Curative Illnesses: Medico-National Allegory in Québécois Fiction 9780773598850

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C u r at iv e Il lnesses

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Curative Illnesses Medico-National Allegory in Québécois Fiction

J ulie R obe rt

McGill-Queen’s University Press Montreal & Kingston · London · Chicago

© McGill-Queen’s University Press 2016 ISBN 978-0-7735-4705-6 (cloth) ISBN 978-0-7735-9885-0 (ePDF) ISBN 978-0-7735-9886-7 (ePUB) Legal deposit first quarter 2016 Bibliothèque nationale du Québec Printed in Canada on acid-free paper that is 100% ancient forest free (100% post-consumer recycled), processed chlorine free McGill-Queen’s University Press acknowledges the support of the Canada Council for the Arts for our publishing program. We also acknowledge the financial support of the Government of Canada through the Canada Book Fund for our publishing activities.

Library and Archives Canada Cataloguing in Publication Robert, Julie, 1980-, author   Curative illnesses : medico-national allegory in Québécois fiction / Julie Robert. Includes bibliographical references and index. Issued in print and electronic formats. ISBN 978-0-7735-4705-6 (bound). – ISBN 978-0-7735-9885-0 (ePDF). – ISBN 978-0-7735-9886-7 (ePUB)   1. Canadian fiction (French) – Québec (Province) – History and criticism. 2. Diseases and literature – Québec (Province). 3. National characteristics, French-Canadian, in literature. 4. Diseases in literature. 5. Nationalism in literature. I. Title. PS8199.5.Q8R62 2016   C843’.54093561   C2015-906625-5 C2015-906626-3

Contents

Acknowledgments / vii Introduction: Sick Readings/Reading Sickness  /  3 1  The Nation as Body  /  20 2  Diagnostic Allegories / 48 3  Sick Doctors / 89 4  Strong Medicine / 123 5  The Normal Pathographical  /  162 Conclusion / 194 Notes / 199 References / 219 Index / 231

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Acknowledgments

Curative Illnesses first took shape as an undergraduate term paper in a Québécois literature class. Well over a decade, two continents, and three universities later, my musings on how nations conceive of themselves and how discourses of illness, health, and pathology intervene in and shape ideas about nationhood have taken on a different form thanks to the instruction and assistance I received from countless people. Teachers and mentors over the years, including Jarrod Hayes, Frieda Ekotto, Martin Pernick, Katherine Ibbett, David Caron, Victor Laurent-Tremblay, and Catherine Black provided the guidance I needed to turn a short essay into a book and naive ideas into ones that are (hopefully) less so. Jennifer Metsker reminded me that the most helpful words when trying to pinpoint gaps in my own logic will always be “I don’t understand.” Colleagues at the University of Technology, Sydney’s Transforming Cultures Research Centre, and in the Cultural Studies Group read drafts, gave encouraging feedback, and offered friendship and moral support in the final phases of the project. Finding such a collaborative and supportive academic home is what young scholars can only hope for. Special thanks go to Sara Wellman, who convinced me that having the right research assistant truly does make all the difference, and who read drafts even before she took on this formal role. Having received so much help along the way, any errors or oversights that remain in the text can only be my own. I also owe my thanks to the various organizations and agencies that funded this research: the Social Sciences and Humanities Research Council of Canada, the Horace H. Rackham School of

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Graduate Studies at the University of Michigan, the University of Technology, Sydney, and its Faculty of Arts and Social Sciences. To my family, friends, and colleagues turned friends, if I have not thanked you enough along the way, effusive acknowledgment here will surely not suffice. Please do, however, remember that this would not have been possible without your support.

C u r at iv e Il lnesses

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Introduction sick readings / reading sickness Starting around 1940, novels in Quebec got sick. The number of narratives about illness exploded during a time of uncertainty over collective identity and unprecedented social transformation. The trend continued as Quebec contended with political shifts that placed questions of nationalism and national authority at the forefront of public consciousness for decades. This book sets out to explain this rhetorical epidemic of illness narratives in literary texts and to gauge its effect on Quebec’s national self-conception. As a nation, Quebec defies conventional categories and classifications. As a French settler colony founded in the seventeenth century, it has been a colonizer of Indigenous lands. As territory ceded to the English during an unsuccessful colonial war, the French inhabitants, in turn, became colonized. It is a province within a larger confederation modelled on British parliamentary traditions. It also acts more independently than other provinces within this system, particularly on the international stage, where it sets its own immigration policy and has diplomatic missions akin to embassies and consulates in other countries. Its francophone majority demands and receives recognition and rights on the grounds of being a linguistic and cultural minority within Canada. This same majority refuses similar concessions on similar grounds for its own anglophone and allophone minorities.1 Suffice it to say that Quebec is a paradoxical nation, one that is decidedly abnormal, particularly in comparison to its developed Western peers. Abnormality, as philosophers of illness like Georges Canguilhem ([1966] 1991) and Havi Carel (2008) note, however, does not necessarily constitute pathology. How and why, therefore, has Quebec adopted the pathological as a defining trait of its self-representations?

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Introduction

The sudden appearance of alarming literary symptoms divides critics as to the appropriate diagnosis. Most view the subject of physiological disease in Québécois literature as not requiring explicit commentary. The growing number of sick characters in early texts is dismissed as an expected result of the realist trend that took hold starting in the late 1930s and early 1940s and that revolutionized Quebec’s literature when urban life found its way onto the page. As such, the novels are thought merely to reflect the unsanitary, disease-ridden existence that has historically accompanied the influx of poor rural populations into urban centres, as occurred in Quebec in the 1930s. Ben-Zion Shek, for example, categorizes the signs of disease, such as fingernails whose markings belie malnutrition as mere “cinematic” details that enrich the realist novel (1977, 36). Others, like François Ricard ([1996] 2000), generally ignore sick characters, which suggests that disease is an unremarkable part of the narrative. Paula Gilbert Lewis (1981) recognizes a recurrent theme of sickness in Gabrielle Roy’s work, but does not link the morbidity and mortality characteristic of her œuvre to anything collective, preferring to read it as related to personal solitude and alienation. So while the individual stories of cancer, tuberculosis, heart failure, and fevers may elicit some comment in relation to larger historical trends, sentiment, or the social-realist movement, they are but rarely perceived as textual epidemics or indications of a sickening national literature in their own right. The more contemporary focus on illness, notably in the twentyfirst-century narratives, has generated surprisingly little commentary from those working on Québécois fiction. One could assume that while the earlier emphasis on sickness was revealing something about Quebec, the persistence of the theme of disease has been attributed to larger currents on the global medical landscape (an aging and sickening population, decades-long chronic illnesses, the emergence of aids) that have found their way into fiction, both in Quebec and elsewhere. In the context of studies of a national literature it appears to be unremarkable. For those few critics who do nevertheless discern a pattern of meaning in fictional narratives about illness, the readings they offer tend to prioritize the earlier narratives and correlate a sick textual body with an enfeebled nation. Maurice Arguin interprets illness among characters as part of a nexus of larger social and individual problems, which can be collected under the heading “défaut de vie,”



Sick Readings / Reading Sickness 5

designating a collective fatal flaw (1985, 79). Jane Moss invests the sick character with metaphorical significance, and reasons that texts can be read as commentary on the nation: “This emphasis on physical, psychological, and sexual debilities suggests that these authors consciously or unconsciously see Quebec society as unhealthy” (1984b, 153). In other words, the sick character’s body becomes a figure for the sick nation. The relative silence with regard to tropes of illness in Quebec’s novels, paradoxically, has not stopped scholars of all stripes from appropriating clinical language in their analyses of other aspects of Quebec’s culture. Éric Schwimmer (1995) titled his anthropological analysis of attitudes to the second referendum on Quebec’s national sovereignty (which occurred in 1995) Le syndrome des Plaines d’Abraham [The Syndrome of the Plains of Abraham].2 Charles Gagnon (1995), Gérard Bergeron (1981), and Jean-Pierre Bonhomme (1989) concur with Schwimmer’s diagnosis, each one using the term syndrome – a collection of pathological symptoms without a known etiology that consistently occur together – to describe the sovereignty referenda of either 1980 or 1995. André Burelle (1995) labels the always contentious federal–provincial relations as Le mal canadien and regards his study (as claimed in the book’s subtitle) as an essai de diagnostic et esquisse d’une thérapie [The Canadian Illness: Diagnostic Essay and Outline of a Therapy]. Arguin’s (1985) work on mid-twentieth-century novels bears the subtitle Symptômes du colonialisme et signes de libération [Symptoms of Colonialism and Signs of Liberation], which suggests a diseased national literature that has begun to show signs of improving health. In a similar vein, historian Michael Behiels comments upon both federalist and early sovereigntist appraisals of the socio-political situation by arguing that “their diagnosis of Quebec society as being gravely stricken with the cancer of authoritarianism and political corruption did not lead to despair” (1985, 235). By mirroring the medical rhetoric in much of Quebec’s fiction, the secondary literature confirms the idea that the nation is unwell.3 As these pathology-inflected assessments of the nation are disseminated via the media, university curricula, and in other forums, they contribute to the saturation of public discourse with ideas of illness, allowing the nation’s pathologies to remain unquestioned. The link between Quebec and sick nationhood consequently becomes simultaneously more entrenched and less noticeable.

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Introduction

The strong currents of medico-national rhetoric across these facets of Quebec’s cultural discourse warrant an integrated critical approach. In response to the question of why the focus on literary texts and their use of medical discourse, scholars like Donald Cuccioletta and Martin Lubin (2003) maintain that the origins of Quebec’s mid-century movement of political and social modernization and national reinvention, the Quiet Revolution, lay in its popular culture, including its novels.4 If literary texts were so influential at that point in Quebec’s history, it behooves us to consider them in a broader context of nation-forming discourses. Furthermore, since these novels evidence(d) a preoccupation with sickness, the role of illness in formulations of the nation begs consideration. Mental illness, it bears stating, has garnered significant critical attention and is the subject of a number of studies.5 In these critical works, the disease (if diagnosed) or condition (if not) is often regarded just as much as a commentary on the difficulty of negotiating French Canadian or Québécois identity as it is on personal circumstance.6 This book though concerns itself primarily with physiological illness, although some narratives feature diseases and conditions that have cognitive and psychological symptoms. If Quebec’s literary, and by extension scholarly, discourses employ clinical terminology and medical imagery in their representation of the nation and its people, it likely owes that vocabulary to undercurrents of pathology, deficiency, and dysfunction in many of its contemporary and historical understandings of its own nationhood. For instance, sovereigntists working under the influence of decolonization and postcolonial theory have proffered that the statelessness of a nation is a pathology that must be remedied in order for full national health to be achieved.7 The idea of a nation under siege or one that must be strong enough to ward off threats from both without and within has also been a common trope among nationalists and models itself, as Emily Martin (1994) elucidates, on infectious and immunological theories of disease. Discussions about national inferiority complexes borrow from the language of psychology (Gilman 1985) but also draw on theories of bodily difference and disability (Keith 2001; Siebers 2008). When literary texts take up these concerns, characters become the embodiment of the nation and its various sicknesses. While equating the sick character with the sick nation opens the door to a number of rich metaphors, it also proves problematic on



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several fronts. First, the excessive morbidity of Quebec’s literary characters not only makes the nation sick, but suggests that it is terminal. With little hope for recovery, the characters act as allegorical figures of the nation and create a national narrative that opposes the larger trends of social reform and national renewal that took root during the lead-up to the Quiet Revolution and that subsequently flourished throughout the 1960s through to the present. Second, the tendency (at least among those who acknowledge the sick characters as significant in their own right) to read illness narratives as commentary on the nation presupposes that the nation is separate from the illness narratives. Simply, these critics take the nation to be an outside element that is to be “read into” the text. Illness narratives, bolstered by medicine’s pretensions to empiricism, are accordingly held up as metaphorized evaluations or assessments of a nation that can be viewed disinterestedly and objectively. Although such readings do reveal a great deal, they generally fail to account for the ways in which the nation is both informed and shaped by representations of itself. When it comes to stories of sickness and disease, the imposed disjunction between text as commentary upon the nation and text as generative of the nation is even more acute, because the repercussions of reading and writing of the nation as sick – namely fostering a pathological national self-image – are all too easily ignored. Third, metaphorical approaches centred on the sick character as a locus for national meaning rest on a deeply problematic equivalence between the individual body and the nation. While metaphors necessarily imply relations of both difference and sameness between their constitutive elements (without difference there would be no point to the trope, yet without some commonality, there would be no basis for comparison), the tendency has been to overemphasize the continuities and to overlook the differences. To move beyond, or at the very least problematize, the earlier readings of sick characters as ailing national bodies entails taking into account the non-correspondence between the medical and the national in these narratives about illness. To do so allows for a much-needed questioning of the assumed equivalence between the corporeal and the national. This shift in approach to what I call illness narratives broadens the possibilities for reading beyond offering national diagnoses based on narrative symptoms; a character’s venereal disease no longer needs to be taken as a sign of national corruption or decadence, just as

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Introduction

tuberculosis doesn’t need to indicate a nation slowly wasting away. To escape this mentality changes the role that oft-repeated literary diagnoses play on the national stage. By disrupting the shorthand between the medical and the national, alternative interpretations of what disease means for the nation become possible. Although it was readings of Quebec’s corpus of twentieth-century novels that sparked the realization that stories of illness and disease abound, the issues raised by the significant presence of pathology in national literature are universal. How we read stories of pathology, how they are taken up as part of the nation’s self-expression, and how we invest characters with representative capacities are questions inherent to any narrative of illness, or more generally, to any narrative that emphasizes embodiment. These concerns are all the more relevant in cultures and societies, such as “new” nations (for instance those that have emerged in the wake of decolonization), in which pathological self-representations may prove to be particularly influential  – for instance because of timing or the relative importance of a small number of texts – to the development of national identity and culture. In reading a nation’s (literary and metaphorical) diseases, we gain significant insight into how the nation sees itself.

the etiology of an epidemic: a few theories As suggested above, critics have attributed Quebec’s turn toward pathology-rich self-depictions to a few factors, namely social realism and a metaphorized inferiority complex, neither of which stands up to scrutiny. Where social realism is concerned, there is the matter of perception versus reality to consider. Conventional thinking relating to the pathological turn in many national literatures upholds the idea that realist novels depict the conditions of the situations they represent. When realist and naturalist novels in France embraced storylines relating to sickness in the nineteenth century, it was against a backdrop of continued epidemics of infectious diseases such as tuberculosis, typhoid, and venereal disease that provoked anxiety about the nation’s health. This concern moreover occurred at a time of escalating tension with rival states such that the remedy for declining population-level health statistics and military humiliation was the betterment of the nation’s collective health via eugenics.8 William Schneider notes that this “fear produced vast amounts of writing on the causes and effects of decline” (1982, 269–70). Accordingly,



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tuberculosis, syphilis, and other “social” ills, like drunkenness and immorality – all thought to have played a role in the nation’s geopolitical crises – became favourite subjects not just for medical commentators and politicians, but also for naturalist authors like Emile Zola and Guy de Maupassant, who attempted to lay bare the causes and consequences of this degeneracy. Like later nineteenth-century France, Quebec was perceived as a place full of sick people, and prior to the 1940s, this reputation was largely deserved. The province, and especially its cities, were among the unhealthiest places to live in North America, and it had one of the highest rates of infant mortality in the Western world (Anctil and Bluteau 1986, 61). They experienced the worst ravages of smallpox in the late nineteenth century (Gaumer, Desrosiers, and Keel 2002) and claimed the dubious honour of exceedingly high rates of tuberculosis (particularly among children) thanks to the consumption of contaminated milk. Early ethnic disparities in public health statistics between French Canadians and other ethnic or national populations in Quebec proved a source of concern, indeed of shame. The infant mortality rate in particular was a focal point for doctors and laypeople who deplored, as usually pro-natalist nationalist Marie Gérin-Lajoie did, a situation in which French Canadian babies “meurent dans des proportions qui nous rapprochent des barbares” [die at rates that liken us to barbarians] (cited in Baillargeon 2002, 123). Dr Raoul Masson, a pioneer of pediatrics, went so far as to metaphorize the problem of infant mortality as a national sickness. “Quoique toujours il soit pénible de reconnaître un tort ou d’accuser une infériorité, il faut avoir le courage d’avouer le mal que l’on veut guérir” (1925, 6) [While it is always painful to recognize a fault or to admit inferiority, we must have the courage to acknowledge the disease we wish to cure]. The impact of such self-criticisms proved enduring for those looking back at these earlier situations. Guérard pinpoints the 1885 smallpox epidemic as fuel for a broader negative attitude toward French Canadians: “Les difficultés rencontrées par les autorités à mettre en œuvre les mesures d’isolation et de vaccination … seront par la suite souvent évoquées pour illustrer le retard des Canadiens français sur le plan de l’hygiène, leur ignorance, l’irresponsabilité de leurs élites” (1996, 22; my ellipsis) [The difficulties in implementing measures for isolation and vaccination encountered by the authorities … would frequently be evoked later to illustrate French

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Introduction

Canadians’ tardiness with regard to public hygiene, their ignorance, and the carelessness of their elites]. Baillargeon similarly argues that doctors saw in the infant mortality rate “les préoccupations d’une société incertaine de son statut, de son avenir et de sa capacité à relever les défis de la ‘modernité’” (2002, 121) [The preoccupations of a society uncertain of its status, of its future, and of its capacity to meet the challenges of “modernity”].9 It was not just French Canadians who were aware of their dismal population health statistics. Around the time of the First World War, they were singled out by their Anglo-Canadian and American neighbours as a kind of “diseased nation,” an unsavoury label that helped to fuel support for eugenics. Montreal’s McGill University (the flagship institution, both educational and cultural, of anglophone Mont­ real) was the home of some of the most vocal campaigners for eugenic reform, who obliquely targeted French Canadians under the cover of a more general rhetoric about public health.10 In New England, the tens of thousands of French Canadians who had settled in the factory and mill towns in the early twentieth century were maligned for being not only foreign and poor, but also a threat to the health of the local population (Gallagher 1999). Despite a history of poorer public health and a slower adoption of the measures meant to rectify this situation, Quebec’s collective vital statistics had improved dramatically leading up to the midpoint in the twentieth century. Indeed, by the time Quebec experienced its spate of illness narratives, many of the epidemiological problems addressed in the continental literature rife with storylines of illness were already solved or on their way to being solved.11 Education campaigns, such as sputum management, reduced the spread of tuberculosis (Feldberg 1995; Poutanen 2006), and a cultural shift toward breastfeeding helped to combat fatal infant sicknesses related to contaminated milk (Baillargeon 2009, 1996). Improved hygienic infrastructure in the form of sanitary sewers, garbage collection, and food inspection were key to keeping water- and food-borne diseases in check, particularly in urban centres. Vaccination campaigns had virtually eradicated smallpox after the devastating 1885 outbreak, and the successful Canadian trials for the bcg (Bacillus CalmetteGuérin) vaccine to combat tuberculosis began in Montreal in 1924, further improving access to vaccination for infectious illness (Feldberg 1995). The combined effect of these measures, coupled with higher standards of living, was so significant that the impact of



Sick Readings / Reading Sickness 11

antibiotics, which were nonetheless acclaimed as panaceas in the popular press (Mann 2004), was overshadowed by the overall trend toward improving vital statistics. Health, not sickness, was therefore the dominant discourse, and by the mid-twentieth century Quebec was perhaps the healthiest it had ever been. When the realities of Quebec’s public health situation are considered in relation to the surge in illness narratives, it would seem that social realism alone could not account for the degree of morbidity. An adjunct of the social realism theory is that the very innovations turning the public health realities around and causing the uptick in vital statistics were translating into a generalized preoccupation with health and disease that (like any other prominent social issue) was taken up by novelists. The province’s daily newspapers devoted considerable space to medical and personal wellness articles. Even a cursory scan of the headlines of two prominent Montreal dailies, the Gazette and La Presse, in the 1940s reveals a keen attention to developments in the medical field, particularly in relation to children’s health.12 Penicillin and sulfa drugs, both of which became widely available in the postwar years, were not only medical triumphs, but also huge media sensations, lifesaving miracle cures, announced from the headlines.13 The successful tests for the polio vaccine carried out in the 1950s were similarly attention grabbing, although the hype surrounding vaccination was less than for antibiotics, probably because the “miracles” of prevention sell fewer papers than the “miracles” of Lazarus-like cures. With formerly dreaded diseases being prevented and lives being improved and saved, it may be that Quebec – like other Western societies – had new (and then potentially shattered) illusions that the cures for all disease should be just around the corner. To be sure, improving the nation’s health was an issue that had the full weight of policy initiatives behind it. Calls for universal health care in Canada began in earnest during the 1930s and were first realized in 1946 with Saskatchewan’s Hospitalization Act. Other provinces, including Quebec, followed suit, and by 1961, joint federal and provincial initiatives were ensuring free hospitalization for all citizens and full health coverage as of 1971. The combination of medical and policy innovations meant that health care was a prominent subject in the media and that Quebec, which lagged behind other provinces in securing universal health care, would have been exposed to the debate for longer than other regions of Canada. These

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Introduction

emotional and ever-present discourses were likely to have infiltrated the novelists’ imaginations just as other topics of considerable social import (war, cultural changes) inspire fiction. The public’s growing interest in all things medical undoubtedly honed sensibilities and focused attention on both sides of the supposed binary of sickness and health, but the illness narratives were, at best, only selectively faithful to public health realities. The tone of the texts, for instance, was still surprisingly pessimistic and the outcomes morbid. Amid such hope and clinical optimism, the illness narratives seem to be at odds with the larger trend. The overlapping but markedly unequal public health systems drawn on ethno-religious lines, and the persistent memory of earlier disparities in public health statistics might therefore explain the paradox of why Quebec’s staggeringly rapid advances in public health have consistently been ignored in explaining the emergence of illness narratives. The second theory about the etiology of the illness narratives is drawn from the work of Sander Gilman, who contends that “the idea of the pathological is a central marker of difference” (1985, 23). This is to say that (to use one of Gilman’s examples), like the German accusations that Jewish men menstruated, French Canadians were cast as having abnormal, even pathological, bodies as a way to mark their difference and specifically their perceived inferiority. The local uptake of this theory is exemplified by Maurice Arguin, who discusses the figure of “l’homme révolté” from Quebec’s psychological novels in physiognomic terms. He argues that the self-loathing psyches of the characters are apparent in their ugly visages: “Au physique, le personnage est laid ou se croit tel, repoussant même, au mieux sans attrait” (Arguin 1985, 143) [Physically, the character is ugly or believes himself to be so – hideous even; at best not attractive]. For Gilman, casting difference (specifically inferiority) in terms of pathology is a way to study the Other “as an idealized definition of the different” (1985, 27). This tenet explains why representations of the bodies of colonized or subaltern subjects so often focus on their abnormalities (from the norms established by the colonizer’s ideal) and pathological states. In Quebec, one could argue that public health, socio-economic, or political differences from the country’s Anglo-Canadian majority were rendered as tropes of pathology. Yet because these expressions of abnormality or inferiority issue from within Quebec, illness is self-pathologizing. Rather than demarcating the Other as different or inferior to position oneself as superior,



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Quebec has repeatedly chosen to represent its difference via tropes that have the potential (when abnormality is taken as analogous to pathology) to reinforce rather than contradict its subaltern status. By suggesting that the turn to disease in public discourse was an internal dynamic, I do not wish to imply that nobody besides French Canadians was engaging in the process. The long history of “race” relations in the province, stretching all the way back to the 1839 Durham Report, is rife with British accusations of the cultural and national shortcomings of French Canadians as justification for their assimilation.14 French Canadians were nevertheless responsible for a substantial share of the pathologization of their difference. As of the 1940s, those on the literary scene took it largely upon themselves to cast this difference as disease, perhaps as caricature, but also likely in extension of existing ethnically motivated bodily rhetoric. In assuming the critical role normally reserved for those outside the group in question, French Canadians find themselves in the curious position of articulating these damaging evaluations for themselves, thus making negative bodily difference a part of their national narrative. The disease-obsessed national discourse that emerges in the 1940s is not communal in that it faithfully reflects actual pathology. On the contrary, the medicalized discourse is an acknowledgment of the social stratification that defined much of the relationship between francophone Québécois and their national Other dubbed les Anglais (in reference to the disambiguated mix of English colonizers, their Anglo-Canadian descendants, and more recent Englishspeaking immigrants). The engrained and pathological perception of inferiority, a trait that had become part of the nation (like language or folk culture) consequently attuned French Canadians to thinking of themselves as collectively sick even when they were, overall, a healthy population. The causal theory of pathologized disadvantage or internalized inferiority is a plausible explanation for Quebec’s initial turn to tropes of illness. In the mid-century decades, French Canadians had a lower economic standard of living, were more likely to receive only the most basic education, and were proportionally under-represented in positions of social, economic, and political power (Dickinson and Young 2008). Such disparities could easily account for the turn to tropes of illness, but the same cannot be said of the more recent texts. The staggering inequalities of the past have been significantly diminished and, in some cases, reversed. French has become

14

Introduction

the language of public life in Quebec, and where there was once great uncertainty about the cultural and linguistic survival of francophones in Canada, those in Quebec are generally more confident in their position (Bouchard and Roy 2007). Although some would argue that Quebec has still not equalized its relationship with English Canada, it is fair to say that the still very serious and alarming tropes of illness employed in later narratives  – cancer, aids, Parkinson’s disease, dementia – do not suggest a more equitable power-sharing arrangement than the cancers and heart disease of past decades. The persistence of the illness narrative despite changing circumstances suggests that pathologized expressions of national inferiority, like the social realism hypothesis, cannot sufficiently explain why Quebec embraced this particular literary sub-genre. The insufficiency of both the social realism and metaphorized inferiority explanations for Quebec’s illness narratives prompt new questions. How might we understand illness narratives in a way that distinguishes perceptions from realities and recognizes both the obvious and the subtle facets of sickness and sick nationhood? How can we account for the continued use of the same tropes when both the medical implications of a given diagnosis and the national situation from which the trope issues and on which it acts have changed so radically over the decades? This book aims to answer these questions using Quebec as a case study, but in so doing argues for a new approach, applicable in many more contexts, to reasons for and the significance of the oft-intertwined discourses of the medicalized body and the nation. The central hypothesis of this study is that illness narratives are a response to change, particularly the kinds of change that occasion collective anxieties about the social, political, and cultural status of the nation. Periods of instability and upheaval in which perceptions may not align with reality, or when previous certainties are questioned and unsettled, cause people to seek stability and familiarity in known narratives and ways of understanding what is happening around them. As a fundamentally destabilizing experience to our personal sense of self – in that it challenges our sense of wholeness, boundedness, and control over our own body  – illness is perhaps the most common and relatable experience that we have for making sense of such periods. Tropes of illness and disease accordingly function as ways of making sense of new realities but must allow for the possibility of both favourable and unfavourable outcomes as well as ambiguous signification.



Sick Readings / Reading Sickness 15

Since the end of the Second World War, when illness narratives emerged as a pattern in Quebec’s literary production, Quebec was nothing if not a crucible of intense change. The shifts it underwent almost unrelentingly pushed it to redefine itself as a nation in ways that challenged its self-conceptions and the very means by which such appraisals were formed. Rapid social and institutional secularization weakened the notion of Quebec as a Catholic nation and circumscribed the power of the Church to continue to uphold Catholicism as central to national self-understanding. The rise of the nationalism movement in the 1960s and 70s twice initiated referenda that called on the people to cast votes on whether Quebec should remain part of Canada or become a sovereign nation-state. Improvements to standards of living bridged the chasm that had economically, educationally, and even physically separated Quebec’s anglophones and francophones from each other and occasioned a rethinking of old assumptions about hierarchies. Demographic changes brought on by urbanization and immigration forced a reimagining of who constituted the nation and by what basis national belonging could be determined. These transformations, whether assessed as positive or negative, generated considerable tension, which found its way into the nation’s literary expression in the form of embodied allegories – illness being one of the most common experiences of anxietyproducing, altered existence that we know.

Alternative Medicine Our understanding of Quebec’s turn to tropes of illness owes to readings that focus on the mere presence of disease in a text as a negative signifier. As a result, we have tended toward reductive and formulaically morbid understandings of illness’s role both in the text and within the broader discourses of the nation. To understand the illness narrative as a mechanism for coping with change, a new way of reading the illness is required. What is therefore proposed is a manner of reading that takes the full context of the illness into account. This approach is predicated on viewing the entire medical interaction represented in the text, not just the disease itself. To illustrate what this alternative way of reading illness enables, let us consider Québécois literature’s many evocations of cancer. Taken as a metaphor, cancer fosters the impression of a weak nation unable to resist its own rapidly growing pathology. Yet to more fully consider Quebec’s illness narratives of characters with

16

Introduction

leukemia, prostate, bone, and lung cancers by considering the entire narrative surrounding the illness (diagnosis, impact on family members, interactions with medical personnel, treatment, the disruption of the doctor-patient binary, implications of the diseases) yields allegories in which the fatalistic diagnoses are not understood or are not sufficiently authoritative to register with the patient, or when faint hope results in cure. To complicate the medical aspect of the trope of the embodied nation disrupts the easy transposition of the figurative diagnosis onto the nation. Readings therefore have the potential to problematize and even mitigate the pathology attributed to the nation via metaphors. When read in a way that probes and troubles the relationship between the sick body and the nation rather than simply accepting them as analogous to one another, Quebec’s illnesses are given the potential be less pathological or even curative. This approach does not categorically seek to reject  – as Susan Sontag (1978) would argue it should  – the medical nature of the tropes by which Quebec has chosen to articulate its own, at times problematic, nationhood. Quite the contrary, it engages with the discourse on its own terms so as not to deny the power to respond to and shape the emerging, modern nation that French Canadian and Québécois novelists found in medicalized discourse and tropes of illness. It works from within the signifying system based on medicine, disease, and the body to reveal what about the relation between the body and the nation does not withstand scrutiny. Attention centres on the often aberrant and contradictory ways in which the supposedly nation-sickening disease functions in the text. Instances where sick characters are able to cure themselves via (self-) diagnosis, where patients continue to live well unaware of their disease, and where the rhetoric of strong medicine for serious ills backfires, all disrupt the supposedly simple process of reading the rhetorical body as commentary on the nation. To focus on what can be construed as the abnormalities within the allegories that trouble the presumed equivalency between the (sick) body and the (supposedly sick) nation is to reassess the determination that the nation is ill. In re-evaluating the apparent diagnosis, readers become diagnosticians not (only) of the nation, but of a national literary tradition that has normalized medico-national allegories to the point that textual disease is simply and uncritically assumed to be an indicator of the nation’s poor health. This book accordingly shifts the focus away from sick characters and instead



Sick Readings / Reading Sickness 17

places it on the narratives about illness and traditional approaches to such discourses. It is less concerned with what the bodies of the sick characters represent than what the articulation of the narratives about them reveal about and do for the nation. Working from the premise that illness is a fundamental disruption to one’s bodily norms and functioning (Carel 2008; Kleinman 1988), it proposes that the points of resistance to the idea of the sick nation embodied by the ailing character might also be thought of as disruptions to the signification process. In short, it considers whether it might be something within the narratives or the critical approach that are, in a manner of speaking, ill. It seeks to understand how and why Quebec cultivates a greater sense of national pathology than may veritably exist and, in so doing, offers a potentially more optimistic second opinion. The chapter outlines that follow sketch how I propose to shift the critical or diagnostic gaze from the nation as a sovereign but diseased “body” to its nation-forming discourses as self-disrupting processes that trouble the assertion that Quebec is a sick nation. Chapter 1, “The Nation as Body,” concerns itself with the critical and theoretical foundations of the work. It traces the history of reading the nation, both in Quebec and more generally, through metaphors of the body and problematizes this practice. The imputed but troublesome equivalence between sick characters and a sick nation, most commonly expressed via the concept of the body politic, serves as the point of departure. The problems of the body politic are exposed, specifically in relation to Quebec’s atypical national situation, and new frameworks for reading illness narratives are outlined. The central features of these new approaches are (1) a more nuanced understanding of nationhood based on a duality of structure (frame/ content) and function (communal/exemplary) and on changeability, and (2) a more comprehensive way of reading illness narratives in light of the national complexities that inhere to both Quebec and other postcolonial societies. Chapter 2, titled “Diagnostic Allegories,” tackles the question of diag­­nosis and frames this central clinical act as one that is responsible for our determinations about whether or not the nation is sick. It advances a theory that the performative speech act of diagnosis, the discursive creation of disease from the illness experience, operates via similar mechanisms as the forming of a nation akin to what Benedict Anderson (1991) has termed an “imagined community.”

18

Introduction

Showing how the diagnostic acts in three canonical novels – Bonheur d’occasion (1945) and Alexandre Chenevert (1954) by Gabrielle Roy and André Langevin’s Poussière sur la ville (1953)  – are incomplete, lacking in authority, erroneous, or otherwise flawed, this chapter exposes how these narratives disrupt the analogous articulation of the nation as legitimately “diseased” during a period often regarded as one of the most conservative and insulated from change in Quebec’s modern history. In chapter 3, “Sick Doctors,” Poussière sur la ville is re-examined through a study of the narrator/protagonist’s drunkenness. Denis Lord’s Aller-Retour (1962) and Anne Bernard’s Cancer (1967) are included in this inquiry into illness narratives about doctors, a figure that unsettles the hierarchical doctor-patient dyad. Contrary to what had been the norm for sick characters in Quebec, these protagonists are cured of their ailments, notably through their own intervention. This chapter focuses on the relationship of these novels to the social and political changes of the Quiet Revolution; specifically, it argues that the transformation of traditional structures of social authority in Quebec both find and do not find their parallel in the hierarchytransgressing figure of the sick doctor. The fourth chapter, titled “Strong Medicine,” focuses on texts emerging from the turbulent years marked by the rise of the sovereignty movement and the 1980 referendum. Jacques Godbout’s Les têtes à Papineau (1981), Hubert Aquin’s Trou de mémoire (1968), and L’enfant du cinquième nord (1982) by Pierre Billon allow for an investigation of treatment regimes. Working from and challenging the popular misconception that treatment is about cure rather than therapy or palliative efforts, the study focuses on how attempts to generate a sense of national urgency around sovereignty and Quebec’s continued role in Canada backfired. The overtly political nature of these texts and the ways in which they push generic conventions cast these narratives as provocative interventions into the larger political discourses of the era. This points to an authorial awareness of the performative power of illness narratives (as popular literature) to intervene and engage in public debates about what, if anything, should be done in response to the questions being posed about the nation and its future. These narratives, which all (problematically) advocate interventionist medicine for the sick characters, emerge as daring and unconventional textual therapies for a nation whose political rhetoric increasingly advocated radical approaches to the nation’s metaphorical health.



Sick Readings / Reading Sickness 19

Chapter 5, “The Normal Pathographical,” serves as a coda for the work. It deals with contemporary illness narratives and includes studies of Du mercure sous la langue by Sylvain Trudel (2001), Gil Courtemanche’s Une belle mort (2005) and Je ne veux pas mourir seul (2010), and Tassia Trifiatis’s Mère-grand (2010), tales that differentiate themselves in their downplaying of national references. These new illness narratives are just as morbid as those studied in earlier chapters but can viewed as part of the larger trend of narrativizing illness as an effective form of therapy. Drawing on insights about pathography (a form of illness-centred life writing), these novels facilitate a generic reconceptualization of earlier illness narratives as nationally therapeutic texts, in the same way that stories of actual illness conceived of as a battle, a journey, or a transformation can be therapeutic. The study of these texts makes clear that there is (and arguably has been all along) something of a functional rather than a content-based allegory at play in Quebec’s stories about sickness and that in recognizing this, we can understand the tropes of illness as something other than simple self-pathologization.

1 The Nation as Body

If Quebec’s sick characters have been focal points of its illness narratives, it is because the body and its processes have long served as the basis for any number of tropes. People are said to experience hungers and thirsts that do not involve physical sustenance. The metaphorical mention of particular organs, such as the heart and the spleen, connote the emotions and temperaments once said to reside in or issue from them. Specific diseases serve as cultural shorthand for a wide range of perceived failures and shortcomings thought to precipitate the affliction.1 The prominence of what might be termed the rhetorical body, the same one that has drawn the attention of some of Quebec’s readers and critics, owes to the universality of the actual body. This is to say that everyone – no matter the differences between them – has a body and, to varying degrees, understands its basic processes. Although different cultural understandings and individual circumstances dictate the particulars, the fundamentals of illness as a disturbance of (one’s own) normalcy are virtually universal. The familiarity of the body thus makes it an effective although complicated signifier, and the tangible and readily comprehensible aspects of the actual body make its rhetorical counterpart an ideal trope for qualifying and explaining highly contingent, complex, and disputed concepts.2 Through its metaphorical or allegorical association with abstractions or illunderstood processes, the rhetorical body lends to these harder-todefine entities much of the objectivity and concreteness that they are thought to lack. In this manner, the rhetorical body bridges the perceived gap between the tangible and the intangible, the largely practical and the mostly theoretical, the organic and the ideological.



The Nation as Body 21

This chapter contextualizes the theoretical underpinnings of the project, namely the links between nations, bodies, and the ways in which “reading” the diseased body both is and is not a way to read the nation as ill. It considers the modern history of the body politic as a metaphor and illustrates how Quebec’s status as a nationwithin-a-nation exposes a fundamental flaw within the trope. From there, a detailed rethinking of nationhood, one that is more flexible and accommodating in its understanding of nations in transition and nations that are predicated on minority (or minoritized) identity is articulated. This more nuanced understanding of the nation in turn underpins a call for narratives of sick nationhood to be read as allegories rather than as metaphors owing to allegory’s ability to encompass contradictions. In revalorizing the incongruities inherent in allegory, I argue that the nearly ubiquitous mediconational trope in not only Quebec’s, but in many other postcolonial literatures, has the potential to be read as something other than a sign of national sickness.

The Body Politic The most common yet enduring example of a naturalizing bodily association is the construct of the body politic. This concept has been used widely in defence of concepts like absolutism and political decisions such as the English split from the Roman Catholic Church. It has become a particularly common trope, having been employed from the Middle Ages and the early modern period, and its use persists. Its deployments range from the discourse of the “King’s two bodies” (Kantorowicz 1957) and Hobbes’s Leviathan (1651) to the Nazi Volkskörper (Kapczynski 2008). In its simplest articulation, it holds that any state or nation may be thought of as a physical body. With the Enlightenment’s twofold emphasis on science and progress and its questioning of absolutism, the body politic took on new meaning. The overt ideological inflections of the model, for instance as justification for absolutist rule, were increasingly cast aside during the so-called age of reason. The rhetorical body that underpins the body politic, however, did not disappear. Rather it benefited from the scientific orientation of the period, which upheld, in the words of Donna Haraway, “untrammelled reason, progress, and materialism” (1976, 20) to lend the impression that the symbolic body was (now) progressively objective, scientific, and free from ideological

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Curative Illnesses

encumbrances. What medicine and science upheld as true of the body (for instance that gangrenous limbs had to be amputated) was thought to translate to the embodied nation. The ways in which the Enlightenment altered the thinking about the rhetorical body produced a kind of tension whereby the ideology of reason (which ironically was touted as the antithesis of ideology) was subsumed by positivism’s claim to objectivity. As with the triumph of reason, the literary naturalists and realists simultaneously advanced various ideologies (theories of nationhood, beliefs about social and moral hygiene) while denying the influence of anything but objectivity, nature, and science on their propositions. Partisans on both sides of an issue (like the nature of the nation) could rely on the rich semantic field of the body and its familiar processes to naturalize the ideologies they espoused.3 Sandy Petrey accounts for the political dimension of this rhetorical dissimulation, noting: “Every dominant class must seek to represent the social system that assures its domination as the consequence of conditions no more subject to revision than one season succeeding another or one thing being named by one word. An essential task of ideology is to confuse nature and history until the difference between them is erased from collective consciousness and the conventional effects of conventional procedures appear to be the material effects of a physical cause” (1988, 180). Petrey contends that in the wake of the Enlightenment, groups seeking to defend their positions eschewed old forms of ideological justification (those predicated on religion or divine order) in favour of explanations understood to be natural, scientific, and therefore unchangeable. David Caron aptly encapsulates the pervasive national bodily rhetoric in what he has termed the nineteenth-century “bourgeoisnation-as-body”: it has “natural boundaries; it consumes, expels waste, seeks normality, reinforces its defenses, fights foreign bodies, and fully realizes itself in the process of reproduction” (2001, 9). Gathering these tropes from French literary and political sources, Caron signals not only the descriptive or explicatory function of the rhetorical body, but also insists on its performative role. This body represents but also, and more importantly, promotes the belief (and thus the “fact”) that the nation is a natural entity whose problems can be diagnosed, treated, and cured as though it were a biological being. This idea of nation-as-body proved to be enduring not only in overtly political or national discourses, but also – and even more prominently – in other genres, such as novels. In France, Zola



The Nation as Body 23

and other naturalists made the novel and the predictable fates of its characters the barometer of the nation’s metaphorical health. The late nineteenth and early twentieth centuries marked the heyday of the national-rhetorical body in France, although Quebec only truly embraced the rhetorical body starting in the 1940s. At first, and contrary to the French example, this body was primarily relegated to literary texts, although it was increasingly taken up, starting in the 1950s, in political and journalistic arenas (Robert 2011, 2014). In France, the discourse’s primary function was diagnostic, in that writers sought to identify the nation’s ills. As exemplified by Zola’s Rougon-Macquart series, an unapologetic exploration of the host of ills (venereal disease, alcoholism, developmental delays, tuberculosis) that plague the series’ title families, the diagnosis of national ills was meant to lead to cure.4 The curative aspects of Quebec’s discourse, by contrast, only became apparent some twenty to thirty years into its own literary movement. In many early Québécois examples notions of cure seem either divorced from or unsuccessfully linked to the diagnostic task the texts perform. Maurice Arguin’s (1985) literary history, which works from Frantz Fanon (1952, 1959, 1961) and Albert Memmi’s (1965) contention that colonization is a psychologically pathological state of being, is exemplary of a morbid prognosis for the nation. Arguin theorizes that French Canada, the sickly nation of traditional nationalists, must die so that a healthy, modern nation – Quebec – can be born. Although his argument is rooted in the kind of nationalism that led to the sovereignty referenda, and is therefore predicated on the unviability of French Canada (as opposed to an independent Quebec), he reads Quebec’s literature in a way that not only suggests but also demands the non-viability of the French Canadian nation.5 Despite the readiness on the part of Quebec’s cultural commentators to embrace the (moribund) rhetorical body, they do so in a manner that occludes certain realities of why the bodily metaphor was employed in the first place. Quebec’s status as a nation-within-anation, in particular, complicates casting the nation as body.6 The ills from which the nation-within-a-nation is said to suffer are so severe as to be mentally and physically crippling (at best) or fatal (at worst). They also tend to be systemic ailments (leukemia, “old age,” dementia, and metastatic cancers) that affect more than one part of the body. Yet if it is the nation-within-the-nation that is ill, the impact of these conditions on the larger Canadian body goes unnoticed by even those most attuned to the dynamic between the nations.7 It is

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Curative Illnesses

as if French Canada’s circulatory problems in no way compromised Canadian blood flow and Quebec’s invasive cancers posed no metastatic risk to a larger body that can cope with such threats and even compensate for the smaller body’s failings. To ignore the singularity and unity of the rhetorical body that makes the discourses of national disease and pathology possible exposes a fundamental flaw in the logic of the trope and divorces the question of national consequences from conventional discourses of national pathology. The net effect of this rhetorical disjunction is an unsettling of the simplicity imputed to the rhetorical body, for it calls into question the explicative utility of the metaphors and other tropes. Tropes such as the body politic, after all, are meant to simplify, explain, and illustrate that which is harder to grasp, not introduce complications that frustrate their very logic. Arguably a specific case, Quebec’s difficulties with and challenges to the concept of the body politic point to more systemic problems with medico-national discourse. Specifically, the diseased nationwithin-a-nation leads, as Donna Haraway argues, “to the testing of the neutral parts of the analogy. It leads to a searching for the limits of the metaphoric system and thus generates the anomalies important to paradigm change” (1976, 9; original emphasis). It is only subsequent to the collapse of (or even evidence of faults within) the signifying system established by the metaphor that one truly seeks to understand the implications of the trope and that which it explains. In the case of Quebec and its frequent use of medical rhetoric, the analogies centring on the body politic, which may hold up when the nation is conceived of as a relatively unitary state, begin to crumble when the analogy is developed, and both the medical and national implications of the specific trope are pushed to their logical ends. Quebec’s national situation, one that has a great deal in common with both nations-within-nations and postcolonial cultures, thus prompts a rethinking of how and why nations are likened to bodies and occasions a re-evaluation of the critical approach to these iterations of the body politic.

The National Paradigm The problems that arise from trying to conceive of Quebec, a nation-within-a-nation, as a singular, biological body reveal a need for, among other things, a more nuanced understanding of what



The Nation as Body 25

is meant by nation. Most often, nation-within-a-nation is used in reference to minoritized groups like the Québécois and combines two different senses of nationhood. The first is less formal in that it is based on an ethnic, linguistic, or religious affiliation shared among people, while the second coincides with a political or civic state. The obliqueness of the single term nation accordingly calls for a more contextual definition. As an alternative, I propose to think of nationhood as a national paradigm.8 The concept of the paradigm (appropriately enough given the turn to scientific metaphors and their claims to objective truth) comes from Thomas Kuhn’s The Structure of Scientific Revolutions (1996). For Kuhn, the paradigm is an organizing principle for all scientific knowledge, a structure that gives shape to a body of facts and theories. It has a frame and a content, neither of which can exist independently of each other, is dual in function, being both exemplary and communal, and is mutable. Haraway (1976), who contends that the success or failure of metaphors in describing scientific phenomena contributes to paradigm shifts, echoes the centrality of the paradigm as a supple yet effective concept for understanding complex phenomena. The bodily trope and its difficulties in capturing the idea of complex nationhood thus portend significance in rethinking the very concept of nationhood. The questions that define the frame of a national paradigm – who is included and what are the parameters that establish inclusion or exclusion – have been a recurrently divisive issue for the Québécois. More often than not, the question is evaded or treated obliquely rather than addressed head on. Those instances where it is taken up, as it was for the Bouchard-Taylor Commission inquiry of 2008, which focused on the cultural and institutional accommodation of ethnic and religious minorities, and federal parliamentary debate on recognition of Quebec’s nationhood (Thompson 2006), proved to be contentious. To wit, in Quebec the nation has become one of those terms that it has become easier to use than define. At the heart of the debate about who should or should not figure into the national paradigm is the question of which criteria determine one’s being part of the paradigm’s frame. These conditions for national belonging in turn become its content. If the term is being used in its legalistic or institutional sense, as it is when one speaks of Quebec’s National Assembly or National Gallery, the nation is (at least technically) synonymous with a politico-legal entity (such

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Curative Illnesses

as a nation-state or a sub-national state) and the people who reside therein. If the term is being employed in a more abstract sense, traits such as ethnicity, language, and religious affiliation tend to come into play and complicate matters, especially as societies change through processes such as migration. The issue of function for the national paradigm arises largely from its structure; how do the “who?” and the “what?” get taken up and acted upon in the normal course of a nation’s existence? The answer here is twofold, for as Haraway explains, the paradigm acts as both a “shared constellation of belief” that reflects realities and a “model or example” that points to how things either ought to or might be (1976, 3). This is to say that all paradigms are always both communal and exemplary in nature. The inherent difficulty with the national paradigm’s dual functionality, however, is the nearly inevitable conflict between its functions, for people are caught between having the nation represent them as they are and conforming to idea(l)s of national belonging. As Homi Bhabha notes in his discussion of the pedagogical (exemplary) and the performative (communal) aspect of nations, there is a “tension between signifying the people as an a priori historical presence, a pedagogical object; and the people constructed in the performance of narrative, its enunciatory ‘present’ marked in the repetition and pulsation of the national sign” (2004, 211). This tension results from the need to negotiate the national pedagogy and for the people to perform their national culture in a way that defines and delimits the nation. Yet, postcolonial critics in particular have noticed – owing to the marginal positions of many of their subjects – that the performance of this idealized national content or pedagogy is inevitably problematic and imperfect. Jarrod Hayes distills the issue, arguing that “writing the Nation is always a rewriting, and in rewriting, there is room for subversion” (2000, 134). The communal performance therefore clashes with the exemplary pedagogy not as an aberration but as a normal feature of nationhood. As Bhabha (2004) indicates by pointing to the disjunction between the historical and the present, one of the principal reasons for the conflict between the national paradigm’s functions owes to the fact that it changes over time. That these transformations often occur in a manner that makes them all but imperceptible as a true paradigm shift until after it has occurred only heightens the potential for conflict. The periods of transition are experienced as phases in which there are unresolved questions, unease, and disruption to the norm. Kuhn (1996) maintains that these instances of discord



The Nation as Body 27

during paradigm shifts can be, and in fact are, largely ignored once the change is complete and a new paradigm has replaced the old.9 For others, notably Eve Kosofsky Sedgwick, these periods of indeterminacy and flux provide the greatest insight into the subject of the paradigm. She maintains that issues “are structured, not by the supersession of one model and the consequent withering away of another, but instead by the relations enabled by the unrationalized coexistence of different models during the times they do coexist” (1990, 47).10 Prioritizing the situations that fit neatly into neither the old nor the new paradigm thus provides a lens for examining the incongruities that are all too often discounted once the shift from one paradigm to another is complete. As for Quebec, the intricacies of its national paradigm are encapsulated by Richard Handler: “To be Québécois is to act Québécois, and to act Québécois comes naturally to those who are Québécois” (1988, 39). The idea that nationhood is in some way an intrinsic or indelible trait, that it can be described using the verb “to be,” stems from a content predicated on the communal function and echoes the kind of thinking about the nation typical of what might be called closed nationalism, which has been theorized, in Quebec, by nationalist cleric Lionel Groulx (1919) and, in France, by authors such as Maurice Barrès (1925). Barrès contends that a nation’s mindset issues form its biological heritage: “Elles [les pensées] ne viennent pas de notre intelligence; elles sont des façons de réagir où se traduisent de très anciennes dispositions physiologiques” (1925, 31) [They [thoughts] do not come from our intelligence; they are ways of reacting that translate very old physiological dispositions]. Groulx speaks plainly about the overlaps between race and nation in Quebec: “Distincts, nous le sommes … par des caractères physiques et moraux déjà fixés et transmis avec la vie” (1919, 7; my ellipsis) [Distinct, that is what we are … because of the physical and moral characteristics that are already established and transmitted at birth and through our life experience]. This kind of nationalism continually returns to the idea of a nation encoded (like dna) in the very bodies of the people who comprise it. In such a model, where either one is or is not part of the nation, there is (at least ideally speaking) no differentiation between the communal and the exemplary functions of the national paradigm. Being Québécois, having nationhood in one’s bones, however, is only half the equation, for there is also an element of acting Québécois at play. Handler admits that this enactment of national culture

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Curative Illnesses

(defined by shared traits such as language, religion, history, and geography) “comes naturally” to those who share in the “traditions, typical ways of behaving, and characteristic modes of conceiving the world,” (1988, 39). He nevertheless dedicates much of his argument to exposing the various ways in which Quebec consciously performs its national culture. These performances, often literally staged as displays of tradition and “authentic” Québécois life, contrast with the traits, modes of thought, and behaviours that are actually common to even those who share in the objectified characteristics that define the Québécois as nationally distinct. In recognizing the aspects of Québécois culture that are very deliberately acted out, Handler points to the more general premise – subsequently elucidated by Bhabha (2004) – that nations are formed by the performance of a nationalist exemplar. In Quebec, this nationalist ideal is anchored in notions of historical origins and shared traits, such as the use of the French language. The sustained performance of a national pedagogy, which is common to all nations, recalls the idea of nationhood put forth by, among others, Ernest Renan ([1882] 1996) and Benedict Anderson (1991). For them, the nation results from processes of collective remembering and forgetting, mutual sacrifice, and a perception of (if not an actual) shared history, all of which contribute to a willingness to live as a limited but sovereign solidarity. Those who participate in these processes, regardless of their race, mother tongue, religion, or place of origin, constitute the nation. In electing to see themselves as part of this nation, to perform the national pedagogy, they bring the nation into existence as what Anderson terms an “imagined community.” This enactment of certain aspects of the majority culture accentuates the idea that nations are based both in being and in action, on conceptions of the nation that are at once closed (based on shared traits) and open (based on participation). For Quebec, “Frenchness” has been central to defining the content of the national paradigm (Lévesque [1968] 1997). “Frenchness,” however, originally encompassed a constellation of almost binary characteristics that separated the French settlers from their national Other: francophone as opposed to anglophone, Catholic not Protestant, rural not urban. With the arrival of large numbers of Catholic immigrants from Ireland in the nineteenth century and from southern Europe in the postwar years, religion became a less precise demarcation of those who conceived of themselves as belonging



The Nation as Body 29

to the national solidarity and those they viewed as anathema to the nation. The gradual shift away from the Church that occurred in the wake of the Second World War and that became an overt phenomenon in the 1960s only further eroded religion’s role in the national pedagogy. When urbanization in the early twentieth century pushed rural French Canadians into the tenements of the province’s cities and the factory towns of New England, the urban-rural distinction also became more of a nostalgic notion than a true test of national belonging. Language, the surviving binary, thus became the litmus test of inclusion and the definitive content of the national paradigm, at least until migrants from the far reaches of France’s former colonial empire began calling Quebec home. Striking a balance between the national paradigm’s two functions had not historically been a concern for nationalists in Quebec, for the paradigm the Québécois of the nineteenth and early twentieth centuries espoused did not extend much beyond the communal level.11 As the francophone population began to become more urban-based, bilingual, and less religious though, national authorities stepped in to establish the paradigm’s slowly eroding content as an exemplary pedagogy. These leaders, mainly political and religious officials, assumed the authority to treat the political state as largely coterminous with the group for whom the national pedagogy or culture “comes naturally.” State power and religious persuasion were thus used to reinforce the exemplary function of the paradigm against a changing communal picture that resembled the ideal less and less. In doing so, these national authorities legislated to preserve the traditional and at one point shared content of the national paradigm. The institutionalized practices surrounding the enactment, and indeed the legal enforcement, of Quebec’s national paradigm epitomizes its exemplary function: people are provided a model of how to be Québécois, and it is expected that all who consider (or wish to consider) themselves part of the nation emulate it.12 It is thus that certain groups of people who were already perceived as exemplary social leaders came to be seen as functional authorities over the nation. This extended to the use of actual pedagogical institutions – including, as Lucie Robert (1989) notes, the right to choose texts for school curricula and the administration of literary prizes – to insulate the paradigm from changes that would threaten their own authority. These national authorities conflated the exemplary function of the paradigm with

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Curative Illnesses

its communal counterpart and gave the exhortation to maintain clerico-conservatism (Frenchness, Catholicism, rurality, etc.) as part of the paradigm the force of moral and institutional obligation. Accordingly, the socio-economic and demographic changes brought on by the Great Depression, the Second World War, immigration, and urbanization that altered the stability and relative homogeneity of Quebec’s population occasioned a particularly pronounced tension between the two functions of Quebec’s national paradigm and its self-professed national authorities.13 The reactions to the national paradigm’s mutability are just as revealing as the changes themselves. So-called revisionist historians and social scientists studying Quebec have embraced Sedgwick’s idea that it is what happens during the periods of paradigm shift that is important. As such, scholars like Jocelyn Létourneau (2004), Michael Gauvreau (2005), and Donald Cuccioleta and Martin Lubin (2003) have given new value to the events and subtle social and political shifts occurring throughout the 1940s and 1950s. In doing so, they have broken away from the notion of the political start of the Quiet Revolution in 1960 as a sudden and monumental paradigm shift in Quebec. My intention is to model off of this historical approach to rethink not just the nation as articulated in literature, but also the established ideas about when the nation was healthy and when it was ill. Critics like Maurice Arguin (1970, 1985) and Jacques Pelletier (1984, 1991) have emphasized the rise of the sovereignty movement as the moment of paradigm shift in Québécois literature. They argue novels are either “Québécois” or “French Canadian” and that such labels are the result of the waxing and waning of the independence movement: “La victoire du non au référendum ne vient-elle pas confirmer l’hypothèse d’un colonialisme toujours latent? Après avoir été Québécois, ne sommes-nous pas en train de redevenir Canadiens français?” (Arguin 1985, 10) [Does the no victory in the referendum not confirm the hypothesis of a colonialism that is still latent? After having been Québécois, are we not again becoming French Canadian?]. To collapse the alleged colonial (sick) and postcolonial (healthy) binary of French Canadian and Québécois, just like taking apart the myth of the Quiet Revolution as a watershed moment, forces a recognition of elements such as oppositional voices that both can be (and have been) ignored once the new paradigm is in place. Indeed, coming to understand and value these interstitial moments may ultimately reveal that the earlier



The Nation as Body 31

situation, the paradigm before the shift, was not as backward, colonized, or otherwise “sick” as had been asserted.

Embodied National Paradigms: A Case for Allegory That the national paradigm can be so dominated by its content, and specifically its communal and exemplary functions – the aspects that create solidarities out of individuals – has a great deal to do with the inherently discursive nature of nations. Anderson (1991) repeatedly acknowledges both narrative and the printed text (novels, histories, newspapers, maps, censuses) as the engines of nation formation. He argues that these avenues for discourse and the discourses themselves are essential for thinking of the nation as something beyond immediate experience and interactions (those people and institutions with which one personally engages). In recognizing oneself as the subject or the audience of one of these national texts, the text becomes an example that spurs the creation of the national community. In allowing people to imagine themselves as part of a solidarity that they can come to know via text, language (and its textual applications) has a transformative effect. It turns a group of people into an established “thing,” a nation, which can be named and classified as distinct from others of its kind. Given the importance of texts to the national paradigm, and particularly to its exemplary function, a text as common in Quebec as the illness narrative merits attention. The rhetorical relationship between bodies and nations, one that critics have reinforced not only with readings centred on illness, but also via discussions of embodied phenomena like gender and sexuality,14 can, moreover, only reinforce the importance of this kind of narrative in positing the national paradigm.15 The unclear demarcations between the national paradigm’s frame, its content and its authorities nevertheless complicate the already intricate and problematic question of nationhood. It is therefore understandable that the reductive concept of the body politic and simple disease metaphors cannot so easily be imposed upon Quebec because it exists both as a unitary body in its own right and also as a part of a larger national body. The diseases attributed to it in literature seem to affect Quebec first, and the rest of Canada second, if at all. Furthermore, a number of texts from the 1960s and ’70s and ’80s, when nationalist discourses were at their peak,

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confound the sources of and the cures for disease. Readers cannot therefore distinguish between etiology and remedy. The intricacy that is played out in the use of bodily tropes signals a kind of national complexity that exceeds that of the body politic. Handler’s evocation of Louis Dumont’s model of a dual-bodied nation reinforces the dual nature of Quebec’s national paradigm. Dumont contends that the nation is always “two things at once: a collection of individuals and a collective individual” (1970, 33).16 The nation is always in tension with itself, balancing which of the two national bodies will prevail upon the other.17 This avowedly paradoxical double definition of the nation, while envisaged primarily to highlight the differences between France and Germany without resorting to two separate analogies, perhaps better suits the Québécois context of complex, dual nationhood. This twofold model is, after all, remarkably similar to Bhabha’s (2004) postcolonial explanation of a collective national ideal that is repeatedly performed by individuals. Dumont also suggests that the kind of nation at issue depends largely upon where a nation conceives of itself in the transition from a traditional to a modern society. The paradigm centred on the “collective individual” is a mark of so-called “traditional” societies, whereas the “collection of individuals” orientation signals a more “modern” paradigm (1970, 32). Until the twentieth century, Quebec maintained (in both the communal and exemplary senses) a national paradigm that was very much in keeping with the idea of the collective individual. Yet as it modernized (especially in the postwar years) and shed what has been thought of as the vestiges of its traditional society, the balance between Dumont’s two aspects of the individual/collective nation began to shift; first communally, but also eventually at the level of the exemplary function of the paradigm (Behiels 1985). Dumont describes this transition as a decades-, even centuries-, long process. In Quebec, however, the overall change in the national paradigm, the result of an ideological shift to a more individualistic world view, seemed to occur much more rapidly than in the examples Dumont considered. Indeed, in the years between the end of the First World War and the widely recognized start of the Quiet Revolution in 1960, Quebec’s traditional society came first into question, then under siege. By the time that immigration, urbanization, secularism, and a movement for political reform had made their impact, the paradigm could no longer be said to centre on an exemplary model of a collective individual.



The Nation as Body 33

Despite the increasing focus on the “collection of individuals” or communal facet of the national paradigm, the image of the collective individual, the exemplar of nationhood, remained an integral part of the formulation. The importance of the Church and state-backed vision of Quebec as a conservative, rural, and francophone nation lingered throughout the 1940s and ’50s.18 This meant that even as Quebec was taking steps toward what would eventually emerge as a new and much more communal “embodied” national paradigm, it still clung, especially in official capacities, to many of the hallmarks of an idealized collective individual. To traditional nationalists (like Groulx), who saw even incremental changes as challenges to the national culture they endorsed (and the mass acceptance of which kept them in power), the unity and vitality of the national paradigm represented by this collective individual was being threatened. Consequently, in the interval between which Quebec had a clearly articulated paradigm centred on the collective individual and an equally lucid understanding of itself as a collection of individuals (if indeed such an understanding yet exists), its national paradigm was in flux. Casting states of national indeterminacy in bodily terms is a common way of thinking about shifting self-conceptions and their problematic outcomes. In The Prison Notebooks, Antonio Gramsci draws on bodily rhetoric by pathologizing the difficult transitions from traditional to modern societies: “The crisis consists precisely in the fact that the old is dying and the new cannot be born; in this interregnum a great variety of morbid symptoms appear” (1971, 276). The transition follows the usual course of organic life – birth, sickness, death, albeit in reverse – as Gramsci pathologizes the intermediary period between the traditional and the modern, the mostly holistic and primarily individual-centred nations, the communal-turned-exemplary pedagogy, and the communal enactment of the national paradigm. Gramsci’s pathologizing of the evolution from old to new, taken together with Dumont’s idea of an embodied nation, supplies the theoretical foundation for a societal illness narrative centred on a “morbidly symptomatic” or sick national paradigm. Moreover, Dumont’s insistence on the essential tension between the two articulations of the nation indicates that this state of sickness is not, as is the case with the actual body, a strictly abnormal situation, but rather one that is in itself typical of all nations. Pathology is, metaphorically speaking, a normal condition of nationhood. For

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postcolonial nations, for which the transitions tend to be both abrupt and profound, national “sickness” can be considered routine. As Gramsci simultaneously pathologizes and normalizes social transitions, he also directs the national paradigm toward a new rhetorical dimension. In passing from the body politic as a static entity to a body in transition, which moves from health to sickness, and then either to death or recovery, he prioritizes allegory over metaphor; that is, he rejects fixed conditions that can be described with metaphors, in favour of processes and interactions that must, in order to be understood, be narrated in their entirety. The necessary move toward narration to tell the story of a national paradigm in pathologized transition makes the illness narrative rather than a disease or diagnosis a key element in understanding the embodied national paradigm. Allegory though eludes easy definition, for there is considerable debate about whether the meaning of allegory is supplied by the author and simply communicated via the text or whether it is up to the reader to determine (rather than just uncover) its signification (Frye [1957] 1967). Certain types of familiar allegories have come to be recognized as “generic allegories” because they adhere to readily identifiable patterns, which “codif[y] the rules for reader expectations” (Quilligan 1979, 16).19 With successive readings, particularly over long periods, it practically becomes a habit to read certain features of a story in certain ways. I contend that the medico-national allegory, or the illness narrative of the embodied nation, has come to constitute a familiar sub-genre of allegory. The metaphorical tradition of equating the body with the nation serves as a kind of intertext, in much the same way that the Bible does for Christian allegory. It provides a recognizable foundation for readings and, with time, reinforces itself as readers, continually confronted by similar images and narratives, become attuned to understanding the illness narrative as an allegory of the nation. The more such narratives abound, the more likely one comes to default to these allegorical readings, accepting them as generically normative. Well-established generic allegories allow for shortcuts to meaning such that where once very deliberate tropes were necessary to create allegorical links between the two narratives, the references on one side of the equation can become all but absent while still generating allegorical meaning. Fredric Jameson’s (1986) essay on Third World national allegory reinforces the generic or author-supplied national allegory of the



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medical storyline. In it, he suggests that the emerging postcolonial nation finds its literary expression in medicalized narratives. While Jameson does not make the connection between the medical and the national explicit, his choice of examples in explaining the role of national allegories in Third World literature draws heavily on bodily or medicalized crises. He references Ousmane Sembène’s Xala (1973), a novel in which a corrupt and Europeanized Senegalese businessman finds himself impotent, to expose Sembène’s allegorized critique of the corruption of postcolonial African society. He also cites a number of short stories by Chinese author Lu Xun (1972), calling the writer “a diagnostician and a physician” for portraying the problems of late imperial China as he does (Jameson 1986, 73). Even in his own analysis, he echoes the medical aspect of the national allegories he examines by repeatedly signalling the national allegory as a diagnostic practice, arguing that it is both a “radical” (82) and an “intellectual” (79) “diagnosis” of the Third World. Jameson’s inclination to bring together the medical and the national, whether accidental or deliberate, both draws on and reinforces the medico-national allegory as a kind of sub-genre. Jameson’s explanation of how national allegories function nevertheless issues from the two contradictory notions of allegory. On the surface, his emphasis on the author’s role as diagnostician implies a generic inclination, which is to say an author- or text-centred orientation to the medico-national allegory. He describes the narrative as an instrument in the hands of the physician, who (to extend the metaphor) wields it with deliberate precision. Moreover, Jameson introduces Xun’s training in Western medicine to make the point that he chose writing as “a more effective form of political medicine” (1986, 73). Such phrasings presuppose, first, that the allegory is embedded within Xun’s narrative as an author-prescribed treatment for the national ills he identifies. Second, Jameson implies that his gravitation toward the medical aspects of national allegory may not be purely coincidental. Further solidifying his position about the generic nature of the (medico-) national allegory is his differentiation of Third World allegory as a very calculated kind of writing: “The point here is that, in distinction to the unconscious allegories of our own cultural texts, third-world national allegories are conscious and overt: they imply a radically different objective relationship of politics to libidinal dynamics” (79–80). Jameson’s assertion of the deliberate nature of the Third World allegory, and his earlier insistence

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on its curative intent indicates an acknowledgment of the coupling of the medical and national that goes far beyond the metaphorical body politic.20 A central point of Jameson’s argument concerns the timing of these (largely pathologically inflected) national allegories. By insisting on the critical period of transition from colonial to postcolonial states, he implies that times of crisis or national uncertainty will produce disease-filled allegories. Deborah Madsen contends that the turn to allegory at such moments is almost predictable, because “allegory flourishes at times of intense cultural disruption” (1994, 135). Thus, like Dumont and Gramsci before him, Jameson recognizes the critical points of national transition that give rise to not just metaphorical but textually manifested morbid symptoms. Perhaps more than anyone else though, Jameson stresses the importance of the total experience of the medical process through his insistence on narrative. His summary of Sembène’s Xala focuses less on the condition than on the protagonist’s unsuccessful attempts to find relief. Similarly, the introduction to his remarks on Xun’s “Diary of a Madman” gives the reader a sense of the protagonist’s rapidly declining mental status, from paranoia to full-on psychosis. The symptoms, treatments, and emotions related to illness that Jameson highlights are made equal to the diagnoses and act as integral parts of the allegorical narratives. In drawing attention to the precarious navigation of states of good and ill health, Jameson signals the equally uneasy coexistence of two visions of the national paradigm, the old and the new. It is thus that the illness narrative, the medico-national allegory, becomes the focal point for positing the national paradigm, particularly in the kind of nations caught between colonial and postcolonial self-representations.

National Health, National Illness: The Québécois Case Before delving further into the role of illness narratives for Quebec’s national paradigm, it would be prudent to explain my use of Jameson’s ideas on Third World national allegories in relation to Quebec, a rich, industrialized Canadian province with a primarily white population that speaks one (if not two or more) of the world’s dominant languages. Given the critiques, most notably by Aijaz Ahmad, levelled against Jameson for his rigid adherence to “his particular



The Nation as Body 37

variant of the Three Worlds Theory,” it would be problematic to continue to employ them here in an unqualified way (1987, 6). Insofar as Jameson’s theories about Third World literature can be said to stem from the colonial experience rather than from the contentious (and largely outdated) geopolitical classification of first, second, and third worlds, however, his ideas can be useful for thinking about Quebec. As Vincent Desroches (2003) notes in his introduction to a special issue of Quebec Studies devoted to the question of Quebec’s postcoloniality, the matter is ambiguous. Rather than summarizing here the content of that volume, which takes up questions relating to language rights, economic status, and other opportunities, I will insist only on the way in which francophone literature in Canada developed as a direct response to English colonialism and specifically the 1839 Durham Report on the “affairs of British North America,” which accused French Canadians of being “a people with no history, and, no literature” (150).21 The implication of the reproach was that such a people could not constitute a nation. In response, historian François-Xavier Garneau penned Histoire du Canada depuis sa découverte jusqu’à nos jours. This multi-volume work opens by referencing the Durham Report’s intent to set an assimiliationist policy for Upper and Lower Canada and articulates its own purpose as proof of the French Canadian nation’s legitimacy and vitality: “À la cause que nous avons embrassée dans ce livre, la conservation de notre religion, de notre langue et de nos lois, se rattache aujourd’hui notre propre destinée. En persévérant dans les croyances et la nationalité de nos pères, nous nous sommes fait peut-être l’ennemi de la politique de l’Angleterre, qui a placé les deux Canadas sous un même gouvernement, pour faire disparaître ces trois grands traits de l’existence des Canadiens” (1859, ix) [“The destiny of Canada is dependent on the cause which we vindicate in this work; namely, the conservation of our religion, our language, and our laws. By holding to the creed and maintaining the nationality of our forefathers, we perhaps are opponents of British policy, which has placed the two Canadas under one government, in view of causing the disappearance of those three great features of Canadian existence”] (Garneau 1866, viii).22 Garneau’s comments announced much of the thinking about the discursive nationhood that would emerge in the twentieth century by detailing the link between his own historical work and the destiny of his nation, which he sees as contingent on religion, language, and laws.23

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More importantly, however, Garneau acknowledges that the nation his text (and presumably those that would follow) frames acts as a form of resistance to the British colonial policy because it asserts French Canada’s literary, historical, and therefore national vitality.24 The colonial legacy in Quebec, much like the political situations in the nations Jameson references, consequently proves to be generative of national literatures, including allegories. From its origins attesting and contributing to the nation’s health (in response to Durham’s accusations), Quebec’s literature seems to take a turn for the worse. In a rare study dedicated to physical illness or medicalized storylines, Jane Moss argues that Québécois novels have given rise to “a feeling that being ill is an essential part of being in Quebec” (1984b, 152; original emphasis). Moss remarks that many of the canonical works from the 1940s onward feature stories of disease, disability, and mental illness. She explains this pattern by venturing that novelists construe Quebec as a less-than-healthy society: “They portray characters as weakened, deformed, mutilated, and paralyzed by the social, economic, political, and religious climate of Quebec” (153). She asserts that there is a deliberate effort, driven primarily by the mid-century move toward realism, to construct a national literature focused on the characters’ physical and mental indispositions. Her article catalogues both the more obvious examples of literary ailments, which place illness and treatment at the heart of the narrative and make it the main storyline, and the relatively minor textual illnesses, when a secondary character falls ill or is said, without fanfare, to be sickly. While Moss seeks primarily to argue how morbid Quebec’s novels are, she also tackles the more important question of why texts suddenly turned to the medical storyline. Her main hypothesis concerns the larger literary context, specifically social realism. It is only as Moss concludes her essay that she introduces the second of her hypotheses: that the rampant “pathological imagery” is metaphorical (1984b, 152). This theory makes the increased number of sick characters throughout the mid-century decades (which she tellingly contrasts to the hardy and healthy figures who populated earlier French Canadian literature) an expression of a greater self-awareness among the Québécois of their own subaltern position. This emerging postcolonial Québécois society becomes an etiological factor in the novels’ new thematic preoccupation. Since Moss does not indicate that her hypotheses are mutually exclusive, one is



The Nation as Body 39

led to believe that the Québécois were in fact a sickly lot and were equally recognizant of their precarious collective health as a symbol of their postcolonial status. It is nevertheless in seeking to explain how Quebec’s literary texts came to tropes of illness in great numbers that Moss intimates that it is not simply the characters in the novels that are sick, but Quebec’s literature as a whole that constitutes a diseased corpus. Drawing on English Canadian novelist and literary critic Margaret Atwood’s (1972) unapologetic position that Canadian literature (in both English and French) has adopted a propensity toward victimhood, Moss construes the plethora of literary illnesses and pathetic characters as indicative of an obsession “with the theme of failure” and a conditioning “by the myth that Canadian heroes are victims and losers” (1984b, 165).25 Acting Québécois, when so many of the texts that constitute the national pedagogy are marked by pathology, accordingly requires the adoption of a “sick” or patient-centred outlook with regard to the nation. Consequently, Moss appears unassumingly to anticipate Jameson’s argument that postcolonial literatures are prone to using allegorical pathology to express their subaltern condition. Quebec’s mid-century narratives of illness-related suffering are accordingly part of a larger trend that links the memory of shared trials and defeat to nationhood: “En fait de souvenirs nationaux, les deuils valent mieux que les triomphes, car ils imposent des devoirs, ils commandent l’effort en commun” (Renan [1882] 1996, 241) [Where national memories are concerned, grief is of more value than triumph, for it imposes duties, and requires a common effort]. Proclaiming national failures the most important ingredient in the glue that holds nations together makes the instances of national mourning and suffering, of having been the underdog, of having been made the victim, central to the national paradigm.26 The pity, guilt, and blame that so often go hand in hand with these situations of collective loss or failure (like they do for disease) thus not only become a part of the nation, but are enshrined as fundamental to it. The centrality of the victim mentality that Moss points to as characteristic of Quebec’s national paradigm establishes a paradoxical state of national normalcy predicated upon disease. Quebec’s balancing act between vital and sick writing is evident in many texts beyond explicitly medical novels. Garneau’s nationaffirming (if not -founding) history continually reminds readers

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that the national history that it both records and creates is that of a people accused of being devoid of history. In a modern context, François Paré’s theorizing of French Canadian literature has led him to declare that so-called small nations (cultures faced with assimilation), produce inherently survival-oriented political texts. These texts in turn become the means for the national existence: “Et puis, les œuvres, à tout moment de l’histoire ont été appelées à soutenir la survie collective ou l’indépendance politique proprement dite des nations. En fait, plus le groupe est étroit, peut-on affirmer, plus le rôle de l’écrivain est ouvertement politique” (2001, 50) [Moreover, these works, throughout history, have been called upon to support the collective survival or the very political independence of nations. In fact one can say that the smaller the group, the more overtly political the writer’s role]. Paré contends that the very act of writing and publishing in the language of the threatened or marginal nation continually reaffirms its presence, lending legitimacy to its continued existence. Yet as his later work (specifically La distance habitée) would elaborate, the survival mentality and the threat to that continued existence become embedded traits of small national literatures: “C’est dans cette même langue menacée de disparaître que se construit par ailleurs l’identité” (2003, 28) [It is moreover through this same language, which is threatened with disappearance, that identity is constructed]. The political nature of these national literatures, therefore, persistently asserts the nation’s vitality even when the content of this writing underlines the precariousness of the national paradigm. The narratives, by their mere existence, continually show the signs of contradiction, revealing both their salutary and pathological effects on the national paradigm. Since nations are posited by more than just the texts that directly address questions of nationhood and national survival, Quebec’s numerous illness narratives fulfill much the same role as Garneau’s and Paré’s works or overtly political writings insofar as the novels that contain allegories of illness also posit the national paradigm. Even these fictional medical allegories mark the national paradigm with the contradiction that for a nation (a postcolonial one in particular) to assert and perform its own survival, it must also be “sick” in one way or another. The sheer number of illness narratives consequently demonstrates the nation’s strength, for, as Paré contends, national vitality can be gauged by literary production. The flip side of the illness narrative’s success (both in positing the national paradigm and as literary



The Nation as Body 41

sub-genre), however, is the implication – the one underpinning Moss’s (1984b) and Atwood’s (1972) studies – that French Canadians are a sick, weak, and dying people. As outlined in the Introduction, there is peril in articulating the national paradigm via medico-national allegories. The morbidity of Québécois texts threatens to create a sense of fatalistic nationhood that tips the balance of sickness and vitality too far toward feebleness. If this internalized sense of inferiority expresses itself in further tropes of pathology, Quebec finds itself in the continual double bind whereby the more it seeks to escape the limits imposed by pathological discourse, the more it risks sickening. The national paradigm therefore risks being weakened by the very means by which it asserts its vitality.

Diagnosis Unlike the diseases featured in the medical storylines, the ills that operate at the narrative and textual levels in illness narratives, those that impede or complicate the one-to-one equivalency of body to nation, cannot be discerned with empirical tests or scans. The medical theme of the narratives nevertheless reveals the problem by providing a means of diagnosing it. Just as norms and ideals serve as the basis for identifying variations from them that can be regarded as symptoms of a disease, medical processes and practices (the use of medical jargon, the diagnostic exercise, doctor-patient interactions, the imputed causal link between treatment and recovery) function as norms and ideals from which deviations can be identified. When these deviations present themselves, they too can be considered symptoms of a sick narrative. To read in a way that is attuned to these aberrations from the clinical norms that are assumed to underpin the medical and by extension the medico-national is to read diagnostically. The idea of reading diagnostically is embedded in both language studies and medicine. Eugen Baer (1988) notes that during Hippocrates’ time, symptomatology (or the study of symptoms, which now typically falls under the category of diagnostic medicine) was simply called semiotics. It was thought that disease was an idea that found its expression in symptoms, which were its outward manifestations. These medical signs in turn allowed doctors to detect and understand – diagnose – the disease. Rita Charon’s notion of narrative medicine, which calls on physicians to be “dutiful and skillful

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reader[s]” (2006, 54) to better help their patients and advocates training in literary and narrative theory for medical practitioners, is but a modern iteration of a very old idea. In medical theory, disease is said to issue from a linguistic process, diagnosis, which converts basic sickness or illness into a medically recognized and culturally salient disease.27 Theorist and psychiatrist Arthur Kleinman elucidates: “Disease is what the practitioner creates in the recasting of illness in terms of theories of disorder” (1988, 5). Michel Foucault, for his part, stresses the linguistic nature of medicine and argues in The Birth of the Clinic that modern medicine hinges on the physician’s mastery of two professional practices: the medical gaze and clinical language. Subjected to the exercise of these two skills, the patient’s signs and symptoms become a distinct disease, for “to be seen and to be spoken immediately communicate in the manifest truth of the disease” ([1963] 2003, 116). While diagnosis depends on the intertwined practices of seeing and saying, Foucault emphasizes the discursive function of medical jargon because this particular language structures the specialized mode of seeing. Language, and specifically reading, consequently becomes the way in which those who have the power to both read and produce the medical “text” posit disease. In many ways, the linguistic or discursive process that allows symptoms to be read and understood as diseases parallels the textual nature of the nation. Both the medical and national discourses centre on transforming things that escape rigid definition (the experience of feeling ill or a heterogeneous group of people) into clearly defined entities (a disease or a nation) by framing them as such. To borrow terminology from Ian Hacking, this discursive work takes an entity that exists “in the world” and supplements its existence with “ideas” about its condition as an “object” (1999, 121–2). It is nonetheless when these objects are reinforced, and even overtaken, by ideas  – notions rooted in particular cultures, traditions, and practices – that nations and diseases take on inflections that unsettle the rhetorical similarity between them. In the Québécois context, where diseases and the national paradigm have been so consistently linked, certain ideas about both the medical and the national aspects of the allegory have become commonplace. One such notion, that illness affects only the weak, is revealed in Moss’s explanation of the prevalence of disease in Quebec’s literature: “Taken at face value, illness impedes happiness



The Nation as Body 43

and threatens life. Taken in a larger sense, illness carries a moral implication, for surely something is wrong with a society that allows itself to be weakened by congenital, environmental, and psychological diseases … [The sick characters] abandon themselves to higher (or lower) forces and assume the role of sick people” (1984b, 164; my ellipsis). Moss’s accusation that illness “carries a moral implication” and that there is “something wrong” with Quebec because it produces so many texts about disease stigmatizes sickness. Related to this contention is the more general but no less problematic notion that illness does not occur without reason.28 Ben-Zion Shek (1977) dispenses with the myriad illnesses (leukemia, tuberculosis, anemia) in Gabrielle Roy’s Bonheur d’occasion in a short paragraph that attributes all disease to the lack of proper food and insalubrious homes that could be characteristic of life for the working poor in Montreal at the time of the novel. Given the well-documented intersections between class and the incidence of disease, his explanation is valid. Yet it also seems simplistic, particularly in light of the symbolic value of so many of these diseases, to account for them merely as effets de réel. Shek himself undermines his realism hypothesis during his discussion of alcoholism. Although alcoholism is a frequent problem in French Canadian novels and he calls it a condition that “is often an indicator of depressed living conditions,” he backtracks immediately by conceding that “it is harder to draw a line linking data on alcoholism and related problems to specific districts in Mont­real, or to concrete living conditions” (1977, 39–40). If some conditions can be accounted for by realism but others escape attribution, it becomes near impossible to uphold the idea of blanket historical cause and literary effect. The critics who consider Quebec’s illness narratives also tend to condense the medical narrative to the disease itself, as though the name of the disease were all-encompassing of the phenomenological illness experience. To focus exclusively on this most obvious facet of the illness narrative, the diagnosis, results in a medico-national reading that is, at best, partial, for the allegory anchored in the illness narrative (as opposed to the simple named disease) is the result of an increasingly complex understanding of the nation. What is needed, therefore, is a way of reading that circumscribes presumptions about the nation’s health, as expressed though its national literature, and that more closely examines and considers the multitude of signs implicated in the medico-national allegory. This

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kind of reading might be considered diagnostic in that it focuses on the complications or aberrations, what one might call the symptoms, in the imputed equivalency of (sick) bodies and (sick) nations. On a textual level, diagnostic reading entails paying attention to the lesser-examined aspects of the illness narrative, such as the impact of the disease on relationships, the material condition of life, representations of illness within the text, and doctor-patient interactions. These key elements force readers to look beyond the body and the named disease to consider the ways in which the narratives deviate from conventions of medical practice and understandings of Quebec as a nation. They also call into question the very metaphorical underpinning of the embodied nation. Via this kind of reading fundamental difficulties that trouble the medico-national relationship present themselves. For example, the esoteric nature of medical language and its link to diagnostic accuracy contrasts with the popular reach of national languages. The concentrated authority of the medical clinic that invests doctors with the power to pronounce people healthy or sick likewise distinguishes itself from the much more diffuse nature of national authority exercised by policy-makers and influential leaders. The disparities between medicine and the nation and their constitutive authorities (doctors on the one hand, national leaders on the other) suggest that like the limits of Haraway’s (1976) scientific metaphors, the medico-national allegory exhibits similar constraints on its ability to posit the national via the medical. These irregularities, expressed in the allegorical text and through its narrative, act as symptoms of a kind of textual illness. They create what Paul de Man has termed allegories of reading, for they undermine the relation of sick bodies to sick nations, turning the unconventional medical story into a national “allegorical narrative of its own deconstruction” (1979, 72). It is the illness narratives or medico-national allegories themselves, not the characters represented therein, that reflect the aberrance or distance from presumed norms that are characteristic of our understanding of illness. While casting these allegories of reading as symptoms may suggest a form of textual sickness within the Québécois tradition of illness narratives, it is worth remembering that confronting the limits of medicalized literary discourse’s ability to articulate and shape the nation does not negate its influence. Jameson maintains that allegory is at heart a genre filled with contradiction but that the genre



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has merely come, through stereotypical personifications and Western insistences on equivalences, to be seen as one-dimensional. “The allegorical spirit,” he corrects, “is profoundly discontinuous, a matter of breaks and heterogeneities” (1986, 73). The medico-national allegory, textually “sick” though it might be, must therefore be thought of as a narrative that simultaneously posits the national paradigm as it eschews or undermines its own structuring metaphor. The normalcy of allegorical contradiction notwithstanding, critics tend to ignore the textual symptoms that paradoxically point to national vitality or health through their undermining of the “sicknation” readings that have dominated the critical tradition. On a structural level, allegories are extended tropes, presumably with many points of accord. The potential to marginalize the discord between the literal and the figurative is therefore significantly greater than with metaphors. This is to say that when the majority of the points between the actual narrative of sickness and the familiar “sick nation” story line up, there is a tendency to overlook those that do not coincide with the narrative that is otherwise recognizable and cohesive. Carolyn Van Dyke characterizes this inclination away from a full examination of the allegory as “seductive,” for allegory all too often “offers confirmation of our unquestioned assumptions” (1985, 69). She explains that the differences or contradictions that underpin allegory (like any other trope) can serve as commentary on or critique of a situation of presumed similarity. Yet in the case of familiar allegories, such as those revolving around the body and nation, the similarities may actually reinforce for readers the very ideas that the allegory seeks to evaluate and question via discordances. With Quebec’s medico-national narratives, the tendency, whether etiologically sound or not, has been to presume that disease is a sign, a symptom, of some known national problem. Most critical readings of illness narratives, by not questioning the causal relationship between national problems and their metaphorical literary expression, reinforce the association of bodily ailments with social, economic, or other problems on a national scale. Such a gambit nevertheless works counter to the diagnostic process (in both its conventional medical sense and as a mode of reading), for it seeks not to infer the less apparent disease from the obvious symptoms, but rather to make the story’s symptoms fit the known (or at least presumed) national disease. Van Dyke argues that when allegory is seen as “a disposable fictional covering,” as it tends to be in these instances,

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“what lies under it must,” according to such logic, “be something that we assume to be real – that is, fundamental, non-problematic, and irreducible. The search for such a hidden reality can distort a narrative to buttress a culture’s preoccupations” (1985, 69). In Quebec, critics have taken the “covering” of the sick character or the assertion of social problems in medical terms to be an authoritative expression of the nation’s sickness. The difficulty of accepting such a stance, however, is that the nation’s sickness is simply assumed to be a fact that authors have gone to some effort to conceal behind characters who are representative of the nation. To seek in medico-national allegory a mere substantiation of an assumed diagnosis negates the very complexity that “necessitated” the original shift to thinking in terms of national paradigms and allegories as opposed to simple nations and metaphors. To equate the sick character to the sick nation, like the nation to the body before it, ignores the pluralities and contradictions of national and allegorical forms. To gloss over these intricacies, whether national or medical, in favour of the known, prosaic narrative disregards what is intrinsically part of the text and thus part of the allegory itself. The inconsistencies of the medico-national allegory must therefore be refigured, as both Jameson and De Man suggest, as integral parts of the narrative. Diagnostic reading affords a re-examination of the assumption that Quebec is fundamentally ill. While the portrayals of historical conditions in the illness narratives and the circumstances decried in political texts may be accurate, all representations, like all readings, are necessarily selective. Historians have successfully done away with historiographical sacred cows by shifting their focus to the “blips” in the larger historical narrative. By focusing on these previously overlooked events and trends, historians moved their inquiries to those points of discord in the larger narrative that earlier historians had relegated to footnotes or altogether ignored. To read illness narratives diagnostically will occasion a similar change. The readings that follow in this volume will not only reconsider the health of the national paradigm by working within the presumption that the nation is personified by the sick character, but will also reexamine the very process by which illness narratives and the criticism they occasion enshrine a paradigm that models itself on a sick body. The focus will shift to those aspects of the narrative, taking into account both the text and the story, which might trouble the



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easy and repeated diagnosis of Quebec’s sickness. To problematize the narratives and the way in which they have been read undermines the dichotomy of sickness and health that has proved both foundational and problematic for understanding Quebec’s relationship to the medical trope. By recognizing the medico-national allegory as an allegory of reading, illness narratives  – taken as more than just the sick character and his or her disease – can be reimagined as diagnostic tools for examining the process of positing the national paradigm via the medical storyline. The medico-national allegory consequently substitutes one object of diagnosis for another. It locates the object of diagnosis outside the story that constitutes the allegory but within the narrative itself; it accordingly becomes possible to move beyond the idea of the sick nation. To do so nevertheless requires the reader to acknowledge that the nation’s enactment through discourse is not itself free of signs of abnormality. In recognizing the very contradictions that are inherent to allegory, these texts have the potential to be critiques of what has become Quebec’s myth of sick nationhood rather than as confirmations of the assumptions underpinning this myth. It is thus that the reader is no longer merely called upon to confirm a national diagnosis. As a diagnostic reader, he or she must also be prepared to recognize the signs of “sickness” within the allegory and to question whether the nation posited is as ill as it originally seems.

2 Diagnostic Allegories

Diagnosis, the process of positing illness as recognized disease, is central to the ideals of scientific medicine and distinguishes medical science from the processes of trial and error or treating symptoms as opposed to the cause of sickness. It is the privileged clinical act that transforms illness into disease, makes scientific treatment possible, and reinforces the physician’s role as expert over the patient and his or her body. This clinical act also parallels the process of positing the national paradigm, for both processes depend on referencing and creating a discursive entity. Illness narratives that highlight the diagnostic process are therefore key texts for examining how Quebec articulates its nationhood. Rather than being simple “uncoverings” of medical truths, however, the scenes of diagnosis in Quebec’s illness narratives are often fraught with complications. In focusing on instances in which disease is discursively created, the narratives at once allow for a staging of medical authority and a re-examination of the diagnostic process. By highlighting cases where the diagnosis is incomplete, contradictory, or contested, these narratives reveal how the presumed monolith of the clinic exposes the cracks in its own authority. These illness narratives consequently call for a discussion of the nation and its alleged ills that does not proceed teleologically from symptoms to definitive diagnosis. Insofar as these diagnostic narratives unsettle a fundamental process carried out on the medicalized body they also jeopardize the semantic correspondence between the sick body and the ailing nation; when these narratives cannot posit disease in a meaningful way and the bodies of sick characters fail to be recognized as legitimately diseased, the nation cannot so easily be regarded as sick in its own right.



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Whereas many of the literary texts that appeared in later years emphasized treatment or accepting disease as a part of normal life, those from the 1940s and ’50s privileged diagnosis as an act, and to a lesser extent as a product of this same process. In Bonheur d’occasion ([1945] 1993) by Gabrielle Roy, the small medical storyline centres on two main issues: the metaphorically loaded diagnosis of leukemia and the problems posed when the diagnosis cannot be meaningfully communicated outside of the closed clinical circle. Together, these issues draw attention to the double marginalization, linguistic and medical, of French Canadians in the 1930s and 1940s. Furthermore, Roy’s debut novel questions whether a medical narrative can exclude its patient-protagonists from the national paradigm it constructs via the narration of their disease. Alexandre Chenevert ([1954] 1995), Roy’s third novel, foregrounds diagnosis and prompts readers to reconsider the social priority accorded to disease as a medically sanctioned entity when a physician fails to diagnose the title character’s cancer. In contrasting the social and scientific aspects of illness and disease, the novel exposes the limits of medicine’s discursive function vis-à-vis the nation. Finally, André Langevin’s Poussière sur la ville (1953) takes diagnostic competence and medical authority as presumed points of departure only to deliberately reject and undermine them and, by extension, Quebec’s national authorities. Together these novels attest to the fact that Quebec’s illness narratives seldom operate in a clinically normative manner. By consequence, readers should not unquestioningly accept the diagnoses brought to bear on the nation. As alluded to in chapter 1, successful diagnostic reading, like accurate medical diagnosis, entails knowing the signs to which one ought to be attentive. It is therefore imperative to recognize the aspects of the diagnostic narratives that determine the relative success or failure of medico-national allegories. The first of these factors is medical authority, which is a precondition for doctors to frame illness as a recognized and accepted disease. As Foucault repeatedly asserts, physicians hold the exclusive power to see disease and to speak it into existence through diagnosis.1 The authority that accrues to physicians via their ability to diagnose means that the doctors within illness narratives are figures of power in the texts. National paradigms, however, issue from a much more diffuse discursive process, in that no one group in the nation is likely to posit a paradigm that is both exemplary and communal. Even so-called national

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authorities, such as the ones who wielded tremendous influence in nineteenth- and early twentieth-century Quebec, are much less central to the national paradigm than doctors are to medicine and its key construct, the disease. To even speak of a national paradigm is to recognize that mass participation is an inherent part of the process by which it comes into existence. It is for this reason that Anderson (1991) locates the threshold for nation formation at the point at which large segments of the population acquire the means, notably literacy, to conceive of themselves as an imagined community. The ill-defined (or altogether absent) role of individual actors in most theories of nationhood attests to the inherently limited function of national authorities.2 The medico-national allegory therefore has to grapple with articulating a national paradigm via a medical narrative, but must do so in a way that circumscribes medicine’s authoritarian structure. In a less theoretical vein, it is worth noting that institutional medical authority in Quebec was in a period of transition, notably of official consolidation and popular recognition, during the time in which the three diagnostic narratives were being published. Denyse Baillargeon’s (2009) research on the medicalization of motherhood makes the point that by the 1960s doctors had elbowed aside professional midwives to become obligatory sources of prenatal care. Folk healers and other alternative practitioners were also gradually excluded from the circles of medical authority, as hospitals became the locations of care. Clinical advances made doctors “lifesavers” instead of professionals who charged too much for their often-ineffective services. At the same time, members of the public, informed by medical opinions disseminated via popular literature (newspaper and magazine articles, advertisements, pamphlets, and books) on proper hygiene as well as nutrition and public health campaigns, were taking a keener interest in the day-to-day issues of health and wellness. As a result, they accumulated for themselves stores of medical knowledge previously reserved for physicians and nurses. Quebec’s diagnostic narratives highlight these transitions and shifts with regard to medical knowledge and authority by showing how they were both being concentrated and dispersed. A second factor to consider, one related to medical authority, is the importance of clinical language. Unlike other specialized languages or quasi-secret codes, which are often devised merely to exclude the uninitiated, medical jargon exists primarily for reasons of precision.



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The phenomena of pathology and the parts of the body on which they are expressed are, in clinical language, each designated by a specific term. Modern physicians depend on medical language for its specificity in referring to both anatomy and pathological phenomena. The specific situation of medicine and its language stands in contrast to the linguistic basis of the national paradigm. While language is essential to the process of enacting the national paradigm, Anderson (1991) makes it clear that the particular national language (French, Farsi, Japanese, etc.) is immaterial. The essential feature is that it be shared among a broad enough group that national narratives can be accessible to the majority, if not a sizable minority. This distinction separates national languages, which are unrestricted codes, from clinical language, which is an idiom that is both limited by professional training and which coincides with an ability to see and give meaning to what others cannot. When non-medical texts, such as novels, employ the abstruse language of the clinic, this language – the very one positing the nation via allegory – may actually prevent the allegory from being understood by readers unfamiliar with medical jargon. This breakdown in allegorical resonance consequently, if ironically, impedes the full articulation of the national paradigm because, as Anderson stresses, the nation is created by shared discourse.3 Accordingly, the allegory as a whole may be comprehensible to non-medical readers, but some of the salient medical aspects thereof may not be. As a result, positing the nation via a medicalized allegory may, on the one hand, produce a paradigm that is largely inaccessible, or on the other, simply fail to produce a paradigm that can be communal. Since the positivist revolution in Western thought, medical discourse, argues Foucault ([1963] 2003), has been perceived as a more exact means of representing the scientific “realities” of the body. These new “truths” can be isolated from the variable and subjective individuals whose bodies manifest the disease from the clinical entity of disease itself. It is precisely because clinical language seeks to avoid having to talk about people that patients, excluded from conversations and decisions about their bodies, are often frustrated by this impenetrable and incomprehensible jargon. In allowing clinicians to talk about conditions and body parts rather than about patients, medical language reduces the patient from a subject in a medical dialogue to an object (or a collection of objects: a liver, a heart, a pancreas) of the physician’s probing gaze and speech. Alienated from

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his or her body as the locus of meaning for the medico-national allegory, the sick character and his or her allegorical importance as the emblem of the national paradigm comes into question. The third aspect of concern for diagnostic narratives is the matter of what becomes of the diagnosis once issued. In a context where modern readers and critics are not only attuned to the metaphorical significance of certain diseases, but are themselves instrumental in the continual process of shaping the nation in the light of these diagnoses, the names given to collections of symptoms matter. Certain diagnoses, the plague for instance, evoke fear and panic; others, such as cancer, may suggest resignation and fatalism; still others, the common cold, can be dismissed as relatively inconsequential. The connotations that diagnoses acquire come largely from what is taken to be common knowledge about diseases. This general knowledge not only adds itself to the medical information about a given condition, but also frequently substitutes for it. Because of this popular appropriation of medicine, Western tradition is full of medical myths about unlikely etiologies and questionable cures. Readings of Quebec’s illness narratives and pronouncements about the health of the national paradigm ought to consider, therefore, not just the official diagnosis, but also the inflections that this diagnosis takes on in both the social and historical contexts of the text and in light of the reader’s own situation.

Loaded Diagnoses, Empty Diagnoses Set during the transition from the Great Depression to the Second World War, Gabrielle Roy’s Bonheur d’occasion ([1945] 1993) is acclaimed as one of the foundational texts of modern Québécois literature. The emotional yet gritty tale, one of the first and the most successful of the social realist novels, draws attention to the plight of the new urban poor crowded into Quebec’s cities and highlights the nationalist tensions surrounding participation in the Second World War.4 Questions of class solidarity and competing national allegiances are embodied by leukemia-stricken six-year-old Daniel Lacasse. His frail body becomes the locus of an allegorical struggle between Anglo-Canadian medical personnel and a French Canadian family as both seek to define and make sense of the youngster’s disease. The connotations of his sickness reinforce the tendency to view the illness narrative as a pathologized linguistic, and therefore



Diagnostic Allegories 53

national, divide, but the medico-national allegory as diagnosis of the nation is undercut by the very linguistic difference at the core of the national paradigm. The diagnosis, integral to one part of the national allegory, winds up semiotically nullifying the allegory because it evacuates the diagnosis of meaning. Throughout the novel, Daniel is described as an unhealthy boy who is thin, pale, feverish, and who coughs a great deal. For the most part, though, he is an unremarkable part of the story, just another mouth to feed in a home where food, money, and parental attention are spread too thinly. Indeed, in the countless pages of literary criticism dedicated to Roy’s debut novel, Daniel’s sickness scarcely elicits much more than a sentence worth of commentary in any one study.5 At the most basic level, his role is that of the tragic victim, an illustration of his family’s poverty. Once removed from his home and his mother’s care, he is taken to an essentially foreign milieu by people who do not speak French and who are not Catholic. He remains there until he eventually succumbs to his disease. The alienation occasioned by his illness is, however, far from just anecdotal or superficial. The gravity of Daniel’s condition leaves little choice but for him to be cared for, albeit as a charity case, at one of the better hospitals in Montreal. This hospital happens to be in a much more prosperous, and traditionally anglophone, part of the city. The language of communication there is English, which shuts out Rose-Anna, Daniel’s mother, who speaks only French, from the explanations and directions that are meant to inform her of her son’s condition. Even simple instructions from the nurse like “He’s getting tired. Maybe, tomorrow, you can stay longer” provoke only shame for Rose-Anna (236, original emphasis).6 She worries that her son’s linguistic isolation will somehow negatively affect him or his care: Elle était prise de cette crainte horrible que son enfant fût incapable de se faire comprendre. Et puis, à son insu, un autre sentiment se glissait en elle avec le froid de l’acier. – Elle parle rien qu’en anglais? demanda-t-elle avec un léger accent d’intimité. Quand t’as besoin de quelque chose, es-tu capable de le demander? – Oui, dit Daniel simplement. – Mais il n’y a pas d’autres enfants qui parlent français ici? – Oui, le petit bébé là …

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– Il est trop petit pour parler. T’as personne à qui parler? – Oui, Jenny. – Mais si elle te comprend pas? – Elle me comprend. (232; my ellipsis) [She had a fear that her child couldn’t make himself understood in this place. And another sentiment made itself felt, as cold as steel. “Does she only speak English?” she asked, with a touch of unfriendliness. “When you need something, can you ask her for it?” “Yes,” said Daniel. “But aren’t there any other children here that speak French?” “Sure, that baby.” … “He’s too small to talk. You’ve got nobody to talk to?” “Yes, Jenny.” “And what if she doesn’t understand you?” “She understands.”] (Roy 1989, 223–4; my ellipsis) Alarmed that her son may be unable to communicate with the staff, Rose-Anna is distressed, for the talkative boy who had always clung needily to her apron strings now answered her in muted, and perfunctory responses. The lack of communication in French is therefore coupled with anxiety about her son’s apparent withdrawal from normal communication.7 It is perhaps for this reason that Rose-Anna shifts her questioning away from Daniel’s exchanges with Jenny, his nurse, to his conversations of a more social nature. Her insistence that Daniel have a community and not just caregivers confirms that French is not simply a language of purposeful communication, but that it is a means of maintaining vital ties to the francophone community that cannot be eclipsed in the anglophone environment. In order to maintain these precious and nationally significant links, Daniel must therefore form bonds with other deterritorialized children, much as expatriates will seek each other out when abroad.8 The salience of the francophone community is clear, but only becomes so once it is so threatened that it is effectively absent. In the first of such instances, Daniel finds himself losing his ability to write, spell, and even remember French words. Playing with some lettered cards in his hospital bed, the boy proudly demonstrates to his mother that he has spelled Jenny’s name, a name that is markedly anglophone and that he was unlikely to have encountered before meeting his newly beloved caregiver. Distraught because she has sensed herself replaced as a mother figure by a member of the staff, Rose-Anna asks her son:



Diagnostic Allegories 55

– Es-tu capable d’écrire autre chose? … – Oui, dit-il gentiment, je vais écrire ton nom. Au bout de quelque temps, elle vit entre les plis du drap quatre lettres qui formaient “Mama.” Elle voulut l’aider à compléter le mot. (235, my ellipsis) [“Can you write anything else?” “Sure,” he said kindly. “I’m going to write your name.” A little later she saw in the folds of the sheet five letters which made “Mamma.” She wanted to help him finish the word.] (Roy 1989, 226–7) Daniel proves unable to spell the word that would prove to his mother that she had not been entirely forgotten. Powerless to complete the word “maman” by adding the “n,” Daniel spells the English equivalent and accordingly shows himself to be disconnected from both his mother and his mother tongue. These kinds of difficulties with writing are a common theme in Roy’s works and, despite their apparent triviality, signal a “deep inner conflict, a tragic division within the self” (Schonberger 1989, 130). This linguistic and familial estrangement is echoed by an alienation from religion, which operates via the same forgetting of key words, notably daily prayers. When Daniel’s pious older sister Yvonne comes to visit him in the hospital, she asks if he remembers his prayers. Daniel, who has been isolated not only from his language, but also from the daily rituals of his Catholic faith in the Protestant hospital, replies “Non, je me souviens plus … Il y a rien que le Notre Père” (373; original ellipsis) [“Nothing but Our Father … ”] (Roy 1989, 355; original ellipsis).9 For French Canadians who had based much of the content of their national paradigm on Catholicism, forgetting one’s prayers constitutes an enormous loss of cultural capital. Moreover, Daniel forgot the one prayer – the Hail Mary – that readily differentiates Catholics from Protestants. The Hail Mary being the prayer used to seek the intercession of the Holy Mother, forgetting this particular prayer doubles Daniel’s earlier forgetting of his mother’s “name” and losing his grip on the language used to express it. Religion therefore mirrors the linguistic connotations of the hospital, and in so doing raises the spectre of the cultural subtexts insofar as they define a French Canadian national paradigm centred on language and religion.10 The importance of being francophone and Catholic is, in fact, never so present in the novel as it is when Daniel’s disease forces him to be hospitalized, precipitating the disintegration of these two facets of his identity. Frenchness and Catholicism

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accordingly come, albeit through their absence in one sick boy, to define the healthy French Canadian. The erosion of these fundamental aspects of what it means to be French Canadian is arguably taken up in the diagnosis of leukemia. Even for those readers who do not know that leukemia is a cancer of the blood, the text’s reference to red and white blood cells being out of balance points to the nature of the disease. Given the rhetorical significance of blood as a common trope for both the family and the nation, leukemia becomes a corruption of and a threat to both Daniel’s family and the national paradigm he embodies. On the level of family, Daniel’s hospitalization and eventual death, like the departure of his brother and father for the army, his sister Florentine’s hurried marriage, and Yvonne’s anticipated retreat to the convent, disturbs the unity of the Lacasse home. On a much more literal level, Daniel’s ties to his family and bloodline are altered by the blood transfusions he receives in hospital. The Lacasse blood, which became dangerous and cancer riddled, is replaced by healthy blood. Although these transfusions are meant to cure him, they also dilute his previously unadulterated blood. The familial assumes national connotations when the blood that is passed from francophone parents to francophone child at birth is mixed with blood that comes only as a result of contact with anglophones in their hospital. That Daniel eventually succumbs to his disease paints, for those who would read the illness narrative as uncomplicated national allegory, a rather grim picture of the future of the nation; a sick francophone boy must be removed to an anglophone environment so that he may be made more anglophone before eventually dying. He becomes, in the words of Marie-Pierre Andron, “un corps problématique qu’il conviendra de minimiser ou de faire disparaître” (2002, 10) [A problematic body that should be minimized or made to disappear]. As Daniel’s body and even his memory vanish from the narrative (his mother at one point exclaiming her own shock at having improbably forgotten about her hospitalized child) he becomes the embodied worst-case scenario of traditional French Canadian nationalists. Yet when one reads between Rose-Anna’s fears and the overdetermined nature of leukemia as signifier, one nonetheless finds the possibility of a national paradigm that complicates interpretations of the text as an allegory of national contamination and immunological collapse. Daniel’s cancer, despite its medical and national consequences, still allows him a measure of independence from his mother and an



Diagnostic Allegories 57

awakening to the larger “world” of Montreal beyond his Saint-Henri neighbourhood. These eye-opening experiences are the by-products of the anglophone medical environment and occur because and not in spite of his cancer. They also allow Rose-Anna to see anglophone Montreal as something else than the other solitude: “Il [Daniel] avait un léger mouvement d’impatience. Et ses yeux cherchaient le sourire de Jenny au fond de la salle. Elle était quelque chose de merveilleux et de tendre qui était entré dans sa vie, et ils se comprendraient toujours même s’ils ne parlaient pas la même langue” (232–3) [“He [Daniel] was getting just a shade impatient. His eyes sought Jenny’s smile at the other end of the ward. She was something wonderful and gentle that had come into his life, and they’d always understand each other, language or no language”] (Roy 1989, 224). The use of wonderful and gentle to describe the nurse who had come into Daniel’s life extols the value of the cross-linguistic bond that was a comfort to the dying boy. Admittedly, Rose-Anna’s earlier dismay situates these moderating comments within an overall context of unease, but the subsequent statement belies a certain acceptance of the fact that, despite their differences, Daniel and Jenny share a bond that bridges the national divide. Indeed, Rose-Anna’s caution with regard to the whole language issue seems to stem not from nationalist apprehension, but rather from envy of her son’s affection for his new caregiver, the same one who spoke to her only in English and only then to ask her to leave. Leukemia can therefore be read as both tragedy and opportunity. Just as the chemotherapy now used to treat the disease is a poison that can bring about cure, cancer complicates and enriches French Canadian identity. Insofar as Roy’s story gives a partially salutary valence to Daniel’s cancer, she frames his leukemia in much the same way that Derrida describes the pharmakon in “Plato’s Pharmacy,” that which is both poison and remedy. Roy thus “interrupt[s] the relations interwoven among different functions of the same word in different places” (Derrida [1968] 1981, 98) because she turns a child’s culturally loaded diagnosis into a palliative, not just for Daniel, but for his mother as well. The child’s illness experience might then signal a new way of thinking about the nation, for disease, even one as connotation-rich as leukemia, becomes an ambiguous signifier. The communal and the more narrowly familial can now (at least in theory) include the difference that it had previously perceived as a threat. For as symbolically pertinent as the product of diagnosis, leukemia, is, it is the process of diagnosis that most imperils readings of the

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nation as terminally stricken. By placing the diagnosis, which can be read as metaphor, in tension with the illness narrative and mediconational allegory it creates, Roy makes a crucial move by questioning the primacy of diagnosis. The diagnosis of leukemia, central to casting the national paradigm in a morbid light, issues from within an Anglo-Protestant medical institution. This means that, like the nurse’s instructions to Rose-Anna, the diagnosis is communicated to her only in English. For the unilingual, francophone Rose-Anna, the character whom the narration follows most closely, the foreignness of the environment, when coupled with the distance that the clinical code imposes, isolates her from her son and compounds the effects of this national sickness. This is because the most salient facts of Daniel’s illness narrative, those on which the sick national paradigm rests, are inaccessible to her. From the story’s outset, the medical discourse that casts Daniel as sick is inextricable from the English language and Montreal’s AngloProtestant culture. The symptoms of leukemia, for instance, are first mentioned to the reader only once Rose-Anna is trudging up Mount Royal to the hospital. It is only once Daniel has been admitted and that his mother is coming to see her hospitalized son that readers are informed that she noticed “de grandes taches violettes sur ses membres” (226) [“Large violet patches on his arms and legs”] (Roy 1989, 217) and was sufficiently alarmed to seek out medical care. In this way, the first disquieting symptom is already situated within the realm of the medical and the anglophone, to the extent that even the seeking of care is circumscribed by the positioning of this information within the clinically and culturally dominated outcome of the trip to the hospital. Rose-Anna’s appreciation of and control over what is happening to her son is also constrained by the doubly foreign language of the anglophone medical environment: “dans sa répugnance à s’en aller, il y avait tout l’effort qu’elle mettait à se souvenir de quelques mots d’anglais. Elle cherchait à s’informer du traitement que subissait Daniel. Elle aurait voulu décrire le caractère de l’enfant afin que la jeune infirmière sût l’aider du mieux possible au moins puisqu’elle devait le lui abandonner. Mais plus elle y pensait, plus une explication de ce genre lui paraissait difficile” (236) [“hating to leave, she stopped, trying desperately to remember a few words of English. She wanted to know what treatment Daniel was getting. She would have



Diagnostic Allegories 59

liked to describe his character so that the young nurse could care for him as well as possible, seeing that she herself had to abandon him. But the more she thought, the more she realized that she was incapable of such an explanation”] (Roy 1989, 227). Lacking the means either to ask questions or to contribute information, Rose-Anna is relegated to observing. Moreover, while English is not as fundamentally esoteric a language as medical discourse, Rose-Anna’s monolingualism proves just as significant a barrier to her participation in her son’s care as her being uninitiated to the clinical code. While national alienation hangs heavy over Daniel’s illness narrative because of his diagnosis, most of the story of his sickness, ironically, is played out in the absence of a named disease. Readers are gradually made privy to a list of symptoms, possible causes, and treatments, all the while being kept in the dark about the name of the singular diagnostic entity  – the disease  – that ties these medically relevant but seemingly secondary elements together. The narrative, which closely follows the thoughts of the distraught and confused RoseAnna, offers up these bits of information like pieces of a puzzle: “Le médecin lui avait parlé de globules rouges, de globules blancs, qui se multipliaient … elle ne savait plus lesquels; et encore de déficiences de vitamines. Elle ne comprenait pas très bien, mais elle revoyait le corps à demi dévêtu de Daniel, marbré de violet, le ventre trop gros, les bras pendants; et elle se sentait comme honteuse” (227–8, original ellipsis) [“The doctor had talked about red corpuscles, about white corpuscles, and some were multiplying, she couldn’t remember which. And vitamin deficiencies as well. She hadn’t understood much of it, but she could still see Daniel’s half-naked body mottled with violet, his belly swollen and his arms hanging helplessly. And she felt ashamed”] (Roy 1989, 219). Although Rose-Anna recognizes, from the obvious symptoms, that something is wrong, she cannot discern what it is. It is clear that she understands the link between symptoms and disease as a general principle, but the explanations offered that extended beyond what she can see with her own eyes, the hematology studies for instance, make no sense to her. Although an informed or medically savvy reader may deduce leukemia from this list of symptoms and laboratory findings, Rose-Anna does not comprehend their significance and the narration offers no clarification. When the definitive word leukemia does finally enter the text, it is presented in a way that does not tie the symptoms Rose-Anna observed to a medically sanctioned interpretation. Instead, the text

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highlights the disjunction between the mother and her son’s disease. It imposes the doctors and the medical establishment as a barrier to making sense of Daniel’s illness: “Au pied du lit, il y avait un dossier sur lequel elle lut: Name: Daniel Lacasse. Age: six years. Puis venait le nom de sa maladie qu’elle ne sut pas déchiffrer” (236, original emphasis) [“On the foot of the bed was a card on which she read: Name: Daniel Lacasse. Age: six years. Then came the name of his illness, which she couldn’t decipher”] (Roy 1989, 227; original emphasis). The differentiated text marks the English words on the chart, name and age, which Rose-Anna has been able to decipher thanks to the context and their similarity to the equivalent French terms. The narrative nevertheless relapses into French, signalled by undifferentiated type, precisely when the diagnosis would have been revealed. While reverting to French, at least in theory, should signal a return to the familiar in a French-language text, Roy’s code switching does just the opposite. French, for Rose-Anna, expresses the unknown and unknowable disease, while English conveys what is already known. The text, but not the story, therefore makes French, ostensibly the language of the healthy French Canadian, the inscrutable language of Daniel’s pathology. Unlike the boy’s name and age, which are preceded by categorical markers, the diagnosis itself and the label for this information are combined into a description, not of the disease, but rather of RoseAnna’s incomprehension. Unable to speak or understand English, and her own mother tongue having been transformed by Roy’s narrative into a language of pathology and impenetrable medical authority, Rose-Anna essentially becomes a woman without a language. Her exclusion from French effectively transforms her into a Derridean monolingual: “Le monolingue dont je parle, il parle une langue dont il est privé … Parce qu’il est donc privé de toute langue, et qu’il n’a plus d’autre recours … ce monolingue est en quelque sorte aphasique” (1996, 117; original emphasis, my ellipses) [“The monolingual of whom I speak speaks a language of which he is deprived … Because he is therefore deprived of all language, and no longer has any other recourse … this monolingual is in a way aphasic”] (Derrida 1998, 60–1; original emphasis, my ellipses). Although Derrida’s monolingual is excluded because of politics or prejudice, Rose-Anna is excluded by the textual construction of disease. She is deprived of her language, that key element of French Canadian identity, by the storyline of one of Quebec’s most canonical texts.



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The key piece of medical information, when it is finally revealed, does symbolically restore Rose-Anna’s language to her, but it also simultaneously deprives French of its capacity to convey meaning. Immediately following her noted incomprehension of the diagnosis, the narrative flashes back to an unspecified time in Daniel’s illness narrative: “‘Leucémie, lui avait dit le médecin; un mal de langueur.’ Elle n’avait pas été trop effarouchée, car il n’avait pas ajouté que de ce mal on ne revient pas” (236) [“‘Leukemia.’ Was that what the doctor had said? ‘A wasting disease … ’ She had not been too frightened, because he had neglected to add that from this disease there was no return”] (Roy 1989, 227–8; original ellipsis). The statement, which reveals that Daniel is dying of leukemia, informs the reader of the diagnosis as it, ironically, confirms Rose-Anna’s ignorance of the disease’s nature or prognosis. Thus while the diagnostic statement discloses that Rose-Anna had been informed of the diagnosis, if not its meaning, it raises the question of whether knowing the name of the disease in the absence of substantive information is anything more than empty knowledge or what Suzanne Fleischman calls “an opaque signifier” (1999, 17). From a narrative point of view, the diagnosis (even though leukemia is never described in much detail) is a turning point in both the story and the national allegory. By informing the reader of the diagnosis and conveying information about the disease, Roy establishes dramatic irony. The reader is made privy to information of which not one, but all, of the characters in the novel (with the exception of the medical personnel) are ignorant. The most benign of these knowledge gaps centres on Daniel himself. Since his mother cannot explain his condition to him, and more likely because a six-year-old cannot truly understand the nature of leukemia, Daniel remains ignorant of his own disease.11 Rose-Anna nevertheless wants to know about her son’s condition, but the anglophone environment imposes itself and makes the diagnosis inaccessible to her. The causes of this incomprehension notwithstanding, the mere existence of such a gap poses problems for reading Bonheur d’occasion as an allegory of a sick nation. Daniel’s illness experience and his diagnosis reaffirm the importance of the French language, family, and Catholicism at a time when war, economic hardship, and a move to the city had occasioned anxieties about their continued significance. Yet, the fact that the diagnosis is effectively an empty signifier prevents the nation from being cast as sick. It is not that the

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morbid medico-national resonance is directly challenged, but rather that the characters’ lacunae in medical knowledge – themselves part of the allegory – limit the possibility of reading the illness narrative as national allegory. As a diagnostic narrative, one that is supposed to identify the problems within the nation, Bonheur d’occasion frustrates the medico-national allegory that declares Quebec sick in the way that a symbolic diagnosis like leukemia would suggest. Instead of specifying the nature of the national ill, Roy highlights the ignorance and incomprehension of the disease affecting the nation. Rather than pointing to the obvious and nationally detrimental erosion of the French language and Catholic values in working-class Montreal, Daniel’s disease draws attention to the difficulties posed by his mother’s uncompromised francophone status. On a more general level, one removed from the specificities of Daniel’s leukemia, Roy’s novel confronts readers with the importance of understanding the nature of both the entities being posited in the story: the disease and the nation. By having a legitimate and medically sanctioned diagnosis whose significance is unknown to those who are most affected by it, Roy underscores the degree to which the process of diagnosis does not include patients. The clinic, according to Foucault ([1963] 2003), is an institution that traditionally consigns patients to the passive role of objects of the medical gaze. Daniel, because he is a child, and Rose-Anna, because she lacks the means to communicate with the medical personnel, prove to be ideal patients in the Foucauldian sense, for they cannot challenge their roles as objects in the medical drama unfolding around and about them. Unlike diseases, which both can be and  – if Foucault’s clinic is upheld as a model of medical practice – are brought into being without patient participation, national paradigms require at least some measure of participation from those who would find themselves part of a given nation.12 Even those paradigms that lean heavily toward “being” a certain way require tacit participation or acknowledgment on the part of those who are to be part of the nation. On the other end of the spectrum of open and closed nationhood, the need for direct participation is even more pronounced. Anderson (1991) stresses the necessity of mass participation for forming a national paradigm when he discusses collective acts required to constitute to nation. He reminds readers that nations must be “imagined” (6) or “conceived”



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(145) as the result of a simultaneous process of “remembering” (187) and “forgetting” (206). These verbs of cognition imply that the national paradigm cannot be formed in the absence of mass participation in the process, even if these necessary acts are only mental and largely unconscious. Individual engagement with a concept of nation that makes national belonging coincident with participation in collective acts therefore proves to be a vital component of the national paradigm. The non-participatory process that brings disease into existence in the medical narrative consequently finds itself at odds with the allegedly parallel but necessarily participatory process of positing the nation. This fundamental limitation of the medico-national allegory is exposed not because Daniel and his mother defy clinical norms; on the contrary, the limits of allegory are shown because they perform the roles of passive patients so perfectly.

Diagnostic Possibilities, Diagnosis as Impossibility If Roy’s earlier novel questions the relevance of a given diagnosis for the national paradigm, her later work, Alexandre Chenevert ([1954] 1995), focuses on how competing and unorthodox diagnoses unsettle it.13 The novel uses clinically unconventional diagnoses and rival medical authorities to challenge accepted notions of what diagnosis is, when it can be considered successful, and what it does in both medical and everyday settings. In probing assumptions about what constitutes a legitimate diagnosis and who has the authority to diagnose, the novel disrupts the authority-driven and scientific orientation of medicine while privileging communal or lay authority in matters of illness and disease. The diagnostic narrative’s ability to posit the national paradigm, and specifically to posit it as sick, is consequently undercut not just by questions of who can make such pronouncements, but also by debates about what truly constitutes a “sick” nation. Roy’s novel tells the story of Alexandre, a sickly and neurotic bank teller concerned about everything from his digestive proclivities to the consequences of the Cold War. After he makes an accounting error at work, Alexandre’s colleagues, who are convinced that something is seriously wrong with him, compel him to seek medical help. An initial examination reveals nothing amiss despite his numerous physical and psychological symptoms. The physician orders Alexandre, who

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seems stressed not only by his job but also by financial concerns and the environment of his Montreal home, to relax by escaping to the countryside. He does as ordered for a time, but the banker’s stress and symptoms persist and worsen. He eventually returns to the doctor and is finally diagnosed with what turns out to be terminal prostate cancer, a symbolically rich diagnosis that was missed during his earlier examinations.14 Alexandre’s body consequently becomes a site of conflict between ineffective and potentially incompetent medical authorities and everyday people who, despite their lack of medical training, are (in a manner of speaking) successful diagnosticians. The illness narrative in turn finds itself alternating between recognizing medical authority based on exercising clinical functions and conferring authority upon those whose diagnoses prove correct. Such ambivalence evacuates meaning from a medical convention based on both authority and scientific principles. Given that the national paradigm was (and remains) in constant tension between the exemplary articulation, which issues from and is enforced by national authorities, and the communal vision that hinges on how the population at large sees and enacts the nation, the crisis of medical authority in the novel can be seen an allegory centring on who actually articulates a “legitimate” national paradigm. By 1954 when Alexandre Chenevert was published, the gap between Quebec’s exemplary and communal formulations of the national paradigm was growing rapidly and even policies designed to buttress a national exemplar (like overrepresenting rural electorates) were failing to uphold the “reality” of this model identity. Everyday people, particularly in the cities, could look around them and notice fewer people in church pews, smaller families, a greater variety of languages being spoken in the streets, and growing dissatisfaction with policies that no longer served the public interest. The discrepancy between the idealized past and the present Alexandre lives in is perhaps the only element of the illness narrative that has garnered any critical attention as explanation for Alexandre’s illnesses. Shek notes the protagonist’s difficult and anxiety-producing process of selectively accepting and rejecting aspects of a national paradigm in flux. He signals the practically unconscious embrace of “traditional nationalist anti-Semitism and anti-communism” (1977, 188) but also his very deliberate expressions of solidarity with the Jewish Hungarian drape maker he moonlights for and his ability to sort through anti-Soviet Cold War propaganda. Likewise, his fascination with the



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rural setting of Lac Vert is short-lived. “The idealized countryside of nationalist ideology … is too isolated, too ignorant, too uncultured, too self-satisfied for Chenevert” (Shek 1977, 189; my ellipsis). Novella Novelli elaborates on Shek’s observations by calling the bank teller’s illness “la manifestation de son incapacité de s’ajuster à la réalité” (1989, 111) [The manifestation of his inability to adjust to reality]. In essence, Shek and Novelli contend that Alexandre is a man caught between worlds, a man who displays physical symptoms because of this awkward existential position – a position common to the ailing protagonists discussed by Jameson (1986) in his analysis of Third World national allegory.15 The competing medical authorities who seek to diagnose Alexandre are reflected in the inner divisions within the patient himself, who is neither traditional nor modern, neither conventional nor revolutionary, and sick because of it. The duality between the communal and the exemplary is fundamental to Quebec’s national self-definition and would appear to translate into a simple allegory. The medical storyline, however, ultimately differentiates itself from the national situation because in medicine there is a right and a wrong diagnosis. Alexandre’s illness narrative, if nothing else, reminds readers that while there is no objectively correct way of conceiving of a nation, incorrect or missed diagnoses can have fatal consequences. The first question Alexandre Chenevert raises is that of who can be considered a legitimate medical authority: Dr Hudon, the embodiment of the medical profession, or members of the public, including Alexandre’s co-workers, Godias and Fontaine, and the patient himself. When the laypeople appropriate the diagnostic function, they must negotiate a rigidly defined and unfamiliar professional process. Additionally, they must diagnose without the tools of the clinic, the gaze and medical jargon, that Foucault contends both enact disease and allow doctors to position themselves as medical authorities. Roy’s illness narrative consequently exposes how these medical amateurs claim professional authority in the absence of the tools and skills that produce it. As they successfully take on the functions of the clinic, the non-doctors problematize the categories of illness and disease, which depend on the institutional recognition of sickness. The novel’s rival diagnostic authorities therefore threaten not just the clinic’s monopoly on medical authority, but also the legitimacy of disease as an entity that issues from clinical processes and authority.

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Alexandre’s illness narrative stages three instances of lay diagnosis. While incomplete on their own, these proto-diagnoses combine to encompass the necessary steps of the clinical processes associated with naming the disease: evaluation of the patient’s symptomological narrative and a physical examination, linking the outward signs and symptoms to a pattern recognized as a disease, and deciding on a prognosis and/or a course of treatment. Together they also happen to produce a diagnosis that is more correct than that of the physician. The first step in diagnosing Alexandre’s condition is surreptitiously performed by a fellow bank teller, Godias, after lunch at their habitual eatery. Here, the cafeteria table doubles as an examination table, as one teller observes and appraises the other: “Il le vit tout petit, si maigre auprès de lui-même. Il observa son mauvais teint, sa bouche plissée et, au lieu d’y reconnaître l’expression d’une âme qui souffrait, Godias crut apercevoir les ravages jusque-là inaperçus de la maladie. ‘Il est plus malade qu’il ne le croit, pensa Godias avec consternation. Il doit être atteint gravement … plus qu’il ne s’en doute’” (59, original ellipsis) [“He became aware of his tininess, his thinness by contrast to his own bulk. He noticed his bad complexion, his puckered mouth, and instead of recognizing the expression of a soul that suffered, Godias believed he saw the hitherto unperceived ravages of illness. ‘He is sicker than he thinks,’ Godias said to himself with alarm. ‘He must be in a bad way … worse than he suspects”] (Roy 1970, 52–3; original ellipsis). This diagnostic process, while not backed in any official capacity by the clinic and its all-pervasive gaze, follows the modern medical model. Godias scrutinizes Alexandre and therein participates in the scientific method, which takes observation, along with hypothesizing and experimentation, as its key operations. The lunchtime remarks, seemingly spontaneous comments on a colleague’s appearance, engage him in a discourse and a methodology at the heart of medicine. What Godias observes – emaciation, poor colour, and a puckered mouth – become, through a presumed knowledge of symptoms, signs of severe sickness. By distinguishing the abnormal and translating it into clinical signs, the healthy bank teller hypothesizes the existence of a serious underlying condition and suggests that a disease is responsible for the observed effects. While he stops short of naming the condition (no doubt, because he lacks the training or knowledge to do so), he proves to be an astute and methodical observer of Alexandre’s body. The empiric way in which Godias inspects his co-worker can also be classified as scientific because he rejects impressionistic



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explanations for Alexandre’s symptoms. The “au lieu” that separates Alexandre’s suffering and tortured soul from the medical explanation of diagnosis that had previously gone unnoticed signals two things. On the one hand, it serves as an outright rejection of an affective explanation for the symptoms. It therefore firmly relegates the emotional to a non-medical context. On the other, Godias’s diagnosis marks a shift in the bank worker’s status from concerned friend to proto-medical authority. Although Godias carries out his examination in accordance with the scientific methodology that anchors medicine, the ways in which his observation diverges from normal clinical practices proves problematic. Given that Godias diagnoses Alexandre without his colleague’s knowledge, the most common symptoms of Alexandre’s actual problem – frequent urination and/or difficulty urinating – are never discussed. In light of the context of this diagnostic encounter, the oversight is understandable; the prim and proper Alexandre is unlikely to have discussed his bathroom habits with a colleague over lunch. The lack of conversation between the diagnostician and the patient therefore reinforces medicine’s status as more than just an application of clinical procedures. The nature of the “maladie” that Godias diagnoses also proves to be a sticking point in his assuming a truly clinical role. The definite article la in la maladie functions in two possible ways: a type (a category) or a token (a particular occurrence within the category). In the first, la could point to sickness in general (in much the same way that la guerre can refer to a general state of hostility without implication of any specific combatants or historical era). In the second, la maladie could indicate an as-yet-unnamed, but singular ailment or disease entity. Since French does not distinguish between illness and disease, as the English translation does, there is nothing particularly unusual about Roy’s use of la maladie. This phrasing nevertheless draws attention to the subtle but foundational distinctions between illness and disease that operate in the context of Godias’s lay diagnosis. Arthur Kleinman defines illness as the experience of being unwell. Illness is “the innately human experience of symptoms and suffering” that “refers to how the sick person and the members of the family or wider social network perceive, live with, and respond to symptoms and disability” (1988, 3). At no point does this definition allude to the presence or influence of institutional medicine. Illness therefore exists outside of medical recognition and clinical frameworks.

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Disease, which does not negate illness, but which often legitimizes it, appears only once a clinical authority recognizes a condition. In Godias’s reflection, however, la maladie, quite aside from the linguistic constraints of French, could refer to either a medically sanctioned state of pathology (a disease) or one that exists outside of a clinical framework (an illness). It is precisely this ambiguity that makes this episode of lay diagnosis pertinent to the question of medical authority that permeates all aspects of Alexandre’s story. If la maladie is taken to refer to a specific but as-yet-unnamed disease, Godias simply does not disclose the name of the ailment with which he believes his co-worker to be afflicted. A problem thus arises because of textual silence during diagnosis, when there should be not only speech, but also the very precise words of the clinical code. This clinical language, argue theorists such as Baer (1988) and Foucault ([1963] 2003), is used in diagnosis not just to be precise, but also to separate those with medical authority from those without it. The esoteric nature of clinical language accordingly preserves medical authority because its use can be restricted to initiates. When Godias attempts, in cataloguing symptoms, to use the language devised precisely for communicating information about observed pathology and abnormality in the body, he only completes half the task. Specifically, he does not demonstrate the mastery of language needed to translate symptoms into disease. Godias’s diagnosis therefore creates a troubling textual void centring around the name of the disease he asserts to be present. By not naming it, he blurs the line between illness and disease by failing to discern the pathology. Is Godias refusing to name the disease or can he, like Rose-Anna, not actually differentiate the nature of the sickness from the state of sickness itself? If medical authority is the element that distinguishes disease from illness, but lay diagnosis erodes the difference between these two categories, Godias’s diagnosis pre-emptively challenges medical authority. As la maladie, taken as unnamed but specific disease, fuses with the idea of illness, the problem of what can actually be diagnosed emerges. By dint of the fact that illness is independent of diagnosis, it makes sense that it does not come into being in the same manner as disease. Yet because Godias confounds processes constitutive of medical authority, namely the gaze, with the ambiguity and nonclinical nature of illness, he makes it possible to “diagnose” both illness and disease. In diagnosing that which cannot be diagnosed – an illness  – the bank teller unsettles the distinction that scholars like Kleinman and Foucault contend is fundamental to the construction of the clinic and medical authority.



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If Godias’s role in the diagnostic process centres on examination and the diagnosis of a non-disease, Fontaine, Alexandre’s boss, contributes to the lay medical process by prescribing treatment. He thereby exacerbates the tension between the laypeople and the authorities, and by extension, the communal and the exemplar in the national allegory. After a stressed and poorly rested Alexandre misplaces a hundred dollars from his cash drawer, Fontaine confronts the distraught employee. Fontaine takes both Alexandre’s behaviour and appearance into account as he diagnoses a problem that is being played out on two levels: the medical and the professional. As Alexandre’s physical problems begin affecting his work, his boss blurs the line between medical and professional authority as he issues his prescription: “‘je vais pourtant exiger quelque chose de vous … de vous faire soigner, dit le directeur. Vous n’avez pas bonne mine … Si vous avez besoin de vacances plus tôt qu’à votre tour, je pense que je pourrai arranger cela … Un peu de repos’” (78, my ellipses) [“‘But I am going to ask you one thing … to get someone to give you a good check up … You don’t look well … If you need your vacation a bit before your turn, I think I could arrange it … Perhaps a little rest.’”] (Roy 1970, 65–6).16 Fontaine’s instructions, denoted by the verb soigner, call for Alexandre to seek out medical care. This choice of words, while still implying the notion of the checkup used in the English translation, also suggests actual treatment. The exhortation to seek care nevertheless insinuates that the patient’s disease has already been identified, for convention holds that diagnosis precedes prescriptive intervention. In prescribing additional care, therefore, the bank manager acts as a general practitioner might when he or she refers a patient to a specialist for treatment. One may consequently construe the manager’s diagnostic silence to mean that Alexandre’s condition is already defined. Ironically then, Fontaine’s lack of diagnosis reinforces his medical authority because he does not explicitly counsel his patient to seek out a diagnosis. Despite Fontaine’s possible deferral of medical authority in this regard, he still affirms it in another, namely in the “prescription” that is possible only because of the employer-employee dynamic. Fontaine’s intervention, while even less explicit than Godias’s, also probes at the illness/disease distinction and its role in the construction of medical authority. The social function of diagnosis, a key concept in Elaine Showalter’s (1997) Hystories and Talcott Parsons’s (1951) reflections on the sick role, accords certain privileges or exemptions to those considered to be sick.17 In acknowledging the effect of Alexandre’s condition on his work and granting him

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certain favours because of it, Fontaine recognizes his employee as legitimately sick. While there is nothing particularly unusual about a boss approving sick leave for an ailing worker, the norm is for a physician to first confirm the legitimacy of the sickness and the privileges it entails. The employer then typically defers to the doctor’s judgment about the patient’s ability to work. The bank manager, however, appropriates the clinic’s evaluative function via the linked actions of diagnosing an aberrant biological state and recognizing that this pathological condition (whatever it may be) merits special consideration.18 In this way, the non-clinical illness again assumes some of the characteristics of the medically authoritative disease and the lay diagnostician, the authority of doctors. Unlike the two earlier instances of lay diagnosis, in which nondoctors deploy the clinic’s methods of naming the disease, Alexandre’s self-diagnosis in no way adheres to these institutional processes. Rather than being systematic, scientific, or connected to a source of authority, the ailing teller’s self-evaluation is best described as the kind of off-the-cuff remark that typically signals frustration. Yet, as a disheartened Alexandre muses, “Je finirai par mourir d’un cancer d’estomac” (15) [“I’ll end by dying of cancer of the stomach”] (Roy 1970, 20), he is able to do the one thing that neither of his colleagues is able to: name his disease. In addition to enumerating a collection of symptoms, the larger self-diagnostic narrative also performs another of the ancillary functions of diagnosis: prognosis. This sarcastic remark about his future cause of death turns out to be both inaccurate and ironically prescient, in that it foreshadows Alexandre’s eventual demise from cancer, albeit of the prostate. Indeed, it is from this flippant, unconventional diagnosis that the unlikely diagnosticians, the bankers, issue their greatest challenge to medical authority. Alexandre’s focus on his stomach as the probable location of his cancer, while not technically correct, creates what will become, in the context of his dysfunctional illness narrative, a medical half-truth. When the nervous cashier finally seeks medical help at his employer’s behest, he complains to his doctor mainly of the stomach pains, headaches, and general malaise, which keep him up at night and force him to adhere to an unhealthy diet of coffee, cigarettes, and nutrient-deficient food. These symptoms and complaints are not unexpected for a man whose gastrointestinal indispositions, worries, sleepless nights, and poor mental health are so thoroughly documented throughout



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the early stages of Roy’s narrative that they practically double as medical history. The doctor predictably uses Alexandre’s copious symptomatology, much of which is elided during the actual medical exchange, to guide his investigations and lab tests. Pronouncing Alexandre free of any discernible disease but undoubtedly suffering, the physician sends him off from the follow-up visit with an exhortation similar to Fontaine’s: to relax and to get out of the city. When this treatment plan does not satisfy Alexandre, whose indisposition, after all, had become severe enough to attract the attention and concern of his colleagues, Dr Hudon gives him a handful of prescriptions for palliative therapies. The doctor therefore finds him to be ill but not diseased, in much the same way that Godias and Fontaine did. Although the doctor lacks neither the knowledge nor the authority to posit disease, he refuses, which signals his doubt as to the veracity of his patient’s claims. By contrast, Godias is convinced that Alexandre is not only sick, but even sicker than the borderline hypochondriac believes and attests through his daily comments and behaviour. Fontaine, who prescribes both rest and follow-up care to his employee, recognizes that he needs more than just a vacation. Alexandre, however, practically has to ask for the portion of his care that extends beyond what might otherwise be construed as friendly advice. The physician winds up being the only one of the novel’s four diagnosticians who categorically rejects the idea of an underlying problem when he too diagnoses an illness rather than a disease. Alexandre’s self-diagnosis nonetheless puts the doctor’s authority and the allegorical nature of the story to the test when the illness narrative shifts toward a more outcome-oriented phase. A year and a half after he had pronounced his patient disease-free, Dr Hudon reevaluates a much sicker Alexandre. As he discerns the now-unmistakable signs of prostate cancer, doubt creeps in as to whether or not his patient’s focus on gastrointestinal symptoms and overall unsteady mental state had caused him to overlook the true cause of his many problems: Se pouvait-il que lui-même, au dernier examen clinique, eût négligé certaines recherches? … À la première consultation, en date du mois d’août, il releva que déjà, à cette époque, “le patient devait se lever la nuit” ; mais le docteur Hudon constata qu’il n’avait alors relié cette habitude qu’à l’insomnie. Il s’était surtout concentré sur les troubles gastriques, l’excessive nervosité

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du malade … la dernière consultation remontait tout de même à plus d’un an, intervalle peut-être suffisant pour l’apparition et le développement des symptômes présents. (228, my ellipses) [Was it possible that he himself, at the last clinical examination, had neglected to invtestigate certain things? … At the first consultation, during the month of August, he found that already then “the patient had to get up during the night”; but Dr Hudon ascertained that he had connected this habit only with insomnia. He had concentrated especially on the gastric disorders and the sick man’s excessive nervousness … after all the last consultation was already more than a year ago, an interval perhaps sufficient for the appearance and the development of the present symptoms.] (Roy 1970, 171) As the doctor looks back at the initial examination, his fears may indeed be justified, for Alexandre had obliquely mentioned both his loss of interest in sex (which could hint at his inability to achieve or maintain an erection) and his failure to sleep through the night. These significant facts aside, the doctor seems to have ascribed such symptoms to his patient’s overall poor mental and physical health rather than considering them an indication of his actual disease. Moreover, while Dr Hudon had presumably performed a standard physical exam and had taken a very thorough medical history, the second of Alexandre’s symptoms is only framed in the context of prostate problems during the second exam.19 The doctor’s skepticism and tentative self-reassurance that he had not missed what had now become a very obvious tumour gives circumstantial, but not strictly etiological, credence to Alexandre’s diagnosis of stomach cancer. By “distracting” the doctor from the real problem, the early symptoms of which he had nonetheless faithfully reported, Alexandre’s focus on his gastric symptoms may have prevented the doctor from considering all the relevant medical possibilities. The physician’s missed diagnosis gives the as-yet-undiscovered tumour time to grow, metastasize, and reach a terminal stage.20 Consequently, it was not so much a cancer located in the stomach that would eventually kill Alexandre, but rather a cancer disguised by the stomach and hidden near the end of the digestive system that would ultimately be responsible for his demise. The confusion over the cancer’s location raises one of the most difficult questions about medical authority in the illness narrative. By



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asking who is the true diagnostician in this case – the grimly prescient Alexandre, his partly intuitive, partly logical colleagues, or his belatedly medically correct doctor – readers are compelled to interrogate what truly constitutes diagnostic authority. If the ultimate goal of diagnosis is to be an intermediate step on the way to cure, then neither the non-doctors nor the physician can legitimately be considered authorities because Alexandre’s symptoms are not alleviated and his cancer spreads. If, however, one thinks of diagnosis in a pathological sense, whereby identifying the cause of bodily abnormality is the object of the exercise, both Alexandre and his doctor become medical authorities because, in a sense, they are both correct. Alexandre does not die of stomach cancer in a way that would show up in an autopsy, but the absence of cancer in the stomach does not preclude the existence of cancer in his body. When the illness narrative posits illness in the same manner that it diagnoses disease it challenges not only the clinic’s hold on medical authority, but also the process by which naming disease in the context of medico-national allegory can inscribe sickness onto the national paradigm. Disease is the condition that is created when medical authorities recognize sickness, but illness can exist without confirmation of its existence. When illness narratives posit the nation, however, they both recognize the nation as it is and shape the national paradigm going forward. If the illness narratives declare the nation sick, these narratives (at least in theory) confirm the nation’s poor health in an authoritative and legitimate manner. Alexandre Chenevert subverts the legitimacy of its national diagnosis of Quebec as ill (as represented by the protagonist’s body) by denying its claim to being a valid (i.e., authoritative) assessment of the nation’s health. It posits the nation as ill but not as diseased, leaving readers to wonder which “diagnosis,” if any, actually renders the nation sick. While the nature of Alexandre’s ailment leaves the nation’s alleged sickness in doubt, the biological realities of his cancer unambiguously impose themselves. The fact that readers can ultimately point to one diagnosis as the objective standard against which all others may be judged accurate or inaccurate differentiates the discursive medical act from its national counterpart. When the definitive diagnosis finally emerges, it does so as the result of an utterly conventional diagnostic exchange, which produces a correct identification of the pathology. Armed with all the clinical tools, which is to say

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examination, the broadly defined gaze (which includes instruments to enhance sight, touch, and sound), and medical language, the doctor is at last able to do what no other diagnostician in the novel succeeds in doing: deducing the precise cause of Alexandre’s symptoms: “La main du docteur palpait un durcissement très reconnaissable” (227) [“The doctor’s hand was palpating a very noticeable area of hardness”] (Roy 1970, 171).21 It is the indissociable acts of palpating the body and discerning the normal from the abnormal, all the while connecting the abnormal with specific states of pathology, that allow the doctor to recognize the tumour and diagnose the cancer. Although Hudon’s second diagnosis is clinically normative and medically authoritative, it comes too late to be of any curative value. In the practical terms of life and death, the physician’s authority is again called into question. His final diagnosis, while correct, fails to occasion successful treatment. It consequently falls short of supplying the undeniable “proof” of medical authority that cure and improving health provide.22 In the national context, however, there are no objectively “true” national paradigms. The communal and the exemplary articulations of the paradigm always exist in legitimate tension with each other. Simply, there is no definitive articulation of the nation that can prevail upon another as an absolute assessment of what ails the nation, let alone what the nation is.23 Alexandre Chenevert therefore draws attention to one of the fundamental difficulties of reading illness narratives as medico-national allegories: the relatively scientific nature of disease, while reinforced by social significance, is at odds with the utter subjectivity and relativity of national paradigms. It is therefore the purported objectivity and simplicity of the medical context, the same one that is supposed to lend rhetorical clarity to the national paradigm, that limit the potential for reading illness narratives as national allegories. As an illness narrative centred largely on diagnosis, Alexandre Chenevert appears to privilege the diagnostic act as the means by which medical professionals consolidate their power. What might be called a misappropriation of this authority by those outside the clinic, and the erroneous outcomes that ostensibly legitimate diagnoses yield, nevertheless disrupt the process by which physicians establish and exercise their medical authority. Diagnosis consequently becomes an act that denies recognized medical practitioners their authority and undermines the means by which they are



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invested with power. Positing the nation via a medical narrative that is so profoundly abnormal doubles the ill-functioning of Alexandre’s body in the dysfunctionality of the diagnostic process. Roy’s text accordingly confounds attempts to read the bank teller and his cancer as emblematic of a sick national paradigm. Instead, the novel directs the reader’s examination onto the diagnostic narrative itself and therein makes the diagnostic process and not its outcomes the relevant locus of national allegory.

Refusing to Diagnose and Denying Allegory Roy’s novels privilege diagnosis, but they do so from the patient’s point of view. They draw attention to the frustrations and challenges of institutional medicine and question how a system that prioritizes scientific objectivity and marginalizes laypeople can posit a national paradigm that is, by its very nature, subjective and participatory. André Langevin’s Poussière sur la ville (1953) breaks with this tradition and offers a glimpse into the diagnostic process from the physician’s perspective. Langevin’s first-person narrative is that of Dr Alain Dubois, an outsider turned source of controversy in the small town of Macklin, Quebec. This sleepy mining town, blanketed by asbestos dust, draws obvious parallels to the actual towns of Asbestos and Thetford Mines, the locations of one of Canada’s most contentious and politically charged labour disputes.24 Thus, unlike earlier illness narratives in which the national context is a function of realism more generally, Langevin’s text is a kind of roman à clef for the events and debates generated by the strike of 1949.25 While the obvious resemblance of Macklin to the mining towns of Quebec’s Eastern Townships makes for a ready-made allegory, one cannot assimilate Poussière sur la ville so easily to the crisis of national authority precipitated by the protracted labour dispute. Rather than fitting itself neatly into the mould of Asbestos or Thetford Mines, its spirit of protest, and its subsequent recasting as one of the first events leading to the Quiet Revolution, Langevin’s novel uses its physician-protagonist and narrator to question the conflicts of authority taking place at this turning point in Quebec’s history. When Dr Dubois rejects medical authority by refusing to diagnose his patients, he undermines both the clinical diagnostic exercise and the allegory. The doctor’s unwillingness to assume the diagnostic function prevents disease from appearing in the text, and

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it consequently absolves him of his medically curative role because a doctor cannot rationally be expected to cure what he cannot diagnose. Insofar as Langevin’s protagonist does not diagnose disease, the text fails to cast the nation as sick. Furthermore, when the doctor eschews his role as instigator of clinical cure he dodges the notion of social cure or change that critics like Christine Tellier (1997), Denis Saint-Jacques (1969), and David Palmieri (2007) have attributed both to the character specifically and to doctors in general at this time in Quebec’s literary history. The physician’s actions (or lack thereof) consequently leave the medico-national allegory not only discordant with the historical narrative and the allusions to Asbestos, but also incomplete. Unlike the nameless doctor in Bonheur d’occasion and Dr Hudon, Alexandre Chenevert’s ineffective physician, Dr Dubois’s medical authority is never taken for granted by those around him. Langevin’s physician, though, does little to secure the townspeople’s respect for him, and from the outset, his relationship to his profession and his professional life in Macklin is fraught. As the new doctor in town, he must establish a practice so that he may one day take over for the town’s retiring physician. The young clinician’s anxiety about his role in Macklin and his status as a new doctor are revealed during his first consultations when he acts both unconventionally and unprofessionally. Called upon to diagnose and treat an eye disorder and an advanced cardiac condition, he shies away from his professional role by refusing to diagnose his patients. It is not that he cannot diagnose them or that he misses the symptoms that are critical to the exercise, but rather that he simply declines to do so. This rejection of professional responsibility prevents Dubois from claiming the medical authority that is rightfully his and, moreover, expected of him. Dubois’s inability to diagnose, unlike the diagnosticians from Alexandre Chenevert, is not rooted in professional incompetence or unfamiliarity with the clinical code. Indeed, despite his recent induction into the profession, the doctor is proficient in the language of the clinic and the subtleties of the medical gaze. When examining a patient he is silently and sarcastically thankful that he is not dealing with a gastrointestinal complaint: “Je n’aurai pas besoin de lui faire préciser pendant trente minutes les symptômes subjectifs comme lorsqu’il s’agit d’un mal d’estomac, l’estomac s’étendant pour eux depuis le cou jusqu’aux fesses” (53) [“I did not have to make her



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state her symptoms more precisely as I usually had to do when they complained of ‘stomach trouble’ – the stomach stretching for them from the neck to the buttocks”] (Langevin 1955, 51). The doctor’s acerbic comment points to his dissatisfaction with the imprecise manner in which his patients reference their own bodies and symptoms. Although this quip is little more than a display of annoyance, it indicates that the doctor acknowledges the useful specificity of the medical code that he (in contrast to his patients) has mastered. Despite his tendency to favour medical jargon (and his unreasonable desire for his patients to use anatomical vocabulary), he avoids the authority-producing code in his interactions with patients. This is not to say that he simply and clearly explains diseases and complex medical treatment plans in plain language (something many wish their doctors would do), but that he dissimulates the true nature of the relatively intelligible problems he identifies simply by not communicating with his patients. Instead, he downplays the significance of the conditions he identifies by reverting to everyday speech, which lessens the perceived severity of the condition. One need only think of the difference between the flu, a routine illness, and influenza, the disease of deadly pandemics, to recognize the impact of clinical language on understanding diagnoses. Dubois rationalizes his euphemisms out of concern for his professional reputation, for in committing to an authoritative-sounding diagnosis he subjects himself to judgments about his clinical skill. This apprehension plays out as he checks the eyes of an influential local businessman, Prévost, who he presumes has only come to see him to test his acumen as a physician: “Je l’examine avec la petite lampe que j’emploie pour les oreilles. Je crois voir une opacité de la cornée. Cataracte sans doute. Je ne ferai certainement pas le diagnostique. Je lui dis: Inflammation du fond de l’œil, je crois” (52) [“I examined him with the small lamp I used for ears, and saw at once a thickening on the cornea. Without doubt a cataract. But I did not want to be the one to make the diagnosis. ‘I think it’s an inflammation at the base of the cornea,’ I said”] (Langevin 1955, 49). The “sans doute” of the internal monologue reveals that he is certain that his actual diagnosis of cataracts is correct. He nevertheless disguises his findings and couches his inaccurate yet official diagnosis (for it is this diagnosis upon which he bases his recommendation for treatment) of inflammation in a subjective statement of belief distinct from fact. Fearing that a misdiagnosis that sounds too official

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could commit him to an error, but that a guess and a referral for a specialist allow him a comfortable margin of fallibility, he opts for simpler language. To defer to the undifferentiated language of his patients, according to the doctor’s logic, is to avoid the responsibility of assuming the medical authority that is created by diagnosing using the gaze and medical language. To think like a doctor yet to speak like everybody else lets him sidestep the expectations and potential liabilities that accompany his professional privilege. In another instance, Dubois hesitates to press clinical language into service because he believes it to be a risk for his patient. Whereas Prévost’s diagnosis was merely toned down to protect the physician, the doctor hides a serious cardiac problem – a combination of dilatation and angina – from a patient for fear that the stress of hearing the alarming diagnosis might worsen her condition. As he concludes his consultation, one already marked by his lack of professional decorum for absent-mindedly leaving his half-naked patient exposed to a waiting room full of people, he again refuses to diagnose. He also corrupts the normal syntax of the medical conversation that helps patients to understand the nature of their conditions. Rather than disclosing his diagnosis, explaining it, and prescribing a course of treatment, Dr Dubois performs the process in reverse. Furthermore, he nearly stops short of completing what should have been one of the first steps in the process: “Il vous faut vous reposer beaucoup plus longtemps. Vous souffrez d’une maladie très grave” (55) [“You’ve got to rest a lot longer than that. You are seriously ill”] (Langevin 1955, 53). Noticing that his orders and explanation, offered in lieu of a diagnosis, have little effect, the doctor reasons to himself: “Je ne peux lui parler de son cœur sans accroître son anxiété” (55) [“I couldn’t tell her about her condition without aggravating her worry”] (Langevin 1955, 53).26 Desperately, as though recognizing that only a diagnosis that at the very least sounds medically authoritative will convince his patient to slow down, he offers: “C’est de la fatigue, l’usure. Une mauvaise circulation du sang” (56) [“It’s fatigue, wear and tear; bad circulation of the blood”] (Langevin 1955, 53). As his pseudo-diagnoses progress in what he perceives to be severity, they also sound more clinical, ending with biological processes (circulation) and components (blood). Admittedly, neither blood nor circulation constitutes obscure medical jargon, but these words are closer to the scientific register than fatigue.27 Dubois falsely believes that the vaguely more medical nature of his subsequent explanations, while stopping short of truly being diagnoses, are sufficiently authoritative



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to convince his patient to adhere to the regimen of rest he nevertheless prescribes.28 The motivations for not disclosing his real diagnoses to either of his patients has little if anything to do with defying professional behaviours as a matter of principle, for he has no discernible axe to grind with the medical profession. His actions are, on the contrary, a reflection of his concern for how his patients will view him as a physician and, particularly, as the new doctor in town. In the first consultation, he is preoccupied with not appearing incompetent, and the patient is more interested in sounding out the young physician’s ability to replace the town’s retiring elder statesman of medicine. In the second, the patient is concerned about her health but only insofar as the diagnosis would facilitate an easy cure that would allow her to continue her work with greater ease, not quit it altogether. The new doctor though is still uneasy about his reputation, as evidenced by the narrative that intertwines his professional fate with that of his patients. This solicitude for how he is perceived by others, argues Socken (1977), is at the heart of Alain’s always uncertain role in the town. In both cases, Dubois has the opportunity to diagnose but ultimately fails to exercise his medical authority. In this he is, as Denis Saint-Jacques suggests, not a man of action, but a professional whose “tentatives d’intervention sont souvent trop faibles et toujours sans effet durable” (1969, 168) [Attempts to intervene are often too feeble and always without lasting effect]. Given that literary critics have staked so much on the diagnoses in illness narratives, the national paradigm has come to depend on recognizing the patient’s body, as diagnosed, as the locus for national meaning. Poussière sur la ville and its physician-narrator nevertheless circumscribe the mediconational allegory’s power to signify. The all-important diagnosis is withheld, and with it, the analogous pronouncement of the nation’s ill health. The nation may well be sick, but the doctor, the symbol of national authority and exemplary nationhood, refuses to acknowledge it as such. As mentioned above, the national allegory in Poussière sur la ville rests upon more than just the parallel processes of positing the disease and the national paradigm as recognizable entities. Macklin’s resemblance to the towns that played host to the acrimonious asbestos strikes evokes postwar Quebec’s first violent reaction against the province’s conservative political leadership. The strike was decisive on the national front in many ways. First, it exposed cracks

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in the traditional alliance of the Catholic Church and conservative, nationalist politicians in Premier Maurice Duplessis’s ruling Union Nationale party. The Church, in the form of Catholic labour unions and many individual clerics (particularly at the parish level, but also in the upper echelons of Church hierarchy, including the Archbishop of Montreal, Msgr Joseph Charbonneau and Bishop Philippe-Servule Danserleau of Sherbrooke), backed the striking workers against the mining companies, which had the support of the government. In May of 1949, police hurled tear gas at women who were marching and reciting the rosary in support of striking workers. Following orders, they also attacked union members in a church; both of these actions underscore the symbolic rift between the Church and its traditional government allies. Second, the strike re-energized the province’s liberal political and social scenes. Young activists, such as Pierre Trudeau and Gérard Pelletier, sided with the workers and lent them a forceful and articulate voice for change. In the direct aftermath of the strike, Trudeau and Pelletier (along with others) would go on to found the liberal political journal Cité Libre to continue to advocate for reforms initially brought to light at this time. Prominent Catholic intellectuals, like André Laurendeau, the editor at the traditional Catholic and nationalist daily Le Devoir, and the Jesuit journal Relations also abandoned their support for Duplessis, the Union Nationale, and the socio-political climate they cultivated. Third, the relationship between Quebec’s people and its traditional national leaders  – its national authorities  – was put into question. People began to ask themselves why an ostensibly nationalist government would back foreign-owned mining companies over its own citizens. As people scrutinized politicians and clergy in the light of the conflict, the relationship between the population at large and those they held up as national authorities began to change. Seizing upon the similarities between Macklin and Asbestos and Thetford Mines, critics have proposed several direct allegorical readings of Langevin’s novel. Christine Tellier, for one, argues that Dr Dubois is a figure of protest and contestation modelled on figures of this ilk from the strike, namely those who would go on to be Citélibristes. The doctor, in her view, “souhaite changer en profondeur la société conservatrice de Macklin” (1997, 574) [wishes to profoundly change Macklin’s conservative society]. In so doing, he becomes a model of liberalism, spurred to his position by the events of 1949 and



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the mirror conditions of its fictional double. Tellier cites as examples of this reforming spirit the doctor’s public quarrel with the town’s priest and his transgressive act of defying social hierarchies by drinking at the hotel with working-class miners. More recently, David Palmieri has suggested that Dubois and his row with the cleric are emblematic of shifting religious attitudes, namely “society’s movement from rigid traditionalism to symbolic pluralism” (2007, 8). In short, critics have embraced Dubois as a social and political reformer akin to those who emerged at Asbestos. The young, unorthodox doctor is cast as a socially curative force for Macklin. Likening Dr Dubois to the Asbestos-era reformers nevertheless proves problematic. The first difficulty stems from the fact that as a doctor, Poussière’s protagonist is neither part of nor a spokesperson for a movement of mass protest. This is not to say that the reformers themselves were members of the proletariat digging in the asbestos mines. (Trudeau, after all, was a wealthy lawyer educated at some of the finest schools on the planet and then went on to be prime minister.) Nevertheless, the movement they inaugurated was one born of mass protest against reactionary clerical conservatism and big business, and its tangible effects, such as anti-unionism, on the lives of the people. In the context of mid-century medical narratives, however, doctors are held up as part of an educated group that enjoys substantial social and professional privilege, which stems from being part of a community’s social and political elite.29 Even a young, not-yet-established doctor like Dubois could be accorded a certain amount of social recognition and credit by simple virtue of his profession: “Jim exprime inconsciemment, comme eux tous, son respect du médecin, de l’homme qui un jour se penchera sur eux en même temps que le prêtre pour un dernier contact humain” (46) [“Jim was expressing unconsciously like all of them, his respect for doctors, for the man who one day would bend over his bedside with the priest, for his final human contacts”] (Langevin 1955, 42). By likening the physician to the priest, Jim, the town’s taxi driver, signals his reflexive reverence for the traditional elites of Québécois society: clerics, doctors, and lawyers. Unlike the other doctors, however, Dubois uses the source of his social authority, his profession, to undermine the socio-political hierarchies in Macklin. Dubois’s problematic relation to his profession is the second factor that stands in the way of reading him as Quebec’s social cure. His medical authority and skill give him the power to act in a curative

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manner, yet his unconventional actions point to his reluctance to embrace this tenuous authority because, on the one hand, it is taken for granted and, on the other, is always subject to erosion, even by those who lack medical training of any kind. Whether it is Prévost’s influence in town or the more insidious but equally damning word of mouth, Dubois is acutely aware that unfavourable outcomes can decimate his reputation in much the same way that cure can reinforce medical authority. As he discovers when confronted with a problematic labour and delivery, the strictly clinical facets of his medical authority function almost independently of his reputation in town. One evening the doctor finds himself drunk but must nevertheless drive into the countryside to help deliver a baby. Upon entering the patient’s residence, the labouring woman’s family members appraise the inebriated physician summoned to assist them. Dubois, taking in their stares, interprets: “Si tout se passe bien, ils admireront qu’en dépit de mon ivresse je m’en sois tiré. Sinon … Tout le canton le saura” (116, original ellipsis) [“If all went well, they would admire the fact that in spite of my drunkenness I had brought it off. If not – the whole province would know about it”] (Langevin 1955, 42). In the binary of success or failure, neither of which are qualified until after the baby is sacrificed to save the mother (a course of action condemned by the Catholic Church), public opinion and not medical outcome determines the respect due to the physician. Even Dr Lafleur’s admission that his junior colleague could not have done anything differently underlines how contingent medical authority is in Macklin: L’hypothèse de la mort de la mère ne les touche pas. Elles ne retiennent que la mort de l’enfant … – Avez-vous déjà rencontré un cas semblable? – Non. Mais à l’âge que j’ai j’aurais pu me charger de la mort de l’enfant. On m’aurait pardonné ou j’aurais pu leur faire comprendre. Avec vous ils seront sans pitié. Il y a à peine trois mois que vous êtes établi à Macklin et vous venez de la grande ville. (125, my ellipsis) [The possibility that the mother might have died doesn’t matter to them. They only feel the reality of the child’s death … “Have you ever run into a case like that before?” “No. But at my age I could have taken the responsibility for the baby’s death. They



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would have forgiven me, or I might have made them understand. With you, they’ll be pitiless. You’ve hardly been in Macklin for three months and you come from the big city”]. (Langevin 1955, 128) Dubois’s status as a newcomer, his city origins, and his youth become the factors that mitigate medical authority. The only other medical professional in town is the one, moreover, who reports on the unconventional trio of factors that constitute medical authority in Macklin. In this unexpected combination of speaker and message, the physician defines medical authority according to popular rather than professional standards. Because Lafleur is not subject to the same non-medical critiques as his younger, uninitiated counterpart, his reputation allows him to diagnose problems that Dubois cannot afford to reveal to his patients. In carrying out what are potentially controversial clinical acts, Lafleur maintains the ability to define medical authority within the clinic. Nevertheless, by switching to a consideration of hypothetical situations, denoted by the conditional, it is clear that even the town’s established physician believes himself to be at the mercy of the community’s judgments. The pronouns in the second sentence of Lafleur’s reply intimate that those who must be convinced of the medical necessity of any given procedure or the inevitability of an outcome, those who are the arbiters of medical authority in Macklin, are not those who are medically knowledgeable. The community’s role in assigning or vacating medical authority, based largely on age and origin, therefore challenges Foucault’s ([1963] 2003) basic contention that medical authority comes from the knowledge used, among other things, to diagnose and treat. The town’s ability to confer medical authority on a physician in spite of unfavourable outcomes or, alternately, to impugn it without just medical cause is a reaction to Dubois’s perceived failures. As Lafleur rationalizes to his younger colleague, he could have explained the situation in a way that convinced the community that the unfortunate outcome was a medical inevitability and not the result of a physician’s hasty and/or immoral decision. This assertion therefore suggests that the older doctor’s medical knowledge (and likely a fair amount of convincing rhetoric and years of built-up trust) could have saved his reputation. Dubois’s actions and not his age, origin, or standing in the community, however, are only excuses that explain

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why he lacks the community’s respect. He readily confesses via his narration that he has acted in a manner that whittles away his medical and social authority in the townsfolk’s eyes. His unsuccessful attempts to deliver a baby while drunk and his refusal to diagnose patients who come to him for help are but the two most obvious examples. Furthermore, he hides pertinent medical information from his patients, which turns out to be a fatal error in professional judgment. While there is a certain sense of inevitability to the outcomes, a view confirmed by Lafleur, Dubois’s admission that he is acting in a manner uncharacteristic of physicians adds a measure of personal agency or responsibility to what might otherwise be natural, albeit unfortunate, occurrences. Dubois’s anxiety over what he initially perceived to be a “benevolently” false diagnosis given to the old woman with the critical heart condition attests to the physician’s difficulty in being able to do anything but erode his own authority and curative function during diagnosis. In seeking to encourage cure, or at least a palliative strategy, he conceals his patient’s condition from her, a decision which proved just as, if not more, dangerous than revealing the alarming diagnosis, for the old woman returned to her arduous work only to provoke a heart attack. Called to her side too late to be of any assistance, the doctor ponders, “Et je me demande quelle force poussait la morte à gagner encore sa vie, avec l’insoutenable anxiété des cardiaques” (77) [“And I wondered what it was that had compelled the dead woman to go on earning her living, with the unbearable frenzy of cardiacs”] (Langevin 1955, 76). Despite his frustration at losing a patient the very same day he saw and “diagnosed” her, the doctor’s assignment of blame is ironic. He asks himself what could have driven a woman with a heart condition to work so hard, yet he seems to have forgotten that because of his supposedly health-sustaining lie about her condition, she could not know the risks awaiting her and that she ought to behave as a cardiac patient should. This episode is an exemplary case for reading a diagnostic narrative that wears away authority from within. The first-person narrative illustrates how the disclosure of clinical facts via narrated medical language contrasts with the concomitant dissimulation of these same facts, which is to say the avoidance of clinical speech in either direct or indirect discourse. When the doctor’s privileged perspective is combined with the life-and-death consequences of his “diagnosis,” readers are afforded an insider’s view of the medical narrative’s



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self-doubting deconstruction of the physician’s curative role in the community. The old woman with the heart condition, he reasons, had come to him for a quick fix for her fatigue and shortness of breath. When he does not prescribe medication, the magic bullet that would allow her to continue to work, he understands that his medical authority counts for little: “En sortant de mon bureau elle concluera peut-être à mon incompétence et retournera certainement travailler. Quelqu’un a dû retenir ses services cet après-midi. Elle sait bien que, si elle annonce qu’elle ne peut accepter parce qu’elle est malade, c’en sera fini de son métier” (56) [“When she left my office, probably she would conclude that I was incompetent. She would certainly return to work. That very afternoon someone was expecting her, and she knew very well that if she said she couldn’t come because she was ill, her working days would be over”] (Langevin 1955, 53). Mere seconds after he orders a heart-healthy regimen for his patient, he recognizes that his professional judgment and advice are likely to be ignored. What the doctor posits in this diagnostic exchange therefore is not a disease, or even an illness, but doubt about his ability to exercise his profession. Dubois’s contestation of the established order in Macklin, at least as far as medicine is concerned, is hardly the act of a reforming crusader. Quite the contrary, a series of errors in judgment show him crumbling under his perception of the weight of the conservative town’s expectations of their physicians. The doctor’s narration of his “diagnoses,” and particularly the differences between thought and action that it reveals, indicates how his desire to align with the town’s expectations pushes him to violate the norms of professional behaviour. The tragedies that result from his acknowledged unconventional practices come to be seen by both town and reader as diminishing his esteem and authority. The first-person narration and the medically knowledgeable insight into the doctor’s actions consequently serve as a lens that casts the doctor as a victim of his own authority, or rather the public perception of an authority of which he seems apprehensive. What then does this mean for the Asbestos strike and the national paradigm that is alluded to via Macklin’s resemblance to this reallife town? If the doctorly narrative and the physician’s clinical role in positing disease entities translates to the national stage, Langevin’s protagonist becomes the figure who should be able to diagnose. Dubois, however, frequently dodges his medical responsibility,

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leaving the national paradigm indeterminate at “a turning point in the social history of Quebec” (Trudeau 1974, ix). While the doctor’s personal actions may align him with the ideals espoused by Pelletier, Trudeau, and other new political notables from 1949, his professional conduct suggests that he is not a fictional extension of a rising generation of critical commentators, let alone somebody who will throw himself into the fray of national power struggles. In exercising his professional authority the doctor turns away from it, suggesting that he is, at least to some degree, part of the complex web of professional and political authority to which he reacts. Moreover, it is not just in responding to this authority but also in actually repudiating it that he becomes an oppositional figure for the Asbestos-based allegory. The real-life reformers, while critical of Duplessis’s incarnation of political power, ultimately sought the chance to govern in turn. The doctor, however, refuses medical authority at several points in the novel, only to return to it as a way to defy those who caused him to abandon it in the first place. Dubois’s muddying the waters of the Asbestos-based allegory notwithstanding, he ultimately succeeds in reading problems with clinical practice in Macklin as problems with medical, and by extension, national authority. In riddling the diagnostic process with selfdoubt, the doctor suggests that authorities, both aspiring (for he is the untested authority in town) and established (in that he is a member of a socially powerful, traditional profession) were going through a period of self-examination and reassessment of the processes by which authorities are constituted. In making clear how medical language, outcomes, and seemingly unrelated factors such as the physician’s age and origin consolidate or undermine the automatic association of authority with positions of social influence, Dr Dubois creates possibilities for changing the way both the readers and the townspeople think about authority. The oblique discourse on power that the doctor illuminates through his questioning and deconstruction of his own role speaks to the social and political climate in Quebec at the time. At the moment that historians like Behiels (1985) and Cuccioletta and Lubin (2003) cite as one of the opening events of the cultural Quiet Revolution, the issue of who could be considered the national authority in Quebec was more uncertain than it had been in over a century. The alliance of the state and the Catholic Church, normally buttressed by



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the Church’s direct involvement in (and financial underwriting of) presumably secular institutions, began to crack under pressure as the Catholic unions backed workers against the “unholy alliance between the Duplessis government and foreign-controlled big business” (Behiels 1985, 121). Anti-clerical, liberal intellectuals and reform-minded nationalists stepped in, also backing workers, a move which made for odd bedfellows as the Church and those who would diminish its influence became allies, if only temporarily. The elements that contribute to the earlier concept of authority consequently had to be weighed against each other in a conscious way. In re-evaluating the national paradigm and the group of those with the power to change it, Langevin uses the illness narrative to challenge not only the ready-made Asbestos allegory, but also Quebec’s understanding of who is a national authority and how their power over the exemplary function of the national paradigm is exercised. The diagnostic narratives of the 1940s and ’50s defy easy interpretation by complicating and refusing obvious allegorical resonance. They undermine the process by which doctors posit the existence of disease and unsettle the concept of authority as it applies to and springs from clinical practice. The unconventional scenes of diagnosis featured in the illness narratives threaten the integrity of the many critical readings that presuppose not only that Quebec’s national paradigm can be read allegorically via the body, but that because a patient’s body is by definition sick, the national paradigm is also diseased. Rather than defying the critics’ diagnosis of Quebec’s national paradigm with one easily recognizable textual symptom, however, the diagnostic narratives themselves resist easy categorization. In some narratives, patients are portrayed as being at the mercy of the clinic, its alienating rules, and its unilateral pronouncements. In others, patients act as arbiters of not only social, but also medical authority, which causes physicians to abdicate professional respect and their claims to influence in the community. The same diagnoses, in some cases, carry tremendous social significance and, in others, are effectively devoid of meaning. Some diagnostic exchanges reinforce the hierarchies of the Foucauldian clinic while others so disrupt the classic relation between doctors and patients that the line between physicians and those they treat blurs. By avoiding any formulaic or

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consistent forms of resistance to the usual diagnostic plot, Quebec’s illness narratives reveal themselves as intricate cases that eclipse allegorical interpretations centred on the simple presence and naming of sickness. Quebec’s atypical diagnostic narratives, in drawing attention to the abnormalities and ambiguities of the process, make the diseases secondary to the manner in which they are diagnosed. This shift in priorities undermines the impression that the national facet of Quebec’s medico-national narratives is the sickness that it projects back upon the nation. Instead, these tales of diagnosis refocus attention on the mechanisms by which diagnosis posits disease as a culturally, scientifically, and allegorically important entity. Reading the illness narrative in way that considers how diseases, like national paradigms, come into being therefore becomes a way to understand Quebec as a nation that is neither objectively (or at least uncomplicatedly) sick nor synonymous with a vision of (sick) nationhood articulated by national authorities. We are thereby entreated to question exactly what (if anything) the pronouncements of sickness mean for the nation, and in so doing, we become aware of how tenuous the link between bodies and nations can be when the full complexity of the diagnostic process is considered.

3 Sick Doctors

When Dr Dubois, the physician from Langevin’s Poussière sur la ville (1953), is called upon to deliver a hydrocephalic baby while drunk, he is at the mercy of the community’s judgments of his medical competence. Unlike the earlier instances of medically suspect behaviour, the delivery puts the doctor in a situation where his unprofessional acts can neither be concealed from the public nor controlled. His medical skill is tested in a very public way, and as a result, both the reader and the community of Macklin are led to believe that he is not competent. Hindered by drunkenness, the doctor and his impaired state generate surprisingly little concern from his patient and her watchful family: “Pas un mot n’a encore été dit. Et je m’aperçois soudain qu’ils savent tous que je suis gris. Je dois empester le whisky à dix pas à la ronde. Ils me regardent faire d’un œil calme qui ne juge pas, constate seulement. Ils ne se demandent pas même si je suis en état de pratiquer mon art” (Langevin 1953, 116) [“Not a word had been said yet. And I suddenly realized that they knew I was drunk. I must have stunk of whisky ten feet away. They looked at me with calm eyes that did not judge, but merely sought to ascertain the facts. They did not even ask if I was in a fit state to practice my profession”] (Langevin 1955, 119). The family’s silence and neutrality toward his obvious inebriation initially seem to run contrary to the precedent by which Dubois finds his medical credibility openly second-guessed at every turn in Macklin. This unusual reversal leaves the drunken doctor stunned. The unsuccessful attempts to deliver a deformed and truly unviable fetus nevertheless allow him to save the mother, turning the doctor into a bizarre model in Québécois medical narratives.

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Incapacitated or “sick” doctors – the term I use to denote physicians whose own health or physical fitness to carry out their professional functions is in question – are paradoxical heroes in a literary tradition that at once emphasizes sickness and downplays cure. The inebriated practitioner musters medical skill and knowledge to occasion a relatively favourable outcome despite his own less-than-healthy condition. A physician like Dubois is, to say the least, an unlikely medical hero: he reeks of whisky, he displays the tell-tale signs of a night of hard drinking, and is so incapacitated by the beginnings of hangover that he resorts to drinking more (a dose of the proverbial hair of the dog) to be functional. All the same, he is the first in a somewhat long line of ill or incapacitated physicians in Québécois medical narratives who unsettle foundational assumptions about both doctors and patients.

Doctorly Exceptionalism Starting with Poussière sur la ville, but truly finding their apogee in the 1960s with Denis Lord’s Aller-retour (1962) and Anne Bernard’s Cancer (1967), sick-doctor narratives draw attention to the curative or doctorly act as a privileged source of authority for the infirm physician. They portray the act of doctoring as a sort of panacea accessible only to physicians. The sudden emergence of these narratives, coincident with the Quiet Revolution, suggests that beyond simply being another manifestation of sick characters, these particular narratives function as allegories of crisis for traditional figures of national authority. As the influential and prestigious medical profession is reduced to patient status, the collective ailments of the doctors that epitomize it imply that the privilege of good health is not assured by a socially privileged status. Like the national authority of Duplessis-era political leaders and clerics, sick doctors had to get used to seeing their roles change. Yet it is the odd resiliency of sick doctors (as opposed to ailing characters in general) that challenges the imputed national allegory of authorities in crisis. The physician’s uncommon ability to regain his health implies a contradiction and turns the allegory into a fraught analogy. The doctor’s recovery, crucially, allows him to live to tell the tale of his own sickness and cure, thereby transforming the national allegory and the potential false analogy into an allegory of reading, for illness and recovery become preconditions, rather than



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“events,” in the sick-doctor story. The physician’s illness paradoxically allows him to display his medical authority and skill as he cures himself, revealing the ultimate dominance, rather than the fragility, of medical authority. If sick doctors are initially taken as literary expressions of crumbling national authority, their predetermined and self-initiated recovery suggests either that national authority is not as tenuous as the dominant historiography of the Quiet Revolution has made it out to be or that doctors did not play the national role that the familiar allegory ascribes to them. The rationale for reading doctors as figures of national authority in Québécois medical narratives of the mid-century period stems from a generalized understanding of their social role in the province leading up to this time. Rising to prominence through a classical education, the limited percentage of upper-middle to upper-class students destined for post-secondary study chose among a limited few career paths: law, theology, and medicine. These traditional professions were still the most obvious and recognizable means by which one attained a superior social status, although technical and commercial training were also gaining ground, and the humanities and social sciences came online in the 1940s. Religious vocations, while failing to attract many newcomers, were still tremendously important, as parish priests and other members of the clergy wielded considerable influence. The effect of concentrating social (to say nothing of economic and political) capital in the hands of select groups of educated people made it both possible and common to equate higher education with the national authority long exercised by Quebec’s politicians and priests. Legal training, either as a lawyer or as a notary, often propelled people toward politics at all levels of government. The de facto link between legal training and politics assured influence, both legitimate and non, to this group, for it controlled a wealth of patronage dollars and public spending, and was able to make laws and create policies for Canada’s largest body of francophones. The historic influence of politicians assures their lasting influence not just on the current administration, but also on the way that the nation conceives of itself. From the time of the Conquest in 1760 the province’s leaders styled themselves as the guardians of the French language, civil law, and the Catholic faith. In so doing, they fused French Canadian distinctiveness with political authority, making government virtually inseparable from what has typically been the loudest and most

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powerful expression of a French Canadian national paradigm. Being a politician therefore entailed speaking on behalf of French Canadians in Quebec as a nation and not just as a political constituency. Priests, like politicians, frequently surpassed the strict limits of their profession or vocation because of their tremendous social and political sway. Especially in the small villages and towns of rural Quebec, members of the clergy were key figures of the community whose influence permeated nearly all aspects of life. From schools and health care to unions, sport, and politics, the church had a role to play in Québécois life and used this almost universal access to the people to perpetuate a vision of the nation and national life that was nearly impossible without the institutional and spiritual intervention of the Church. Taking on these responsibilities, including in a financial sense, further secured the clergy’s place among Quebec’s influential governing class. Maurice Duplessis “declared Quebec a Catholic province and actively promoted the Church’s welfare” (Seljak 1996, 109), and he championed the idea that the Church and the government were mutually reinforcing extensions of each other. In this power-sharing arrangement, the Church was granted much leeway to administer and dictate policy and curricula as it saw fit. The state’s delegation of social services provided unfettered and nearly total access to a population that depended on these essential services and furnished something of a captive audience for the Church’s message about its own centrality to the nation. Both the priests and politicians, as suggested by the history of the pre–Quiet Revolution period dubbed the grande noirceur, helped to prop each other up as local elites and national authorities.1 These two groups banded together under the banner of “traditional religious nationalism, which united a conservative, clerical version of Catholicism and French Canadian ethnic identity” (Seljak 1996, 109). It is in this manner that social prominence in the community, whether via direct influence or mere assumptions about education and social standing, was parlayed by politicians and priests into national authority. Physicians, often thought to occupy only the margins of the national stage by comparison, were nevertheless perceived as filling just “as vital a social role” (Trudeau 1968, 11) as the other professions within the traditional organization of society.2 The doctor was a notable member of almost all of the province’s communities, no matter how large or small. He was educated, generally occupied



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a superior economic rank, and personally (and often single-handedly) provided an essential service for the population. This standing is faithfully reflected in the province’s literature, particularly in rural or small-town settings, where, with the exception of the priest, the caretaker of the population’s spiritual rather than physical health, other social elites were scarce.3 Whereas religious influence was in decline from its nineteenth-century peak and disaffection with politics is a perennial phenomenon, the doctor’s prestige and authority experienced a boon between the Second World War and the Quiet Revolution. High-profile medical innovations that reduced mortality and occasioned dramatic improvements in public health elevated physicians to the rank of guardians of a population that still clung to its long-inculcated survivance mentality.4 Baillargeon’s (2002, 2009) studies of motherhood make explicit the ways in which physicians cast themselves as both monitors and saviours of the demographic advantage that secured electoral (if not economic) dominance for francophones within Quebec. Doctors, ostensibly on the periphery of the well-documented alliance of politicians and priests that turned la survivance into a state ideology, thus participated in the national mission through the very concrete and empirical means of keeping Quebec’s francophone population alive, healthy, and growing. Tasked with a function as important as this, it is little wonder that the physician’s ill health in sick-doctor narratives may be construed as a challenge to the standing that doctors, and by extension other national authorities, epitomize, if only because their arm’s-length connection to the more identifiable elites allows them to stand in for priests and politicians who could not be criticized as directly, given the political climate.5 The physician’s sickness, although effectively an illness like any other, is most often construed as an event or a circumstance that imperils the physician’s social role and professional authority, because it strikes to the heart of what distinguishes doctors from patients. Medical training inculcates an “irrational belief that … intimate contact with disease and death confers immunity” (Charon 2006, 24), and John Nolland argues in his examination of the biblical exhortation “physician heal thyself” that there is an “implicit assumption that at least ideally a doctor should enjoy perfect health” (1979, 198). The infirm physician, the subject of parables and cautionary tales, is perceived to be an aberrant figure, one incongruous with the idea(l)s of what the profession entails. Like the immoral priest

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or the corrupt politician, he is tainted by allusions of hypocrisy and incompetence for showing himself to be subject to the same foibles and afflictions as the population at large.6 For sick doctors, the double standard of perfect health is just as common in the closed ranks of the profession as it is among laypersons. Galen, the medical pioneer whose insights dominated the field until late in the early modern period, had reflected upon the idea of the ailing healer and had responded to it being used as a jeering insult among physicians (Nolland 1979, 202). For one of the founders of Western medicine to comment upon the legitimacy of such an affront in his writings reifies and practically codifies the unnatural monstrosity of the sick doctor for the medical profession. Qualitative evidence collected by Robert Klitzman reveals that modern physicians have not left Galen behind, as they discriminate against and marginalize colleagues who find themselves severely or chronically ill: “Once they were perceived as sick, these doctors lost status and power. Illness might not impair a physician’s ability to function, but was nevertheless seen as doing so” (2008, 130; original emphasis).7 The perceived loss of medical skill instigates calls, whether explicit or only quietly expressed, for the fallen elites to remove themselves from the positions of authority they occupy, at least until the conditions that disqualify them are remedied. Consequently, the sick doctor who continues to practise, while hardly an anomaly since illness and death eventually find us all, is viewed as an extreme and disconcerting aberration that blurs the roles of doctor and patient. While ill physicians in real life are far more common than many would suspect, the doctors in Québécois medical narratives, particularly after 1960, seem unusually predisposed to sickness.8 Both when considered on their own, and when compared to other groups, professions, or classes in Quebec’s illness narratives, doctors appear to be one of the sicker populations. The patients in the illness narratives as a whole come from a variety of professions (bank tellers, engineers, writers, businessmen, hairdressers, housewives, retirees) and social classes (urban poor, lower middle class, struggling farmers, affluent townsfolk), but no single characteristic dominates the ranks of Quebec’s sick characters as much as medical training does. Within this group, unified only by their profession, the conditions range from very specific diseases of known physical etiologies (lung cancer) to vague mental illnesses and contested somatized behaviours



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(alcoholism). Despite the variety of ailments, the sudden presence of sick doctors in the 1960s presents a striking pattern that has largely escaped attention in Québécois literary criticism. The question that nevertheless remains is why literary physicians, an erstwhile healthy and unremarkable group, experienced an epidemic of illnesses starting in 1960. The answer may lie in the changes initiated as part of the Quiet Revolution. When the provincial Liberals under Jean Lesage defeated the Union Nationale in 1960 (following the deaths of leaders Maurice Duplessis and Paul Sauvé) they began what was perceived by many to be Quebec’s overdue removal of elites who, like sick doctors, had long since lost legitimate claim to the positions of power and influence they held. Political newcomers ousted Union Nationale members from their seats in the Assemblée Nationale, purging the government of what many saw as corrupt and ineffective leaders.9 The change in political regimes and the policy changes that ensued also brought the Church’s formal ties to the government, which had been weakening over previous decades, to an end, as their administration of social services was taken over by newly formed or greatly reinvigorated provincial ministries of education, welfare, and health. By no longer directly controlling school curricula and the provision of social services, the Church found its authority in Quebec circumscribed. To put it somewhat simply, the Quiet Revolution deprived the national paradigm of its former exemplary leadership as it transformed one-time political leaders into ordinary citizens, administrator-priests into simple spiritual advisers. The medical narratives of the period had a similarly metamorphic effect on their physician-protagonists; it changed them from ideally healthy people into diseased individuals, from doctors into patients. It was as though the real-world changes affecting the political and clerical elements of Quebec’s social triumvirate were, for the doctors, playing out in literature. The overwhelming presence of the sick doctor may therefore be taken as an indication of a need for reform of the social and political authority in Quebec, one that coincides with the sweeping socio-economic, bureaucratic, and nationalist upheavals in the province. If, however, the surge in sick doctors can be read as an allegory for a nation ridding itself of old or ineffective authorities, the illness narratives stop short of fully dispensing with the elites. Although the stories present stark and often shocking portraits of their ill physician-protagonists they also reorient themselves away

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from the doctor’s disease and illness to focus instead on treatment and the healer’s recovery. That cure should play so central a role in medical narrative is not surprising. Western medicine, contends Arthur Frank, is “obsessed with cure,” to the point where full recovery becomes “medicine’s single-minded telos” (1995, 83). According to this logic, it is imperative that the representatives of medicine as social institution, the doctors, embody the founding assumption of their discipline: that their treatments be effective. What this means for Québécois texts is that the physicians’ stories, unlike the earlier patient-centred narratives, focus less on illness than they do on treatment and the patient’s recovery. Moreover, the sick-doctor narratives are driven by the search for cure, which is in itself remarkable for a literary tradition marked by morbidity. The literary doctors are thus provided with a loophole that the Quiet Revolution did not furnish the province’s priests and politicians. As the clinicians are able to resume their practices, they also restore their professional identities and re-establish their social and specialized authority as doctors. The physician’s slipping between health and sickness, and back again, consequently becomes a sticking point for the allegory of the nation’s traditional authority figures permanently giving way to new ones.

The Talking Cure Given that Poussière sur la ville does not deal explicitly with an ailing doctor, but rather with one who is temporarily incapacitated, this early text may be read as a precursor to the much more resolutely “ill” of the sick-doctor narratives that followed. As the first of these stories, Langevin’s novel nonetheless raises many of the questions  – namely competency, the limits of the physician’s role, and self-cure – implied in the physician’s becoming a patient. Contrary to expectation, Dr Alain Dubois’s obvious alcohol-induced impairment generates little comment from his patient or her family, for they remain mute about any concern they may have. Indeed, the doctor feels the need to comment on their lack of response, which implies his own, medicalized, doubts about his professionalism. With the possibility of his patient’s recovery and all it entails for his professional standing still firmly in his hands, the drunken physician’s circumstantial incompetence is not sufficient to pre-emptorily challenge his authority.



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Generally, the physician’s own health, state of mind, and bodily limits seldom appear to elicit comment, much less restrict medical authority, judgment, or ability in medical narratives. While the parable of “physician, heal thyself” suggests that the doctor’s (ill) health is a subject that merits reproach, there is little resonance between the biblical exhortation and Quebec’s sick-doctor narratives. Even the implied allegory of national authorities in crisis suggests that the sick doctor should both be noticed and dealt with accordingly; if the physician cannot live up to professional expectations, he should be removed from his position. These precedents notwithstanding, the narratives almost never fulfill this expectation. Quite the contrary, the physicians seem to practise medicine almost unimpeded by their indispositions or the scrutiny they should occasion. Furthermore, the physician’s weaker or less authoritative state paradoxically allows the sick doctor to cure with double the efficiency. This is to say that in treating others, the infirm physician is also able to remedy his own condition. In the most pronounced instance of this doubled cure, Dubois literally eliminates his own drunkenness from the medical narrative by simultaneously engaging in diagnostic and self-curative acts. Initially unable to see straight, to concentrate on the road in front of him, or process the simple answers to the medical questions he was asking his patient’s family, his debilitating symptoms disappear once he falls into the routines of medical reasoning and delivering a baby so familiar to a country doctor: Pendant ce temps j’ai pris ma décision. Je donne un peu de chloroforme, puis je fais deux brèves incisions latérales. J’ignore ce que je vais saisir avec le forceps, mais je n’ai le choix qu’entre l’inaction et les fers … Le forceps glisse. Je me reprends. Peine perdue. Il est trop petit. Je n’en ai de plus grand … Mais qu’est-ce que c’est, grands dieux ! Pas le placenta. Le forceps l’aurait saisi. J’enlève mon gant et vérifie. Je vois tomber ma sueur sur le lit. Je touche des cheveux! Je ne suis plus ivre ! Je ne me crée pas moimême des monstres! Cette tête-là est celle d’un monstre. Elle est engagée dans le col, le bloque complètement et fait ourlet à l’intérieur. Puis l’idée me stupéfie. Un hydrocéphale! … Oh! mon cerveau fonctionne maintenant, à sa plus grande vitesse. Tout est clair, cruellement clair. Mes prochains gestes je les vois, leur inexorable enchaînement.” (Langevin 1953, 117–18; my ellipses)

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[Meanwhile I had made my decision. I gave the patient a little chloroform and then made two lateral incisions. I didn’t know what I was about to seize with the forceps, but my only choice was between the instruments and utter inaction … The forceps slipped. I got hold of myself. It was work wasted. The forceps was [sic] too small, and I had no larger ones with me … But good God, what could it mean? There was no placenta! The forceps would have gripped it. I raised my glove and verified the fact. I saw my sweat falling on the bed. I touched hair. I was no longer drunk! I wasn’t creating monsters for myself. The head was the head of monster! It was jammed in the passage, blocking it completely and rimming it. Then the truth struck me. The baby was hydrocephalic! … Ah, my brain began to function then at full speed. Everything was clear, cruelly clear. I saw what my next actions must be, their inexorable progress.] (Langevin 1955, 121–2; my ellipses) The physician’s drunken diagnosis of an unusual birth defect is woven into the remains of his earlier narration of his own near-paralyzing headache. The alcohol-laden sweat of his brow is textually intermingled with his physical examination of his patients, who are more acutely in need of medical care than he. All the same, the headache and the sweat disappear once Dubois realizes that things are not as they should be and that his medical skills will be needed. At the same time as he diagnoses hydrocephalus, he also de-diagnoses himself no longer intoxicated, no longer envisioning terrible drunken sights, for the monstrousness in his mind had become real through his medical intervention. For the rest of the time that Dubois is with his patient and her family, neither the signs of inebriation nor those of the looming hangover reappear. The need to diagnose sobers the clinician instantaneously and actually propels him to a more efficient state of mind than is typical of the calculating but bumbling physician. The more his medical presence becomes justified among those who had hesitated to call for his expertise, the more capable and competent the reluctant doctor becomes. Knowing that he is the only one who can possibly save his patient reinforces his medical authority and his sobriety. His clinical thoughts about what must happen next thereafter seem to flow faster than his ability to narrate, as his sentences become clipped exclamations. While the intoxication, hangover, or whichever state in



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between the two Dubois occupies cannot physiologically disappear in a moment, the doctor’s re-entry into the clinical realm, in both speech and the act of examination, propels his speedy recovery. As the physician who both can and does heal himself, Dubois subverts the dictate of the Lukan parable. Typically issued as a kind of warning, “physician heal thyself” suggests that the situation is one that should not occur in the first place. Yet if the circumstances do occur, the incongruity may be attenuated and hypocrisy avoided if the physician first takes care of his own problems before ministering to those of others. Macklin’s young physician is nevertheless pressed into caring for others while incapacitated himself. Transgressing the implied order results not only in the hypocrisy warned against, but also in further potential harm to the doctor’s patient(s) as a result of clouded thinking and unsteady hands. Dubois’s initial drunken actions and the decisions he makes simultaneous with his miraculous recovery are, however, instrumental in bringing about the best possible medical outcome. As his much-respected colleague later confirms, the doctor’s quick thinking and decisive act (puncturing the baby’s fluid-filled head so that the body could pass), the same one that chases away the vestiges of alcohol in his system, is what saves the mother’s life. In going against the prescribed order of events, Dubois begins to redefine the proverb and in the process removes the allegations of hypocrisy; he shows himself to be doubly successful and rehabilitates the figure of the impaired physician. In so doing, he also elevates unwell clinicians – a class of sick people who are stigmatized not by the content of their illnesses, but by the mere fact that they are unhealthy – to the status of unlikely heroes. He thereby sets a unique precedent for ill or impaired physicians in Québécois medical narratives, for his ability to bring about the best medical outcome possible (despite the inevitability of the baby’s demise and his own inebriation) serves to normalize, if not exalt, the concept of the sick doctor. The physician, as Richard Malmsheimer argues in Doctors Only, is frequently construed as an idealized figure, plagued by “an untenable image of the doctor as omnipotent and priestlike” (1988, 1).10 One notable facet of this myth is that clinicians are somehow seen as immune to the normal troubles, such as sickness, that plague the rest of the population. One of the sick doctors interviewed by Klitzman rationalized, falsely, that “you can’t be diseased because you’re the one who cures disease” (2008, 33). The manner in which Dubois

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resolves the tension around his own incapacitation is nevertheless the very element that suggests that he does not so much dispense with the ideological and practical difficulties of the sick physician as he avoids them with the narrative equivalent of sleight of hand. As he asserts his doctorly role, perhaps the first time in the novel in which he does so with any conviction or authority, he eradicates his sickness while effectively eliminating any reference to his own therapeutic role or the healing process. In eclipsing his work of doctoring, or more appropriately, self-doctoring, he confounds the act of self-cure and the narration thereof.11 By dispensing with his own potential incapacitation and aberrance in the same narrative act, he remedies his problem of being a sick doctor. In stepping into the physician’s role, it is as if he were able to jump between states of being, trading off his incapacitation for doctorly qualities. Unlike others who may wish themselves cured, Dubois has the authority to declare himself so, which allows him to solve or, perhaps more appropriately, to avoid the paradox of the sick physician. If Dubois can dodge the supposed crisis in medical authority brought on by his drunkenness, the national authorities he allegorizes could not escape the challenges to their own authority. While the luxury of hindsight and history does part of the work of undoing the parallels to the Quiet Revolution, the very basis of nations and national authority also puts the text’s status as national allegory into question. Nations, argues Renan, are constituted by “un plébiscite de tous les jours” [a daily plebiscite] ([1882] 1996, 241) in which the people continually accord to live as a nation. Under what Renan terms a “solidarity,” no one voice, not even that of a so-called national authority, can act unilaterally upon the national paradigm. Yet, Dubois single-handedly reveals his own sickness and then pronounces himself cured as the result of his own doctorly acts. Medical authority accordingly shows itself to be more flexible and one-sided than its national counterpart for dealing with instances of crisis in authority.

Cure as Disease, Disease as Cure Like Dubois, René, the physician-protagonist and narrator in Denis Lord’s Aller-retour (1962), struggles with alcohol’s effects on his medical practice.12 His self-avowed and self-diagnosed alcoholism, however, winds up being the least of his worries, for the deaths of his



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wife and daughter at the end of the first part of the novel precipitate a nervous breakdown. This mental illness leaves René hospitalized and struggling to regain his grip on reality and the aspects of his former life that his illness(es) had forced him to abandon. As he propels himself from one malady to another, effectively providing two sickdoctor stories in one, medicine assumes the dual role of both cause and cure of disease, which makes the doctor’s relation to his profession the link between the two illness narratives.13 The pharmakon-like quality that medicine takes on in this twopronged story stems from René’s uneasy and atypical navigation of his roles as both sick person and physician. Always neither patient nor doctor, yet always also both, René consistently claims professional recognition and rejects patienthood, alternately via doctorly acts and an inherent doctorly identity. This vacillation, not only between doctor and patient status, but also, and more importantly, between the ways in which he asserts his medical authority, suggests that René’s claim to medical power is tenuous at best. Yet in spite of his fragile and shifting pretensions to authority, he solidifies his professional position by doing to himself as patient – being an effective physician – that which his illnesses prevent him doing for others. It is in occupying the liminal space between the two oppositional medical roles that René’s authority is made manifest, and not, as the imputed allegory or even contemporary practice would suggest, put into crisis. In the first part of the novel, René’s alcoholism advances relatively unchecked, as he progresses from teetotalling medical student to fullfledged drunk doctor within a couple of years and a matter of paragraphs. As the doctor’s alcoholism worsens, affecting all aspects of his life, René and those around him come to scrutinize his medical competence, for his professional and ethical standards slide when he is under the influence. Medical acumen and René’s doctor status are cast as spurs to and not casualties of his alcohol-sodden downfall, for the initial illness narrative paints the sick doctor’s detrimental effect on his practice as little more than an inconvenience. When René first notices his drinking severely interfering with his medical studies, he argues to his future wife that he is becoming an alcoholic: “J’ai dit plusieurs fois à Clarence que je devenais alcoolique mais elle ne me croyait pas et pensait que le fait d’avoir été abstinent durant plusieurs années me faisait exagérer mon état” (32) [I told Clarence repeatedly that I was becoming

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an alcoholic, but she didn’t believe me and thought the fact that I had been sober for so many years made me exaggerate my condition]. The self-diagnosis, reported without equivocation or doubt, is nevertheless dispelled by the fiancée’s belief that his earlier abstention had distorted his perceptions and made him overly sensitive to the effects of alcohol. In critiquing René’s exaggerated sensibilities, Clarence, a nurse-trainee, also indirectly challenges his diagnostic acumen because of his unfamiliarity with alcohol’s effects. Her reported reasoning holds that René’s lack of experience with the acceptable or moderate forms of behaviour that constitute the disease prevents him from effectively diagnosing it in its extreme or pathological forms. Her argument establishes, even before the full extent of René’s problem is known, an expectation that the physician have some sort of personal experience  – even if in limited or benign form – with the condition he attempts to diagnose.14 The idea of the sick physician is thus insinuated into the illness narrative not as an aberration, but rather as a prerequisite to successful doctoring. As a result, medical authority can only be strengthened by the moments of alleged crisis occasioned by disease and illness. This in turn gives sick doctors reason to embrace the adage “what doesn’t kill you makes you stronger.” While most would regard Clarence’s ironic defence of René’s drinking as unfounded and potentially irresponsible, René takes it to heart (and to the extreme), as he becomes a full-fledged alcoholic. At some point, though, the doctor shifts from drinking in service of medicine (however bizarre such an idea might be) to imbibing as an escape from it: “Quand je veux me débarasser de cette horripilante servitude de ma profession de médecin, quand j’en ai par-dessus la tête d’ausculter, de diagnostiquer et de prescrire, je cherche une évasion. Alors, il me faut boire, ça devient une nécessité de me plonger dans les délices de l’ivresse” (35–6) [When I want to free myself from the exasperating servitude of the medical profession, when I can no longer stand auscultating, diagnosing, and prescribing, I look for an escape. So I have to drink; it becomes necessary to immerse myself in the delights of drunkenness]. Unlike for Dr Alain Dubois, who finds almost instantaneous sobriety in the exercise of the medical profession, René finds in the quotidian acts of a doctor only a spur for his disease. It is therefore somewhat fitting that the first of the doctor’s medical skills to succumb to the effects of his alcoholism, his ability to diagnose, is also one of the tedium-inducing activities he lists.



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Musing to himself, René asks: “Si ma fringale de rye et de whisky était d’origine névrotique, par hasard? Suis-je un malade? Je serais porté à le croire car je suis un homme de volonté et je réussis tout ce que j’entreprends sauf ce qui touche à la boisson … D’ailleurs, il faut m’enlever cette idée de maladie, je ne suis pas un malade mais un ivrogne” (67, my ellipsis) [What if my raging fever for rye and whisky was, per chance, rooted in neurosis? Am I a sick man? I’m tempted to believe so, because I’m strong willed and succeed in everything I undertake, unless it’s related to booze … No, I’ve got to get away from this idea of sickness; I’m not sick, I’m a drunk]. The doctor’s hesitation to diagnose himself an alcoholic reveals his reluctance to turn medical reasoning inward. This reluctance furthermore juxtaposes two interpretations of excessive drinking: alcoholism and drunkenness. In distinguishing between the two, René implies that one condition is objectively different from the other rather than being a matter of different social definitions (the former medical, the latter moral) of the same behaviour. This most recent deliberation on his condition evacuates the doctor’s earlier, and arguably valid, selfassessment that a disease related to his drinking was a negative influence on his personal and professional life. This time, however, it is not Clarence who demedicalizes his excessive drinking by doubting him and his professional self-assessment, but René himself. In undercutting his own professional skills as a diagnostician, René weakens the medical reasoning that links symptoms to causes, making this cornerstone of medicine the first victim of a disease the sick doctor blames on medicine. Alcoholism, like many other somatized addictions and socially problematic behaviours, is the subject of numerous “conflicts surrounding the ontological status  – and thus social legitimacy  – of behavioral and emotional ills” (Rosenberg 2006, 410). René’s own alcoholism, like the condition in general, allows for little consensus around its status as nosological entity or vice. His internal debate concerning his own diagnosis therefore takes up the larger conflict around somatization in the medical community and anchors it in his own experience. Yet unlike those who see in somatized explanations a “tool for the ideological management of problematic emotions and behaviors” (Rosenberg 2006, 420), René identifies the tool, the medicalized interpretation of the problem, as the problem (diagnosis) that is a spur to his drinking. He therefore creates a cycle of diagnosis-induced drunkenness.

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As a doctor, René knows that labelling himself an alcoholic accords professional recognition to a problem that, at least in later years, he tries to hide from everyone, including his colleagues. The drunken doctor therefore rejects the medicalized interpretation of his problem and instead opts for an explanation that neither casts him as an ill physician nor forces him into diagnosing himself. In seeking to diminish the discursive severity of his condition, René demedicalizes not only his case but also the phenomenon of excessive drinking as a disease. Unlike those outside the medical profession whose opinions in such matters count for little in the medical arena, René’s thoughts and actions with regard to his own case contribute to and shape the discourse about substance abuse as a legitimate medical diagnosis. As a doctor, albeit one who shies away from diagnosis, he is in the ironic position of being a medical authority whose refusal to exercise his power in this arena actually shapes the institution and the discourse he rejects. It is thus from the self-selected margins of the medical profession that René intervenes into one of the enduring clinical debates of the twentieth century. He retains his authority, even in spite of himself, simply because he is a doctor. Although the distance that René’s drinking puts between him and the clinic (as institution) is largely discursive in nature, it also has “objective” or “scientific” implications. His grasp of basic medical facts weakens, and what should have been a simple understanding of biological correspondences is affected by his ever-worsening sickness. When he develops terrible headaches because of his constant intoxication, he is slow to connect his aberrant behaviour to an abnormal and unpleasant state of being: “Pourtant, je commence à les redouter, ces dangereux compagnons, car plus je bois, plus mes maux de tête augmentent. Ce ne sont plus des migraines ordinaires mais de violentes céphalées qui durent des semaines complètes, jour et nuit. Je soupçonne mes abus répétés de liqueurs enivrantes d’être la cause première de ces terribles maux de tête” (56) [Yet, I’m starting to fear them, these dangerous companions, for the more I drink, the worse my headaches become. They are no longer ordinary migraines, but violent cephalalgias that last for weeks on end, day and night. I suspect my repeated abuse of intoxicating liquors to be the main cause of these terrible headaches]. The skepticism as to the cause of the headaches is preposterous given the norms of physiology, not to mention common sense. The fact that it took René weeks of constant pain to arrive at this simple association suggests a level



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of ignorance uncharacteristic of even an ordinary patient, much less one with extensive medical training. Just as René is slow to connect his headaches to his drinking, he is also hesitant to link his shrinking suburban practice to his addiction. Despite his wife’s warnings that his patients were taking note of his imbibing and choosing to see other physicians, the doctor remained falsely confident that he would have a steady flow of both patients and income. His ignorance of what should have been an obvious causal relationship only worsens his problems, and this blindness in turn drives him deeper into debt and toward blatantly unethical conduct; he sells pharmaceutical samples, prescribes second-rate drugs because of the kickbacks he receives from their manufacturers, and even administers penicillin unnecessarily so that he can bill patients for a product acquired at marginal cost. Whether René’s ignorance is the result of persistent denial or of his potentially diminished capacity to perceive the effects of his behaviour, the consequences of his addiction spell unprofessionalism. His peers, however, never call him out on his behaviour, no matter now obvious or egregious his medical misdeeds. The physician’s invulnerability when it comes to matters of professional standing accordingly remains in place. The issue of René’s rightful claim to medical authority eventually deteriorates in a scene reminiscent of the ultimate test of the drunken doctor in Poussière sur la ville. Desperate for money to support both his drinking habit and his wife’s cancer treatments, René agrees to perform an illicit abortion. The night before the procedure, though, he is unable to sleep and proceeds to drink all night long, so much so that he finds himself in the same state as Dubois the night that he was called out to the farmhouse for the disastrous delivery. Both doctors were drunk as they committed one of the greatest social and religious sins, not to mention crimes, of mid-century Quebec. Dr Dubois nevertheless felt medically compelled to act as he did and never anticipated having to attend to patients when he sat down to drink that night. René, on the contrary, knowingly performed an abortion and used alcohol to insulate himself from this task. The more René’s profession becomes a problem for him, the more he turns to alcohol as either a remedy or a prophylactic measure. Indeed, as the demands on him as a physician increase, he finds his escape in actions that he recognizes (at least at first) as a disease. René’s illness narrative about his alcoholism makes doctoring the self-declared etiology of his disease, and his disease the remedy for

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the self-diagnosed problem, doctoring. The sick doctor therefore turns the habitual poison (alcohol) into antidote and the normally curative processes into disease-inducing conduct. His illness narrative manipulates and doubles the Derridean pharmakon in such a way that both substances and processes take on valences wholly opposite to what medicine as institution upholds. In trying to escape the trappings of his medical authority via alcohol, René continually finds himself unable to shrug it off. The crisis of authority in the medical narrative is therefore radically different from the one faced by Quebec’s priests and politicians, for whereas René seeks to avoid his authority, the national leaders of the 1950s lost the authority they tried desperately to hold on to. The transitional point between René’s two illness narratives, and therefore between the two stages of his relationship to medical authority, occurs with a definitively destructive act of doctoring. René provides what he believes is a fatal dose of painkillers to his dying wife and child. Waking to find that his daughter had died, joining her mother in an early grave, his connection to reality frays under the combined forces of grief and guilt: “J’ai gâché mon existence et j’ai tué les deux être [sic] que j’aimais le plus au monde. J’ai tué, j’ai agi comme un fou, parce que depuis longtemps déjà j’ai perdu la raison … Je suis fou ! Je suis fou !” (99, original ellipsis) [I’ve wasted my life and I killed the two people I loved most in this world. I killed, I acted like a lunatic because I lost my mind long ago … I’m crazy! I’m crazy!] René’s ramblings become delusional exclamations as he links his medical actions (his administering morphine) to the outcome (death) and then to his own state of mind. While autopsies reveal that the cancer and not the morphine killed Clarence and Jacqueline, this fact is of no import to the doctor. His belief that the drugs caused the deaths at last prompts him to self-assess and self-diagnose. When he does finally turn a diagnostic eye back upon himself, he pronounces the results of his self-assessment using a term, crazy, that is colloquial rather than clinical. Furthermore, his self-diagnosis etiologically links three separate medical cases in one sentence: his wife’s, his daughter’s, and his own. This key clinical act connects his wasted life (likely a reference to his drinking), his medical role in his family’s demise, and his newly weakened mental health. This traumatic event, one that supposedly cuts him off from all forms of logic and reasoning, is nevertheless the turning point at which the alcoholic physician finally acknowledges his drinking



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problem as being medically relevant to his new, more obvious, and potentially more severe condition. As a result, the physician’s acute health crisis strengthens his medical authority at the very moment that he is at both his most and least competent. The illness narrative that paints René as a drunken doctor centres on the medical acts that distinguish physicians from the rest of the population, but only insofar as the ill physician fails to perform them for his patients. René’s shortcomings in diagnosing, prescribing, and treating, owing to his own diminished capacity, are what put his medical authority in question. As René narrates his “descente à l’abîme” (9) [descent into the abyss], he accentuates the instances of medical malpractice that, along with his drinking, diminish his medical authority, both for the other characters and for the reader. The doctor’s deficiencies, or rather paradoxical successes, in acting as a physician are nonetheless ignored when defining medical authority. Basing medical authority on acts is nonetheless what Robert Klitzman identifies as one of the key elements of Western institutional medicine: it “compels its members to define themselves by their work” (2008, 297). Accordingly, clinicians become identifiable by their doctorly acts more so than by their training, their titles, or other facets of their identity. In the second sick-doctor story, however, those around René defer to his professional title despite his undisputable role as a patient and his inability to act in a doctorly manner. It does not seem to matter that he can no longer even pretend to perform the acts that earlier defined the medical role, for the doctor’s identity, once acquired, serves as the basis for medical authority. As René switches from claiming medical authority via empty or problematic acts to exercising it through a hollow identity, he exposes how fragile, but also how tenacious, this authority is. Even in the face of the total evacuation of its meaning, René demonstrates that medical authority is still influential. René’s nervous breakdown at his daughter’s bedside is followed by a narrative break, which corresponds to a two-week period in which he slips in and out of consciousness. During this time and throughout his recovery, René is unable to act as doctor and is largely powerless to take care of himself; simple logic escapes him, he lives by an institutional schedule, and cannot comprehend the therapeutic value of what is being done to him. It is nevertheless during the long and slow period of René’s recovery in the hospital that the ailing

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doctor’s medical acumen and authority are assumed, by sheer dint of his having a medical degree, to be intact in a way that is commensurate neither with his condition nor with his circumstances. René’s breakdown, like any other illness in a physician, stresses his relationship to other doctors. Rather than marginalizing the sick member of their fraternity, however, the doctors close ranks to restore their colleague, who has become a patient, to his former clinical status. Ironically, when René’s condition worsens to the point where he can no longer simply be an alcoholic “sick doctor,” but must become a patient, that is to say, someone under the care of a physician, the professional respect accorded to him increases. The orderlies, pharmacy technicians, and even other doctors are diligent in reminding him of his professional status. They repeatedly address him as docteur, as if to underline his special standing among the hospital’s patients and to remind him of his former role as the non-patient par excellence.15 While one could argue that docteur is little more than a courtesy, the fact that other physicians refer to René by their shared title insinuates a certain level of sincerity, particularly in light of the profession’s tendency to shun its sick members. In continuing to address René by his title, his former colleagues unseat the defining principle of medical authority. They recognize their patient as a doctor not by his acts (as Klitzman contends is the norm), for René has arguably not been a doctor (much less a good one) in quite some time. Instead, they use his title to recognize what is assumed to be an inherent identity. This sets up a peculiar contradiction, for the binary logic of “us” (doctors) and “them” (patients) that shapes medical theory from Parsons to Foucault stipulates that one cannot be both a doctor and a patient. René is therefore the physician who is not one according to logic of either doctorly acts or doctorly identities. Yet he is able to sustain the respect of colleagues, which suggests that his medical authority and sick doctorhood run contrary to established norms, challenging the connotations imputed to both. If the mere considerations afforded René in address expose the limits of the trope, the more substantive ways in which his doctorly identity is put into play in the narrative push the challenge still further. When his colleague and brother-in-law, Charbonneau, checks in on a newly conscious René, he accords his friend special privileges based on his status as a doctor: “Je ne montrerais pas ces lettres à un patient ordinaire mais, toi, tu es médecin et tu connais le processus



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de ta maladie” (107) [I wouldn’t show these letters to an ordinary patient, but you, you’re a doctor and you understand the course of your sickness]. In giving René a privileged peek at parts of his chart, Charbonneau simultaneously identifies René as both doctor and patient. Despite René’s severely compromised state, Charbonneau assumes that his friend knows about the complex workings of the mind and his own case even though the “letters” he is given as a diagnostic tool reveal nothing but a mass of squiggles. Still more unreasonable is Charbonneau’s insistence that René understands (note the present indicative) his sickness even though he remembers nothing of the previous two weeks, and does not know his diagnosis. In seeking to reaffirm the hospitalized doctor’s medical identity, the other physicians invest him with an unreasonable amount of medical knowledge and esteem. Their insistence on building up their infirm counterpart by making him rhetorically (if not actually) responsible for his own care attempts to force René back into a doctorly role in which he cares for himself. The patient is nevertheless unable to fulfill these expectations, and re-establishing medical authority via acts becomes impossible. Authority via identity, while still a hollow construct, therefore becomes the only way for the doctors to uphold the medical authority they once shared. Charbonneau’s good-natured (if optimistic) comments to his colleague and his confidence in René’s capacities still gesture to a peculiar facet of the myths surrounding the sick doctor. If there is a tendency among the general population to blame those afflicted with a particular disease for bringing it upon themselves (smokers for lung cancer, sex workers or intravenous drug users for aids), this penchant is exaggerated among doctors: “Depuis un an et demi tu vivais dans une tension nerveuse extrême qui allait en s’accentuant et que tu alimentais, que tu excitais encore, par tes nombreuses soûleries. Tu es docteur, mon vieux, tu le sais” (108) [For a year and a half you were living in a state of extreme stress that kept getting worse and that you fed and even exacerbated repeatedly with your numerous benders. You’re a doctor, my friend; you know this]. While Charbonneau uses René’s doctorhood as pretence for chastising him, he also reinforces René’s status as a physician. It is nonetheless in pointing out the failed action from the first illness narrative  – the lack of medical reasoning needed to foresee the effects of alcoholism  – that the healthy doctor highlights and reiterates his sick counterpart’s medical identity. The doctor’s physicianhood, the same one

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that allows for blame, is in this manner reappropriated and the (lack of) medical knowledge (used to criticize him) made productive in legitimately reclaiming his former status. As René’s doctors reaffirm his medical identity for him, the patient asserts a doctorly persona despite his illness and hospitalization. Glossing over his treatment, he remarks, “Je double les doses de phénobarbital, mais je ne dors jamais plus de deux ou trois heures” (130) [I’ve doubled the doses of phenobarbital but I never sleep more than two or three hours]. In articulating himself as the subject of the verb, René blurs the line between himself as the doctor, the one prescribing the double dose, and the patient on the receiving end of the prescription. While he exercises no direct control over his pharmaceutical regimen in the institutional setting, the phrasing suggests that he does. Doctorly work is therefore placed – if only narratively – back in his hands. The more René takes on what can be considered doctorly responsibilities and actions within the hospital, the more his own health improves, thereby reversing (or rather returning to normal) the curative valence of his acts. The correspondence of René’s improved health and his renewed ability (and indeed interest) in medicine implies that the ailing physician’s doctoring goes hand in hand with his recovery. This unlikely connection is nevertheless the basis of a secretive treatment regimen devised by René’s doctors to reintegrate him into medical practice. They encourage him to work in the hospital’s small pharmacy and lab and task him with analyzing specimens and writing cursory reports. Even though René knows his toil to be of little clinical value, the sick doctor finds his activities to be beneficial. He muses, “quand je m’y occupe, mes maux de tête disparaissent” (141) [when I busy myself with it, my headaches disappear]. More important than any therapeutic value, though, René finds in the lab a refuge from his life as a patient. He is once again made privy to information about other patients and is seen as a colleague, even a superior, by the young technician who works there with him: “Elle est très gentille avec moi et elle ne me parle jamais de ma maladie” (141) [She is very kind to me and never talks to me about my illness]. In acting as a doctor in the lab, for the one-time physician recognizes that he is playing doctor more so than actually being one, René is able to escape his patienthood and at least temporarily return to his former status as a physician. Resuming the doctorly role is a turning point, for at this moment René is doctorly in both his perceived identity and in action. That these two conditions, which



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best restore medical authority, occur within the clinical space of the hospital where he is a patient would appear to limit his authority. It is, however, only insofar as René is being treated for his psychiatric condition that he is able to regain this authority, since it is only as a patient that he has the opportunity to function and be recognized as a doctor. Treatment and the more severe condition that requires it are (once again) made the preconditions of medical authority that had earlier eluded René because of his alcoholism. The sick doctor therefore depends on his worsened mental state to allow him to both “legitimately” act as a physician and be recognized as such. Despite René’s earlier reservations about medicine, he and his psychiatrists rely on the exceptional patient’s  – the sick doctor’s  – medical authority to bring about his cure. His physicians, in devising a treatment that calls on him to perform his doctorly role to bring about his recovery, assume that doctoring is in itself a curative act.16 They allow him to forget that he is a patient by forcing him into a role that is itself predicated on a binary that rigidly separates doctors from patients. Quite simply, the more doctorly René’s therapy forces him to be, the less patient-like he becomes. His treatment, however, not only draws on but also reinforces the clinical divide between doctors and patients. Since not every patient can engage in the type of therapy prescribed to him (because laypersons cannot practise medicine), the ailing physician’s treatment plan confirms that doctors are a special class not only of patients but also of sick people. The ill physician who can be cured by doctoring is one whose illness, no matter what it is, responds to a treatment that no other patient’s would. Physicians are therefore seemingly infinitely renewable sources of authority, for it is within a doctor’s power to cure him or herself. Cure, itself a proof of medical authority (cf. Alexandre Chenevert), is thus latent in any physician simply by dint of his or her professional identity. It is for this reason that René’s psychologists make it a priority to reinstate and confirm René’s identity as a doctor, even if they must do so via a game of make-believe. Consequently, the very potential for cure via doctoring marks physicians as distinct from any other segment of the population that may find itself sick. That said, it is only in exposing the fallibility and fragility of the physician’s health that doctors are able to show themselves to be so adept at their craft as to go the extra, implausible step to cure themselves. If ill physicians prove to be exceptional in their temporary adoption of the patient role, Quebec’s actual physicians were demonstrating

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their own difference from other, more traditional, sources of national authority at roughly the same time. Stepping back from the association of all social elites with not only national authority, but also the clerico-conservative national exemplar, the province’s doctors quietly set themselves apart. In fact, they selectively positioned themselves against the other, fading, national authorities. Indeed, physicians in mid-century Quebec were often the ones whittling away at some of the institutions that supported those who had the loudest voices in articulating the national paradigm. Since the days of New France, the Catholic Church (largely through the efforts of orders of nursing sisters) administered the majority of the province’s hospitals and asylums, particularly those serving the francophone population. As people moved into urban centres in the first part of the twentieth century, hospitals became the locus of an increasingly specialized and scientific medical practice. This demographic and institutional change brought doctors out of their home offices and house-call-based practices and into the public space of the hospital, where religious and medical leaders jockeyed for influence. Increased staffing needs in health care centres meant that more secular workers had to be hired, and the staffing ratios rapidly shifted the balance of power away from the Church. As Charles, Guérard, and Rousseau (2003) contend in their historical study of changing power dynamics in Quebec’s health care system, the increasingly technical nature of medical care and the greater day-to-day presence of physicians in hospitals vaulted them into administrative roles, even at religious institutions. It was therefore not outside commercial interests (such as private insurers), the Lesage government, or competitors (such as Anglo-Protestant or Jewish hospitals) that undermined the Church’s hold over health care. Instead, it was the doctors, one of the three groups in Quebec’s triumvirate of social elites who carved away at the influence of the clergy. Quebec’s physicians, despite their affiliation with priests and politicians were never actually threatened with the same kind of diminishing influence that their clerical and political colleagues were. If one assumes, as the general allegory does, that physicians were as vulnerable to the upheavals of the Quiet Revolution as other national authorities, Quebec’s doctors not only proved to be surprisingly resilient among the nation’s elites, but (overall) came out ahead. The sick-doctor allegory is not one of crisis and illness for traditional authorities, but one in which the infirm physician’s ability to heal himself mirrors the far-less-discussed role of Quebec’s medical practitioners.



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When René assumes medical agency and shores up his doctorly identity he threatens more than just his illness narrative’s status as national allegory. He also calls into question conventional understandings of the medical relationship in which the doctor and the patient exist as separate and almost mutually exclusive entities. Each pole of this binary is defined by oppositional sets of characteristics: patients are sick, helpless, and receiving care; doctors are presumed to be the helpful, healthy providers of care to others. Scholars such as Foucault ([1963] 2003), Parsons (1951), and Kleinman (1988), who make the physician central to the definition of disease and the adoption of the sick role, have only reinforced the binaries of the clinic as they seek to explain them. By making the practitioner pivotal to both diagnosis and the treatment of disease, they posit sickness within a realm into which doctors must intervene. The sick doctor, however, receives care because he or she is sick as well and as such is often forced by the underlying clinical norms either to fully inhabit the domain of sickness or to allow illness and disease to permeate the supposed realm of health. While many illness narratives, such as the aids novels of Hervé Guibert (1990, 1991), largely dismantle the doctor-patient distinction by, as David Caron argues, destabilizing “the traditional health/ disease rhetoric and the power structure that rests on it” (2001, 113), Quebec’s sick-doctor stories ultimately reinforce the clinical distance between the providers of care and those they treat. Even when sick, doctors embrace their roles as physicians and ignore their illnesses whenever possible. The exception to this dictate, as found in both Alain Dubois’s and René’s illness narratives, occurs when the infirm physician cures himself. This exceptional act draws attention to the healer’s own sickness. In doing so, however, it also re-establishes the conventional and binary order of the clinic. Quebec’s sick-doctor stories therefore operate in a manner that questions but does not fundamentally destabilize medical power relations.

Curative Patienthood Xavier, the cancer-stricken obstetrician in Anne Bernard’s Cancer (1967), reprises the uneasy navigation of the liminal space between doctorhood and patienthood in a story narrated by his all-but-anonymous wife Isabelle. Unlike Dubois and René, whose actions and narration reinforce their medical authority in spite of their illnesses, Xavier’s doctorhood is largely taken for granted. Yet by showing

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how the sick doctor can take on certain elements of the patient role and reject others, Xavier’s sickness provides a new perspective on the paradoxical position of the ill physician. He manages his dual role by continuing to act as any other doctor on an interpersonal level, but also by consenting to be the patient in – and for – a larger medical context. Acknowledging the contradictory role in which he finds himself because of his disease and the figurative repercussions of his being a sick doctor, Xavier becomes a full-fledged patient as a sort of sacrificial gesture for the good of his profession. In allowing others to cure him, the cancer-stricken doctor is able to heal the enfeebled authority of a profession symbolically weakened by the sickness of one of their own. Unlike many sick-doctor narratives, Cancer is told from the perspective of a healthy layperson and not by the ill physician himself. Despite the change in narrative voice, the narrator nevertheless brings to the sick-doctor story an affective experience of patienthood that is reminiscent of the illness narratives of the 1940s and ’50s. The healthy Isabelle adopts what may be thought of as a patientlike tone and mannerisms from the outset of the novel, mimicking what Talcott Parsons (1951) has called the sick role. She does so to such a degree of stereotypical perfection that one may in fact wonder whether Bernard had a copy of Parsons’s sociological study open beside her as she wrote. Isabelle, for instance, exempts herself from her social responsibilities until the cancer is in full remission, fervently believes in the possibility of cure, and pursues every option to bring about a full recovery. Her experience of her husband’s cancer is so slavishly close to Parson’s definition that it seems as though she and not her husband were the sick person. She is the one who withdraws from her social circles while he continues his professional and social interactions unfettered. She decries the pity and paroles réconfortantes (27) [comforting words] offered to her by her friends. Indeed, she goes so far in her adoption of it that she depicts herself using physical descriptors associated with various disease states, as though to lend rhetorical legitimacy to her claim of being the patient. She brings pathology upon herself in her narration, proclaiming, “je suis un paquet malade” (51) [I am a bundle of sickness] and likening herself to “une plaie vive, écorchée par le moindre souffle” (53) [an open wound, flayed by the slightest breeze]. As her husband recovers, she seems to enter a state of remission as well, announcing “j’étais en train de guérir” (141) [I was in the process of healing].



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Isabelle’s narration confuses the logical object of her discourse, her ailing husband, with her as speaking subject. In pronouncing herself in remission, she poses a stark contrast to her husband, whom she simply says by way of status report has resumed work following his operation. By emphasizing her act of recovering but skipping over the undoubtedly long and painful process of coming back to work following a surgery that opened the thoracic cavity, Isabelle foregrounds the affective component of the illness experience at the expense of its physiological elements. She therefore establishes a physical parallel to her emotional understanding of Xavier’s illness and takes it upon herself to feel sick or well. Isabelle’s psychological adoption of her husband’s cancer acts as a bizarre defence mechanism, aimed not at protecting herself, but rather her husband. She introjects his cancer and takes on the characteristics of his bodily state. Introjection, an act that Hoyle Leigh and Morton Reiser (1985) attribute to patients who seek to graft elements of a healthy identity onto their sick body, is – in a highly unusual reversal  – Isabelle’s way of assuming her husband’s disease. Her embrace of behaviours and defence mechanisms normally attributed to patients creates a unique situation whereby she dissociates sickness from patienthood and cancer from the presence of cancerous cells. While seemingly odd, Isabelle’s comportment is not actually that unusual. Like many couples threatened by disease, “the spouses become bonded … seeing themselves as together requesting and receiving care” (Klitzman 2008, 221). Illness experiences such as these also find resonance in other medical traditions, such as those of traditional Chinese medicine, where “the illness is believed to be constituted by both the affected person and his family: both are labeled ill” (Kleinman 1980, 73). Isabelle does not simply add herself to her husband’s illness though. She assumes the role of patient so that Xavier does not have to, except in the most technical sense. While he is the one who undergoes the procedures meant to treat his biological disease, she assumes the social and psychological dimensions of patienthood that are supposed to belong to Xavier. Their splitting of the patient role into its medical and social dimensions allows Xavier to maintain his status as a doctor, for despite his sickness and his treatment, neither of them view (nor likely care to think of) the ailing physician as a patient.17 By dividing the patient role into a medically acceptable biological sickness and its negatively perceived

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psychosocial dimension, Isabelle is able to buttress the doctor-patient binary. Relegating the elements of the sick role that most contrast with the medical models to herself, she allows Xavier to continue to occupy an imperfect, but still sufficiently “doctorly” role. As in other sick-doctor stories, Isabelle reinforces her husband’s position as a doctor by making medical practice an element of his treatment plan. She recognizes her husband’s practice as a healthful activity in that it serves as a distraction and a guard against fully falling into patienthood. When Xavier is called away to perform an emergency Caesarean section, Isabelle dubs the operation a “diversion providentielle” [providential distraction] and rationalizes that “La concentration d’esprit, indispensable à l’intervention, l’empêchera de penser à son problème” (67) [the mental focus that is indispensable to the surgery will keep him from thinking about his problem]. Isabelle’s reflection on her husband’s dual role, while it tacitly acknowledges his condition, only alludes to his cancer euphemistically. Using problème instead of a word with medical connotations of any sort – illness, sickness, disease, cancer – suggests that the narrator hesitates to bring Xavier’s actual sickness into proximity of his doctorly functions. While it might be expected that distraction is an effective treatment for psychological illnesses like René’s, it is less plausible that engrossing oneself in Caesarean sections will cure small-cell carcinoma. Nevertheless, the diversion is given a relatively salutary valence because it creates a fortuitous hierarchy of sickness. Isabelle’s comment distinguishes the patient’s emergent case from the doctor’s euphemistically chronic one. Since somebody else’s health is worse than his, Xavier appears healthy by comparison and therefore less patient-like. Xavier’s specialty, obstetrics and gynecology, because of the gendered nature of the specialty, also precludes him from ever becoming a patient by the standards of his own practice. By implying that the criterion for successful doctoring is that the physician must appear healthier than his patient, Xavier can reprise his former role. In actively treating others, he definitively resumes his place in the doctor-patient relationship, or at least insofar as the difference between these two actors is predicated by the act of one treating the other. I have previously defined patienthood in a summary way that opposes it to doctorhood and that hinges on binaries of giving and receiving care, as well as of health and sickness. The term patient is



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not, however, interchangeable with the label sick person.18 The story of Isabelle’s experience of her husband’s illness as well as studies like those of Leigh and Reiser (1985) indicate that there is an affective element to being a patient. This less “objective” way of experiencing illness is what lends to the term patient certain negative connotations, particularly among doctors. In distinguishing the patient from the sick person, Kleinman specifies that the term is “redolent with the sights and smells of the clinic” that “leaves an afterimage of a compliant, passive object of medical care” (1988, 4n). Such connotations might explain why the professional literature on sick doctors (particularly the literature about how to deal with clinicians whose conditions interfere with their work) rarely refers to physicians in ill health as patients. The British Medical Journal, for instance, features a number of articles on physicians who find themselves ill but does not typically designate them by the marker patient.19 Isabelle’s surrogate patienthood is confirmed by the way she acts in the clinical setting, mirroring Kleinman’s description of the patient as passive and compliant. These tendencies are exacerbated when Xavier is in the hospital, at his most patient-like as well. For example, whenever her husband is speaking with his physicians, Isabelle is never present, always relying on her husband to interpret the findings and treatment plans for her. Additionally, she knows that Xavier is fully aware of his prognosis and the likely side effects of the treatments he elects, but she does not share such details with the reader, as if to suggest that they are hidden from her as well. It is thus she, and not the expected patient (the sick person), who is passive and compliant, for Xavier’s colleagues always consult him extensively about every aspect of his care. Compliance with medical authority, when coupled with the affective response to illness, does much to suggest that the “patient” in Cancer is actually Isabelle. The sick person and the patient of Kleinman’s explanations are, therefore, not one in the same, but rather two separate individuals for whom neither health nor disease define patienthood. In disaggregating the sickness from the authority-laden implications of patienthood, the doctor can be sick without surrendering his medical authority. Xavier’s authority-preserving status as sick person without being a patient is, however, not absolute, for he is under the care of (fellow) physicians, a precondition of patienthood according to Kleinman and Parsons. All the same, he resists the vestiges of this role. Despite his increased odds of successful treatment, owing to his being a medical

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vip and having the latest therapies available to him, Xavier engages in these treatments with a sense of futility and reluctance, not the expectation of cure, as he prefers to finish out the rest of his days treating patients and living a good life: “C’est ce que j’ai de mieux à faire. Travailler le temps qu’il me reste à vive. Finir en beauté” (56) [That’s the best I can do. Work for however long I have left to live. Go out on a high note]. The eventual decision to undertake painful and potentially life-shortening treatment, although a dilemma for many patients, is reached in spite of Xavier’s insistence that his schedule and medical activities, like the outcome of his treatment, will be unaffected. Patients undergo treatment with a presumption of cure, or at the very least a sense that their conditions will improve or their discomfort will lessen. They submit themselves to the clinic (and its demands on time, finances, autonomy, and bodily limits) in the hope that it will yield positive results. Such a belief stems from an assumption that the sick will get well, that health will be restored, and that the patients will go on to tell the tale from the perspective of no longer being patients (Kleinman 1980, 437).20 Xavier, however, is under no such illusions and even successfully convinces his wife (who now wonders why he would reform his engrained behaviours, such as smoking, knowing that he will not recover) that death, and not cure, will end his illness experience. That he does finally consent to treatment and the assumptions of patienthood it entails comes as a form of professional courtesy, not out of a genuine adoption of the sick role: “Puisqu’il se laisse traiter, il le fait consciencieusement pour donner toute latitude aux médecins d’accomplir leur travail comme il le ferait, lui en pareille circonstance … il se soigne surtout pour les autres, pas tellement pour lui” (77, my ellipsis) [While he is letting himself be treated, he is doing so conscientiously, to give the doctors the latitude to do their jobs, as he would under the same circumstances … he is being treated mostly for the others, not so much for himself]. Treatment is meant to appease doctors and to maintain professional norms, not to cause him to go into remission. Yet in these seemingly altruistic acts that make him clinically submissive, Xavier is able to regain the authority imperilled by his cancer and also by his initial lack of faith in medicine’s ability to cure. By submitting to aggressive treatment while doubting the possibility of cure, Xavier engages in what can only be perceived as a profession-, but not life-, sustaining exercise. Treatment is then transformed from an action centred on the body to one



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directed toward an external element for which the sick doctor is emblematic. The Parsonian sick role is displaced onto the entire medical profession via the synecdochical body of the diseased physician. Xavier’s seemingly futile actions to let other doctors try to cure him appear to be a way for him to make professional amends for having fallen ill, and thereby having threatened collective medical authority. In undergoing treatment in spite of disbelieving its potential for cure, Xavier proves to be a sort of sacrificial patient who allows a body that is threatened by his sickness – the medical profession – to be cured. Just like the other infirm doctors who regain their individual health by practising medicine, Xavier provides an opportunity for his colleagues to do the same. He takes on patient status so that they may continue to doctor in spite of both the illness of one of their own and their collective symbolic sickness. In Xavier’s quasi-selfless act, there is an element of sacrificial behaviour reminiscent of René Girard’s concept of the scapegoat, for members of a group who perceive themselves as threatened “instinctively seek an immediate and violent cure for the onslaught” (1977, 84). Becoming a patient in the full and clinical sense of the term casts Xavier as a professional Other and allows him to become the victim of the most literally violent of cures, surgery, which is also sacrificial in nature. Unlike Girardian violence, however, in which the victim of collective aggression receives no personal benefit for having taken on the role of scapegoat, the doctors are able to reclaim the one-time patient as one of their own by curing him while they cure themselves. In successfully treating the physician’s disease and restoring him to health the profession renews the separation of doctors and patients that is foundational to the clinic and their medical authority.

The Patient’s Voice Across all three sick-doctor narratives, the physicians demonstrate uncommon physical and mental resilience attributable to their status as doctors. To be a doctor though means many things, any number of which could influence the potential for cure. vip treatment and access to the best available therapies may help to explain the high rate of medical success. Xavier’s lung cancer is treated not simply with the traditional option of surgery, but rather with “un nouveau traitement employé aux États-Unis” (Bernard 1967, 65–6) [a new treatment being used in the United States]. This description stresses

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both the novelty of a combination of radiation and chemotherapies and the persistent Canadian faith in the fact that the best health care is offered south of the border.21 René’s psychological and psychiatric treatment is repeatedly praised for being innovative and aggressive, and his rapid recovery from a condition that normally takes years to overcome attests to its efficacy. Xavier’s and René’s therapeutic successes notwithstanding, René tries and fails to cure his wife’s leukemia with radiation therapies that are both cutting edge and almost prohibitively expensive, even for somebody as economically privileged as a doctor. Despite the cost and novelty of the treatment, Clarence succumbs to her disease and displays symptoms akin to radiation sickness that suggest that her treatment may have caused more harm than good. The more significant proof of the inherently resilient medical constitution is the overwhelming rate of cure among physicians when compared to other sick individuals in Québécois medical narratives. Xavier’s cancer quickly goes into remission, but the cancers of Daniel Lacasse, Alexandre Chenevert, and René’s wife and daughter (as well as many others, some of which are discussed below) are fatal.22 Dubois’s inebriation almost instantaneously disappears, defying physiology, and René’s alcoholism and his mental illness fade into his past in a way uncharacteristic of those afflicted with similar problems. In the corpus of Quebec’s medical novels, the overwhelming majority of the characters who recover from their ailments are doctors.23 The exceptions, such as Jacintha (Xavier and Isabelle’s housekeeper) and Benoît, a fellow patient in Du mercure sous la langue (Trudel 2001), are often secondary characters whose stories do not delve into the experience of their illness. La survivance, survival, the dogma of Québécois nationalists, is a principle at the very heart of the sick-doctor stories. Because they are generally narrated by the doctors themselves, the texts are predicated on the doctor-patient’s survival and ability to tell the tale of recovery. Aller-retour, for instance, draws attention to the inherently recuperative narrative premise at the outset of the novel. René frames his entire story as a narrative of recovery by stating in the preface that the two-part illness narrative is an autobiographical account of a physician’s health crisis: “Trois cent soixante-cinq jours, sans parler de médecine, sans soigner, sans pratiquer. Repos complet, par ordre des médecins … Pour meubler ces longues vacances, je deviens écrivain et ce simple journal, que j’ai tenu fidèlement prend l’allusion d’un



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roman” (Lord 1962, 7) [Three hundred and sixty-five days without speaking of medicine, without treating, without practising. Total rest, doctors’ orders … To fill this long holiday, I have become a writer, and this simple journal, which I faithfully kept, takes on the qualities of a novel]. Presented as part of the healing process, the narrative both describes and plays a role in his recuperation. Healing becomes, even for those who do not present their cases in such explicit terms, an inherent part of the infirm physician’s narrative.24 Their accounts, to allude to Arthur Frank’s (1995) distinction of the kinds of illness stories people tell, become the ultimate “restitution narratives,” for without the narrator’s recovery, there can be no firstperson, physician narration. If allegory is to be understood as a narrative that can be equated with meanings that lie outside of the narrative itself, the sick doctor’s story poses a problem for the allegory of rebuffed national authorities. This is because Quebec’s sick-doctor stories always contain the physician’s self-driven return to their previous positions of medical authority. To read the sick-doctor narrative simply as a metaphor for the sick nation or, alternately, an allegory of national authority in crisis is an incomplete reading that not only ignores a significant element in the plot – the recovery – but that also discounts its narrative premise. The choice to focus on the illnesses and diseases in Quebec’s sickdoctor narratives and to overlook the recovery is a trend all too common in Québécois cultural studies. There is a penchant, observes Jocelyn Létourneau, for Quebecers to “carry their past like a cross. For them, despite what many historians are now telling them loud and clear, the past is a breeding ground of painful, depressing memories rather than a pretext for positive remembering” (2004, 15). The so-called victim mentality that has plagued Quebec’s history is equally present in its literary criticism. From Moss’s (1984b) aptly titled essay “The Morbid World of the Quebec Novel,” to the numerous studies on the tragedy of madness and psychiatric illness in modern Québécois fiction (Kègle 1993; Lacroix 2012; Moss 1984a; Waelti-Walters 1979), Quebec’s literary and cultural critics have cultivated an ethos of pathology. Just as historians who framed the Quiet Revolution as a radical break from the preceding era hesitated to acknowledge many of the incremental changes that made the 1960 electoral shift possible, the salutary elements within Quebec’s illness narratives have been pushed to the margins of the critical field

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in favour of a readily identifiable and symbolically rich diagnosis. Even the allegories of sick doctors as representatives of crumbling national authority hinge their cohesion on the historical elements and complexities obscured by the nation’s negative remembering; the same ones that Charles, Gurérard, and Rousseau (2003), Gauvreau (2005), Létourneau (2004), Cuccioletta and Lubin (2003), and Seljak (1996) bring back to light, and which complicate the attempt to read infirm physicians as symbols of a sick nation. The lesson of revisionist historians’ revalorization of the period leading up to the Quiet Revolution is that they recognize the salutary elements in the periods of crisis that make the resolution possible. Like the authors whose ill-physician characters not only find a cure, but produce their own recovery, the potential for positive revaluation is always within reach. The sick-doctor narratives, which are inherently recuperative narratives despite the illnesses that occasion them, contain within themselves the undoing of the morbid medico-national allegory and the myth of the (pre-)Quiet Revolution–era sick nation.

4 Strong Medicine

If the Quiet Revolution brought politics to the forefront of Québécois consciousness and infused the illness narratives with a more overt political dimension, growing interest in and support for the nationalist movement amplified this tendency. From what began as a protest movement associated with university students, unionists, and political fringe parties, the nationalist cause morphed into a mainstream political party and a popularly accepted idea thanks to René Lévesque’s Parti Québécois, which formed a government in 1976 and held the first of two province-wide referenda on national sovereignty in 1980. During this era, which is defined by the rise of nationalism, medical rhetoric became an increasingly prominent feature of Quebec’s political discourse. National problems such as economic inequality, political marginalization, and systemic linguistic and cultural discrimination were brought to the population’s attention using metaphors of illness and disease. Politicians and journalists urged the electorate, often employing deliberate medical tropes, to throw their support behind candidates and initiatives, most often advocating the radical solution of independence from Canada, that proposed to solve Quebec’s many and major problems (Robert 2014). The literary scene echoed these discourses of strong medicine for serious ills in its turn toward illness narratives centring on treatment and medical intervention. Unlike the previous illness narratives, those of the nationalist era were blatant vehicles for the authors’ political views. At a time when cultural production and politics were inextricably entwined and the political leanings and activities of (at least some) authors were widely known, Quebec’s illness narratives faithfully emphasized the call for and the effects of decisive action.

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Most explicit in this literary uptake of the strong medicine theme are the revolutionary-nationalist narrators in Hubert Aquin’s Trou de mémoire ([1968] 1993), who wax on about their careers as pharmacists being the perfect training for their often-illicit manoeuvrings on the national stage. More allegorical but no less overt are Jacques Godbout’s twin protagonists in Les têtes à Papineau (1981), who resort to highly experimental surgery to redress the problem of their allegorically rich bicephaly. Pierre Billon’s L’enfant du cinquième nord ([1982] 2003) is more reserved in its handling of the national question, but its resonances can still be discerned in this story that focuses on using aggressive therapies to treat a young girl with cancer and military force to quarantine another young patient with a mysterious illness. Each of these texts foregrounds treatment and cure, but when treatments fail to produce the desired results and occasion severe side effects they ultimately question medical authority’s ability to bring about the desired and supposedly beneficial ends. To hold together the texts of Aquin, Godbout, and Billon may seem a bit of an arbitrary choice, particularly given the chronological distance between the former and the latter two novels and the fact that both Aquin and Godbout are known for their political views, whereas Billon’s take on nationalism has been much more of a private matter. They nonetheless share similarities relevant to the question of strong medicine for serious national ills. First, all three take up, frequently in explicit terms, the fractious relationships between anglophone and francophone protagonists insofar as they differ in their opinions of both if and how radical medical intervention should proceed. This ethno-linguistic demarcation signals an overt engagement with the national question. Each of the texts also differentiates itself from earlier generic models of illness narratives. Godbout’s novel, although it, like Langevin’s, is a roman à clef, firmly rejects any pretense of realism that had marked earlier texts. The story of the two-headed boy(s) is positively surreal in its monstrous premise. Billon’s stories of illness are located within the scope of science fiction, a relatively new literary genre for Quebec and one that, despite frequent uptake of the theme of (bio-)technology as it pertains to medicine, has not traditionally focused on illness as a lived personal experience. As for Aquin, he alternates between the epistolary and the confessional journal whose disputed intradiegetic authorship itself is a source of intrigue. As the authors take less conventional approaches to narrating the nation



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via allegories of illness, they daringly intervene in the larger cultural process by which Quebec articulated its nationhood via the figure of the sick protagonist. Their textual innovations build upon the shift to first-person narration in the sick-doctor stories to further displace the focus of the illness narrative from the simple presence of pathology in conventional texts onto the often-problematic act of narrating illness. A further point of commonality is the consciousness of the performative nature of medico-national allegory that each of these texts displays. By this I mean that the texts point to the ways in which they seek to deliberately intervene in the positing of the nation. Rather than simply acting as diagnosticians, as Jameson (1986) argues authors of postcolonial allegories do, the authors of these narratives evoke the specific political concerns of the day and employ provocative literary choices (such as those related to genre) to incite discussion about what can or should be done to address these issues. Their focus on the curative aspect of medical narratives emphasizes the way in which the nation, presumed to be in need of cure, can be treated through the discursive intervention of the medico-national narrative. The texts, especially given the challenging ways in which they were written, prove to be enticements to determine the best course of curative action for the nation and to enact it. In essence, the texts (like the politicians of the day) make rhetorical and discursive choices that call upon the reader to take responsibility for the decisions that will determine the future of the nation. Finally, the three novels are united by their mismatch between clinical intention and outcomes; the medical interventions in the stories do not produce the anticipated (largely owing to what is known about an author’s politics) or desired results. Although this major feature of each of the texts can be interpreted as undermining the nationalist agenda, which advocated the most radical approaches to Quebec’s problems, the failure of the treatments can also be seen as opening up a space of genuine debate and discussion about how best to approach the national question. Using the fiction of the often unsubtle allegory to intervene in the real-life discourse that both references and enacts  – and at this crucial juncture potentially redefines – the national paradigm, these texts do far more than simply disrupt the diagnosis of the nation as sick or challenge national authority. The writing of the nation in these texts brings the questions of the fiction, specifically those about treatment, to bear on the nation.

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The Imperative of Treatment Like diagnosis and the doctor-patient relationship, treatment is an aspect of medical practice that is subject to conventions and debates, most notably about when and how one should treat. As discussed in relation to Xavier in Cancer (Bernard 1967), the sick role compels patients to seek out cure wherever possible. In modern medicine, which subscribes to a theory of sickness based on disease, there is a presumption that if the means to treat a given condition are available they should and will be used. Medical ethicists, who work from theories of sickness based on the patient-centred illness, however, are increasingly concerned with the decisions about whether treatment should or should not proceed, and even then, whether it should be aimed at curing disease or helping the patient. As countless studies and even popular debates suggest, such matters are highly contentious, for what counts as a disease needing treatment (even in the case of a dreaded diagnosis like cancer) is often a matter of dispute (Chapman, Barratt, and Stockler 2010; Sulik 2011). Aggressive and palliative approaches, as well as forms of therapy based on different medical paradigms (alternative versus conventional Western medicine) vie for legitimacy depending on the circumstances and the theory of sickness being brought to bear on the case. As Cassell (2004) argues, a medical perspective that seeks to eliminate or correct pathology within the body will produce a treatment plan that prioritizes the biological aspects of the disease. A patient-centred orientation, by contrast, might seek to minimize the disruptions that treatment entails or could mean that the therapeutic interventions do not actually target the biological causes or effects of the illness, but provide benefit via symptom relief instead. Central to most debates about treatment are ethical questions of risk. The consequences of inaction must be weighed against the dangers posed by side effects, the latter including the conventional medical sense of the term as well as broader questions of patient well-being. When most medical treatments involve a compromise between these factors, doctors and patients negotiate what they are willing and able to do and to endure. A guiding principle in these deliberations is minimizing suffering while maximizing the potential for recovery or better quality of life. When neither recovery nor cure can be reasonably expected, Schneiderman, Jecker, and Jonsen (1990) and Jecker (1991) contend that medicine should remain



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faithful to its Hippocratic dictates to do no harm by withholding treatment when recovery is judged to be out of reach. The considerations that weigh upon both physicians and patients when considering if and how to engage in a course of treatment resonate with the questions that were put to the Québécois throughout much of the nationalist era. The political stakes of being perceived as having the best treatment plan were high. Aggressive approaches that would radically redefine the national paradigm were favoured by sovereigntists, more conservative strategies to reorient federalprovincial relations by federalists. Both groups recognized the need for something to be done and advocated treatment based on the suitability, defined largely in terms of risk of side effects, of the therapy for the nation’s problems.

Revolutionary Medicine Hubert Aquin’s Trou de mémoire engages with the question of side effects defined in the most conventional sense of the term, which is to say in relation to pharmaceuticals. Prescription drugs and the role of the pharmacist as national revolutionary actor come to the fore in a text that confounds readers with its convoluted storylines, intricate narrative structures, and a sheer verbosity that both author and critics (Desmeules 2009; Wall 1996) describe in medicalized terms that liken it to verbal diarrhea or delusional ramblings. This challenging literary style has been the subject of many critiques (Brind’Amour 1980; Gagnon 1975; Randall 1998, 2006), although the medical aspects of the text remain comparatively unexplored. The novel is nonetheless explicit in its views of the nationalist and decolonization movements (both in Quebec and elsewhere) as processes akin to urgently needed medical, and specifically pharmacological, intervention for a patient. As is so often the case with modern medicine and treatments, though, attempts to cure and manage symptoms result in side effects that in turn necessitate further, damaging, intervention. Considering Trou de mémoire as a novel about the interplay between desired outcomes and unintended effects recasts not only the storyline(s) but also the complex writing as a deliberate engagement with the idea of the nation’s health. The pharmacological imprint on Aquin’s text is undeniable. The two most prominent narrators (among the many to take up the role of speaking or writing subject) are two pharmacists, Olympe

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Ghezzo-Quénum and Paul X. Magnant, who are each, respectively, engaged in the independence movements of the Ivory Coast and Quebec. While the Ivoirian makes no claims to being anything other than a standard practitioner, Magnant is presented as a pharmacological innovator, an inventor of new preparations, namely a new form of sedative, and something of a professional luminary. Furthermore, he is a guinea pig in that he is known to have habitually consumed a variety of medications at doses that far exceed recommended guidelines. Joan, an Anglo-Canadian researcher drugged and murdered by Magnant anterior to the time of the narration, is involved in biomedical research. Her sister Rachel, who had been a nurse in Africa, is someone who has administered drugs to patients and is herself subjected to pharmaceutical manipulation both to keep her sedated and to elicit her recollections following her rape by Magnant. This inventory of the characters’ involvement with drugs is simply to demonstrate that not one of the novel’s protagonists is untouched by the pharmacological. This says as much about Aquin’s views on the pharmacy’s reach into everyday life as it does about the extraordinary circumstances of his novel. Aquin’s penchant for the pharmacological is signalled in Paterson and Randall’s (1993) introduction to the most recent critical edition of the work. In it they argue that “les habitudes toxiocomanes” (x) [the drug habits] and “de nombreux sujets psychopharmacologiques qui le concernaient personnellement” (x) [the numerous psychopharmacological matters that were of personal concern] were among the personal interests and preoccupations that found their way into the pages of the tome. Public opinion surrounding the effects and impacts of prescription drugs had been subject to radical swings, and this adjunct of medicine was once again in the news at the time that Aquin was writing. In the 1940s and ’50s, antibiotics and other pharmaceuticals had inspired public trust and had fostered renewed hope in the notion of a magic bullet that could cure previously deadly diseases and infections (Mann 2004). Starting in the 1960s, prescription medications (especially tranquilizers and sedatives) came to be regarded with far more scrutiny and suspicion. The so-called Valium panics, which referred to the abuse of benzodiazepines (most acutely by women), thrust the negative consequences of prescription drugs into the public spotlight. David Herzberg (2006) notes that pop culture hits from 1966 such as the Rolling Stones song “Mother’s Little Helper” and Jacqueline Susann’s novel Valley of the Dolls generated



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a sense that everybody was being lulled into complacency by drugs. It is against this backdrop of interest in prescription drugs that Aquin inflects his nationalist narrative with a proliferation of ties to the pharmacological and uses it as a potent symbol for that which can be both highly beneficial and dangerous. From the outset of the story, pharmacy is made to be a notable point, for Ghezzo-Quénum remarks in his opening letter to Magnant that they share a profession. Potentially a coincidence and nothing more, the choice to draw attention to this serendipity suggests that it is indeed something other than a fluke. From this initial observation, the text moves to explicitly link the pharmacological to the nation via a series of never-quite-complete analogies. Ghezzo-Quénum argues that the pharmacist’s role of supplying the substances that deliver patients from their indispositions affords the professional a revered status (8) and that the demands of the profession speak to the pharmacist’s attention to detail (10). Such qualities, cast as typical not only of the profession but also of national revolutionaries, are then alluded to be in conflict with the police, who are deemed to be infected with malaria (15). Although the police are described as a pathology from the revolutionary’s point of view and are seen as unforgiving, the pharmacist would assuredly have known that both natural and synthetic anti-malarials (notably quinine and its synthetic derivative chloroquine) were in use and were effective against the disease. It would, however, be up to the pharmacist/revolutionary to oppose the malaria/police or other agents that sought to repress burgeoning nationalist movements. GhezzoQuénum accordingly positions the pharmacist as the provider of national cure and sets the stage for seeing the nation as subject to (his) pharmaceutical manipulation. The Ivoirian’s linking of the professional and political vocations is amplified by Magnant: “Mon activité politique, d’autre part, me prouve que j’incarne une image archétypale de pharmacien, car je rêve de provoquer des réactions dans un pays malade: je rêve de m’introduire en lui, sulfate ou soluble, pour influencer (par mon action sur les centres diencéphaliques) le cours de son agonie et transformer celle-ci en régénérescence (69–70) [“My political activity, on the other hand, proves to me that I am the archetypal pharmacist incarnate, for I dream of provoking reactions in a sick country. I dream of entering its system as a sulphate or soluble, to influence (by my action on its diencephalic centres) the course of its death-struggle

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and transform this into regeneration”] (Aquin 1974, 48). Magnant’s desire to insinuate himself into the brain of the sick nation, to heal it, and to give purpose and meaning to the nation’s previous suffering takes for granted that the nation is ill and that it is wracked with pain. These insinuations are crucial in establishing the prerequisite conditions for treatment: alleviation of suffering and likelihood of positive response. That he specifies that his action will affect the diencephalon or “interbrain” region suggests that he (as the drug) will, among other things, influence the nation’s development and sexual maturation (via the pituitary gland and hypothalamus) and its ability to sleep and awaken (as determined by the pineal gland and thalamus). These bodily processes are redolent with political meaning in a context where the nation could be accused of being underdeveloped or immature thanks to the limiting influence of the colonial legacy or of having accepted a harmful political fate like a sleeper or comatose patient unaware of the harms befalling them as they slumbered. Indeed, this theme was a prominent one among the medicalized rhetoric in René Lévesque’s Option Québec ([1968] 1997), the manifesto of the Mouvement Souveraineté-Association principally penned by the future Parti Québécois premier. This text advocated greater awareness of the impact of certain federal government initiatives and cautioned against the dangerous “numbing out” effect that these alleged cures for Quebec’s national problems and concerns provoked. It is in this spirit that the Canadian centennial celebrations of 1967 were derided as an “opération-endormitoire” [sleepinducing process] through which “on tâcha de nous administrer à plus fortes doses que jamais ce bon vieux sédatif: le français from coast to coast” (275, emphasis in original) [they tried to administer the strongest doses yet of that good old sedative: French from coast to coast]. Similarly, Lévesque railed against federalists who “administrent … désespérément le somnifère de la dualité culturelle d’un océan à l’autre, avec l’espoir que le coma durera le temps requis pour que l’opération s’effectue sans douleur” (253, my ellipsis) [despairingly administer … the sedative of biculturalism from one ocean to another in the hope that the coma will last long enough for the operation to be performed painlessly]. The sedative effect of these policies, akin to the Valium that was of such broad cultural concern, anesthetizes Quebec to the point that it no longer realizes that it is being harmed by federalist interventions in other areas, such as those



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pertaining to its economic interests. Federalists are cast as irresponsible health-care professionals because they cause harm (or allow harm to be caused) to the nation. Somebody sharing Magnant’s views would seek to stimulate rather than slow the brain’s activity in order to promote a revolutionary consciousness. According to Magnant (and this is where readers can see that Aquin as a member of the Front de Libération du Québec and a more radical nationalist diverges from the likes of Lévesque) the pharmacist’s revolutionary role is not limited to the metaphorical.1 He argues that the turmoil and angst brought on by incessant political struggle drove people to seek solace in sedatives and hypnotic drugs. These environmental factors in turn increased the pharmacists’ business and made them wealthy. There is nevertheless a suggestion that the pharmacist’s role in shepherding the revolution along involved more than simply lending financial and palliative support to the cause: “le pharmacien est toujours en quête d’une nouvelle poudre cristalline blanche, peu soluble dans l’eau, dont le mode d’emploi préfigure le combat meurtier de la révolution.* Tout le monde sait que, dans les nations engagées dans le processus révolutionnaire, le recrutement des pharmaciens est surabondant” (70–1) [“The pharmacist is forever in search of a new white, crystalline powder, difficult to dissolve in water, whose dosage directions presage the murderous combat of the revolution. Everyone knows that in those nations engaged in the revolutionary process there is a heavy recruitment of pharmacists”] (Aquin 1974, 49). The asterisk directs the reader to the following note, ostensibly from the editor of Magnant’s journal, who is also part of the story: “Par respect pour l’auteur, j’ai transcrit cette phrase telle quelle bien que je n’en comprenne pas le sens. Note de l’éditeur” (71, original emphasis) [“Out of respect for the author I have left this phrase as it is, though I do not understand it. Ed. note”] (Aquin 1974, 49). The editor’s irony-rich naïveté draws attention to itself as an especially unsophisticated reading of the pharmacist’s potential role in a revolutionary struggle that is described as murderous. Given that Magnant had drugged and killed his socio-economically privileged anglophone lover, a symbolic personification of his political enemy in the revolutionary nationalist struggle, it is all but confessed that pharmacists make excellent political assassins. The reader, well aware of this crime, becomes complicit in the veiled confession of the larger pattern of illicit acts committed in the name of the independence campaigns.

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For all the discussion of how pharmacists make excellent revolutionaries, of how much nascent nations are in need of decisive and curative action, and how prominently pharmaceutical preparations figure in the story, the drugs in question generally fail to provoke the desired results on either the medical or national fronts. For Magnant, pharmaceuticals act both in ways that are desired and in ways that seem to run counter to intention. Jarryd Desmeules (2009) argues that Magnant’s megalomania is thoroughly imbricated with his use of drugs, for the altered states that are characteristic of the pharmacist and his writing are also characteristic of the delusional. At the same time he concedes that Magnant’s supreme faith in his profession both overrides and underpins what appears to be the result of drugs, for “Aux yeux de Magnant, sa connaissance et sa maîtrise de la pharmacologie lui accorde un statut presque divin” (Desmeules 2009, 32) [In Magnant’s eyes, his knowledge and mastery of pharmacology accords him an almost God-like status]. Nowhere is the pharmacist’s ability to play God clearer than in his fatal interaction with Joan. The drugs Magnant selected to first sedate her and then to kill her were highly effective in that they performed the task. The larger moral quandary about whether their use was warranted in the first place nonetheless prevents us from recognizing the intervention as a success.2 As for Magnant’s self-medication, the novel’s internal editor sheds light on the fact that there were some unfortunate side effects to his dosing. After cryptically admitting in his journal that he was sometimes impotent in his relations with Joan, the editor intervenes with a footnote that strengthens a medical interpretation of what could have legitimately been a more metaphorical impotence: “Cet aveu assez incroyable nous mystifie : je ne saurai jamais s’il correspond à une accumulation d’échecs vénériens. Peut-être P.X. Magnant traversera-t-il une période d’impuissance partielle due sans doute à l’absorption exagérée qu’il a toujours faite de médicaments. Note de l’éditeur” (129, original emphasis) [“This rather incredible admission mystifies us. I will never know whether or not it refers to an accumulation of erotic failures. Perhaps P.X. Magnant went through a period of partial impotence due, no doubt, to his constant and immoderate absorption of medications. Ed. note”] (Aquin 1974, 91). If, as the editor suspects, Magnant had drugged himself impotent, surely this could be considered an undesirable side effect for a man so enamoured with power and control on both a personal and political level. The internal editor also recognizes that the very confused,



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neologism-littered, and rambling text he has to work with, ostensibly Magnant’s journal, is itself the likely product of the author’s selfmedication (122–3). “Graphorrhée,” a term redolent with the connotations of verbal or textual diarrhea (Wall 1996), characterizes the journal’s text. The first-person narrative contained in the journal (and that constitutes part of the text of the novel) accordingly becomes the side effect of Magnant’s self-drugging in the same way that Trou de mémoire as a whole can be said to be a product of Aquin’s pharmacological experimentation. Although Magnant’s at once creative and destructive engagements with drugs are strewn about the text, the central problematic of the pharmaceutical undertaking is most thoroughly explored in relation to Ghezzo-Quénum’s repeated drugging of his lover, Rachel Ruskin (Joan’s sister), subsequent to her having been raped by Magnant. What emerges from this series of scenes in the novel is a sense that despite all the best plans and the noblest of intentions, strong medicine will not succeed in bringing about the desired results and that the side effects of the therapy risk being worse than the supposed cure. When Ghezzo-Quénum finds Rachel, understandably shaken by the experience of her assault, he administers a massive dose of Equanil (a brand name for meprobamate), which was originally prescribed as an anti-anxiety medication and a tranquilizer, and has her chase down the pills with gin. The pharmacist’s intention at this juncture seems reasonable, for a sedative and/or a drink are often given to those who are experiencing distressing events. While the medication initially works as intended and calms her, which allows her to sleep and to temporarily escape the trauma of the rape, Rachel later undertakes a frenzied retelling of those aspects of the assault that she can recall. “Sous l’effet décontractant du medicament, RR est devenue volubile : elle a repris son histoire depuis le début, l’orage sur le lac Léman, jusqu’au moment crucial, et s’est perdue alors en digressions inutiles qui n’avaient pour but que de détourner mon attention … ces récapitulations infinitésimales mais toujours inachevées me rendent malade” (206, my ellipsis) [“Under the relaxing effects of the drug RR became voluble. She retold her story from the start, the whole business, the storm on Lake Leman, right up to the crucial moment, then wandered off in futile digressions designed to distract my attention … her minute but always incomplete recapitulations make me sick”] (Aquin 1974, 144; my ellipsis). Rather than sedate her, the medication agitates Rachel. Instead of providing respite from distressing thoughts, it plunges her back into their depths and provides

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no way clear of the terrifying reliving of the events. So strong are the unanticipated effects of the medication that even Ghezzo-Quénum admits to suffering their sickness-inducing side effects. As the doses continue to be administered, hoping that they will eventually yield a different result, Rachel seems to become less and not more able to deal with her thoughts. To passersby she appears deranged, muttering to herself (207); in private, she experiences a voracious sexual appetite, all while being in a semi-hypnotized state. On the receiving end of these frenzied attentions, Ghezzo-Quénum remedicalizes the curious side effects of the medication: “Quand je réalise ce qui arrive, je suis déjà pris dans l’étreinte sacrée de ses lèvres, en proie à la fièvre pourprée du plaisir” (207) [“When I realize what’s happening I’m already caught in the sacred suction of her lips, prey to the purpura of pleasure”] (Aquin 1974, 145). The metaphorical evocation of Rocky Mountain spotted fever (a relatively rare tick-borne – and thus preventable – disease) emphasizes, even sensationalizes, the severity of Rachel’s ardour in a rhetorical tradition that uses distressing, little-known, or severe diagnoses to communicate the gravity of problems requiring solutions. It is this state of affairs, coupled with the fact that Rachel cannot remember the details of the rape that would satisfy their mutual curiosity about the event and its after-effects, that provokes the pharmacist to further intervene by attempting to counteract one side effect (frenzied and fragmentary memory) by administering another drug, amobarbital. It is at this point that suspicions about whether or not the pharmacist is acting in Rachel’s best interests are stirred, for amobarbital is a barbiturate that had been used as a truth serum as early as the 1930s, but especially contemporaneously during the Cold War. Ghezzo-Quénum’s unlikely familiarity with narcoanalysis (interrogation with truth serum) suggests that it, like political assassination via undetectable poisoning, was one of the skills that make pharmacists valuable revolutionaries. This second drug was meant to free the memories of the crime so that the cycles of strange behaviours that resulted from it could be arrested, but the connotation of its use as a weapon for intelligence gathering (a definition that would also encompass torture) casts doubt on the legitimacy of the intervention as being in Rachel’s best interests. Upon administering the first doses, the pharmacist-turned-interrogator is confronted with effects that go against anything that could have been foreseen. “Et alors, au lieu de replonger dans son sommeil,



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elle est restée éveillée, agitée, incapable de s’apaiser à nouveau. Chose certaine, elle n’était plus en état de subnarcose ; mes deux capsules d’amytal avaient eu tout le temps de se volatiliser dans les couloirs de son hypothalamus, elles n’avaient plus d’effet” (210) [“Instead of falling asleep again, she remained awake, agitated, unable to calm down. One thing was clear; she was no longer in a state of sub-narcosis. My two capsules of amytal had had ample time to become volatilized in the corridors of her hypothalamus. Their effect had worn off”] (Aquin 1974, 147). The reference to the brain’s anatomy reminds readers of the medical expertise that is being brought to bear on Rachel, at the same time as it highlights the treatment’s failure to bring about the desired result. As the narcoanalysis proceeds, Ghezzo-Quénum is horrified to hear Rachel, his lover, implore her rapist to bring her to orgasm, to touch her breasts, and to caress her body. His response, betraying all sense of professionalism, is to abandon the interrogation and to give in to Rachel’s misdirected pleas. Ghezzo-Quénum’s entire pharmacological entanglement with Rachel subsequent to her rape appears to be a series of false starts and increasingly desperate moves to use the tools of his trade to counteract the unforeseen consequences of one attempt to reduce the effects of yet another disastrous treatment. Despite his eventual desire to suspend the use of the drugs, he recognizes that the process is likely to produce withdrawal symptoms and must therefore proceed via titration. The serious physical side effects of the drugs that cause him to want to abandon their use – a slowed heart rate, low blood pressure, a state of induced anorexia – speak to a new physical dimension of a previously psychological injury. He not only failed to treat the initial problems (anxiety, stress, and agitation) but created others (both physical and mental), which worsened rather than ameliorated Rachel’s overall state of health. Given that the text itself repeatedly renders the nation as akin to the body that responds to the pharmacist/revolutionary’s curative interventions, the attempts to intervene and to act in what is assumed to be the best interests of the patient/embodied nation read far more as a cautionary tale than as an endorsement of a nationalist agenda. Experience, skill, and a belief in the efficacy of that particular course of treatment – all clearly factors in Ghezzo-Quénum’s decision to act  – notwithstanding, the results of the interventions undermine the deliberate medico-national act. At best, the pharmacist is left to experiment, trying one possible remedy after another,

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hoping that one will have the desired effect. The difficulty posed by this approach when transposed to the national stage is that in contrast to the treatments administered to Rachel, who proved resilient in spite of the negative consequences of the drugs, and the dosing of Ghezzo-Quénum, who was able to reverse course and abandon his treatment regime when it was clearly failing, the nation’s prescription cannot really be changed once “treatment” is begun. Once a decision to undertake a radical intervention like separation from Canada is put into effect, it is unlikely that a reversal would be possible. There would be no choice but to continue treating side effects until a suitable result (which may or may not prove to be better than the initial state of affairs) is achieved. Trou de mémoire calls upon its readers to recognize the play of trial and error and false paths offered not just in the pharmacological story, but also in the construction of the narrative itself. Made up of letters received by Magnant, two edited journals, a manuscript for a novel, and editorial notes from at least two different editors, the text itself is a complex compound whose effects and interactions are difficult to trace. Intentions behind the editorial interventions in particular are made explicit: “Il serait injuste, de ma part, d’infliger au manuscrit de l’auteur une distorsion qui le rende plus fidèle aux événements” (79) [“It would be unjust on my part to inflict on the author’s manuscript any distortion that would bring it closer to actual events”] (Aquin 1974, 55). However, these intentions are also continually undermined as not being in the reader’s (or author’s) best interest: “RR, telle qu’elle s’exhibe dans ce faux témoignage, m’oblige à la refuter avec la dernière violence!” (155) [“RR, as she shows herself in this false testimony, obliges me to refute her with all the violence at my disposal!”] (Aquin 1974, 108). Like drugs administered to treat one problem but which occasion side effects that require their own form of treatment, the novel’s various internal authors, narrators, and editors pick up on the work of those who have come before them. Each rewrites and reworks what preceded, acting upon the text and our ultimate understanding of it. The overall effect is one that complicates and obscures any obvious sense of what is or what should be or the role of any actor or particular part of the text in creating the whole. In so meddling with the normative horizons of the text and in reprising the content’s play of trial and error in its form, Aquin both suggests and enacts a radical form of therapy for the nation always



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in the process of being written by the medico-national allegory. He subverts confidence in the logic of causes and effects, of actions and reactions, that underpins the medical (and medico-national) dimensions of the story and the text. What Aquin ultimately leaves his readers with is a sense  – in its medical, textual, and political iterations  – that there is an urgent need for conscious and deliberate intervention, but that drastic attempts (such as those employed in the story/text) to bring remedy, clarity, or a desirable outcome will only result in a worsening of the situation, not an alleviation of the problem or its effects. What is accordingly called for is restraint and consideration – not necessarily action – from those eager to remedy the nation’s problems. In light of Aquin’s well-known political leanings, this conclusion seems quite at odds with what readers would have been, and are, likely to expect. The call for restraint within the medico-national allegory accordingly comes into conflict with the expectations about more forceful solutions that are brought to bear on the novel thanks to what was widely known about Aquin’s views on sovereignty. The allegory is thus functioning simultaneously at the level of story and of text to create a dissonance that cannot easily be reconciled if the medico-national allegory is considered in its fullness. What eventuates from a diagnostic reading of the narrative as a whole is an exhortation to re-evaluate what course of treatment, if any, should be administered to the nation.

Radical Approaches Whereas Aquin uses his convoluted narrative structure to both make plain and conceal the medico-national resonances of Trou de mémoire, Jacques Godbout’s Les têtes à Papineau has been criticized by the likes of Jacques Pelletier (1991), Gilles Dorion (1986), and Eunice Galery (1983) because the allegorical meaning, which rests in the unusual body of the novel’s protagonist(s), is ridiculously overdetermined. Charles-François Papineau is, in the strictest sense, a bicephalic young man. Charles and François, however, are the two individuals who inhabit the same body save for the neck and the head, the two major body parts that are in their exceptional case multiple rather than conventionally singular. Charles, through his preferences in literature, humour, his no-nonsense personality, and his greater ease with English, is identified with Anglo-Canadian

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culture; François, through his own preferences, greater attachment to his family, and relative unease in this other language, is linked to the francophone culture of his/their parents. After living out their early years having worked out how to inhabit their shared body and balancing their divergent interests, “les Têtes” (as they are affectionately known) opt to pursue experimental surgery that would split both heads and brains and then combine the left halves of Charles’s head and brain with the right halves of François’s. Conducted by Dr Gregory B. Northridge, an American-trained neurosurgeon of French Canadian ancestry but of Anglo-Canadian upbringing, the surgery succeeds, but only in a manner of speaking. What remains of the post-operative Têtes is a fully functional and physiologically normative individual, but one who has lost the ability to speak French. Godbout’s novel is far from subtle as it coaxes its readers to recognize the national connotations reminiscent of the previous year’s failed sovereignty referendum and the nationalist concerns that put the question of sovereignty-association to the public. The Têtes acknowledge their unique status as an object of curiosity and seemingly without a trace of irony, as though belying a supremely dry wit that all but compels the reader to see Godbout’s analogy, admit that they are “un sujet aussi inévitable que la problématique de la langue ou le pénible portrait de l’homme colonisé canadien-français” [a subject as inevitable as the problematics of language or the pitiful image of the colonized French Canadian] (27). Even the novel’s dramatic conclusion that reveals the outcome of the surgery is provocatively written entirely in English. To a unilingual francophone reader, the final chapter is incomprehensible, but its meaning is still clear and is redolent with national overtones. That this English end to a Frenchlanguage novel was ostensibly written in the typonomically loaded Vancouver suburb of English Bay (156) cannot but beg an allegorical reading of the nation through this medical narrative. For Québécois readers, the text’s allegorical resonance does not come through the familiarity of the rhetorical body, for in this case the body in question is anything but familiar. Rather, the bridge between the medical and the national is supplied by a socio-political context that was saturated with discourses of competing nationhoods as a result of the rise of, first, a variety of neo-nationalist political organizations and parties (such as the Rassemblement pour l’Indépendance Nationale and the Ralliement National), then, the Parti Québécois, and finally, the 1980 referendum on sovereignty-association.3



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References to historical figures (former premier Maurice Duplessis, the Dionne quintuplets) notwithstanding, the national allegory hinges on a common knowledge of the social and political events in Quebec shortly preceding the novel’s publication (Sadkowski 2004; Vautier 1986). To take it even further back, one could look to one of Paul Chamberland’s contributions to the socialist and nationalist political and literary journal Parti pris, in which he argued that “l’univers canadien est en fait plus qu’un univers scindé en deux, c’est un monde bicéphale … On prejuge assez bien du fonctionnement de telles monstruosités” (1964, 66; original emphasis and ellipsis) [the Canadian universe is, in fact, more than a universe split in two, it is a bicephalic world … One can fairly easily foretell how well such monstrosities function]. Pivotal in this process of recognizing Godbout’s allegory is appreciating how the characters are developed as almost caricatured versions of anglophone and francophone Canadians. The protagonists, alternately narrating as a first-person plural nous and as third-person singular narrators describing their other half, portray themselves in terms that were and remain likely to be accepted as anglophone or francophone affiliated. François is described as having a “coté gaulois” (17) [Gallic sense of humour] for his love of puns and wordplay, and is “beaucoup plus porté, en toute circonstance, à gueuler, à discutailler, à se plaindre” (17) [far more given, no matter the circumstances, to hollering, quibbling, and complaining]. Charles, by contrast, “préfère l’approche américaine” (17) [prefers the American approach], is said to be more discreet and more serious, and admires the English because “les Anglais ont de l’esprit” (17) [the English are witty]. It is he who prefers to forget the past, whereas for François, history and its retelling are great preoccupations, traits which liken him to the Québécois, whose provincial motto “Je me souviens” [I remember] virtually makes memory a civic obligation. François dreams of having a big family (62), reminiscent of Church-inspired approaches to both contraception and national influence via demographic advantage. Charles would rather they be sterile (62), a preference that evokes both eugenics and the assimilationist ambitions of the early days of anglophone and francophone coexistence within Canada. Charles also reacts viscerally to the topic of ancestry (80) and prefers to put as much distance between himself and the past as is possible. This polarization of personality traits makes each half of les Têtes a sort of caricature suggestive of

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countless analogies that frame anglophone and francophone Canada (or federalists and sovereigntists) as a feuding couple.4 The division of traits is not, as Alain Piette (1984) notes, stereotypically predictable in all ways, but it is more than sufficient to establish a sense of which nation each of the boys represents. That Charles is repeatedly described in terms that render him as the dominant, almost bullying, force in the relationship (Galery 1983; Piette 1984) is, moreover, likely to elicit sympathy from readers attuned to a national narrative of perpetually being the minority and minoritized subject. Breaking with the dominant interpretation of the characters’ allegorical significance (Bernd 1986; Galery 1983; Vautier 1986), Piette proposes an alternative theory of national meaning, one where Charles-François Papineau as a singular individual stands in for the profoundly abnormal entity that is a binational nation: “CharlesFrançois Papineau symbolise le Québec: la marginalité biologique est métaphore de la marginalité culturelle, le bicéphale s’oppose à l’unicéphale” (1984, 120) [Charles-François Papineau symbolizes Quebec: the biological marginality is a trope of cultural marginality; bicephaly versus unicephaly]. In a similar vein, Jacques Pelletier (1991) has opted to read each of the two heads as a facet of the collective Québécois persona, Charles representing its “américanité” and François its “francité.” In a situation where nothing but the trope of a profoundly abnormal body could represent Quebec as a nation, however, the body – particularly when considered through the lens of a medical tradition that seeks to remedy disability and abnormality by making it synonymous with pathology (GarlandThomson 1997; Stiker 1999) – serves as a call to action. The novel’s nationalist overtones, despite being principally localized on the Têtes, also extend to their doctor. Dr Northridge’s lineage, for instance, is ascribed a national significance. His mother, Germaine Beaupré, had intended to create one more French Canadian soul to contribute to the demographic push of la vengence des berceaux, but the child she had placed up for adoption wound up growing up as an anglophone. The best intentions for the nation are framed as ultimately futile acts that produce effects entirely contrary to those envisioned, an echo of the failed pharmacological (and textual) experimentation in Trou de mémoire and a prescient foreshadowing of the surgery’s outcome if the nationalist lens is to be kept in place. The doctor’s own ambitions are described as being more in line with the Cold War era mentality of the United States



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than with the localized national aspirations of Quebec: “Il se fiche de savoir où sont ses racines … Il veut transformer le monde. Le monde. La famille le laisse froid” (19, my ellipsis) [He doesn’t give a damn about his roots … He wants to change the world. The world. Family leaves him cold]. Despite this broader scope of ambitions, critics have principally focused their attention on the surgeon as a representation of Canadian historical figures. Gilles Dorion (1986) argues that he is akin to Pierre Trudeau, the federalist prime minister of the time, accused of ensuring a victory for the “no” side in the 1980 referendum. Alternately, Piotr Sadkowski likens him to “an avatar of Durham” (2004, 152), the assimilationist governor general of the early 1840s and the author of the Durham Report. Christian Flaugh (2012) breaks with political readings, but credits the doctor with the same deliberately assimilationist motives, claiming that Northridge, acting as an exemplar of how medicine views disability, had planted and then cultivated ideas that the bicephaly was a pathological disability rather than a manifestation of extraordinary bodily and cognitive ability. Whether or not Northridge can be charged with “rhetorically brainwash[ing]” (Flaugh 2012, 107) the Têtes into seeing their conjoined status as a problem, it is undeniable that the text, which is written by the Têtes as a first-person narrative (a journal or autobiography), insists upon the inconveniences and difficulties of their unusual embodiment, and through it the union of the two ethno-linguistic nations and cultures. In continually drawing attention to the problems relating to both mental and physical health that the Têtes face, the case for surgery as a risky but worthwhile and potentially necessary solution to these problems is made stronger. On the psychological front, Charles and François jokingly refer to themselves as “une Erreur” (21), the upper-case letter confirming, despite the indefinite article, their singular status as an unparalleled natural mishap. In everyday reasoning, errors demand correction. For the Têtes, those who through their status as both singular and collective narrators give voice to Godbout’s nationalist ideas, their embodied situation is therefore deemed untenable: “On se gêne, dit Charles, et nous en avons assez de partager le même territoire” (68) [We’re getting in each other’s way and we’ve had enough of sharing the same space]. If patient input and a clear expression of their wishes were not sufficiently compelling reasons to proceed with the surgery, outside observers confirm the necessity of intervention. Their doctor,

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admittedly displaying the scientist’s zeal to achieve something no one else has by performing their ground-breaking surgery, urges them to consider the operation by arguing that they are not, despite his plural salutation, two men but rather incomplete entities: “Messieurs Papineau, vous n’êtes que des moitiés d’hommes” (21) [Messrs. Papineau, you are but half-men]. The psychological effects of recognizing oneself as an error, of being crowded, cowed, and being seen as less than other humans, although never explicitly discussed, are always just below the surface of an increasingly strained relationship between the brothers and their ever-more-isolated position relative to friends and family. If the emotional or psychological implications of their abnormal physiology are discussed obliquely, the physical consequences of their conjunction, in keeping with the trend that physical ailments and infirmities are often given more heed as “legitimate” medical needs, are made manifest. Since the desired result is to convince the reader that to not perform the surgery is a form of unethical or life-threatening inaction, the current state of affairs must be rendered objectively (and not just subjectively) intolerable. Accordingly, when Charles and François are said to be at odds with each other, they do nothing less than threaten their mutual existence: “Chaque fois que nous nous opposons nous nous rapprochons de la mort. Cela commencera par la rupture des organes. Puis le sang comme un marée envahira l’estomac. Le foie crèvera comme une grenade. Ces trois dernières semaines nous ont nerveusement épuisés” (148) [Every time we argue with each other, we come closer to death. It will begin with aneurysms. Then blood will pool and flood the stomach. The liver will burst like a grenade. These last three weeks have mentally exhausted us]. Fantastic (rupturing, exploding) organ failure and massive internal bleeding are fatalistic consequences of their inability to live conjoined. The Têtes nonetheless give plenty of other anecdotal evidence, most of it far less emphatic, of the limitations their shared organs place upon them. Neither brother can drink as much as he would like, for the gustatory pleasure of the wine must be weighed against the burden that each drinking to their individual satisfaction would place upon their common liver. Similarly, achieving an erection and reaching orgasm require both Charles and François, who predictably have different opinions about what is sexually arousing, to both mentally and physically work together to accomplish a simple sex act. Most alarmingly, Charles is said to have taken to minor fits of anthropophagy, occasionally trying to nibble



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or gnaw on François’s nose or ear. Even swallowing is described as a concerted negotiation that, prior to its being mastered and rendered a largely unconscious process, threatened one or both of them with choking. Such inconveniences, restrictions, and indeed threats to the bodily integrity and life of the Têtes confirm and heighten the need for remedial action at all costs. Both matters of life and death and of quality of life, a concept that was increasingly being taken up in discussions about the human impact of illness and disease, were put forward as justifications compelling medical action.5 The status quo, whether it had always been as such or had been newly reframed as untenable, was no longer an option, and treatment was indispensable. Given both Godbout’s own well-known political associations (he was a founding member of the Mouvement Souveraineté-Association, which became the referendum-launching Parti Québécois) and the blatant nature of this roman à clef, it is hardly surprising that the very problem that Godbout articulates in teratologically embodied form had already been presented in political contexts using the bodily rhetoric of paralysis, illness, and cure. In Option Québec English and French Canada are said to be in a unified but mutually harmful state, albeit one that can be remedied with decisive and bold action: Dans cette quête parallèle de deux sécurités nationales, tant qu’on prétendrait la poursuivre sans les structures actuelles ou quoi que ce soit d’approchant, on ne pourrait aboutir qu’à une double paralysie. Cherchant en fin de compte la même chose – la chance de vivre leur vie, à leur façon, selon leurs besoins et leurs aspirations –, les deux majorités ne pourraient aller que se cognant toujours plus durement l’une contre l’autre et se faisant réciproquement un mal qui finirait par être sans remède. (Lévesque [1968] 1997, 183–4) [In this parallel quest for the security of two nations, for as long as we profess to pursue it without the current structures or whatever might resemble them, we will never wind up with anything save double paralysis. The two majorities, which are ultimately seeking the same thing – the chance to live their lives, as they choose, according to their needs and aspirations – will never be able to do anything except keep banging their heads together harder and harder and inflicting injury on each other that will finally prove to be irremediable].

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The impetus for Lévesque’s bodily rhetoric was to prompt the public, who were likely imbued with the spirit of progress from the previous decades’ rapid advances in medicine and the false belief that the end to all disease could be just around the corner, to do everything within their power to remedy bodily, and by extension national, ills.6 In light of these obvious parallels between the characters and historical actors on the national stage and the commonality of the strategy employed in both the Têtes’ narrative and the sovereigntist discourse, the medico-national allegory seems all too obvious and morbid from a Québécois perspective. Just as François as the embodiment of French Canada is fated to cease to exist, so too is the francophone nation threatened. It is, however, this macabre outcome, along with the premise underlying the whole drive toward the surgery that subverts the intertwined narratives of strong medicine for serious ills. For the Têtes, the question of treatment must be framed in terms of surgical objectives, although this seemingly uncomplicated matter emerges as a point of contention. Charles and François understand their surgery not as a separation, but as a union, an amalgamation or a putting together of that which is neither fully separate, nor entirely unified: “C’est tout autre chose … Le Dr Northridge va nous amalgamer” (69, my ellipsis, original emphasis) [It’s not that at all … Dr Northridge is going to amalgamate us]. This elucidation of what the surgery entails follows a troubled query from Marie Papineau, the mother of the Têtes, who feared that it would involve one head being transplanted onto a donor body to create a second, entirely separate being. (More than thirty years after Godbout imagined it, this hypothetical operation still seems inspired by science fiction!) Unlike in the referendum, the issue is not one of severing connections, but rather of making them stronger. Despite this optimism about union, there is a loss that only the Têtes’ family seems to acknowledge, for the shared body with two heads is, even in the most perfect of scenarios, to lose half its head and brain mass by fusing two cranial lobes together. The result may be neater and normative, but it will always bear the scars of its creation and these scars will always be a reminder of what was lost. By pursuing treatment that would amalgamate them, the Têtes make union both the remediable reason for the extreme measures (when considered corporeally) and the desired result of the radical intervention (when considered cranially or cephalically). Nonetheless,



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the potential consequences of this strengthened union are marked in starkly negative terms by most others in the story. Charles and François’s father, Alain-Auguste, perceptively jokes: “Hamalgham! lança ‘A.A.’ avec un faux véritable accent allemand. Ein Kultur, ein nation, ein head, Ein Führer! Ya?!” (69) [“Hamalgham!” blurted A.A. in a real fake German accent. “Ein Kultur, ein nation, ein head, Ein Führer! Ya?!”]. This Germanic reminder of National Socialism and the politics of extreme nationalism cast complete unity  – by virtue of their association with the regime responsible for one of the worst eugenically inspired horrors of the modern era  – as something to be feared. Given that the annihilation of the distinctly francophone identity is the surgery’s outcome, it seems that the national project is once again framed in cautionary and not enthusiastic terms. Far from advocating remedial action at all costs, the foreshadowing and the denouement warn the reader of the medico-national allegory about the dangers of pursuing singularity, for complete separation is not an option and amalgamation proves unviable. The narrative is therefore at odds in both advocating intervention as a solution, indeed the only viable one presented, to the problems of union and cautioning against this same approach. Although there are certainly indications  – the doubts about Northridge’s competence (Piette 1984, 114), Charles’s zealous pushing for the surgery – that foreshadow the outcome and lend credence to the idea that the intervention was misguided, the narrative remains equivocal about what course of action to pursue and pessimistic about union, either in its partial form as the status quo or as a complete project. The narrative that is constructed around establishing the need for intervention and the preparations that will make it possible ultimately presents readers with a situation in which both action and inaction are harmful. As Maria Leonor de Abreu (1997) describes it, it is a choice between the neurosis of the status quo and the schizophrenic existence of post-operative life.7 The result is a double bind that posits Quebec as a nation that will never be able to be both physiologically normal and free of the problems that (whether insinuated into existence by Northridge or extant beforehand) have become a growing concern for the Têtes’ physical and mental health. Faced with the unenviable choice of being either normal or healthy, but not both, Quebec is seemingly consigned to either sick or monstrous nationhood. This lamenting interpretation of the post-referendum situation has certainly been a focal point for critics like Sadkowski (2004),

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Pelletier (1991), and Galery (1983), who see Godbout’s approach as an irresolvable Catch-22. In rethinking what is meant by the loaded terms “normal” and “healthy” and their role in establishing the need for medical action, however, the discourse of necessary but harmful interventionism can be undermined. As foundational medical thinker Georges Canguilhem ([1966] 1991) argues, not all bodily abnormality should be qualified as pathology. To apply this thinking to the Têtes would suggest, as Christian Flaugh (2012) does, that no intervention was warranted. Seeing the Têtes on a spectrum of bodily abilities that is all too often viewed solely with a focus on the extreme related to disability, Flaugh maintains that Charles-François Papineau (as a single bicephalic person) was not disabled or limited in terms of what was possible, but in fact, because of his different embodiment, possessed skills and abilities  – namely a superior intellect and accrued knowledge due to being able to sleep in rotation – that superseded those of singleheaded humans. In differently valuing the unusual body, namely by not seeing it as lacking a second body but rather as benefiting form the advantages of two heads (and two heads are, at least proverbially, better than one!), the presence of a pathological existence is denied, thereby obviating the need for curative medical intervention. Even if one were one to accept the Têtes’ existence as pathological, though, the need for intervention cannot be assumed to flow from this fact. A growing percentage of recent medical thinking about diseases such as prostate cancer now advocates for a more conservative approach of symptom management and careful monitoring rather than proceeding directly to radical surgical interventions with potential for serious side effects and negative consequences (Chapman, Barratt, and Stockler 2010). By questioning both the existence of pathology and the logic of a given course of treatment being necessary as a result of this pathology, the need to treat disease, illness, or infirmity (in a certain way) is rendered a false premise. By extension, the nation, even if accepted as being in a pathological state, need not be subjected to attempts to cure it that may prove more harmful than beneficial. There is, in short, a point being made about a mediconational “good enough” that is similar to the call for restraint that emerges from Aquin’s novel. By casting doubt upon the medical institution’s aggressive approach to diagnosing abnormalities as pathologies and its ability to effectively intervene to “correct” or “control,” the illness narrative



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disperses the blame for the allegorically unfortunate outcome of the surgery. The Têtes are neither the singularly pathological entity desperate for a cure, nor the entity that is so sick that the result of the surgery can be rationalized as the best outcome that could realistically have been expected. Instead they are presented as a player in a system in which there have been multiple failures and missteps from diagnosis through to treatment and in which the errors compounded. By consequence, the nation is similarly spared the connotative burden of being undeniably sick and desperately in need of treatment at all costs.

Unlikely Cures Although Aquin and Godbout are well known for their sovereigntist politics and their literary works make these allegiances clear, Swissborn Québécois writer Pierre Billon’s L’enfant du cinquième nord ([1982] 2003), much like Bernard’s Cancer (1967) or Lord’s Allerretour (1962), breaks with the tradition of narratives in which the national situation is made more or less obvious. Set in the OntarioQuebec border city and national capital of Ottawa (itself an unusual choice), this multi-generic work of science fiction, crime thriller, social commentary, and psychological novel (Boivin 2004) uses one illness narrative to introduce what, at least initially, presents as another. Florence Lecoultre, the patient in the first of these narratives, is a young girl who, in the opening chapter of the novel, is diagnosed with cancer. In the children’s ward of the hospital, she receives treatment for what readers (due to the attention given to prosthetic limbs) are led to believe is bone cancer. Amid her parents’ solicitude about outcomes and the doctors’ efficient but caring comings and goings, another sick child – Max Sieber – is introduced. Unlike Florence and most of the other children with known diseases, Max and his ailment mystify doctors, for he seems to be in perfect health. His condition, though, has the paradoxical effect of regenerating or healing proximate organic matter, Florence’s sick body included, at the same time as it causes the rapid disintegration of inorganic substances such as metals and plastics. As the medical personnel begin to piece together the puzzle of Max’s condition, he becomes the object of a tightly guarded security operation. Florence’s father, Daniel, and her doctor, Maureen Davis, suspecting some sort of cover-up, track the evacuated Max to a military facility, wherein the youngster’s

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unique degenerative capabilities were being researched for their applications in weaponry. The narrative wraps up with Max being killed in a plane crash – caused by his own deteriorating effect on the plane’s structure and instrumentation – as he is being transferred to an American military facility for further research. Florence and a number of the other children who were hospitalized alongside Max benefited from “l’effet Seiber” and go on to live presumably normal and healthy lives. Although francophone science fiction from Canada does not tend to engage with the detailed concerns of politics, many of the larger social anxieties of a given era or circumstance typically find their way into the narratives. As Weiss observes, “Freedom and liberation are seen by francophones in more general terms, rather than merely political ones, especially after the Quiet Revolution; the spirit and emotions must be freed, not just the government of Québec” (1998, 53–4). Jean-Marc Gouanvic (1988) sees this playing out when themes of utopia and dystopia echo trepidations about the progress or state of a given society and when concerns about changing material circumstances and processes, principally technology, are taken up in storylines about technological failures that have become hallmarks of the genre. Amy Ransom’s (2000) study of nationalist-era science fiction from Quebec outlines a more politically engaged orientation to some texts but notes a lack of consensus about whether or not nationalism provides a way forward. According to Aurélien Boivin (2004), Billon’s text does not so much take up the question of nationalism as it focuses on the social uses of science and employs rather stark contrasts of “good” (curing cancer) and “evil” (weapons) uses of science to make the point that it risks being mobilized for ends that do not best serve society. While taking nothing away from these observations, the nationalist concerns of 1980s Quebec, particularly the matters of the status of the francophone community and its relationship with the federal government, are very much at play in Billon’s narrative. The always-contentious matter of language and culture is the first area in which Billon engages with issues on the national stage. Unlike more conventional works that are set in Quebec and feature unilingual characters who are excluded or marginalized because they are francophones, Billon’s characters are almost all, at least ostensibly, bilingual. Daniel nonetheless finds himself almost constantly irritated by other people’s poor French, particularly when they are employees



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of the public service in one capacity or another. His annoyance, reminiscent of Pierre Trudeau’s scathing remark about the poor quality of French spoken by his fellow Québécois, is a recurrent theme in the novel. Daniel reproaches his ex-wife, hospital personnel, his civil servant neighbour, and even the minister of defence for their pathetic attempts at bilingualism. Such contempt for the ambitious policies of official bilingualism and the disappointing realities that resulted from the initiative can be read as a rather pointed critique of the failings of the policies of official bilingualism in the federal government, which were introduced with the Official Languages Act of 1969 and championed by Trudeau. In a more personal rendering of the debate, Florence’s divorced parents are presented in such a way that each half of the former couple represents one side of the bilingual and bicultural Canadian reality. Daniel reveals that he is something of a professional francophone in that he was promoted to a new role in the federal ministry of defence so that he could be the “francophone de service” (45) [“the token francophone”] (Billon 1995, 32) in Minister John Butler’s inner circle. Sandy, his ex-wife – a status that itself gestures toward the incompatibility of the two cultures – is both anglophone and a resident of New York. Beyond the question of mother tongue, the descriptions of the characters (much like in Godbout’s text) hint at opposing cultural stereotypes. Daniel’s self-description emphasizes his pragmatism and his focus on a more routine life of family and work, whereas Sandy’s life in New York is always somewhat shrouded in mystery, but is alluded to with references to her renown for her work (presumably some role in the creative industries) and a lifestyle punctuated by fashionable parties. This contrast exacerbates the sense that Daniel’s desires are, especially in relation to his children (who are, atypically for the era and Quebec’s literary norms, in his sole custody), modest, sensible, and relatable.8 When these personalities come to bear on the illness narrative, it is the francophone father who emerges as always having the best interests of the sick child, and therefore the embodied nation, in mind. The second way in which the novel takes up the political concerns of its time has to do with the unusually prominent but also suspect role of the federal government and its various agencies. It is the Royal Canadian Mounted Police, the federal police service, which enforces Max’s isolation and bars hospital personnel from determining what is best for him. Daniel, the story’s principal narrator, is a

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high-ranking civil servant. The Canadian military, realizing Max’s potential for defence purposes, essentially detains the ten-year-old and then, presumably with the co-operation of other government departments and members of the cabinet, arranges to transfer his custody to the much more powerful American military. There is even suspicion that the government killed Max’s mother and covered it up so as to have unfettered access to the child. Given how rarely the civil service, the federal police, or even the military feature in not just Quebec’s illness narratives, but in much of its literature more generally, Ottawa’s tentacular presence in Billon’s text is notable.9 It is all the more so because Max’s illness narrative links the larger cultural and governmental aspects of Daniel’s professional life to his private turmoil as the father of a sick child. Max’s illness narrative brings medicine and the military into alliance, and as a result Daniel takes on the role of a francophone David against a composite Goliath of cancer, institutional medicine, and government. Indeed, he muses that “l’honorable Butler [the minister of defence and his boss] me semblait entretenir soudain une parenté troublante avec la maladie terrifiante qui se développait dans l’organisme de mon enfant” (48) [“The Honourable John Butler suddenly seemed to have a disturbing kinship with the terrifying disease that was developing in the body of my child”] (Billon 1995, 34). To fight cancer thereby becomes a fight against a primarily Anglo-oriented federal government that is far too intimately bound up with the Cold-War-era concerns of the American military. At a time when Quebec’s media was saturated with debates about the utility and benefit of a continued relationship with Ottawa, not to mention the form that this relationship should take, the deep and pathologized distrust of the Canadian government suggests that, at a minimum, care must be taken to ensure that the government does not overreach or act in ways that do not fully consider the public interest, however one might define this highly variable term. Billon in no way belabours the political dimensions of Florence’s illness narrative, but the question of acting in someone’s best interests sits at the heart of both Florence and Max’s experiences in the hospital. With Max, the government’s role is clearly painted as an intrusion into and a detriment to the normal relationships that parents and other legitimate caregivers such as doctors should have with children or patients. For Florence, the issue of best interests is far



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more nuanced. Instead, it is the larger cultural concerns represented by Daniel’s relationship with Sandy and their disagreements about her treatment that dominate the story. Max’s illness narrative, which I will consider in the first instance, is not so much the recounting of a story of conventional illness as it is a tale of reactions to an unexplained bodily phenomenon. The assertion that Max is not suffering from a sickness, illness, or disease is as recurrent as Daniel’s jibes about the differences between him and his ex-wife or his dismay over the attitudes toward bilingualism in the community. When Daniel is first, but obliquely, apprised of Max’s condition, he inquires whether the ten-year-old’s illness is contagious, figuring that for a child to be hospitalized and quarantined, he must surely be quite ill. He is nonetheless told by one of the hospital’s chaplains that this is not the case: “‘Non, on ne peut pas dire que Max soit contagieux … en tout cas pas au sens où vous l’entendez!’” (68, original ellipsis) [“‘No, it’s not that Max is contagious … not in the way you mean at any rate!’”] (Billon 1995, 49). Similar inquiries with other members of staff yield equally equivocal answers: – Je voulais dire au revoir à Max. – On ne peut pas, dit-elle, il est en observation. – Vous voulez dire qu’il est contagieux? – Je n’ai rien dit de pareil, Il ne resterait pas à l’étage … – Pourquoi l’enfermez-vous s’il n’est pas contagieux? – Pour son bien, dit-elle péremptoirement. La porte n’était pas fermée pour empêcher les microbes de sortir, expliqua-t-elle en me parlant comme à un vrai demeuré, mais pour les empêcher d’entrer. Max avait perdu momentanément ses défenses contre l’infection, un rhume de cerveau pouvait lui être fatal. (72) [“I wanted to say goodbye to Max.” “That’s not possible,” she said, “he’s under observation.” “You mean he’s contagious?” “I said nothing of the sort. He wouldn’t still be on this floor.” … “Why is he locked up if he’s not contagious?” “For his own good,” she said imperiously. Speaking as if I were a half-wit, she explained that the door was locked not to keep germs from getting out, but to prevent them from getting in. Max had momentarily lost his defences against infection, so a head cold could be fatal. (Billon 1995, 51–2)]

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This rapid-fire sequence of questions generates an increasingly suspect series of responses, resulting first in hedging, then ambiguity, and eventually an outright lie to supply any plausible answer that might bring what had begun to resemble an interrogation to its end. Daniel’s inquiries here function as the voice of reason and take up the reader’s own ponderings: If Max is not sick, why is he in the hospital? If he is not contagious, why he is he being held in isolation? If it is he that must be protected from the possibility of infection from the other patients, why is he still allowed contact with them? The lack of forthcoming or medically plausible responses heightens suspicion that whatever the real answers are, they are unlikely to be innocuous or clinically justifiable. Suspicions about the remedy not being appropriate for the disease  – a key concern of the era  – are consequently aroused. As the truth is brought to light, it is clear that the reactions to his condition and its implications are not in any way medically motivated, but are rather extreme and sinister. Max’s mother, Lotte, for instance is mysteriously killed in a hit-and-run accident only to have her son transferred out of the hospital under army guard within a few hours of her death. For those like the doctors and the other parents of children in the children’s wing who had developed relationships with her, this news evokes suspicion that she was murdered in a way that was made to look like an accident. This alleged murder is furthermore cast as the event that allowed Max to be brought to a military base in a remote corner of northern Ontario only to be virtually imprisoned in a bunker with two military nurses. Most significant in this list of governmental transgressions and violations of civil liberties is the fact that Max is made a commodity. “Ottawa avait fait débloquer plusieurs questions en litige dans le contentieux des relations avec Washington, en échange du transfert de l’enfant Sieber dans un laboratoire de recherches de l’armée américaine” (251–2) [“Ottawa had expedited several matters under dispute with Washington in exchange for the Sieber child’s transfer to an American army research laboratory”] (Billon 1995, 179). The government’s trading of one of its own citizens  – an orphaned ten-year-old at that – casts the government and those involved with it (notably the minister of defence) as disgraceful and loathsome. Daniel’s resignation from his job as a result of what he has come to know about his employer and his government leaves no doubt that Billon wishes his reader to see the federal government as an entity



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that deserves neither support nor trust. Whereas illness narratives have tended to show the clergy as the national authority that undermines the protagonists’ ambitions or that is worthy of contempt, L’enfant du cinquième nord places the federal government in this role.10 It also paradoxically makes the novel’s sole representative of the clergy, the unconventional Father Maurice, an ally in the fight against the secrecy, surveillance, and abuse of power concerning Max. Although it would be unfounded to consider this novel a sovereigntist or nationalist text, for as a political entity Quebec is all but absent, there can be no question that the function of the federal government and its benefit to those it is meant to represent and protect (who in the case of the novel are primarily francophones) is unwaveringly critiqued. While Max’s story condemns the government as institution and likens it to a doctor in violation of his or her Hippocratic oath to do no harm, Florence’s illness narrative is more conventional in that it focuses on the sickness, medicine, and treatment of disease. This is not to say, however, that questions of nationhood are not addressed, albeit subtly. Daniel’s culturally coded differentiation of himself and his ex-wife is continually echoed in the central conflict of Florence’s illness narrative, which is how best to care for their daughter and treat her cancer. It is because of Daniel’s self-presentation as the rational, grounded parent that his opinions and positions concerning Florence’s treatment, which is utterly conventional and in line with the dictates of mainstream medicine, are understood as the more obvious and better choices. Sandy, by contrast, is depicted as being more concerned with aspects of Florence’s care that are (presented as) either irrelevant or detrimental to her prognosis. An alliance between Daniel and Florence’s doctors is therefore formed, and science, logic, and the best interests of the patient/ child are made the undisputable impetuses for an aggressive treatment regimen that will cure the ills of a child who, like Charles-François Papineau, is bilingual, bicultural, and regarded as being in need of strong medicine. The advocacy for the best treatment available begins in relation to the choice of hospital itself. Daniel, perhaps not conscious of the reason for his choice other than its being the default option, preferred that Florence be treated at Memorial Hospital, a large medical centre. Sandy protested that their daughter should be cared for in a smaller clinic. The dispute is presented largely as a fait accompli

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in which Dr Davis, the oncologist at the larger facility favoured by Daniel, retroactively endorses the father’s decision to place his daughter in her care: Riverdale voyait passer une demi-douzaine de cas dans les meilleures années, alors que dans le même temps le Memorial en traitait une bonne centaine. “L’usine,” comme disait Mme Lecoultre, avait l’équipement le plus perfectionné et toutes les pièces de rechange. On y appliquait des approaches thérapeutiques combinées, et on y offrait aussi des services de physiothérapie, de psycho-thérapie et d’ergothérapie. (26) [At Riverdale they saw half a dozen cases in a good year, whereas in the same period of time Memorial would treat a hundred. The “factory,” as Mrs. Chevalier put it, had the most up-to-date equipment and whatever spare parts might be needed. They applied combined therapeutic approaches and they also offered physiotherapy, psychotherapy, and occupational therapy]. (Billon 1995, 19)11 The doctor’s reporting to one parent her earlier conversation with the other serves to validate Daniel’s choice with reassurances of expertise and experience. Care, as suggested by the mocking of the hospital’s industrial nickname, is best when it is efficient, well rehearsed, and technologically sophisticated. When the question of a second opinion arises, Daniel once again receives (and reports upon) his validation from the medical expert. The American-based Sandy argued that Florence should be examined by a Dr Silberberg, a pediatric oncologist, in Philadelphia. Reprising the refrain of superior medical technology, expertise, or treatment innovations that can be found in the United States, Davis – herself recognized in the US for her work in the field (59) – protests the uselessness of seeking out her American counterpart: “C’était beaucoup d’argent pour faire confirmer un diagnostic qui ne faisait pas l’ombre d’un doute” (27) [“It would mean spending a lot of money just to confirm a diagnosis about which there’s not a shadow of a doubt”] (Billon 1995, 19). She adds: “L’étape après Silberberg serait celle des fakirs, du pèlerinage à Lourdes et des cures macro-biotiques” (27) [“The next step after Silberberg would be fakirs, the pilgrimage to Lourdes and macrobiotic cures”] (Billon 1995, 19–20). Clearly trumpeting decisive action, her own



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expertise and the Western medical paradigm’s relative but scientifically proven efficacy in treating cancer, Davis defends her reputation and her profession at the same time as she, despite her own AngloCanadian heritage, supports Daniel in his preference for the homegrown, aggressive, and conventional approach. Daniel’s clear partiality toward hospital-based chemotherapy and Sandy’s advocacy for homeopathic remedies, specifically Laertryl (an alternative remedy derived from apricots), are at the core of a more extended debate between Florence’s parents. The father, although conscious of chemotherapy’s side effects, is determined to see the treatment through and to await results. Sandy proposes interrupting the conventional and hard-line regime because of its physical toll on Florence: “Elle déclara que je ne me rendais pas compte des véritables effets du traitement, mais c’était une dévastation. On injectait des poisons hideux qui ne détruisaient pas seulement les cellules cancéreuses, mais les autres aussi, les cellules saines qui transportaient l’oxygène dans le sang et prévenaient l’hémorragie et les infections” (84, original emphasis) [“She declared that I didn’t realize the true effects of the treatment, it was devastating. The hideous poisons they injected destroyed not just the cancerous cells but others too, the healthy cells that delivered oxygen to the blood and prevented haemorrhage and infections”] (Billon 1995, 60; original emphasis). Sandy’s reported pleas to change course mobilize the discourse of risk and side effects inherent in any considered discussion of how best to treat. Her exhortations tap into affective registers through their use of terms like devastation and poison, but also appeal to scientific rationality by means of (pseudo-)clinical discourse. Daniel’s response to her suggestion is nonetheless a mocking quip: “Bref, tu es prête à te rabattre sur les noyaux d’abricot” (84) [“‘So what you’re saying is, you’re ready to try apricot pits’”] (Billon 1995, 60). By not engaging with Sandy in a serious discussion about the treatment but rather in using sarcasm to undermine her suggestion, Daniel presents conventional Western medicine as the only serious option, no matter its drawbacks. Alternative treatments, be they those offered by folk healers, faith healers, prayer, or homeopathy, are derisively dismissed as wastes of time that only further imperil the patient. Having internalized the rhetoric of the institutional approach, Daniel disregards the gentler therapies as quackery and champions the “strong medicine for serious ills” mantra that has underpinned both the fictional and the political discourses of the era.

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Debates about who should treat and what therapies should be employed aside, questions about the general utility of treatment are frequent. From almost the moment the reader learns of Florence’s cancer, it is framed as a terminal condition with only the slightest chance of remission. The medical staff, who are more attuned to the statistics than the parents who cling to any shred of hope, admit that “la douleur infligée l’était probablement en pure perte” (73) [“the pain being inflicted was probably totally pointless”] (Billon 1995, 53). Chemotherapy is nonetheless construed as something that requires diligence and timeliness: “Je vous répète que nous ne pouvons pas nous permettre de perdre du temps. J’entends bien, dis-je. On m’a donné en haut votre ordonnance et la fiche d’instructions” (77) [“‘I repeat, we can’t afford to waste any time.’ ‘I understand,’ I said. ‘Upstairs they gave me your prescription and the sheet of instructions’”] (Billon 1995, 55). Davis’s insistence on compliance with the treatment regimen underscores its necessity and intimates that cure is foremost contingent on the action of the patient and her caregiver rather than on the biological processes that are described as almost unstoppable. That these instructions are given to Daniel as he is about to take Florence out of the hospital for a vacation that Sandy insisted on booking casts him as the responsible parent most likely to respond to the rationale of continuing to diligently fight the cancer despite the clearly unpleasant aspects of the treatment. Disputes about how to respond to a challenging situation like a child’s illness, particularly between divorced parents who have different backgrounds and wildly dissimilar lifestyles and outlooks on life, can in no way be construed as unusual. As Daniel remarks, “Le mal de notre enfant ne nous avait pas rapprochés l’un de l’autre, et son progrès ne faisait qu’aggraver nos divergences sur la façon la plus appropriée d’y faire face” (86) [“Our child’s disease had not brought us closer together, and its progress was only aggravating our differences over the most appropriate way to confront it”] (Billon 1995, 61). Yet Billon’s insistence on the linguistic and cultural differences between the two parents inflects the treatment options with national or political notes. Daniel’s favouring of the interventionist and aggressive approaches to Florence’s treatment suggestively echoes the rhetoric of the sovereignty movement, which has maintained that the tough problems of cultural survival must be dealt with using all the means at one’s disposal. Davis’s heavy-handed dismissal of the option of a second opinion, reported by Daniel as one among many potential details about



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Florence’s treatment  – but one which endorses his own views  – is similar to early Parti Québécois self-portrayals as a political force dedicated to getting something done. In one of its first publicly released policy documents, for instance, “la manie des diagnostics à répétition à la place du traitement” (Conseil exécutif du Parti Québécois 1972, 37) [the frenzy for repeated diagnoses in lieu of treatment] is derided and made a point of prideful differentiation for the stillnascent but action-oriented political party. The language about painful and difficult choices that patients and their families must make about treatments like chemotherapy is similar to Lévesque’s discourse about the economic reforms that followed the Parti Québécois’ first electoral victory in 1976 and that were seen as a precursor to sovereignty: “Pour commencer ce travail d’assainissement, nous avons tranché douleureusement” (1978, 58) [To begin this healing work, we had to cut painfully]. These statements share an emphasis on curative action over, on the one hand, reiteration of the problems and, on the other, the easier course of inaction and denial of the problem’s existence. Even if one were reluctant to ascribe too much partisan significance to Daniel’s perspectives on his daughter’s treatment, it would be nearly impossible to deny the profound influence of medicalized political discourse from the time of the Quiet Revolution onward to the 1995 referendum. Whether it was Jean Chrétien, federal justice minister in 1980 who argued that Parti Québécois supporters were “de la vraie gangrene … et il va falloir couper ça et écraser ça le 20 mai” (“René Lévesque: Le magicien du verbe et la passion du Québec” 1980, my ellipsis) [real gangrene … and we’ll have to cut it out and crush it on the 20th of May], or a 1985 speech by Lévesque to Parti Québécois faithful that referred to the mass resignation of highranking party officials as both an “hémorragie cruelle” (Lévesque 2009, 61) [cruel hemorrhage] and a lifesaving surgery, medical discourse was a common facet of the era’s political speech and writings. These comments, along with hundreds of others representing sovereigntists and federalists, socialists and economic conservatives, attest to a widespread penchant for thinking about the nation in medical terms, particularly insofar as the troubled times called for clear diagnosis of national ills and a steady, unswerving approach to remedying them. The logic of this medicalized discourse hinges on a political entity or course of action being seen as curative. In the same way, clinical discourse (as exemplified by Dr Davis’s early conversations with

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Daniel) seeks, at least in the case of favourable outcomes, to establish a causative relationship between the therapies, the treatment centres, the medical expertise, and the remedy. Such causal relationships are the reason for the impassioned defences of particular therapies and the basis for testimonials about the efficacy of a given cure. In Florence’s case, however, the very treatment regime that inspired her doctor and her father to advocate so strongly for a given course of action, one redolent with linguistic and cultural connotations, proved almost entirely unrelated to her remission. “Au cours des derniers mois, les traitements donnés au cinquième nord avaient enregistré un taux de succès nettement au-dessus de la moyenne … tous les enfants qui avaient été en contact avec Max pour une période de quelques jours étaient stationnnaires ou en voie de guérison” (238–9; my ellipsis) [“Over these past months the success rate of cases treated in the children’s wing had been well above average … every child who had come into contact with Max over a period of a few days was stable or on the road to recovery”] (Billon 1995, 170; my ellipsis). It is for this reason that Dr Davis had stopped the treatments of those children who had been hospitalized alongside Max: Comment aurait-elle pu continuer à s’occuper d’enfants atteints d’un cancer terminal, à leur prescrire des traitements chimiques barbares et à assister à leur agonie, tout en sachant que la cure existait et qu’il n’y avait maintenant pas d’autre solution que d’en rechercher désespérément le mécanisme? M’avait-elle dit que le petit Jacques, qui était hospitalisé en meme temps que Max, n’avait pas survécu, contrairement aux autres enfants? Pourtant, sa tumeur était en régression, mais les médicaments qu’il prenait l’avaient empoisonné. (270–1) [How could she go on caring for children with terminal cancer, prescribing barbarous chemotherapy and watching while they died, all the while knowing that a cure existed and she now had no alternative but to try desperately to find out how it worked? Had she told me that little Jacques, unlike the other children who had been hospitalized along with Max had not survived? Even though his cancer had been in remission, the drugs he was taking had poisoned him]. (Billon 1995, 194) The treatment, far from being in the patient’s best interest, was little more than an ordeal to endure for the sake of being in proximity to the curative force that was Max. A series of enjoyable play dates



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between the children would undoubtedly have produced the same result without any of the pain, discomfort, disturbance, or trauma that chemotherapy and hospitalization typically entail. Florence’s illness narrative intimates that the desire for cure, the means employed to bring it about, and the actual processes that occasioned it do not subscribe to scientific logic. Favourable outcomes (whatever one might deem these to be) are not attributed to particular actions, but are rather posited as the chance result of processes that either defy explanation or seem to be nothing more than a random occurrence. When transposed to the national stage, the political logic national authorities use to motivate reforms and to inculcate more fundamental changes to the national paradigm’s communal and exemplary functions becomes equally illogical and unpredictable. Without a measure of confidence that the risks undertaken in the hope of securing a better future are likely to yield results, intervention – whether political or medical – would be unlikely, but also ill-advised. In showing how doctors, those potent symbols of national authority, transition from staunch advocates of resolute and immediate action to cautious figures who cease to believe in the efficacy of their treatments, Billon undermines the very premise of the nation’s exemplary discourse about itself leading up to the 1980 referendum. Here once more, restraint rather than possible recklessness is the national prescription. The two illness narratives that Billon presents in his single tome cast doubt over both the intention and the efficacy of treatment regimes to achieve their goals. On the one hand, treatment and medicine are only a guise for abuses of power; on the other, they are well intentioned but misguided and ultimately not the cause of any benefit. Given that Billon was writing long enough after the 1980 referendum to be able to observe the outcome of the pledges and promises of change and better futures for the nation, it is perhaps best to see his novel as a cynical, double-edged critique of the political matters of the era. On the one hand, it is a reminder of the limits of national authorities to change the national paradigm. On the other, it is a warning that these same authorities can wield tremendous power in working against the best interests of the nation and that as the ones who are ultimately responsible for the nation’s health, it is up to the people to put the best interests of the nation first. The literary texts of the nationalist era exhibited a keen awareness of the power of literature, including the illness narrative, to influence

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the national paradigm. Politically engaged authors like Aquin and Godbout were attuned to popular writing’s political and social function, and, as Luneau (2006) argues of the latter in particular, they used the literary field as an arena from which to resist dominant discourses and fashion new ones. “L’écriture est donc conçue dans le but d’encourager le mouvement révolutionnaire et de traduire la voix du peuple attiré par la régénération et l’innovation” (Zarai 2012, 164) [Writing is therefore envisaged with the goal of encouraging the revolutionary movement and giving voice to the people’s desire for renewal and innovation]. Their questioning of the national status quo took the form of illness narratives that championed nationalist ideology and concerns at the same time as they emphasized writing and narrative as participating in this process. The manner in which these novels picked up on the very medical rhetoric that was being used by political leaders to convince the Québécois to radically redefine their national paradigm attests to the interpenetrated nature of popular and political discourses at this juncture in Quebec’s history. The dangers of complacency and the failure to act decisively in response to serious problems emerged as key themes in both sovereigntist rhetoric and the illness narratives. The outward and almost predictable endorsement of strong medicine is nonetheless undercut by results that do anything but vouch for its efficacy. This subversion of expectations suggests that the aim of these texts is not to act as allegorical polemics championing a particular approach, but rather to open up debate through writing about the best way treat the nation; this constitutes an enactment of the larger aims of the political discourse on both sides of the sovereignty debate. The Têtes’ indecision about whether or not to proceed with their surgery and the shocking end to the story renewed the questions of the previous year’s sovereignty referendum in preparation for what Lévesque announced on the night of the defeat would simply be the next time that the question of independence would be put to the people. The dialogues expressing deep distrust of the federal government that took place in Billon’s novel act as reminders of key questions in the referendum and foreshadow the constitutional wrangling, notably over the balance of federal and provincial powers, that would take place starting in 1987 with the introduction of the Meech Lake Accord.12 Even the ruinous end of all but one of Aquin’s characters prompts questions about whether the violent, revolutionary path to independence is the best course of action.



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The illness narratives accordingly show themselves to be more than simply medicalized echoes of political discourse about nationalism and sovereignty. They are forceful, attention-getting interventions in this conversation. They hypothesize about different outcomes and raise questions pertinent to the political matters at hand. Like a movie with a startling twist, they are blatant in their provocation of the public to engage with the matter of the national paradigm, for they challenge their readers through their attention to questions of writing, genre, and reader expectations. The consistent use of the strong-medicine theme pushes readers into examining their own stance on the issues and in a way that forces them, using the tropes of illegal drug use, bicephaly, cancer, and unknown contagion, to ponder which means the nation should employ to remedy its ills.

5 The Normal Pathographical

In Catherine Mavrikakis’s Deuils cannibales et mélancoliques, illness and death are at once the story’s uniting themes, and utterly banal in their ubiquity. The novel relates a series of vignettes about the deaths of the narrator’s loved ones and acquaintances, most of whom share the given name Hervé. The story begins with a comparison that frames the narrative and its content as both predictable and mundane: “J’apprends la mort de mes amis comme d’autres découvrent que leur billet de loterie n’est toujours pas gagnant. Cette semaine j’ai encore perdu un Hervé, et statistiquement, c’était prévisible puisque tous mes amis s’appellent Hervé et sont, pour la plupart, séropositifs” (2009, 13) [I learn of the death of my friends in the same way that others discover that their lottery ticket was once again a loser. This week I lost another Hervé, which was statistically foreseeable since nearly all my friends are called Hervé and they are, for the most part, hiv-positive]. The more than a dozen Hervés, whose fates are virtually foregone conclusions for the narrator, have no surnames and are solely identified by either their cause of death or their relation to the narrator. In some cases, it is difficult to parse whether she is referring to the same person or to two separate people. Such slippages construct the anonymity of those who are sick and dying or already dead and make them, but for their unusual conglomeration around one individual, unremarkable stories of pathology and accident. Their illnesses, suicide-inducing psychological troubles, and misfortunes, as illness narratives, are at best secondary concerns. Given Quebec’s preponderance of ailing protagonists and sickly characters, the narrator’s experience could well be



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akin to somebody who has chosen to immerse him or herself in the nation’s novelistic fiction. Illness and death abound, and although some coincidences such as sick doctors or children with cancer are striking, they are not surprising enough to merit much more attention than Mavrikakis’s narrator accords to her own collection of sick and dying friends. For the narrator, her way of describing her friends, family members, and acquaintances as anonymous and predictably prone to death seems to act as a sort of insulating defence mechanism. The premature loss of loved ones, a trauma that has generated more than one anguished narrative over the centuries, seems to produce mostly resignation and pensive reflections on the absurd coincidences. The literature professor-narrator, revealing more about herself than others, reflects on the “normal” way of dealing with death: “La littérature a appris à mes anciens étudiants comme à tout le monde qu’il faut parler de la mort avec des métaphores. Lorsqu’on n’emploie pas de figures de style, ils patinent, décontenancés. La mort … Ils en ont tellement peur qu’ils l’apprivoisent à l’avance pour ne pas y penser quand elle arrivera” (Mavrikakis 2009, 71; original ellipsis) [Literature taught my former students, as it taught everybody else, that we must speak of death in metaphors. When we don’t use tropes, they skate around it disconcertedly. Death … They’re so scared of it that they tame it ahead of time so they don’t have to think about it when it arrives]. Language, she remarks, can take the sting out of the unanticipated arrival of pathology and its consequences. Rather than masking it via euphemisms to soften the blow as her students do, the narrator desensitizes herself by routinizing death. In this bizarrely depressing yet charming narrative, illustrative of a larger trend within contemporary Québécois illness narratives, the power of narrative to shape and give meaning to morbid experiences such as sickness comes to the fore. Sensitivity to the power of narrative, illustrated in both point and counterpoint by Mavrikakis, has emerged as a characteristic and a theme of Quebec’s twenty-first-century illness narratives. In this, they build upon the foundation of attention to narrative that began with the sick-doctor stories and persisted throughout the nationalist era. Like those texts examined in the previous chapter, these narratives also attempt to do something to and for the nation, although it is fair to say that this is done in a far subtler manner in the more

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recent novels, for there seems to be little in terms of references to language, national identity, or events that demarcates the novels as Québécois texts. This national anonymity might be construed as a reflection of the relative uneventfulness on Quebec’s national stage. With the crisis of the 1995 referendum in the past and the sovereignty issue seemingly dormant, the era’s major concerns revolved around matters such as the integration of religious and cultural minorities and other immigrants into Quebec society. By the admission of even those who were charged with investigating the tensions that arose from these integrative processes, these were minor uproars that were more mediaspurred exaggerations of the gap between the national paradigm’s communal and exemplar functions than systemic rifts and divergences of the kind seen in decades past (Bouchard and Taylor 2008). Given the lack of change to respond to, the continued presence of illness as a prominent theme in Quebec’s literature would seem to be out of keeping with the earlier pattern and their utility for the nation. Yet if we return to the core principle, which is that medico-national allegories intervene in the nation’s discourse about itself as a way to make sense of changes, these most recent narratives uphold the discursive tradition because they provide a way, a model if you will, for Quebec to understand its mid-century turn toward tropes of illness. The process of understanding these narratives therefore serves as a coda for the tradition of reading illness in Quebec’s literary tradition; it is a way to bring the analysis to an end in a way that is not entirely in keeping with the main theme but is nonetheless related to what preceded. Gil Courtemanche’s Une belle mort (2005) and Je ne veux pas mourir seul (2010), Tassia Trifiatis’s Mère-grand (2010), and Sylvain Trudel’s Du mercure sous la langue (2001) approach illness not just as a bodily phenomenon, but one that requires a new way of thinking, talking, and writing about the experience in order to come to terms with it. This tends to result, as Mavrikakis suggested with the idea of metaphor as a way of being able to accept death, in an almost deliberate and self-reflexive association – or even a deflection – of the illness onto other concerns, such as a relationship, a matter secondary to the illness or the very act of writing about one’s sickness. Linking illness with another narrative in order to make sense of it corresponds to what Anne Hunsaker Hawkins (1999a, 1999b) has identified as a genre, pathography, which constructs a narrative of illness



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around an organizing metaphor or myth. This myth or metaphor, she explains in her pioneering study, has therapeutic effects, be they purely psychological or psychosomatic. In looking at the pathographic strategies that these Québécois texts employ to allow illness to be reconceptualized, fought, accepted, or integrated as an essential part of identity, it is possible to see how these narratives might also be thought of as therapeutic, if not of initiating curative effects for the nation. The protagonists in Quebec’s illness narratives have long found writing about their conditions to be therapeutic. What we read of René in Aller-retour (Lord 1962), a tale where the doctor heals himself, and Charles-François in Les têtes à Papineau (Godbout 1981), where the writing is part of the surgery’s preparatory phases, is in fact their journals about their experiences. It is because of this correspondence of the illness narrative as story and as text that the nationally therapeutic potential of narrating tales of illness and treatment is heightened. This is to say that as a character uses narrative to make sense of their sickness or as part of their therapy within the fiction of the novel, the narrative that they produce – which is the text that we read – also plays a role in informing the national paradigm. There is therefore a direct link between the therapeutic processes being undertaken within the fiction and the therapeutic processes for the nation that is enacted by initiating a re-examination of the assumption that the nation is ill. Although initially driven by the content of the trope, there is also something of an analogous procedure, or a functional allegory between body and nation, at play. With the pathographical texts of recent times, the characters’ narration of their illness (or that of a family member) attempts to normalize pathology through language. Transposed to the national stage, we see that these narratives point to a process whereby the narrating of disturbing events and practices (like national upheavals) and the use of tropes (including allegories of illness) to make sense of them can be a therapeutic activity. In viewing these new narratives as functional as opposed to content-centred allegories, these texts draw attention to what can be interpreted as an effort to rethink how pathology shapes (national) identity in ways that make illness productive and even a positive aspect of the national paradigm. To view the narration of sickness, as opposed to the trope of disease, as the basis of national allegory, one can see the nation as making (the narration of) illness curative for itself.

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Pathography In light of this chapter’s focus on the effect of narrating illness, it is worth exploring what has emerged as the generic term for these kinds of texts. In the first of the two common definitions, pathography is a process of historical or retrospective diagnosis of an individual or a group that seeks to understand the influence and effects of disease on behaviours. Linnda Caporael’s (1976) contentious article in Science about how hallucinations caused by ergot poisoning might explain the accusations of witchcraft against women in seventeenth-century Salem, Massachusetts, is perhaps the most famous example. Countless members of the medical profession have similarly sought to diagnose the ailments of literary characters and to explain an author’s choices based on either their confirmed or suspected medical conditions. This type of pathography has been heavily critiqued by scholars of literature and medicine like Stephen L. Daniel (1987) as being speculative, at best, and wholly reductive, at worst. The anxiety is that in seeking to explain a character’s actions according to a symptomatology for a disease whose presence is likely never to be determined, there is potential to not only draw upon but also to reinforce stereotypes about particular diseases. The same can be said of attributing particular forms or expressions of creativity to medical conditions, such as alcoholism or schizophrenia. The second definition, however, is the one that most bears on this study. Pathography, in this broad sense, is understood as a type of life writing (biography or autobiography) that overstates the negative aspects of the subject’s life and specifically focuses on an illness experience. Hunsaker Hawkins, the first to systematically study the genre, contends that it is in many ways the by-product of modern medicine. She points to the flourishing of the genre as one of the most effective ways for patients to “restore the experiential dimension to illness and treatment,” something that is often lost in modern medicine’s depersonalized treatment regimes (1999a, 128). Reincorporating the patient’s voice in this process, a notion gleaned from trauma theory, can be highly therapeutic.1 Hunsaker Hawkins, along with Rita Charon (2006), Arthur Frank (1995), a host of medical personnel, and authors of scores of pathographies, emphasize the psychological benefits of claiming control over a disempowering experience, ordering it and giving it meaning through the narrative process. “The deconstructions of the identities of ill persons as powerless, disabled,



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and freakish, and to reconstruct them as having a story to tell, a case to put, and a reminder to drive home” (Kinnane 2000, 103) are but some of the most often cited psychological benefits of writing about one’s experience of illness. Clinical studies also show that narrativizing one’s illness has measurable health benefits that surpass those of other forms of other expressive therapies such as music or visual arts.2 James Pennebaker writes: “At least six different laboratories report that writing produces positive effects on blood markers of immune function. Other studies indicate that writing is associated with less pain and reduced medication use among arthritis sufferers, and in a sample of asthmatics, improvements in markers of lung function” (2000, 5). It is likely because of the combined mental and physical health benefits that treatment programs or support groups for chronic and/or life-threatening illnesses often offer writing classes or workshops for patients. In recent times, authors of pathographies have become, as Hunsaker Hawkins notes, self-reflexively aware of the power of narrative and have included in their writings commentary on the therapeutic benefits of telling their stories of illness. The clinical benefits of pathography are readily acknowledged, but the influence of the genre in broader cultural terms remains more obscure. Hunsaker Hawkins locates the emergence of the pathography as not only a distinct but also a popular genre in the latter half of the twentieth century, at a time when institutional medicine was under fire for treating disease without treating the patient (1999a, 128).3 The success of modern medicine at this time also meant that sickness, once an ordinary part of life, came to be seen more as a profound disturbance of a normal order, as something that had to be ushered to the margins and contained from the rest of normal or healthy society. Reflecting such relegation in real life, the literary and narrative place accorded to illness was also increasingly made separate from life writing more generally. The illness narratives that once comprised parts of larger autobiographical works such as memoirs became stand-alone texts. They came to be classified as something other than life writing or (auto)biographies, for the emphasis in many (although not all) pathographies is on recovery, which as Frank notes, is just as likely to place these tomes on a self-help bookshelf (1995, 139). A corollary genre, the semi-autobiographical pathography, also emerged around this time, although perhaps slightly later than the

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1950s start date Hunsaker Hawkins identifies.4 These texts differ from the purely autobiographical ones in that they are often written with a more obviously literary orientation in mind and are frequently classified as fiction for their use of literary techniques and styles despite their often openly acknowledged autobiographical elements. Many works in this category are referred to as autofiction, a broader term that comes from contemporary French writing. Some of the best-known examples of contemporary autofiction nonetheless take the form of pathographies. Hervé Guibert’s (1990, 1991) aids novels, prominent intertexts for Mavrikakis, while not labelled as part of the genre, were quite openly talked about as being autobiographical texts, and Guibert publicly disclosed the extent to which art imitated life (Caron 2001). Although theorists of pathography tend to leave aside the narratives that make no claim to an (auto)biographical dimension rooted in an illness experience, it is nonetheless possible to think of them as something other than simple fictions about illness.5 Although they do not necessarily privilege a real-life author’s experience, they do “describe personal experiences of illness, treatment, and sometimes death” (Hunsaker Hawkins 1999b, 1) and often do so from a firstperson perspective. Just like the (auto)biographical pathographies, they provide something therapeutic to the reader in that they can offer a narrative that helps to make sense of what may be going on in their own lives. It is also possible, although far harder to prove, that they supply something to the author in their writing. The safer middle ground might be to conclude that the narrators of such texts provide a pathographical model for narrativizing illness akin to those supplied by the (auto)biographical texts and that their influence, as such, ought to be considered, particularly insofar as it is the narrative of (sick) nationhood that is at stake. Whether fictionalized or presented as a true reckoning of one’s experience, pathographies tend to share a limited range of motives. The desire to normalize, despite the paradoxical emphasis on the negatives of illness, may be the most common. Kinnane cites the “rebirth” narrative as one that presents survival or remission as an inspiration to others (2000, 102), and Hunsaker Hawkins (1999b) notes how such narratives are in many ways similar to earlier centuries’ stories of religious conversion. She also argues that many pathographies seek to impugn the medical system, either through “angry” narratives that take direct aim or ones that phrase their critiques



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in a more oblique fashion by presenting alternatives to standard protocols. Sharing knowledge in this way, whether as a warning to others or in the form of suggestions about what worked for them, constitutes a form of didactic pathography for patients and ensures that the primary audience for most of these texts are those close to a given disease, through either their own sickness or that of a loved one. Arthur Frank, quite appropriately for the context of this study, argues that illness narratives give voice to bodies in a way that parallels the postcolonial subject’s need “to speak rather than being spoken for and to represent oneself rather than being represented, or in the worst cases, rather than being effaced entirely” (1995, 13). Furthermore, the narratives, no matter what their motive, are useful, as those humanities scholars who now teach in medical schools maintain, as a valuable resource for medical personnel insofar as they teach them about the patient’s experience of illness as a complement to their knowledge of disease. The motives, both plainly stated and inferred, converge around the idea that pathography provides a way for those who experience illness to describe it and in that process of narrating a collection of bodily, cultural, and emotional occurrences to impose a coherence and to fashion a meaning for themselves and for their readers. It is for this reason that the medical-humanities’ understanding of pathography might be read as one that, while perhaps overemphasizing illness as a negative dimension of one’s life story, still operates within a rehabilitative framework. Hunsaker Hawkins writes, “pathographies concern the attempts of individuals to orient themselves in the world of sickness … to achieve a new balance between self and reality” (1999b, 2). The emphasis on recreating an equilibrium between how one conceives of oneself (be it healthy or ill) and the way in which one exists in the world and is perceived by others draws on Canguilhem’s contention that health is the ability to bring about new biological norms ([1966] 1991, 196). Using pathography to recreate coherence, if only mental, emotional, or ontological, where it was once disturbed makes the narration of illness a normative mechanism and legitimates pathography as a sort of writing cure in a psychoanalytic paradigm. To view Quebec’s twenty-first-century illness narratives as pathographies, which is to say as texts that serve therapeutic ends because of their ability to help individuals make sense of illness, is to recognize, by extension, that its illness narratives in general do not

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necessarily represent a strictly fatalistic view of the nation. The change in perspective ends what had previously been seen as a kind of metaphor-driven imperative to interpret sickness as an absolute disruption to the norm or to what should be. As Havi Carel notes in her pathographically inflected philosophical treatise on illness, when she was diagnosed with a terminal respiratory disease, “my life changed beyond recognition and yet remained the same” (2008, 6). The model afforded by pathography, as Carel’s summary of her situation demonstrates, allows illness to be dealt with, accommodated into existing frameworks, and also placed at the centre of new ways of thinking about oneself. So too, I argue, for the allegedly sick nation. Quebec’s national paradigm can be both acknowledged as displaying signs of disease (a preoccupation with sickness in its national narratives) and of not being defined by these morbid symptoms. The discourses of illness, those that focus on sickness, can accordingly be recognized as texts that, like pathographies, simply emphasize a particular (negative) aspect of a life story. Pathographies, however, also model how illness can be seen as something positive, whether it is for the author or the reader. Quebec, therefore, need not view its pathological self-representations as a fatal diagnosis for a sick nation. Rather, it might, like Hunsaker Hawkins (1999b) argues of the mythology and metaphors of battle, quest, and rebirth common to many pathographies, come to recognize illness as the trope it has chosen to make sense of the significant changes and crises facing the nation over the past seventy years. What is in fact taking place is an inversion of Frank’s (1995) postcolonial metaphor. It is not illness that is to be understood in national terms, but nationhood in terms of pathography, albeit with the rehabilitative and empowering aspects of the postcolonial discourse that are so often lost remaining in place when the metaphor is stood on its head. In writing about disempowerment, articulating a desire for more national agency, and in reacting to profound changes via its self-disrupting medical allegories, Quebec can be seen as rehabilitating its national paradigm via the expressions of resistance to the defeatist and seemingly teleological narrative of “one gets sick and dies.” Thus, much like Jarrod Hayes’s (2000) Queer Nations sees in all Maghrebian literature, not just that of the anti-ethnographic, pre-independence period, the potential to be what Frantz Fanon described as “combat literature,” I argue that Quebec’s illness narratives sit on a similar continuum whereby any illness narrative, no



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matter how subtle or overt its treatment of illness or how morbid the outcome, has the potential to be therapeutic.6 In reframing a pathological national outlook, a victim complex, or a tendency to dwell on the negative as a form of therapeutic writing that allows for a movement beyond pathology conceived of as a pessimistic “phase,” it becomes possible to understand Quebec’s corpus of illness narratives as both normal and pathographical, which is to say as therapeutic or even curative.

Continuity and Disruption In Une belle mort (2005), Gil Courtemanche pens the story of how a family copes with chronic and degenerative illness. For readers of Courtemanche’s generation, those of the Baby Boom whose parents are aging and for whom decisions about end-of-life care have become a daily reality, the narrative is undoubtedly familiar. The novel chronicles a disaffected son’s struggle to accept and deal with his eighty-six-year-old father’s rapidly advancing Parkinson’s disease and cardiac problems. As our window into the familial universe, the narrator, André, also relates the difficulties that his mother, siblings, and nephew have both in approaching the management of the disease as some sort of separate entity and in relating to the father, whose life, at least on the surface, has been profoundly changed by the physical and relational effects of his illness. The narrative is an attempt to reconcile two stories: one in which the father is healthy but contemptible, another in which he is sick and pitiful in a way that makes contempt problematic. Perhaps more than with any other illness narrative studied here, the outcome is a foregone conclusion given the title of the novel; the narrator helps not only his ailing father but also his otherwise healthy mother to die in a manner of their choosing. The intrigue, however, comes from the never-ending conflict that pits the narrator against other members of his family as they decide how to relate to their increasingly difficult father, the effects his illness has on their mother, and the role they must each take up in the family drama. The father’s Parkinson’s is described in simple yet readily comprehensible terms in the opening pages of the novel as a problem with the connections between neurons. Crucially, it is rendered not as a change to the person, but rather as a simple variation in the speed of the father’s actions: “Le malade veut parler, mais ses cordes vocales

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et sa bouche réagissent trop tard. Elles n’ont pas reçu à temps les impulsions électriques. Il sait comment marcher, comment parler, il est conscient, il comprend tout. Mais il tombe, il balbutie et vous avez l’impression qu’il est absent et ne vous entend pas. Voilà, ce n’est pas compliqué” (11–12) [The patient wants to talk, but his vocal cords and his mouth react too late. They didn’t receive the electrical impulses in time. He knows how to walk, how to talk, he’s conscious, he understands everything. But he falls, he stammers and you have the impression that he isn’t there and that he doesn’t hear you. That’s how it is, it’s not complicated]. The doctor’s summation of the disease’s effects, as the entrée to the story, frames the tensions that André and other family members must wrestle with as they try to both understand the pathology and care for both of their parents. The commentary about the simplicity of the situation is nonetheless quite ironic, for the cognitive dissonance produced by the vivid memories of how their father was and how he is before them now is one of the driving forces of the narrative. The Lévesque “children,” the oldest of whom is himself a sixty-year-old grandfather, struggle to see their father as the stern and authoritarian patriarch he once was. Yet, his difficultly uttered protests and frustrated rages remind them that the man André so often compares to Joseph Stalin is still there, sitting at the head of the family table, causing behaviours to be modified because of his protests just like he did when they were young. The problems posed by these contradictory behaviours from both the infirm father and his family signal the novel’s central theme, which is the way in which illness is both a profound change to and a continuation of one’s identity under different circumstances. The paradox of illness and identity sits at the heart of most pathographies, whether conceived of as autobiographically inspired philosophical essays like those of Frank (1995) or Carel (2008) or much less academically ambitious tomes penned by any number of sick people or their caregivers. Frank writes of the wounded storyteller, the narrator of illness, as a witness to a truth that is generally hidden (1995, 137). Carel’s introduction contains dozens of sentences that begin with the word I that document the ways in which her life had been changed by her illness: “I found I had to reinvent my life … I learned to rethink my aspirations and plans … I learned to cope, to surrender vanities. I adjusted. I learned to live a Janusheaded life: young but old, healthy-looking but ill, happy but also incredibly sad” (2008, 7). Hunsaker Hawkins (1999b) writes of how



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those pathographers who have adopted the rebirth model often think of themselves as changed people following the cure of their disease or upon surviving a major health crisis such as a heart attack. More generally, the act of writing a pathography – particularly in cases of narratives that aim to be didactic – allows people to see themselves as teachers or guides for others. In Courtemanche’s novel, the paradox of illness and identity is played out repeatedly. For the father, his illness has deprived him of the ability to act as he used to and to enjoy the things he used to love. For many of his grown children, he has become something of a child, a person who must be cared for and attended to by them, who have replaced him in the role of authoritarian parental figure. For André, though, the struggle seems more personal, for he attempts to reconcile his filial dislike for his father with what he assumes are obligations to act as a loving and caring son now that his parent is ill. As for most family members of ill persons, illness involves rethinking relationships, re-evaluating feelings and roles, and conceiving of oneself differently, mostly to conform to ideas of how they ought to be acting. It involves a negotiation between the healthy past and the disease-marked present and a realization that although a diagnosis may neatly demarcate those two states, it is far more difficult to discard feelings and memories or to reimagine lifelong relationships. One of the ways Courtemanche develops these tensions is through repeated commentary on what had always been normal for the family and the disruptions that are brought on by pathology. His narrator intersperses vignettes about the now-ailing father’s conduct and recollections from his childhood about how his father used to act. Amid descriptions of his father’s seemingly incomprehensible and irrational behaviour at the family dinner table, André recounts stories about a working life spent as a bread salesman, a ruthless temper and magisterial demeanour, and a propensity to behave as what might euphemistically be described as “a character” for going to the market dressed in gardening clothes while all the other fathers would be dressed in business attire. These memories, when juxtaposed with the current behaviour, appear to be dredged from the narrator’s consciousness because they evoke what is happening in the present, whether due to their sharp contrast with the current situation or to their similarities. His father’s gluttonous consumption of bread slathered with cheese, pâté, or any other spreadable substance is framed as a logical extension of the fact that his father had always

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had a tendency to overeat and had a long-standing love affair with bread in all its forms thanks to his job. The comparisons of the father to Stalin seem to be triggered by a series of incidents that culminate in his father being brought home from an ambulatory care clinic in a straitjacket for having been violent with a nurse. Yet early in the narrative, long before such incidents occur, André recounts the opinion of his since-dismissed therapist who characterized his father as “un admirable dictateur roublard” (34) [an admirable and cunning dictator]. Even the commentary on what his father chose to wear to do errands helps to establish that he had long preferred to do what was comfortable rather than what was expected. It is therefore not surprising that he refused to behave in a manner that conformed to his children’s opinions of how a sick person should act: eschewing tasty but unhealthy foods, abstaining from alcohol, spending lots of time in bed, avoiding “upsetting” situations, not engaging with young children, and generally being passive. The current behaviours that André’s siblings take as symptoms of worsening mental and physical health might simply be construed as manifestations of his father’s lifelong behaviours and reflections of his character. Illness, however, has given new inflections to some of the old behaviours, which is not surprising given that the corollary to normalizing pathology is the pathologization of normalcy. What had always been a robust appetite and an appreciation of good food, at least in the narrator’s estimation, is transformed by the diagnosis and the doctor’s prescriptions for a low-fat, low-calorie, low-salt diet into what some members of the family see as a reckless disregard for health and outright gluttony. Even André, who concedes that this behaviour is not a radical departure from previous conduct, recognizes that there has been an intensification of his father’s appetite subsequent to his diagnosis and the physician’s counsel of moderation: “Mon père a toujours été goinfre, mais jamais autant que depuis que les médecins lui ont prédit que cela le tuerait” (32) [My father had always been a pig, but never so much as since the doctors told him that it would kill him]. The father’s dictatorial character can similarly be explained  – indeed explained away to a certain extent – by the onset of the illness. Whether it is because he feels that he should be kinder to his sick father or because observing the way that his siblings are treating him differently has inspired a kind of sympathy, André’s attitude



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toward his father softens. When his father emerges half-naked from his bedroom, having been exiled there by those who feared he was getting too emotional for the Christmas festivities, André reacts to the shocked horror of all the adults in the room who went quiet when the old man appeared: “C’est la première fois que nous voyons papa tel qu’il est. Nous ne connaissions que son visage, les symptômes, les diagnostics, les manifestations, mais jamais nous n’avons vu un homme aussi démuni, aussi nu, un père aussi laid” (106) [It was the first time we were seeing dad as he was. We only knew his face, the symptoms, the diagnoses, the effects, but we had never seen a man so helpless, so naked, a father so ugly]. Although he does not exclude himself from the group of those who fall silent at the sight, André lets the harsh judgments and comparisons slide. He does not insist on the fact that he does not like his father (as he does at several other points in the narrative), nor does he make the obvious joke about the emperor having no clothes. Rather, guided by a sense of pity that is perhaps equally problematic, André is inclined to let his antipathy toward his father ease. When his siblings are all expressing concern over the effect that their father’s illness is having on their mother, André is the lone advocate for their father. This change in behaviour surprises even him, for “normalement nos conversations sur le bonheur de nos parents s’articulent autour de celui de maman, comme si le bonheur de papa s’était éteint à jamais avec le diagnostic” (59) [normally our conversations about the happiness of our parents revolved around mom’s happiness, as if dad’s happiness had forever been snuffed out with the diagnosis]. He rationalizes this uncharacteristic change of heart by arguing that since their father had become ill he had started to acquiesce more and to balk less, as if sensing that the end was nearer than it had ever been and that it was no longer as important to be the undisputed master of the large family. What is clear from André’s recounting of events is that he finds it difficult to reconcile long-held views of his father with new feelings of sympathy, or perhaps even the perceived obligation to sympathy created by the illness: “Je n’aime pas ce contact physique avec mon père. Lui ne le sait pas. Trop tard pour lui expliquer le déplaisir que je ressens en le soutenant et en l’accompagnant dans ses pas. Inutile aussi. Voilà, j’ai compris, c’est un vieux que je raccompagne à son lit, un vieux qui meurt, n’importe lequel vieux qui me fait penser à un père mourant. Cela me va” (44) [I don’t like this physical contact

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with my father. He doesn’t know that. Too late to explain to him the distaste I feel while holding him up, walking beside him. Useless too. I’ve got it, he’s an old man that I’m helping back to bed, an old man who is dying, just a random old man who reminds me of a dying father. That suits me]. That the actions expected toward a sickly man come only when André can separate the illness and its allowances under the theory of the sick role from the person who is his father shows just how partial and tentative are the changes brought by the diagnosis. These necessary actions are performed nonetheless, and almost in spite of himself the narrator is able to normalize his relationship with his father.7 The tensions between the disease-marked present and the “healthy” past are also played out with regard to the father’s speech. Given that the story is one of conflict within a family, there is surprisingly little dialogue in the text. Rather than being offered up as verbal duels for the reader to appraise him or herself, most of the exchanges between members of the family are simply reported in the narrative, glossed in their passing mention. The father’s words nevertheless find their way into the text as direct discourse. His speech is conspicuously inserted, faithfully transcribed with its pauses, halts, and verbal ticks. Ellipses separate the words of a painfully slowly uttered sentence or even the syllables of words that have replaced the sentence and paragraph-length orations of earlier years. It is as though the scarcity of speech from the normally verbose man has prioritized his words in the text and given his painstakingly uttered commands for attention or respect and good-hearted jokes a status above those of the others. When the father’s speech is uncharacteristically fluid, this too is noted in detail: “‘J’ai faim et je veux une belle mort.’ C’est presque ainsi qu’il a parlé, avec peut-être une légère hésitation avant ‘je veux une belle mort’” (175) [“I’m hungry and I want a good death.” That’s almost how he said it, albeit maybe with a slight hesitation before “I want a good death.”]. This attention to the way in which his father speaks is André’s way of illustrating the profound change in behaviour for the formerly long-winded man. He no longer communicates fluidly or at length as he once did, but when the limitations of speech can be circumvented, for instance through writing, the earlier patterns of discourse return. The man who “avait plutôt l’habitude de parler en paragraphes” (12) [more or less had the propensity to speak in paragraphs], with the assistance of a pen, a notebook, and a person willing to read his proclamations, regains his ability to not only



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“speak” at length, but also to disparage his children and condemn their conduct like in the years that preceded his falling ill. The slowed or non-voiced interventions in the conversation show much of the same content that the narrator remembers. A remark about liking rosé when red and white wines are accidentally mixed in his glass is taken as a joke by both the narrator and his mother, although there is an indication that both of them fear that the comment was not so much meant to be funny as it is a sign of a weakened mental faculties. This fear seems to be allayed, however, when the father writes out a rather funny joke several weeks later about an incident that occurred almost half a century earlier. This evidence of persistent wit despite the diminished capacity to communicate it is mirrored in the continuance of many of the other facets of his discourse once he begins to write out his thoughts: “Il ressasse ses phobies modérément racistes et multiplie ses mauvaises blagues sur les homosexuels, sur les artistes comme moi qui ne font rien d’utile dans la vie. Il a recommencé, toujours par écrit, à donner des ordres” (199) [He keeps trotting out his moderately racist phobias and multiplies his bad jokes about homosexuals, about artists like me who do nothing useful in life. He’s once again started, always in writing, to give orders]. Although there is a rather clear indication that the narrator could do without the kinds of comments his father has once again taken to sharing with those around him, the son’s renewed antipathy toward his father comes as something of a comfort, particularly for his mother. The attention accorded the father’s speech, halting and abrupt though it may be, is a way for André to emphasize the continuities between the pre- and post-symptomatic “versions” of his father: “Il possède les mots et toutes les pensées, mais personne ne les entend. Il sait tous les pas et les gestes, mais il tombe ou laisse échapper le verre. C’est ainsi qu’assis à sa gauche durant chaque repas de famille j’interprète ses colères ou ses démissions. Je préfère les colères. Elles disent que l’homme que j’ai connu, et que je n’aime pas, existe encore” (13) [He has all the words and all the thoughts, but nobody hears them. He knows all the steps and all the gestures, but he falls or lets the glass slip. That’s the way I, from the chair to his left at every family meal, interpret his furies or his resignations. I prefer the furies. They tell me that the man that I knew, and that I don’t like, still exists]. The two sentences built around contradictory conjunctions give way to shorter phrases that, while no less paradoxical in their

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meaning, possess a certain straightforwardness in assuring readers that something of the pre-diagnosis and pre-illness days endures. This theme – and indeed the pairing of the adverbs encore or toujours and the conjunction mais – occurs at several points in the novel and thus seems to be an important formulation of illness’s effects for the narrator. André, after all, is making sense of both his father’s illness and death and their long-troubled relationship through the articulation of the pathographical narrative. If their troubled relationship is/was the problem, the narration of illness’s intervention into that relationship is what is helpful. One of the ways that André sorts out his feelings and arrives at his own sense of equanimity is by analyzing the behaviour of others toward his father. When his brother Bernard chastises the patriarch’s yuletide indulgences by wondering aloud if maybe their father hasn’t already had enough to drink, it prompts André to silently critique his brother’s rhetorical question: “Il y a quelque chose d’indécent dans cette façon qu’ont les enfants de parler à haute voix de leurs parents comme s’ils n’entendaient rien” (31) [There’s something indecent about the way children talk aloud about their parents as if they couldn’t hear]. Remarking how Bernard’s comment has reduced their father to an unhearing object in the room, André silently takes his brother to task. As their father’s health worsens over the course of the evening and he is rushed to hospital, the confrontations between André and his siblings pass from musings and quiet reproaches to fights that are then reported in the narrative. He divides the family into “Buddhists” and “Medicals” depending on how strictly they believe in adhering to the clinical prescriptions. He critiques his siblings for infantilizing their father, for depriving him of the things that bring him enjoyment and the behaviours, however objectionable, that are characteristic of him because some disease has intervened. The grievance, it would seem, is that they are treating their father poorly because of his diagnosis. His own negative and voluminous commentary on his father and the objectification of the man in a narrative that he self-consciously reflects on writing, however, seems entirely acceptable. It is almost as though André uses his narrative to establish that he disapproves of how others treat their father because he is ill, but that his mistreatment or dislike has nothing to do with the illness because it predates it. The son’s behaviours, just like the father’s, are therefore both allowed to remain unchanged and modified because of the illness. What is remarkable about this narrative is



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the way that it grapples with the impact of medical authority on the day-to-day interactions between the protagonists, the way in which the pronouncement of disease changes everything. André nevertheless emerges as a voice of protest against the differential treatment of his father, reasoning that the diagnosis has not so much changed him as it has changed what others think and expect of him. Quebec’s national pedagogy, thanks to decades worth of exhortations (perpetuated by illness narratives, to say nothing of political rhetoric) to see itself as ill and to act in accordance with the demands of its condition, was oriented toward a national sick role. Having been so fervently and repeatedly diagnosed in the illness narratives of the preceding decades, Quebec has been expected to be and act ill, whether that means having a fatalistic outlook on the survival of its language and culture or continually searching for examples of lessthan-optimal functioning within the society (political corruption, economic stagnation, regional inequality) as proof of metaphorical national illness. Courtemanche’s narrative, insofar as it operates as a functional allegory, authorizes freedom from the need to think and act like a “sick nation.” His text suggests that these problems do not need to be seen as stemming from an inherent national malady. Moreover, diagnoses or articulations of the national paradigm as sick do not replace other equally valid understandings of what the nation is and why it is so.

Illness by Another Name Most pathographies, as Hunsaker Hawkins (1999b) explains, use a metaphor or other structuring trope to deflect attention away from the illness’s minutiae as well as to reconceptualize the experience of sickness, which can be foreign, alienating, and distressing, as something more familiar – and while no less challenging – more psychologically assimilable. In Tassia Trifiatis’s Mère-grand (2010) and Courtemanche’s later and more autobiographical Je ne veux pas mourir seul (2010), illness is both dealt with in a straightforward manner and considered via the mediation of tropes. In Trifiatis’s novel, the narrator chronicles her grandmother’s decline through dementia and the physical limitations of a body that no longer receives or adequately responds to signals from the brain. The ever-diminishing range of functions the grandmother can perform is expressed through a recurrent narrative of moving from her house

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to ever-smaller and more institutionalized confines. The ritual of moving, one so painstakingly captured in Roy’s Bonheur d’occasion ([1945] 1993), where the ritual is a yearly one, and the image of the moving box stand in for illness and the displacements it occasions. Courtemanche’s autofiction about the intertwined tragedies of his laryngeal cancer diagnosis and the announcement that his marriage is ending allow cancer itself to become the metaphor for the greater trauma of the failed relationship. In both of these illness narratives, as in Mavrikakis’s (2009) novel, metaphors allow the protagonist to make sense of a traumatic and seemingly interminable experience but also to provide a conceptual respite from the ubiquitous and unrelenting nature of their affliction, be it illness or emotional turmoil. The tropes for illness consequently provide for the pathographers what the tropes of illness supply to the nation: a means to link the concrete and the abstract threats not only, as Frank suggests, to the body (1995, 175–6), but also to the notion of one’s very identity. Like Courtemanche’s earlier novel, Trifiatis tackles a question common to what Hunsaker Hawkins (1999b) calls second-generation pathographies, which is how to allow someone to die with dignity. Rather than questioning or railing against the actual medical procedures and various lifesaving or palliative strategies that the hospital and nursing home staff employ, she focuses on the ironic futility of measures that are meant to appease the guilt of the institution and the family about not being able to “do” anything. Giving those closest to death rooms with scenic views, for instance, is decried as a tactic that prioritizes survivor guilt. Whereas Courtemanche largely avoided the clinical setting and focused on the family and the father’s symptoms, Trifiatis’s series of ever-changing homes for the grandmother almost stands in for the signs of the disease. Each move, although justified with a reference to a worsening condition, could be read on its own as a sign of the body’s gradual shutting down. Trifiatis’s novel is narrated over a series of Sundays that follows the Catholic calendar. In these familiar rhythms of ordinary time and special observances, Joseffa recounts her weekly visits with a grandmother whose mental and physical health are in rapid decline. Although she too notes how her grandmother’s illness has simply accentuated traits that were there before her diagnosis  – “elle était devenue elle-même à l’extrême” (94) [She had become an extreme version of herself]  – the primary thrust of the narrative is to show how illness has radically altered the nature of their



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relationship. Remarking how she has forgotten what it is like to hear her grandmother’s footsteps, she marvels at how quickly this forgetting has occurred: “Soixante-dix-huit ans de marche contre deux mois assise: effarant calcul où ce sont les deux mois qui l’emportent” (95) [Seventy-eight years of walking versus two months of sitting: an astounding equation where it is the two months that take precedence]. The verminous hallucinations caused by worsening dementia that call on Joseffa to “slay” the imaginary creatures occupying her grandmother’s room prompt her to reflect that she has come to hate her grandmother and to wish that she could “faire comme les autres légumes et regarder des étés interminables et des fées dans l’avoine” (96) [do like the other vegetables and see endless summers and fairies in the oats]. Despite the causticity of the above comment, which might best be characterized as an expression of frustration, Joseffa’s love for her grandmother remains constant, as is evidenced by the time she spends with her and the fervour with which she defends her right to keep caring for her when she feels the nursing home staff are negligent in their duties.8 The transition from independent to assisted living proves just as, if not more, difficult for Joseffa as it does for her grandmother, whose dementia seems to have rendered her mostly (and arguably mercifully) ignorant of her changing surrounds. She is forced to leave the duplex home that she shared with Joseffa and her mother for a smaller apartment, which in turn is traded against a series of rooms, either private or semi-private, in an equally and mockingly indistinguishable series of “centres” and “milieux” for the aged and infirm and hospitals of various kinds. As the relatively rapid transition from house to apartment to room is effected, it generates comments that both justify and bemoan the relocations. The combination of a broken hip and dementia, which prevented rehabilitation in the form of relearning how to walk, acts as a rationalization that supports the initial position that the changes in living situation were inevitable: “nous n’avions pas eu le choix: il avait fallu la forcer à habiter dans plus petit” (7) [we didn’t have a choice: we had to force her to live in something smaller]. The move to a single room in an institutional setting is similarly justified: “Ma grand-mère devait quitter cet endroit parce qu’elle avait oublié qu’elle oubliait, ce qui est plus dangereux que de seulement oublier” (45) [My grandmother had to leave this place because she had forgotten that she was forgetting, which is more dangerous than simply forgetting]. Emphasizing

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the danger of the new circumstances allows Joseffa to attenuate her considerable guilt about placing her beloved grandmother in a nursing home. The hurtful actions come under the familiar umbrella of being “for one’s own good.” If the narrative of relocation acts as an allegory for the illness, the boxes and bags of the grandmother’s personal effects serve as the metaphors of her grandmother’s lost independence and impending death: “son corps diminuant à la même vitesse que son espace vital, nous jetions toujours un peu plus de son essentiel” (64) [her body shrinking at the same speed as her living space; we were always throwing out a little bit more of what was essential to her], muses Joseffa as she tries to accommodate more of her grandmother’s possessions in her own tiny apartment to spare them the indignity of being discarded. She concludes that she will have to move to bigger quarters to take in the objects (kitchen utensils, sheets, knick-knacks) that her grandmother had touched and used. In many ways, Joseffa transfers her guilt about having to abandon and institutionalize her grandmother onto her possessions, which are written of as though they were sentient beings, abandoned pets, or orphaned children, and which can be cared for as a substitute for being able to care for her grandmother: “Je devenais la maison du répit des choses. Des objets qui savent que leur fin approche puisqu’ils n’entendent plus la voix de ma grand-mère chanter en époussetant … je me disais qu’ils étaient tout de même mieux avec moi. Au moins, ils verraient des ombres, des mains s’agiter autour d’eux, et ça leur rappellerait le bon vieux temps” (64–5, my ellipsis) [I became the respite home for the things. Objects that know that their end is coming because they no longer hear my grandmother’s voice singing while she dusts … I told myself that they would be better off with me anyway. At least they would see shadows, hands moving about them, and it would remind them of the good old days]. The troubling realities of the shrinking troves of possessions like the diminishing space occupied by her grandmother nonetheless reassert themselves. The delusion that Joseffa will be able to take in all her grandmother’s forcibly discarded belongings and to care for them as she would prefer to care for her grandmother ends: “à son prochain départ, il n’y aura qu’une seule boîte. Et elle sera dedans” (88) [at her next departure there will only be one box. And she will be in it]. Still twinned, the notions of household effects that must be moved and her grandmother’s health settle into Joseffa’s mind and she eventually accepts that the



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measuring cups and tablecloths might not be able to be saved. This realization precedes and also fosters the acknowledgment that neither she nor the rest of her family can save her grandmother, which is suggestive of the fact that the association allows Joseffa to better understand and come to terms with the realities of the situation. The truths of moving are well known to the Québécois, who uphold the 1 July moving day ritual as a sign of cultural differentiation (Grescoe 2001). It is therefore the accepted realities of familiar transitions that occasion new acceptance of frightening changes and moves  – the exact process that occurs on a national level with the embrace of allegories of illness to make sense of profound changes to the national paradigm. Courtemanche’s Je ne veux pas mourir seul (2010), a work of autofiction about the author/narrator’s difficult acceptance of divorce and a diagnosis of cancer, does not fit neatly within the conventional paradigms of pathography. Unlike his earlier novel, which despite its fictional premise is very much a biographical pathography, the style, focus, and content of the autobiographical illness narrative steers the reader away from the illness as the subject of the book. The text is nonetheless pathographical insofar as it is an overstated but therapeutic accounting of both illness and interpersonal emotional trauma. The author, however, consciously adopts the illness as a metaphor for understanding and coming to terms with the more distressing life experience that is his divorce. To employ the illness deliberately as a metaphor in a pathography, where other myths and metaphors tend to structure the thinking about illness, highlights how even cancer in its biological and not purely metaphorical form can be understood as an explicative device rather than as a potentially fatal diagnosis. To understand illness in such a way in an illness narrative that is literally about cancer allows for a shift in thinking about the role illness plays in the strictly figurative formulations of nations as diseased bodies. As a pathography that would be recognized as such according to the strictly (auto)biographical definition of the genre, Je ne veux pas mourir seul sets itself apart. It is not characterized by the “conservative and at times amateurish literary mode” that Kinnane attributes to most pathographies, the majority of which are written by novice authors who come to writing strictly because of their illness (2000, 102).9 On the contrary, Courtemanche’s background as a journalist and novelist allows him to deploy a refined style, and his literary

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choices, while hardly revolutionary, may be considered provocative. The many short chapters, for instance, are with a few notable exceptions alternately titled “la vie” [life] and “la mort” [death] and speak to the author’s Manichean fashion of seeing his entwined traumas as a way of living with death and having to fight to live long enough to rebuild a life for himself. These chapters form something of a disjointed narrative that would seem, to reference Frank’s (1995) idea of postmodern testimony, to reject the grand narrative of medicine as curative, even though the story is one that ends with the protagonist’s cancer in remission. The prose is direct but frequently haunting in its simple statements of living with loss and regret. The impetus for writing is similarly at odds with established models. Courtemanche frames his pathography primarily as one that addresses the emotional content of his divorce, not his illness: “J’écris pour vivre encore. Quand j’écris, je vis un peu, je te parle, je discute avec toi, je te fais part de mes découvertes, de mes doutes, de mes regrets, de mes angoisses” (111) [I write to keep living. When I write I live a little, I talk to you, I discuss with you, I tell you of my discoveries, my doubts, my regrets, my anxieties]. He continues: “C’est aussi pour ce con, cet imbécile, cet idiot que je fus que j’écris. Peut-être lui, ou un autre comme lui, nous sommes nombreux, lira-til ce petit livre et se mettra-t-il à la tendresse et à l’amour avant qu’il ne soit trop tard” (113) [It is also for that asshole, that imbecile, that idiot that I was that I write. Maybe he or another like him – there are many of us – will read this little book and will get on with tenderness and love before it’s too late]. Statements that focus on valorizing the interpersonal relationship situate the illness narrative within a didactic mode, but one that has virtually nothing to do with the content of the illness itself. Rather, the author’s cancer reminds him of his own mortality and of the ways in which he took his relationship with Violaine, his now ex-wife, for granted. He sees his work as a cautionary tale, not of consequences of a life spent drinking, smoking, and otherwise engaging in a lifestyle that likely contributed to his cancer, but of emotional distance from those around him. The consequences of the narrator’s interlinked tragedies are analogously framed as an overlay of illness and the failed relationship: “La peur de la mort ne m’est pas venue de l’annonce de la maladie, elle m’est venue de cette femme qui m’a quitté” (27) [My fear of death did not come from the announcement of the disease, it came from this woman who left me]. Death, a recurrent theme in many



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pathographies, is flatly denied as stemming from illness. It is instead the emotive capacity of Violaine that inspires fear. When the doctors fail to recognize the dominant emotional effects of the separation, they become a source of frustration akin to the doctors who do not acknowledge patient complaints, fears of recurrences, or new symptoms as legitimate: “Avec le médecin, j’ai vaguement évoqué une situation difficile sur le plan sentimental. ‘Et alors?’ m’a-t-elle dit. Et alors, docteur, bordel, vous ignorez ma principale maladie, le mal qui ne détruit pas que mon larynx, mais mon cœur, mon ventre, mes pieds qui marchent à peine, ma bouche qui a perdu le sourire, mes rides qui accusent ma nouvelle laideur” (32) [With the doctor, I’d vaguely alluded to a difficult emotional situation. “So?” she said. So, doctor, goddammit, you’re ignoring my main illness, the evil that isn’t only destroying my larynx, but my heart, my stomach, my feet that hardly work anymore, my mouth that has lost its smile, my wrinkles that betray a new ugliness]. The litany of physical symptoms to which the doctor should be attuned even if she is ignorant of their cause is, for Courtemanche, justifiable reason for indignation. The entanglement of the diagnosis and the dissolution of the relationship are so complete that they flow into each other: “C’est le départ de la femme plutôt que la maladie qui répond, mais je suis un homme poli et respectueux. Je ferai silence sur mes maladies” (12) [It is the woman’s departure more than the illness that responds, but I am a polite and respectful man. I will keep silent about my illnesses]. The way in which Courtemanche’s illness becomes plural is but the first in a series of descriptions of heartbreak couched in medical terms. Upon Violaine’s leaving, she is conceived as an immune system without which he is sure to perish (35), and he describes her as “l’antibiotique absolu” (35) [the absolute antibiotic]. Her email announcing her departure is rendered as the death for which the author is preparing himself: “La mort est plus subtile, c’est un cancer qui s’annonce, un courriel qui dit: ‘je te quitte’” (34) [Death is subtler; it’s a cancer that announces itself, an email that says, “I’m leaving you.”]. Life without Violaine is described as “une forme insidieuse de mort, une sorte de cancer émotif” (108) [an insidious form of death, a sort of emotional cancer]. The slippage in these statements is not only between emotional upset and cancer, but also between cancer and death. In the first instance, the association is the source of critique from the likes of Susan Sontag (1978), who repudiates the idea that cancer is a disease linked to emotional passions and failures.10

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In the second, cancer becomes synonymous with death, a fatalistic perspective that forms a vicious circle whereby cancer becomes only an explanation of how Violaine’s departure is akin to death. The overlay of the medical on matters of the failed relationship is no doubt the by-product of having learned of the divorce on the same day as the diagnosis. The correspondence, however, also likely owes to illness’s long cultural history of representing that which is abstract and mysterious. Illness and disease, those readily understandable problems that we all face, become the metaphors that make emotional suffering comprehensible. In this, there is little new, for as was outlined in chapter 1, the highly accessible figure of the body, its functions and its disturbances have long been used to explain more conceptual phenomena. It is no accident that we speak of heartbreak and love sickness. Where Courtemanche varies from earlier Québécois illness narratives, and indeed from his own previous professional experience, is in the absolute distance he imposes between the highly personal and the generalizably political. The narrative is, in its entirety, about his own situation: about his health, about his love life, about his family, about his senses and emotions. Even his experience of the oncology ward and the dreary outpatient treatment facilities at the hospital, a seemingly perfect opening for commentary on the state of public health care for a politically engaged writer, or the aggressiveness of conventional Western medicine, elicits little more than affect-driven prose.11 The personal of illness appears to be resolutely and even conspicuously anti-political. Given that the text ostensibly refuses political commentary in favour of a much more intimate accounting of events, Courtemanche locates the motives for his writing in the intertwined themes of life and death. Writing is the means for the author to live when he has in many respects deemed himself dead from the moment of his diagnosis/divorce. When the novel opens, the narrator is in a bar writing his will, which serves as an announcement to both the inquisitive waitress and the reader that the man who describes himself as not looking like he’s dying in fact is (11). Unusually for an illness narrative, the disease precedes the illness. As this first titleless chapter cedes to the back and forth of life and death in the subsequent chapters and the illness narrative is played out in descriptions of the hospital, radiation treatments, and occasionally inappropriate interactions with medical personnel, there is a realization that it is the



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writing itself that allows Courtemanche to live. The “J’écris pour vivre encore” (111) [I write to keep living] is preceded by “Maintenant, je sais” (111) [Now I know]. While the disease becomes an illness for the protagonist, it makes itself known in a way that only an intimate experience of being sick and taking on the sick role can make possible. In the time of the story “Elle parle, se manifeste” (98) [It speaks, it manifests itself].12 Almost unbeknownst to the reader, these recounted experiences occupy the time of the text that account for the months that allow the cancer to go into remission. Indeed, at the story’s conclusion, in a chapter that also escapes the binaristic chapter titles, the narrator has become involved in another relationship and we learn that five years have passed since his diagnosis. This combination of new circumstances addresses, indeed remedies, the twinned maladies of the divorce and the disease. Courtemanche’s text can be construed as a pathography that not only reflects, but also reflects on the therapeutic nature of writing about one’s illness. Although alluded to in previous chapters, the idea that writing about illness, and specifically that writing about a problem is in some way therapeutic, has gained currency. Yet it is in Courtemanche’s text that consciously using illness as a metaphor for other matters, specifically a difficult transition, becomes therapeutic. Reminiscent of the transitions evoked by Gramsci (1971) and Jameson (1986), the attention to illness is a way to grapple with other matters and to recognize that it too is a trope that is used to cope. For Courtemanche, disease is less of a diagnosis and more a part of a process of recovery.

Meta-pathography The positive effects of combining illness and writing are explored in their greatest depth in Sylvain Trudel’s (2001) Du mercure sous la langue, a novel about a sixteen-year-old boy dying of bone cancer. To cope with his terminal illness just as much as with the alienation of the hospital that cuts him off from the life of a normal teenager (school, family, dating), Frédéric turns to poetry and embraces the grim pseudonym of “Métastase” [Metastasis] after an eighteenthcentury Italian poet of the same name. The illness narrative contains one of the most comprehensive meditations on the role of writing for the sick. Writing about illness is valorized on three fronts: as an act of agency in the face of a disempowering illness, as resistance

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to institutional medicine and the prescribed roles for the sick, and finally as a bridge to normal experiences. The fictional pathography consequently becomes a meta-pathography in much the same way that The Wounded Storyteller (Frank 1995), a theoretical work inspired by the author’s own experience of being sick, expounds on the benefits of narrating illness. The novel itself is a first-person narrative centring on both the experience of illness and hospitalization and meditations on what this suffering means in philosophical and theological terms. It is likely this second component of the novel that leads Michel Biron to categorize it as a romantic farewell letter (2002, 339). The inescapable references to chemotherapy drugs, bodily disturbances, and the animalized (“cochon d’Inde maléfique” (25) [baleful guinea pig], “hamster têtu et imbécile” (67) [stubborn idiotic hamster], “pieuvre” (67) [octopus]) tumour residing in the narrator’s hipbone nonetheless underscore the ways in which this text fits within the more immediate tradition of Québécois illness narratives. It is the possibility of imminent death that compels the narrator to pen his thoughts, not so much because he wishes to say goodbye, but because in writing there is the possibility to gain a measure of control over the timeline that leads him to his death. In writing, Frédéric is able to escape, defer, the presentness of his condition in favour of the past and future. As a retrospective and reflective act, writing allows him to contextualize and give new meaning to experiences. “Dans l’après-midi, pour me désennuyer,” Frédéric writes, “j’ai fait de la fièvre” (76) [In the afternoon, to amuse myself, I ran a fever]. Here the narrative transforms an involuntary immune response into a conscious decision akin to choosing to read or watch a movie to keep boredom at bay. Symptoms are normalized, for the patient claims authority over the illness and its consequences. There is a refusal of the teleology of decline (or alternately of the teleology of recovery) inherent in many illness narratives. Writing ensures that there is also meaning given to the future, where the vicissitudes of illness might otherwise deprive Frédéric’s demise of the weight he feels it deserves. For the young poet, already keenly attuned to language and his own shortfalls as an accomplished wordsmith, there is a preoccupation with what his last words will be: “je risque de ne pas voir venir dans mon dos le coup de pied de biche et d’expirer une platitude au moment crucial, et j’aurais tout gâché l’effet dramatique de mes dernières paroles” (24) [I risk



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not seeing the blow to my back with the crowbar and exhaling some platitude at the crucial moment and I’ll have completely ruined the dramatic effect of my last words]. To leave behind not only the poems but also the philosophical narrative that contains them is an assurance that something of substance, beyond the pattern of the carpet or the buzzing of a fly, remains. It is perhaps for this reason that the volume’s final words, “Dieu hait son âme. Et puis fuck” (125) [God hates his soul. Well then, fuck], so strike the reader as out of keeping with the tenor of the novel, even amid its other moments of profanity, desperation, and exasperation. One might say that Frédéric is preoccupied with how his dying words, like his description of his illness, are received by others. Akin to a stand-up comedian who analyses the impact of his jokes, he evaluates the different approaches he takes to verbalizing the experience of his malady. He observes that his jokes often fall flat, that his poetic meditations, which he himself denigrates as puerile, alarm those around him, and that his stubborn coldness before the priest’s efforts to comfort him gives him a certain satisfaction. This poetic persona, the one so concerned with saying exactly the right or wrong thing, emerges roughly two-thirds of the way through the narrative, although snippets of his poems, which he repeatedly describes as “con” [stupid], punctuate the whole text. In contrast to the morose poems are the darkly humorous “purgatory letters” Frédéric is writing to his family. Entrusted to a fellow teenaged patient who is thought to be well on the way to recovery, the letters are to be mailed a year after his death. From the sample letter reproduced in the narrative, there is no trace of the brooding poet, only the wry observations of a cynical adolescent who jokes about his projected home in the afterlife to his devout Catholic family members. These three forms of pathography – the illness narrative itself, the poems, and the letters – each give the protagonist a way to make sense of what is happening to him. Already in the choice of pen name, the mise en abyme of illness narratives in this first-person account is about letting the disease speak. The fundamentally disempowering nature of illness is acknowledged in verse: “mais je suis un petit livre illisible” (12) [but I am a book, small and illegible], at the same time as this sentiment is located in the doubly legible space of the poem contained within the illness narrative. In writing, there is, as with Courtemanche, a sense of life (at least) being lived. At the outset of the narrative and

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before the first of the excerpts of his poems are woven into the text, Frédéric expresses regret for not having begun to live until today (9). The coming to writing is therefore framed as a way of (re)gaining a sense of agency and more importantly of engaging in the act, living, that is being menaced by its morbid counterpart. To write is a way to resist death, but it is also a means of resisting the clinical apparatus and its codes, which is a common feature of pathography: Les autorités n’aiment pas du tout mon nouveau pseudonyme, ni même l’idée que je me suis débaptisé tout seul dans mon coin, sans les avertir de ma métamorphose. Je sais pas, on dirait que cette mutation symbolique les terrorise plus que toutes les mutations génétiques … Je les dégoûte par ma façon d’être en vie et de croquer la mort.13 (91, my ellipsis) [The authorities really don’t like my new pseudonym, and they don’t even like the idea that I dechristened myself all by myself without alerting them to my metamorphosis. I dunno, it’s like this symbolic mutation terrorizes them more than all the genetic mutations. I disgust them with my way of being alive and making death disappear.] In writing, the author posits an adversarial relationship with medical personnel, the authorities, against whom actions must be taken in secret, as though the surveillance of clinical space were so difficult to escape that the only acts possible are symbolic. The hospital staff respond to Frédéric’s writing, or rather his insistence on elliptically writing as his cancer, by both problematizing and somatizing it: “les infirmières et mon oncologue trouvent malsaine ma relation avec la maladie” (91) [the nurses and my oncologist find my relation to illness to be unhealthy], the irony of course being that there isn’t, ontologically speaking, a healthy way to be unhealthy. The desire to restore health to the facets of the experience where it can be restored, which is to say to the mental approach to one’s illness, introduces a clinical psychotherapist to, in Frédéric’s interpretation, argue with him about how to die. Frédéric/Métastase’s reactions to this further medical intervention clearly defend his poetry as a way for him to make peace with his impending death: “Fuck! On peut-t’y crever comme on veut, icitte, tabarnac? Est-ce que je passe mon temps à vous dire comment vivre, moi? Va-t’y falloir que je



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me garroche en bas du septième étage pour m’arracher à vos griffes d’enragés?” (91) [Fuck! What do you have to do to die like you want to around here, dammit? Do I spend my time telling you how to live? Am I going to have to fling myself off the seventh floor to tear myself from your fanatical claws?]. The cancer and his way of dealing with the prognosis are something that he is quite forceful about, as though his anger about the denial of his pathography and its benefits might escape his reader. His exasperation is but thinly veiled incredulity that health professionals have not figured out that patients employ a variety of coping mechanisms. He therefore rails against a sort of emotional quarantine that seeks to contain the spread of a narrative conceived of as ill. Although not so explicitly taken up by the sick teenager, poetry and letter writing allow Frédéric a bridge to normal adolescent experiences denied to him by his sickness. He strikes up a friendship, one that turns to innocent love and eventually lust, with a fellow patient named Marilou, who is also a poet. They trade melancholy verses and reflect on their shared circumstances much as other teenagers might share their angst about parents, school, and a developing sense of identity. The letters that he entrusts to Benoît also bind the boys together through mutual responsibility. Just as some young men might bond via the shared obligations of team sports, these two patients become implicated in a duty to deliver the letters when the time is right. The circumstance of illness shared by these teens leads Biron to dub them members of a not-quite-dead poets’ society (“société des poètes sur le point de disparaître” [2002, 340]), although the community he describes is also one predicated on poetry and thus on writing. The romance and the deep friendship fostered in the hospital are in many ways indicative of how the clinical space has imposed an order of substitutions on the other relationships Frédéric has. His friends are his fellow patients, and those who get better and are discharged are those who drift away as shared interests diverge. Those who are in the hospital for the duration, like him, become the most intimate of his acquaintances, effectively replacing his siblings. The medical staff that surround him day in and day out take on parental roles. His psychotherapist, for instance, scolds him instead of counselling him to give up his pseudonym: “‘Pourquoi au juste as-tu choisi un tel nom? Comprends-tu que ça peut traumatiser ceux qui t’aiment et qui espèrent te voir guérir? Qu’est-ce que tu cherches à

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nous dire par là?’” (91–2) [Why did you choose a name like that? Do you understand that it can traumatize those who love you and hope to see you get well? What are you trying to tell us with this?]. Lapsing into the stereotypical role of the guilt-tripping mother, the counsellor reproduces behavioural dynamics that would be more likely in a family setting. The nurses are indistinguishable from one another, each one referred to only as “matante” [auntie] if not by their professional designation, as an attempt to create a sort of family that the narrator suspects will do no harm even if redefining the family relationships does no good. Only Frédéric’s paternal grandmother, Émilia, escapes the redefinition imposed by the clinical space. Kveˇta Kunešová contends that this one remaining allegiance owes to the fact that in the ensemble of Trudel’s work, grandparents represent origins and are faithful to a sense of how things were (1986, 214). When the expressed wish is for members of his family to act normally around him, the deference that they show him is an annoyance that further marks him as different. Paradoxically though, Émilia is perhaps the one person in Frédéric’s life who successfully navigates his transition from health to illness and eventually to acceptance of his impending death without losing sense of who Frédéric is. When everybody else despairs about his pen name, she offers to scour the bookshops of the Montreal area to locate a book of the original Metastases’s verses and when that quest proves unsuccessful offers him a book on rituals of death and dying throughout the world. Frédéric’s various illness narratives are, in much the same way as the other texts studied here, narratives about coming to terms with death. Hunsaker Hawkins describes this kind of pathography as more recent compared with those that focus on recovery, arguing that they are primarily a phenomenon that emerged in the late twentieth century and replaced an earlier reluctance to discuss death in literary or dramatic contexts (1999b, 91).14 Perhaps more than in any of the other texts considered in this chapter, however, Trudel’s novel quite consciously emphasizes how writing about illness and even death robs it of its power to control and dictate the way that those who are ill conceive of themselves and their situations. It is the way in which they present the experience, argue scholars of pathographies, that shapes the reality as they experience it. In positing how illness is like a situation over which we have some control, how it is a predictable extension of what we have known before, or how it is fundamentally no different from any one of life’s potential tragedies, it becomes controllable, predictable, and known.



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Twenty-first-century illness narratives highlight the fundamental role of narrative in profoundly altering the experience and meaning of illness. Narrative allows for a normalization of the disruptions and changes occasioned by sickness and provides those affected with the means to conceptualize and explain these painful and disorienting transitions. Pathography can therefore be said to be less about the content of the narrative than it is about its function, what it allows, facilitates, and does. In similar circumstances of profound and rapid changes, such as those that confronted Quebec throughout much of the twentieth century, narrative has also proven to be instrumental to making sense of and gaining a feeling of control over the experience. Illness emerged as a favoured trope for understanding and ordering (by giving a familiar narrative arc to) these events. The illness narratives, too, should accordingly be understood in terms of function, what they allow, facilitate, and do. Understanding illness narratives as functional allegories enables new ways of reading that prioritize what lessons (so to speak) might be learned from Quebec’s morbid texts. Through the most explicitly pathographical of Quebec’s illness narratives, one comes to appreciate the importance of normalizing disease, of using tropes to facilitate our understanding of it, and of using narrative to gain a sense of agency over a process that would otherwise make one feel powerless. To apply similar logic to the national situation entails recognizing disease and illness as therapeutic tropes, not as diagnoses. What it means to be a “sick nation” is therefore radically redefined. Quebec’s illness narratives, pathographies all, might thus be about disease and sickness, but they are also about recognizing the processes of positive, even curative, meaning-making through illness and not just about it.

Conclusion

It is fair to say that among concerns about the changing nature of its society, its future as a nation, and rapid technological and material advances, Quebec responded by holding on to certain ideas about itself as a nation, jettisoning others, and formulating new aspects of its self-image. The French language’s survival is a proud testament to how particular traits have endured and become fundamental to notions of what makes someone Québécois. Catholicism and an identity predicated on rural living have gone by the wayside, ceasing to be even exemplary notions of what it is to be Québécois. Amid these better-studied changes, a new facet of the national paradigm took shape: as a propensity toward pathology-driven self-representations in the form of sick characters. From the canonical works of the mid-century period to the more challenging and bold experiments of the years marked by the political ascendency of the Parti Québécois and again in contemporary narratives that, in their own way, address the limits of modern medicine, the ailing and their diseases have figured prominently in Quebec’s national literature, and by consequence in the national paradigm. This study has sought to do two things: to understand what Quebec’s illness narratives and the tales of its sick characters say about it as a nation and to appreciate what these medico-national allegories do to the national paradigm they posit. The first question, broadly speaking, is about the nation read into the text, the second concerns the nation influenced by it. With over seventy years of illness narratives to consider and several of Quebec’s most famous works featuring stories of disease and sickness, though, the questions are almost hopelessly entangled.



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The answers to the first query are in many ways easier to come by. Both francophone and anglophone critics, following the logic of the body politic, took as rhetorically equivalent the body and the nation. Their conclusion was simple: with so many sick characters populating its national literature, Quebec, especially given its tenuous political and cultural situation within Canada and its economic marginalization, had to be a sick nation. At certain periods this judgment was taken literally, as theories of social realism framed the literature as a mirror for the nation’s public health realities. As vital statistics improved and rates of morbidity in the province drew level with those of the rest of the developed world, explanations turned to theories of metaphorized inferiority. The Québécois were either appreciably substandard compared to another group, such as English Canadians, or were falling short of a norm or an ideal, and these shortcomings were expressed as pathology. In both of these scenarios, established (negative) opinions about the nation and its (poor) metaphorical health underpin the allegorical reading, and the tropes of illness can be considered a reinforcement of these beliefs thanks to the readily understandable image of the sick body. The weak, the meek, the immature, and the poor, all in some way thought to be representative of the nation, were favourite characters to write into a sickbed. Such interpretations relied on reading the body in a way that fit assumptions about the nation rather than working outward from the text, its bodies, and its medical interactions. To suspend judgment about the nation’s diagnoses and prognoses invites other theories about why Quebec’s literature turned to tropes of illness. The very fact that similar tropes show up at seventy years’ remove from one another, when the medical and national situations in Quebec were radically different than they were previously, suggests that the cause of the nation’s turn to illness is neither a reflection nor the result of a particular medical or historical circumstance. Rather, it is the constancy of the trope amid changes both rapid and multiple that prompts us to look to the work of theorists like Gramsci (1971) and Jameson (1986), who argue that tropes of illness and disease are a common social and cultural response to change. The unsettling nature of change, particularly the kinds of transformations that eventuated in Quebec throughout the latter half of the twentieth century, prompted a search for ways to make sense of what was happening. The experience of political, social, and cultural life at the time incited people to analogize the destabilizing

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events with scenarios and experiences that brought understanding and familiarity. Illness, one of the most ubiquitous among this type of experience, was therefore not a reflection of a dire national situation; it was a collective strategy to cope, manage, and respond to change. Alexandre Chenevert’s variously somatized difficulties adjusting to the pace of modern life in Montreal, the transformation of the structures of national authority instigated by the Quiet Revolution represented by the sick doctors, and the anxiety about the fate of the nation after the 1980 sovereignty referendum surreally embodied as a two-headed man exemplify how the turn to tropes of illness within narratives corresponds with disruptions in the milieu from which these texts issue. Gil Courtemanche’s Je ne veux pas mourir seul (2010) perfectly illustrates this impulse in its rendering of the trauma of change as an illness because the disease is the more comprehensible experience. Shifting the way we understand how illness narratives came about in Quebec, namely that they are not the direct result of seeking a corporeal correspondence to the nation’s presumed deficiencies, is to turn away from a “nation-to-text” reading. To fully enact a “text-tonation” approach, though, requires different questions to be asked of the illness narratives. We must query what the narratives do rather than what they represent or why they came about. This is done by reading the narratives in a way that is open to what is taking place within the text; it entails potentially troubling the equivalence of the medical and national sides of the rhetorical equation. When read in this way, Quebec’s numerous illness narratives reveal that for nearly every narrative that can be read as painting the nation as sick, there is an embedded counterpoint to that finding. Narratives that focus on diagnosis evacuate the meanings out of connotatively rich diseases and contrast the esoteric and restricted authority of the doctor with the collective and relatively diffuse nature of national authority. This divergence in the supposedly aligned discursive processes that enact both diseases and nations undermined the diagnosis of the nation as sick at the very point that the “epidemic” of ailing characters began to typecast the nation as ill. The appearance of ill physicians in the 1960s destabilized the boundary between doctors and patients, a foundational premise of medical authority, and consequently troubled assumptions about the nature of medical versus national authority during the hierarchy-redefining



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Quiet Revolution. The curative power of the ailing physician also frustrated attempts to read this particular kind of sick character as a personification of the nation. Politically engaged narratives from the years of the sovereignty debates focused on advocating for interventionist medicine and treating disease aggressively, but undermined their own premise by interrogating whether patients were in need of treatment, particularly given the provocative side effects that resulted from the attempts to cure and palliate. Texts like Les têtes à Papineau probed the very foundations of the medico-national relationship in Quebec by challenging the notion that a single, unified, and normative body (even one that can get sick) is an appropriate trope for a nation that is inherently plural, divided, and unconventional. Such inconsistencies are not isolated aberrations, but are systematic checks on the determinations that we can reach about the nation’s allegedly poor health from reading its national literature. With renewed attention brought to the allegory, it becomes a vehicle for according different signification to the nation based on the narratives rather than seeing characters as corporeal illustrations of the nation’s “known” ills. The way in which we understand what the illness narratives say about the nation – that it is a society in transition, not one that is fundamentally ill – is key to appreciating what they do, namely that they normalize change and provide an outlet for collective anxieties. If we take the allegories to be (only) diagnoses of national ills and confirmations of suspected ailments, they contribute to a wellentrenched discourse of national failing and blindly reinforce the basis of the trope of the body politic. If we see them as psychological coping mechanisms to help society come to terms with a rapidly changing environment, they are therapeutic tales. Taken in this light, medico-national allegories play a central role in shaping the nation’s self-image, not as one that is ill, but as one that is proactive in its uses of national pedagogy to resist labels of sick nationhood, to question assumptions about national diagnoses, to spark legitimate debate about matters of concern, and to develop alternative frameworks for understanding issues on the national stage. The normalization of illness as a theme begs the question of whether or not the illness narrative will continue to feature as prominently in national literature as before or whether the apparent fascination with pathology will go out of style. If we look to earlier trends, the allegories are at both their most overt and morbid during the

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periods of greatest flux or indeterminacy in the national paradigm. The postwar years featured in Roy’s urban narratives brought agonizing portraits of people dying of cancer, the stirrings of nationalism in the lead-up to the 1970 October Crisis occasioned a text in which prescribed remedies fail and virtually every protagonist winds up dead, and the first sovereignty referendum produced a novel that bordered on being farcical, so explicit was its national premise. By contrast, the relative quiet of the political and social scenes since the 1995 referendum has caused the illness narratives to shed their blatant national overtones and to focus more on how illness forces people to find ways of making sense of it and incorporating it into their lives as a normal facet of biological existence. This evolution of the genre suggests that if no major disturbances to Quebec’s social and political scenes eventuate, illness will continue its retreat to being a life event like any other that may inspire or feature in a narrative. If, however, Quebec once again finds itself in a state where its national paradigm is uncertain and old convictions are being challenged, for instance with a new round of sovereignty debates, the morbid symptoms are likely to reappear and the focus is apt to shift away from discourses of normalization. What becomes of any future illness narratives, which is to say how they are interpreted in popular and scholarly discourse, is perhaps the more salient question, since change in any society is inevitable. Given that Quebec’s circumstances have been so transformed since the mid-twentieth-century advent of illness as a prominent theme in the national literature, it is unlikely that even the previous readings focused on a pathologized inferiority complex will maintain their validity. This fact alone will help to break free of the interpretative tendency to look to previous states of affairs as defining of present situations. It will nonetheless remain a challenge for a nation like Quebec, which continues to define itself in terms of the legacy of its past, to fully turn away from its propensity to read sick characters as simple metaphors for a sick nation. Reading differently, whether as allegory or simply with a mind to not seek in the narrative a confirmation of one’s suppositions about the nation, will nonetheless allow the illness narratives to signify something other – something potentially far healthier – than what these kinds of texts have previously meant for the nation.

Notes

Introduction 1 The term “allophone” is commonly used in Quebec to designate those – primarily of immigrant backgrounds, for Indigenous peoples are generally excluded from the designation – whose mother tongue is neither English (anglophones) nor French (francophones). 2 Unless citation information is provided with the translation, all translations are my own. 3 Medical rhetoric has also infused much of Quebec’s political discourse. See Robert (2011), “Fractured Bodies and Diseased Societies,” and Robert (2014), “Selling the Cure.” 4 The Quiet Revolution, generally regarded as having officially begun with the election of the Liberal government of Jean Lesage in the 1960 provincial election, was a period of rapid social and political change. Key transformations included the secularization and government takeover of services such as education, hospitals, and other social welfare institutions previously handled by the Catholic Church and the nationalization of the province’s considerable hydroelectric power generation resources. The effects of these initiatives were profound in that thousands of jobs in the civil service were created, education (at all stages, through to the post-secondary level) was made a priority, and the social and political influence of the Church declined considerably. 5 See, for example, Robert Viau (1989), Les fous de papier; Jane Moss (1984a), “Les folles du Québec”; Jennifer Waelti-Walters (1979), “Beauty and Madness in M.-C. Blais’ La belle bête”; Marvin Richards (1995), “Poet, Hero, Icon”; Claudine Fisher (2001), “Féminitude et folie dans Les fous de Basan d’Anne Hébert”; and Alain-Michel Rocheleau (1996), “La folie de Marcel.”

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6 Although sometimes used interchangeably, the terms “French Canadian” and “Québécois” carry different political valences. The designation “Québécois” gained popularity in the 1960s and is often associated with the rise of secular nationalist sentiment. Today, it designates the residents of the province of Quebec, although it remains associated with francophone identity and its origins in the nationalist movement. “French Canadian” by contrast was seen by those who adopted the term “Québécois” as an identity that was associated with Canadian federalism and Quebec’s subaltern status within Canadian confederation. See Marcel Rioux (1974), Les Québécois. For the sake of clarity, I use “French Canadian” when referring to the people, events, and circumstances prior to the Quiet Revolution and also when designating francophones who reside outside of the province of Quebec. 7 See, for instance, the edition of Parti pris (1964) that was dedicated to “les problèmes de l’indivi-colonisé” and emphasized the psychological toll of political marginalization and economic inferiority on the Québécois. 8 Eugenics at this time did not take the form of Mendelian or “active” eugenics, those now associated with forced sterilization campaigns or genocide. It referred instead to Lamarckian or “passive” eugenics, which (not without problems or objection) sought to encourage births from genetically favourable couples all the while discouraging procreation by those deemed less fit. 9 The questions about both the willingness and the capacity to do anything about the alarming rates of infection and mortality in the early half of the twentieth century were in many ways well-founded concerns due to unequal public health infrastructures between anglophone and francophone Québécois. See Anctil and Bluteau (1986), Santé et assistance publique au Québec 1886–1986, and Guérard (1996), Histoire de la santé au Québec. 10 In an analysis of eugenic rhetoric in Montreal from 1890 to 1942, Sebastien Normandin (1998) cites Carrie Derrick’s October 1914 speech on the need to screen out “backwards” pupils from other students in the public school system. Profiling the kind of family that she believed was prone to producing such problem children, Derrick elaborates: “They remain at home, and marry young, and have large families. It is a well-known fact that the feeble minded have larger families than normal people. One has to choose between quantity and quality. Early marriages are to be deprecated, as too many children do not make for the highest development of the race” (69). Derrick appears to take issue with the kind of families encouraged by the Catholic Church, which condemned all forms of contraception. Although Montreal’s Irish, Italian, and Portuguese communities



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Notes to pages 10–13 201 were also overwhelmingly Catholic and thus subject to the same religious doctrines, Derrick is accused of targeting French Canadians. Normandin introduces Derrick’s comments by remarking that “her description sounds disturbingly like a typical French-Canadian family of the time” (68). His assessment, while likely an accurate reading of Derrick’s speech and sentiment given that French Canadians were by far the largest Catholic group in Montreal, nevertheless reveals the entrenched tendency (even among francophones) to perceive French Canadians as the source of public health problems. The one possible exception to this trend relates to venereal disease (vd). As had been the case in France, military recruiting fully exposed the shabby state of the population in this regard. The 4th military district in Montreal had, from the outset of the Second World War, the highest rate of venereal disease in all of Canada (Cassel 1987). The problem was believed to stem from the large population of prostitutes in Montreal. While often resistant to public health measures that called for change, for instance with regard to limiting family size to reduce infant mortality rates, conservative Catholic nationalists in Quebec were unusually eager to sign on to anti-vd initiatives, even if they entailed working with federal government oversight. Citing vd’s role in the degeneracy of the “race” and linking it to the number of stillborn babies, these traditional nationalists teamed up with public health officials and even welcomed them at parish events (Guérard 1996, 49). The major Montreal daily of each language group was the basis of the inquiry. Given the volume of material and the lack of access to digitized and/or searchable versions of these papers, a truly comprehensive survey of all articles was not feasible. Scanning headlines and pictures with captions on both the front page and the front page of the Metro section for both of these publications for references to matters of public health and medical breakthroughs from 1940 to 1949 nonetheless revealed a high rate of interest in these topics. (The need to consider the front page of the Metro section was a direct result of the front page often being dedicated to the events of the Second World War.) Even this limited and unsystematic analysis gives insight into the reader’s mentality, for the headlines and pictures supply information likely to catch the reader’s attention, either by playing to existing preoccupations or by sharpening curiosity about new issues (Couldry 2004). John Mann reports that sulfonamides “achieved star status” when it was made public that they had saved Winston Churchill from pneumonia, which he had contracted while travelling in North Africa in 1943 (2004, 29). For further explanation, see chapter 1.

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chapter one 1 Claude Quétel, for instance, argues that syphilis was a terrifying disease associated with “sexual depravity,” “lecherous ways,” and war, owing to its having been rampant among soldiers (from the Renaissance to the twentieth century) who frequented prostitutes while deployed (1990, 4–5). 2 Susan Sontag (1978) is perhaps the most outspoken critic of using illness (or more appropriately disease) as metaphor. She argues that using diseases as tropes negates the experience of suffering lived by those who are sick. Liat Ben-Moshe (2006) takes a more didactic approach to the question of bodily metaphors in her discussion of how to teach José Saramago’s Blindness. 3 Both Emile Zola and Maurice Barrès had recourse to tropes of organicism in their discussion of the nation. See Sternhell (2000), Maurice Barrès et le nationalisme français. 4 The cure promised is finally delivered in 1893 in the eugenically influenced Le docteur Pascal (Zola [1893] 1993). 5 The two types of nationalism, clerico-conservative or traditional and sovereigntist or modern, to which Arguin refers are discussed in more detail by Gougeon (1993). 6 The concept of a nation-within-a-nation is contested. Some groups, like Basque and Québécois separatists, believe that multiple nations within a single state constitute an unreasonable and impracticable situation. The nation-within-a-nation is therefore untenable for the survival of the minority culture in such an arrangement. Extremist majority positions also disapprove of the nation-within-a-nation but have instead campaigned (often violently) for homogeneity within a single state without carving out separate sovereignties for minorities. In the Canadian context, federalists have maintained that the accommodation of multiple nations within a single state is both possible and desirable. 7 Former prime minister Pierre Trudeau, an ardent federalist, lambasted sovereigntist aspirations by declaring Quebec to be (among other things) too culturally anemic and spiritually sclerotic (1962, 12) to survive as an independent nation-state. His comments bear no trace of the impact of such diagnoses on the Canadian body politic. 8 Hereafter the term nation will refer to this paradigmatic conception of nationhood. 9 Kuhn’s notion of the paradigm, while binary in structure, is essentially holistic insofar as science supports the existence of only one paradigm of “normal science” at a time. 10 While Sedgwick draws mostly on Foucault’s idea of the paradigm, there is considerable overlap between the French philosopher’s



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Notes to pages 29–33 203 definition, applicable to all knowledge, and Kuhn’s explanation of the paradigm as a manner of organizing scientific knowledge. The long-established presence of anglophone Protestants and Jews was accounted for with parallel systems and infrastructures (schools, hospitals) and power-sharing arrangements such as the implicit alternation of English- and French-speaking mayors in Montreal. As such, the various “national” leaders could concern themselves primarily with their own constituencies. The fines issued for signs in which French was not prominent enough and the Office québécois de la langue française’s inspections of businesses to see if trade was being conducted in French were the most contentious and obvious ways in which the province policed national culture. The much-lampooned war on apostrophes in English business names almost became a parody of the national paradigm’s content. See Grescoe (2001). This dynamic was once again played out in Quebec in the meeting rooms of the Bouchard-Taylor Commission in 2007, for it was tasked with striking a balance between an engrained expectation of adherence to a national paradigm on the part of immigrants and a recognition that the content of Quebec’s national paradigm could no longer be assumed to reflect the values of the population in the same way that it used to. On the importance of gender and sexuality to the national paradigm, see Gilbert et al. (2000), Schwartzwald (1991), Saint-Martin (2008), Probyn (1997). The term “posit” reflects the dual nature of the paradigm in that it both refers to the people who comprise the nation and constitutes this same community as a nation via a discourse that both defines and comments upon it. Dumont’s critics, Josep Llobera (1996) among them, accuse him of merely echoing the concept of the body politic, albeit with the twist of an imposed individualistic/holistic continuum, and reducing the issue to binary thinking via his choice of extreme examples. Dumont’s articulation nonetheless clearly delineates the twofold nature of nationhood – the communal and the exemplary, the frame and the content – appropriate to Quebec. Dumont rejects the idea that a nation can conceive of itself as equally individualistic and holistic. The redistribution of electoral seats that would officially recognize the concentration of the population in the cities, which were more multi-ethnic and liberal than the countryside, did not occur until 1965, subsequent to the independent Grenier Report on electoral issues. Schools remained in Church hands until 1964 even though calls for curriculum reform and an administrative overhaul that

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would have circumscribed (but not ended) Church influence could be heard a decade earlier during the provincial Tremblay Commission. See Gauvreau (2005). 19 This is undoubtedly the case with personifications and Christian allegories. Readers familiar with the biblical pre-texts use their knowledge of the anterior narratives to structure their reading. For example, they have become attuned to discerning the traveller as the paragon of Christian virtue, the difficulties impeding his journey as temptations. 20 The generic or text-bound nature of the medicalized national allegory is not absolute in Jameson’s thinking though. That the reader must possess the experiences to make sense of the national allegory as written signals a partial return to a way of thinking about allegory as a mode of reading rather than as a true genre. He terms the process of making use of familiarities, “allegorical resonance,” and deems it an essential part of a national allegory, which is contingent on specific cultural and historical contexts (1986, 71). While knowledge of the particular situations inherent to Third World texts often serves as a barrier to First World understandings of these allegories (and thus results in a fair amount of criticism for Jameson’s proposition and the allegories themselves), their medical or bodily nature helps to mitigate these barriers. The hurdle of allegorical resonance is more easily overcome in the case of medico-national allegory precisely because the experience of illness is so largely universal that allegorical resonance can almost be assumed. Authors choosing storylines about sick characters therefore effectively circumscribe the reader-driven allegory, for the generic conventions of the medical storyline and the familiarity of illness almost pre-suppose a reading centred on the “sick nation.” The medico-national allegory, as indirectly theorized by Jameson, consequently becomes something of an anomaly within the genre/mode divisions of allegory, for it draws on both ways of thinking about the form. 21 In a way, Durham was correct in his assessment of the paucity of French Canadian cultural institutions. Under the French regime, no books had been published in the colony. The first novel published in Quebec, Philippe Aubert de Gaspé, fils’s, L’influence d’un livre, published in 1837, appeared only two years prior to Durham’s report. Lucie Robert (1989) also notes that all the learned societies operating in Lower Canada in the early nineteenth century were bilingual, which lent credence to Durham’s assertion that French Canadians had no cultural institutions that were entirely their own. Anglo-Canadian literary and cultural institutions, despite being equally colonial during this time period, escaped criticism until 1857, when Thomas D’Arcy



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Notes to pages 37–43 205 McGee, an Irish immigrant and future Father of Confederation, levelled the charge. The politician and publisher, report Daymond and Monkman (1984, 42–3), called English Canadians non-literary, “plain,” and “matter-of-fact” and exhorted them to develop their own national literature (distancing themselves from the tradition of English and Irish literature) if they wished to preserve (or perhaps more appropriately establish) a nation of their own. The translation of “in view of causing” might be better understood as “with a view to.” The Durham Report and Garneau’s response to it have created a somewhat exceptional circumstance in Quebec, for they make explicit from the outset of the literary tradition the connection between history or literature and the vitality of the nation. It is rather ironic that French Canadians would have already taken steps to remedy their lack of a national literature before English Canadians would even recognize the need for a corresponding national literature in English. The haste on the part of francophones attests to the perceived urgency of establishing the legitimacy of their nation. The corresponding lag from English Canadians seems to speak to their acceptance of the role of British (colonial) subjects. Atwood pushes the idea of victimhood in French Canadian literature to the point of being incendiary. She not only comments on the high rates of infant mortality in Quebec’s literature as a matter of frequency, but adds a particularly morbid explanation to her observation: “An almost standard Quebec vision of death is the vision of the dead baby (or dead babies); it’s a fantasy often indulged in by mothers or grandmothers, and it’s hard to tell whether they are torturing themselves with it or enjoying it, or both” (1972, 223). While Renan deals primarily with colonizing nations rather than those who found themselves on the other side of the colonial experience, it stands to reason that the founding trauma of conquest would only accentuate the prominence of suffering, victimhood, or trauma in the national discourse. Diagnoses are tremendously powerful words. They can, aside from their purely medical implications, legitimate reprieves from normal responsibilities (work, school, military service), disallow insurance coverage, and grant immunity from criminal liability. Scholars of biographical and autobiographical pathographies signal a recurrent theme within the genre, which is the desire to attribute a cause to their illness. By locating a logical source, illness becomes less random and they can conceive of themselves as something other than victims of chance. See Anne Hunsaker Hawkin’s chapter “The Myth of Rebirth” (1999b) and Arthur Frank (1995) on the chaos narrative.

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chapter two 1 While the Internet and patient support and advocacy groups have increasingly challenged the doctors’ privilege with regard to diagnosis, physicians have historically had exclusive authority in this area. Still today, a doctor’s diagnosis is required in many situations, such as to authorize insurance payments, medical leave, disability permits, and exemptions from certain types of work. 2 So-called cults of personality, although they emphasize particular individuals, are not indicative of nationhood as a whole and do not represent much beyond a face that covers for a type of nationhood. 3 It is worth noting that medical language, derived primarily from Greek and Latin, largely transcends the boundaries of national languages. In this way, medical jargon functions much like Latin did in medieval Europe, providing a common language that superseded any of the vernaculars. Doctors thus constitute something of a global diasporic nation operating within, but also beyond, nation-states. 4 In 1942, the federal government asked Canadians to vote on a plebiscite authorizing conscription during the Second World War. French Canadians – particularly those living in Quebec – voted against the rest of the country, soundly rejecting Prime Minister William Lyon Mackenzie King’s idea of “conscription if necessary, but not necessarily conscription.” 5 Paula Gilbert Lewis’s (1981) work on the themes of old age, sickness, and death in Roy’s works is a notable exception, although even her analysis remains relatively brief. It nevertheless touches on aspects of the illness experience, such as interactions with medical personnel, which figure the boy’s sickness as more than a simple diagnosis. 6 In Brown’s English translation, the narrator interjects that Jenny directed Rose-Anna to leave in English. Quotes from the literary texts will be followed only by the page number when the source text is obvious from context. 7 Linguist Ludmila Isurin (2000), who has studied first-language loss among children immersed in a second-language environment, has noted that the cessation of communication is one of two possible outcomes in such situations; the other is the acquisition of certain words and expressions in the second language at the expense of the first. 8 The possibility of viewing sickness as a foreign country, much like the model established by David Lowenthal’s (1985) analysis of nostalgia, suggests that illness is a fundamentally alienating or deterritorializing experience. Emily Martin’s study of metaphors for the immune system reinforces the spatial alterity of illness: “The notion that the immune system maintains a clear boundary between self and nonself is often accompanied by a conception of the nonself world as foreign



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Notes to pages 55–64 207 and hostile” (1994, 53; my emphasis). Susan Sontag also famously describes illness as “a more onerous citizenship” that forces us to identify with the “kingdom of the sick” (1978, 3). Brown’s translation elides the first part of Daniel’s statement. Father of Confederation, journalist, and historian Thomas Chapais remarked on the imperative of this dual identity: “Un Canadien français qui n’est pas un catholique est une anomalie, un Canadien français qui ne l’est plus après l’avoir été est un phénomène mons­ trueux” (quoted in Dion 1993, 72) [A French Canadian who is not Catholic is an anomaly; a French Canadian who is no longer a Catholic after having been one is a monstrosity]. The intrusion of the teratological into a statement on linguistic and religious identity reinforces, if not exaggerates, the link between the forgetting of language and prayers and pathology that Roy puts forth in her novel. It is reasonable to expect that nobody would want to explain such a devastating condition to a child who had already been dragged from his home to an unfamiliar hospital filled with strangers. Brigid Lusk (2005) notes that this would have been standard practice for the era, since even adults with cancer would have their diagnoses concealed from them by family and nursing staff. In speaking of Foucault’s clinic as a model of medical practice, I do not mean to advocate for clinical practice that marginalizes patients. Such clinical models, when implemented in ways that ignore patients, note Rita Charon (2006), Arthur Frank (1995), Arthur Kleinman (1980), and other physician-theorists, frequently fail to provide effective care. Rather, describing the Foucauldian clinic as a model refers to a type of medical practice, the one that has dominated in Western medicine since the eighteenth century, which is centred on the physician. In recent times, particularly since the emergence of aids and the advent of the Internet, patients have been assuming a greater role in the clinical process, often to the frustration of conservative segments of the medical community. See Caron (2001), aids in French Culture, and Patton, Inventing aids (1990) and Fatal Advice (1996). The title of the English translation is The Cashier. The titular shift from personal name to occupation is intriguing when one considers that for a third of the novel, Alexandre can no longer work due to his illness and hospitalization. Although he was diagnosed with cancer, a disease that is commonly thought to represent a usurping of an individual’s identity (Sontag 1978), the professional rather than personal title reinforces the way in which cancer is self-alienating. The treatment of choice for prostate cancer at the time of the novel, despite the fact that radiation therapy had been in use in cancer treatment since the 1920s, was still a prostatectomy. The loss of sexual function that is a frequent side effect of this treatment option

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Notes to pages 65–72 symbolically emasculates the patient. The process of diagnosing prostate cancer – although Roy’s text does not describe it at all in the first exam and only obliquely in the second – is also figuratively emasculating (at least in heteronormative terms) for the rectum must be penetrated and the prostate palpated. Alexandre’s disease and the medico-national allegory it occasions consequently seem to imply not only that the national paradigm is sick, but also that it hinges on compromised masculinity. Both of these explanations refer to the general malaise of the first illness rather than the more identifiable condition anchoring the second. Andron addresses the issue of prostate cancer specifically, but more as a flip side to Mme Chenevert’s frustrated sexuality than as an explanation of Alexandre’s illness narrative: “Sa chair fut son malheur et celui de sa femme, contrainte à ses désirs. La dimension empathique, parfois christique du personnage, permet de penser que ce personnage ne peut mourir que par là où il a ‘péché’” (2002, 189) [His flesh was his misfortune and his wife’s as well, bound by his desires. The character’s empathetic, at times Christ-like, dimension allows one to think that this character can only die in the same way as he “sinned”]. Although Andron breaks with the critical tradition, she arguably pushes her point too far when she explains the main element of the plot as retribution for a secondary character’s sufferings at the hands of a man who was neither sadistic nor cruel, but merely frustrated himself. The ellipses appear in Roy’s text, although the narrator (whose words I have not included here) intervenes between the bank manager’s utterances. The concept of the sick role is a nearly omnipresent force in Roy’s novel. Alexandre begins by coveting the role and its privileges only to recognize, once he is admitted to the hospital, that it is not a situation that allows for the rest and calm he had anticipated. Charles Rosenberg supports this less physician-centred model when he contends that disease is “an amalgam of biological state and a social definition” (1987, 5n). There is no indication that the exam administered during the second visit differed in any way from that performed during the initial consultation. The text, however, elides many of the details of the actual exam(s), including any of the individual tests or procedures used to assess the patient. For instance, it makes no reference to the manner or even the area of the body the doctor palpated to detect the tumour. Therefore, while a digital rectal exam had been the standard diagnostic technique for this kind of cancer since the 1910s, Roy (who



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Notes to pages 72–5 209 for obvious reasons has never had a prostate exam) omits any overt reference to the procedure from her narrative even though her husband Marcel was a doctor – a surgeon and oncologist specifically – and, notes her biographer, had suggested corrections of a medical nature to the novel’s manuscript. See François Ricard ([1996] 2000), Gabrielle Roy: Une vie. The question of the missed diagnosis in this 1954 text is oddly coincidental with the abandonment of a provincial bill, introduced in 1951, that would have funded and put into operation a number of centres for diagnostic medicine throughout Quebec (Dion 1993, 101). The meaning of the French, which is not quite captured by the translation, is that the tumour was recognizable in the clinical sense, which is to say as an observation linked to medical knowledge that gives it significance. Medical “proof” was rather important to Alexandre, who appeared to be swayed by the notion that cure bestowed medical credibility. Despite his miserly ways, he frequently purchased patent medicines from all manner of charlatans to relieve him of his indispositions. The effectiveness of advertising for these products, as Adelaide Hechtlinger notes, often relied on “extravagant claims and testimonials” to provide proof of cure (1974, 224). Larger advertisements would often publish not just one, but a handful of testimonials citing the near-miraculous curative effects of various pills, powders, tonics, and emulsions. While the great era of patent medicines had passed by about 1900, even some of today’s non-prescription remedies advertise using the testimonial model. When one takes history and changing definitions of disease into account, even medicine loses some of its objectivity. Certain conditions were once considered diseases but no longer are (homosexuality for instance), others became diseases over time (Alzheimer’s, alcoholism, depression), and still others have evolved through the ages (one may have died of consumption, phthisis, or tuberculosis, all caused by the same bacillus, depending on one’s historical situation). The Asbestos strike of 1949 was a four-month-long dispute that pitted francophone workers (represented by a trade union and a Catholic worker’s union) against American and Anglo-Canadian mine operators who had the support of Maurice Duplessis’s Union Nationale government. The strike was particularly violent, but it is mostly recognized for that which had more to do with shifting allegiances within the previous Church–government power block and the rise to the national stage of unionist Jean Marchand and journalists Gérard Pelletier and Pierre Trudeau, all of whom went on to notable careers

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Notes to pages 76–93 as federal Liberal politicians. See Aivalis (2013), “In the Name of Liberalism.” The key issues for the striking workers were better pay and, significantly for a novel that forefronts medical interactions, health insurance. See van Horssen (2012). The translation here is also a bit vague, for the doctor could be reluctant to tell her, specifically, about her heart. The English translation of “wear and tear,” which might be more appropriate to a mechanic’s speech than a physician’s, accentuates the non-medical tone that the doctor adopts. For more on the debates about the impact of using medical language versus plain speech in communicating a diagnosis to patients, see Suzanne Fleischman (1999). For more on the social standing of doctors in Quebec, see chapter 3.

chapter three 1 The term grande noirceur [Great Darkness] refers to the years preceding the political start of the Quiet Revolution in 1960. Its similarity to the idea of the Dark Ages popularly connotes a period of little intellectual value or historical significance. As with the European Dark Ages, this has largely proven to be a myth, although the highly conservative political climate (coupled with far less publicized moves toward reform) and the subsequent liberalization of many facets of life in Quebec made this, at least at first glance, an apt comparison. 2 By the mid-twentieth century, an increasing number of physicians were abandoning clinical practice to venture into politics. My thanks to Michael Gauvreau for sharing this observation. 3 See, for example, Anne Hébert’s Kamouraska (1970) and Jacques Ferron’s oeuvre on the important social role of the small-town doctor. 4 La survivance [survival] was a national policy aimed at preserving the Francophone community in North America. Although not a law per se, it was influential among French Canadians subsequent to the Act of Union in 1841, which through the reorganization of the legislative assemblies, gave the minority anglophone community the electoral (and thus political) edge. Maintaining demographic advantage in the form of simply outnumbering anglophones therefore served political and cultural ends. One of the better-known planks of la survivance was the so-called vengence des berceaux [revenge of the cradles], which aimed to promote high birth rates among French Canadians. Some official measures, such as a government payment to mothers upon the birth of their tenth child, were



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Notes to pages 93–100 211 direct supports of the unofficial policy. By the 1960s, the birth rates had dropped off considerably, which caused significant anxiety. See Maroney (1992). Although direct clerical censorship had abated by the 1960s, fierce literary debates still raged between clerical critics such as Lionel Groulx and Camille Roy and their secular counterparts. The quarrel between Msgr Félix-Antoine Savard, dean of the Faculty of Arts at l’Université Laval from 1950 to 1957, and Professor Jeanne Lapointe of the same institution, for example, was showcased in the pages of Cité libre (Lapointe 1954). As Nolland (1979, 207) traced the antecedents and parallels to the proverb, he notes a rabbinic text, Midrash Rabbah (from the late third century), that directly places the sick doctor alongside sinning priests, blind governors, and legal defenders who play prosecutor. These comparisons suggest that Quebec’s linking of the medical profession to the clerical and legal or political classes is not without precedent. Klitzman’s conclusions were based on a series of interviews conducted with ill physicians dealing with health concerns ranging from hiv to bipolar disorder. The stories that he analyzes in his qualitative study detail how some ill physicians were expected or forced to resign or circumscribe their duties, or how the necessities of medical practice (a functioning telephone system, hospital privileges, patient referrals) were withheld until the physicians once again demonstrated their health and/or competence to colleagues. A Hastings Center Report by George Annas estimated that a sobering 5 to 10 per cent of the medical profession could be classified as “impaired physicians,” meaning “alcoholic, drug dependent, or too ill, mentally or physically, to function competently” (1978, 18). The Duplessis government was notorious for electoral irregularities, which ranged from a refusal to reapportion representation in the Assemblée Nationale in the face of a growing urban (and more liberal) population, to the outright buying of votes. In “Réflexions sur la politique du Canada français,” Trudeau (1952) exemplifies the attitudes of those who ushered in the revolution in Québécois politics. It is curious that the sick doctor is often seen as a hypocritical figure and that one of the most common moral charges levelled against priests, particularly in literature (cf. Molière’s Le Tartuffe), is hypocrisy. The “omnipotent and priestlike,” be they priests or doctors, are therefore often felled by the same moral shortcoming. Kathryn Montgomery Hunter analyzes the medical act of presentation in a similar manner, citing the patient’s act of presenting

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Notes to pages 100–8 him- or herself to a doctor for treatment and the doctor’s presentation of the patient’s case to colleagues or superiors (for instance during rounds) as, respectively, the act and the narration of that act (1991, 58). Dubois transposes this familiar clinical practice from the start of the medical case to its end and combines the patient and physician functions. In all the sick-doctor narratives, only the first and least “sick” of them, Poussière sur la ville, actually provides the doctor with a given name and a surname. In all the others, the doctor is referred to only by his first name, which suggests that, at least on the surface, the sick doctors of the 1960s are somewhat less authoritative than the presumably healthy doctors (with professional titles) in earlier texts. Some of the most widely publicized real sick-doctor narratives are, paradoxically, those in which the doctors’ illnesses are caused by their professional exposure to infectious agents. The physicians who contract hiv through needle sticks and those who specialize in the treatment of tuberculosis who wind up contracting the disease through exposure to their own patients have captivated public attention both in news stories and in fictionalized accounts, such as on medical television dramas and movies. This popularity might owe to the fact that it contradicts the myth that doctors are immune to the diseases they treat. Alternately it may be that the public is simply more likely to appreciate stories about illness that are exceptional than those that are more common or that accord medicine no special status. Some doctors in the nineteenth century experienced a similar conflict with regard to personal experience in reference to the habitual use and effects of opiates. Physicians unwilling to use the drug (perhaps not the overwhelming number one might hope or expect) sought out medical advice from laypersons who had extensive experience with it, such as Thomas de Quincey, author of the ironically anti-medical Confessions of an English Opium Eater. One of the first modern physicians to systematically catalogue known pharmaceuticals, Robert Christison, “ultimately grants all De Quincey’s claims, not only admitting he has greater experience but also acknowledging that such experience constitutes a basis for superior authority on the subject in the first place” (Milligan 2005, 544). This is not to say that the use of a professional designation to refer to patients, whether the profession is real or imagined, is not common in this particular clinical setting. René finds himself in the company of “le musicien,” a pianist who refuses to use his thumbs to play piano, and “le numéro neuf,” one of many imitators of Montreal Canadiens



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Notes to pages 111–20 213 hockey legend Maurice Richard, who wore the number nine, to appear in Québécois fiction. Klitzman’s study of sick doctors, while it focuses on how doctors self-treat and self-diagnose, comments very little on doctors who derive cure from their treatment of others. The one instance in which the issue does come up is with regard to the psychological benefit (and perhaps a corresponding psychosomatic boost) that ill physicians derive from treating patients who are sicker than they are. Not even the other physicians at Xavier’s hospital, where he is being treated, view him as a patient. Indeed, they had just re-elected him chair of the hospital’s board, placing the sick and supposedly less authoritative doctor atop their medical hierarchy. The noun patient furthermore eliminates the direct reference to personhood that is explicit in the clumsier term sick person. Groups that have fought against the medicalization of bodily difference, such as the disability-rights community, have advocated for “person-centred” language that keeps the person integrated in, rather than excluded from, the expression of non-normative bodily status. A search using the online search tool provided by the journal turned up seventy-four responses to the query “sick doctors,” but only eleven for “doctors as patients” in a full text search of issues ranging from January 1994 to December 2008. Arthur Frank (1995) takes issue with the presumption of cure inherent in the sick role, arguing that it obliterates other experiences of illness, such as chronic illness, that are not oriented toward what he terms a “restitution narrative.” Although the United States had become an international leader in medicine by this time, Montreal had been one of the centres of medical innovation in the late nineteenth and early twentieth centuries. William Osler began his career at the prestigious McGill Medical School and Wilder Penfield mapped the human brain at the Montreal Neurological Institute. Today, however, films like Denys Arcand’s Les invasions barbares (2003) confirm the belief that the United States offers the best health care money can buy. Gil Courtemanche’s narrator in his autofiction does enter remission after five years. See chapter 5. Courtemanche, however, died of cancer in August 2011, not long after the volume’s publication. Admittedly, not all sick doctors recover as well as the three studied here do. Stefano, the Italian physician with vaguely defined heart troubles in Jacqueline Dupuy’s Dure est ma joie (1962), succumbs to his illness as a Christic figure who is out of touch with the realities of his era. Charles Lévy of Monique Bosco’s Charles Lévy, m.d. (1977), a novel that comes later in Quebec’s literary history, dies of lung cancer.

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24 Isabelle’s adoption of the patient role, complete with an assimilation of Xavier’s sickness, has the paradoxical effect of removing him from the danger of his cancer, thus also ensuring his ability to “survive to tell the tale.”

chapter four 1 Aquin had been a member of the Front de Libération du Québec (flq), a terrorist organization that was responsible for several bombings and robberies in Quebec throughout the 1960s as well as the infamous October Crisis in 1970 that resulted in the political assassination of Quebec cabinet minister Pierre Laporte and the kidnapping of British trade official James Cross. Having joined the organization in 1964, Aquin was shortly thereafter arrested for possession of an illegal firearm and was imprisoned for four months in a psychiatric facility before being acquitted of the charge. 2 Lori Saint-Martin’s (1984) gender-conscious critique of this event all but undermines any possibility of seeing Joan’s murder as a legitimate political act of a revolutionary nationalist. 3 The 20 May 1980 referendum on renegotiating the relationship between Canada and Quebec was not a vote for or against independence, per se, but rather a decision about whether or not to reopen the terms of confederation for a debate that would have, in Lévesque’s estimation, given Quebec complete autonomy over most areas of its government but which would have preserved a form of union with Canada in matters such as defence. 4 André Smith (1976), writing before the publication of Les têtes à Papineau, had already identified a trend in Godbout’s novels relating to failed couplings. Although imagined in the sense of romantic relationships, the inability of two to successfully become one could certainly be said to apply in the case of les Têtes. 5 On the growing importance of “quality of life” in contemporary public discourse about medicine and disease, see Campbell, Converse, and Rodgers (1976), The Quality of American Life. 6 Similar rhetoric was used in the 1995 sovereignty referendum. Éric Schwimmer’s analysis of the political standoff characterized Parti Québécois leader and Quebec Premier Jacques Parizeau’s take on the situation in medical, indeed surgical, terms: “Le remède est, une fois de plus radical: il ne s’agit plus de supprimer quoi que ce soit, mais plutôt de diviser par une intervention chirurgicale l’organisme politique. Le diagnostic de Parizeau est impitoyable: l’État est malade, et à moins d’une intervention rapide son cas risque d’être fatal. En coupant l’organisme en deux, chaque partie recouvrera parfaitement la santé” (1995, 121) [Once again, the remedy is radical. It is



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Notes to pages 145–66 215 no longer a question of suppressing this or that, but rather of surgically separating the political organism. Parizeau’s diagnosis is without mercy; the State is sick and without quick surgical intervention, it could be fatal. In cutting the organism in two, each part will fully regain its health]. The claim that Charles’s post-operative life would be marked by schizophrenia seems to be an extrapolation based on a common metaphorical usage of the stigmatized psychological condition to point to a life – such as that lived in colonial or neo-colonial situations – where an internalized deference to another cultural power is regarded as “schizophrenic.” See Jonathan Metzl (2009), The Protest Psychosis. See Lori Saint-Martin (2010) for more on the role of the father in contemporary Québécois literature and cultural productions. Where the military does have a presence in Québécois fiction, it is largely portrayed in negative terms, such as in Roch Carrier’s La guerre, yes sir! (originally published in 1968). Alain Dubois’s numerous run-ins with the local priest in Poussière sur la ville (Langevin 1953) not only were of a personal nature, in that they pertained to his conjugal relationship, but also ventured into the territory of medicine when Alain placed medical need above religious dictates in sacrificing the baby to save the mother. Alexandre Chenevert (Roy [1954] 1995) was also very suspicious of the hospital chaplain, and René’s pressured vow to his confessor to abstain from alcohol as a desperate bargain to save his beloved grandfather from death in Aller-retour (Lord 1962) is framed as a contributing factor to his alcoholism. The family names of Daniel, Sandy, and the rest of the family have been changed in the English translation. When Canada amended its constitution in 1982 with the Constitution Act, which among other modifications, enacted the Canadian Charter of Rights and Freedoms, all provinces and territories save Quebec approved the change. There have since been attempts, notably the Meech Lake Accord of 1987 and Charlottetown Accord of 1992, to have Quebec sign on to the amended constitution, but none have been successful. The Meech Lake Accord would have redefined federal-provincial relations in favour of granting provinces more autonomy and would, crucially, have recognized Quebec as a distinct society within Canada.

chapter five 1 Hunsaker Hawkins cites Robert Jay Lifton’s study of the survivors of the Hiroshima bombing and the resultant concept of formulation

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Notes to pages 167–76 as an analogue to the rebuilding and reordering of one’s life that pathography allows. Frank (1995) similarly writes of the “testimonial” nature of pathographies, a term that has been taken up with reference to writing by Holocaust survivors and the survivors of Latin American dictatorships. See Pennebaker (2000), “Telling Stories.” It is possible to argue that online blogs and forums have become the preferred media for pathography in the twenty-first century. See Campbell and Longhurst (2013), “Obsessive-Compulsive Disorder,” and Walter et al. (2011–12), “Does the Internet Change How We Die and Mourn?” In the preface to the second edition of Reconstructing Illness: Studies in Pathography, Hunsaker Hawkins slightly reconsiders her choice of 1950 as the origin of the modern pathography, but despite having come to know of a group of tuberculosis sanatorium narratives from the 1920s and 1930s, maintains that pathography is a genre of the latter half of the twentieth century. Hunsaker Hawkins’s position on the role of fiction in pathography generally subscribes to this understanding. She concedes that “even ‘authentic’ pathographies – that is, narratives by or about a real, flesh-and-blood individual’s actual experience of illness – necessarily blend fiction and fact” (1999b, 185) and updates her work with an acknowledgment that some newer pathographies have blurred this line even more by stepping fully into fiction but come across as “creative nonfiction.” She similarly acknowledges a post-1990 movement, particularly among male homosexual authors, toward novels about aids, but does not really analyze such texts with anything close to the attention she pays to non-fiction narratives. The overall position seems to be that fictional narratives about illness, while perhaps fulfilling many of the functions of non-fiction pathographies, constitute a separate genre. Hayes (2000) rejects the notion that certain works can or should be classified as “combat literature” while others that postdate independence or were deemed ethnographic (and thereby pandering to an exoticizing Western gaze) are denied the classification. He also maintains that elements of combativeness within a text need not be the defining storyline; they can be either central or quite marginal. André’s early comments about his therapist’s “diagnosis” of an entirely normal Québécois father-son relationship also normalizes their dysfunction, so much so that André discontinues his own therapy on the grounds that “on ne soigne pas la normalité” (35) [you don’t treat normalcy]. This cultural observation is the only real



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Notes to pages 181–92 217 sense of the national or cultural setting of the novel. In this there is a rapprochement of (imputed) pathology and normalcy. It is curious to note that although there are references to the grandmother’s seven daughters, these other family members seem to be rather absent from the grandmother’s life due to their absence in the narrative. Joseffa thereby privileges their relationship (even though we see it taking place only every seventh day) and suggests that she sees herself as solely responsible for her grandmother’s care. One might see a parallel between the novice writer’s attempts to master the literary code or style and a desire for patients to gain currency in the clinical code. Pathography, particularly for inexperienced writers, may thus help to supply a sense of substituted mastery over an esoteric practice of representing a bodily reality. Sontag rejects the multiplicity of pseudo-scientific studies linking cancer to depression, dissatisfaction, or loss occasioned by death or separation. “Investigations are cited … in which out of, say, several hundred cancer patients, two-thirds or three-fifths report being depressed or unsatisfied with their lives, and having suffered from the loss (through death or rejection or separation) of a parent, lover, spouse, or close friend. But it seems likely that of several hundred people who do not have cancer, most would also report depressing emotions and past traumas: this is called the human condition” (1978, 50; original emphasis, my ellipsis). This is not the case in Une belle mort, where the health care system (while hardly the centrepiece of commentary) provokes a few sympathetic barbs from Courtemanche about the aggressive sense of entitlement that some patients and family members have with regard to a strained public health care system. An alternative interpretation would see the illness personified as a woman, a distinct possibility given that the cancer was already tied to Violaine. “Croquer la mort” also resonates with the French term for an undertaker (croque-morts), which would suggest a self-management of one’s own death. I believe that Hunsaker Hawkins’s point in this regard has more to do with a reluctance to make death the subject of a narrative rather than a refusal to show or talk about death in general, as was the case of classical French theatre, where the bienséances or conventions of the genre demanded that death occur offstage and only be reported to the audience.

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Index

abortion, 99, 105 aids, 4, 14, 109, 113, 168, 207n12, 216n5 alcoholism, 23, 43, 101–5, 120, 166, 209n23, 215n10. See also Aller-retour Alexandre Chenevert, 49, 63–75 allegory, 34–6, 45–6, 75, 121, 125, 144, 204n20; allegory of reading, 44–5, 47, 50–3; functional, 19, 165, 179; versus metaphor, 21, 34, 43, 46, 58 Aller-retour, 90, 100–13, 120, 165, 215n10 alternative therapies, 58, 126, 155 Anderson, Benedict, 17, 28, 31, 50–1, 62. See also imagined community angina, 79. See also heart disease anglophones, 3, 10 15, 28, 54–8, 124, 139–40, 149, 195, 199n1, 200n9, 203n11, 210n4 antibiotics, 11, 19, 128, 185 anxiety, 133, 135 Aquin, Hubert, 124, 128–9, 131, 133, 137, 160 Asbestos, 75–6, 79–81, 85–7, 209n24

Bhabha, Homi, 26, 28, 32 bicephaly, 124, 137–41, 146, 196. See also Les têtes à Papineau bilingualism, 29, 148–9, 151, 153, 204n21; official, 149 Billon, Pierre, 124 bleeding, 142 blood, 24, 56, 78, 142, 155, 167; cells, 56; transfusion, 56 body politic, 17, 21, 24, 31–6, 195, 197, 203n16 Bonheur d’occasion, 43, 49, 52–63, 180 broken bones, 181 cancer, 5, 14–16, 23–4, 109, 120, 126, 150, 180, 183, 207n11, 207n13, 217n10; bone, 147 (see also L’enfant du cinquième nord and Du mercure sous la langue); laryngeal, 180 (see also Je ne veux pas mourir seul); leukemia, 23, 43, 56–62, 120 (see also Bonheur d’occasion); lung, 109, 116, 199, 213n23 (see also Cancer); prostate, 64, 70–2, 146, 207–8n14, 208n15, 209n19 (see also Alexandre Chenevert)

232

Index

Cancer, 18, 90, 113–19 Canguilhem, Georges, 3, 146, 169 cataracts, 77 chemotherapy, 57, 120, 155–9, 188 clergy, 80, 91–2, 112, 153 clinic, 44, 48, 67–8, 70, 76, 87, 104, 117–19, 207n12. See also Foucault, Michel colonialism, 3, 30, 36–8, 130, 204n21, 205n26, 215n7 contagion, 151–2 counsellor, 192 Courtemanche, Gil, 171, 183–4, 213n22 cure, 9, 11, 16, 18, 23, 32, 52, 73–4, 76, 82, 90–1, 96–7. See also remission dementia, 14, 23, 177, 181, 209n23 Deuils cannibales et mélancoliques, 162–4 diagnosis: medical/clinical, 42–3, 48–52, 56–63, 66–75, 75–9, 104, 113, 174–6; self-, 102–3, 106; social/national, 23, 35, 52–3, 125, 157, 170; textual; 16–7, 34, 47, 87–8, 170, 196 disability, 6, 38, 140–1, 146, 213n18 doctor-patient relationship, 16, 41, 44, 116; hierarchy thereof, 18, 113. See also medical authority drugs, 11, 105, 127–36, 158, 188. See also pharmacology drunkenness, 9, 18, 82, 89, 97, 100– 3. See also Poussière sur la ville Du mercure sous la langue, 120, 187–92 Duplessis, Maurice, 80, 86–7, 92, 95, 139, 209n24, 211n9 Enfant du cinquième nord, L’ 124, 147–59

English Canadians. See anglophones eugenics, 8–10, 139, 145, 200n8, 200n10, 202n4 examination, medical, 63–4, 66–7, 72, 74, 76–7, 98–9 federal government, 11, 25, 130– 1, 148–50, 152–3, 160, 210n11, 206n4 Foucault, Michel, 29, 42, 51, 62, 65, 68, 83, 113 francophones. See French Canadians Frank, Arthur, 96, 121, 166–7, 169– 70, 172, 180, 184, 213n20 French Canadians, 9–15, 23, 30, 49, 56, 91–3, 148, 153, 200n6, 205n24; and literary tradition, 37, 40–1 Front de Libération du Québec (flq), 131, 214n1 gangrene, 157 Garneau, François-Xavier, 37–40, 205n23 gastrointestinal symptoms, 70–1, 76–7 Godbout, Jacques, 124, 143, 160, 214n4 Gramsci, Antonio, 33–4, 187, 195 Groulx, Lionel, 27, 33, 211n5 Guibert, Hervé, 113, 168 hallucinations, 166, 181 health insurance. See universal health care heart disease, 4, 84–5, 171, 213n23 hemorrhage, 155, 157. See also bleeding Hippocratic oath, 127, 153 hospital, 53, 107, 110–11, 117, 151–4, 181, 186, 187–8, 191; system in Quebec, 50, 112, 203n11



Index 233

Hunsaker-Hawkins, Anne, 164, 166–70, 172, 179–80, 192. See also pathography hydrocephalus, 97–8 illness/disease distinction, 17, 41–4, 48–9, 50–60, 65–75, 113, 115, 126, 167, 169, 186–7, 208n18 imagined community, 17, 28, 50 immunity, 6, 56, 167, 185; and physicians, 93, 99 infant mortality, 9–10, 210n11, 205n25 infection, 128, 151–2, 155 inferiority complex hypothesis, 6, 8–9, 12–14, 41, 195, 198, 200n7

mental illness, 6, 36, 38, 70–2, 94, 101, 106–9, 135, 145, 200n7. See also anxiety; schizophrenia Mère-grand, 179–83 metaphor, 5–8, 20, 23–5, 44–5, 140, 170, 163–4, 182, 202n2, 206n8; and cancer, 15, 49, 52, 180, 183; and pathography, 165, 170, 179– 80, 183; political, 18, 123; versus allegory, 16, 34, 45–6, 58, 121. See also body politic; inferiority complex hypothesis metastasis, 23–4, 72, 187

narrative voice, 75, 84–5, 90, 114, 125, 133, 139, 141, 188–9 national paradigm, 24–31, 36, 39–41, 87, 95, 125, 159–61, 183, Jameson, Fredric, 34–9, 44, 46, 65, 194; as analogous to diagnosis, 125, 187, 195, 204n20 48–53, 62–4, 73–5, 100; Je ne veux pas mourir seul, 179, discursivity of, 31–4, 45–6, 88 183–7, 196 national pedagogy, 26, 28–9, 33, 39, 179, 197. See also Bhabha, Homi Kleinman, Arthur, 42, 67–8, 113, nationalism, 3, 6, 27–9, 52, 200n6; 117 clerico-conservative, 23, 33, 56, Kuhn, Thomas, 25–6 65, 80, 92, 120, 210n11; closed, 27, 29, 64, 145; open, 27–9; Lévesque, René, 123, 130–1, 143–4, sovereignty, 15, 23, 31, 123–5, 157, 160, 214n3 138–9 life writing, 19, 166–7 nurses, 53–4, 57–9, 102, 128, 152, liver, 142 174, 190, 192 medical authority, 48–9, 64–8, 82–3, 85, 100, 108, 117, 121, 179; Parkinson’s disease, 14, 171. See also Une belle mort and clinical language, 50–1, 60, 68–70; compromised by physician Parti Québécois, 123, 138, 143, 157 pathography, 19, 164–71, 173, 183, illness, 97–8, 101–2, 107, 111, 187–93 119, 196; proof thereof, 64, 72–4, pathology, 3, 8, 12–13, 17, 33, 51, 82, 91, 124; repudiation thereof, 68, 140, 146, 174 75–82, 86–7, 104–7; in transition patienthood, 39, 51, 62–3, 77–9, in Quebec, 50. See also Foucault, 84–5, 87, 96, 101, 110, 113–19 Michel pharmacology, 128–9, 132 Meech Lake Accord, 160, 215n12

234

Index

pharmacy. See pharmacology pharmakon, 57, 101, 106 poisoning, 134, 166 postcoloniality, 6, 17, 21, 24–6, 32–40, 125, 169–70 Poussière sur la ville, 49, 75–87, 89–90, 96–100, 212n12, 215n10 prayers, 55 priests, 81, 91–3, 96, 112, 189, 211n6. See also clergy psychologist, 111. See also counsellor psychosis, 36 public health, 9–12, 50, 93, 186, 195, 200n9, 201n11. See also social realism hypothesis

sedatives, 110, 128–31, 133 sick role, 69, 113–19, 126, 176, 179, 187, 208n17, 213n20 side effects, 117, 124–7, 132–6, 146, 155, 197 smallpox, 9–10 social realism hypothesis, 8–11, 38–9, 43, 75, 124, 195 surgery, 115–16, 119, 124, 138–45, 157, 160, 165. See also Cancer and Les têtes à Papineau survivance, la, 93, 120, 210n4 symptoms, 4, 7, 33, 36, 41–5, 58–9, 63–77, 97, 103, 126–7, 166, 188

Les têtes à Papineau, 124, 137–47, 165, 197 trauma, 106, 133, 163, 166, 180, 184, 196, 205n26, 217n10 treatment, 18, 48–9, 69, 78, 96, radiation, 120, 186, 207n14 110–11, 116–19, 123–5, 130, referenda on sovereignty, 15, 23; 151–9; withholding, 126, 137, in 1980, 18, 30, 138, 141, 144–5, 146; writing as, 35, 166–7. 159–60, 214n3; in 1995, 5, 157, See also pathography; side effects 164, 214n6 Trou de mémoire, 124, 127–37, 140 remission, 114–15, 118, 120, 156– 8, 168, 184, 187, 213n22. See also Trudeau, Pierre, 80–1, 141, 149, 202n7 cure Renan, Ernest, 28, 39, 100, 205n26 tuberculosis, 8–10, 23, 43, 209n23 Rocky Mountain spotted fever, 154 Une belle mort, 171–9, 217n11 Roy, Gabrielle, 4, 55, 75, 198, United States health care system, 208–9n19 119–20, 138, 154, 213n21 universal health care, 11 schizophrenia, 145, 166, 215n7 science fiction, 124, 147–8 vaccination, 9–11 secularization, 15, 32, 87, 112 Quiet Revolution, 6–7, 18, 30, 75, 90–1, 95–6, 112, 196–7