The last forty years or so has seen a general turn to nonfictional autobiographical writing. The medical humanities have embraced this surge for their sensitive and expansive accounts of illness. But relatively little work tracks a similar growth in the doctor memoir. For this section of the project, led by our Engaged Research Fellow Dr Arthur Rose, we looked at the development of the doctor memoir from the late 20th Century to the present, paying particular attention to the ways that they narrate events often associated with shameful feelings and shaming practices. By isolating and elaborating on the representation of patient, professional and learner experiences, these memoirs can help us to address the shaping effects of shame in medical practice.
We accumulated a corpus of 77 memoirs written by doctors, nurses and midwives in the UK, the USA and South Africa, published from 1967 to the present. The majority of this corpus was of texts published after 1987, with John Berger’s A Fortunate Man and Doctor X’s Intern providing comparators for earlier memoirs. This corpus was reviewed for accounts of shame. Through a general thematic analysis, we found that the memoirs tended to mention or refer to shame or other negative self-conscious emotions when raising serious, identity-threatening issues such as medical error, humiliation by senior colleagues, institutional failings, and personal failure to live up to expressed ideals of medical service. Although similar shame incidents occurred across the corpus, further analysis in relation to literary modes, purposes, publishers and styles showed that shame incidents tended to 1) be taken seriously, even in works of medical satire, 2) highlight particular concerns with burnout, error, suicide and whistleblowing, 3) have different targets, depending on whether they were self-published or published by mainstream publishers, and 4) be treated very differently in texts with self-consciously literary aspirations. Close readings of the final category yielded rich accounts of how shame is expressed, and to what end.
The results of this work are currently being written up into a book by Arthur Rose.
