1x1.gif (807 bytes)

© 2010 Mahala Yates Stripling

All Rights Reserved

=========================

This publication has 3 maps, 20 pages of photographs, and 2 fan-tree genealogies.

IMAGINE A MAN: THE SURGEON STORYTELLER

A Literary Biography of Richard Selzer, in two parts.

Part 1: Reinventing his life  (1928-1984)

TABLE OF CONTENTS

Cover Sketch:  RS (1988), presented by his friend Richard B. Sewall

Flyleaf painting of Second Street door (Armstrong)

Foreword (by medical humanities illuminati)

Preface

List of Abbreviations

Chronology of Events 

Introduction

I.   A Family of Weepers (1899-1927)

           II. The Young Trojan (1928-36) 

III. Doctors’ Row (1937-41)

IV. High School and War (1941-45)

V.   Becoming a Doctor (1945-52)

VI.  Yale—Drafted and Married (1953-55)

VII. Korea: Despair and Resolution (1955)

           VIII. Korea: Hope and Celebration (1956)

IX.  Returning to Yale—Chief Resident (1957-60)

X.  The Doctor with Two Heads  (1961-67) 

XI. Saint, Fellow & Friend—Published (1968-70)

XII.  Surgeons Love Horror, Don't You Know? (1971-74) 

XIII.  The Birth of Literature and Medicine (1975)

XIV.  Mortal Lessons: The Doctor as Writer  (1976-78)  

XV. Artist in Residence (Bellagio/Yaddo) 1979-84

XVI.  The Last Grand Rounds at Yale (Dec. 15, 1984)

Afterword 

Endnotes/Works Cited

Sketches, Maps, and Photographs

Acknowledgments

Index

 

 PREFACE

 I am really the simplest of men, an open book myself.  When asked recently about my literary influences, I was quick to kneel at the feet of Edgar Allan Poe. . . . Even now, some seventy years later, I am easily bewitched by the great enchanter. Nowadays it just doesn't do to profess a liking for Poe.  He has been dismissed by the arbiters of taste.  But not by me.  I loved him then; I love him still.  I don't know how one can write a biography of someone whose literary taste is so primitive.  Harold Bloom would curl his lip at the news--Richard Selzer

           It’s typical of Richard Selzer to humbly profess a kind of literary naiveté when his work teems with references to Homer, Shakespeare, and Chekhov.  But Anton Chekhov is about as modern as Selzer's taste gets.  Although he reads voraciously, including in French, Italian, and Latin, rarely will you find him immersed in anything au courant.

           Perhaps Selzer's humility--be it real or teasing--stems from his awareness that many writers consider literature a full-time occupation, without having also pursued an important career as a surgeon.  But Selzer has integrated his two disciplines in imaginative ways, and today he is often mentioned in the same breath with his literary ancestors Chekhov, John Keats, and William Carlos Williams.

           Selzer's short stories, essays, art critiques, diaries, letters, and memoirs have appeared in thirteen books from 1974 to the present. A novel he wrote fifty years ago on his experiences in Korea has been reclaimed and makes his fourteenth book. Many of these books have been translated into several different languages and none have ever been out of print due in large part to staunch lay readers and patients.  Educators use them in high school English classes and bioethics clubs; undergraduate, graduate, and medical school science and humanities courses; and post-graduate medical training to teach writing skills (theme and style) and bioethical lessons (morality of issues) as well as to provide models for patient care.

           And because we are all patients, Selzer’s growing legacy to us comes through his poetic perception on the human condition, which inspires our doctors in their work. In addition, his writings and mentoring of others helped to establish the interdisciplinary field of literature and medicine.  For his contributions, he has been recognized abundantly, having received the National Magazine Award, the Pushcart  Prize, a Guggenheim and a National Endowment for the Arts Fellowship, and the American Medical Writer's Association Book Award. He was a PEN/Faulkner Award semifinalist and has received over a dozen honorary degrees.  He has been a resident  scholar at both Yaddo in Saratoga  Springs,  New York, and at the Bellagio Study Center on Lake Como, Italy. 

           Selzer's literary biography, begun fifteen years ago, is his first full biographical treatment. Volume I is a straightforward narrative of his life and art, covering his Jewish heritage and early life in Troy, New York, and includes a genealogy. It offers insight into both the education and practice of a doctor and an author. A great deal of new material describes Selzer's activities in Korea from 1955-6, when he was a lieutenant in charge of a medical detachment south of the DMZ. Often using primitive medicine and having inadequate supplies and help, he treated thousands of natives.  His humanitarian contributions are so vast that they are incalculable.  He returned to his Yale residency, a changed man, and became Chief Resident. In the ensuing  years, he began a busy surgical practice and started a family, but he was continually being inspired to write.

         Volume II begins after his retirement in 1985 from a career in surgery--thirty-one years in the making--when he  commenced to make his living by his wits alone, "like the fool in King Lear," he says. This volumes describes his life-threatening coma in 1991 and the surprising events that followed. It includes numerous photographs of Selzer’s family and colleagues at many stages of his life and gives a timeline of significant events and contributions over the next twenty-some years, including lectures, plays, and writing institutes. It is broken down by his multifaceted contributions: Letters, Diaries, Plays, Works in Curricula, Lectures and Teaching, and Interviews. It contains the Comprehensive Selzer Bibliography (1968-20--) and details his legacy in the medical humanities through the eyes of colleagues such as Sherwin Nuland, Howard Spiro, Ralph Horwitz, Bernie Siegel, Andy Graham, Ashgar Rastegar, Jerome Groopman, Atul Gawande, Leon Kass, Ed Pellegrino, Bob Brustein, Myra Skarlew, Ian Porter, Anne Hudson Jones, Rita Charon, Father Tom Phelan, and many others.  In October of 2009 I talked with Father Andrew of San Giorgio Maggiore, Venice, Italy, where Selzer wrote "Diary of an Infidel."   He delighted in correcting a few factual errata and at the same time confirmed the deep spiritual significance of the monks' lives, lived out in a long daily presence together.    

           Selzer is many things to many different readers, and this book attempts to reflect that.  The general reader will find a poignant coming-of-age tale of a boy who learned medicine at his father’s knee in Depression-era Troy, where the waiting room on the first floor of their house was filled with prostitutes.  He lost his father early and was forced to pull himself up by his bootstraps, just as that father had.  Selzer was a young man with a creative imagination and an artistic soul (his mother dressed him in knickers and a beret). He knew he was different from  everyone else, so he spent his entire life trying to fit in.  Selzer’s life was not a religious one, but I show how a growing spirituality and mysticism informed his work. 

           Writing professionals will learn how a doctor, who is immersed in a dozen short stories every day, can shape his experience through the powers of observation and with writing skills into unique art. Medical professionals will appreciate learning more about Selzer’s training and his experience performing surgery inside the Demilitarized Zone in Korea. In looking at Selzer’s thirty-one years as a surgeon, I discuss how the guiding principle of Hippocrates’ maxim— “to be useful; but, first, to do no harm”—has informed his work, even though it can be anathema in any medical practice. And I endeavor to read Selzer’s work in light of bioethical and medical issues, describing an American cultural, social, and medical history from the turn of one century to the next.

           My objectives in this biography are fourfold: I connect Selzer’s works to his life experiences, showing how his imagination flies; I comment on his themes and styles; I explicate his role in balancing the technological outlook of medicine with empathy for patients; and I establish his significance in the evolving canon known as literature and medicine.

           In many respects Richard Selzer’s life, characterized for over forty years in his own work, is “an open book,” as he claimed in an email to me.  We have up until now learned more about him from his creative short stories, unflinching essays, and poignant memoirs than from any other source.  Other times, interviewers have tendered valuable facts and let Selzer spin stories.  He gives to each of them the focused, singular attention of a great clinician with a patient. While I sometimes note previous scholarship and the tales it recounts, this work is based on 15 years of original interviews, letters, and emails from Selzer, his family, childhood friends, and colleagues. In the course of my research, I have spoken with over 100 intimates and acquaintances for corroboration and alternate perspectives, and have consulted Selzer’s uncensored diaries and candid correspondence in the Selzer Archive at the University of Texas Medical Branch—Galveston. I have augmented Selzer’s compelling accounts with facts and ideas gleaned from numerous book reviews and critical pieces. 

           Aside from the joy of growing closer to the mind that created some of my favorite works of literature, Richard Selzer is a pleasure to be with, as a continuum of Selzerian scholars attests.  Their zeal combined with his openness has created many lasting friendships.  To some, Selzer is particularly generous with nicknames.  The two men he refers to as “a brace of Chucks” are Charles Schuster and Charles Anderson. Peter Josyph signs his early letters “Boswell” to Selzer’s Dr. Johnson. Faith Lagay and Faith McLellan, two graduate students who were early editors of his diaries, he affectionately refers to as “the Faiths 2 . “  Many other notable authors from different fields have given him their attention.  Some who have addressed Selzer’s growing oeuvre are, but not limited to, Peter Elbow, Ron Carson, Don Faulkner, David Morris, Robert Davis, Louis Borgenicht, Susan Cheever, Sarah Boxer, Diane Ackerman, Anatole Broyard, Annie Dillard, Suzanne Poirier, Angela Carter, William Cole, John Stone, Edward Hoagland, and Iliana Alexandra Semmler.  See their citations in my Comprehensive Selzer Bibliography (1968-2008), Richard Selzer: A Literary Biography (Vol. II).

         Writing about Selzer’s life and work has bolstered the careers for scholars in the humanities as well as in medicine. Indeed, Selzer has blushingly acknowledged the burgeoning interest in his work, referring to himself as “Richard Selzer, Incorporated.” Nonetheless, his writings have not been without controversy, as fully detailed in this biography. They have addressed headline topics such as right-to-life morality (“Abortion”), physician-assisted suicide confidentially (“A Question of Mercy”), and transplant recipient autonomy (“Whither Thou Goest”).  He surprises readers by taking them into unexpected places, from professional wrestling (“The Masked Marvel’s Last Toehold”) to an Italian monastery (“Diary of an Infidel”). His exquisitely rendered writing creates characters with all the frailties and ambiguities of real people, putting them into situations that shed a profound light on the human condition.  Perhaps that does suggest a writer of “primitive” literary values, as Selzer claims; it certainly does mark him as a pre-modernist.  It may be a side virtue of having spent a profound and successful career in medicine that Selzer could be cavalier about academic trends.  It is to his readers’ benefit that he could focus on the timeless, and likely the highest, theme of fiction.

           As Selzer's biographer I have put the events of his life in chronological order, which helped to square away a few facts. Along the way I show what contributed to his becoming  a surgeon, first, then a writer. As I researched each stage of Richard Selzer's life, I felt the pleasure of getting to know him all over again. And thusly will my readers come to understand an important contemporary figure in American literature and medicine. But even the most exhaustively researched biographical work is an interpretative balancing act.  The sometimes blurred mixture of fact and fiction I document and evaluate means that some things are probably unknowable. Like most people, Selzer’s memories, self-styled as "gap-toothed," can be sharp and focused or foggy. But when he's in storyteller mode the events come to life.  Richard Selzer: A Literary Biography includes these riveting new stories and adds many other valuable viewpoints.  One review of Charles Anderson’s book about Selzer was entitled “Desperately Seeking Selzer,”1 a play on the 1985 indie film Desperately Seeking Susan.  For all who have been seeking Selzer rather desperately, I hope that this book has gotten us closer. —M.Y.S.

-------------

1 Malone, William. “Desperately Seeking Selzer.” Medical Humanities Review 1990 rev. of Charles Anderson’s Richard Selzer and the Rhetoric of Surgery.

====================================================

IMAGINE A MAN: THE SURGEON STORYTELLER

A Literary biography of Richard Selzer, in two parts.

Part two: Living by his Wits Alone  (1985-  )

           Foreword

Preface

Lists of Abbreviations, Maps, and Photographs

Chronology of Events 

Introduction

I.     Trial and Tribulation (1985-90) TWR,IAW

II.    The Carrot of Woe--Yaddo

III.    A Question of Mercy (1991) 

IV.   The Bard of Troy (DFT 1992)

V.      Roosting on the Podia (lectures)

VI.     Raising the Dead  (1993)  Coma crisis

VII.  The Black Swan (1994) “the men wept”

VIII.   The Doctor Stories (1998) book & play

IX.   The Loonies [ministry]; The Exact Location of the Soul (2001)

X. The Whistler’s Room (2004)

XI. Bag of Tricks (teaching at RPI & Yale Med)

XII.  The Illuminati (2005-6) Selzer, Nuland, Siegel

XIII. The Letters, The Diaries, Knife Song Korea (2009-10)

XIV.  Legacy: Works in curricula           (bioethics/humanities), lectures,                         teaching, interviews   

          Conclusion 

Endnotes/Works Cited

Acknowledgments

Comprehensive Selzer Bibliography (1968-20--)

Index

           *DVD interview tapes.

====================================================

Book by Dr. Stripling

 

Customer Reviews

Average Customer Reviews:

 
 
Wonderful step by step guide through these changing times, February 28, 2006
 
Reviewer: Melanie Cox - See all my reviews
(REAL NAME)   
I read a great deal of literature while sitting vigil at a hospice. Dr. Stripling takes you through our changing times and leads us to wonderful reference material.  She very gently takes us on a nonjudgmental journey and helps us to see our own truths and limitations as we strive to help this world be a more giving and and caring place. I would hope to see this book in every high school and college library and hospice in our country.

This resource for high school teachers and librarians describes ten accessible works of fiction that may be used to help students explore a number of contemporary issues in medicine and bioethics. The selections analyzed span two centuries, from Mary Shelley's romantic novel Frankenstein (1818) to Margaret Edson's play, Wit (1999). Supplemental materials include a glossary, a list of recommended movies, and a chronology of key events in literature, medicine, and science.”–SciTech Book News

Science, ethics and literature mesh well, February 4, 2006

Reviewer: Linda Lucas "Library Junkie" (Ft. Worth, Texas) - See all my reviews
(REAL NAME)   
This book is a fascinating combination of science and science fiction. The reader is transported to the past through Shelley's "Frankenstein" and into the future with Huxley's "Brave New World" and Cook's "Coma." We read of the true ethical dilemma of Feldshuh's "Miss Evers' Boys" and the disturbing issues of experimentation with human cloning, stem cell research, and bioterrorism. Dr. Stripling leads the reader through a maze of fiction and truth. She ties it all together, with an occasional touch of humor, in a narrative that is easy and interesting to read. This book should be in high school classrooms and in medical school curricula. I thoroughly enjoyed the ethical and medical issues linked with literature.

Topics for oral or written discussion accompany synopses of plots, July 6, 2005
 

Reviewer: Midwest Book Review (Oregon, WI USA) -
Advances in science have brought with them their own unique ethical and medical dilemmas, bringing the discipline of philosophy directly into the world of science. Students from high school to pre-med receive a well-rounded introduction to literary references to bioethical questions, from the beings created by technology to illness and end of life issues. Topics for oral or written discussion accompany synopses of plots.

Reviewer: School Library Journal
This series promotes a multidisciplinary and multicultural approach to teaching literature across the curriculum. Each title includes a chronology of events related to the literature and the social issues), an introduction, discussions about the works with plot synopses, literary analyses, historical context, further-reading suggestions, lists of topics for written and oral discussion, and recommended movies and Web sites.

Worthwhile addition for schools with an integrated curriculum.–Pat Bender, The Shipley School, Bryn Mawr, PA
 

Loved it!!, May 29, 2005
 
Reviewer: Nancy B. Parker -
 
This book is so 'present tense.' Mahala Stripling is delving into questions that all of us must face. I love the timeline; it gives me perspective outside of the contents of the book, as well as within. The author has tied together literary criticism, literature, and unavoidable 21st century decisions within the pages of her book.

 
 

 BIOETHICS AND MEDICAL ISSUES IN LITERATURE 

GREENWOOD PRESS, 2005

Table of Contents

Foreword                                                                                              Preface

Chronology of Events in Literature, Medicine, & Science       Introduction

Chapter 1. Technology's Creature                             Historical Context, Literary Analysis, and Plot Synopsis of      Shelley's Frankenstein & Hawthorne's "Rappaccini's Daughter"

Chapter 2. A Brave New World                                         Historical Context, Literary Analysis, and Plot Synopsis of     Huxley's Brave New World & Cook's Coma

Chapter 3. Contagions/Isolations                                            Historical Context, Literary Analysis, and Plot Synopsis of      Camus' The Plague & Feldshuh's Miss Evers' Boys

Chapter 4. Illness and Culture                                        Historical Context, Literary Analysis, and Plot Synopsis of     Kesey's One Flew Over the Cuckoo's Nest & Walker's Possessing    the Secret of Joy

Chapter 5. End of Life--Disease and Death                  Historical Context, Literary Analysis, and Plot Synopsis of     Updike's Rabbit at Rest & Edson's Wit.

Glossary of Terms: Literary, Medical, and Scientific              

Afterword                                                                                    

Appendix A: Recommended Movies                               

Appendix B: Recommended Internet Sites                          

Appendix C: Recommended Books and                      

Appendix D: Recommended Methods for Teaching                           

Index

TO ORDER:

http://www.greenwood.com/catalog/GR2040.aspx

http://www.amazon.com/gp/product/0313320403/ref=sr_11_1/102-0287773-4685706?%5Fencoding=UTF8

Book Code: GR2040
ISBN: 0-313-32040-3

April 30, 2005

NOTE: Useful for teaching interdisciplinary studies, from high school to post-graduate medical school.

SAMPLE CHAPTER:

 

    Chapter 4: Illness and Culture

An Analysis of Ken Kesey’s One Flew Over

the Cuckoo’s Nest and Alice Walker’s

Possessing the Secret of Joy

 

Introduction

           Ken Kesey’s One Flew Over the Cuckoo’s Nest embodies the rebellious energy of the psychedelic 1960s, a prosperous time following World War II when drugs were rampant, and the counterculture challenged authority.  A classic description of mental illness, Cuckoo’s Nest encapsulates Kesey’s experimentation with alternative forms of perception, while highlighting ethical issues.  The setting is a mental institution where a power struggle exists between the staff and the patients afflicted with many types of mental illness.  Paradoxically, reading this important novel feels liberating while it asks the disturbing question, who among us is completely sane? In fact, the United States has gone through a slow and arduous process to learn how to identify and to treat mental disorders.  Early on the mentally ill and retarded roamed the streets, were confined by relatives, or were thrown into prisons with criminals; later, psychoanalysis led to greater understanding.  Finally, in 1946 the National Institute of Mental Health was created, recognizing the need to diagnose and to help the mentally ill.  With the advent of mental institutions came radical therapies such as electroshock treatment and lobotomy. Today these controversial approaches are often replaced by psychotherapy, the so-called talking cure, and by drugs such as Prozac and Halcyon. With today’s brain scans and DNA analysis some mental disorders are more readily detected and treated.  Other topics Cuckoo’s Nest develops concern sexuality and institutionalization; humor and illness; nursing and group therapy; and psychiatry and surgery.             

 Kesey’s Cuckoo’s Nest continues to influence twenty-first- century medical issues and ethics as does Walker’s Possessing the Secret of Joy by describing the cultural origins of mental illness.  The female genital mutilation ritual Walker describes in a certain African culture illustrates how society constructs practices that inflict psychological trauma and have long-term physical consequences. The FGM surgical procedure viewed as sane in one culture is judged unethical and criminally insane in others, linking health and human rights.  Increasing immigration brings the surgical ritual, once commonplace in Puritan times, back to the United States. In addition, worldwide awareness causes petitioners seeking asylum based on sexual discrimination to flock to the United States.   

            Possessing the Secret of Joy also teaches morality lessons and the importance of the mother-child relationship all within the context of cultural relativism and Social Darwinism.  The main issue, however, is of global concern, how human rights violations perpetuate women’s mental and physical health problems.  In the Western world the long history in which women were seen as objects springs from Aristotle’s view that women were unfinished men.  This thinking was at the heart of early Greek medical practices such as female circumcision, just as, ironically, was Hippocrates’ “first, to do not harm” mandate.   Many cultures continue to subjugate women to fundamentalist beliefs, denying them equal protection under the law, even though the United Nations Universal Declaration of Human Rights states that human rights are inalienable: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment” (United Nations General Assembly Resolution 1948).  

           Both Kesey and Walker show how illness derives from culture as well as from disease, and that our views on normalcy depend on the culture and the time in which we live. While Possessing the Secret of Joy projects issues that for some may be difficult to explore at first, by putting a face onto the estimated 100 million women worldwide who have undergone FGM, Walker has crafted a chilling book of literary importance.

  

The ward door opened, and the black boys wheeled in this Gurney with a chart at the bottom that said in heavy black letters, MC MURPHY, RANDLE P. POST-OPERATIVE. And below this was written in ink, LOBOTOMY.  —Cuckoo’s Nest

Ken Kesey’s One Flew Over the Cuckoo’s Nest (1962)

 Historical Context

            Ken Kesey (1935-2001), born in Colorado and reared in Oregon, appreciated nature and loved wrestling. He received a degree in speech and communication from the University of Oregon. Then, with a Woodrow Wilson Scholarship, he enrolled in the Stanford University Creative Writing program. While a graduate student, he participated in life-altering psychology department research involving psilocybin, mescaline, amphetamine, and LSD. For several weeks Kesey, a 24-year-old paid research volunteer, ingested these mind-expanding drugs.  Later, as a Veteran’s Administration psychiatric ward orderly on the night shift, he observed that many of the patients, rather than being crazy, were just nonconformists in a sterile environment.  While drug-induced, Kesey hallucinated about an Indian sweeping the floors, who became “Chief Broom,” his schizophrenic narrator in One Flew Over the Cuckoo's Nest.  His novel was an immediate success, allowing Kesey and his wife Faye to buy a farm that became a site for an influential bohemian community experimenting with drugs, believing altered mental states could improve society.  Because Kesey’s parties were notorious for illegal drug use, he was soon arrested and jailed for several months.  Nonetheless, with his new fame, Kesey drew the attention of Neal Cassady (hero of Jack Kerouac’s On the Road) and others, and soon the hippie-aesthetic, antiwar group the Merry Pranksters was formed, exploding into the psychedelic era.  

           In 1964 the notorious Pranksters drove cross-country in a Day Glo bus, obstensively to see the New York World’s Fair, but it became instead a creative adventure.  Cassady drove the bus, and its riders dropped acid and smoked marijuana along the journey, which was filmed for posterity. The bus became a metaphor for “living your art,” and the saying “You’re either on the bus or you’re off the bus,” was Beat Generation lingo for creative tripping. The exploits of the Pranksters are the subject of Tom Wolfe’s The Electric Kool-Aid Acid Test (1968), a book voraciously consumed by antiestablishment hippies in search of the universe within.  Kesey went on to write other novels, but none achieved the success of Cuckoo’s Nest, which subsequently influenced popular culture with its stage and film productions.  Late in life, Kesey, the pied piper of the psychedelic era, took drugs only for his diabetes and hepatitis C, finding the pure adrenaline of experiencing nature enough. He died on November 10, 2001, in Pleasant Hill, Oregon, following surgery for liver cancer.

             Cuckoo’s Nest continues to be a prototypical depiction of mental illness by describing various mental disabilities as well as the legal and ethical issues arising from them. The novel’s publication brought to the American consciousness what a slow and arduous process it has been to define and to devise treatment for mental disorders.  From Colonial times, before the proper diagnosis of the mentally ill and retarded, madmen roamed free.  Alternatively, shamed families cruelly locked abnormal relatives in an attic or chained them to a wall.  Society’s first priority was to feel safe, then to punish the evil they believed inherent in the mentally ill. The very first mental institutions were small, primitive nontherapeutic holding facilities, such as the one founded in Williamsburg, Virginia, in 1773. Until larger mental asylums were created, particularly troublesome individuals—including the poor— were incarcerated with criminals or sent to the poorhouse. 

            Over time many unusual theories have been espoused regarding the diagnosis and treatment of mental illness. In the late 1700s, Philadelphia’s Dr. Benjamin Rush, a signer of the Declaration of Independence and the Father of American Psychiatry, challenged demonic causation and believed moral treatment that controlled the environment would cure insanity in acute patients. Thinking brain arterial disease resulting from gluttony caused mental illness, he advocated a restricted diet, extensive bleeding, emetics to encourage vomiting, and hot or cold showers to slow metabolism. He also invented the gyrator, a spinning chair or plank upon which the patient was tied, designed to increase the brain’s blood supply.  Rush’s Medical Inquiries and Observations upon the Diseases of the Mind made him a  revolutionary authority on madness, and he became a popular lecturer.  Much later, in the mid-1800s, Christian social reformer Dorothea Dix (1802–87) raised money to establish the first state mental institution in Massachusetts after she saw the mentally ill housed with criminals in unsanitary conditions. Her efforts brought national focus upon human rights abuses. Since that time, numerous civil rights laws help differentiate criminals from the mentally ill who are often involuntarily committed upon proof they would be a danger to themselves or others.  With an increased awareness of civil liberties also came an individual’s right to refuse treatment. State-specific rules apply to involuntarily committing and treating teenagers.  The remedy for being confined against a person’s will is to have a lawyer file a habeas corpus petition with the court asking the institution to show cause why that person should be held. Thus, insanity (lacking mental capacity) is foremost a legal term, not a medical one.

           In the late nineteenth century the upper class with socially acceptable nervous diseases oftentimes voluntarily availed themselves of short and long-term residencies, such as in Philadelphia neurologist S. Weir Mitchell’s rest cure involving isolation, electrical massage, and a milk diet.  Charlotte Perkins Gillman in “The Yellow Wallpaper” chronicles her incipient insanity and the “wise man” who withdrew her from all active stimulation by putting her to bed to rest.  At the end of her treatment, she was ordered to return to domestic life and only "have but two hours' intellectual life a day" and "never to touch pen, brush, or pencil again.” After three months these conditions pressed her “near the borderline of utter mental ruin,” she wrote later (“Why I Wrote 'The Yellow Wallpaper'"). Ironically, after Dr. Mitchell read her account of descending slowly into madness and the ineffective cure, he altered his future treatment for neurasthenia (meaning “tired nerves”) and melancholia (depression).  Another popular “spa treatment” to calm agitation was hydrotherapy, which was more than a nice warm bath.  For instance, one practice was to wrap an agitated patient in cold (50 degree), wet sheets. A very disturbed patient could be placed in a continuous bath 18 hours a day for 2-3 weeks—or whatever it took to change the aberrant behavior. The dangers of hydrotherapy were hypothermia, convulsions, and even drowning. 

           Another part of U.S. history, the 1920s eugenics movement, unfortunately influenced the1940s Nazi practice of sterilizing the feebleminded. In Germany it led to euthanizing the congenitally inferior in order to purify the population.  The movement began after the American Civil War when medical professionals, who saw few results from the Moral Movement, embraced the idea of Social Darwinism.  Patients were being increasingly subdued by drugs such as chloroform, bromides, and ether, and 30 states, with the support of prominent Americans, legalized forced sterilization. In Virginia, Carrie Buck was an institutionalized18-year-old unwed mother, whose mother and child were also feebleminded. She was forcibly sterilized under Virginia’s 1924 eugenics law. Her case was appealed to the Supreme Court, claiming that the plaintiff, under the Fourteenth Amendment, was denied due process and equal protection of the laws.  However, Supreme Court Justice Oliver Wendell Holmes in Buck v. Bell (1927) upheld the state eugenics law, declaringthree generations of imbeciles are enough.”  With this precedent, over the next 40 years 60,000 people nationwide were sterilized for other types of unacceptable behaviors or conditions, such as alcoholism, promiscuity, criminal acts, epilepsy, and running away from home.  In an attempt to make restitution, several governors have formally apologized to their states’ eugenics victims.

           Besides sterilization procedures performed for the greater good, in the 1930s Washington D.C. neuropsychiatrist Dr. Walter Freeman pioneered his drastic ice-pick psychosurgery.  Also known as lobotomy, it initially involved partially destroying one of the brain’s frontal lobes, thus causing great disfiguration. Freeman explains in “Glimpses of Postlobotomy Personalities” how, when all else fails, the desired change in the patient’s anxious and fearful personality is effected:  “Without the long, painful process of developing insight in the patients, psychosurgery somehow relieves them of their sufferings and makes it possible for them to go back to their homes and to survive in the very environment in which their disorders developed “(Robinson and Freeman, 15). In his case studies, however, the postoperative realities sound grim.  Patients often were described as slothful, irritable, and angry. Nonetheless, in A History of Psychiatry Edward Shorter points out, “The idea of operating on the brain to cure madness does not seem intrinsically unreasonable.  Physicians have always intuited that a physical intervention in the brain, perhaps cutting some tract causing compulsive behavior or removing a center producing some malignant protein, might put an end to a pattern of psychosis” (Shorter, 225).  The relationship between the brain and the mind is being continually studied, of course, with new methods of brain imaging such as MRI (magnetic resonance imaging), CT (computerized-tomography), and PET (positron-emission-tomography) proving immensely helpful in diagnosing and mapping progressive diseases.  Although the adverse publicity arising from Cuckoo’s Nest caused lobotomy to be largely replaced with antipsychotic drugs, today successful psychosurgeries like cingulotomy relieve severe compulsive neuroses and depression.

           Besides psychosurgery, electroshock therapy (ECT) has proved a valuable psychiatric treatment for mental illness.  In 1938, after an earlier scientist observed that schizophrenics seemed symptom-free following seizures, Italian scientists Cereletti and Bini devised electroshock therapy as an efficient way to manage uncontrollable patients.  Today, a severely depressed patient receiving ECT, administered in a series of treatments, has an intravenous relaxant administered and a mouth guard inserted before an anesthetic renders him unconscious.  The airway is protected, and electrodes are connected with conducting jelly on the temples. Electric current comparable to a 60-watt bulb shoots through the brain causing a 20-second grand-mal seizure. The patient wakes about 30-minutes later, confused and disoriented, with a headache and short-term memory loss. In essence, ECT helps disturbed patients regain the control necessary to enter into a therapeutic relationship. Short-term impaired memory follows; complications from possible fractures and dislocations caused by muscle contractions are a thing of the past.  For generations Kesey’s Cuckoo’s Nest inflamed the public consciousness by depicting ECT as a means to punish misbehaving patients, easily associating it with electrocution.  Over the years attempts to pass state laws banning ECT have failed.  As horrific as it sounds, some neuropsychiatrists still find ECT to be an effective treatment for severely depressed and suicidal patients, especially after psychotherapy and slow-acting, cyclical drug regimens fail.  Depression, more than a character weakness and feeling just down, is a brain disease often detectable on a PET scan that indicates receptor chemistry abnormality. It affects millions of Americans who often feel ashamed they cannot pull themselves up by their bootstraps.  Hence, they often fail to seek help. New electromagnetic brain treatments, easily applied and without side effects, are proving effective, and recent NIH DNA studies indicate a 50 percent to 80 percent genetic component. In 2003 scientists, after working decades, documented a clear link between a gene controlling serotonin levels in the brain and depression, leading to possible new drugs.  Tying genes with behavior, scientists say depression has roots in both genetics and personal history (i.e., nurture and nature).

           The beginning of World War II brought more awareness to mental and emotional problems with more than a million inductees rejected for military duty as unsound. This was shocking evidence of public fragility.  Returning servicemen, on the other hand, benefited both from medical advances, such as penicillin and blood banking, as well as from psychiatric screening.  Subsequently, the number of psychologists proliferated and terms such as post-traumatic stress disorder were coined.  PTSD, formerly referred to as battle fatigue or shell shock, is not new, but the term continues to be applied to returning soldiers with ongoing problems such as loss of concentration, sleep disturbances, nightmares, flashbacks, intrusive thoughts, and emotional stress. This spotlight on identifying prospective mental disorders brought about the National Institute for Mental Health in 1949, advocating more study on the origin of mental illness, its diagnosis, and its treatment.  For the first time—in the place of hospitalization—the new drug chlorpromazine was used to relieve anxiety and control delusions.  Thorazine, the prescription straitjacket, was used to treat and ameliorate depressive or compulsive disorders.  With the widespread use of these drugs and others, the psychopharmaceutical revolution in mental health care began.  Ironically, as the 1950s rolled in, the counterculture movement looked to their drugs, such as LSD and peyote, to escape from the conventional rationality.

           The psychiatric climate in the 1960s when Cuckoo’s Nest was published included two main schools of thought: the behaviorists and the humanists. A leading American behaviorist, B.F. Skinner (1904-90), believed we could solve major mental problems by improving our understanding of human conditioning.  When he objectively observed aberrant behavior, he felt it should be ignored or punished. Good behavior, he thought, could be positively conditioned with encouragement and reward.  Behaviorists tended to pigeonhole patients into categories in which they would be forever tracked.  The other major view of the time came from the humanists who hesitated to label the patient, but who also socially constructed mental illness.  For example, Scottish psychiatrist R.D. Laing (1927-89), “the philosopher of madness,” believed that a schizophrenic only acted abnormally as a mechanism to cope with a stressful situation. This view is increasingly seen as outdated as work is underway to confirm a genetic mutation as the disease’s cause.  Two million American schizophrenics have lost touch with reality, hallucinate, and suffer from this disabling disease.  Laing vehemently opposed the dehumanizing use of ECT and lobotomy.  American psychiatrist Thomas S. Szasz (born 1920) took humanism a step further by writing about “the myth of mental illness” and the ethical and moral issues physicians contend with.  He advocates patient autonomy, including the right to refuse involuntary “imprisonment” and treatment.  For better or worse, in recent times mental patients have greater civil rights, and more scrutiny is given to psychiatric institution admission methods, leaving the standard five-day admission to include a quick psychiatric evaluation, drug readjustment, and then release.  The result is that a large population of mental patients is not benefiting from lengthy psychotherapeutic interactions with caring psychiatrists and, therefore, is left to fend for itself, often on the street. 

           Mental institutions in the1970s, due in part to Cuckoo’s Nest’s adverse publicity that fostered hostility against authority, were seen as warehouses that inflicted physical and sexual abuse on patients. With the current trend toward deinstitutionalization, more patients are treated on an outpatient basis with psychotropic drugs.  There are new ways to diagnose and many other types of treatment for mental illness, of course, besides psychosurgery, ECT, drugs, and confinement. In the early part of the twentieth century American psychotherapy, which tended to classify disorders by symptoms rather than causations, proliferated. It stemmed in part from the work of Austrian Sigmund Freud (1856-1939), the Father of Psychoanalysis. Psychotherapy slowly became popular and arguably successful.  Some of the concepts Freud's talk therapy popularized, as translated, included the Oedipus complex; the id, ego, and superego; anxiety and defense mechanisms; repression, displacement, and rejection; and the libido and death instinct. His therapeutical approaches include dream analysis, free association, and transference. Indeed, Freud even made the terms hysteria and penis envy household words, but today criticism of his unorthodox research methods and emphasis on sexuality makes his practices less relevant.  Currently, one in four American adults seeks professional psychological advice some time during his or her life for services ranging from treating severe depression to counseling on life strategies. The stigma is gone. New disorders, some consider fads, are continually being defined, including the seemingly pervasive attention deficit disorder with hyperactivity (ADHD). In 1995, 2.5 million American children were on Ritalin. In the 1980s multiple personality disorder (MPD) became epidemic. In essence, critics claim personality traits formerly seen as eccentric or troublesome are being pathologized, causing the field of psychiatry to grow. Again for better or for worse, in recent times drug therapy—even with its side effects—continues to replace lengthy patient-oriented talk sessions as the gold standard of care. 

Because the history of mental illness reaches back as far as the written word, this abbreviated version provides merely a snapshot illumination of specific issues in Cuckoo’s Nest. Over the centuries attempts to treat madness have, from our perspective today, seemed cruel and unusual. Besides, with pathology poorly defined, odd behavior alone would be cause for confinement. Today, while new methods advance understanding and care, a significant part of the future of mental illness diagnosis may lie in constant revelations arising from brain imaging and the deciphered genome, with the promise of targeted treatments. Nonetheless, even with vast knowledge of the human body, Edward Shorter adds, “Science wanders astray easily in the world of quotidian anxiety and sadness, in the obsessive traits of behavior and the misfiring personality types that are the lot of humankind. Here the genetic trail grows dim and the neurotransmitters evaporate. Biology counts for little, culture and socialization for lots” (A History of Psychiatry, 288). The nature versus nurture debate is very much alive.

 

Literary Analysis

            Cuckoo’s Nest, one of the most influential novels of the twentieth century, derives from Ken Kesey’s observations at a mental institution. Although it is a popular myth that Cuckoo’s Nest sprung full-blown from Kesey’s drug-induced state, he admits only some of it was inspired that way.  Written during the post-World War II era of the psychedelic 1960s—when the U.S. faced a Communist threat—he wanted his black satire’s good v. evil plot, rich with symbols, literary allusions, and bioethical and medical issues, to show how individuals must stand up to authority so their rights are not quashed by government control.  As a prototypical depiction of mental illness, Cuckoo’s Nest describes how the mentally ill were treated, and this analysis focuses on the effects of the therapies applied at the time.    

 Chief Bromden’s observations as narrator make him the most important character in the novel. The “deaf and dumb” American Indian, who has seen his lands taken away to build a hydroelectric dam and his family destroyed, tells the story, at first in a flashback sequence and then in hallucinatory visions.  It is possible to trace throughout the novel his self-evolving passage out of the fog of schizophrenia.  The action centers on the free-spirited Randle P. McMurphy (Mack), who of course personifies the counterculture Beat Generation.  He “was a giant come out of the sky to save us from the Combine,” the Big Chief believes.  Mack faces off against Nurse Ratched, who personifies governmental authority and repression, and in whom the Combine (evil government forces seeking conformity) culminates. The Combine includes Ratched’s network of handpicked and personally trained nurses, doctors, and aides. Mack, “crazy like a fox,” has “capitalist intent “ in feigning mental illness to leave a prison work farm.  However much of a charming con man he appears to be, though, in setting up gambling opportunities, his antiauthoritarian rebelliousness makes him an imperfect antihero.  Because he has been involuntarily committed by the prison, Ratched has absolute power to hold him until she deems him cured. But most of the other Acute patients who are deemed hard-core and seek institutional discipline can release themselves. In his battle with his nemesis, Nurse Ratched (symbolically a ratchet, a tool controlling by degree), he appears to be both a classic psychopath and a cocky comic book figure.  Regardless of the impurity of Mack's self-serving hustling instincts, his antagonizing Ratched allows him to grow and the other patients to be liberated. Considering the complexity of mental states, it is ambiguous whether he extended his stay (breaking the nurses’ station window twice) for his greed or for solidarity with the patients.  Is he the victim of an ill-conceived plan or a martyr?  

          While Mack  “walks out of step; hears another drum,” a literary reference to Henry David Thoreau that is a lietmotif symbolizing individualism, the Chief stands for the vanishing American Indian, an invisible man diminished by white society. Kesey goes into great detail about how the Chief’s disintegrating culture has paralyzed him into catatonia, effecting a split personality and sporadic loss of reality.  The Chief has been on the ward the longest; Mack is the new patient.  Each is putting on an act: the Chief’s hallucinatory insights on hospital activities reflect his silent savvy; Mack’s noisy bravado either agitates or rallies patients by challenging Ratched’s matriarchal authority. Kesey's contrasting the Chief and Mack causes interest.  But the most ingenious part of the novel is the ability to trace Mack’s influence on the Chief.  Inextricably linking mental prowess and physical size, the Chief in his mind’s eye appears to grow physically bigger as he becomes mentally released from his schizophrenic fog.  In an example of the complexity of Mack’s motives, he uses the Chief to lift the control room panel as the basis of a bet, but at the same time it empowers the Chief.  

           The mental institution culture in Cuckoo’s Nest reveals how the lines between sanity and insanity are often blurred.  It describes many types of illness, divided between the Acutes and the Chronics, and includes the obsessive-compulsive disorder (OCD) patient who cannot get dirty,  two epileptics with opposing drug administration problems, cowering depressives, self-mutilating passive-aggressives, hallucinating schizophrenics, and troublemaking psychopaths.  In a group therapy meeting Mack sets out to challenge authority by persuading most of the patients to vote to watch the World Series during their work detail. Although a democratic vote is taken—modeling the type of behavior needed on the outside--Ratched wields her authority and cuts the power to the set.  The patients then gather in front of it in a rebellious sit-in.  The Chief tacitly observes they would all appear crazy to an outsider. Talk therapies based on ward log entries are run like confrontational pecking parties, with the patients acting like scared rabbits.  Harding and others both fear Ratched, viewed as a surrogate wife and mother, and want her to keep them in their place. Throughout the novel women are mostly portrayed as dominating “ballcutters” or submissive pleasure-givers. 

          Dale Harding, symbolizing the voice of reason as president of the Patients’ Council, explains the system and treatments like electroshock therapy and lobotomy.  What may be inexplicable, though, is the therapeutic role of nature and the healing power of laughter seen throughout the novel.  In a classic road literature scenario, Mack and the other patients on a fishing trip learn and grow along the way as they face challenges and overcome obstacles.  Mack laughs at fishing trip mishaps, the Chief tells us,  

            Because he knows you have to laugh at the things that hurt you just to keep yourself in balance, just to keep the world from running you plumb crazy. He   knows there’s a painful side; he knows my thumb smarts and his girl friend has a     bruised breast and the doctor is losing his glasses, but he won’t let the pain blot    out the humor no more’n he’ll let the humor blot out the pain.  

          The contagious laughter pumped the men up, as it “rang out on the water in ever-widening circles.”  Laughter, in fact, as a proponent of the holistic mind-body-spirit approach to health and healing, may relieve pain and renew hope.  In 1964 Dr. Norman Cousins,  diagnosed with the crippling and degenerative disease ankolysing spodylitis, with his doctor’s permission removed himself from the clinical environment and checked into a hotel for combination therapy comprised of belly laughter (watching Marx Brothers films) and taking massive doses of vitamin C.  His disease went into remission. He did not necessarily reject scientific, Western medicine that documents how positive emotions affect the adrenal glands and the endocrine system, and how the placebo effect  increases the mind’s willpower over matter. Cousins, in writing up his account in Anatomy of an Illness (1981), answers critics and leaves others to speculate about his alternative therapy, “Laughter may or may not activate the endorphins or enhance respiration, as some medical researchers contend.  What seems clear, however, is that laughter is an antidote to apprehension and panic.”  He was, in effect, retaking control of his life.  Since Cousin’s classic book, others have espoused hope, faith, and love as therapeutic values, such as Bernie Siegel’s Love, Medicine & Miracles.  Nonetheless, when considering alternative or holistic approaches to medicine, it is wise to beware of age-old quackery.

             Mack’s therapeutic role—if it can be called such—demonstrates the importance of levity as well as of maintaining some self-respect in institutional living.  Unfortunately, in Ratched’s therapeutic community her dehumanizing and belittling ways “ballcut” all men, including Dr. Spivey. Contrary to today's conventional wisdom, she controls the population by diminishing the men’s self-esteem.  She also administers narcotic drugs daily. Her threats of using electroshock therapy and lobotomy as punishment would now be seen as unethical, at the least. Mack progressively builds up their masculine confidence.  But then he lets them down, until in one last hurrah he puts his personal interests aside when he and the Chief protect George in a fistfight with the black aides who try to give him an enema.  Although Ratched gives Mack a chance to get out of ECT as punishment by admitting he has been wrong, in a pivotal show of selfless solidarity, he refuses, feeling it would be the same as confessing to a “plot to overthrow the government.”  As he undergoes a series of ECT in the Disturbed Ward, his bravado creates a heroic legendary status that Ratched fears.  In a psychological ploy to regain control, she brings him back to the ward where she can watch him—and plot. 

           Sexuality is also a part of life—even in an institution.  Mack arranges for Billy Bibbit, 31 but mentally an adolescent controlled by his mother, to lose his virginity to a smuggled-in prostitute during a drunken evening on the ward.  Mack’s attempt to restore a manly independence in the men may release some from psychosomatic illness; however, for Billy, things are not that simple.  Ratched, in her zeal to keep things under control, shames him into extreme guilt.  Fearful of his mother, he commits suicide.  At this point Cuckoo Nest’s rich literary references to Melville culminate in Moby Dick’s good versus evil overtones and in a suggestion of Billy Budd’s stuttering, innocent protagonist.  Applying Darwinian reasoning to the pecking order of the mental ward, Ratched’s “ballcutting” approach mandates that only the fittest survive. So Mack viciously attacks Ratched for Billy’s suicide, leading to her final retaliation:  his lobotomy.  What makes Kesey’s dramatization so compelling, however, is the way Christian imagery used throughout the novel coalesces into his final redemption:  Mack is the martyred Christ who has compromised authority and released the patients from the Combine’s control of them.  In fact, Cuckoo’s Nest’s grotesque description is so compelling it took lobotomy as therapeutic psychosurgery underground, until today when updated versions of it are deemed acceptable, beneficial treatments.  In the end, the Chief’s releasing Mack from his vegetative state and escaping out into a new life show the healing power of individuals. Nonetheless, life is messy, and Kesey’s ambiguous conclusion causes speculation that the Combine, bigger than Nurse Ratched and her mental institution, cannot be so easily defeated.    

            The allegorical title, One Flew Over the Cuckoo’s Nest, comes from a nursery rhyme the Chief recites in part 4:

            Ting. Tingle, tingle, tremble toes, she’s a good fisherman, catches hens,    puts ‘em inna pens . . . wire blier, limber lock, three geese inna flock . . . one flew          east, one flew west, one flew over the cuckoo’s nest . . . O-U-T  spells out . . .         goose swoops down and plucks you out.   

The cuckoo’s nest is the mental hospital; Ratched “tremble toes” pecks at the men; the Bull Goose Loony Mack “plucks out” the Chief , who embodies Mack’s spirit as he makes his hopeful escape out into the moonlight.  Kesey’s cautionary tale, a metaphor for how society socially constructs its attitudes toward mental illness, makes us question, conversely, how mental illness derives from culture as well as from disease.  What is more clearly understood, however, is that views of insanity change in our culture, and that therapies go in and out of fashion.  Cuckoo’s Nest makes us wonder how we should balance mental health care’s need to control and to conform with maintaining individual rights.  In Kesey’s novel, the psychiatric staff are not always the good guys, and the patients are often more complicated than they first appear.  With generational fluctuations in psychiatric perception, it is necessary to ask, by whose idea of normal should we be measured?   

Synopsis of the Novel

             An Oregon state mental institution in the 1960s is the scene for a contest of wills between the staff and the inmates. The catatonic Native American Indian Chief Bromden (Chief Broom) narrates One Flew Over the Cuckoo’s Nest even though he appears deaf and mute. Diagnosed with delusional paranoia, while in a fog and feeling helpless, he fears the Combine controls everything. The driving force in the mental institution is the militaristic Nurse Ratched (the Big Nurse), who wields her authority severely over everyone, including the professional medical staff, the black boy aides, and the patients.  The new patient, Randle P. McMurphy (Mack), whom the court ruled a psychopathic prisoner, has feigned insanity to be transferred from Pendleton Work Farm. In his cocky, in-your-face manner, he introduces himself as “a gambling fool” to other asylum inmates. Using his charm, he craftily sets them up as pigeons to pluck in card games. The patients are divided into the incurable Chronics like the big half-breed Chief, who is a flawed product of the Combine, and the curable Acutes who Nurse Ratched eggs on, attacking them where they are most vulnerable. A patient may come in as an Acute and then be turned into a robotic Chronic (Walker, Wheeler, or Vegetable) after being punished in the Shock Shop with electroshock treatments or with the permanent disfiguration of psychosurgery (lobotomy).  Threats with these therapies enforce cooperation while keeping the two groups separated.  Ratched has already assessed Mac as a troublemaker who will manipulate the system and disrupt the mental ward. She runs a tight ship—shunning outside disturbances—to keep the precision asylum machinery (the Combine) humming. Her ideal medical staff, the Chief tells us, has been hand-picked and after years of training molded to suit her needs, staying “in contact on a high-voltage wavelength of hate.”  She taught them her way to get inmates into shape was to patiently “wait for a little advantage . . . then twist the rope and keep the pressure steady.”  

            Through the fog of his schizophrenia the Big Chief keenly watches the new admission, McMurphy, in the group psychotherapy meeting. Ratched begins the discussion from a topic logged in the ward book having to do with Dale Harding’s promiscuous, well-endowed young wife, his feelings of inferiority, and resultant sexual dysfunction. He is a probable case of situational madness resulting from his wife’s emasculating nature. Mack had initially challenged Harding, the effeminate, college-educated president of the Patients’ Council, for the role of the Bull Goose Loony or the alpha male, but they soon become friendly when Harding proves a valuable source of information. Mack garners the most interest in the meeting, however, when Ratched introduces him as a recipient of the Distinguished Service Cross in Korea for leading a Communist prison camp escape. Subsequently, he was dishonorably discharged for insubordination and later arrested for drunkenness, gambling, assault and battery, and statutory rape.  Mack refutes only the latter. Dr. Spivey, the ward doctor, misaddresses him as “Mr. McMurry”-- Ratched’s attempt to demoralize Mack through improperly pronouncing his name—and looks into his file, reading the diagnosis:  “repeated outbreaks of passion that suggest the possible diagnosis of psychopath.” In retaliation, Mack tries to intimidate Ratched. Meanwhile, Dr. Spivey explains the group meeting protocol and why a democratic therapeutic community, as a prototype of the outside world, requires conformity that will allow them to return to the outside.  The patients in group therapy are encouraged to discuss and confess, revealing the secrets of the subconscious.  Rather than being Freud-inspired talk therapy, though, it turns out to be a Ratched-led pecking party, and this time Harding is unmercifully grilled and shamed. Hearing all this and watching an agitated patient receive a subduing hip shot, Mack, in the end, thinks it might be smart to carefully assess the situation, before he “makes any kind of play." He enters into a lengthy dialogue with Harding and others about Ratched’s role in emasculating them, culminating in a bet that he will “get her goat” within a week. 

            Mack’s rebellious nature takes over as he begins rallying the patients and gaining hero status by challenging Ratched’s authority and by procuring special favors for them.  For example, in the shower room Mack complains to a black orderly about the ward policy that he can brush his teeth at only a certain time, and when Ratched comes in, he tells her his clothes were taken and threatens to drop his towel. Ratched angrily calls for new clothes. Further taunting Ratched, Mack complains about loud ward music overriding his conversation while gambling for cigarettes; however, Ratched says it consoles the hard-of-hearing older patients. Mack then presses to move his game to the old tub room, no longer in use because drugs have replaced hydrotherapy. She refuses, but Mack persuades Dr. Spivey to change the venue.  Mack continues to break the rules by using real money (not cigarettes) to play Monopoly. He takes bets on the World Series.  In a key vote to watch the World Series, Mack gets the Big Chief to raise his hand. Ratched balks at the schedule change, and the Acutes do a sit-in protest in front of the TV set. With each loss of authority Ratched patiently, coldly waits: “she has all the power of the Combine behind her.”   

            In part 2 Ratched is suspicious of the Big Chief’s new cognitive responsiveness, and even though he still exhibits paranoia, his schizophrenic fog may be lifting. In a staff meeting, the question arises whether Mack is a clever con man or a violent psychopath. Ratched convinces others that sending Mack to the Disturbed Ward would only enhance his hero status; therefore, she favors keeping him in the general population where, before long, he will show his own avarice and cowardice.  The Chief, in his narration, theorizes Mack truly is an extraordinary man, capable of resisting the Combine. Noting aberrant staff actions, however, he questions who in the mental institution is completely sane.  Mack’s leadership continues to embolden the Acutes.  He has given them a reason “to wake up, and they now question ward policies, such as on rationing cigarettes. Then Mack, in a catch-22, backs off when he realizes, as an involuntarily committed patient, Ratched decides if he is cured or not (released or not). By failing to rally forces against Ratched, he disheartens the patients, possibly leading to Cheswick’s suicide.  Ward privileges are revoked, and therapy sessions return to silence.  

Mack witnesses an epileptic seizure, learning about the side effects of the drug that may prevent it, as well as the staff wielding its power through using electroshock therapy (“brain burning”), which, ironically, is actually the induction of a seizure. Mack is shocked to learn that Harding, Billy, and others have voluntarily committed themselves, and are free to leave at any time. It is only their fears of the outside world that keep them there.   Ratched, feeling her control returned, smugly informs the men that they must have the privilege of using the tub room for card playing taken away as punishment for their insurrections, and that having a sense of order and discipline will help them adjust to societal rules in the outside world.  Convinced she had the final victory and control over Mack, Ratched is startled to see him plunge his hand through the glass window of the nurses’ station, extracting one of his own cigarettes. She does not retaliate, but bides her time.  

In part 3 sports are introduced, causing the men to renew their muscle-flexing and to build self-esteem. Being denied day passes, Mack again puts his hand through Ratched’s glass window. Tension builds as Mack’s rebelliousness increases.  At this time, he recruits the patients to go on a supervised deep-sea fishing trip, but Ratched frightens the men.  Chief Bromden really wants to go, but knows he will blow his cover by indicating so.  Acting deaf has allowed him to hear. It started as a child when outside people who saw an American Indian as invisible quit listening to him. When Indian land was seized to make a hydroelectric dam, the government had his white mother, instead of his chief father, sign the deal. Chief Broom begins to emerge from his silence one night when Mack offers him some gum, and he replies, “Thank you.”  A conversation ensues, and Mack works on the Chief’s ego to convince him to throw the tub room control panel out the window for escape.  

Mack pushes to arrange a deep-sea fishing trip, signing up the Chief as the only Chronic going.  With great effort, because Ratched had tried to “damp the man out of them,” Mack gets the quota needed for the trip.  But, when only one chaperone shows up, the prostitute Candy Starr, Dr. Spivey must step forward as the second chaperone.  All the way to the dock, the men show bravado and courage, and instinctively a manliness once derailed returns. They surpass many obstacles on their road trip to the sea; in the end, without a properly signed waiver, they even hijack a boat. The fishing trip, complete with victorious fishing and hearty camaraderie, has returned a natural masculinity to formerly emasculated men. And laughter “started slow and pumped itself full, swelling the men bigger and bigger.” Mack watches as the men appear to slowly take back their lives. Billy and Candy become smitten, and Mack invites her to the mental institution on Saturday.  

Back at the mental institution in part 4, Ratched plots to discredit Mack by disclosing to the patients how much money he is making on them from gambling and arranging games and trips. Her ploy seems to be working, until Mack and Chief Bromden defend George Sorenson in a fistfight with the black orderlies. As punishment, they receive EST in the Disturbed Ward, which Mack compares to electrocution.   Because he will not relent, but rather acts heroically, Ratched orders more EST for Mack.  When he begins to attain legendary status, Ratched brings him back to her ward where she works on making him appear weak.  Still rebellious, Mack arranges for Billy to lose his virginity to Candy during a drunken night on the ward. The other patients urge Mack to escape rather than face further repercussion from Ratched.  But, drugged and drunk, he falls asleep. In the morning, Ratched takes it all in and threatens to tell Billy’s mother about his encounter with Candy. When Billy cuts his throat, Mack attacks Ratched. In retaliation, she has him lobotomized.  Bromden humanely releases Mack from his vegetative state by suffocating him, and he escapes back out into his life.

Questions for oral and written discussion:

1. What role did the rebellious Merry Pranksters have in defining the counterculture into which Cuckoo's Nest is set?

2. What psychological characteristics make Chief Bromden an effective narrator?

3.  How does the individual versus the Combine encapsulate the book's conflict?  

4.   Through scene analysis, define incidents of insanity as well as gender, and racial bias. 

5.  How is the fishing trip therapeutic for the patients?

6.  As seen through the eyes of Chief Bromden, whose mental illness may derive from a cultural schism, relate Christian imagery to Mack and his "ultimate sacrifice." 

7.  Describe Ratched's ward in totalitarian terms, incorporating a discussion of her authoritarian ways and the patients' loss of civil liberties.

8.  Discuss the psychological effect of domineering women in Cuckoo's Nest.

9. In the black satire Cuckoo's Nest would electroshock therapy and lobotomy administered as therapy and/or punishment be ethical now?  

10. Throughout the novel, trace Mack's influence on Chief Bromden's passage out of the fog of schizophrenia.  

Note: These discussion-type questions perform the task of the text as patient; i.e., students transfer the skill of understanding and constructing narratives and developing critical thinking to conversing with patients, which help them to understand their patients’ histories and think through ethical dilemmas.   

 

Reference Works:

Cousins, Norman. Anatomy of an Illness:  As Perceived by the Patient. New York:   Bantam, 1981.

Freud, Sigmund. Introductory Lectures on Psycho-Analysis. Trans. James Strachey.  New York:  Norton, 1966.

Gilman, Charlotte Perkins. “Why I Wrote 'The Yellow Wallpaper'.”  World Wide School Library. http://worldwideschool.org

Kerouac, Jack. On the Road. New York:  Viking, 1957.

Kesey, Ken.  One Flew Over the Cuckoo’s Nest. (40th Anniversary Edition).  New York, Viking, 2002.

Robinson, Mary Frances, Ph.D. and Walter Freeman, M.D., Ph.D. “Glimpses of Postlobotomy Personalties.” Psychosurgery and the Self: New York: Grune, 1954: 15-32. 

Siegel, Bernie S. Love, Medicine & Miracles. New York: Harper, 1986.

Shorter, Edward. A History of Psychiatry.  New York: Wiley, 1997. 

Wolfe, Tom. The Electric Kool-Aid Acid Test.  NY:  Farrar, 1968.   

Suggested Further Reading:

Grandin, Temple.  Thinking in Pictures and Other Reports from My Life with Autism. New York: Vintage Books, 1996. [The increasingly diagnosed high-functioning autism blurs the lines between normal and abnormal.]

Green, Hannah.  I Never Promised You a Rose Garden.

Kesey, Ken.  The Further Inquiry. 

Jamison, Kay Redfield. An Unquiet Mind: A Memoir

- - - . Night Falls Fast: Understanding Suicide.

Sheehan, Susan. Is there No Place on Earth for Me?  

Styron, William. Darkness, Visible: A Memoir of Madness.

What’s Normal:  Narratives of Mental and Emotional Disorders. Ed. Carol Donley and S. Buckley. Kent, Ohio: Kent State University Press, 2000. (Exceptional anthology]

 

 There are those who believe Black people possess the secret of joy and that it is this that will sustain them  through any spiritual or moral or physical devastation.

                   —Alice Walker, epigraph Possessing the Secret of Joy

 

Alice Walker’s Possessing the Secret of Joy (1992) 

Note to teachers:  Contains mature subjects. Please see appendix D.

 Historical Context

             While Kesey’s One Flew Over Cuckoo’s Nest and Walker’s Possessing the Secret of Joy are both cultural representations of mental and physical illnesses, they are as diverse in time, setting, and characterization as the backgrounds of their authors. Alice Walker (born 1944), the first black woman to win both the Pulitzer Prize and the American Book Award, for The Color Purple (1983), was born to poor sharecropper parents in Eatonton, Georgia, the last of eight children. Her mother’s grandmother was mostly Cherokee Indian.  At the age of nine, Walker was blinded in the right eye with a BB gun pellet and facially disfigured while playing cowboys and Indians with her brothers. She retreated into books. Walker excelled despite the partial loss of eyesight, and at her high school graduation in 1961, she was valedictorian and prom queen.  She received a scholarship to Spelman College in Atlanta, Georgia, but before she left her mother wisely gave her three gifts:  “a sewing machine for self-sufficiency, a suitcase for independence, and a typewriter for creativity.” While in Atlanta, Dr. Martin Luther King, Jr. invited her to his home, and later Walker attended the Youth World Peace Festival in Helsinki, Finland.  These two events immersed her in the civil rights movement and gave her greater understanding of other cultures.  In 1963 Walker took part in the March on Washington for Jobs and Freedom, where she heard Dr. King’s “I Have a Dream” speech.   

            After two years at Spelman, Walker received a scholarship to attend the prestigious Sarah Lawrence College in Bronxville, New York.  During her senior year she became pregnant and consequently suffered from suicidal thoughts and depression.  She poured her feelings into poetry and a short story, “To Hell With Dying,” which was published after receiving the endorsement of the famous poet Langston Hughes. With the help of classmates, Walker arranged to safely abort the pregnancy, which was illegal at the time.  Following college graduation in 1965, Walker increased her civil rights activism by the door-to-door registering of poor voters in Georgia.  Later she met and married Mel Leventhal, a Jewish law student in New York City, who later worked for the NAACP.  They moved to Mississippi where threats of violence tested their interracial marriage.   Walker got pregnant again, but lost the baby during the frenetic time following King’s assassination.  She later delivered a healthy daughter.  After receiving a number of grants and fellowships, Walker taught at Wellesley College in Massachusetts, one of the colleges that in the nineteenth century championed women’s rights (a movement born out of abolitionism), including voting and property rights, education and health reform.  While there, Walker created one of the first women’s studies courses.  In the mid-1970s she and Leventhal divorced. .

After Walker finished her most famous work, The Color Purple, she traveled to Africa to research the oppressive practice of female genital mutilation (FGM), which also occurs in the Middle East and in part of the Western Hemisphere.  Her work on the topic turned into Possessing the Secret of Joy, which focuses on one woman’s traumatic experience with FGM. Later with collaborator Pratibha Parmar she filmed a documentary with a companion book, Warrior Marks (1993).  Walker draws from a deep reservoir of personal experiences to write realistically about many issues in her novels and poetry.  For instance, she cares very much about poverty, racism, and the health issues that emanate from global violence against women.  Her works dramatize the oppression of women, in particular, and lately have addressed bisexual and father-daughter relationships. As a former teacher, she hopes to educate her readers on the brutality of misogyny, the dangers of silent taboos, and the effects of rituals. Her activism, which started during her college days at Spelman, now addresses other causes such as protecting indigenous cultures in their natural environments. Walker, a California resident, continues to write and to lecture.  

The main topic Walker addresses in Possessing the Secret of Joy is how the female genital mutilation ritual in a specific African tribe affects the mind, body, and spirit of its bicultural protagonist, her family, and her countries.  However, it is necessary to note that Walker’s literary representation of FGM applies to only a small percentage of African tribes, and that the surgical ritual is conducted in many different ways, in hospitals as well as in huts, for many different reasons.  For these general purposes, the procedure is more descriptively called female genital cutting (FGC) because, by degree, it ranges from a slight ceremonial nicking of the clitoris to draw blood to the more radical excision (removing some or all of the outer genitals) and infibulation (sewing up the vagina and leaving a small opening for urination and menstrual flow).   The ritual’s end result spans the gamut from a proud youth who has experienced a spiritual initiation into adulthood and elevated tribal status to a scared young girl’s agonizing pain and lingering death.  A woman who has had the more radical procedure often has very painful intercourse and child delivery.  Even the newborn may be harmed mentally and physically from passing through the narrow opening.   After childbirth, the woman is reinfibulated, or sewn back up.  

The origin of FGC goes back as far as Aristotle’s thinking that women were unfinished men; consequently, the malformed and unclean female parts needed altering.  It is believed Queen Cleopatra of Egypt had undergone pharaonic circumcision to, theoretically, ensure a union that could extend her realm’s interests. Historically, only a virgin who could protect the paternal bloodline was marriageable, and therefore FGC (euphemistically “having a bath” or “cutting the rose”) effected a sort of chastity belt. It became a mother’s duty to keep her daughter pure until marriage, and therefore a prospective bride’s excised and infibulated vagina became aesthetically desirable. In addition, a desexed girl was more likely to keep chaste until and during marriage. For these reasons, African mothers who force FGC on their daughters help maintain their status and that of their daughters.  In 2003, a 32-year-old unwed pregnant Nigerian mother, charged with adultery, was sentenced to death by stoning in a case where global human rights activists debated fundamentalist Islamic law. Because of international attention she was found not guilty by an Islamic appeals court. Thus, a mother who takes extreme measures to keep her daughter chaste could even protect her life.  Contrary to popular belief, the rite of passage tradition in some cultures does not derive solely from male dominance; rather, it gives the girls who prove their bravery by transcending physical pain more control over their tribal lives. In fact, some describe their experience as spiritual ecstasy. Those who show cowardice (“crying the knife”) are socially ostracized. The tradition in a few tribes includes boys who vie for tribal leadership by a test of their courage. They must be stoic while, without anesthesia, their penises are circumcised and ritually mutilated.    

Putting FGC into its cultural context and comparing it with other rituals, taboos, and practices is helpful.  Christian missionaries were trying to eradicate FGC in Africa at the same time Puritan moralists in America believed clitoridectomy was a necessary surgery to control nymphomania and masturbation and to cure hysteria and melancholia.  While some argue that there is no sound medical reason for male circumcision, in the Western world and elsewhere it is still done both for hygienic purposes and as a powerful religious ritual. However, for males, circumcision (the removal of the foreskin) is relatively trivial—unless it goes awry— compared to its female counterpart (clitoridectomy, at its worst), in which sexual pleasure is replaced with pain.  Other related myths, taboos, and practices shed light on how FGC is culturally represented.  Historically, menstruation and menopause myths declaring women unclean or undesirable, respectively, have mandated isolation and subjugation.  Ancient Chinese foot binding hobbled women into a helpless desirability, while recent headlines report female infanticide where sons are desirable.   

 Whether rituals, traditions, and practices are considered heinous or not is a matter of perspective, though, because to many around the world the American death penalty (an ancient form of justice stemming from the philosophy of an eye for an eye) is considered barbaric.  A hot contemporary issue in the United States is the sexual reassignment of hermaphrodites or intersexuals (1 in 2,000 births; or .5% of the population) whose genitals do not fit into the culture's binary notions. Cheryl Chase, born with ambiguous genitals, argues in “’Cultural Practice’ or ‘Reconstructive Surgery’? U.S. Genital Cutting” that it is a double standard to call FGM a barbaric ritual and sexual reassignment surgery a scientific necessity exempt from the federal law banning FGM.  Chase asserts that in sexual reassignment cases, done since the 1950s, surgeons perpetuate violence against intersexuals by trying to transform “transgressive bodies into ones that can safely be labeled female and subjected to the many forms of social control with which women must contend” (Chase, 145).  Doctors said Chase, born with a micropenis, undescended testes, hypospadias, and other abnormalities, could not function as a male in our society, so he was surgically and hormonally altered to appear female but is nonorgasmic and infertile, something s/he is not emotionally comfortable with.  U.S. surgeons reconstruct intersexuals’ genitals to fit into a narrowly defined psycho-social system, just as mothers who force FGM onto their daughters consider their social well being in the particular tribal culture.   Whether it occurs here or in Africa, Chase asks, Isn’t genitally mutilating children who cannot give informed consent child abuse?  

            Anthropologists and missionaries have known about FGC for many centuries. It was brought to the popular consciousness, though, in a 1980 Ms. Magazine article by Gloria Steinem and Robin Morgan titled “The International Crime of Genital Mutilation.”  Later Democratic Representative Patricia Schroeder of Colorado shocked Congress with the reality of FGM, and eventually it passed the Federal Prohibition of Female Genital Mutilation Act in 1996, making it a federal crime punishable by up to five years in prison. Intersex reassignment surgeries are exempt.  Alice Walker, who fictionalized the issue in Possessing the Secret of Joy and others who wrote about their private ordeals have horrified Americans. What followed these revelations was a Western media blitz on national news and talk shows. Claire C. Robertson, interested both in diminishing FGC and in eradicating poverty, writes in “Getting Beyond the Ew! Factor” that she is concerned about these “tendencies toward sensationalism and polemics,” saying First World feminists seem arrogant and Americans voyeuristic with prurient tendencies when “All issues were being subsumed into this one and African women [were] being reduced to their genital status” (Robertson, 54-5).  Can we claim moral superiority in a country where increasing incidents of rape, sexual assault, wife battering, and sexual harassment against women made it necessary for us to pass the Violence Against Women Act in 1994?   

          Whether or not First World countries can claim moral superiority, it is going to take the hard work of an international community, including the support of Amnesty International, the World Health Organization, and the United Nations, as well as local and international human rights and women’s organizations, to debate the violation of human rights and health issues. The polar positions taken are: 1) extreme cultural relativism—FGC practiced on girls is tied up with national identity, and we cannot judge another country’s morals and interfere; or 2) we should withhold aid from countries practicing FGC.  With the consequences of FGC stirring the public conscience, it is not that easy to remain uninvolved, as evidenced in the action our government took in AIDS funding..  In 2003 former South African president and Nobel Peace Prize laureate Nelson Mandela praised President George W. Bush for pledging $15 billion to fight AIDS, a disease expected to kill 20 million more Africans by the end of the decade. The United Nations estimates that 45 million worldwide are HIV-infected.  The world community continues to interfere in domestic human rights issues by condemning slavery, genocide, and infanticide, while it educates and provides other basic needs, such as food, clean water, and urgent health care.  The two million girls every year who undergo FGC, and especially infibulation, risk a myriad of mental and physical health problems, including shock, trauma, and hemorrhage; bacterial and HIV infections; incontinence and menstrual problems; sterility, frigidity, and childbirth problems. Many will die.  As difficult as eliminating the culturally-entrenched habit of smoking, which annually kills 440,000 Americans and 4.9 million worldwide, the World Health Organization says it will take educating three generations and many more years to eradicate FGC. 

          Part of the world feels it’s contentious to call their venerable female circumcision rite “mutilation”; nevertheless, for most Americans Secretary of State Madeleine Albright put it best:  “When people are mutilated, it is criminal, not cultural.”

Literary Analysis     

In Possessing the Secret of Joy the black liberal feminist Alice Walker dramatizes how her main character, Tashi, in an act of tribal allegiance, gets facial scarring and circumcision “because she recognized it as the only remaining definitive stamp of Olinka tradition."  The tribe’s leader, who is compared to Nelson Mandela and even Jesus Christ, has instructed the people “not [to] neglect ancient customs.” He has been imprisoned by the white regime. Walker explores the effects of FGM in a dazzling style that simultaneously seems to contrast and to transcend cultural differences. The various viewpoints are artfully integrated into dialogue and flashbacks, intermixed with myths, symbols, and psychology. Walker uses the narrative device of renaming Tashi relative to her changing cultural and psychological state of mind; for example, when referring to her evolving American self she is “Tashi-Evelyn.” In this way, Walker conveys the essence of Tashi’s journey.  However, Tashi is not described sympathetically because she was circumcised against the wishes of her Christian mother whose other daughter died as a result of FGM.  Furthermore, because Tashi was sexually responsive with Adam, she knows the operation will result in a loss of pleasure.  Even after Tashi’s sparkling youthfulness turns into a flat-eyed passivity, Adam marries her, and she emigrates with him to America.  Only then does she understand her physical and emotional loss and explode into rage.  This analysis focuses on Walker's literary achievement in Possessing the Secret of Joy, in which she creates a bicultural lens through which we can examine Tashi’s African soul and warring American consciousness.   

            The title, Possessing the Secret of Joy, reflected in the first epigraph, derives more fully from a passage in Mirella Ricciardi’s 1982 memoir African Saga.  Ricciardi was a French-Italian woman born and raised on a farm in Kenya, then a colony in British East Africa, who wrote, “Black people are natural, they possess the secret of joy, which is why they can survive the suffering and humiliation inflicted upon them. They are alive physically and emotionally, which makes them easy to live with. What I had not yet learned to deal with was their cunning and their natural instinct for self-preservation” (Ricciardi 147). The condescending tone of Ricciardi’s colonial remembrance highlights how nationalistic backlash plays into Tashi’s mindset when she undergoes FGM.  In Possessing’s scenario, a First World organization’s attempts to change a Third World culture causes defiant anticolonial acts. Walker’ssecond  epigraph/proverb further sets the story into its bicultural context, prophesying Tashi’s state of being torn apart from within: “When the axe came into the forest, the trees said the handle is one of us."  Walker’s plot borrows further from Ngugi wa Thiong’o’s novel The River Between (1965), in which two lovers living across the river from each other play out the drama of Christian converts clashing with African traditionalists.  Like The River Between, Walker’s theme in Possessing argues that female circumcision destroys not only individual women but their country as well.  Tashi endures pain to prove her devotion to tribal heritage—she symbolizes ritual sacrifice and the ultimate hope for change. Conversely, the circumciser M’Lissa, a “monument,” symbolizes age-old beliefs and keeping the old ways.  

            Possessing the Secret of Joy is a vehicle for Walker’s own feminist agenda. By putting Tashi into a particular context, Walker is able to develop her human rights and health issues, as well as argue for political change. Tashi’s story becomes part of Walker’s own.  For instance, the autobiographical elements are clear when Walker refers to FGM as “sexual blinding,” a reference to her brothers shooting her in the eye and swearing her to silence. Both Walker and her character Tashi aborted a pregnancy and bridged cultures in search of an identity.  They are storytellers whose myths teach lessons, filling the novel with stories of repression, of struggles, and eventually of self-actualization. Walker’s strong female character, Adam’s lover Lisette (Walker’s alter-ego), is an altruistic white woman who, as the voice of reason, contrasts with the emotional Tashi.  As a youth Lisette had visited Olinka with a church youth group, and her family were colonists in Algeria.  As an adult, she is a high school French teacher in Paris who studies her ”co-wife” Tashi from afar. The novel’s opening “parable of the panther” foreshadows the Tashi-Adam-Lisette love triangle and even foretells the outcome. Adam’s child with Tashi, the American-born retarded Benny, is a painful sideshow for Western doctors; his child with Lisette, the Paris-born precocious Pierre, is the result of a natural, orgasmic home birth.  The autonomous Lisette starkly contrasts with the fractured Tashi. 

            After Lisette dies from cancer, Pierre "continues to untangle the threads of mystery that kept [his stepmother Tashi] enmeshed."  He reports that FGM may have been a reaction to “the Hottentot apron,” or, as described by early European anthropologists, the unusually elongated labia on uncircumcised Khoisan women with enlarged buttocks (steatopygia). The bisexual and biracial Harvard-educated Pierre explains how some tribes eventually decided a woman’s dual genitalia needed modifying because she could not perform both female and male roles.  Continuing on Tashi’s journey to self-knowledge, Olivia takes her sister-in-law to her first “shrink,” a white “son of Freud” couch-analyst who gawks at her as a publishable case history.  He simplistically declares that healing is impossible because Africans cannot blame their mothers.  Tashi’s next analyst is Lisette’s uncle, the Old Man or Mzee.  Clearly, as Walker references in her afterword, her Old Man character is Carl Jung (1875-1961), the Swiss analytical psychologist who opposed Freud’s idea that the libido (sexual instinct) alone drives life. Jung differed from Freud by espousing an interest in the opposites in nature (the divided self), even expressed in the way Jung, unlike Freud’s couch analysis, sat in a chair opposite his patient to actively engage in dialogue.  

Applying the Old Man’s Jungian psychology to the bicultural and divided Tashi, she must reconcile her conscious ego with her unconscious, repressed experiences through interpreting her dreams, stories, and art. For example, during art therapy, after Tashi draws a large, evil rooster (“a humongous feathered creature”), she felt she was “seeing the cause of [her] anxiety itself for the first time, exactly as it was.”  It was a beast-sized indication of her psychosis, the “[e]motions that had frightened her insane.” All at once Tashi remembered hiding in the grass and witnessing her sister’s murder: “No longer would my weeping be separate from what I knew.” The insidious tribal taboo, demanding silence and repression, had subverted her childhood memory.  In Possessing Walker applies to Tashi’s recovery the Jungian analysis she herself underwent. Jung’s archetypal elements of the ego (central consciousness), shadow (unpleasant unconscious—Dr. Jekyll to Mr. Hyde), animus (Tashi’s masculine unconscious mind), and Self (whole regulating center of the psyche, transcending the ego) help identify Tashi’s psychological process toward wholeness or individuation. More simply put, Walker equates Jung’s psychic ideal—harmonizing the conscious and unconscious; decentralizing the ego; and acknowledging the shadow and animus—with Tashi’s coming to terms with her past, at last bringing her discovered Self spiritual peace.  Even Walker’s final chapter heading, “Tashi Evelyn Johnson Soul,” cues the reader that Tashi’s fragmented mental state is at last reconciled.  

            After the Old Man dies, Tashi’s new analyst, the black American feminist Raye, only understands Tashi’s physical pain after having periodontal surgery. Tashi opens up to her, breaking her silence and referencing her shadow or dark self, and self-acceptance follows.  Raye and Pierre analyze Tashi’s dream of being the queen termite imprisoned in a dark tower with broken wings. In African culture, the protruding termite hill symbolizes an elevated clitoris barring male entry; the hill being cut down symbolizes the ritual desexing.  Because the girl’s male soul is in the clitoris, it must be excised to rid her of the dangerous duality.  Nonetheless, Tashi’s personal anguish cannot be assuaged by Pierre’s anthropological facts, the Old Man’s analytical psychology, or Raye’s empathy alone, so she premeditates killing the old circumciser M’Lissa. Tashi returns to Africa with a banner that reads, "If you lie to yourself about your own pain, you will be killed by those who claimed you enjoyed it." Ironically, M’Lissa is disdainful about her ancient practice, unfeelingly excising and infibulating the Olinkan girls, and even expects to be martyred, robbing Tashi of complete satisfaction. Walker, as embodied in Possessing, speaks more to the tribal mothers who she believes subject their daughters to perpetual lies, familiar tortures, and to the numerous murders of the spirit. 

Walker’s novel, detractors say, is overwrought sensationalism and polemics and should not be read as a fact-based anthropological study of FGM, in decline since 1920. Nevertheless, Walker’s feminist ideology in Possessing has had an impact on FGM legislation here and cultural interventions abroad. But it tends to subsume the myriad of issues facing African women into the reductionist’s view they are only mutilated genitals.  Hence, the “yuck factor” eclipses productive debate. On the other hand, the cultural relativists believe tribal customs are an integral part of each society and should be observed but not interfered with.  In the mid-twentieth century their controversial views superseded the late- nineteenth-century Social Darwinians who tended to classify (read subjugate) societies on the basis of race.  Regrettably, when First World  organizations attack tribal practices perceived as objectionable, nationalistic backlashes occur.  Moreover, the notion of women as oppressed victims of men becomes questionable in some cultures where the social interaction in FGC builds sisterhoods and elevates their tribal status, says Efua Dorkenoo in Cutting the Rose.  Critics contend that Walker’s Possessing the Secret of Joy created an explosive topic with some misrepresentation and started a mass media trend toward First World voyeurism, leaving to be desired practical approaches to address human rights and health issues. 

Possessing the Secret of Joy is about one woman’s struggle with her African heritage and her right to self-determination beyond cultural constraints.  It is not a factual anthropologist’s case study but rather has the emotional power of literature. Even as sensationalized cultural criticism, it has added to the general dialogue on human rights and health issues.  In principle, it foregrounds a number of issues of cultural, medical, and legal importance.  It shows women complicit in a world run by male ideologies; culture intersecting with gender and health issues; and Walker’s ethical basis for a controversial worldwide stance. In a postscript Walker addresses her reader, saying she does not know where her African ancestors came from, but she claims Tashi as her sister.  While Possessing powerfully addresses FGM and highlights AIDS, for some her Western feminist approach remains problematic. In the end, Tashi’’s friend Mbati reflects on the colonialist memoir, Ricciardi’s African Saga, underscoring Walker’s interpretation of “possessing the secret of joy”:  "Oh, I say. These settler cannibals. Why don't they just steal our land, mine our gold, chop down our forests, pollute our rivers, enslave us to work on their farms, fuck us, devour our flesh and leave us alone? Why must they also write about how much joy we possess?"  At Tashi’s execution, her friends and family hold a sign: "RESISTANCE IS THE SECRET OF JOY!"  And only after dying, when her divided selves unite into her whole Self, has Tashi resisted what is evil (the power over her) to possess “the secret of joy.”

Synopsis of the Novel

           In Walker’s Possessing the Secret of Joy there are seven main characters, and every few pages the viewpoint changes with each new speaker.  Tashi, who is a peripheral character in The Color Purple, has shown allegiance to her Olinkan people by having the tribal marks cut onto her face and by having the female genital cutting ceremony. The book begins in a flashback when the imaginative Tashi, who is now an American, reflects on what her life has become.  Telling the parable of the panthers, Tashi sets the tone for the whole book, and she moves the plot along by intermittently telling myths and stories.  Raised in Olinka, Tashi’s sister, Dura, died after a ceremonial genital cutting ritual. The African-American missionary’s children, Olivia and Adam, befriend Tashi. Adam becomes her lover, breaking tribal taboos. Adam also meets Lisette, a white French Algerian missionary, with whom he shares stories of the Olinkan culture. Tashi, in the name of Olinkan pride, has the circumciser M’Lissa excise and infibulate her, above the protests of her Christian mother, Adam, and Olivia.  By doing this, she intends to join in solidarity with the other women, whom she envisions as completely strong and invincible African women.  Days after the operation, Tashi is told to sit up and walk a few steps—her own proud walk has become a permanent shuffle.  It takes 15  minutes to urinate now.  Her menstrual cramps last half the month because  it is nearly impossible for flow to pass through so tiny an aperture.  The residual flow that does not find its way out and is not reabsorbed into her body has nowhere to go; so the odor of soured blood follows her around.  Tashi’s friend Olivia observes, “That her soul had been dealt a mortal blow was plain for anyone who dared look into her eyes.”   

Adam marries his friend, the once proud and lively Tashi, who is now heartbreakingly slowed by pain, and he takes her back to the United States.  Living biculturally, Tashi cannot rationalize the emotional anguish she experiences daily in the name of her tribal leader’s call for Olinkan pride, so she sees several psychiatrists.  The first one tells her Negro women cannot be cured ”because they can never bring themselves to blame their mothers.”  Tashi still thinks of herself as an African woman, not an American Negro.  Another psychiatrist, Lisette’s white uncle (the Old Man or Mzee), tries to help Tashi in Switzerland with art therapy and by analyzing her dreams, which she cannot share with her husband.  When the Old Man dies, the black feminist Raye becomes her therapist. Tashi explains to her how their African leader mandated FGM from one generation to the next through a sacred tribal code, there being a strong cultural taboo against speaking of it to outsiders.  The act was designed to keep the female body pure by cutting out the “dual female soul” that interferes with male domination.  If a woman is not circumcised, the myth goes, her unclean parts will grow long and touch her thighs.  Unremedied, warn the elders, who act as if they have recently witnessed this evil, no man can enter this masculine woman, who arouses herself.  The circumcised women do not remember having vaginal lips or a clitoris, so they laugh and jeer at the monstrous “tail”; circumcised girls run from “the demon.”  The tribe passes on unverified beliefs because the old ways must be kept.  Tashi, who had been a young orgasmic girl with Adam, gave up her sexuality to preserve the old ways. 

            In America, Adam and Tashi have a son, Benny, born retarded from passing through the birth canal narrowed by FGM. Unable to bear further pain, Tashi then aborts a subsequent pregnancy. Adam later becomes reacquainted with the free spirited Lisette, and they become lovers, seeing each other on his biannual visits to Paris.  Together they have a child, Pierre, which enrages the dispirited Tashi.  Pierre, unlike Benny, is bright and inquisitive—he studies black American literature and decides to go to school in America. His mother has died, and he wants to become closer to his father. Tashi feels threatened and attacks Pierre. Tashi returns to Olinka when she reads about M’Lissa’s becoming a venerated symbol of Olinkan pride.  In an elaborate scheme, the tortured Tashi, now in “advanced middle age,” plots her revenge.  She seeks an “audience” with the venerated circumciser M’Lissa, and over a period of several weeks they talk. Tashi ritually washes her intended victim, who taunts her for foolishly submitting to circumcision.  M’Lissa is prepared to become a martyr, and Tashi smothers her with a pillow as she attends her.  She is indicted for murder. 

             Tashi is imprisoned in Olinka and put on trial for killing M’Lissa.  Her family and friends are there to support her, and Adam reflects on how he has witnessed his wife’s “hell on earth.” The prison also houses a whole floor of AIDS patients waiting to die.  Many believe they contracted AIDS in an experiment, like the Tuskegee Syphilis Study, when scientists “vaccinated” them for polio. In the end, Tashi grows weary of the plodding trial and confesses to the murder; nevertheless, the trial, a media circus, goes on.  At her execution by firing squad on the soccer field, Tashi is released from her tortured soul for “killing someone who, many years ago, killed me.” Adam, Olivia, Benny, Pierre, Raye, and Mbati hold a banner:  RESISTANCE IS THE SECRET OF JOY! 

Questions for oral and written discussion:

1. Compare and contrast Kesey’s Big Chief and Walker’s Tashi as examples of how mental and physical illness derives from a specific culture as well as from disease.  How have Cuckoo’s Nest and Possessing had the power to change the system?  

2. With increasing global awareness of human rights violations effected through literature and organizations such as Amnesty International, the World Health Organization, and the United Nations, why do certain cultural practices like FGM and stoning continue? What are cultural relativism and Social Darwinism?  Relate the culturally entrenched habit of smoking (also called the “brown plague”) to FGM?

3. Reflecting on Tashi’s painful physical abnormalities, describe how it affects her mental state, as she describes it to her various mental professionals.  How in particular does the Jungian analytical psychologist work with her to ultimately achieve her Self?

4.While the Olinkan male Leader appears to mandate FGM, how and why are the tribal women complicit in maintaining the ritual?

5.Compare and contrast the tortured Tashi and the free- spirited Lisette.  How do these two women interrelate?

6. Discuss how Pierre and Benny represent their respective mother’s autonomy and inadequacies.

7.  How does Walker, an imaginative storyteller, use symbols (Tashi, M’Lissa, termite hill, clay), parables, and myths to tell Tashi’s story and to teach a lesson?

8. .As highlighted in Possessing, how has the Tuskegee Syphilis Study impacted the question of trust in treating AIDS in Africa?

9. What is M’Lissa’s perspective on FGM and her actions, as told to Tashi before her death?

10. On Tashi’s journey toward wholeness, what is her resistance to, in teaching us about possessing the secret of joy?

Referenced Works:

Amnesty International. Universal Declaration of Human Rights (1948).              http://www.amnestyusa.org/udhr.html.

Baartman, Saartjie. Tragic Venus. August 15, 2003.             http://www.insanetree.com/images/special/saartjie.htm

Chase, Cheryl. “’Cultural Practice’ or ‘Reconstructive Surgery’? U.S. Genital Cutting, the Intersex Movement, and Medical Double Standards.”  Genital Cutting and Transnational Sisterhood:  Disputing U.S. Polemics. Ed. Stanlie M. James and Claire C. Robertson. U  of Illinois P, 2002.  126-51

Dorkenson, Efua. Cutting the Rose. London: Minority Rights, 1994.

The C.G. Jung Page: An Introduction to Jung. http://www.cgjungpage.org/jpintro.html

Jung, Carl. Man and His Symbols. New York: Dell, 1968

Ngugi, wa Thiong'O. The River Between.  NH: Heinemann, 1965.

Ricciardi, Mirella. African Saga. London:  Collins, 1981. [sic]

Robertson, Claire C. “Getting Beyond the Ew! Factor:  Rethinking U.S. Approaches to  African Female Genital Cutting.” Genital Cutting and Transnational Sisterhood:  Disputing U.S. Polemics. Ed. Stanlie M. James and Claire C. Robertson. U of  Illinois P, 2002.  54-86

Understanding Violence Against Women.  National Academy P, 1996. .

Walker, Alice.  Possessing the Secret of Joy.  New York:  HBJ, 1992.

- - - , and Pratibha Parmar, eds. Warrior Marks: Female Genital Mutilation and the             Sexual Blinding of Women. New York: Harcourt, 1993.  Book and video

World Health Organization, Fact Sheet No 241: Female Genital Mutilation June 2000. http://www.who.int/inf-fs/en/fact241.html

 Suggested Further Reading:

Atwood, Margaret. The Handmaid’s Tale. New York:  Fawcett, 1986.

Chopin, Kate. The Awakening.  New York:  Bard-Avon, 1972. A desperate women swims out to sea (1899).

Conrad, Joseph. Heart of Darkness. 1901: Available on-line.  Marlow  travels to the dark interior of Congo searching for his European self in Mr. Kurtz.

Eugendies, Jeffrey. Middlesex.  New York:  Farrar, 2002. 

Kassindja, Fauziya. Do They Hear You When You Cry? New York:  Delacorte, 1998.

Thiam, Awa. Speak Out, Black Sisters: Feminism and Oppression in Black Africa. London: Pluto, 1978.  Graphic descriptions of FGM; cultural perspectives.

Walker, Alice. “Advancing Luna—and Ida B. Wells.”  You Can’t Keep a Good Woman Down: Short Stories. New York:  Harvest-Harcourt, 1981.  85-104  A White woman raped by a Black civil-rights leader remains silent to advance the cause.

- - -.  The Color Purple. New York:  Washington Square P, 1982.

Whitney, Ruth Linnea.  Slim.  Dallas, Texas: SMU P, 2003. 

 

ALL RIGHTS RESERVED


Home | About Dr. Stripling | Lectures | "The Diagnostic Embrace" | Speaking Schedule | Publications | Book Chapter | Medical Humanities Curricula | Student Papers | What the Students Say | Email | Links

 

   

           “Every style is a means of insisting on something.” 

                         ---Susan Sontag, “On Style” 155.