O, P, H, E, R. It was much more primitive but that’s what we started with, we put the annotations on this gopher program. Marty’s associate, Roy Smith, was instrumental in helping to set up the gopher program. Roy maintained his interest in our project as it moved forward. Then maybe a year or two later, I don’t know what the time lag was, but when the World Wide Web became available to anybody, I recognized that that would be really important, because it allowed you to make links with hypertext. You could make links between annotations; if you were referring from one thing to another; you could make links to art if you were annotating an art piece. You could make links –that was so key. So the web was just great. That was the way to go. And we were just lucky that it was there pretty early on.

Lucy
You recognized its potential.

Felice
And that wasn’t just Marty, actually. That was me.

Lucy 
And you chose the format of annotation versus a longer review. Was your goal to divide it into summary and commentary, specifically so that people understood what the work was about, but also how it connected to medicine and health? 

Felice 
I was going back to the format, or a slight modification of the book that Joanne Banks published in 1978. I think she used key words and a short paragraph about what the work was about. I think I expanded it to make both a summary and a commentary, because I thought that would be more helpful to people. I was modeling this thing after what she had done in 1978 and then again, she published another version, an updated version, I think, in 1982. In fact she and I had a phone conversation about our respective projects. 

Lucy 
One of the strengths of the web site was open access. You didn’t have to subscribe. That was important to you, I would imagine,

Felice 
Marty was very insistent on that. There were people who said, Oh, you should be charging something or whatever. And he said, No, if you want to make people aware of this field, you just make it completely accessible,

Lucy 
And it stayed that way, and the new site is open access. That leads me to ask, what do you think the role of health humanities is now? 

Felice 
You know, with all this artificial intelligence stuff, –I was reading about, or I saw online, a woman who, instead of having people as friends, she has some kind of an AI setup. And she’s not the only one, apparently, who’s, you know, relying instead of on human contact –on these bots. To me, it’s mind boggling. So I think there is definitely still importance to making this kind of work accessible and promoting it. And I also think it still should be part of medical education, health education, and it should be accessible to anybody who wants it.

Lucy 
Moving on to our new project. It’s based on the database but one of the differences, in my view, is that we’re including reviews that are a little more in depth than the annotations. How do you feel about what’s going on with the new site and how it’s evolved? And you can be honest. I mean, please.

Felice 
I think it is different from the database, and that’s good. It’s fine. You have your own vision of what you’d like to accomplish, and I think it’s working well, you’ve recruited people who’ve written some interesting things, not annotations, but more like essays. And you’ve expanded it so you have included art. I don’t know what else you’re planning to do, but I think it’s a good site, it’s valuable. It’s nice to have something up there that’s medical humanities related. And I really admire what you’ve done. 

Lucy 
Thank you. I think one difference is, you pioneered using links in the old database, and we’re using links much more now that it’s possible to do so. So if we review a book, then the author is interviewed by someone, we might link to the YouTube video. That’s been interesting to do and adds to what we can offer. It’s hard to know who’s using the site. We’re still in the very early stages, but I think it has a fairly broad appeal beyond just practitioners whether they’re doctors, nurses, or trainees, and I’m trying to have the public be interested in the work that we choose.

Felice 
I think you have your vision of the website, and that’s what you’ve voiced here, but it’s not my view of medical humanities.

In fact, I found this online at George Washington University, on their medical humanities site, and they quote me, but they don’t acknowledge that it was me, where I wrote: “Medical Humanities is an interdisciplinary field that includes the humanities, social sciences and the arts and their application to medical education and practice,” and then whatever education materials people develop that are designed “to help students develop and nurture skills of observation, analysis, empathy and self-reflection, skills that are essential for humane medical care.” [Quotes are from the GW website and were at the original NYU medical humanities site.] Especially the first part that I read, I mean that it is a broad, interdisciplinary scholarly field. That is how I have always, or at least for many years, maybe not in the very beginning, looked at it. So that’s a little different from what you are trying to do. And I’m not criticizing you in any way. I mean, I’m just recognizing that there is a difference in what you want to do with your site and what we did with ours.

Lucy 
One of the things that the database could do was show different cultures and describe experiences that the students themselves might not have directly. MedHum is a bridge into other cultures, and that’s what I mean when I say it is a lens on the human experience. That by reading literature, by reading about other societies, and what people who live in those societies go through, which you know only too well, it broadens your ability, hopefully, to empathize and to understand the differences among people.

Thank you, Felice for speaking with me today and for your editorial guidance throughout the years. It’s been an extremely fruitful collaboration.

Web image by Medhum.org

Posts Written by Dr. Felice Aull

Art Review

Three Paintings by Edvard Munch

07.23.26 19

Art ReviewVideo

The Waiting Room by George Tooker

06.12.26 427

Book ReviewVideo

Autobiography of a Face by Lucy Grealy

05.25.26 530

Art ReviewVideo

The Broken Column by Frida Kahlo 

04.15.26 600

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Susan Sontag has said, “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick.” Author Lina Meruane challenges the idea that people with illnesses are necessarily separated into a different kingdom than those who are not sick, asserting instead that illness can be part of anyone’s normality. She makes this case through her novel, Nervous System. The novel tells the stories of four family members and a boyfriend who, at one time or another, develop a serious illness or help take care of one of the others with a serious illness: it’s all illness, it’s all the time, it’s normal. We talk with Dr. Meruane about her idea of illness as normality as she presented it in the novel, and about how its atypical structure and its evocative and memorable prose contribute to the stories told and the ideas offered.

Co-host

Daniel Albrant

Source
Nervous System by Lina Meruane, translated by Meghan McDowell, Graywolf Press, 2021.

Links
–Lina Meruane’s bio
–Russell Teagarden’s blog piece about the novel, Nervous System, and his blog piece about the MRI scene in the novel.
–Russell Teagarden’s blog piece about Lina Meruane’s novel, Seeing Red.
–Video conversation between Lina Meruane and Meghan McDowell about Nervous System.
–Interview with Lina Meruane in LALT magazine about Nervous System.

A big thanks to Lina Meruane for sharing her thoughts on illness as normality and her writing processes.

The Clinic & The Person is a podcast developed by our editor Russell Teagarden to summon or quicken the attention of health care professionals, their educators, researchers and others to the interests and plights of people with specific health problems aided through knowledge and perspectives the humanities provide.

Web image by Medhum.org

Before embarking on my project, I reviewed the literature pertaining to the use of plays in medical settings.  Friedrich Schiller, the German playwright (who was, incidentally, a physician), laid the groundwork for the use of theater as an educational tool in his 1784 essay “The Stage as a Moral Institution” calling it “a great school of practical wisdom, a guide for civil life, and a key to the mind” (Schiller, page 252).  In his view, the theatricalization of the “vices and virtues of men” and of “human woe” not only makes them more palatable, but it also actually teaches the audience to be more empathic. 

I found a wide range of milieus in which plays have been used.  In 1938, The Federal Theatre Project, a program sponsored by the WPA, produced a play entitled Spirochete with the goal of reducing the spread of syphilis (Flanagan, page 144).  More recently, dramatic narratives were used by scientists to provide a forum for learning about human genetics; these have been collected in a volume entitled The Drama of DNA.  

A pioneering program that proved inspirational to me is Medical Readers’ Theater, developed in the 1980s at East Carolina University’s Brody School of Medicine. Stories by William Carlos Williams and other doctor writers have been turned into scripts used to encourage dialogue among medical staff, students and the public about a variety of medical issues. These plays are available in anthologies accompanied by discussion questions.   

There are also numerous popular plays which are natural fits for teaching because they illustrate points of ethics, diagnosis, doctor-patient relationship, etc. at the same time as just being entertaining.  Some of the ones I have used include Wit, A Streetcar Named Desire, and Next to Normal.    

While deciding what to do for my thesis project, I was becoming quite taken with Anton Chekhov’s writing through working with Jack Coulehan at Stony Brook.  Previously, although I knew of course that Chekhov had a reputation for being one of the great playwrights, I had had the impression that his plays were a bit boring because nothing much happens in them.  What can I say?  I must just not have seen the right productions.   

I researched Chekhov’s life, read his short stories, and even plowed through Sakhalin Island, the epidemiological survey he wrote about health conditions in a penal colony. As a result, I became an admirer and gained insight into his method.  It does not matter whether there appears to be anything happening or not.  The author’s job is to record what he observes. It is not by chance that this is also the job of a physician.  One can understand why Chekhov might have wanted to continue to practice medicine even after becoming one of Russia’s most celebrated writers.  Chekhov soon became my personal role model as a doctor writer, and it felt like an honor to dedicate my time and energy to his work, and in my own extremely modest way, to add to his dramatic corpus.   

Chekhov wrote over 500 short stories, and doctors play a significant role in about 25 of them.  I chose “A Nervous Breakdown” (1889) and “A Doctor’s Visit” (1898) “for adaptation.  As “A Doctor’s Visit” has fewer characters and is the shorter of the two that is the one I use to teach.  Some students may even have read the original story already because it is so well known.   

The plot may be summarized as follows:  A doctor has been summoned away from the city to see the daughter of a factory owner, but for some reason he sends his assistant instead.  (Perhaps he just did not want to go out to the boondocks.) The assistant doctor arrives at the house and examines the young lady.  After not finding anything wrong, he concludes that he’s been called for nothing. The patient’s mother, who is depressed and overwhelmed, implores him to spend the night instead of going home to his family.  The doctor is not in a position to refuse, but he feels as if his time is being wasted and he is annoyed.  

However, in the short time he is in the factory town, the doctor gets a sense of what it is like in live in such a place. He sees how unhealthy the environment is for the workers. He sees how, despite having lavished a fortune on expensive furnishings, the inhabitants of the house are miserable. Adding insult to injury, a servant repeatedly contradicts him and gets on his nerves.  

In spite of the prejudices he has brought with him from the city, the totality of his experience makes an impression on this doctor. The next morning, he meets with the patient again. This time, he recognizes that she is a sensitive and intelligent young lady, and he now has empathy for what she must be going through. There is a moment of understanding between them. Although it does not perhaps appear as if the doctor has applied any treatment, the patient responds and shows a sense of hope.  The doctor has also changed as a result of this experience. He leaves the house and heads home in a good mood.   

Like general practitioners today, general practitioners in 19^th-century Russia undoubtedly ended up doing a good bit of psychiatry.  Although Chekhov and Freud were contemporaries, there seems to be no evidence that Chekhov was aware of Freud’s “talking cure. “  But even if not, and even if the doctor in “A Doctor’s Visit” does not think he has done anything, the doctor has in fact unwittingly administered a brief psychotherapy session.  The powerful results he obtains with such simple means remind me of some of my own experiences as a psychiatrist.  Sometimes when one uses one’s psychoanalytic theories to make what one thinks are brilliant interpretations, they fall on deaf ears.  Just being present and listening often produces the best outcomes.   

The greatest technical challenge this playwright confronted in dramatizing “A Doctor’s Visit” was figuring what to do about the doctor’s internal thoughts.  There is plenty of spoken dialogue in Chekhov’s story, and I used much of it practically verbatim.   But how to dramatize one’s inner dialogue?  It would be cumbersome to have a narrator describe it, and unnatural to have the doctor verbalize it.  My solution was to create a brand-new character, a young apprentice, someone the doctor uses to bounce ideas off.   I hope audiences and readers feel this was a reasonable compromise on my part.   

My adaptations of Chekhov’s two stories made their debut in 2015.  Since then, “A Doctor’s Visit” has been used to teach students at several medical schools:  Stony Brook, Drexel, New York University, Boston University, Cleveland Clinic, and the University of Pennsylvania.   At all but one of these I introduced the play in person, read the stage directions aloud, and led the discussion.  The text of the play is included in an appendix to this article in the hope that other schools will take it up.  And I am still available to read stage directions! 

References: 
Chekhov, Anton: “A Doctor’s Visit.”  Translated by Constance Garnett.  https://www.ibiblio.org/eldritch/ac/jr/193.h
Coulehan, Jack.  “Cold Eye, Warm Heart: Medicine and Anton Chekhov.” MedHum, October 2, 2025 Flanagan, Hallie. 1940, reprinted 1985. Arena: The Story of the Federal Theatre. New York: Limelight Editions 
Rothenberg, Karen H. and Bush, Lynn Wein. 2014. The Drama of DNA. New York: Oxford University Press 
Savitt, Todd L. (ed.) 2002.  Medical Readers’ Theater:  A Guide and Scripts.  Iowa City: University of Iowa Press 
Schiller, Friedrich. 1784. “The Stage as a Moral Institution.” In Theatre/Theory/Theatre, 250-254.  New York:  Applause 

Web image created based on this vintage illustration from WikiCommons

A Doctor’s Visit:  An Adaptation of a Short Story by Chekhov

by Guy Fredrick Glass

Downloads of this play may be distributed and performed for educational purposes only, with permission of the author.  Dr Glass may be contacted at gf***@*ol.com 

[embedpress_pdf]https://medhum.org/wp-content/uploads/2025/12/A-Doctors-Visit-2017-version-copy.pdf[/embedpress_pdf]

Directed by Anne Kauffman, the play features “Primes,” or holographic simulations of the dead intended for therapeutic use by the living. June Squibb—who, at 96, is making history as the oldest performer to open a Broadway show—astonishes as Marjorie, an impish 85-year-old with dementia using a much younger version of her husband Walter (an uncanny yet tender Christopher Lowell) to regain and retain her memory. Marjorie’s daughter Tess (the incredible Cynthia Nixon) is skeptical and fearful of the technology, whereas Tess’s husband Jon, played by a standout Danny Burstein, is a fan—until an on-the-nose change of heart in the penultimate scene. 

Marjorie Prime’s central flaw is that it favors concepts over dramatic depth. The characters are well-acted but underdeveloped, and almost all they do is talk; the biggest event may be Marjorie urinating herself. Yet, despite its slow pace and formulaic structure, Marjorie Prime is intelligent and poignant. 

Marjorie’s memories are embellished and sanitized for her comfort and convenience. The fallibility of memory is hardly a novel concept, but the Primes enable this reconstructive process and also become a stand-in for genuine connection in the wake of grief, preventing the family from confronting painful realities and repairing their relationships.  

By the time the truth fully surfaces in the unsettling final scene, which makes adroit use of a stage turntable (props to scenic designer Lee Jellinek), there are no humans left to heal. When storytelling is delegated to AI, truth becomes archival rather than relational; however, truth must be witnessed between living people in order to be ethically and therapeutically meaningful.  

Playwright Jordan Harrison’s Primes, like flesh-and-blood clinicians, absorb and co-construct patients’ accounts of self, yet they are disembodied, unfeeling, and ultimately unable to act with compassion, turning dynamic stories into datasets.   

Marjorie Prime, through Feb. 15 at the Helen Hayes Theater in New York; 2st.com/shows/marjorie-prime.  

“Much of healthcare happens in interpersonal moments,” write Maura Spiegel and Danielle Spencer in the first chapter of The Principles and Practice of Narrative Medicine—and machines are good at many things, but participating in a truly interpersonal moment is likely not one of them. Several studies have suggested that models perform worse for underrepresented groups because they are trained on datasets that lack racial, cultural, and linguistic diversity. Additionally, AI may miss subtle emotional cues and fail to interpret tone, context, and metaphors, which, one bioethicist [1] predicts, could “fundamentally alter” how trust is practiced in healthcare. Others [2] have underscored that “AI should be viewed not as a replacement for the physician, but as a partner in delivering empathetic, patient-centered care.” 

However, AI is not wholly bad. For example, a recent systematic review [3] found that applying natural language processing (NLP) to unstructured text in electronic health records (EHRs) can detect signs of cognitive impairment. Some [4] have found solace in text-based simulations with lost loved ones. And perhaps technology should be viewed as a vehicle for strengthening partnerships between clinicians and patients. Designed by Gabriela Gomes, the video game Healing Spaces aims to help those with neurodegenerative diseases connect with their caregivers. It is a multisensory experience: an app with beach and forest scenes, and a box with aromatherapy that smells like pine trees. Healing Spaces may evoke memories or even create new ones between caregiver and patient, unlike the Primes’ hollow curation. 

Healing Spaces also includes sunscreen-scented lotion that caregivers can use to massage the hands of those in their care. Needless to say, holograms and lotion don’t pair well. “You can’t touch a hologram. So there’s something about them looking so much like your loved ones, but not being able to quite achieve intimacy with them,” said Harrison during Marjorie Prime’s Off-Broadway run about a decade ago. “The loneliness can never be quite extinguished, never satisfied, because they’re just pixels.”  

[1] Kerasidou, Angeliki. “Artificial Intelligence and the Ongoing Need for Empathy,  Compassion and Trust in Healthcare.” Bulletin of the World Health Organization, vol. 98, no. 4, 2020, pp. 245-250. pmc.ncbi.nlm.nih.gov/articles/PMC7133472/. 

[2] Ghenimi, Nadirah, et al. “Integrating AI with Narrative-Based Medicine: Enhancing Patient-Centered Care in Primary Practice.” Perspectives in Primary Care, 5 Dec. 2024, info.primarycare.hms.harvard.edu/perspectives/articles/integrating-ai-with-narrative-based-medicine.  

[3] Shankar, Ravi et al. “Natural Language Processing of Electronic Health Records for Early Detection of Cognitive Decline: A Systematic Review.”npj Digital Medicine, vol. 8, no. 1, 2025, p. 133. pubmed.ncbi.nlm.nih.gov/40025194/. 

[4] Fagone, Jason. “The Jessica Simulation: Love and Loss in the Age of A.I.” The San Francisco Chronicle, 23 July 2021, sfchronicle.com/projects/2021/jessica-simulation-artificial-intelligence/. 

Web image from 2nd Street Theater.

Many modern physicians minimize, or are unaware of, a second source of historical medical success: the power of language and ritual to facilitate physical and psychological healing. Assisted by his priests, Aesculapius, the Greek god of medicine, healed the sick through poetry, narrative, and ritual. Even Hippocrates, the father of naturalistic Western medicine, paid tribute to Aesculapius in his famous Oath, and emphasized in many of his case histories the importance of interpersonal and contextual factors in patient care. While the healing power of language and context was rarely explicit in the subsequent history of Western medicine, it finally emerged into consciousness during the last two hundred years, when it was given the name placebo effect. Initially considered a minor aberration in suggestible people, more recently this component of healing has been recognized as an almost universal human facility (or reaction) of varying and sometimes amazing power.  

In this essay I present a case study of a traditional healing ceremony in which the therapy consists entirely of language, especially poetry, and the ritual context in which the language is spoken and chanted. I argue that this is a very powerful example of contextual healing. I then examine our contemporary understanding of the placebo effect, which is also a form of contextual healing, albeit ordinarily much less striking and more “dilute” than the Navajo example. Finally, I comment briefly on some features of healing miracles in the Catholic Church, arguing that these, too, are powerful instances of contextual healing that suggest at their upper limit, so to speak, such mechanisms may actually be able to reverse disease processes, like cancer or neurological impairment. Of course, this outcome is rare, unpredictable, and not at all understood.  

Sarah Mailcarrier and the Night Way 

Dark cloud is at the door. 
The trail out of it is dark cloud. 
The zigzag lightning stands high upon it. 
An offering I make. 
Restore my feet for me. 
Restore my legs for me. 
Restore my body for me. 
Restore my mind for me. 
Restore my voice for me. 
This very day take out your spell for me.  

Happily, I recover. 
Happily my interior becomes cool. 
Happily I go forth. 
My interior feeling cool, may I walk. 
No longer sore, may I walk. 
Impervious to pain, may I walk. 
With lively feelings may I walk. 
As it used to be long ago, may I walk.¹ 

These lines constitute a small segment from one of the poems chanted during the Night Way, a nine-day Navajo healing ceremony. In the early 1970s, Sarah Mailcarrier was the matriarch of an extended family whose camp was at Cornfields in Beautiful Valley near Klagetoh Mesa. A healthy woman well into her 60s, she developed severe lower abdominal pain, vaginal bleeding, poor appetite, and swelling of her legs over a period of two to three months. Her family took her to Fort Defiance Indian Hospital, some 50 miles from home, where she was discovered to be suffering from cancer of the cervix, which had spread widely, blocking lymphatic ducts in her legs and partially obstructing her kidneys. The recommended treatment was palliative radiation at Gallup Indian Medical Center, a larger hospital in Gallup, New Mexico, another 30 miles distant from Cornfields. Sarah and her family declined this option and, instead, consulted a hand trembler, who diagnosed her problem and recommended a Night Way Sing or healing ceremony. The family hired a ha’a’tali or traditional healer who, along with his assistants, conducted the ceremony over nine days and nights at her camp in Cornfields.² 

According to Navajo diagnostic taxonomy, Sarah had fallen out of harmony with the cosmic narrative that defines the proper relationships among the Earth Surface People, the Holy People, and the natural world. This likely was the result of certain traumatic exposures and events in her life. Healing would require restoration of harmony through the chants, rituals, images, and stories that the Holy People had given to the Navajo for just this purpose. The ceremony was successful. Sarah’s symptoms were relieved, her energy restored, her anxiety disappeared, and she continued to function in her role as matriarch for several months until she drifted into a long sleep and died. 

To explore the nature of Sarah’s healing, I have to explain a little more about Navajo medical beliefs. In traditional Navajo thought, all illness represents disharmony, in essence a snag or gap in the interconnectedness that characterizes the dineh (people), the harmonious Navajo Way. While there are many causes of disharmony (e.g. witchcraft, demon possession, soul loss, taboo violation, and traumatic exposure, as with Sarah Mailcarrier), the goal of treatment is always the same—to restore proper harmony at all levels, from within the patient’s own heart, to his or her relationship to the cosmos.  

The ceremonies, which can last up to nine days, require the patient and family to hire an ha’a’tali and his assistants, and to invite friends and clan members to set aside their other responsibilities and participate in songs, dances, prayers, and other rituals appropriate to the ceremony. Sung by the ha’a’tali these are magnificent narrative poems that tell of the creation of the Navajo people, and how all things were originally placed into their proper order. Likewise, in ceremonial dances, men impersonate Yei Be Chai, intermediaries between the Holy People (whom we might call “gods”) and the Earth Surface People (us), and channel their healing power.  

However, the dineh have never rejected Western medicine. Instead, they have integrated Western physicians, clinics, and hospitals into their overall worldview, considering them synergistic with, rather than antagonistic to, traditional ceremonies. The dineh believe that Western health care has simply added a different set of stories and a different network of ceremonies (e.g. clinic visits, x-rays, penicillin shots, arthritis pills) onto their already existing—and far more important—traditional healing practices. The Navajo were quick to observe that bilighani treatments were effective in alleviating outward manifestations, or what we would call symptoms, of disharmony, but they also maintained that such treatments had no influence on the underlying existential disorder. In other words, penicillin shots and arthritis pills are only symptomatic treatments. While bilighani methods could make the fever or rash or cough disappear, at least for a time, the fundamental issue of disharmony would remain. Why me? What does this illness mean in my life? How does this illness reflect my relationship to the cosmos? These questions could only be answered with reference, for example, to the story of Spider Woman, or the Hero Twins, or other narratives of Navajo cosmogony.  

Returning to Sarah Mailcarrier, it appears that by undergoing a Night Way Sing, she experienced a dramatic improvement in her quality of life. From a Western perspective, why might this be the case? First, the lengthy ceremony provided extensive and intense social support, represented by the participation of her extended family and friends, their contributions of time and money³, and overall solidarity. An extensive body of research indicates that high level of social support and prosocial behavior are associated with longer life, less morbidity, less disability, and greater satisfaction. Second, Sings are integral components of religious practice. For a person like Sarah Mailcarrier, religious belief (in the Western sense of the term) and cultural practices were inextricable. Once again, considerable research indicates that frequency and intensity of religious practice is associated with the same positive outcomes. Third, the ritual chants, vivid poetic images, storytelling, sandpainting, and dancing of the Night Way embody a belief system that generates positive expectations—and restores coherence to the patient’s life.⁴  

These components—social support, core beliefs, and positive expectations—all rely on language and communication. Empathy, the human ability to “intuit” what another person is thinking or feeling⁵, is a more basic neurological property than language, but without language humans could not have created the rich symbolic world in which we live. In the 1980s the psychiatrist Donald Sandler distinguished between Navajo symbolic healing, based on an integrated cultural narrative, including symbol and ritual; and scientific healing, which he believed could be clearly distinguished from the latter and which relies solely on specific instrumental effects of drugs, surgery, and so forth.⁶ Like Sandler, today’s physicians are quite willing to make allowances for the beliefs of patients from other cultures, but at the same time they cling to the belief that scientific medicine transcends culture and our effectiveness as healers is solely, or almost solely, explained by the instrumental effects of drugs and procedures. Thus, there is a widespread belief that scientific medicine is, as a system of curing disease, intrinsically culture-free. Antibiotics kill bacteria whether the patient is a middle-class American or an Amazonian Indian. Culture may enter into the picture for the Indian, e.g. because of his mistaken beliefs about illness, but has no effect on the American, whose beliefs (whatever they are) are medically invisible.  

From Placebo Effect to Contextual Healing 

For over 200 years Western physicians have been explicitly aware of the so-called placebo effect, but for most of that time have considered it a minor and somewhat disreputable factor on the medical scene. The first person to recognize and demonstrate the placebo effect was English physician John Haygarth in 1799, who was curious about the purported benefit a popular medical treatment of his time called “Perkins tractors,” metal pointers supposedly able to ‘draw out’ disease from the patient’s body. They were sold at the extremely high price of five guineas, and Haygarth set out to show that the high cost was unnecessary. He did this by comparing the beneficial results obtained by using dummy wooden tractors with those obtained with a set of allegedly active metal tractors. There was no difference. He published his findings in a book called On the Imagination as a Cause & as a Cure of Disorders of the Body.⁷ Subsequently, the term placebo (“I will please”) was coined to mean, as in this 1811 definition, “an epithet given to any medicine adopted more to please than to benefit the patient.” 

The modern understanding of the power of placebo intervention probably originated with Henry K. Beecher‘s 1955 classic paper, “The Powerful Placebo,” in which he described his experience as a medic during World War II⁸ After running out of pain-killing morphine, in desperation he replaced it with a simple saline solution, while continuing to tell the wounded soldiers that the injection was morphine. He often found that saline appeared to be almost as effective as morphine in relieving his patients’ pain and anxiety. Despite this dramatic demonstration, the orthodoxy surrounding placebo effects for the next several decades came to include three major components:  

• A focus on the specific intervention as its cause, i.e. the pill or the procedure itself “carried” or “transmitted” the placebo effect. 

• Importance of patient vulnerability, i.e. only suggestible persons were placebo-responders. 

• Miscommunication, i.e. the patient must deceived, directly or indirectly, into believing that he or she was receiving an “active” treatment.  

However, research in the last 30 years has completely exploded this orthodoxy and replaced it with a much more complex understanding that sheds light, for example, on the power of traditional medical systems, like the Navajo, that rely on poetry, narrative, and ritual to heal. To quote Franklin Miller and Ted Kaptchuk, two of today’s most prominent investigators in the field: “To promote a more accurate understanding of the elusive and confusing phenomenon known as the placebo effect, we suggest that it should be reconceptualized as contextual healing… Factors that may play a role in contextual healing include the environment of the clinical setting, cognitive and affective communication of clinicians, and the ritual of administering treatment.”⁹ Elsewhere, Kaptchuk added, “Research also suggests that (narrative and) ritual healing not only represents changes in affect, self-awareness, and self-appraisal of behavioral capacities, but involves modulations of symptoms through neurobiological mechanisms.”¹⁰  

Contextual healing, as the term implies, occurs in the context of expectations that arise from a network of beliefs. Moerman and Jonas, highlighting the fact that context can communicate therapeutic meaning to the patient, prefer using the term “meaning response.”¹¹ In some cases these beliefs may be based on past experience, but isolated from, or not intimately connected to, deeply meaningful worldviews (e.g. that penicillin cures a sore throat). In other cases they may closely connected to robust belief systems about the nature and origin of illness and healing (e.g. the Navajo Night Way). The latter are obviously more important than the former. The net valence of one’s beliefs determines the meaning of any medical interaction or treatment and, therefore, one’s expectations of its effect. Language, communication, empathy, narrative, and ritual determine the healing context. The universality of contextual effects on symptom relief has been demonstrated convincingly in neurobiological studies, especially those dealing with pain reduction. For example, on fMRI “placebo” treatment reduces activation of pain-related areas of the brain, e.g. the dorsolateral pre-frontal cortex.^{12, 13}  

Contemporary research on contextual healing has also revealed a number of unexpected features that are inconsistent with the earlier orthodoxy regarding placebo effects. For example, 

• Placebo effectiveness does not require deception; patients may report relief of symptoms even when told they are receiving placebo treatment.¹⁴ 

• There may be a link between genetic variants in the dopamine, opioid, serotonin, and endocannabinoid pathways in the brain and placebo responsiveness.¹⁵ 

• Placebo effects (as well as nocebo, or harmful effects) can exist in routine clinical practice, even if no “intervention” is given.^{16, 17} 

• Placebo response is greater when observed in clinical practice than when measured in randomized clinical trials.^{8, 19}  

This last feature requires some clarification. This is precisely the opposite of specific medication effects, which are almost always more prominent in clinical trials than in routine practice because the populations in trials are highly homogenized (e.g. limited age range, selected to exclude co-morbidities), adhere to highly structured protocols (e.g. frequent follow-up, expert clinicians. methods to insure, or at least measure, compliance) and include only highly motivated subjects. These conditions are ideal for demonstrating the drug’s maximal specific benefit (efficacy), while at the same time somewhat less ideal for showing contextual healing power, since individual variation and personal narrative are minimized. The specify potency of a drug tends to be less in ordinary clinical practice (effectiveness) where there are a mixture of patients with different ages, backgrounds, comorbidities, and levels of compliance. However, the latter less-than-standardized conditions are likely to enhance the power of contextual healing. For example, “It seems likely that the effectiveness of placebo for pain relief in osteoarthritis can be considerably larger than its efficacy. The artificial conditions of a clinical trial constrain the extent to which context effects…” can be manifested.²⁰ 

Can Language Spoken in Context Cure Disease? 

Given that contextual or narrative healing may be a powerful force in relieving symptoms and improving quality of life, can it ever cure chronic or progressive disease? It is unlikely that Sarah Mailcarrier’s Night Way ceremony damaged her cancer cells or had any influence on their progress. However, it seems clear that narrative healing may in many cases “cure” at least some cases of major depression, generalized anxiety, post-traumatic stress syndrome, substance abuse, and perhaps even schizophrenia. Since these disorders are all characterized by abnormal concentrations or function of neurotransmitters, it is safe to say that contextual healing influences brain chemistry. Likewise, fMRI studies have shown that placebo treatments alter brain function. For example, placebo treatment in Parkinson’s disease may result in demonstrable changes in imaging, primarily resulting from increased dopamine release in certain areas of the basal ganglia.²¹ These changes may be associated with improvements in patient function. Likewise, placebo has also been shown to modulate physiological processes, like lowering blood sugar in diabetics and treatment enhancing immune responses, which may be related to neurophysiology in complex ways. ^{22, 23} 

There is a long history of rare, unexplained, but yet well-documented, cures in medicine. As medical knowledge has increased, the number of such inexplicable or “miracle” cures has diminished. Nonetheless, instances of the disappearance of widely metastatic cancer, or the resolution of aggressive autoimmune disease, do occur. Religious persons attribute these unexplained cures to supernatural intervention. Jacalyn Duffin’s 2009 book Medical Miracles: Doctors, Saints and Healing in the Modern World describes her investigation in the Vatican archives of 1400 cases of miracle cures that were cited as evidence in canonization proceedings between 1588 and 1999.²⁴ Of these, 503 cases occurred in the 20^th century and 220 of them between 1975 and 1999, the final year of her study. Most in the 1975-1999 group were extremely well-documented. 20^th century cures included 41 cases of cancer or leukemia, 109 neurological diseases (e.g. multiple sclerosis, myasthenia gravis, Parkinson’s disease), and 89 obvious orthopedic conditions. The unifying factor was that every “miracle” was associated with narrative and ritual. Prayer to Jesus, Mary, or another person, i.e. the candidate for sainthood, took place in various contexts, solitary or communal narrative associated with Masses, novenas, relics, monuments, tombs, etc. These features are all analogous to Navajo healing ceremonies. The same sort of analysis has been applied to “miracle” cures at Lourdes, a pilgrimage site in France, with similar results: a relatively small number of thoroughly documented and inexplicable cures among many thousands of claims.²⁵ 

A Note on Nocebo 

Traditional cultures also recognize the power of language to harm, as well as heal. This includes spells, hexes, curses, and similar verbal insults that produce harmful effects on the person to whom they are directed. Since the phenomenon of “Voodoo death” was described by Cannon in 1942²⁶, various other syndromes of illness and death based on witchcraft and curses were re-evaluated or newly described have been reported; for example, “bone-pointing” (kurdaitcha) in Australia and “breaking tapu” in New Zealand. Among Aboriginal people an individual targeted by bone pointing may die within 24 hours or may decline inexorably over a period of days. ²⁷ Such a curse can only be reversed by the intervention of an appropriate sorcerer. Among the Navajo, many serious illnesses are caused by curses that lead to “soul loss” or “possession.”  

Likewise, in Western medicine the words of physicians or other health care professionals, and the context in which they are spoken, may actually increase a patient’s symptoms, anxiety, and suffering. The eminent internist Eric Cassell, paraphrasing an old childhood chant, taught “Sticks and stones may break your bones, but a word can kill you.” (Personal communication) There is no room here to discuss nocebo-inducing language in medical practice, which is analyzed in detail in chapter 13 of Coulehan and Block.^{28, 29} 

Conclusion 

In this essay I make the claim that contextual healing (aka the placebo effect) plays a major role in medical practice and that language, either spoken verbally, or used internally to represent beliefs and personal meanings, is the carrier or operative agent of contextual healing. In most circumstances contextual healing has a limited, but clinically significant, range of effects. The clinician by employing “skillful means” (to use a Buddhist expression) can promote and enhance contextual healing in the clinical setting.^{20, 31} Navajo medicine is an example of a traditional medical system built almost entirely on exploiting the vast resources available to contextual healing. To a greater or lesser extent, Curanderismo, Vodun, homeopathy, Christian Science, and many other approaches to the treatment of illness are based on contextual healing. The upper limit of this healing power is normally modest, but under certain circumstances for certain people it may be quite spectacular, as in presumptive miracle cures.  

Notes 

1. Navajo Night Way Song, https://www.lindavallejo.com/wp-content/uploads/2018/12/Chants-Prayers-Poems-2011-2.pdf, accessed on 3 December 2025. 
2. Coulehan J. May I Walk in Beauty. Humane Medicine, 1992; 8: 65-69. 
3. Kaptchuk TJ. Placebo studies and ritual theory: a comparative analysis of Navajo, acupuncture and biomedical healing. Phil Trans R Soc B. 2011; 366: 1849-1858 
4. By “intuit” I mean the development of a theory of mind (i.e. others have minds just like me). Primates and perhaps some other mammals have an analogous ability, but presumably without a symbolic language. 
5. A Sing is expensive. The patient’s family must hire an ha’a’tali and his assistants and also provide food and drink for a large number of participants and attendees. Some participants must also take time off from their jobs or other pursuits for several days. 
6. Haygarth J MD. On the Imagination as a Cause & as a Cure of Disorders of the Body, Bath; R. Cruttwell, 1801. 
7. Sandler D. Navaho Symbols of Healing. New York, Harcourt Brace Jovanovich, 1979, pp. 265-273.  
8. Beecher HK. The powerful placebo. JAMA. 1955;159(17):1602-1606 
9. Miller FG, Kaptchuk TJ. The power of context: reconceptualizing the placebo effect. JRSM. 2008; 101: 222-225, p. 223. 
10. Kaptchuk TJ. Placebo studies and ritual theory: a comparative analysis of Navajo, acupuncture and biomedical healing. Phil Trans R Soc B Biol Sci. 2011; 366: 1849-1858, p. 1849. 
11. Moerman DE, Jonas WB. Deconstructing the placebo effect and finding the meaning response. Ann Intern Med 2002; 471-476. 
12. Brody H, Miller FG. Lessons from recent research about the placebo effect—from art to science. JAMA 2011; 306 (23): 2612-2613 
13. Colagiuri B, Schenk LA, Kessler MD, Dorsey SG, Colloca L. The placebo effect: From concepts to genes. Neuroscience. 2015; 307: 171-190 
14. Pecina M, Zubieta JK. Molecular mechanisms of placebo responses in humans. Mol Psychiatry. 2015; 20: 416-423 
15. Miller FG, Coilloca L, Kaptchuk TJ. The placebo effect: illness and interpersonal healing. Perspect Biol Med. 2009; 52: 518 
16. Stub T, Foss N, Liodden I. “Placebo effect is probably what we refer to as patient healing power”: a qualitative pilot study examining how Norwegian complementary therapists reflect on their practice, BMC Complementary and Alternative Med. 2017; 17:262 
17. Benedetti F, Pollo A, Lopiana L, Lanotte M, Vighetti S, Rainero I. Conscious expectation and unconscious conditioning in analgesic, motor, and hormonal placebo/nocebo responses. J Neurosci. 2003; 23: 4315-4323 
18. Dieppe P, Goldingay S, Greville-Harris M. The power and value of placebo and nocebo in painful osteoarthritis. Osteoarthritis and Cartilage. 2016; 24:1850-1857 
19. Haake M, Muller HH, Schade-Brittinger C et al. German acupuncture trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med. 2007; 167: 1892-1898 
20. Dieppe et al, p. 1852. 
21. Fuente-Fernandez R, Ruth TJ, Sossi V, Schulzer M, Calne DB, Stoessl AJ, Expectation and Dopamine Release: Mechanism of the Placebo Effect in Parkinson’s Disease. Science. 2001; 293: 1164-1166. 
22. Skvortsova A, Veldhuijzen DS, van Dillen LF, Zech H, Derkson SM, Sars RH, Meijer OC, Pijl H, Evers AWM. Influencing the Insulin System by Placebo Effects in Patients With Diabetes Type 2 and Healthy Controls: A Randomized Controlled Trial. Psychosomatic Medicine. 2023; 85: 551-560 
23. Smits RM et al. The role of placebo effects in immune-related conditions: mechanisms and clinical considerations. Expert Rev Clin Immunol. 2018; 14(9): 761-770. 
24. Duffin J. Medical Miracles. Doctors, Saints, and Healing in the Modern World. New York, Oxford University Press, 2009. 
25. François B, Sternberg EM, Fee E. The Lourdes medical cures revisited. J Hist Med Allied Sci. 2014 Jan;69(1):135-62.  
26. Cannon WB. “Voodoo” death. American Anthropologist, 1942; 44: 169-181. Reprinted in Am J Public Health. 2002; 92 (10): 1593-1596. 
27. Spencer, Baldwin; Gillen, F.J. Native Tribes of Central Australia. Cambridge University Press, 2010 [1899], pp. 476–477. 
28. Coulehan J, Block M. The Medical Interview. Mastering Skills for Clinical Practice. Philadelphia, F.A. Davis Company, 5^th edition, 2006, pp. 21-44 and 249-278.  
29. Hansen E, Zech N. Nocebo effects and negative suggestions in daily clinical practice – forms, impact and approaches to avoid them. Front Pharmacol. 2019 Feb 13; 10:77. 
30. Coulehan J, Clary P. Healing the healer: Poetry in Palliative Care, J Palliative Medicine, 2005; 8: 382-389. 
31. Blasini M, Peiris N, Wright T, Colloca L The role of patient-practitioner relationships in placebo and nocebo phenomena. Int Rev Neurobiol. 2018; 139:211-231.  

Web image created by Medhum.org

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.