Diagnosing narratives: illness, the case history, and Victorian fiction

“Diagnosing Narratives: Illness, the Case History, and Victorian Fiction” explores how the medical case study competes with patients’ experiential accounts of disease in the development of popular nineteenth-century fictions. During most of the Victorian period, clinical medicine served as the primary producer of medical knowledge. At the same time, its objectification of the sufferer—epitomized by the case narrative, the most prevalent form of nineteenth-century medical writing—led to an increasingly distanced relationship between doctor and patient. I argue that the mid-century novel responds by featuring narrator-sufferers who co-opt aspects of the medical case in order to represent their own subjective experiences and rethink what constitutes medical knowledge. As the century came to a close, however, sciences of the laboratory, rather than the clinic, began to gain epistemological sway. In light of widespread skepticism regarding the possibility of translating discoveries made in the lab into effective bedside practices, I contend that popular novels and short stories now returned full circle to the clinical case approach as a valuable alternative to the laboratory. The result is late-century fiction structurally and thematically driven by the useful yet sometimes callous techniques of the diagnostician and his case method. I chart these shifts through an examination of works by Charles Dickens, Wilkie Collins, Mary Elizabeth Braddon, Robert Louis Stevenson, Bram Stoker, and Arthur Conan Doyle. My project illustrates the responses of these authors to prevailing power dynamics in the world of medicine and offers a new reading of the ways in which the Victorian preoccupation with disease shaped literary narrative.