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The application of Sarbin's theory of emotions as narrative emplotments to stories of two men diagnosed with cancer

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The application of Sarbin's theory of emotions as narrative emplotments to stories of two men diagnosed with cancer

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THE APPLICATION OF SARBIN'S THEORY OF EMOTIONS
AS NARRATIVE EMPLOTMENTS TO STORIES OF TWO MEN
DIAGNOSED WITH CANCER
by
Jennifer Brown
A Thesis Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
MASTER OF ARTS
(Occupational Therapy)
May 1995
Copyright 1995 Jennifer Lynn Brown
UMI Number: 1378402
UMI Microform 1378402
Copyright 1996, by UMI Company. All rights reserved.
This microform edition is protected against unauthorized
copying under Title 17, United States Code.
UMI
300 North Zeeb Road
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UNIVERSITY O F SOU TH ERN CALIFORNIA
TH E GRADUATE S C H O O L
U N IV ER SITY PA R K
LOS A N G ELE S. C A L IF O R N IA 9 0 0 0 7
This thesis, written by
JENNIFER LYNN BROWN
under the direction of h.ar Thesis Committee,
and approved by all its members, has been pre
sented to and accepted by the Dean of The
Graduate School, in partial fulfillment of the
requirements for the degree of
MASTER OF ARTS..................
— C . . „
Dean
Date ....
THESIS COMMITTEE .
ii
TABLE OF CONTENTS
CHAPTER 1 - STATEMENT OF THE PROBLEM......................1
CHAPTER 2 - REVIEW OF THE LITERATURE.......... .............5
Emotions and Cancer.................................... 6
Narrative as a Method for Understanding
Human Experience..................................8
The Use of Narrative in Studying Human Action 12
Sarbin's Theory of Emotions as Narrative
Emplotments........................................ 14
CHAPTER 3 - METHODS........................................... 24
CHAPTER 4 - DISCUSSION........................................27
CHAPTER 5 - CONCLUSION........................................69
REFERENCES..................................................... 78
APPENDIX A ......................................................80
APPENDIX B......................................................83
P
Chapter 1 - Statement of the Problem
The purpose of this literary analysis is to explore
how the initial diagnosis of cancer impacts on lived
experience of cancer patients, in the choices of actions,
their intentions and their emotions. I have used Sarbin's
theory of emotions as narrative emplotments as a basis
for this study.
Sarbin's theory of emotions is based on a narratory
principle which he describes is, "human beings think,
perceive, imagine, and make moral choices according to
narrative structures" (1986, p. 8); humans naturally
connect pieces of information to form a story that relates
the information in some patterned way. Emotions are
enacted to preserve moral identity in a context of social
roles. He identifies moral identity as a means by which
to evaluate oneself in relation to the Good. Social roles
prescribe the expected conduct of a person given his
or her status in a collectivity, dictate performances
that maintain collective stability, and answer the
question: who am I? (Sarbin, 1986; Sarbin, 1989a, 1989b
Schiebe, 1983).
The significance of this literary analysis is its
contribution to the knowledge base concerning emotions
and choice of activity related to living with cancer.
It has explored these emotions and actions from a
hermeneutic, or interpretive perspective. Much of the
current literature addresses this topic from the
standpoints of rationalism or empiricism, either
neglecting context altogether or considering it only
in terms of cause and effect relationships. In contrast,
hermeneutic inquiry seeks to explain, to produce an
interpretation, and to understand the individual
experience of emotions (Packer, 1985).
This project is relevant to the emerging discipline
of occupational science. In discussing the importance
of developing theories to support the study of humans
as occupational beings, Clark et al. (1991) state, "We
believe that in generating theory about occupation, we
must examine the rules, moral convictions, symbolic
meanings, emotional responses, and sociocultural and
historical contexts that influence one's decision about
whether to invest one's energy in particular occupations"
(p. 302). Sarbin (1989a, 1989b) asserts that those aspects
of human action sometimes referred to as emotions can
best be understood when examined in a moral,
sociocultural, temporal and historical context. By
exploring the applicability of this theory to the
discipline of occupational science, a greater
understanding of the emotions, experiences, and actions
of individuals living with cancer was sought.
3
This paper also has relevance to the practice of
occupational therapy. Adolf Meyer, one of occupational
therapy's founding fathers stated,
This growing conviction that personality is
fundamentally determined by performance rather than
by mere good-will and good intention rapidly became
the backbone of our psychology....It became a fair
task for our ingenuity to obtain performance wherever
it had failed to come spontaneously and thereby
to serve the organism in the task of keeping itself
in good form. (1977, p. 641)
It is demonstrated that Sarbin's theory lends itself
to the practice of occupational therapy which is based
on the philosophy outlined by Meyer because it, too,
considers personality, or identity and the way in which
it is upheld through activity.
The narratives of two men, Arthur Frank and Reynolds
Price were selected for analysis. Both men were diagnosed
with cancer, experienced various modes of treatment and
have thus far remained in remission. They are writers
by trade, and having survived cancer and its devastating
treatments, have written books about their experiences.
The principles of Sarbin's theory were used as a basis
for analysis in order to gain an understanding of the
manner in which emotions emplot action in individuals
diagnosed with cancer.
This thesis is a qualitative, descriptive project
employing principles of hermeneutic inquiry. The
narratives were analyzed and interpreted, "noting
underlying patterns across examples of stories"
(Polkinghorne, 1988, p. 177). These patterns refer to
the principles of Sarbin's theory which illustrate the
relationship between emotion and action. Information
was generated regarding the following questions: What
emotions are generated in reaction to living cancer?
Can emotions experienced in conjunction with an internal
situation such as cancer be interpreted via actions in
a social context? Does the individual feel that the
diagnosis is an attack on his or her moral identity?
Does the individual act to defend his or her moral
identity and, if so, how? What are the features of the
settings that instigate and maintain certain actions
(Sarbin, 1989a, 1989b)?
For this analysis, it is assumed that living with
cancer has an impact on one's emotions, and therefore,
on his or her actions. It is also assumed that the
narratives chosen for analysis are true representations
of each man's experience.
This analysis is limited by the number of narratives
analyzed. Therefore, the ability to generalize information
collected is very limited and, in fact, not one of the
goals of the paper. Furthermore, analysis is limited
to only that which appears on the printed page. No
questions or further clarification were possible.
5
Chapter 2 - Review of the Literature
To provide the reader with a finer grasp of the
perspective that emotions are not unconnected to intention
and action, I begin this review by presenting the extant
literature on emotion and cancer. These studies reveal
what patients report they felt in reaction to their
diagnosis, yet they do not present a picture of what
action followed and how the diagnosis affected their
everyday activities and priorities. It is these activities
and priorities which shape the unfolding story that
constitutes a human life. In the second section of this
review, I define narrative, present its key features
and summarize how it can be employed as a method for
understanding human experience. Next I discuss how
narrative can be used to study human action.
Finally, because this paper is concerned with the link
between how we feel and what we do, I carefully review
Sarbin's theory of emotions as narrative emplotments.
I present in detail the key points of the theory including
the uselessness of measuring internal happenings in
understanding human action, the importance of narrative
in providing an ecologically valid model for studying
human action, and the structure narrative imposes on
human action. The importance of narrative in maintaining
and enhancing identity is discussed and the concepts
6
of "passions", "dramatistic" and "dramaturgic" roles,
and "embodiment" are defined.
Emotions and Cancer
Literature pertaining to emotions and cancer is
sparse. What there is seems to be limited to observational
and anecdotal notes on individual reactions to cancer
(Frank-Stromborg, Wright, Segalla, & Diekmann, 1984).
"The paucity of research on initial reactions to the
diagnosis of cancer is understandable when you consider
that before the '70's, the majority of physicians withheld
the diagnosis from their patients" (p. 16). However,
among the literature that does exist, it is consistently
reported that anger, guilt, fear and depression are the
standard responses to a diagnosis of a life-threatening
illness (Frank-Stromborg, Wright, Segalla, & Diekmann,
1984; Slaby & Glickman, 1985; Blanchard & Ruckdeschel
1986; Gise, Israel, & Dottino, 1989).
Slaby and Glickman (1985) report that anger is a
frequent initial reaction to a diagnosis of cancer.
Individuals often express a feeling of being robbed,
or an incredulous "why me?" "The anger associated with
the development of cancer is to some degree an anger
at ourselves for acting as if we were going to live
forever" (pp. 49-50), letting opportunities slip away.
This is exemplified in a transcript of a patient-team
conference between a dying patient and her medical team:
I didn't ever have time for myself. My life fell
into a pattern of going to work and coming home
and looking after a sick member of my family. When
I turned around everyone was dead. Now I could do
something, take a trip or something, and I got sick.
It seems pretty cruel. Unfair. (Gise, Israel, &
Dottino, 1989, p. 374)
Frank-Stromborg, Wright, Segalla and Diekmann (1985)
found that anger and depression resulted from the
frustration of having one's illness go undiagnosed or
misdiagnosed.
Fear often stems from the inability to know what
lies ahead. Individuals diagnosed with cancer also fear
pain, loss of control, the dying process and death itself
and fear of abandonment (Frank-Stromborg, Wright, Segalla
& Diekmann, 1984; Slaby & Glickman, 1985; Blanchard &
Ruckdeschel, 1986; Gise, Israel, & Dottino, 1989).
When faced with death, guilt often results from
the idea of leaving unfinished business or loved ones
behind, or from the feeling that one is being punished
for past sins. "Patients may feel guilty about their
life-styles or behavior patterns that contributed to
their disease. They may also feel guilty over other
behaviors or relationships in their lives" (Blanchard
& Ruckdeschel, 1986).
Despite the negative connotations of a diagnosis
of cancer, Frank-Stromborg, Wright, Segalla, and Diekmann
(1984) found that a surprising number of patients
responded positively. In most of these cases, the
diagnosis did not come as a surprise and the patients
expressed relief at finally arriving at a diagnosis.
It is clear from the literature that people with
cancer experience an array of emotions as a result of
the diagnosis. This thesis examines these emotions and
their influence upon action as they emerge from the
selected narratives.
Narrative as a Method for Understanding Human Experience
Polkinghorne defines narrative as "the kind of
organizational scheme expressed in story form" (1988,
p. 13). He goes on to say that narrative can refer to
the process involved in creating a story, as well as
to the cognitive scheme of the story, and to the result
of the process--tales, stories of histories. Narrative
can also be defined as "a description of reality,...a
way of seeing that aims at verisimilitude" (Vitz, 1990,
p. 710), or a perception that appears true or real.
The literature on narrative discusses several
important themes. The first is the pervasiveness of
narrative. Polkinghorne (1988) points out the ubiquitous
character of narrative by presenting examples such as
the novels we read, the movies we watch, and the fairy
tales we are told as children. He discusses the use of
narrative in the storied accounts we use to describe
our past actions and to explain the behavior of others.
Even our dreams and fantasies are experienced as
narratives (Sarbin, 1986; 1989a).
Another feature of narrative is the organizational
structure it provides for linking a series of events
into meaningful experiences. This organizational structure
is referred to as plot.
The plot functions to transform a chronicle or
listing of events into a schematic whole by
highlighting and recognizing the contribution that
certain events make to the development and outcome
of the story. Without the recognition of significance
given by the plot, each event would appear as
discontinuous and separate, and its meaning would
be limited to its categorical identification or
its spatiotemporal location. (Polkinghorne, 1988,
pp. 18-19)
A plot serves to weave together events so they make sense
or have meaning (Keen, 1986; Polkinghorne, 1988). In
this manner, each event acts as a basis for understanding
why the next event occurs (Gergen & Gergen, 1986;
Polkinghorne, 1988). A single series of events can be
explained by more that one plot, and each explanation
will result in a different interpretation of those same
events. For example, cultural traditions influence the
plot lines we choose to explain events (Polkinghorne,
1988). Thus, isolated events can be understood and
interpreted when connected within the structure of a
plot.
Temporality is another important characteristic
of narrative. "Perhaps the most essential ingredient
1 0
of narrative accounting (or storytelling) is its
capability to structure events in such a way that they
demonstrate...a sense of movement or direction through
time" (Gergen & Gergen, 1986). Polkinghorne (1988) views
temporality as important, not so much for a sense of
direction, but rather as a tool for establishing points
of reference or perspective. "To be temporal, an event
must be more than a singular occurrence; it must be
located in relation to other events that have preceded
it or will come after it" (p. 131). However, a mere
listing of chronological events does not, in itself,
represent narrative. It is the gathering of these events
into the unity of a plot which makes them stand in relief
from the plane of linear time by assigning them importance
relative to other events.
A consistent theme in the literature is the role
narrative plays in the formation and maintenance of
identity or self-concept. In his work on self-narratives
and adventure, Scheibe (1986) proposes that life stories
are the major supports for human identities. He goes
on to state that "self-narratives are developed stories
that must be told in specific historical terms, using
a particular language, reference to a particular stock
of working historical conventions and a particular pattern
of dominant beliefs and values" (p. 131). These self
narratives, as they are developed throughout life, evolve
into the construction of identity. In a similar vein,
Polkinghorne (1988) takes the stance that personal
identities and self concepts are achieved through the
use of narrative configuration. "We make our existence
into a whole by understanding it as an expression of
a single unfolding and developing story" (p. 150). He
elaborates by stating that the experience of self is
organized along a temporal dimension in the same way
that events are organized by plot into a story. The story
begins at birth, contains middle episodes throughout
the life span and ends in death and the meaning of this
existence is articulated in a narrative plot. Lazarus
(1991) claims that it is this identity that influences
the emotions we experience and thus the actions in which
we engage in response to these emotions. Using the term
"ego-identity" to define self or identity, Lazarus (1991)
states, "emotions require some elemental or emerging
sense of ego-identity to advance and protect" (p. 100).
A final theme is the role narrative plays in
understanding human action. Narrative thinking is the
most effective method of organizing action (Robinson
& Hawpe, 1986). In a narrative approach, action is viewed
as an expression of existence, and "its organization
manifests the narrative organization of human experience"
(Polkinghorne, 1988, p. 142). Polkinghorne (1988) says
that acting is analogous to writing a story and that
1 2
understanding action is analogous to arriving at an
interpretation of the story. "Narrative is the form of
hermeneutic expression in which human action is understood
and made meaningful. Action itself is the living narrative
expression of a personal and social life" (p. 145).
Narrative serves to connect actions into integrated plots
of life stories.
The pervasiveness of narrative, plot, temporality,
the role of narrative in identity formation and
maintenance, and the organizational structure it provides
for understanding human action are the characteristics
which make narrative an ideal method with which to gain
an understanding of human experience. Thus, this paper
examined narratives collected from two men who had cancer
to arrive at interpretations of their actions.
The Use of Narrative in Studying Human Action
Because the phenomenon of human action is complex
and often ambiguous, a methodology chosen to examine
it must be suited to its intricacies and peculiarities
(Packer, 1 985 ) .
Occupational science acknowledges the critical role
that values, vision, imagination, reflection, and
emotion play in decisions about what to do each
day and how to do it. It regards the human as a
conscious, active agent who dynamically interacts
in specific sociocultural and historical contexts.
(Clark et al., 1991, p. 304)
With this in mind, it appears that a hermeneutic approach
is well suited for this type of analysis. Packer (1985)
1 3
states that in hermeneutic inquiry, the primary origin
of knowledge is direct, practical, everyday activity:
involvement with tools, artifacts and people. "Most
notably, it involves no context-free elements definable
in the absence of interpretation" (p. 1083). Packer goes
on to say that the hermeneutic method employs detailed,
progressive descriptions of social interchange in a
semantic structure rather than a logical or causal
structure.
It is this semantic structure that makes narrative
a useful tool in studying human emotions as emplotted
actions. According to Polkinghorne (1988), narrative
theory focuses on human existence as it is lived,
experienced and interpreted by the individual. This
interpretation involves the processes of language as
well as the order of meaning.
The basic figuration process that produces the human
experience of one's own life and action and the
lives and actions of others is the narrative. Through
the action of emplotment, the narrative form
constitutes human reality into wholes, manifests
human values, and bestows meaning on life.
(Polkinghorne, 1988, p. 159)
Descriptive narrative analysis attempts to produce
accurate descriptions of the interpretive narrative
accounts humans use to organize events in their lives
into meaningful experiences. This type of analysis does
not produce new narratives, it merely reports existing
ones. It attends to the collection of narrative schemes
1 4
that operated for individuals and to the situations that
bring particular narratives into interpretive expression
(Polkinghorne, 1988). Therefore, this thesis attempts
to create descriptions of the narratives the authors
provide to organize their actions and emotions surrounding
their diagnosis into meaningful experiences.
Sarbin's Theory of Emotions as Narrative Emplotments
Theodore R. Sarbin, Ph.D. and professor of psychology
and criminology at the University of California, Santa
Cruz became disillusioned with the outcomes of
psychological research and the popular attitude that
social behavior could be dissected into its elements
in the laboratory. As a result, he developed an
alternative theory to this reductionistic viewpoint that
would allow for social context to be considered when
studying human action (Sarbin, 1986).
Sarbin's theory of emotions as narrative emplotments
is based on four principles. The first is that reports
and measurements of internal happenings are of little
use in understanding the complexity of human action
(1989a). In questioning people about the definition of
the term "emotion", he found that respondents consistently
included an internal locus for emotion in their
definitions. When asked to provide illustrations of
emotion, Sarbin found, without exception, that these
illustrations "were recounted as narratives without
reference to happenings inside the body" (p. 185) and
that they covered a wide range of human action. Sarbin
claims that expressions used to describe feelings, such
as "It feels good," or "It feels terrible" are
non-informative. He concludes that the term "feelings"
is "a linguistic device, devoid of meaning unless located
in a narrative context" (p. 199). He also states that
as a class name, the term "emotion" is misleading. Such
a term leads us to believe that a particular set of
dimensions can describe the multifarious experiences
represented in the lexicon of emotions (1989b). Thus,
this paper was not simply concerned with reports of
Frank's and Price's feelings or emotions, but rather
what did they did and why. It will look at how their
daily lives were transformed since the diagnosis of
cancer.
Sarbin's second principle is that for those human
events referred to as "emotions" or "passions," narrative
provides a more ecologically valid and more satisfying
explanatory model (1989a, 1989b). He believes that in
an effort to understand human experience, the question,
"What is emotion?" is footless, and suggests that
responses to the following questions would be more
fruitful: Who are the actors? What is the setting? When
did the action take place? What did the actors do or
say? What were the features of the ecological setting
1 6
that instigated or maintained certain actions? Answers
to these questions produce a narrative. "To understand
any human phenomenon, one must be able to construct a
coherent narrative, a narrative that tries to account
for the reasons that historical figures chose one rather
than another mode of conduct" (Sarbin, 1989a, p. 190).
He goes on to say that reasons can only be interpreted
in identifiable contexts and that causes, often sought
in traditional inquiry into human action, are intended
to be context-free. In his work on emotion, Lazarus (1991)
also illustrates this point:
To make sense of what people feel requires, I
believe, that we examine how they think and act
to cope with the demands, constraints, and resources
presented by their environments and to actualize
personality characteristics such as goals and belief
systems— all of which affect...the specific emotion
that is experienced, (p. 221)
Adopting this perspective, from the authors' narratives
I tried to develop a sense of the unfolding drama in
which they found themselves. Toward what overall goal
did their activity seem directed? Who were the key actors
in these dramas, and what did they do and say?
The third principle in Sarbin's theory is that the
narratory principle guides and organizes thought and
action. He proposes the narratory principle: that humans
think, perceive, imagine, and make moral choices
according to narrative structures. Present two or
three pictures, or descriptive phrases, to a person
and he or she will connect them to form a story,
1 7
an account that relates the pictures or the meanings
of the phrases in some patterned way. (1986, p.
8)
Narrative is a way of organizing actions and accounts
of actions by linking together events and incorporating
time and place. It also allows for the inclusion of the
individual's reasons for his or her acts. Human beings
use this organizing principle to impose structure on
the flow of human experience. Sarbin (1986, 1989a)
presents as examples the storied nature of our dreams,
fantasies, daydreams and the rituals of daily life.
Following this idea, in my work, I demonstrate a sense
of the patterns or structure the two men use to organize
and give meaning to the events surrounding their
diagnoses.
The final principle is that "passions are rhetorical
acts intentionally performed in the service of maintaining
or enhancing a person's moral identity" (Sarbin, 1989a,
p. 200). Sarbin excludes those classes of emotion such
as feelings, affects, moods, sentiment, aesthetic
experiences, pain, visceral reactions, and many others
from the applicability of this theory and limits
application to the class of emotions he terms "passions."
He lists two features which distinguish passions from
other forms of conduct: 1) passions are intimately
connected to the process of communicating a moral
position, and 2) individuals participating in passionate
18
encounters are highly involved in the action. Examples
of passions include anger, fear, jealousy, guilt,
exultation, love, joy and envy to name a few.
Sarbin (1989a) claims that individuals engage in
rhetorical acts to communicate moral stances. He defines
rhetorical acts as "the organized use of verbal and
gestural conduct to bring about changes in the
relationship between self and other" (p. 191), and he
states that this is the most powerful means of resolving
or creating the uncertainties that characterize social
lif e.
Sarbin (1989a, 1989b) maintains that there are two
types of rhetorical action. Using theater as a source
of metaphor, he refers to these actions as dramaturgic
and dramatistic. Dramaturgic rhetoric refers to the
"patterned oral and gestural behavior created and employed
by the actor in the interest of impression formation"
(Sarbin, 1989a, p. 192). In dramaturgical action, the
actor is the author of the unwritten script. The actor
monitors the rhetoric, alert to feedback from the
audience, modulating the amplitude, and shifting from
one tactic to another with the intention of persuading
and convincing the audience (sometimes the self) of the
validity of his or her claims. Examples of such behavior
include deception, withholding or restricting the flow
of information, and selective feedback.
1 9
Dramatistic rhetoric differs from dramaturgic
rhetoric in terms of authorship. Dramatistic rhetorical
action is culturally prescribed rather than self-authored.
"Some prescriptions are in the form of codified rules,
but most are contained in half-remembered folktales,
myths, legends, fables, morality plays, parables, songs,
poems, bedtime stories, novels, scenarios, and other
narrative forms" (Sarbin, 1989a, p. 193). The point of
these narratives is the development or solution of a
moral problem. Moral features of human relations, such
as duty and obligation, pride and shame, and honor and
dishonor are addressed in the plots of these narratives
(Sarbin, 1989a, 1989b). "These narratives contain models
of conduct for solving problems generated in connection
with the upward or downward valuation of one's sense
of self, or identity" (Sarbin, 1989b, p. 84). Similar
to dramaturgical rhetorical actions, dramatistic
rhetorical actions are not disorganized responses, but
recognizable, intentional patterns of conduct. "They
are the moral judgments, intentions, and actions that
are sometimes identified as emotions or passions" (Sarbin,
1989b, p. 85).
To further clarify the idea of rhetorical acts as
a means of maintaining or enhancing moral identity, Sarbin
(1989a, 1989b) discusses the concept of role. One type
of role is social role which he defines as, "the expected
20
conduct of a person, given his or her position in a
collectivity" (1989b, p. 85). Closely tied to social
structure, these roles dictate performances that maintain
stability within the collectivity. The criteria for
judging one's performance in social roles are public.
Feedback from performance in social roles addresses the
question: who am I? Answers to this question comprise
a person's social identity. Examples of this type of
role are mother, husband, nurse and president. The other
type of role pertinent to this theory is what Sarbin
labels identity roles. This class of conduct involves
"patterned enactments that are intended to preserve and
enhance an actor's moral identity" (1989b, p. 86).
Enactments of these roles serve to answer the question:
what am I in relation to the Good and to the codes of
morality? Criteria for judging performance of identity
roles may be private rather than public. Examples of
identity roles include jealous husband, guilty sinner,
and martyred saint.
Sarbin (1989a) points out that "moral identity roles
are always enacted in a context of social roles" (p.
194). He continues with:
As the narrative figure (the self as actor) in one's
own self-narrative confronts problematic moral
situations, the self-as-author of the ongoing
self-narrative, as agent, chooses a role enactment
that fits the perceived requirements of his/her
moral career, (p. 194)
21
Thus, passions are intentional enactments, with the self
as agent in defending his/her moral identity.
A final concept in the clarification of this
principle is that of embodiment. With this concept, Sarbin
(1989a, 1989b) attempts to bridge the gap between reports
of emotions as embodied, or internal happenings and the
highly involved actions in which they are exemplified.
One cannot overlook the frequency with which self-reports
of emotions are in terms of "being" or "feeling," or
the actual bodily changes that occur when one is
experiencing an emotion. To account for these
observations, Sarbin considers an individual's level
of involvement in an action. At the lowest level, there
is little or no organismic involvement. The example he
uses for this is the interchange between a motorist and
a toll collector. Few or no physiological changes occur.
The high end is exemplified by ecstasy where there is
a great deal of organismic involvement such as increased
heart rate, flushing, glandular secretions and other
reflex actions.
At the low end of the dimension, role and self are
differentiated, few organic systems are called into
play, and effort is minimal. At the high end, role
and self are undifferentiated, the entire organism
is involved, and great effort is expended. (Sarbin,
1989b, p. 90)
Sarbin maintains that passions, or dramatistic rhetorical
acts are carried out at the high end of the continuum,
22
and that while embodied, this complex conduct cannot
be reduced to the mere interplay of biological forces.
In summary, Sarbin feels that, in the study of human
experience, it is fruitless to ask the question: what
is emotion? To acquire an understanding of experience,
an example must be provided in the form of narrative.
He describes passions as rhetorical acts that are guided
by the narratory principle. They are not disorganized
responses to stimuli, but logical, orchestrated actions
expressed to maintain or enhance one's moral identity
within the context of social roles. Passions involve
a high degree of organismic involvement including
semiautonomous physiological reactions. Thus, in my thesis
I was concerned with uncovering the "passions" of the
authors as they express them in the unfolding plot of
their lives following the diagnosis of cancer.
To understand humans as occupational beings, Clark
et al. (1991) believe it is important to examine the
emotional responses, sociocultural and historical
contexts, and moral convictions which influence one's
decision to engage in particular occupations. The
literature reviewed here demonstrates a lack of inquiry
into the emotions generated from a diagnosis of cancer
and how these emotions influence one's decision to act.
Lazarus (1991) suggests that emotions can only be
understood or interpreted within a context. Sarbin
23
(1989a, 1989b), too, writes that emotions, or passions,
expressed as rhetorical acts are best examined within
a context or story. With these ideas in mind, I used
narrative as a method for examining the emotions and
choices of action of two men diagnosed with cancer.
Narrative is a useful method of hermeneutic inquiry
because of the emphasis it places on context through
the use of plot, temporality, and identity formation
and maintenance. It also serves to organize human action
by relating single events into meaningful sequences
(Polkinghorne, 1988). Applying Sarbin's (1989a, 1989b)
theory of emotions as narrative emplotments to the stories
of individuals diagnosed with cancer, I describe their
emotions and actions within their sociocultural and
historical contexts. These descriptions focused on the
following questions surrounding the respondents emotions:
What actions did they take? Why were these actions chosen?
Who are the key players in the drama? How are the
respondents' moral identities developed or maintained?
How did daily life change?
24
Chapter 3 - Methods
It was originally intended that this thesis be a
qualitative research project based on narratives collected
from subjects diagnosed with and receiving treatment
for cancer. The narratives were then to be analyzed in
terms of Sarbin's theory of emotions as narrative
emplotments to examine the way in which emotions influence
one's engagement in activity following a diagnosis of
cancer. Permission to interview subjects was sought at
numerous facilities. However, after many requests,
permission was denied at every facility that had been
approached. Hence, two autobiographies were selected
for analysis which detail the lives of the authors as
they experienced cancer and its treatments.
This paper is a descriptive narrative literary
analysis. "The purpose of descriptive narrative research
is to produce an accurate description of the interpretive
narrative accounts individuals or groups use to make
sequences of events in their lives or organizations
meaningful" (Polkinghorne, 1988, pp. 161-162). Although
this is not a research project, the purpose of this
analysis is the same: to produce an accurate description
of the stories the authors used to give meaning to the
events surrounding their diagnoses. It employs a
hermeneutic approach designed to gain an understanding
of human action in context. The goal of this type of
25
analysis is to achieve an explanation of human action
rather than to determine causal relationships (Packer,
1985).
In this thesis I used works by two men who have
been diagnosed with cancer, received various treatments,
and have thus far survived. Each has written narrative
accounts of this process to convey the emotions, the
changes in daily life, the meaning of illness, and the
ultimate shift in identity he has experienced. Sarbin's
theory of emotions as narrative emplotments is used as
a basis for discussing these narratives.
Reynolds Price, novelist, poet, playwright, and
Duke University professor was 51 years of age when he
was diagnosed with spinal cancer. Arthur Frank, a medical
sociologist was diagnosed with testicular cancer at age
40. Each man has used his writing as a means to organize
and give meaning to the events and emotions surrounding
his diagnosis.
Answers to the following questions were sought in
the process of examining the narratives: 1) What were
Frank's and Price's reactions to the initial diagnosis
of cancer? 2) What did they do when they received the
diagnosis? 3) What was foremost on their minds? 4) What
encounters stand out in their minds? 5) What encounters
were especially meaningful to them? 6) What was it about
these encounters that made them special? 7) What projects,
26
if any, did they take on, and why? 8) Were there any
activities they gave up for reasons other than physical
limitations, and if so, why? 9) Did they have any thoughts
about justice and injustice? 10) How did the diagnosis
impact their lives?
Analysis was conducted based on the four principles
of Sarbin's theory outlined above. The narratives examined
were interpreted in terms of the authors' reported
emotions or feelings and the actions they chose in
response to those emotions. Particular attention was
given to the context in which these actions occurred,
the authors' moral stance or identity being defended,
and the extent of involvement or embodiment they
experienced. Finally, the narratives were analyzed in
terms of Sarbin's (1986) narratory principle. The
organization and structure of the authors' experience
and the meaning they generated from this structure were
examined.
27
Chapter 4 - Discussion
The first principle of Sarbin's theory of emotions
as narrative emplotments is that emotions are generally
defined in terms internal loci, yet illustrations of
emotion, which are required for understanding, are
provided in the form of narrative with little reference
to internal happenings (1989a). It is necessary here
to clarify that "internal happenings" refers to those
physiological processes such as increased heart rate
or dilated pupils that occur when one is experiencing
an emotion, or to the intangible reports of "feelings,"
and not to the process of disease.
Both of the authors experienced a wide range of
emotions with respect to their diagnoses, their
relationships with their health-care providers, their
physical pain, their treatment and its outcomes, and
their relationships with friends and loved ones. Fear
is a common emotion of individuals facing potentially
life threatening diagnoses, and both men attest to this.
Sarbin's principle that narrative is necessary for
understanding reports of emotions is clearly demonstrated
by Frank when he compares the fear he experienced with
a heart attack with the fear he experienced with cancer.
Although we may understand that Frank does feel fear
in each case, we cannot understand what exactly or how
he feels until an explanation is given.
28
With heart problems my fears were of sudden
disappearance. But at least as I imagined it, I
would have gone out like the athlete dying young
in the poem of that title. In full flower, as I
thought of it. Thirty-nine is not that young, and
I was never much of an athlete, but in imagining
my own death I allowed myself some poetic license.
(Frank, 1991, p. 42)
He goes on to explain how his fear with cancer differed.
My fear was less of being dead than of dying slowly,
of decaying, suffering interminably, the body spewing
out foul fluids.... Popular fears of cancer, which
I shared, exaggerate the drama of its terrors but
underestimate the mundane discomforts that
accumulate. If a heart attack blows you away, cancer
chips at you bit by bit. (p. 43)
These examples clearly show that reports of fear provide
little in the way of meaning without an accompanying
narrative.
Price describes a slowly rising fear using terms
such as "eerie" and "concerned" as he relates the onset
of symptoms that ultimately lead to his diagnosis of
cancer. He begins his story relating a sense of impending
doom, though, in general things had been going well for
him. "In all the elation of recent months, I somehow
knew I was on a thin-aired precipice" (Price, 1994, p.
2). After this, he tells of developing difficulty with
movement of his legs and feet. First was the incident
when a friend had noticed he was slapping his left foot
on the pavement as they walked together. Next was the
episode in the video store when he could not raise his
right leg. He had also noticed a decrease in sexual
appetite and a "sense of risky balance" (p. 3) but had
29
written these off to old age. Then he describes an
experience of having one drink prior to administering
an exam and finding himself in a state of unprecedented
drunkenness. Here he states "my sense had deepened that
something was eerie" (p. 6). Following another failed
attempt to run, he reports "I was concerned but still
not quite scared enough to mention the newness to a friend
or to see a doctor" (p. 6). He first hints at "fear"
when, as his symptoms progress and he begins to consider
the possibilities, he remembers a friend with severe
multiple sclerosis. "Her plight was a fearsome
possibility" (p. 7). This rising sense culminated when
he sought medical attention and was told he required
a complete neurological work-up.
I said I was off to New York in a few days for a
week's business but would then be free.
They [the physicians] glanced at each other;
and the internist said "No, we need you now"....That
was my first real body blow from fear. (p. 8)
Here Price expresses his fear as an internal happening
with the use of the phrase "body blow". However, it is
only through the relationship of the entire series of
events, or plot, along with the sense of movement through
time, or temporal quality, that the reader gains a true
sense of Price's experience with fear.
Having received a diagnosis of spinal cancer, Price's
fear became more specific and is expressed in a series
of nightmares. "They were far more shapely and terrifying
30
than any I could remember from childhood, and they plainly
poured through me from the seed of cancer-dread" (p.
29). He relates several nightmares in his story but his
fear is not clarified until he describes one in
particular.
The third night was worst, but that dream finally
stated its point with brute candor. I was walking
the seventy miles from Durham to Warren County,
North Carolina to find my birthplace, my mother's
home-place in the village of Macon. When I found
the house and searched the rooms, it proved abandoned
and sadly empty— no relation of mine had lived there
for years. But once I was outside again in the dark,
a small young black-haired man appeared like a
cringing demon, writhing around me in a sinuous
dance; then saying, "Now you must learn the bat
dance." I suddenly knew that his bat dance was death,
death from cancer, (p. 30)
Even for Price himself, the meaning of his fear was not
evident until it was expressed to him as the story of
the bat dance in his dream.
Both men discuss the fear they faced while receiving
treatment for cancer— Frank received chemotherapy, Price
radiation.
The three months of chemotherapy seemed like a
lifetime to me, in part because of my fear that
it might be the end of my life....The chemotherapy
used for testicular cancer was first described to
me as one of the "most aggressive" treatments given.
I had this image of five brawny guys throwing me
on a bed and starting an IV. (Frank, 1991, p. 73)
By presenting his "image," Frank provides the cognitive
scheme through which the reader can envision his state
of mind. Price, on the other hand, combines the use of
plot as he lists a series of emerging unpleasant symptoms,
31
with the cognitive scheme, or "image" that he formed
of the effects of the radiation on his spinal cord.
Fear flooded in more than once toward the end of
radiation as the weakness mounted and, in the last
week of radiation, when an eight-inch-long
second-degree burn developed on my neck and upper
back. It was a suppurating lesion that required
me to sleep on a sheep-skin for weeks--the dry fleece
cushioned the long wound while the steroid, which
was meant to reduce inflammation, badly slowed repair
throughout my body. If that was the state of my
outer skin near the radiation site, imagine the
state of my spinal cord an inch below at the focus
of the fire. (Price, 1994, pp. 65-66)
Frank communicates not only fear, but also a sense
of loss associated with his diagnosis. In the following
example, the role this narrative plays in development
of Frank's changing identity is seen as he talks about
his body image.
Loss of the future is complemented by loss of the
past. I felt this loss most keenly one night shortly
before the surgery to remove the tumorous
testicle....Several nights before surgery, I looked
at myself in a mirror. The body I saw was not the
body I had had at twenty-two or even thirty, but
it retained for me a continuity with those bodies.
The changes, the deteriorations, had been
gradual....That night I knew that after surgery
I would never be the same....It was like saying
goodbye to a place I had lived in and loved. (1991,
pp. 37-38)
Only through Frank's recounting of the events of that
evening as they relate to his sense of who he is can
the reader gain a true comprehension of his loss.
We also see the role of narrative in the changing
selfconcept of Price as he relates a strong sense of
loneliness when faced with the prospect of hiring a
32
companion as his condition worsened. Price had seen
himself as a single, independent man prior to that point.
So the hardest challenge I knew I faced was the
prospect of hiring a practical nurse or some other
tame and bearable companion. As a single man though,
who'd lived mostly alone since the age of
nineteen...I could see no natural place to turn....So
the longest-postponed implication of a solitary
life was now another blank wall at my face--'Live
alone and you'll die alone.' For numerous days,
dry-eyed as a snake, I weighed that cold fact in
my mind. It felt as heavy as a stockyard axe. (1994,
P. 70)
Even though Price uses very descriptive language such
as "heavy as a stockyard axe," it is the narrative which
precedes that phrase that enables us to understand his
feeling of loneliness.
As is mentioned in the review of the literature,
emotions experienced in relation to having cancer are
not limited to negative ones. Both authors tell of
experiencing positive emotions as well, and the same
principles of narrative are used to communicate these
to the reader. Frank reports a feeling of relief as he
comes to terms with a changing identity unfolding in
his narrative as a man with cancer.
The tumors may have been a painful part of me, they
may have threatened my life, but they were still
me. They were part of a body that would not function
much longer unless it changed, but that body was
still who I was. I could never split my body into
two warring camps: the bad guy tumors opposed to
the naturally healthy me. There was only one me,
one body, tumors and all. Accepting that I was still
one body brought me a great sense of relief. (1991,
p. 84)
33
Price, on a number of occasions expresses feelings
of triumph. One of his most triumphant moments occurred
during his period of rehabilitation after completely
losing the use of his legs.
Best of all as a culminating new skill, in the same
sunbroiled parking lot where fifteen months ago
I'd discovered my appalling inability to run, I
proved to Wilkie my ability at moving unaided by
means of the narrow wood transferboard from the
wheelchair to the driver's seat of my own car; then
folding the chair, removing its wheels and stashing
the parts in the back seat behind me....veteran
that I was of so many forties and fifties films
that charted the literal resurrection of bodies
from war wounds, I felt for the first time, in that
parking lot, the same sense of triumph that always
flooded the ends of those stories. (1994, p. 104)
The temporal nature of the comparison of his first
experience in the parking lot, unable to run, with that
of his second, mastering the transfer, allows the reader
to know Price's triumph.
Price also tells of feeling hope. In this example,
he had a quiet evening at home before checking into the
hospital for his first surgery.
I took a wobbly look upstairs in my bedroom at the
wall of pictures of friends and loves I'd assembled
to face me, morning and night; these reminders of
their presence had been both a source of delight
and a good wailing-wall for years now--they could
listen mutely....since I'd notified all those friends
who were still alive, I thought I could sense their
hope like a firm wind at my back. It felt like the
pressure of transmitted courage, sent from as far
off as Britain and Africa....(1994, p. 22)
The excerpt here demonstrates the manner in which the
narrative serves to integrate Price's action of looking
34
to the wall into a cohesive part of his life story.
Looking to the wall is a comfort to Price, but the reader
can only comprehend this through Price's recounting the
meaning he has attached to the wall over the years.
All of these examples provide evidence to support
Sarbin's theory that explanations of emotions simply
as internal sensations or feelings are not sufficient
to communicate meaning. Narrative, because of its
characteristics of plot, temporality, the organizational
structure provides for understanding human feeling,
intention, and ultimately action, and its pervasiveness,
must accompany reports of emotions in order for the reader
or listener to gain an understanding.
Sarbin's second principle asserts that narrative
provides a more ecologically valid and satisfying
explanatory model for examining and understanding emotions
and human action. It does so by providing answers to
questions such as: Who are the actors? What is the
setting? When did the actions take place? How did the
actors respond? What features of the setting instigated
and/or maintained certain actions? This principle is
seen in excerpts from the works of both authors describing
encounters with physicians that left them feeling angry.
Frank tells of an incident that occurred during
the period in which he was receiving chemotherapy.
35
One day I was lying in day care, waiting for blood
results to come back from the lab. On the other
side of the treatment area a physician was talking
loudly with a volunteer, discussing vacation spots
in the Caribbean, specifically, which side of some
island was the rainy side. This was not a
conversation I or the others having chemotherapy
wanted to hear. Most of us were worried about getting
through the day's treatment without having a vein
collapse. We were wondering if we would ever leave
Calgary again, much less get to a place like the
Caribbean. (1991, p. 112)
A statement about being angered by overhearing a
conversation about Caribbean vacations would have been
meaningless. Instead Frank presents a story. He introduces
the actors: the physician, the volunteer, himself. The
setting is the treatment area filled with patients
fighting life-threatening diseases. The action took place
during a time when Frank was suffering the horrible side
effects of chemotherapy and was not yet certain that
he would survive the treatment or the disease. What
features of the setting instigated or maintained the
conversation? Obviously a lack of privacy existed for
both the patients and staff. Furthermore, Frank's
perception of the treatment area was that of a place
to fight for one's life; the physician and volunteer
likely viewed it simply as an appropriate place to
exchange pleasantries.
In this story, Frank goes on to explain his mode
of conduct in response to this anger, and the context
which supported his choice of conduct.
36
But Cathie [his wife] and I kept our anger to
ourselves....We grumbled only to ourselves because
I was dependent on the treatment facility, and we
were making our best deal....Ill persons rarely
perceive expressing anger as part of the best deal.
Dependence is the primary fact of illness, and ill
persons act with more or less fear of offending
those they depend on. It seems like a bad deal to
express anger at someone who may soon be approaching
your body with sharp pointed instruments or, if
offended may be slow to bring a bedpan, or who may
be the only person one can say goodnight to. (1991,
p. 112)
Ultimately, it is in the writing of the book where Frank
felt safe to redress the situation and express his anger.
Price tells of feeling frustration or anger at a
similar lack of privacy as he received some very bad
news from his physicians.
I was lying on a stretcher in a crowded hallway,
wearing only one of those backless hip-length gowns
designed by the standard medical-warehouse sadist.
Like all such wearers I was passed and stared at
by the usual throng of stunned pedestrians who swarm
hospitals round the world. (1994, p. 13)
Here Price sets the scene. He then introduces the actors:
himself, his brother, and his two original doctors.
All I recall the two men saying at that instant,
then and there in the hallway mob scene, was "The
upper ten or twelve inches of your spinal cord have
swelled and are crowding the available space. The
cause could be a tumor, a large cyst or something
else. We recommend immediate surgery." I could hear
they were betting on a long tumor.... Then they moved
on, leaving me and my brother empty as wind socks,
stared at by strangers. (1994, p. 13)
Price laments that the two "splendidly trained" (1994,
p. 14) physicians did not wait until he had been returned
to his room to deliver the news. "At least on private
ground, with the door shut, the inevitable shock of awful
37
news could have been absorbed, apart from the eyes of
alien gawkers, by the only two human beings involved"
(1994, p. 14). Like Frank, Price chose not to express
his anger until he does so in the writing of his book.
As in the previous example, a mere report of Price's
feelings of anger or frustration would not have been
adequate for the reader to understand his experience.
Instead, Price sets the scene and provides a context
within which the scene unfolds. Only then is the reader
able to comprehend Price's experience.
Another example of Sarbin's second principle can
been seen in the following excerpt. Price expresses a
feeling of elation upon receiving a recommendation that
he enter a rehabilitation program. Again, he presents
the background which prompted the scene: his physical
condition was worsening as was his state of mind. His
radiologist, upon completion of his treatment indicated
that his prognosis was poor. At the urging of a relative
and his caretaker, he sought medical advice from yet
another neurologist. In this excerpt, he introduces the
actors, describes the scene, and tells what the actors
did and said.
At his office in Greenville Dr. Ross Shuping spent
an uninterrupted seventy minutes examining me and
observing my walk as I hung my arms around his and
Dan's shoulders and dragged myself across five yards
of floor. Then he sat us down and confronted me
eye-to-eye with clear and believable
conclusions.... He said I was obviously in bad shape
38
for walking; that hard reality would likely not
improve. I was, equally obviously, not dying fast....
He further said that I might well have many
years to live; how was I going to navigate them?
What I needed, he said--and he urged me to find
it immediately--was a thorough course of re-education
at a rigorous in-patient rehabilitation center that
could show me one of two things: how to lead an
independent life with my losses or, failing that,
how to use whatever strengths I had and might go
on having in whatever future I got with companions.
My response was elation....(1994, pp. 96-97)
Price's response to this was to immediately take a tour
of the state rehabilitation facility and to write in
his calendar (an activity in which he participated
inconsistently throughout his illness) of his hope. The
actors, the setting and the interactions among the actors
are clear, but what feature of the encounter instigated
Price's action of investigating the rehabilitation
facility and noting his feelings in his calendar? It
was Price's enthusiasm toward receiving positive, concrete
recommendations--a sharp contrast to negative prognosis
he had received from other physicians. Without this
contrast, the reader would not be in a position to grasp
Price's sudden and intense feeling of elation.
These narratives present the reader with the contexts
that account for each man's reports of emotions and his
ensuing action: writing a book, touring a rehabilitation
center or making notes in a calendar. Without the
backgrounds provided in these narratives the reader would
have no basis on which to understand each authors mode
of conduct.
39
The third principle of Sarbin's theory states that
the narratory principle guides and organizes human thought
and action. Given two or three phrases or pictures, humans
will, according to Sarbin, relate them in such a way
as to form a story that links the phrases or pictures
in a meaningful way. Price confirms this in his own story
when he first comes to terms with the fact that he has
a long malignant tumor in his spinal cord.
This lethal eel is hid in my spinal cord and will
kill me. From early childhood I'd had a tendency
to think in pictures more than in words....So once
my mind was sober again, I quickly saw the threat
as a thing, a visible object; and from the first
that object was a dark gray eel embedded live in
the midst of my spine. (1994, p. 29)
Given his diagnosis, Price creates a story of an eel
attacking him. He refers to the "eel" ("...the blind
eel bumbling toward my brain" [1994, p. 36], "...my first
instinctive image of the tumor as an alien and deadly
eel concealed in my cord" [1994, p. 52]), and his ensuing
"war" against it throughout his book.
Now at last I must enter what was plainly a war,
with lifeor-death stakes, and assume the fight in
the only way I knew to fight--in the arts of
picture-making and storytelling that I'd worked
at since childhood. I'd be myself to the outer limit
of all I could be, resourceful as any hunted man
in the bone-dry desert, licking dew from cactus
thorns. So even that early, I'd cast myself as the
hero of an epic struggle....(1 994, p. 31)
He even went on to write a poem entitled "The Eel" (see
appendix A for the full poem) and in it refers to his
fight: "To fight this hardest battle now--" (1994, p.
40
204). The story of this eel and his war against it is
the story of his experience with cancer; it is this story
that gives meaning to his suffering and his eventual
recovery.
Frank did not envision his cancer as something to
be fought as Price did. As described earlier, Frank found
comfort in accepting his cancer as an integrated part
of himself rather than some foreign object within.
However, the narratory principle still guided his thinking
about the disease.
Though I did not personify my tumors, it seemed
useful to visualize them. This process has nothing
to do with fighting cancer. I simply allowed images
of the tumors, to appear, with as little conscious
direction as possible, and visualized them
disappearing.... I imagined the white cells, but
an image of them attacking the tumors never came
to me. They were simply there, on guard, standing
silhouetted on mountain cliffs. My imagination gave
the white cells the form of ancient Greek soldiers,
perhaps because my white cell count reminded me
of the number of Greeks at the battle of Marathon,
a word that has particular connotations for me as
a runner. (1991, p. 85)
Frank likens his experience with cancer to that of running
a marathon. He states that running a marathon, although
a struggle, cannot be a fight. To succeed in a marathon,
one must "coddle the body" (1991, p. 86). If treated
gently, Frank says, the body knows how to run, "you have
to learn to let it" (p. 86). The following example
illustrates how his experience of cancer became the
story of a marathon runner by allowing the body to take
care of itself.
41
During cancer I tried to let my body do what it
wanted with the tumors. The white cells, my Greek
guards, were there, watching. The tumors had no
identity, no faces, hardly even shapes. Flaccid
and without purpose, they were vulnerable. They
had no basis for survival. It wasn't necessary to
"attack" them; they simply disappeared. (1991, p.
86)
Thus, the scenario of Greek soldiers on the mountain
cliffs and the struggle of a marathon runner becomes
the narrative structure which organized Frank's thought
process about his disease.
Price uses the narratory principle to organize and
give meaning to an extraordinary experience which, at
first, was difficult for him to understand.
An actual happening intervened with no trace of
warning. I was suddenly not propped in my brass
bed or even contained in my familiar house. By the
dim new, thoroughly credible light that rose around
me, it was barely dawn; and I was lying fully dressed
in modern street clothes on a slope by a lake I
knew at once. It was the big lake of Kinnereth,
the Sea of Galilee, in the north of Israel— green
Galilee, the scene of Jesus' first teaching and
healing. (1994, p. 42)
He continues with a detailed description of seeing Jesus
and his twelve disciples, and of how Jesus pardons him
of his sins and proclaims that he is cured.
Jesus silently took up handfuls of water and poured
them over my head and back till water ran down my
puckered scar. Then he spoke once— "Your sins are
forgiven"--and turned to shore again, done with
me.
I came on behind him, thinking in standard
greedy fashion, 'It's not my sins I'm worried about.'
So to Jesus' receding back, I had the gall to say
"Am I also cured?"
He turned to face me, no sign of a smile, and
finally said two words--"That too." Then he climbed
42
from the water, not looking round, really done with
me.
I followed him out and then, with no palpable
seam in the texture of time or place, I was home
again in my wide bed. (1994, p. 43)
Price was unsure if the incident was a dream or something
"real". Unable to answer that question, he forms a
narrative through which he comprehends the experience
as a spiritual event. This event served as a source of
strength and hope throughout the course of his disease.
Later in the book, Price tells how this experience
influenced his drawing, an activity in which he engaged
regularly while he was ill. Upon confiding this incident
to his cousin, she asked him to sketch the scene for
her.
When I was done, rough as I'd drawn it, the sketch
showed at least the relative positions of Jesus
and me and the purple oblong that boxed my wound.
The fact of regaining just that much on paper
triggered the subject of all the dozens of drawings
I'd make in the next two years. They were all, every
one, meditations on the face of Jesus; and looking
back through them now, I can wonder how I narrowed
so much of my limited strength and hope for survival
down to the space of a sheet of paper with a few
brushed lines in search of the face that had driven
Western art for more than a thousand years. (1994,
p. 75)
The narrative Price creates out of this experience allows
the experience to be meaningful in relation to his pain
and suffering. Furthermore, as Price explains in the
excerpt above, the narrative guides not only his thought,
but also his action.
43
Each author, in facing life threatening disease,
excruciating pain, and treatments with horrible side
effects, makes sense of his experience through the
narratory principle. Each event, from the initial
diagnosis, through the various treatments, eventual
healing, and the subsequent writing of a book, contributes
to the unfolding plot which organizes each man's life
into a meaningful story.
Sarbin's final principle suggests that "passions,"
forms of conduct which are intimately connected to the
process of communicating a moral position and which
maintain a high degree of individual involvement, are
rhetorical acts intentionally performed to maintain one's
moral identity. Moral identity will be discussed in more
detail later. Frank and Price each gave examples of
passionate encounters throughout their books. However,
it will be demonstrated that the act of writing the book
was, in itself, a passion, or rhetorical act.
A simple example of this principle can be seen early
in Frank's book when he tells of a conversation he had
with his doctor regarding his heart attack.
Professional talk goes this way: A problem seems
to have come up, more serious than we thought, but
we can still manage it. Here's our plan; any
questions? Hearing this talk, I knew full well that
I was being offered a deal. If my response was
equally cool and professional, I would have at least
a junior place on the management team. I knew that
as a patient's choices go, it wasn't a bad deal,
so I took it. (1991, p. 10)
44
The passion was fear. Frank chose a mode of conduct,
to be cool and professional, in order to maintain the
moral position of the "good" patient so that he would
be allowed to participate in the decision making process
surrounding his treatment. Obviously he was highly
involved in this exchange; his life was at stake. "My
body is the means and medium of my life; I live not only
in my body but also through it" (1991, p. 10).
Price chose a similar mode of conduct when faced
with the seriousness of his condition. Not only did he
behave in a cool and professional manner with his
physicians, he also chose not to be too inquisitive.
At no point did I ask to see my voluminous medical
charts....From the start of the trouble, I made
a conscious choice not to open my file and confront
what doctors believed was the worst--I saw in their
eyes that they had slim hope, and I knew I must
defy them....All my life I've tended to try to meet
people's hopes. Predict my death and I'm liable
to oblige; keep me ignorant and I stand a chance
of lasting. (1994, p. viii)
This is a mode of conduct Price practiced throughout
his ordeal in response to his fear. Knowing that his
moral identity had always been that of an obliging
individual, he desperately wanted this to change in
order to preserve his life.
Sarbin refers to these choices of moral conduct
as rhetorical acts and states that they are orchestrated
to bring about changes in relationships between oneself
and others. He goes on to say that rhetorical action
45
is the most powerful method of bringing about or resolving
dubiety of human interaction. In the example above, Frank
chose to accept the deal, that is, to refer to his heart
attack as though he were speaking of a malfunctioning
auto part. This action required that he squelch his fear
and dissociate himself from "the problem." In doing so,
he guaranteed that the physician would allow him to be
privy to the decisions regarding his treatment. Being
part of "the management team" as he put it, rather than
a subordinate with no voice was the change in the
relationship between Frank and his doctor that he sought.
Price, on the other hand was afraid of his lack of ability
to dissociate himself from the prognosis. He therefore
deliberately chose to remain in the dark regarding the
likely outcome of his condition. This conduct created
uncertainty for Price; he preferred uncertainty to
assurances of certain death. He claimed to be an obliging
person when faced with others expectations and this was
the relationship he hoped to change.
In his discussion on rhetorical action, Sarbin
distinguishes between two types: dramaturgic and
dramatistic. The goal of dramaturgic rhetorical action
is impression formation. The individual authors the script
as it unfolds with the intention of convincing his
audience--sometimes his or her self--of the soundness
of his or her claims.
46
Following his heart attack, Frank engaged in the
dramaturgic rhetorical action described below.
Fifteen months after my heart attack I was once
again feeling healthy. In July I competed in a
swim-bike-run triathlon, finished within a minute
of my time two years earlier, and decided I was
back where I had been. That was what I wanted from
recovery— to get back to where I was before. (1991,
p. 22)
By participating in the race, Frank's goal was to convince
himself that he was again back to normal as if nothing
had ever happened. If he could meet such a rigorous
physical demand just as he had prior to his heart attack,
then he must be back to his old self. He was the author
of the script; the action was intentionally carried out.
In this example, he was also the audience, the intended
recipient of persuasion.
Price also gives an example of dramaturgic rhetorical
action in which he is the target audience. Similar to
Frank, the action was in response to the fear that his
health was not what it should be. Through his writing
of poetry, Price attempted to convince himself that he
was merely in need of some rest.
Rest. The promise of a week like silt
In a sweetwater delta, stirred only by minnows
and the mutter of each slow skin of nacre
As it welds to the pearl of a somnolent oyster--
Mindless companion while I too mutter
Round my gritty core, this ruined glad life. (1994,
p. 7)
As in the example by Frank, Price is the author of the
unwritten script as he monitors feedback from his audience
47
(in this case himself). Price's writing and drawing were
the primary types of dramaturgic rhetorical action in
which he engaged to address his fears throughout his
illness. In another example Price tries to convince
himself that his fear stemming from the series of
nightmares that suggested he would die from cancer was
unfounded. He wrote the poem entitled "The Dream of
Refusal" (see Appendix B for the entire poem) which ended
with, "I will walk all night. I will not die of cancer.
Nothing will make me dance in that dark (1994, p. 30).
An example of dramaturgic rhetorical action where
the intended recipient of persuasion is other than the
self can be seen in the following excerpt by Price.
But on through the early days of rehab, still I
fiercely denied that my losses were permanent.
Whenever my assigned trainer--a pleasantly tough
young physical therapist named Wilkie Thomas--would
remark that I was paraplegic, I'd correct her:
"I can walk. I just need help."
Yet my calendar shows that on the third day,
Wilkie told me "Walking is now an unrealistic goal."
She repeated it firmly the following day when I
brought her to my room on the ward and demonstrated
the few steps I could manage in a walker. (1994,
P. 99)
Here Price attempts to convince his therapist that she
is wrong, that he could still walk. By his action, he
remains the creator of the script, however, his therapist
is now the audience.
The second type of rhetorical action, dramatistic,
differs in terms of authorship. Rather than being
self-authored, dramatistic rhetorical action is culturally
48
prescribed. Societal standards of behavior dictate
dramatistic rhetorical action and this type of action
is geared toward the development of or solution to the
moral problems that arise in human interaction. Whereas
dramaturgic rhetorical action addresses image formation,
dramatistic rhetorical action addresses the valuation
of the actor's identity in relation to the Good through
concepts such as justice, honor, shame and duty.
An example of dramatistic rhetorical action can
be seen in the following excerpt by Frank. Frank was
angry that throughout his interaction with medical
professionals he had been treated merely as a disease
and was never recognized as a complete human being.
The night before I had surgery, I was visited by
an anesthesiologist who represented the culmination
of my annoyance with this nonrecognition. He refused
to look at me, and he even had the facts of the
planned operation wrong. When he was leaving, I
did the worst thing to him I could think of: I
made him shake hands. A hand held out to be shaken
cannot be refused without direct insult, but to
shake a hand is to acknowledge the other as an equal.
The anesthesiologist trembled visibly as he brushed
his hand over mine, and I allowed myself to enjoy
his discomfort.... I wanted him to recognize that
the operation I was having and the disease it was
part of were no small thing. (1991, p. 55)
The moral issue was one of equality. Frank wanted to
be recognized as a fellow human being, not as a laboratory
rat or research specimen. He took advantage of the
culturally prescribed mores associated with the gesture
of shaking hands to obtain the recognition he sought.
In a similar situation with his surgeon, he refused to
sign the consent form for the surgery. Only then did
his surgeon take the time to speak to him.
We then had a long conversation. His knowledge and
experience helped me, but this help came only after
I had hit him with the only two-by-four a patient
has. Or perhaps, in the inverted world of hospitals
my not signing permitted him to have the kind of
contact he would like to have with patients but
cannot justify. (1991, p. 102)
Frank acknowledges the hospital culture which discourage
patients from asking too many questions and physicians
from spending too much time with patients. To resolve
the feeling of inequality, he purposefully broke the
patient tradition of signing the consent form without
hesitation.
Price addressed an issue of equality as well, but
from a different angle. In his case, it involved his
relationship with his students. After three surgeries,
years of excruciating pain and dependence upon opiates,
Price was finally able to get his pain under control
and return his focus to the pleasures of teaching.
I found myself thoroughly cornered when I heard
my voice tell the new class that I'd write beside
them as a fullfledged contributor. Each time they
owed the group a story, I'd owe the group a story
of the same length and theme.
Years earlier, when I was barely older than
the students, I'd worked at similar commitments
to them. Now that I was silvered, seated and only
a little younger than their grandfathers, this new
round of students eyed me warily. (1994, p. 165)
By making this commitment, not only was the issue of
equality addressed, but also the issue of trust. Price
acknowledges in his book that students automatically
50
distrust any breach of routine and that they likely were
reluctant to commit career-suicide by criticizing his
work. Because the mores of the student-teacher
relationship dictate that students are the producers,
and the professors are to be revered, this was a
dramatistic rhetorical action in which Price created
a moral dilemma for the students. Price's action was
intentional, and cultural norms which define the
student-professor relationship set the scene for the
action.
Rhetorical actions, according to Sarbin, are carried
out in order to maintain or enhance one's moral identity
as it relates to the specific role he or she is attempting
to fulfill. Sarbin discusses two types of role. He defines
social role as the expected conduct of an individual
given his or her position in a group or society. An
individual's performance in a social role is judged by
standards which are public. Social role defines the answer
to the question: who am I? For example, Frank defines
himself as a medical sociologist, husband, father, and
amateur athlete to name a few. Price's social roles
include author, poet, professor, and brother.
Each man, throughout his illness, also fulfilled
the social role of patient which, to a great extent,
precluded participation in other social roles. For
example, Frank stated, "While I was in active treatment,
51
the university where I work was most solicitous.
Arrangements were made for others to teach my classes
when I was too ill, and my department sent flowers to
the hospital" (1991, p. 102). Frank's role as a university
professor was put on hold while he was involved in the
role of patient. The criteria for judging Frank's
performance were public. Putting his role as university
professor on hold during the time he was most deeply
involved in the patient role was expected of him. He
received feedback from co-workers letting him know that
while participating in the role of a cancer patient,
it was acceptable that he set aside obligations of his
role as a university professor. Frank gives other examples
of expected behavior in the patient role. Referring to
interactions with his physicians, Frank states "I acted
exactly as patients are trained to act" (1991, p. 11).
He goes on to describe the expected behavior of the
patient during a patient/physician interaction.
The patient hangs on what brief words are said,
what parts of the body are examined or left
unattended. When the physician has gone, the patient
recounts to visitors everything he did and said,
and together they repeatedly consider and interpret
his visit. The patient wonders what the
physician meant by this joke or that frown. (1991,
p. 56)
He also describes the patient role in relation to
those not in the health care profession.
Society praises ill persons with words such as
courageous, optimistic, and cheerful. Family and
friends speak approvingly of the patient who jokes
52
or just smiles, making them, the visitors, feel
good. Everyone around the ill person becomes
committed to the idea that recovery is the only
outcome worth thinking about. No matter what the
actual odds, an attitude of "You're going to be
fine" dominates the sickroom. Everyone works to
sustain it. (1991, p. 64)
Here the criteria for behavior is clearly and publicly
laid out. Performance is judged by how comfortable and
happy the visitors feel.
The way in which social roles dictate performance
can be seen in the example listed above where Frank tells
of suppressing anger in order to receive the best care.
In this example, it is understood that the patient will
be passive and accepting of the hospital environment.
Cultural norms dictate that patients are passive and
that health care providers, especially physicians, are
not to be challenged. Frank understood that he had to
fulfill the patient role in the traditional manner in
order to receive the best care.
Price's role as a writer was interrupted by his
role as patient as well. "As in all hospitals, time bore
down between events. For me it hung surprisingly heavy
because, for the first time since grade school, I'd run
head-on into a block on my work" (1994, p. 34). A few
months following his radiation treatments, he had still
not returned to his role as writer. "Still I had no
thought of returning to my novel; I could barely make
myself enter the study, and the sight of my computer
53
was literally repellent" (1994, p. 53). Yet despite this
interruption, Price received an opportunity to return
to his role as a writer.
Still, it was mid-fall and work didn't come....Then
chance, or something more conscious, intervened.
In early November I got a call from Hendrix College
in Arkansas....The strong theater department at
Hendrix was under the direction of Rosemary
Henenberg....and it was she who called now to ask
if I'd accept a commission from the department to
write a play for their students....
But first I made a full disclosure; I told
Rosemary they'd be taking a bet on a man in trouble,
with a clouded future.
She'd heard nothing of my situation, but her
Texan voice was undeterred--would I write the play?
(1994, pp. 86-87)
Again, the expectations and standards of conduct for
fulfilling this social role of playwright were public.
An entire theater department of faculty and students,
not to mention the future audiences, were anticipating
a play of quality from him. Our cultural principles of
conduct suggest that when one accepts a commission to
write a play, a play of quality will be produced within
the prescribed time frame. Price was fully aware of this
and expressed concern regarding his ability to meet these
standards. He knew that these expectations were based
solely on his role as a writer without regard to his
role as a cancer patient.
The other type of role Sarbin discusses is labeled
identity role. Performance in this type of role addresses
the codes of morality such as goodness and fairness.
Identity roles are carried out within the context of
54
social roles and are what qualify social roles. Standards
of performance can be public or private, but are
orchestrated intentionally with the self as agent in
defense of his or her identity role.
Frank provides an example of how he felt his identity
role was challenged when he became ill.
Every day society sends us messages that the body
can and ought to be controlled. Advertisements for
prescription and nonprescription drugs, grooming
and beauty advice, diet books and fitness promotion
literature all presuppose an ideal of control of
the body. Control is good manners as well as a moral
duty; to lose control is to fail socially and
morally. But along comes illness, and the body goes
out of control. (1991, p. 58)
Frank viewed himself as a well-mannered, morally
upstanding, successful member of society. When cancer
struck and he had lost control of his body, this
perception was challenged and he began to feel at though
he had somehow failed.
Price addresses the issue of magnanimity as his
identity role was challenged as he suffered from cancer
and its treatments.
From my pained but hilarious and magnanimous parents,
I'd half understood that a normal life is sacrificial
and is lived in good part, as in their case, for
the sake of others or somehow for the unknown. This
patch of fate I was treading now surely felt like
sacrifice, though I often wondered for whom or what.
In prayer I even occasionally tried to offer my
trials in substitute for certain others whom I valued
and saw in serious pain of their own, but a victim
needs to be braver than I to take much comfort from
that thin gruel--thin and mysterious (you'll never
know if your pain is credited to another's account).
(1994, p. 54)
55
In this case, as in the previous example by Frank, Price's
identity role was challenged by disease. Here Price
explains that he was raised to believe that to be good,
one should be above resentment, unselfish and gracious.
As he points out, it was difficult to maintain magnanimity
when he could not see any benefit to himself or others.
In an attempt to defend his identity role of a magnanimous
soul, he first engaged in the rhetorical act of offering
deals during prayer. Price states that he never felt
as though his suffering was a punishment for past sins
and therefore found it difficult to remain noble of heart
and forgiving when there was no clear reason for his
agony. As his prayers continued to go unanswered, Price
began to use his drawing as offerings.
I know that the drawings became my main new means
of prayer when my earlier means were near exhaustion.
By now I'd asked a thousand times for healing, for
ease and a longer life. But calamity proceeded,
and even the repetition of "You're will be done"
had come to sound empty. So the drawings were a
sudden better way, an outcry and an offering. (1994,
P. 76)
Price's prayers and drawings were rhetorical acts that
were intentionally carried out in the defense of his
moral identity within his social roles as Christian and
artist.
Sarbin's final concept is that of embodiment. Sarbin
suggests that passions are rhetorical acts in which there
is little differentiation between self and role, that
they involve the entire organism including physiological
56
changes and increased energy expenditure. In contrast,
Sarbin explains that actions of lesser intensity involve
greater differentiation between self and role where few
of the organism's systems are called into play.
Frank discusses the manner in which the emotions
experienced with serious illness involve high degrees
of embodiment. The first example he presents is in
reference to his heart attack but can easily be
generalized to his experience with cancer as well.
What happens when my body breaks down happens not
just to that body but also to my life, which is
lived in that body. When the body breaks down, so
does the life. Even when medicine can fix the body,
that doesn't always put the life back together again.
Medicine can diagnose and treat the breakdown, but
sometimes so much fear and frustration have been
aroused in the ill person that fixing the breakdown
does not quiet them. (1991, p. 8)
He goes on to say, "What happens to my body happens to
my life. My life consists of temperature and circulation,
but also of hopes and disappointments, joys and sorrows,
none or which can be measured" (p. 13). Here Frank laments
the impossibility of separating self and role. The self
is his broken down body; the roles are the various
positions he holds in society such as husband, friend,
and employee. "Disease cannot be separated from other
parts of a person's identity and life. Disease changed
my life as husband, father, professor, and everything
else" (p. 57). The resulting rhetorical action was likely
57
the writing of his book, and this is discussed in more
detail below.
Price also presents examples of passions and the
accompanying high levels of embodiment. The first excerpt
refers to his admission to the hospital for tests prior
to receiving his diagnosis of cancer, but after he began
to realize he had a serious problem. Reference has already
been made regarding Price's determination to stay ignorant
of his prognosis lest he fulfill it.
Inquisitive to a fault though I'd been all my life,
some deep-down voice was running me now. Its primal
aim was self-preservation. Don't make them tell
you, and it may not happen. Whatever they tell you
may be wrong anyhow. Stay quiet. Stay dark. (1994,
p. 1 1 )
Price tells of a "deep-down", or embodied voice that
runs him. Self, the embodied voice was undifferentiated
from his role as patient at that moment. Staying dark
and quiet as the voice instructed was the rhetorical
action aimed at self-preservation.
A high degree of embodiment can be seen in the
example below describing Price's nightmares following
his first surgery when he realized the surgery did little
to save his life.
The picture-making went on with a vengeance for
the next three nights, force-feeding me all the
omens and fears that the opiate had screened. On
morphine I'd slept too deeply to dream. Now suddenly
withdrawn, I felt the pain of both my wounds, to
mind and body. On successive nights I responded
by staging, for the first time in years long credible
nightmares. (1994, p. 29)
58
Again, Price's entire being was involved with his fear.
As he states, he experienced pain of body and mind which
culminated in a series of horrifying nightmares. The
resulting rhetorical action was Price's writing of his
poem "The Dream of Refusal" where he attempted to convince
himself that he would not succumb to his fears.
In their books, both authors talk of their need
to suppress their emotions in order cope with their
treatment. Frank did so in order to "make the best deal"
with health care providers. Price, on the other hand,
did not want to acknowledge his prognosis for fear that
it would come true. Only after their ordeals had ended
and they were presumed to be in remission did they feel
safe to express these emotions. In keeping with Sarbin's
theory, the writing of their books can be interpreted
as passions or rhetorical actions in response to the
emotions they experienced after receiving a diagnosis
of and surviving the experience of cancer.
Each man experienced a variety of emotions ranging
from fear, frustration, and anger to hope, joy, and
gratitude. These emotions are expressed via the narratives
in their books and these narratives often share a common
theme of justice or fairness. For example, throughout
his book, Frank discusses his frustration with the
expectations placed upon him to act the role of a patient,
to be passive, silent, cheerful and unquestioning. He
59
felt it to be too risky not to conform to these
expectations during his illness, but expresses his
frustrations and anger in his book.
Too many ill persons are deprived of
conversation....By talk about illness, I do not
mean explanations of their diagnoses and treatment.
What most ill persons say about their illness comes
from their physicians and other medical staff, not
from themselves. The ill person as patient is simply
repeating what has been said elsewhere--boring
second-hand medical talk. When ill persons try to
talk in medicalese, they deny themselves the drama
of their personal experience.
Ill persons have a great deal to say for
themselves, but rarely do I hear them talk about
their hopes and fears, about what it is like to
be in pain, about what sense they make of suffering
and the prospect of death. Because such talk
embarrasses us we do not have practice with it.
Lacking practice, we find such talk difficult. People
then believe that illness is not something to talk
about. They miss the opportunity of learning to
experience it with another. Renewal is easiest if
it is a shared process. (1991, p. 4)
Frank eventually came to accept the limitations he faced
in dealing with the medical field as an ill person,
however his frustration and sense of injustice remained.
After five years of dealing with medical
professionals in the context of critical illness... I
have accepted their limits, even if I have never
become comfortable with them. Perhaps medicine should
reform itself and learn to share illness talk with
patients instead of imposing disease talk on them.
Or perhaps physicians and nurses should simply do
what they already do well--treat the breakdowns--and
not claim to do more. (1991, p. 14)
According to Sarbin, Frank's feelings of anger and
frustration stemmed from what Frank felt was an attack
of his identity role as an equal, someone to be
recognized. By behaving in the prescribed manner of the
60
patient role, Frank felt cheated. To be a good patient,
he ceased to become a fellow human being. Writing the
book was the dramatistic rhetorical act in which Frank
defends his identity role by claiming that he needed
to experience his illness fully and that he needed this
experience to be recognized. In the beginning of his
book he states, "However much suffering there is and
however much we want to avoid being ill, we may need
illness. Expressing that need, finding the terms in which
to celebrate illness, is the task that lies ahead" (1991,
p. 15).
Price had the same experience with some of his
medical professionals. He laments the passing era of
the family doctor who came to the patient's home and
who knew the patient in other roles.
In my experience, those doctors never indulged in
false consolation...but the depth of understanding
that they gained by submitting themselves to the
lives of their patients--as opposed to demanding
that their patients come to them, however
painfully--gave them a far better chance of meeting
the sick as their equals, their human kinsmen, not
as victim-supplicants broiled in institutional light
and the dehumanizing air of all hospitals known
to me. (1994, p. 145)
He also accuses modern medical professionals of lacking
the skills to treat patients with equality and concern.
Those are merely the skills of human sympathy, the
skills for letting another creature know that his
or her concern is honored and valued and that,
whether a cure is likely or not, all possible efforts
will be expended to achieve that aim or to ease
incurable agony toward its welcome end....What else
but the urge to use and perfect such skills on other
61
human beings in need could drive a man or woman
into medicine? What but a massive failure to
recognize one's stunted emotions before they blunder
against live tissue--that and an avid taste for
money and power? And having blundered on other
creatures, how can the blunderer not attempt to
change?...Maybe we have the right to demand that
such a flawed practitioner display a warning on
the office door or the starched lab coat, like those
on other dangerous bets--Expert technician. Expect
no more. The quality of your life and death are
your concern. (1994, pp. 145-146)
Like Frank, Price felt as though his identity role as
an equal human being had been attacked by certain members
of the medical profession. The writing of his book was
the resultant dramatistic rhetorical action.
Frank uses his writing to express his feelings of
guilt and shame of the stigma associated with being a
cancer patient.
Whenever I told someone I had cancer I felt myself
tighten as I said it....A heart attack was simply
bad news. But I never stopped thinking that cancer
said something about my worth as a person. This
difference between heart attack and cancer is stigma.
A stigma is, literally a sign on the surface of
the body marking it as dangerous, guilty, and
unclean. (1991, p. 91)
He goes on to say, "During my heart problems I could
no longer participate in certain activities; during cancer
I felt I had no right to be among others" (1991, p. 92),
followed by, "The sad answer is that I experienced the
visible signs of cancer as defects not just in my
appearance, but in myself" (p. 92). Frank believed that
his worth as a human being was diminished once he had
been diagnosed with cancer. Furthermore, he felt that
62
in some way he was a failure. These feelings challenged
his identity role of a valuable member of society. Writing
the book was the dramatistic rhetorical action in which
Frank chose to address his feelings of stigmatization.
"To lose the sense of stigma, persons with cancer must
come in from the margins and be visible. Organizations
of ill persons are one form of visibility; I hope this
book will be another" (1991, p. 97).
Frank also experienced guilt when he was not able
to fulfill his social role as an employee during the
time he was ill. This guilt turned to anger when he was
chastised for a decrease in productivity on the job.
In the annual assessment written about each faculty
member, the time of my illness was described as
showing a "lack of scholarly productivity." I had
to remind the administrator who wrote the report
to specify that this lack was due to illness. But
illness does not matter for institutions.... Since
most of us have to work, it is hard for ill persons
to resist accepting "productivity" as the measure
of our worth. (1991, pp. 102-103)
Frank continues, "The sad logic of such denials is that
the ill person ends up feeling guilty for the disease,
the suffering, or the low productivity" (p. 103). Through
his writing, Frank addresses the unfairness of the
situation and defends himself against this assault on
his identity.
As the prayer I learned as a child in church said,
"We have left undone those things which we ought
to have done, And we have done those things which
we ought not to have done, And"--here's the
punchline--"there is no health in us." What terrible
words to put in the mind of a child! It becomes
63
all too easy for an ill person to work backward:
If there is no health in me, then I must have done
something wrong or at least left something undone.
This kind of confessional thinking led me to
all sorts of regrets....To believe my own
inadequacies were so spectacular that they gave
me cancer is just vanity.
As a bodily process, cancer "just happened"
to me. (1991, pp. 86-87)
In this excerpt, Frank defends his identity role as a
morally upstanding individual that "just happened" to
have bad luck.
Throughout his book, Price often expresses gratitude
towards those who offered him love and support during
his period of hardship.
Jeff Anderson stayed with me, he and Lettie cooked
for me, and during that weekend they made me an
offer of astonishing friendship....Now with no hint
to me, and certainly none from me, Jeff and Lettie
had redrawn their plans for a house they planned
to build on ten acres of woodland I'd sold them
uphill behind me.
Their revised plan included a wing designed
for me and the wheelchair; I'd live with them for
the rest of my life. I thought long and happily
about their gift....No one since the death of my
parents had made me the offer of such a long
commitment, and that fact alone would be as strong
a prop as I'd have in the bone-rattling change that
waited for me six months ahead. (1994, pp. 116-117)
In the prologue, Price states, "the giving of thanks
in many quarters is another big aim here" (1994, p. ix).
He uses the book to uphold his identity role of a gracious
and appreciative friend.
Both men communicate regret that they did not have
opportunities to share in another's similar experience.
64
Their books are attempts to rectify this lack of human
sharing for others who may find themselves in similar
positions.
What I have to tell relates no cures I have
discovered or medical miracles. I got sick, went
through the prescribed treatments, engaged in my
share of obnoxious behavior, managed to cope, and
lived to tell the tale. This tale will not tell
anyone how to cope, but it does bear witness to
what goes into coping. That witness, I believe,
is enough. (Frank, 1991, pp. 4-5)
In Price's prologue, he writes, "The record is offered
first to others in physical or psychic trials of their
own, to their families and other helpers and then to
the curious reader who waits for his or her own
devastation" (1994, p. vii). He goes on to say, "In my
worst times I'd have given a lot to hear from veterans
of the kind of ordeal I was trapped in" (p. vii). It
is the intention of both men, as writers, to share their
experiences with the hope that it may make another's
ordeal a little easier. The creation of these narratives
serves to uphold the authors identity roles of caring,
compassionate members of the human race.
Ultimately, however, Frank and Price wrote their
books to organize and give meaning to their ordeals and
to tell how their experiences changed not only their
lives, but who they have become. The meaning of Frank's
experience was that illness is an opportunity that should
be embraced. "To seize the opportunities offered by
65
illness, we must live illness actively: we must think
about it and talk about it, and some, like me, must write
about it" (1991, p. 3). Frank continues,
For all you lose, you have an opportunity to gain:
closer relationships, more poignant appreciations,
clarified values. You are entitled to mourn what
you can no longer be, but do not let this mourning
obscure your sense of what you can become. You are
embarking on a dangerous opportunity. Do not curse
your fate; count your possibilities. (1991, p. 7)
Frank also discusses the value he now assigns to illness.
The ultimate value of illness is that it teaches
us the value of being alive; this is why the ill
are not just charity cases, but a presence to be
valued. Illness and, ultimately, death remind us
of living....Death is no enemy of life; it restores
our sense of the value of living. Illness restores
the sense of proportion that is lost when we take
life for granted. To learn about value and proportion
we need to honor illness, and ultimately to honor
death. (1991, p. 120)
Finally, Frank tells of his changing identity.
After cancer I had no desire to go back to where
I was before. The opportunity for change had been
purchased at too great a cost to let it slip away.
I had seen too much suffering from a perspective
that is often invisible to the young and the healthy.
I could not take up the same game in the old terms.
I wanted less to recover what I had been than to
discover what else I might be. Writing is part of
this discovery. (1991, p. 2)
Price's experience was disastrous and catastrophic.
However, through his writing, he was able to organize
and give meaning to it.
But if I were called on to value honestly my present
life beside my past— the years from 1933 till '84
against the years after--l'd have to say that,
despite an enjoyable fifty-year start, these recent
years since full catastrophe have gone still better.
66
They've brought more in and sent more out— more
love and care, more knowledge and patience, more
work in less time. (1994, p. 179)
Price also took the opportunity to appreciate things
that, prior to his illness had been taken for granted.
The very fact of strict limitations soon had me
tasting a fresh intensity of focus and pleasure
in the strengths that were left me. I'll risk the
claim that, from the time I left rehab, I've taken
more pleasure than most adults ever come to know
from my present eyesight, hearing and taste, from
the stretches of my skin that still have feeling,
and from my mind's new grip on patience--surely
more pleasure than I'd known till now, and I've
been a competent epicure. (1994, p. 102)
A changed identity is something Price experienced
as well. In his book he laments that he was not prepared
for this and had no guidance in creating a new one.
Nobody known to me...is presently offering useful
instruction in how to absorb the staggering but
not-quite-lethal blow of a fist that ends your former
life and offers you nothing by way of a new life
that you can begin to think of wanting, though you
clearly have to go on feeding your gimped-up body
and roofing the space above your bed.
So after ten years at what seems a job that
means to last me till death at least, I'll offer
a few suggestions from my own slow and blundering
course. (1994, p. 181)
He goes on to say,
The kindest thing anyone could have done for me,
once I'd completed five weeks' radiation, would
have been to look me square in the eye and say this
clearly, "Reynolds Price is dead. Who will you be
now? Who can you be and how can you get there,
double-time?" (p. 184)
Price advises the reader in the face of disaster to ask
not "Why me?" but "What next?"
67
In Price's final chapter he explains what he has
tried to accomplish with his book.
As truly as I could manage here in an intimate
memoir, without exposing the private gifts of men
and women who never asked to perform in my books,
I've tried to map the lines of that change and the
ways I traveled toward the reinvention and reassembly
of a life that bears some relations with a now dead
life but is radically altered, trimmed for a whole
new wind and route. A different life and— till now
at least, as again I've said--a markedly better
way to live, for me and for my response to most
of the people whom my life touches. (1994, p. 189)
In keeping with Sarbin's theory of emotions as
narrative emplotments, Frank and Price share their
experiences with cancer through the use of narrative.
Because narrative provides context, plot, temporality,
and a means for organizing and giving meaning to
experience, the reader is able to truly understand the
authors' feelings and resulting actions. The act of
writing a book was, for each man, a dramatistic rhetorical
act aimed at defending his identity role of a worthy,
contributing member of the human race, deserving of
recognition despite, or because of his illness. This
rhetorical act was carried out within each man's social
role of writer. Certainly for Price--"My work admittedly
has been of the sort that, when it's available, permits
deep absorption" (1994, p. 186)— and likely for Frank,
writing the book involved a level of embodiment on the
high end of the continuum. Thus, the act of writing their
68
books, according to Sarbin, was a passion resulting from
the emotions experienced in receiving a diagnosis of
and surviving the treatment for cancer.
69
Chapter 5 - Conclusion
The purpose of this project was to examine the
pragmatic value of Sarbin's theory of emotions as
narrative emplotments and to determine its usefulness
in the field of occupational science and the practice
of occupational therapy. The narratives chosen for
analysis are the stories of two men, their experiences
with cancer and of the impact of these experiences on
the unfolding stories of their lives. The narratives
were not written for the purpose of demonstrating the
influence of emotions on action, but are indeed the result
of the influence of emotions on action.
Following the analysis in chapter four, the question
arises: do the stories of the two authors support Sarbin's
theory? The answer is yes on several levels. First, Sarbin
claims that narrative provides the necessary information
to communicate meaning when studying emotions. Without
it, meaning is lost and left to the imagination of the
recipient of the report of the emotion. Plot contributes
to the understanding of each man's experience. The
narratives of Frank and Price consist of series of events
which relate not only the individual emotions the men
report in their books, but also the their overall
experience with cancer and its treatment. The temporal
quality of narrative is also seen in these stories. The
reader is aware of a sense of time or a sense of Frank's
70
and Price's lives moving through time from the start
of their troubles to the writing of their books. This
sense of the passage of time further clarifies the
relationship between the series of events which make
up the plot. It has also been shown through their
descriptive reports of mental images and interpretations
that their narratives provide an organizational structure
or cognitive scheme within which an understanding of
their experiences can be achieved.
Sarbin also suggests that narrative presents
situations analogous to theatrical scenes which indicate
to the reader who the actors are, what the setting is,
when the actions took place, how the actors responded,
and what features of the scene contributed to the
situation. This information is also necessary in the
communication of human emotion and action and is provided
throughout each man's book. Both men presented examples
of situations involving physicians, therapists and other
health care workers in various settings that were
emotionally charged.
These narratives were particularly suited to support
Sarbin's principle which states that the narratory
principle guides and organizes human thought and action.
Because these men are writers by trade, producing
narrative to organize their experiences was a natural
step. Both men state in their books that their intention
71
was to communicate the meaning of the illness experience.
In order to accomplish this, the events, emotions, and
actions surrounding their illnesses were organized in
story form. It was also demonstrated in the previous
chapter how both men used the narratory principle to
guide their thinking about their tumors; one imagined
a war against a monstrous eel in his spine, the other
pictured Greek soldiers standing guard against his tumors.
Finally, these narratives support Sarbin's principle
that suggests passions are rhetorical acts intentionally
carried out to maintain one's moral identity. This was
demonstrated on two levels. First, in the previous
chapter, examples of specific emotions and the resultant
rhetorical actions were presented along with the moral
identity being defended. Each author discussed engaging
in passive behavior stemming from fear, and engaging
in this behavior within the context of his role as
patient. Frank did so to convince his physicians that
he should be included in the decision-making process
surrounding his treatment; Price did so in order to
persuade himself that he would not fulfill his physicians'
predictions. Price also presents examples of rhetorical
action resulting from positive emotions such as the
hopefulness he felt when the possibility of rehabilitation
was presented to him.
72
However, these narratives support Sarbin's fourth
principle on a larger scale as well. The act of writing
a book in and of itself can be interpreted as a rhetorical
act. It was carried out within the context of their social
roles as writers to defend their worth as human beings
despite their illnesses. This and their desire to
communicate the meaning of their experience were the
stated goals of each of their books.
Another question that arises is: Is Sarbin's theory
sufficient to study the relationship between emotion
and action? Sarbin's theory provides a strong basis for
the examination of the more extreme emotions such as
fear, anger, love and hope for all of the reasons listed
above. However, Sarbin himself limits the application
of his theory to these more powerful emotions and
passions, or rhetorical acts aimed at persuasion. The
theory does not address the relationship between emotions
and activity which is not rhetorical in nature. Sarbin's
theory suggests the way in which emotions can influence
one's choice of activity, but it does not address the
manner in which emotions influence one's performance
in activity. Sarbin's theory is also limited in that
it does not consider states of mind or mood and their
relationship to activity.
Based on the analysis of Frank's and Price's
narratives, Sarbin's theory appears to be a useful tool
73
for the field of occupational science. In the process
of examining the influence of the authors' emotions on
their choices of action using Sarbin's theory, several
issues were explored. Both men held the moral conviction
that one's value as a human being does not diminish
because he or she becomes ill. Both men presented the
symbolic meaning they held of their tumors. Both men
discussed their roles as patients, employees, writers,
and loved ones and both men presented the historical
context within which their disease occurred. Sarbin
maintains the necessity of considering these issues in
developing an understanding of human emotion and action.
It is precisely these issues, moral convictions, symbolic
meanings, emotional responses, and sociocultural and
historical contexts which Clark et al. (1991) believe
must be examined in developing theory about human
occupation.
Sarbin's theory also has a place in the practice
of occupational therapy. It provides us with an
explanation of one way in which emotions fuel engagement
in occupation. This knowledge can be put to use in two
ways. First, by attending to the emotional issues that
emerge in his or her patients' stories, the occupational
therapist can acquire a better understanding the patients'
experience as well as some insight into the motivation
behind the patients' actions.
74
Second, principles of Sarbin's theory can be used
to elicit therapeutic action. One of the characteristics
of passions, according to Sarbin, is a high degree of
embodiment. This characteristic of embodiment can be
highly motivating. By providing opportunities for his
or her patients to experience emotions and ultimately
express those emotions through rhetorical action, the
occupational therapist can facilitate therapeutic
activity. Price gives an example of this in his book:
If I try to recall the good moments that relieved
those five weeks of radiation— the moments that
I'm still sure were curative--I come up with a slim
but powerful number of minutes or hours....Among
them a few spring to mind as especially useful.
I've mentioned the attentions of Diana Betz, my
physical therapist, to a body that was daily growing
weaker and less magnetic. I'd lie on the floor three
times a week while she patiently led me through
all I could do....
In a silent honesty that our eyes shared, she
and I knew that the efforts were producing no visible
return of function or strength....
And with all Diana's professional goodwill
and the trust she gave me in confiding problems
of her own, our sessions kept me at least from
loathing the flesh of a body which I'd always
enjoyed...but which now was sliding past my control
at a scary speed. And when Diana told me quietly
at the end of a session that the previous night
she'd dreamt of me walking unaided through the woods
just outside the room where we worked, I responded
with a promise that she and I together would walk
in the beech woods by Thanksgiving. (1994, pp. 59-60)
This example demonstrates how the therapist, by
communicating her degree of investment in and concern
for her patient's recovery instilled in him a sense of
hope despite all evidence that his condition was
worsening. This hope, in turn, resulted in Price's
75
continued efforts in therapy— rhetorical action aimed
at convincing his therapist and himself that he was worth
the effort.
Another issue that was raised by both authors, was
their lack of preparation for and assistance in the
process of changing identities as a result of their
diseases. Both men discuss the struggle they encountered
in this process even though they appreciate the change
in the end. Perhaps occupational therapists can apply
Sarbin's theory to elicit rhetorical action from the
patient geared toward achieving this change more smoothly,
and accepting a new, or certainly altered identity. Price
experienced this to some extent when Dr. Shuping very
clearly pointed out that it was time he get on with his
life with whatever limitations he had and for whatever
time he had. Price's enrollment in a rehabilitation
program was a rhetorical action through which he began
to come to terms with a drastically altered way of life.
By having an awareness of the manner in which rhetorical
action shapes our self concept, occupational therapists
can better guide patients in their choice of occupation.
Perhaps, too, therapeutic occupation can be used
to express emotion. By listening to the patient's story,
the occupational therapist can become aware of the
emotions the patient is experiencing and the ways in
which the patient historically expresses emotion. This
76
information can also assist the therapist in directing
the choice of activity for the patient.
In listening for the stories of our patients and
coming to an understanding of their experiences, the
process of occupational therapy can only become more
enriching and meaningful for patients and therapists
alike. Frank (1991) discussed the value of illness and
the importance of sharing the illness experience.
The ultimate value of illness is that it teaches
us the value of being alive; this is why the ill
are not just charity cases, but a presence to be
valued. Illness and, ultimately, death remind us
of living....Death is no enemy of life; it restores
our sense of the value of living. Illness restores
the sense of proportion that is lost when we take
life for granted. To learn about value and proportion
we need to honor illness, and ultimately to honor
death, (p. 120)
Taking time to hear stories and develop an
understanding of patients' experiences requires an initial
time investment that our current health care system does
not support. Yet surely the efficiency of treatment
following this initial investment is greatly increased.
The therapist, having come to know and understand the
patient, can then effectively choose appropriate modes
of treatment rather than selecting them by trial and
error.
Sarbin's theory of emotions as narrative emplotments
has been applied to the stories of two men diagnosed
with cancer to determine if it has a place in the fields
of occupational science and occupational therapy. Analysis
of the two narratives clearly provides examples of the
manner in which Sarbin claims emotions emplot action
and the ways these actions can be interpreted through
narrative making the theory a useful tool for occupational
scientists. The theory also has a place in the practice
of occupational therapy as it guides therapists in
selecting or providing opportunities for appropriate
activity selection.
78
References
Blanchard, C. & Ruckdeschel, J. (1986). Psychosocial
aspects of cancer in adults: Implications for
teaching medical students. Journal of Cancer
Education, 1(4), 237-248.
Clark, F. A., Parham, D., Carlson, M. E., Frank, G.,
Jackson, J., Pierce, D., Wolfe, R. J., & Zemke,
R. (1991). Occupational science: Academic innovation
in the service of occupational therapy's future.
The American Journal of Occupational Therapy, 45(4),
300-310.
Frank, A. W. (1991). At the will of the body: Reflections
on illness. Boston: Houghton Mifflin.
Frank-Stromborg, M., Wright, P., Segalla, M., & Diekmann,
J. (1984). Psychological impact of the "cancer"
diagnosis. Oncology Nursing Forum, 1_1_(3), 16-22.
Gergen, K. & Gergen, M. (1986). Narrative form and the
construction of psychological science. In T. R.
Sarbin (Ed.), Narrative psychology: The storied
nature of human conduct (pp. 22-44). NY: Praeger
Special Studies.
Gise, L., Israel, S., & Dottino, P. (1989). Medical
psychiatric rounds on a gynecologic oncology service:
End-stage cervical carcinoma in a Jehovah's Witness
refusing treatment. General Hospital Psychiatry,
H(5), 372-376.
Keen, E. (1986). Paranoia and cataclysmic narratives.
In T. R. Sarbin (Ed.), Narrative psychology: The
storied nature of human conduct (pp. 174-190). NY:
Praeger Special Studies.
Lazarus, R. A. (1991). Emotion and adaptation. NY: Oxford
University Press.
Meyer, A. (1977). The psychology of occupational therapy.
The American Journal of Occupational Therapy, 31(10),
639-642.
Packer, M. J. (1985). Hermeneutic inquiry in the study
of human conduct. American Psychologist, 40(10),
1081-1093.
Polkinghorne, D. E. (1988). Narrative knowing and the
human sciences. Albany: State University of New
York Press.
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Price, R. (1994). A whole new life: An illness and a
healing. NY: Atheneum.
Robinson, J. & Hawpe, L. (1986). Narrative thinking as
a heuristic process. In T. R. Sarbin (Ed.), Narrative
psychology: The storied nature of human conduct
(pp. 111-125). NY: Praeger Special Studies.
Sarbin, T. R. (1989). Emotions as narrative emplotments.
In M. Packer & R. Addison (Eds.), Entering the
circle: Hermeneutic investigation in psychology
(pp. 185-201). Albany: State University of New
York Press.
Sarbin, T. R. (1989). Emotions as situated actions. In
L. Cirillo, B. Kaplan, & S. Wapner (Eds.), Emotions
in ideal human development (pp. 77-99). NJ: Lawrence
Erlbaum Associates.
Sarbin, T. R. (1986). The narrative as a root metaphor
for psychology. In T. R. Sarbin (Ed.), Narrative
psychology: The storied nature of human conduct
(pp. 3-21). NY: Praeger Special Studies.
Scheibe, K. E. (1986). Self-narratives and adventure.
In T. R. Sarbin (Ed.), Narrative psychology: The
storied nature of human conduct (pp. 129-151). NY:
Praeger Special Studies.
Slaby, A. & Glickman, A. (1985). Adapting to
life-threatening illness. NY: Praeger Special
Studies.
Vitz, P. C. (1990). The use of stories in moral
development: New psychological reasons for an old
education method. American Psychologist, 45(6) ,
709-720.
Appendix A
The Eel
1. 25 July 1984
Mother, the name of this thing is the eel.
It is one foot long, thick as a pencil
And lives in the upper half of my spine--
Ambitious now to grow all ways.
Every atom of me it turns to it
Is me consumed.
Yet it's been there always,
Original part--which is my first news
For you in years. It came in the first
Two cells of me, a gift therefore
From you or Father— my secret twin
Through those hard years that threatened desolation
But found rescue in dumb resort
To inner company, a final friend
Concealed at the core on which I'd press
Companionship, brief cries for help.
It helped. My purple baby convulsions
That got more notice than a four-car wreck, Weak arms
that balked a playground career
And kept me in for books and art,
Toilet mishaps, occasional blanks--
Tidy gifts to aim and guide me.
I steadily thanked it and on we came,
Paired for service fifty years
*
Now it means to be me. And has made huge gains.
I'm numb as brass over one and a half legs,
All my upper back, groin, now my scalp;
Both arms are cringing weaker today,
And i walk like a stove-up hobo at dawn.
What broke the bond, the life-in-life
That saw us both through so much good?
Mother of us both, you left here
Nineteen years ago--your own brain
Drowning itself, eager blood--
And prayers to the dead are not my line;
But a question then: have you learned a way,
There where you watch, to help me kill
This first wombmate; strangle, fire out
Every trace of one more heirloom
Grinding jaws? Do you choose me to live?
Struggle to tell.
2. 26 July 1984
Mother, this man is now all eel.
Each morning he's hauled upright to a chair
And sits all day by a window near trees.
Pale leafshine honors the green of his skin,
The black-bead eyes. He wants no more;
His final triumph stokes him with permanent
Fuel for the years of wait, twitched
Only by drafts, damp rubs by his nurse
Or mild waves of gravity flushing the compact
Waste from his bore.
He does not know you
Nor the twin he ate. He could not name
The taste of joy, but he licks it slowly
In his bone hook-jaws. He thinks only "Me.
I became all me."
82
3. 26-30 July 1984
Mother, this man will stay a man.
He knows it three ways. First, he's watched
A credible vision--no dream rigged for comfort
But a visible act in a palpable place
Where Jesus washed and healed his wound,
The old eel sluiced out harmless in the lake.
Then a woman he trusts like a high stone wall
Phoned to say "You will not die.
You'll live and work to a ripe old age"--
And quoted Psalm 91's reckless vow,
He will give his angels charge over you
To guard you in all your ways.
Then he knows what a weight of good rests in him,
The stocked warehouses of fifty-one years—
Waiting for export, barter, gift;
Lucid poems of fate and grace,
Novels like patient hands through the maze,
Honest memories of his own ruins and pleasures
(All human, though many blind and cruel).
Years more to teach the famished children
Rising each spring like throats of flowers,
Asking for proof that life is literally
Viable in time.
Long years more
To use what I think I finally glimpse--
The steady means of daily love
In daily life: The patience, trust,
Suspended fear, to choose one soul
And stand nearby and say "Be you.
Be near but you."
And thereby praise,
Thank, recompense to mind of God
That sent me, Mother, through straits of your
Own hectic womb and into life
to fight this hardest battle now—
A man upright and free to give,
In desperate need. (Price, 1994, pp. 200-204)
83
Appendix B
The Dream of Refusal
I've come on foot through dark dense as fur
(Clean, dry but pressed to my mouth)
To find my mother's father's house
In Macon, N.C. I know he's been dead
Since she was a girl, but--stronger--I know
A secret's here I must face to live.
At the end of seventy miles I see it,
Though the dark's unbroken and no light shows
From any tall window or the open door.
I pull myself through the rooms by hand--
All dead, empty, no stick or thread,
Not the house I lived in childhood.
And no more hint of a vital secret
Tank noon sun stamps on a working hand.
I forget my life is staked on this hunt,
That these walls store dried acts or words
To kill or save precisely me who pass
Fool-fearless and out again— the yard, lighter dark.
I'm leaving the place and have reached the thicket
Of shrubs near the road. I step through the last
Clear space that can still be called my goal—
My mother's father's home in Macon.
I lift my foot to enter freedom
(And death? I no longer think of death).
*
Behind me I feel a quick condensation--
Sizable presence barely humming
In furious motion. Fear thrusts up in me
Like rammed pack-ice. But I know again
Why I'm here at all, and slowly I turn
Onto whatever deadly shadow waits.
What seems a small man--blackhaired, young--
Crouches in yellow glow he makes,
A smoke from his skin. I know at once
His motion is dance; that he dances every
Instant he breathes, huddled ecstatic.
His hands are empty. He beckons me.
I know he will make his thrust any moment;
I cannot guess what aim it will take.
Then as--appalled— I watch him quiver,
He says "Now you must learn the bat dance."
I know he has struck. It is why I came.
In one long silent step, I refuse and turn toward home.
84
I will walk all night. I will not die of cancer.
Nothing will make me dance in that dark. (Price, 1994,
pp. 198-199)

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Asset Metadata

Creator Brown, Jennifer Lynn (author)

Core Title The application of Sarbin's theory of emotions as narrative emplotments to stories of two men diagnosed with cancer

School Graduate School

Degree Master of Arts

Degree Program Occupational Therapy

Degree Conferral Date 1995-05

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag health sciences, occupational health and safety,health sciences, oncology,OAI-PMH Harvest,psychology, clinical

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Clark, Howie A. (committee chair), Neville-Jan, Ann (committee member), Porkinghorne, Donald E. (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c18-10719

Unique identifier UC11356843

Identifier 1378402.pdf (filename),usctheses-c18-10719 (legacy record id)

Legacy Identifier 1378402-0.pdf

Dmrecord 10719

Document Type Thesis

Rights Brown, Jennifer Lynn

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA