Playing in the medical encounter with Kathy Acker and David Foster Wallace or A thesis of the whole person

This thesis starts from the premise that Western medicine incorporates the twin epistemologies of the scientific and artistic methods but while the scientific method has dominated, the artistic side of medicine has been historically neglected or actively suppressed. It outlines how the disciplines of medical humanities and narrative medicine emerged as a restorative to this institutional sickness in Western medicine. It proposes that the ludic texts of Kathy Acker and David Foster Wallace contribute to, and exemplify, a new canon of fictions under the rubric “Sick Literature” in accord with the medically humanist demand for a ‘medicine of the whole person’, as part of this restorative measure. The concept of “Sick Literature” is shown to emerge from a canon of post-war American literature that covers issues such as the narrativization of depression and suicide, the role of the female body, questions of addiction, sexuality, trauma, sexual desire, masochism, pain… I present this thesis as an exercise in ‘narrative medicine’ and it consists of a series of critical reflections on medically humanist articulations of the medical encounter, which, in an act of mimesis, utilize the “Sick Literature” of Kathy Acker and David Foster Wallace in conjunction with the author’s personal testimony of experiences in the medical encounter. Part of its contribution in this regard is the proposition that ‘the arts’ and ‘artworks’ have inherent medical, or medicinal value. That this value has been overlooked and dismissed in the field is because of a failure of imagination within extant medical praxis to identify, deconstruct and democratize the parameters by which it institutes its orthodoxies and constructs its patients as medical objects through an idealized medical epistemology, rather than an individualized one. Its major contribution is to present “Sick Literature” as an artistic methodology or medically humanist praxis of ‘creative-destruction’ (formulated in line with D.W. Winnicott’s notion of ‘play’) that challenges the exclusions of strictly scientific approaches to questions of physiological and psychological “sickness”. It offers the disorderly pleasures of the ludic – the playful – as another mode of medical theory, one which is more open, inclusive, complex, and constructive and provides for both the quantifiable and qualitative nature of human experience to confirm the “artistic method” must be an integral component of medical practice, not an addition to.