Anne Whitehead, Medicine and Empathy in Contemporary British Fiction: An Intervention in Medical Humanities

Anne Whitehead, Medicine and Empathy in Contemporary British Fiction: An Intervention in Medical Humanities (Edinburgh: Edinburgh University Press, 2017) 224 pp. £22.99 Pb. ISBN: 9781474452410

As its title suggests, Anne Whitehead’s Medicine and Empathy in Contemporary British Fiction: An Intervention in Medical Humanities offers a new way into thinking about empathy through a medical humanities framework. Structured across five distinct chapters, each concerned with empathy alongside a different, secondary thematic focus, Whitehead looks to the role of empathy in five works of contemporary fiction, resulting in an acutely interdisciplinary analysis which employs close textual reading alongside innovative theoretical exploration. Maintaining attention throughout on the expansive, and evolving, nature of the medical humanities, Whitehead successfully argues for the centrality of literature ‘in and for’ the discipline (p. 19), and for a consideration of empathy as biomedically, as well as humanistically, significant.

The text’s introduction teases out some of the key critical strands underlying Whitehead’s subsequent analysis. Referring to her earlier work with Angela Woods in their seminal edited collection, The Edinburgh Companion to the Critical Medical Humanities (2006), Whitehead looks to the three ‘Es’ that have shaped medical humanities research since its inception – ethics, education, and experience; alongside Woods, Whitehead here identified the fourth E, ‘empathy’. Moving beyond this foundational work, Whitehead argues, Medicine and Empathy in Contemporary British Fiction remains ‘firmly committed to the belief that empathy remains relevant to the medical humanities’ (p. 7), but now recognises that the instinctive positivity with which empathy was regarded in first-wave medical humanities has prevented a more critical approach to the topic. Rather than asking how empathy can be cultivated in biomedicine, Whitehead recommends a refocused analysis which presents more complex, and pressing, questions – what is empathy, and what does it do?

In Chapter 1 ‘Empathy and Mind’, Whitehead reads Mark Haddon’s The Curious Incident of the Dog in the Night-Time (2003) to ‘[locate] empathy in the medical context of diagnosis’ (p. 28), focusing on the novel’s depiction of autism as a diagnostic classification within which the experience, or absence, of empathy is deemed to be central. Through close critical attention to the theorisation of autism within the cognitive neurosciences, Whitehead highlights the dual scientific and cultural influences which are involved in the construction of diagnostic categories. The chapter also draws on Ian Hacking’s work on autism within the philosophy of science, as well as Patricia Waugh’s definition of the ‘neo-phenomenological novel’; the latter in particular, Whitehead argues, offers an approach to literary criticism which focuses less on the novel as a ‘narrative vehicle for accessing the autistic mind’, and more on the ways in which characters are ‘oriented towards the imagined world of the novel’ (p. 44). In the case of The Curious Incident, such a reading illuminates the novel’s articulation of a more radical form of empathy, not looking to emphasise ‘shared humanity’ with autistic characters, but instead recognise and celebrate human difference.

Chapters 2, 3, and 4 highlight Whitehead’s central contention that an analysis of the role of empathy within these texts would be limited in scope by a focus on individualised care relations, turning instead to the ways in which clinical encounters can be reevaluated within structures of ‘biomedical power’ (p. 6). In Chapter 2 ‘Empathy and Ethics’, Whitehead introduces the enhanced profile of human rights discourses in the early years of the millennium, and notes that this field of study is closely aligned with first-wave medical humanities. Focusing primarily on Pat Barker’s Life Class (2007), the chapter’s textual analysis turns to the institutional context of this historical novel to propose a reading of empathy which is ‘cognisant in its own implications in structures of power and privilege’ (p. 20). In terms of an accompanying theoretical framework, the chapter looks to a feminist politics of affect informed by Sara Ahmed and to Susan Sontag’s Regarding the Pain of Others (2003). Read within these contexts, Whitehead explores the ways in which Barker’s novel speaks to issues of positionality, and the role of empathy within the ‘authority, the anonymity, and the indifference’ (p. 86) of the institution.

Where Chapters 1 and 2 examine, respectively, the neuroscientific and ethical contexts behind a contemporary interest in empathy, Whitehead acknowledges at the beginning of the third chapter that different concepts of empathy often emerge between the sciences and humanities. Chapter 3 ‘Empathy and Interdisciplinarity’ therefore seems an appropriate place to interrogate what interdisciplinarity means within the medical humanities, and how empathy can be reconfigured in the ‘conceptual space’ between medicine and the arts (p. 91). The chapter takes as its textual locus Ian McEwan’s Saturday (2005), focusing on the ways in which the novel’s depiction of empathy speaks to issues of interdisciplinarity within the context of ‘two culture’ and ‘third culture’ debates surrounding the conceptual interactions between literature and science. Whitehead’s problematisation of McEwan’s third culture stance here allows the chapter to make a broader point about the role of literature within the medical humanities, which, as the book’s introduction outlined, has often been relegated to the position of ‘supportive friend’ to the biological sciences (p. 19). The chapter is also interested in a political dimension to McEwan’s portrayal of empathy, particularly on the novel’s focus on the family unit which, Whitehead argues, ‘[allies] empathy with political stasis and exclusion, and also [bridges] the gap between individual and social in a mode that effectively bypasses political action’ (p. 107). Whitehead makes the fascinating point that empathy can operate as a form of depoliticization, with an emphasis on the affective register of individual confrontations subsuming ‘broader structural questions’ (p. 118).

Across the book, the political significance of empathy is a continuing undercurrent, but from this point in Chapter 3, politics is at the centre of Whitehead’s analysis, and the final two chapters make this shift in focus most apparent. Ahmed reappears in Chapter 4 ‘Empathy and the Geopolitical’, which uses her work on the circulation of affect, as well as current debates on medical migration, to read Aminatta Forna’s The Memory of Love (2010) and consider its depiction of geographic disparities in standards and practices of healthcare. Whitehead highlights the ways in which the novel, set in Sierra Leone over four decades, ‘[foregrounds] the importance of a steady erosion of material, social and economic resource’ (p. 138) which have created the country’s medical ‘crisis’. The circulation of medical knowledge, goods, and personnel is compared effectively in this chapter with the circulation of empathy, and Whitehead here draws again on critical human-rights scholarship, particularly the work of Joseph R. Slaughter.

As Chapter 4 introduces empathy as a circulating component of geopolitical influence, Chapter 5 ‘Empathy and Capitalism’ builds on this analysis of empathy within ‘trajectories of capital’ (p. 157), focusing particularly on biotechnology capital – ‘bodily fragments, tissues and organs that can be extracted from an individual body and are available for transfer to another’ (p. 157). Whitehead here analyses Kazuo Ishiguro’s Never Let Me Go (2005), building on the critical discussions introduced in previous chapters around interrelationality, feminist theories of affect, and the production and circulation of emotions. Sianne Ngai’s discussion around ‘ugly feelings’ is also utilised here to great effect to ‘open up the questions of what emotions are produced and circulated when affect is co-opted by and for the capitalist marketplace’ (p. 22). Beginning with a phenomenological evaluation of organ transfer, the chapter reads Ishiguro’s dystopian novel with close attention to its depiction of biocapitalism and dehumanisation resulting from the ‘commercialisation of feeling’ (p. 7). This chapter is one of the more theoretically complex in Medicine and Empathy, but never reads as too critically dense, and Whitehead successfully here balances a range of secondary perspectives within her own focused reading of empathy.

Overall, Medicine and Empathy in Contemporary British Fiction offers a striking and innovative approach to empathy within a dually literary and medical context. The book is well-structured to reveal the thematic and critical connections between each chapter, building an exhaustive picture of the role that empathy plays in individual, structural, and cultural relations of power. Whitehead notes in the book’s conclusion that the textual case studies at the heart of this analysis were selected for their diversity, showcasing the range of genres, narrative structures, and temporal and geographical settings which can engage with the ‘medical’ in differing ways. Bringing these diverse texts into conversation through their attention to empathy, Whitehead successfully argues for the relevance of literature more broadly as part of a critical medical humanities, particularly within the study of affect. This book is a welcome intervention in these fields, and will also be of interest to researchers of contemporary fiction, medical ethics, and biopolitics.

Rosalind Crocker, University of Sheffield