Student Papers
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Writers are very observant of their surroundings. They are great hunters who stalk the words to express
the feelings that make the world more understandable.
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| Paul C. (student) |

Medical Humanities Pioneers
Writing Assignments
Student 2-pp paper assignments (Spring 2000):
1) Read Selzer’s Brute and Wms’ Use of Force. Write a 2-pp response comparing and contrasting Brute and Use of Force. Answer these questions: 1) Is force justified in either case? 2) How do the doctors’ levels of patience and fatigue affect the art of healing in each story (case narration)? 3) Could the doctor have handled the situation in any other way?
2) Read Selzer’s Toenails. Identify/comment on Selzer’s ethos (character), pathos (emotions), and/or logos (logic). Does the doctor’s appearance of dignity suffer? Identify Selzer’s style (e.g. similessomething like or as another) and comment on how it appeals to you as a reader and connects you to the human experience.
3) Read Selzer’s ’The Black Swan’ Revisited. Write a 2pp paper addressing irony (Love/Death theme) and symbolism (e.g. swan, bread, decay) in the story. Terms: Ironyexpression in which the intended meaning of the words is the opposite of their usual sense. An event or result that is the opposite of what is expected. Symbolism: an object, animate or inanimate, which represents or stands for something else. [It might be helpful to relate to other ironic incidents.]
4) Read Selzer’s Abortion and Wordsworth’s We Are Seven. Selzer gives many perspectives in Abortion such as those of the doctor-observer-narrator (Selzer) . . . and others. What does he make you feel about the patient or any member of the medical team? How does Selzer’s style (grotesque images, literary allusion, shifters, unattributed quotations) appeal to your emotions? What clearly developed theme in We Are Seven can you relate to Abortion? What previous readings from On Doctoring support your views?
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"Hush Little Baby"--paper on "Abortion"
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You Only Live Twiceunraveling a natural order of things (Selzer’s Black Swan)
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Out of These Ashes Shall Arise a Swan [lit.allus.]symbols & irony in Black Swan
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Podiatry in the Pottyempathy and service to humanity (Toenails,--lit. devices)
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He That is Greatest Among You Shall Be Your Servantliterary analysis Toenails
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How Lovely are the Feet of Those Who Bring Good NewsToenails response.
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"In the Guise of Love"--paper on Selzer's "Black Swan"
Instructions (4-5pp paper): This is your opportunity to explore a topic of special interest to you. It is always desirable to incorporate literary references. In the end have an effective title that sets up your introduction, followed by a solid body that develops several points, incorporating quotations. The conclusion should pull all together, leaving the reader with a satisfied sense of completion. Use MLA style and aim for quality, incorporating sentence and punctuation variety. Proofread carefully. Minimum of three outside references. Six simple steps to composition: Prewriting, freewriting, responding, revising, editing, and evaluation.
Student 4-5 pp paper titles/topics (Spring 2000):
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Elevators of Elationa veteran nurse’s perspective on wet-behind-the-ears interns
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To Be, or Not to Be (Vaccinated)?historical view on communicable diseases
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A Duty to Prognosticatepros and cons of giving predictions to terminal patients
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For the Times, They are a Changin’touching (political and social climates)
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Illness: A Personal Narrativestudent’s own account of surviving malaria
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How Could She Do It?analysis of Hemingway’s Hills Like White Elephants
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The Advantages of a Dual Professionstudent as both pharmacist and ob/gyn
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Wired: The Story of Caffeinehistorical perspective; today’s market and uses
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Drugs in the NFLpersonal views on steroid, marijuana, alcohol, and cocaine use
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Adam’s Gift to Uspersonal account of dealing with death (related to readings)
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Stroke: The Silent Killerpersonal account/research on family stroke victims
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Don’t Touch . . . dramatization of Werner Forssmann’s early heart research
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Symbolism in Selzer’s ‘Imposter’Christian symbolism; myth and allegory
Students 6-8pp Term Papers (Spring 2000):
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Skin Cancercomprehensive treatment of the most common malignancy in the US
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I Scream, You Scream, We All Scream For . . . stress, the bane of man’s existence
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Drug Reaction: A Change of Lifestylepersonal account of traumatic reaction
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The Most Neglected Necessitysleep deprivation (comprehensive study)
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To Sleep, Perchance to Dreameffects of sleep deprivation in medical students
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Treating Humans’ Oldest Foe: Painan interview with Dr.Gregory L. Skie
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The Journeydeath as the final stage of growth (Dr. Elizabeth Kubler-Ross)
*Others include personal illness narrative; comparing and contrasting the poetic and clinical approaches to death; violence in America; and a brief history of medicine.
Semester Assignments: four 2pp papers on specific readings (exactteaches focus); one 4-5pp paper (more room to think things through); one 6-8pp research paper or interview; and two oral presentations. Aristotle’s rhetorical approach (logos, ethos, and pathos) in analyses is encouraged. The class discusses outside readings, with three questions prepared in advance. Students bring in weekly journal/newspaper articles on contemporary medicine (double points for humor). Mid-term and Final Exam.
Textbooks: Richard Selzer’s The Doctor Stories and anthology, On Doctoring.
In the Guise of Love
by
Kim Higgins
In "‘The Black Swan’ Revisited" Richard Selzer explores the theme of the vanity of beauty illustrating the Biblical truth revealed in James 1:15: "Then when lust has conceived, it gives birth to sin; and when sin is accomplished, it brings forth death." Rosalie is an emotionally deceived woman who believes she is in love, but settles for a relationship based on lust. It is the irony of this story that her "love" brings forth death instead of life. Selzer uses the literary tools of allegory, symbolism, and irony to show the emptiness of vanity.
First, Selzer takes us on a literary journey through the caverns of Rosalie’s diseased reproductive system using the symbolism of an old castle ruin and a dried up moat. We see the moat figuratively as the condition of her sexual organsorgans appearing dried up, the parched desolation representing the menopause she has undergone. Selzer then draws the reader into the internal dance of sexual relations between Rosalie and Ken. The courting and apparent seduction are depicted when "Rosalie drew him toward the ancient pile of stone that had been a castle and that lay half-tumbled down the slope of a long lawn. An empty moat surrounded the ruin." Again, the reader is privy to their sexual rendezvous as "they crossed the bridge" and entered into the "expectant archway" that led to "the flight of descending stone steps, each one spotted with a rash of gray lichen." Selzer artfully uses symbolism to allow the reader to visualize the vagina’s "expectant archway" and its disease-ridden walls coated with "gray lichen" colored sores. Continuing the symbolism of the sexual act, we can imagine Ken reaching the bottom of the cellar with its door locked and bolted. He cannot enter the chamber of her uterus, for it has been closed by menopause and locked shut by disease. It is a womb forever closed. Then the orgasm occurs, and she calls out his name, followed by the calm after the storm passes. All that Rosalie is left with is the queasiness caused by her sickness, symbolized as the odor of decaying leaves. After the sexual encounter, Selzer shows Ken’s lack of emotional support as he smells the terrible stench, her illness, and wants to leave her. There is an illusion of a penis being extracted as "a sudden shaft of sunlight struck" and as Ken disengages himself from Rosalie to wipe away "the damp leaves that had become stuck to the soles of his feet." The entire castle trip is an allegory depicting a sexual act and the truth of a lustful relationship.
Next, highly derivative of the ballet, "Swan Lake," and of Greek mythology’s swan as representative of the goddess of love, Aphrodite, Selzer epitomizes in black swan symbolism Rosalie’s deceptions on love and youth. Throughout the story, evidence of Rosalie’s deceptions emerges. (In fact, Selzer’s story is a rewrite of Thomas Mann’s novella titled "Die Betrogene" or "The Deceived One.") In particular, Rosalie believes that she has found true love, and that this love has become her fountain of youth. Although she admits to herself that "it is lust. An obsession with his body," she later argues that "to call it anything elseinfatuation, obsessionwould be an act of cowardice. And a lie. I love him." She believes that nature has given her back her youth to be worthy of her love. For Rosalie, the return of her monthly flow is her life being restored to her because of her love for Ken.
Selzer shows the irony of death coming in the guise of love. Rosalie perceives her raging emotions as love, misunderstanding that the tumor’s secretions are accentuating her feelings of lust. The hormones seeping from Rosalie’s uterus are causing her to confuse the bloody secretions of death with the blood of life. Interestingly, there are religious overtures throughout the story. For example, Rosalie "stood to fill his glass, as though it were a sacrament," then, with a tremor, spills her own wine. This parallels the spilled blood of Jesus. She believes that "bleeding to death is painless. It is a death reserved for the righteous." Additionally, Selzer symbolizes the eating of the swans’ bread crumbs as Rosalie’s effort to have communion, "as she snatched the bread from Ken’s hand and "stuffed it into her mouth." Throughout the story, Selzer takes the reader back to the irony of love bringing forth deatha womb intended to bear life instead brings forth disease and death.
In "‘The Black Swan’ Revisited" Selzer captivates the reader by courting the illusion that love, or lust, becomes a fountain of youth for Rosalie. Later, the allegorical depictions of a sexual encounter with Rosalie’s diseased, decaying body lead to an understanding of her physical state and the true lust relationship between her and Ken. In the end, Selzer portrays Rosalie’s fortitude as "transcendent over the vicissitudes of the flesh," as she, wasting away as she decays from the inside, tries to appear physically appealing to her lover. Rosalie is a deceived woman who does not understand that it is the beauty of the inner spirit, rather than physical appearance, that makes one loveable.
How to Write a Metaphor
Richard Selzer often teaches writing workshops. In this 1998 interview, I asked him how he teaches students to create images or to write a metaphor.
Selzer: I’ll show you. We’ll pick two words out of the dictionary [simulates book in hands and the action of opening a book]. We’ll open it at random. We’ll say one word is butterfly. Close the dictionary, now, and pick it up again. Pick out another word. The word is smoke. So now you have two words that seem to have no relationship to each other at all when you first think of them. However, think on, and you will find that they do something; each one of them does something that the other one does.
Stripling: It’s motionthe flight of the butterfly and the flight of a cloud of smoke are quite similar.
Selzer: So, they do a couple things exactly in common: they rise, float, or come down. So now you have a basis for a comparison, and you can write a metaphor. If you said, "The white butterflies smoked through the trees," that creates an image that combines both smoking, as a verb now, and the butterflies. So it gives you an image that together is more powerful than either the word butterfly or the word smoke. Combining the two, it enhances the image. Does that make sense?
- A storm of insults fell as hailstones, cold and painful.
- Joy flooded the caverns of her heart, springing forth torrents of hope.
- Loneliness echoed the desert of her soul, as a love-parched drum beating in her empty chest. (all by Kim Higgins, Medical Humanities student, 2000)
On Writer’s Block*: Richard Selzer writes every day but admits that there are days when he rips a page from his diary, tears it up, and throws it away. That is not good, he agrees. However, Darn it, he adds, that might happen for two days, but I don't get worried about it because the third day is there. Undoubtedly, Selzer is expressing the views of an experienced writer who does not get frustrated when things do not flow immediately. In this 1993 Selzer-Stripling interview Selzer shares with us his way of combating writer’s block.
Stripling: There is such a thing as writer's block?
Selzer: I think there is. What I do is turn off the lights, light a candle, and put it on the desk. All at once the universe shrinks down to just me, the sheet of paper and pen, and that flickering, haunting, mysterious light--and that focuses my imagination. And so, that helps me.
Stripling: You are sitting at your desk, and you can see the paper, your pen, the light. That's all?
Selzer: Uh-huh. And I am transformed. Lighting a candle and turning off the light is an act of transformation for me. I am no longer who I was in electric light. I am set free to a different . . . and that's maybe a game, I don't know. Maybe I'm fooling myself.
Stripling: But, if you believe in it, and it works.
Selzer: It works, you see. Maybe not every time; but, I don’t have that much writer’s block.
Stripling: And then it comes to you. It's discipline.
Selzer: Yes, the discipline of surgery. I transferred it. I was really lucky because surgery is such a discipline. You have to keep going at it. You can't just walk away and let things take care of themselves until tomorrow. No! You can't do that, no matter what's bothering you. I was able-- when I became a writer--to transfer that discipline over into the writing so that I know it doesn't matter how I feel or what I think, I have to write.
Stripling: When you hold your pen and the ink flows--maybe just like blood used to flow from the scalpel--does it feel at all the same? Do you ever imagine that you are . . . ?
Selzer: No, I don't consciously. The metaphor is there, but I don't think that I am shedding blood on the page. I can't remember who said it, "Writing is easy. All you have to do is cut an artery and let the blood flow out of the pen."
*Excerpted from The Tending Act, The Journal of Medical Humanities 17.3 (Fall 1996): 147-164.
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