Making Space for the Patient’s Voice: notes from a creative writing workshop (part 2)

Gillian Shirreffs writes: 

In early November 2020, Jane Hartshorn and I hosted a workshop as part of the Thinking Through Things: Object Encounters in the Medical Humanities project. We used images from Wellcome Collection and drew upon our doctoral research, creative practice, and lived experience of chronic illness to explore ways to make space for the patient’s voice.

My focus was on fiction writing. I read from my novel Brodie and discussed my doctoral project, in which I explore the relationship between object and illness, with specific reference to multiple sclerosis. Brodie is narrated by an object: a copy of The Prime of Miss Jean Brodie. In writing it, I sought to use the voice of the narrator to make space for my voice: the voice of a patient.

The idea for my object narrator first came to me during a period of bedrest after I was diagnosed with multiple sclerosis. I’d gone from someone with no known health condition to someone who disappeared from sight over the course of a weekend – having lost the feeling from my toes to my chest – and who eventually returned, under house arrest, with a diagnosis of MS.

Friends, colleagues, and family members didn’t know how to react, how to respond. When they visited, I could just make out, from somewhere below, whispered reverential tones in which they offered condolences to my husband. They would arrive upstairs with wide smiles fixed in place and when our conversation had gone from dry to desiccated, they would retreat to the kitchen where my husband would make them tea, coffee, or something stronger.

As visitors left my room to head downstairs, I would hear the beginnings of conversations and would have to imagine the rest. Sometimes, rather deliciously, I would know they were headed to a room where someone they didn’t like was already installed. My imagination would take over: inventing what might be said; what might happen next.

The idea for my object narrator was born. A narrator without self-agency, but with every other sense and faculty, lacking merely the ability to move at will.

In writing Brodie, I was able to explore the feeling of being simultaneously present and absent; the invisibility cloak of illness and the opportunities it affords for eavesdropping; the lack of freedom in medical settings – to choose where you are, who you are with, what is done to you; the feeling of being trapped – within a body, a bed, a house; the altered quality of time; and the sense of loss that accompanies the sudden onset of serious illness.

In order to give a sense of the voice of my narrator, I read the following extract from chapter twenty-three of Brodie:

Laurel was off for almost three weeks over Christmas. During this time, she took me with her wherever she went. Mostly I was transported in her backpack, but there were times when she would dress smartly and drop me into a leather handbag – it was tan in colour and had soft lining with vertical stripes in pink and green and brown.

We went mainly to cafés. Once there, Laurel would order a complicated sounding coffee. She would then sit down at a table and use me to create a buffer between herself and the other customers.

This, I confess, is merely my interpretation of the situation. I do not know for certain why she would lay me on the table in front of her and then raise me up in her hands, thereby creating the impression I was being read. I was not. Let me assure you, I can tell the difference.

My most enduring memory of this time is of the afternoon that Laurel took me to the Winter Gardens at the People’s Palace. A band played music in one corner. The café was busy, but despite this, she managed to find a table. It was small and had only one chair. The table next to us was just as small but there three were crowded around people it.

I found the neighbouring trio quite fascinating. Their hands and faces looked as though they had been fashioned out of pink crepe paper. They wore knitted apparel in cream and various shades of blue. Each one had a head of tight white curls. I decided, by the way they were quietly bickering, that they must be sisters. One had iridescent powder sprinkled from her forehead to her chin. It seemed she was the instigator of whatever conflict there was amongst them.

‘He did not,’ she said.

‘Yes. He did,’ said the sturdiest of the women.

Agreeing with her hardy sister, the frailest one said something akin to, ‘Mm Hm.’

The first one wagged a gnarled finger and said, ‘I’m telling you, he did not.’

And I’m telling you, he did,’ said the second.

MM HM,’ said the third, nodding her bony head emphatically.

I never did find out who he was and what it was that he was supposed to have done, or not done, because at this moment I felt Laurel’s hand tense.

I surveyed the room.

A couple had entered. The man was unremarkable. His companion, however, was striking in that she looked like a younger version of Laurel.

Laurel grabbed at her handbag.

She stood up – abandoning her hazelnut macchiato – and pushed past the old ladies in a way that incited the powdered one to snarl something about manners.

I was still in Laurel’s hand as she made her way to the garden part of the Winter Gardens, which, unlike the section with tables, chairs and the band, was virtually deserted. She sat down on a bench in the midst of the desolate rainforest and tried to regulate her breathing.

I began to wonder if the unremarkable man had even noticed Laurel’s flight into the ferns and, if he had, whether or not his eyes would have had any interest in prying. In the short time I had been able to observe him, it seemed his attention was fixed on his girlish consort and her alone. As I considered this matter, Laurel picked me up.

She held me close to her face.

I heard the unremarkable man address the girl on his arm.

‘You’re such a silly thing,’ he said.

I would like to be able to report that she did something else, but, in truth, she wrinkled her nose and giggled.

‘Am not,’ she said, tilting her cherub cheeks downwards.

He reached a hand inside her wool coat and wound it around her waist.

‘You are very silly,’ he said.

‘Fuck sake,’ Laurel growled.

I knew from his face that he had heard her.

He hardly moved his head as his eyes swivelled to look round.

‘Here, Chris? Really?’ Laurel said without raising her head from my pages.

As he guided the girl away by the arm, I heard her say, ‘Who was that, Christopher?’

I imagined he would not answer her question until they were far away under the cold December sky. I also imagined that his answer would not be truthful.

With this as our backdrop, we used the following images as prompts for fiction writing.

Syringes: Hypodermic, made by Down Bros.. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

The needles in this image don’t have a date, but I learned from other items in Wellcome Collection that the manufacturer, Down Brothers, produced medical instruments and equipment in the late 1800s and early 1900s. We used this image as a way to try to get to know an inanimate object, choosing one needle and having it express its opinion of the other. The results were both fascinating and funny.

A patient entering a computerized tomography scanner, seen from the control room. Etching and aquatint by Virginia Powell, ca. 1995.. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

The lettering that accompanies this image, an etching by Virginia Powell, is: breathe in and out breathe in and hold your breath very still, the reading of which, due to the lack of punctuation, can render the reader a little breathless. Powell’s interest was in “people at work” as her subject. It could be suggested that she renders these people, her subjects, as object. We leaned into this thought in our writing exercise.

Specification of Edmund Adolphus Kirby : adjusting couch for medical, surgical, and general purposes.. Credit: Wellcome Collection. Attribution 4.0 International (CC BY 4.0)

This final image is a drawing of Edmund Adolphus Kirby’s “adjusting couch for medical, surgical and general purposes”. Wellcome Collection holds Kirby’s patent application in which he explains, “couches for invalids hitherto have been complicated in construction, costly in price”. His, however, “shall be easily adjustable to every position required in the treatment of disease or accident”. Kirby, a medical doctor in the mid-1800s, chose to turn inventor in order to improve this medical object for the benefit of his medical subjects. This provided an interesting context for our writing.

15-Minute Fiction Writing Exercises

If you’re interested in trying this out for yourself, below are two of the writing exercises. They use the image of the etching by Virginia Powell.

We began by studying the image.

  1. Imagine that the image represents the opening scene of a piece of short fiction written in third person. Use the image as a prompt and begin to write the story. Let the story flow: no judgments; no editing as you go.
  2. I’m not sure how you looked at the image in the first exercise, but this time, experience the scene solely from the point of view of the person who is partially inside the machine: the patient. Write a short monologue from the patient’s perspective and, by doing so, make space for them in this medical place.

 

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