In the second part of this contribution on medical humanities and the Irish language, Síobhra Aiken explores how the linguistic hierarchies governing modern healthcare shape the production of illness narratives among minoritised language speakers.
Narrative medicine is one of the more practised and discussed aspects of the medical humanities. But the production of any illness narrative usually involves two processes that cannot be taken for granted: firstly, the ability to find the words to describe the subjective experience of illness and, secondly, access to an audience that can validate the narrative. Both processes generate particular challenges for speakers of minoritised languages, which are often overlooked in dominant Western and anglocentric approaches to the study of narrative and life writing. As Angela Woods perceptively argues, “Too often particular kinds of narrative are presented as transcultural, transhistorical truths of the human experience, a view that operates at the expense of a more historically and anthropologically grounded approach to understanding the cultural specificity of idioms of distress” (2011: 74).
Hierarchies of knowledge: the persistence of the Irish language
The case study of the Irish language is a useful example for exploring how cultural, social, and linguistic hierarchies inform narratives of illness and healthcare. As explored in the first part of this contribution, the rapid decline of the Irish language from the beginning of the nineteenth century coincided with the rise of modern medicine. The deployment of “imperial medicine” in European colonies across the world was inherently connected to colonial knowledge production; in Ireland, the National System of Education was introduced in 1831 and established English as the only language of formal education and official knowledge brokering.
Though the language continues (quite remarkably) to be spoken as a community language and is now taught as a core subject within the school system in the Republic of Ireland, the legacies of linguistic oppression remain. Oral forms of knowledge tend to be marginalised in dominant academic studies. Publishing in the Irish language also continues to face major obstacles in terms of funding, distribution and reception, with poetry, including oral performance poetry, persisting as the language’s most practised and celebrated genre (see Ní Ghearbhuigh 2020). From the outset, then, illness narratives in this context are unlikely to comply with the conventions of the linear written narrative often favoured in medical humanities research (see Hey 2022).
The “primal scene” for the minoritised language patient
The experience of minoritised language speakers also upturns what has been identified as the “primal scene” of first-wave medical humanities: the communication of a diagnosis to a patient (Whitehead and Woods 2016, 1–4). While this interpersonal scene is often evoked to probe questions of communication and empathy, what happens when the patient and doctor do not understand each other’s language? Accounts of unintelligible medical encounters are some of the most common examples of illness narratives in the Irish language. Often the confusion and shame evoked by the meaningless medical exchange overshadows any attempt to describe the patient’s condition.
One snippet of oral folklore, collected in 1938 through the Irish Folklore Collection, illustrates how humour could be employed to address this common scenario: a woman (with no English) misunderstands her doctor (with no Irish) and hurls curses at him for his perceived ineptitude. Unlike the patient, there are no negative consequences for the doctor: he presumably emerges unscathed, blissful in his ignorance (Ó Flannagáin 1938).
More often, however, accounts of such communicative blocks are characterised by profound distress. The columnist Máire Ní Fhinneadha wrote in 2019 about the “fuarallas” [cold sweat] she still experiences when she thinks about the five days she spent in hospital at five years of age, where she couldn’t get as much as a glass of water for her lack of English and the hospital staff’s lack of Irish (2019). More harrowing again is the tragic tale of two-year old Micilín Ó Fiannachta, who died from tetanus in Tralee hospital in the 1930s, where staff mistook his repeated requests for a “deoch” [drink] for the English word “duck” (Hickey 2019).
In 2022, I co-presented a two-part documentary, Eipidéim [Epidemic] – directed by Ciara Hyland – on the social history of epidemics in Ireland for Irish-language television station TG4. One of the interviews that most affected me was Barbara McDonagh’s account of contracting polio in the 1950s, as a small child. Barbara was taken from her Irish-speaking home in Connemara and placed in hospital in Galway for treatment. Not only did she have to adapt to a new setting, but she also had to accustom herself to the English-only environment of the hospital.
By the time Barbara was returned to her family several years later, she had forgotten her Irish and found herself once again struggling to understand what was happening in her surroundings. Barbara’s story highlights Ireland’s dismal track record on institutionalisation, a state which in the mid-twentieth century institutionalised more of its population than any country in the world. But it also highlights the linguistic oppression embedded into this system, a history that resonates with the indignities forced upon indigenous communities in Canada, Australia, the US and elsewhere (see Magan 2024).
Families who decide to raise their children through Irish continue to navigate these linguistic hierarchies. The Mac Gabhann family from Belfast have been at the centre of a campaign for organ donation reform in Northern Ireland, as they continue to wait for their young son Dáithí to receive a heart transplant. During this process, they have spoken about the challenges of raising a child through a minoritised language within such an extraordinary medical context, as the home language (Irish) has to be dropped when a doctor or nurse enters the ward and English is required for more “important” discussions (Mac Gabhann 2022). The implication here is that patients (and their families) are not only dealing with the trauma of the medical condition but are also faced with questioning their own “social value” as minoritised language speakers within what French sociologist Pierre Bourdieu (1991) referred to as the dominant “linguistic market” (see also Toke 2017).
The medical as surreal
Children’s books continue to be published in Irish to acquaint young readers with new vocabulary relating to the hospital. However, these writings are so at odds with the generally anglocentric reality of medical settings that they might be described as utopian fictions. This clash between the wider English-speaking reality and often more intimate Irish-speaking contexts creates something of a dilemma for Irish speakers when narrating – and invariably translating – experiences that occur within the dominant English-language realm. Sociolinguistic research shows that a visit to an English-speaking setting, such as a hospital, can be a “trigger” for more use of English among speakers of non-dominant languages, often through codeswitching (Troike 2008, 144; see also Ní Laoire 2023). Equally, however, the use of technical dictionary vocabulary in Irish can appear alien to other speakers.
The unease around medical narratives in Irish is particularly apparent in the reception of Celia de Fréine’s celebrated poetry collection Fiacha Fola [Blood Debts] (2004). The collection relates to the Anti-D blood transfusion scandal, whereby pregnant women in Ireland (and also in the UK) were infused with blood that was contaminated with the hepatitis C virus from the mid-1970s to the early 1990s. The female narrator grapples with various misdiagnoses and incorrect prescriptions before finally discovering the cause of her condition. The collection is peppered with specific medical terms (“fleibeatamaí” [phlebotomist], “ocsatóicin” [oxytocin], “galar uath-imdhíonachta” [auto-immune disease]).
A reviewer of the collection worried whether the terminology used might be perceived as “threatening and alien to the reader in Irish” (Ó Dúill 2005, 75). Meanwhile, in an introduction, the poet Máire Mhac an tSaoi ironically characterised the entire volume as “surreal,” due to its placing of the Irish language in such unfamiliar terrain: “Irish is spoken as an everyday language in this world. Thanks be to God for that — we wouldn’t like it were the events recounted in this story to happen in any world in which we ourselves were living!” (2014, 11).
The idea that medical experiences are surreal by default for Irish speakers is also hinted at in the work of acclaimed poet Nuala Ní Dhomhnaill. Much of Ní Dhomhnaill’s poetry draws on folkloric sources to delve into contemporary psychological concerns, and in doing so, her work explores the clashing worlds of inherited folk knowledge and the “aigne mheánaoiseach” [medieval mind] the poet associates with conventional medicine. The poem “An Mhurúch san Ospidéal” [The Mermaid in the Hospital] is included in a series of poems based around folktales of merpeople who become stranded on dryland. The poem can be read as a reflection of the confusion and displacement of the Irish-speaking patient in the medical setting; a mermaid awakens to find that her mertail has been violently removed as part, perhaps, of some sort of forced assimilation project:
Dhúisigh sí
agus ní raibh a heireaball éisc ann
níos mó
ach istigh sa leaba léi
bhí an dá rud fada fuar seo.
Ba dhóigh leat gur gaid mhara iad
nó slaimicí feola.
She awoke
to find her fishtail
clean gone
but in the bed with her were two long, cold thingammies.
You’d have thought they were tangles of kelp
or collops of ham.
(2007, 35–6; trans. Paul Muldoon)
Both Ní Dhomhnall and de Fréine arguably subvert the individualisation of illness, or to use Woods’s (2016, 76) words, the production of “Western middle-class, liberal and neo-liberal modes of being” evident in dominant confessional illness narratives. The Irish language is often associated with pre-modernist sense of collective solidarity. For example, during the COVID-19 pandemic, mainstream media repeatedly evoked common Irish proverbs such as “ní neart go cur le chéile” [There is no strength without unity] or “Ar scáth a chéile a mhaireann na daoine” [Under each other’s shadow is how people survive] (Nic Eoin 2020).
This pull away from individualism marks both Ní Dhomhnaill and de Fréine’s works. Ní Dhomhnaill’s nonhuman characters extend metaphorically beyond the local or national to reflect transnational questions of colonialism, forced migration, and language loss. De Fréine, for her part, only revealed ten years after her collection’s publication that she herself was a victim of the Hepatitis C scandal. Up to that point, she preferred to allow the narrator of the poems speak not just individually but on behalf of the collective group of women who suffered and to whom the work is dedicated.
Narrative and resistance
Despite the many challenges facing Irish-speaking patients in terms of access to terminology and audience, there remains an investment in the potential solace offered by forms of expression and storytelling in Irish. Angela Bourke (1992) coined the term “síceoilfhilíocht” (psycho-poetry) to describe the emotional release offered by the female practice of keening, which was performed during burial rituals until the mid-twentieth century. The acclaimed poet Seán Ó Ríordáin maintained diaries for most of his life, through which he processed his condition with tuberculosis (see Ó Liatháin & Breathnach); his private dialect of Irish included his own newly composed compound terms and arguably offered an alternative to the English of his medical treatment (this is the subject of ongoing research by Katie Nic Con Midhe at Queen’s University Belfast). More recently, Conor Torbóid’s radio series for the BBC/RTÉ (2023) investigated how participants in the community writing programme, “Scríbhneoirí an tSléibhe” in West Belfast are turning to writing to address intergenerational trauma and the legacies of the “Troubles.” In sharing these writings with attentive local audiences, the community have ensured no one’s story goes “unlistened-to.”
It would seem, then, that the perceived surrealism of medical accounts in Irish is not a hindrance but may offer a means to reclaim personal and communal linguistic identities in a world characterised by linguistic inequalities.
About the author
Síobhra Aiken is a senior lecturer in Irish and Celtic Studies at Queen’s University Belfast and a member of the Young Academy Ireland (YAI). She has published widely on various aspects of the social and cultural history of twentieth-century Ireland. Her monograph, Spiritual Wounds: Trauma, Testimony and the Irish Civil War, was awarded the Michael J. Durkan Prize for Books in Language and Culture in 2022 and the Whitfield Prize from the Royal Historical Society in 2023.
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