This thesis is about autobiographical and fictional accounts of chronic illness professionally published between 1990 and 2012. It begins with a survey of popular and critical thinking about illness accounts, in which I show how both the medical humanities and literary studies have placed restrictions on what these accounts can mean, and thus on the kinds of cultural work they can do: restrictions that frequently belie the complexity of the aesthetics and ethics at work in many of the texts considered in this thesis. I build on this claim through close reading of a cross-section of contemporary illness accounts in which I flag up the presence of aesthetic elements distinct to the literary—including aspects of imagery, form, symbolic structure, address, and so on—, and show how these elements work not just to underscore the informative content of these illness accounts, but also to create new patterns of meaning, new networks of relation, and new modes of engagement.
Though this project focuses on the contemporary, Virginia Woolf’s essay On Being Ill (1926) acts as its theoretical nucleus. In chapter 2, I show how On Being Ill provides a productive framework within which to explore the relationship between illness, literary aesthetics, and ethics. I also tease out the themes that are to define the chapters that follow, for, as Woolf demonstrates, at stake in the representation of the embodied self and the sensations it experiences are issues such as the referentiality of language and of fiction; the workings of metaphor and allegory; and the possibilities and limitations of the discursive sediment that accrues around words, images, and narrative tropes. In chapter 3, I explore this latter issue in a study of the construction of the narrative self and of the body in four autoethnographies by women academics. In chapter 4, I look at the representational experiments that Hilary Mantel and Paul West undertake in their memoirs as they seek to describe the physical and psychological effects of illness. Finally, in chapter 5 I consider how two South African fictions of illness—J. M. Coetzee’s Age of Iron (1990) and Marlene van Niekerk’s Agaat (2006)—provide a valuable case study for thinking about the relationship between illness and allegory in fiction. My conclusion draws these strands together, arguing that illness accounts can contribute not just to our understanding of the illness experience, but to our thinking about the nature of the literary and its participation in the ethical also.
