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Introduction
The process of managing disease, as well as developing a general understanding of its concept and the phenomenon of well-being, hinge on one’s sociocultural background to a large extent. The illness narrative and the uniqueness thereof in different cultures at different time slots can be tracked down comparatively easily when considering different works of fiction that reflect the associated values and ideas of health. The presence of stereotypes, prejudices against specific ideas, and strong personal beliefs linked to one’s culture make experiences with illness, definitions of disease, its diagnosis, and further treatment quite homogenous across a particular culture. However, with the current propensity toward globalization and cross-cultural dialogue, the propensity toward similarities in health-related experiences can be noticed.
Despite understandable cultural differences in the perception of diseases, including their nature, management, and awareness about them, there are points of contact between the current cultural perspectives on the subject matter. Specifically, Frank (2013) singles out three crucial phases of the illness narrative, which can be found in any patient. Similarly, elements of homogeneity in patients’ narratives can be explained by the historical development of healthcare as a global concept. According to Frank (2013), the transition from the use of traditional medicine to the increase in the influence and control of healthcare professionals occurring in the early 19th century became the platform for promoting a change in managing patients’ needs. As a result, the perspective on the disease as a notion, the treatment thereof, and patient education have shifted toward the concept of a nurse-patient dialogue has allowed improving the efficacy of healthcare exponentially.
Main body
The introduction of the three types of narratives, namely, chaos, quest, and restitution, reflects the stages through which a patient passes when reconciling with their health issues and developing basic health literacy. The body-self-community chart that Frank (2013) offers as a map to the current concept of wellness, outlining four types of an ideal body. According to Frank, these are encompassed by the notions of “the disciplined body, the mirroring body, the dominating body, and the communicative body” (Frank, 2013, p. 30).
A different perspective on the subject matter can be introduced when considering the methods of describing a health issue. By distilling different narrative types, one will be able to locate culture-specific attitudes, philosophies, and perspectives of a patient, delineating the approach toward health management and patient education (2006). As Charon explains, the described goals can be attained by introducing a narrative into the clinical setting. According to Charon (2006), the idea of the narrative medicine is comprised of the notions of nurse-patient communication, analysis of the development of a patient’s story, and the identification of the deconstruction of the cultural perceptions of health management, with the erasure of harmful myths and the promotion of a deeper understanding of what health, disease, and treatment are. The proposed perspective allows approaching the analysis of health management as it is reflected in literature, with cultural specifics of the lead characters and the notion of health management intertwined.
To put the concept of narrative medicine into perspective, one will need to consider a literature piece that addresses the issue of health. “The Death of Ivan Illych” is, perhaps, one of the most famous pieces in world literature that addresses the subject matter (Tolstoy, 1886, p. 3). Representing the problem of a desperate lack of health literacy and awareness, the narrative in question portrays a disturbing mixture of the lack of self-directed care and the rise in the number of problems within the healthcare context. The lack of any serious health issues that preceded the patient’s fall and the further development of massive health complications increases the sense of health being a fragile and complex notion, thus outlining the portrait of a Russian patient as they used to look before the introduction of literacy into the public sphere.
However, the problem of physical and especially mental wellness as a notion that transcends the boundaries of culture and allows setting uniform standards for everyone is also mentioned in Young’s “The Case of the Proud Marine.” The short story introduces the reader to the idea of descending into madness in a rather casual, matter-of-fact way. However, what shines through especially vividly is the notion of collective trauma as an important aspect of the illness narrative in the context of a specific culture. Moreover, the importance of personal, as opposed to the global, is displayed very evidently in the story: “I asked him what was the most traumatic event after he returned from Vietnam. He described an incident in which he was thrown to the ground by a peace demonstrator who tore his uniform” (Young, 1997, p. 156). Thus, the story represents a metaphor for overcoming the nationwide tragedy.
The historical perspective and the misconceptions that healthcare experts and society, in general, used to have about specific vulnerable groups and their characteristics, such as gender, also shines through in numerous literature pieces. In “The Yellow Paper,” the reader follows a young woman’s descent into madness caused by rampant misogyny that was tragically common during the specified era (Stetson, 1892, p. 648). Similarly, the disdain for people of a particular class is also reflected in the notorious experiment known as the Tuskegee study, where people were purposefully deceived about syphilis treatment options (Schoenbach, 2015).
The notion of cultural perception of illness and well-being in the narrative becomes obvious s when considering some of the stylistic devices used by the authors. For instance, in “The Yellow Paper,” the fate of the leading character shows the threats and trappings of gender-related prejudices and the necessity to abandons stereotypes related to gender as a critical goal that society needs to accomplish in order to become mentally healthy. The chronicle of the main character’s descent into madness that the narrative represents can also be defined as the historical evidence of the mistakes made in the past in regard to the management of health issues. Thus, in a certain way, the short story represents not only culture-specific misconceptions about gender roles that have caused the main character to lose her mind but also the general trend in the development of misogyny as a highly unhealthy principle in building interpersonal relationships within a society.
The symbolism in the novels under analysis truly shines through. For instance, the yellow wallpaper in the titular novel is the direct metaphor for the descent into madness (Charon, 2006). The importance of the described interpretation is amplified by the suffocating, claustrophobic impression that the room of the protagonist leaves on the reader. As Charon (2006) explains, “That the sections in Charlotte Perkins Gilman’s story “The Yellow Wallpaper” get progressively shorter provides important information about the narrator’s state of mind” (p. 117).
The analysis in question also allows exploring diagnosis as a technology and the mark of the stage that society passes in its development. The precision of a diagnosis and the efficacy of the following treatment is defined by the extent of technological development of a society and the presence of accurate diagnostic tools that allow locating a problem and introducing a corresponding set of tools for addressing it from a clinical perspective. Therefore, in the narratives under analysis, the importance of technology as the catalyst of building a decent healthcare framework and encouraging nurses to construct a complex caring system based on a profound knowledge of the human body is emphasized.
Overall, the narratives in question display the effects of sociocultural factors on understanding the concept of wellness, disease, and treatment quite clearly, The change in the social perception of a disease over time as new notions are introduced into healthcare, as well as the problem of social exclusion, are outlined quite clearly in the described novels. By creating an artificial concept of wellness based on a misconception or a false notion ne will inevitably cause a shift in priorities, alienating the people that experience a particular health concern from others.
Conclusion
Sociocultural factors define one’s experience with diseases, their diagnosis, treatment, and their definition linked directly to one’s cultural legacy, yet the recent focus on globalization and the promotion of the cross-cultural dialogue seem to have been contributing to the development of homogenous experiences of the subject matter. Nonetheless, the differences in the cultural perception of wellness and disease, as well as the concept of treatment, diagnosis, and health literacy, have been one of the driving forces behind the development of cultural differences. Thus, historical and cultural contexts still shape people’s attitudes toward health and their corresponding behaviors, affecting the efficacy of health management within communities. Therefore, the integration of a program aimed at global health literacy promotion and eradication of dangerous health myths, as well as knowledge sharing, is expected to assist in addressing global public health issues.
References
Charon, R. (2006). Narrative medicine: Honoring the stories of illness. Oxford, UK: Oxford University Press.
Frank, A. W. (2013). The wounded storyteller: Body, illness, and ethics (2nd ed.). Chicago, IL: University of Chicago Press.
Schoenbach, V. (2015). Voices of the Tuskegee study [Video file]. Web.
Stetson, C. P. (1892).The yellow wallpaper. Web.
Tolstoy, L. (1886).The death of Ivan Illych. Web.
Young, A. (1997). The harmony of illusions: Inventing post-traumatic stress disorder. Princeton, NJ: Princeton University Press.
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