Narrative Medicine Close Reading Session: Night by Alice Munro
In the words of Dr. Rita Charon Narrative Medicine is "medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness." She calls this a "new frame" for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess "narrative competence" are able to bridge the "divides" of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions… Show more of shame, blame, and fear.
In Narrative Medicine close reading sessions health practitioners, attorneys, yoga instructors, teachers, social workers, and writers gather around a table and "close read" a text. Applying the five steps of close reading (plot, frame, form, time, desire), the group gently, patiently, supportively, and daringly "open" the text while observing our tendencies to impose, assert, and otherwise obstruct meaning. The result is a deeper abilty to listen and an increased experience of empathy and understanding.
The session is led by Dr. Claire Hicks, M.D. and Professor Laura Hope-Gill, NC Arts Fellow in Creative Nonfiction.
This is a judgment-free zone. Contact firstname.lastname@example.org with questions and to learn more about Narrative Medicine at Lenoir-Rhyne Asheville and Hickory.
The text is below and will soon be available at asheville.lr.edu
Night by Alice Munro
W hen I was young, there seemed to be never a childbirth, or a burst appendix, or any other drastic physical event that did not occur simultaneously with a snowstorm. The roads would be closed, there was no question of digging out a car anyway, and some horses had to be hitched up to make their way into town to the hospital. It was just lucky that there were horses still around – in the normal course of events they would have been given up, but the war and gas rationing had changed all that, at least for the time being.
When the pain in my side struck, therefore, it had to do so at about eleven o’clock at night, and a blizzard had to be blowing, and since we were not stabling any horses at the moment, the neighbours’ team had to be brought into action to take me to the hospital. A trip of no more than a mile and a half but an adventure all the same. The doctor was waiting, and to nobody’s surprise he prepared to take out my appendix.
Did more appendixes have to be taken out then? I know it still happens, and it is necessary – I even know of somebody who died because it did not happen soon enough – but as I remember it was a kind of rite that quite a few people my age had to undergo, not in large numbers by any means but not all that unexpectedly, and perhaps not all that unhappily because it meant a holiday from school and it gave you some kind of status – set you apart, briefly, as one touched by the wing of mortality, all at a time in your life when that could be gratifying.
So I lay, minus my appendix, for some days, looking out a hospital window at the snow sifting in a sombre way through some evergreens. I don’t suppose it ever crossed my head to wonder how my father was going to pay for this distinction. (I think he sold a woodlot that he had kept when he disposed of his father’s farm, hoping to use it for trapping or sugaring or perhaps out of unmentionable nostalgia.)
Then I went back to school, and enjoyed being excused from physical training for longer than necessary, and one Saturday morning when my mother and I were alone in the kitchen she told me that my appendix had been taken out in the hospital, just as I thought, but it was not the only thing removed. The doctor had seen fit to take it out while he was at it, but the main thing that concerned him was a growth. A growth, my mother said, the size of a turkey’s egg.
But don’t worry, she said, it was all over now.
The thought of cancer never entered my head and she never mentioned it. I don’t think there could be such a revelation today without some kind of question, some probing about whether it was or it wasn’t. Cancerous or benign – we would want to know at once. The only way I can explain our failure to speak of it was that there must have been a cloud around that word like the cloud around the mention of sex. Worse, even. Sex was disgusting but there must be some gratification there – indeed we knew there was, though our mothers were not aware of it – while even the word cancer made you think of some dark, rotting, ill-smelling creature that you would not look at even when you kicked it out of the way.
So I did not ask and wasn’t told and can only suppose it was benign or was most skilfully got rid of, for here I am today. And so little do I think of it that all through my life when called upon to list my surgeries, I automatically say or write only ‘Appendix’.
This conversation with my mother would probably have taken place in the Easter holidays, when all the snowstorms, the snow-mountains, had vanished and the creeks were in flood, laying hold of anything they could get at, and the brazen summer just looming ahead. Our climate had no dallying, no mercies.
In the heat of early June I got out of school, having made good enough marks to free me from the final examinations. I looked well, I did chores around the house, I read books as usual, nobody knew there was a thing the matter with me.
Now I have to describe the sleeping arrangements in the bedroom occupied by my sister and me. It was a small room that could not accommodate two single beds, side by side, so the solution was a bunk bed, with a ladder in place to help whoever slept in the top bunk climb into bed. That was me. When I had been younger and prone to teasing, I would lift up the corner of my thin mattress and threaten to spit on my little sister lying helpless in the bunk below. Of course my sister – her name was Catherine – was not really helpless. She could hide under her covers, but my game was to watch until suffocation or curiosity drove her out, and at that moment to spit or successfully pretend to spit on her bared face, enraging her.
I was too old for such fooling, certainly too old now. My sister was nine when I was fourteen. The relationship between us was always unsettled. When I wasn’t tormenting her, teasing her in some asinine way, I would take on the role of sophisticated counsellor or hair-raising storyteller. I would dress her up in some of the old clothes that had been put away in my mother’s hope chest, being too fine to be cut up for quilts and too worn and precious for anybody to wear. I would put my mother’s old caked rouge and powder on her face and tell her how pretty she looked. She was pretty, without a doubt, though the face I put on her gave her the look of a freakish foreign doll.
I don’t mean to say that I was entirely in control of her, or even that our lives were constantly intertwined. She had her own friends, her own games. These tended towards domesticity rather than glamour. Dolls were taken for walks in their baby carriages, or sometimes kittens were dressed up and walked in the dolls’ stead, always frantic to get out. Also there were play sessions where somebody got to be the teacher and could slap the others over the wrists and make them pretend to cry, for various infractions and stupidities.
In the month of June, as I have said, I was free of school and left on my own, as I don’t remember being in quite the same way at any other time of my growing up. I did some chores in the house, but my mother must have been well enough, as yet, to handle most of that work. Or perhaps we had just enough money at the time to hire what she – my mother – would call a maid, though everybody else said hired-girl. I don’t remember, at any rate, having to tackle any of those jobs that piled up for me in later summers, when I fought quite willingly to maintain the decency of our house. It seems that the mysterious turkey egg must have given me some invalid status, so that I could spend part of the time wandering about like a visitor.
Though not trailing any special clouds. Nobody in our family would have got away with that. It was all inward – this uselessness and strangeness I felt. And not continual uselessness either. I remember squatting down to thin the baby carrots, as you had to do every spring. So the root would grow to a decent size to be eaten.
It must have been just that every moment of the day was not filled up with jobs, as it was in summers before and after.
So maybe that was the reason that I had begun to have trouble getting to sleep. At first, I think, that meant lying awake maybe till around midnight and wondering at how wide awake I was, with the rest of the household asleep. I would have read, and got tired in the usual way, and turned out my light and waited. Nobody would have called out to me earlier, telling me to put out my light and get to sleep. For the first time ever (and this too must have marked a special status) I was left to make up my own mind about such a thing.
It took a while for the house to change, from the light of day and then of the household lights turned on late in the evening, from the general clatter of things to be done, hung up, finished with, to a stranger place in which people and the work that dictated their lives fell away, their uses for everything around them fell away, all the furniture retreated into itself without wanting or needing any attention from you.
You might think this was liberation. At first, perhaps it was. The freedom. The strangeness. But as my failure to fall asleep prolonged itself and as it finally took hold altogether until it changed into the dawn, I became more and more disturbed. I started saying rhymes, then real poetry, first to make myself go under but then hardly of my own volition. But the activity seemed to mock me. I was mocking myself, as the words turned into absurdity, into the silliest random speech.
I was not myself.
I had been hearing that said of people now and then, all my life, without thinking what it could mean.
So who do you think you are, then?
I’d been hearing that too, without attaching to it any real menace, just taking it as a sort of routine jeering.
By this time it wasn’t sleep I was after. I knew mere sleep wasn’t likely. Maybe not even desirable. Something was taking hold of me and it was my business, my hope, to fight it off. I had the sense to do that, but only barely, as it seemed. It was trying to tell me to do things, not exactly for any reason but just to see if such acts were possible. It was informing me that motives were not necessary.
It was only necessary to give in. How strange. Not out of revenge, or even cruelty, but just because you had thought of something.
And I did think of it. The more I chased the thought away, the more it came back. No vengeance, no hatred – as I’ve said, no reason, except that something like an utterly cold deep thought that was hardly an urging, more of a contemplation, could take possession of me. I must not even think of it but I did think of it.
The thought was there and hanging on to my mind. The thought that I could strangle my little sister, who was asleep in the bunk below me and whom I loved more than anybody in the world.
I might do it not for any jealousy, viciousness or anger, but because of madness, which could be lying right beside me there in the night. Not a savage madness either, but something that could be almost teasing. A lazy, teasing, half-sluggish suggestion that seemed to have been waiting a long time.
It might be saying why not? Why not try the worst?
The worst. Here in the most familiar place, the room where we had lain for all of our lives and thought ourselves most safe. I might do it for no reason I or anybody could understand, except that I could not help it.
The thing to do was to get up, to get myself out of that room and out of the house. I went down the rungs of the ladder and never cast a single look at my sister where she slept. Then quietly down the stairs, nobody stirring, into the kitchen where everything was so familiar to me that I could make my way without a light. The kitchen door was not really locked – I am not even sure that we possessed a key. A chair was pushed under the doorknob, so that anybody trying to get in would make a great clatter. A slow careful removal of the chair could be managed without making any noise at all.
After the first night I was able to make my moves without a break, so as to be outside within a couple of smooth seconds.
There. At first everything was black, because I would have lain wakeful for a long time, and the moon had already gone down. I kept on staying in bed as long as I thought I could for several nights, as if it was a defeat to have to give up trying to sleep, but after some time I got out of bed as a regular habit, as soon as the house seemed to be dreaming. And the moon of course had its own habits, so sometimes I stepped into a pool of silver.
Of course there were no street lights – we were too far from town.
Everything was larger. The trees around the house were always called by their names – the beech tree, the elm tree, the oak tree, the maples always spoken of in the plural and not differentiated, because they clung together. The white lilac tree and the purple lilac tree never referred to as bushes because they had grown too big. The front and back and side lawns were easy to negotiate because mowed by myself with the idea of giving us some town-like respectability. My mother had once had that idea too. She had planted a semicircular lawn past the lilac trees, and edged to with spirea bushes and delphinium plants. That was all gone now.
The east side of our house and the west side looked on two different worlds, or so it seemed to me. The east side was the town side, even though you could not see any town. Not more than two miles away there were houses in rows, with street lights and running water, and though, as I have said, you could not see any of that, I am really not sure that you couldn’t get a faint glow if you stared long enough. To the west, the long curve of the river and the fields and the trees and the sunsets had nothing to interrupt them ever.
Back and forth I walked, first close to the house and then venturing here and there as I got to rely on my eyesight and could count on not bumping into the pump handle or the platform that supported the clothes line. The birds began to stir, and then to sing – as if each of them had thought of it separately, up there in the trees. They woke far earlier than I would have thought possible. But soon, soon after those earliest starting songs, there got to be a little whitening to the sky. And suddenly I was overwhelmed with sleepiness. I went back into the house, where there was suddenly darkness everywhere, and I very properly, carefully, silently, set the tilted chair under its knob, and went upstairs without a sound, managing doors and steps with the caution necessary although I seemed already half asleep. I fell into my pillow. And I woke late – late in our house being around nine o’clock.
I would remember everything then but it was so absurd – the bad part of it indeed was so absurd – that I could hardly bother about it. My brother and sister had gone off to school – being still in public school, they were not getting time off for good exam performances, as I was. When they got home in the afternoon my sister was somebody who could never have passed through such a danger. It was absurd. We swung together in the hammock, one of us at either end.
It was in that hammock that I spent much of the days, and that may have been the simple reason for my not getting to sleep at night. And since I did not speak of my night difficulties, nobody came up with the simple information that I’d be better to get more action during the daytime.
My troubles returned with the night, of course. The demons grabbed hold of me again. And in fact it got worse. I knew enough to get up and out of my bunk without any pretending that things would get better and I would go to sleep if I just tried hard enough. I made my way as carefully out of the house as I had done before. I became able to find my way around more easily; even the inside of those rooms became more visible to me and yet more strange. I could make out the tongue-in-groove kitchen ceiling put in when the house was built maybe a hundred years ago, and the northern window frame partly chewed away by a dog that had been shut in the house one night long before I was born. I remembered what I had completely forgotten – that I used to have a sandbox there, placed where my mother could watch me out the north window. A great bunch of golden glow was flowering in its place now, you could hardly see out of that window at all.
The east wall of the kitchen had no windows in it but it had a door opening on a stoop where we stood to hang out the heavy wet washing, and haul it in when it was dry and smelling fresh and triumphant, from white sheets to dark heavy overalls.
At that stoop I sometimes halted in my night walks. I never sat down but it eased me to look towards town, maybe just to inhale the sanity of it. All the people getting up before long, having their shops to go to, their doors to unlock and window arrangements to see to, their busyness.
One night – I can’t say whether it was the twentieth or the twelfth or only the eighth or the ninth that I had got up and walked – I got a sense, too late for me to change my pace, that there was somebody around the corner. There was somebody waiting there and I could do nothing but walk right on. I would be caught if I turned back.
Who was it? Nobody but my father. He too was looking towards town and that improbably faint light. He was dressed in his day clothes – dark work pants, the next thing to overalls but not quite, and dark shirt and boots. He was smoking a cigarette. A roll-your-own, of course. Maybe the cigarette smoke had alerted me to another presence, though it’s possible that in those days the smell of tobacco smoke was everywhere, inside and out.
He said good morning, in what might have seemed a natural way except that there was nothing natural about it. We weren’t accustomed to giving such greetings in our family. There was nothing hostile about this – it was just thought unnecessary, I suppose, to give a greeting to somebody you would be seeing off and on all day long.
I said good morning back. And it must have really been getting towards morning or my father would not have been dressed for a day’s work in that way. The sky may have been whitening but hidden still between the heavy trees. The birds singing, too. I had taken to staying away from my bunk till later and later, even though I didn’t get comfort from doing that as I had at first. The possibilities that had once inhabited only the bedroom, the bunk beds, were taking up the corners everywhere.
Now that I come to think of it, why wasn’t my father in his overalls? He was dressed as if he had to go into town for something, first thing in the morning.
I could not continue walking, the whole rhythm of it had been broken.
‘Having trouble sleeping?’ he said.
My impulse was to say no, but then I thought of the difficulties of explaining that I was just walking around, so I said yes.
He said that was often the case on summer nights.
‘You go to bed tired out and then just as you think you’re falling asleep you’re wide awake. Isn’t that the way?’
I said yes.
I knew now that he had not heard me getting up and walking around on just this one night. The person whose livestock was on the premises, whose earnings such as they were lay all close by, who kept a handgun in his desk drawer, was certainly going to stir at the slightest creeping on the stairs and the easiest turning of a knob.
I am not sure what conversation he meant to follow then, as regards my being awake. He had declared such wakefulness to be a nuisance. Was that to be all? I certainly did not intend to tell him more. If he had given the slightest intimation that he knew there was more, if he’d even hinted that he had come here intending to hear it, I don’t think he’d have got anything out of me at all. I had to break the silence out of my own will, saying that I could not sleep. I had to get out of bed and walk.
Why was that?
I had dreams.
I don’t know if he asked me, were those bad dreams?
We could take that for granted, I think.
He let me wait to go on, he didn’t ask anything. I meant to back off but I kept talking. The truth was told with only the slightest modification.
When I spoke of my little sister I said that I was afraid I would hurt her. I believed that he would know what I meant. Kill. Not hurt. Kill, and for no reason. None at all. A possession.
There was no satisfaction, really, once I had got that out. I had to say it then. Kill her.
Now I could not unsay it, I could not go back to the person I had been before.
My father had heard it. He had heard that I thought myself capable – for no reason, capable – of strangling my little sister in her sleep. He said, ‘Well.’
Then he said not to worry. He said, ‘People have those kinds of thoughts sometimes.’
He said this quite seriously but without any sort of alarm or jumpy surprise. People have these kinds of thoughts or fears if you like, but there’s no real worry about it, no more than a dream. Probably to do with the ether.
e did not say, specifically, that I was in no danger of doing any such thing. He seemed more to be taking it for granted that such a thing could not happen. An effect of the ether, he said. No more sense than a dream. It could not happen, in the way that a meteor could not hit our house (of course it could, but the likelihood of it doing so put it in the category of couldn’t).
He did not blame me, though, for thinking of it.
There were other things he could have said. He could have questioned me further about my attitude to my little sister or my dissatisfactions with my life in general. If this were happening today, he might have made an appointment for me to see a psychiatrist. (I think that is what I might have done, a generation and an income further on.)
The fact is that what he did worked as well. It set me down, but without either mockery or alarm, in the world we were living in.
If you live long enough as a parent you discover that you have made mistakes you didn’t bother to know about as well as the ones you do know about, all too well. You are somewhat humbled at heart, sometimes disgusted with yourself. I don’t think my father felt anything like this. I do know that if I had ever taxed him, he might have said something about liking or lumping it. The encounters I had as a child with his belt or the razor strop. (Why do I say encounters? It’s to show I’m not a howling sissy any more, I can make light.) Those strappings, then, would have stayed in his mind, if they stayed at all, as no more than quite adequate curbing of a mouthy child’s imagining that she could rule the roost.
‘You thought you were too smart,’ was what he might have given as his reason, and indeed one heard that often in those times. Not always referring to myself. But a number of times, it did.
However, on that breaking morning he gave me just what I needed to hear and what I was to forget about, soon enough.
I have thought that he was maybe in his better work clothes because he had a morning appointment to go to the bank, and to learn there, not to his surprise, that there was no extension to his loan, he had worked as hard as he could but the market was not going to turn around and he had to find a new way of supporting us and paying off what we owed at the same time. Or he may have found out that there was a name for my mother’s shakiness and that it was not going to stop. Or that he was in love with an impossible woman.
Never mind. From then on I could sleep. ■
Granta 120: Medicine
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