Anne Whitehead, Medicine and Empathy in Contemporary British Fiction: A Critical Intervention in Medical Humanities (Edinburgh: Edinburgh University Press, 2017).
Empathy, power structures, and what we are capable of not doing
In a 1988 interview with George Plimpton, Maya Angelou passionately argued for the importance of fiction by saying that novelists don’t lie: ‘The fact is that […] they are using some made up names, and made-up people and made-up places, and made-up times, but they are telling the truth about the human being, what we are capable of.’ Angelou unwittingly positions affect, which for Spinoza is the capability to act and feel, simultaneously at the heart of the truth of human beings and at the heart of fiction. Anne Whitehead’s recent book Medicine and Empathy in Contemporary British Fiction expands this view by arguing that the affect of empathy stands at the forefront not only of what we are capable of doing, but also of what we are capable of not doing. Her original argument is that empathy in culture and literature is not necessarily a positive concept, but an affect that is central to the discourses of power and privilege.
Medicine and Empathy starts as an exploration of the role of empathy in the humanities and the sciences, but quickly turns into a fierce discussion of the role that empathy plays in neoliberalism. Whitehead offers a structured review of conceptualisations of empathy within the medical humanities and broader scientific discourse before going on to explore the “dark side” of empathy in fiction. To perform this rather challenging task, Whitehead debunks the prevalent view of fiction according to which narrative and storytelling must induce empathy in the reader. Instead, she explores narratives with topics ranging from war and encounters with the Other (Chapter 2 and 4), to the doctor-patient relationship (Chapter 3), to dealing with autism and syndromes (Chapter 1), in order to depict the nuanced and insidious aspects of empathy in British literature. Whitehead’s neatly signposted and concise monograph includes close readings of contemporary British fiction by Mark Haddon, Pat Barker, Ian McEwan, Aminatta Forna, and Kazuo Ishiguro. Through these close-readings, she makes a convincing case for the existence and development of empathy in the British novel as an Other-oriented affect, that, instead of claiming power over the other’s consciousness, enables the individual to recognise and celebrate difference. This view of empathy relies on a neo-phenomenological reading and on feminist affect theory in order to ’emphasise an account of empathy that does not claim to know or to understand the other, but remains alert to her distance and her difference’ (2).
Whitehead finds that for the sciences, the definition of empathy is ‘volatile, unstable, and contested’ (53); at the same time, for the humanities, the complex of empathy is viewed as necessary for the development of ethics and human rights in general. Whitehead debunks, or rather, re-situates, this almost sacrosanct view of empathy by asserting that there is ‘a scarcity of tangible evidence that readerly empathy translates into greater altruism in everyday behaviour’ (64). The book proposes empathy’s moving away from the dual doctor-patient relationship dominating the Medical Humanities and asks what it is that ’empathy does, as well as who […] does the labour of empathy’ (12) and what implications this has for global power structures. In other words, Whitehead employs key British fictional texts to show that empathy cannot be separated from its sociopolitical origin, and to highlight that building on a supposedly inherently positive view of empathy can have serious racial, political, and economic implications.
As Whitehead’s interdisciplinary study shows, dominant accounts in the humanities and the sciences assume that empathy is an inherently positive affect; both claim that the individual can probe into another’s mind as a result of fiction; and both are wrong. Instead, Whitehead sees empathy as the potential limit of human capability, understanding, and ultimately emotion. Empathy is what we should be moving towards, but its full attainment is impossible and unwanted, since it can distract or divert from political change (11). Consistent with this view, the most important accomplishment of the book is that it employs empathy as a tool to explore what being human means in an age of biomedicine, bio-capitalism, and commodification of emotion: by showing that one of the most enduring definitions of empathy include ‘how one would […] respond to a particular set of circumstances’ (62), Whitehead boldly relates the capability of feeling empathy as a means to re-invent oneself so that one fits into the neoliberal ideal.
Not all is bleak, though. Through a series of stimulating close-readings where privilege and existing power structures are called into question, as in the close-reading of McEwan’s Saturday and Ishiguro’s Never Let Me Go, Whitehead points to literature’s positive influence on political change by reading them ‘against the grain,’ challenging prevalent notions and critical views of these novels. In Chapter 2, where the book’s main argument of politicising empathy is in full swing, Whitehead asks ‘what difference does it make to our understanding of the empathetic encounter if we ask where and when it takes place, as well as between whom?’ (61), a question that echoes Pierre Bourdieu’s notion of ‘symbolic violence’ (1992): Whitehead here argues that empathy legitimizes the status quo, as Bourdieu argued with regard to dominant ideology, while grappling with difficult narratives and controversial issues, such as Kathy’s affectlessness in Never Let Me Go (Chapter 4) or the imperialist affect in Forna’s The Memory of Love (Chapter 3) to point out that no-one and nothing is a-political; not even suffering. By narrating, diagnosing, or exhibiting suffering and illness, as well as by gazing at, talking about, and treating pain and suffering, a political agenda is always already at play.
Medicine and Empathy is a challenging read, in that it raises more questions than it can possibly provide answers for. These questions, though, and the debates they bookend, are a necessary provocation for scholars in any discipline that studies how humans relate to each other, whether the object of investigation is communication through brainwaves or through storytelling. Medicine and Empathy is a significant and much-needed book: Whitehead is a relentless summoner of doubts as to how empathy is deployed in the Medical Humanities and a reconstitutor of the humanities in the medical. Ultimately, Medicine and Empathy is a manifesto for contemporary British literature, not because the latter shows us what we are capable of, but because it problematises what we haven’t been able to do so far.
Dr Iro Filippaki obtained her PhD from the University of Glasgow in 2017 in English Literature and Medical Humanities, where she explored the representation of war traumatic narratives in the twentieth and twenty-first centuries. She currently teaches Academic Writing at the University of Glasgow, as well as a Student Selected Component for UofG’s Medical School, titled Literature and Medicine.