Emily Mahew and David McArthur's article on diaries makes a good case for the value that inclusion of patient and practitioner perspectives in a written format can bring to an illness experience. It was the complete lack of this perspective that drove my research on Mary Ely, whose story had to be reconstructed largely from newspaper accounts. In many ways, Mary's case reminds me of Charlotte Perkin Gilman's famous short story, "The Yellow Wallpaper." Like Gilman, Mary was treated by the most famous doctor of his day, S. Weir Mitchell. If Mitchell's treatment of Mary was anything like his practice with Gilman, she would have been discouraged not only from recording her thoughts but even uttering them. Expressions of concern that she was not really improving would have been dismissed or ignored since they were antithetical to the absolute submission to a specific cure regimen that was at the heart of Mitchell's practice. Gilman's central character gradually succumbs to madness, with the climax of the story involving her husband breaking down the door and discovering her crawling on hands and knees trying to free a woman whom she insists is imprisoned behind the wallpaper in her room. This parallels Mary Ely's suicide, her dramatic gesture of deliberately stepping in front of a trolley in Camden, New Jersey following a visit with her nurse to Mitchell's office in Philadelphia. Mayhew and McArthur's article made me speculate about the conversation that might have taken place in Mitchell's office that day had she been encouraged to share her thoughts and feelings. I also wonder how a conversation with Mitchell might have modified her course of treatment and ultimately directed her away from her decision to end her life. The diary article makes a compelling case for their use for patients and medical professionals alike. Not only do diaries document events that the patient might not recall, but they also provide sustaining narrative for family members should the patient not survive. At the same time, giving medical professionals the opportunity to record the personal aspects associated with caring for their patients also provides a reminder that at the heart of medical practice is a human being, who is more than the sum total of any diagnosis, no matter how compelling or challenging that diagnosis might be.
Lori Duin Kelly is Professor Emeritus of English at Carroll University, with a special interest in the intersection of gender and medical issues in the 19th century. Her work in this area has appeared in Journal of Medical Humanities, Southern Studies, Legacy, and Studies in Popular Culture as well in a collection of essays on the body, Bodily Inscriptions: Interdisciplinary Explorations into Embodiment. She is currently working on a study of neurologist S. Weir Mitchell's work with Civil War soldiers. Her essay "The Full Measure of Cheerfulness: Mary Ely, Weir Mitchell, and Victorian Views on Treating Melancholia" appears in the Fall 2015 issue of The Intima.
© 2016 Intima: A Journal of Narrative Medicine