Monday, March 9, 2009
Literature Meets the DSM-IV
We saw half of Lowell House Opera Society's production of Otello last night, in which our daughter sang in the children's chorus, then brought her home at intermission.
That's ok. I prefer Puccini to Verdi anyway, and I had no desire to watch Otello strangle Desdemona. I always find intensely frustrating the problems that arise in books, movies, operas, and plays that could be so easily avoided by simple communication among the characters. Why didn't Emilia go to Desdemona right away after Iago forced her to hand over the handkerchief? Why didn't Otello just confront Desdemona directly about Cassio, instead of getting himself all worked up over hearsay? But I suppose a lot of relationship problems stem from completely unnecessary misunderstandings.
Sometimes I enjoy applying diagnostic criteria I learned in medical school to literary figures. Shakespeare's work is replete with DSM-IV disorders. Poor Desdemona was the innocent victim of Iago's Antisocial Personality Disorder working on Othello's Paranoid Personality Disorder. Hamlet was a veritable poster-boy for major depression.
I found my psychiatry rotation during medical school fascinating. It did shake my faith, though: things that we, in common parlance, often call "character flaws" or even "moral failings" are attributed in medicine to brain chemistry and the interplay of environmental influences, gene expression, and neurologic development - a highly deterministic view that many argue is largely supported by research and observation. If no one can really help their behavior (although some people feel they can), is anyone ultimately responsible, or despicable, or laudable, for it? Perhaps the human brain only seems to have free will...("Seems, Madam! Nay, it is; I know not 'seems.' ...I have that within which passeth show...")
I've just reread a book I consider one of the greatest achievements in contemporary fiction: Mark Haddon's The Curious Incident of the Dog in the Night-time, which is narrated by a gifted but highly challenged teenager with Asperger syndrome. Like George Saunders entering into his character Morse's intractable anxiety in the short story "The Falls" and Robert Morgan living through a patient's dementia in "Night Thoughts," Haddon is able to inhabit the mind of his protagonist, Christopher, and give the reader an intimate, vivid look into his perceptions of the world. It's a truly brilliant piece of work.
What makes these stories, and any story, so good is the way they bring about fresh recognition of some part of ourselves as readers, even if the characters are nothing like us. "I'm totally like that sometimes!" we think, or, "I SO get how that could happen." We diagnose our our own humanity, like med students leafing through the DSM-IV, exclaiming, "That's me...and so is that!" and in the process, come to some better understanding of mysteries our inadequate words can barely express.
So we should keep reading stories, and watching them, and listening to them, and writing them. We should do it for our patients, our families, ourselves. Maybe someday, then, we'll actually be able to say, "Oh yes! Now I understand." At least for a moment, until the next mystery unfolds.