Imagine a woman by Richard Seizer: uses in a doctoring course.

Family Medicine November-December 2001 Literature and the Arts in Medical Education Johanna Shapiro, PhD Feature Editor Editor’s Note: In this column, teachers who are currently using literary and artistic materials as part of their curricula will briefly summarize specific works, delineate their purposes and goals in using these media, describe their audience and teaching strategies, discuss their methods of evaluation, and speculate about the impact of these teaching tools on learners (and teachers). Submissions should be three to five double-spaced pages with a minimum of references. Send your submissions to me at University of California, Irvine, Department of Family Medicine, 101 City Drive South, Building 200, Room 512, Route 81, Orange, CA 92868-3298. 949-824-3748. Fax: 714- 456-7984. jfshapir@uci.edu. Imagine a Woman by Richard Selzer: Uses in a Doctoring Course Desiree Lie, MD, MSEd As its title suggests, this thought- provoking short story from Richard Selzer’s collection, The Doctor Sto- ries, 1 invites the reader to stretch the imagination across place and time, to be present with a narrator who writes, we ultimately discover, from beyond the grave. The piece sets a mood and tone that leaves much room for interpretation, judgement, and most importantly, feeling. As an instructional tool, it exem- plifies the use of literary stories to “teach desire.” In the words of Rita Charon, “The desire that swamps medicine is the same desire that swamps literature: the hunger to tell, the yearning to hear, the long- ing to read to the end, and the drive to search beyond the ending.” 2 Contemporary narratives about death and dying, and in particular about AIDS, often chronicle the dis- ease by challenging myths sur- rounding the illness and its sufferer. For example, in AIDS and Its Meta- phors, Susan Sontag exposes, criti- (Fam Med 2001;33(10):736-7.) From the Department of Family Medicine, University of California, Irvine. cizes, and condemns the metaphors that stereotype and thus exacerbate the pain of the AIDS-afflicted pa- tient. Emmanuel Dreuilhe’s Mortal Embrace is a rare autobiographical account of AIDS presented as a se- ries of essays without a structured plot or chronology. Imagine a Woman, by contrast, as a fictional short story, alludes to the physical and emotional stigmata of AIDS without directly attacking the popular culture and background that create these negative attitudes toward sufferers of the disease. The message is subtle and implied. In- deed, the story has been criticized for being too romanticized, too “clean and pristine” in its portrayal of how people really die from AIDS. 3 At her prenatal visit, a newly pregnant young woman, Monica, discovers unexpectedly from her obstetrician that she is infected with the AIDS virus. She surmises that her bisexual husband, whom she knows has a lover, has passed this infection on to her. Choosing to es- cape confrontation, she instead de- cides to live out her last year in ano- nymity, with hospitable strangers in an idyllic French village. As the story progresses, the Monet-like countryside takes on a dreamlike, surreal quality. Characters and scenes are drawn with endearing, exquisite detail, sprinkled with doses of lively humor and skepti- cal mysticism. The woman’s journal, to be sent to her husband on her death, ex- plores the course of her pregnancy, which ends in stillbirth, her inner life of coming to terms with her undeserved fate, her transition from repressed to resolved anger, and her letting go of her past. We learn little about her family, something about a barren marriage, much about her spiritual transformation, and more about the emotional protection of- fered by the loving kindness of oth- ers. While not spared the full force and wrath of AIDS-related sick- ness—Kaposi’s sarcoma, shingles and wasting, symptoms of pain, nausea, vomiting, fatigue, bleeding, cough, dypsnoea, and eventually clouding consciousness—Monica is somehow rescued by engaging in the simple life around her. The story can be edited and short- ened to present in a small-group