Cambridge Medical Humanities Society

Book Club
4pm 20 July 2020

Introduction

‘On Being Ill’ was written by Virginia Woolf in 1925 when she was 42 years old. She had been
suffering from a bout of illness and wrote this essay whilst she was bedridden, considering the
ways that illness transforms our sense of being and the way in which we perceive the world. She
sent it to T. S. Eliot, who then published the work in his first issue of The Criterion in January 1926.

Despite Woolf having had numerous experiences with illness, suffering both mentally and
physically, she claims that illness can also liberate oneself from the normal busyness of life and
inspire creativity. Illness allows her to embrace a state of idleness, void of distractions or
responsibilities, in which she is able to take the time to enjoy simple things that are often taken for
granted.

She argues that illness is transformative and evocative of ‘spiritual change’, where one is able to
explore ‘the snowfield of the mind, where man has not trodden’. Woolf suggests that illness
allows access to certain sensations, ways of thinking and seeing the world that are inaccessible to
us when the body is healthy.

She opposes the concept of mind/body dualism and criticises the way in which matters of the
mind are favoured over that of the body: ‘literature does its best to maintain that its concern is
with the mind; that the body is a sheet of plane glass through which the soul looks straight and
clear, and, save for one or two passions such as desire and greed, is null, negligible and non-
existent.’

The larger question that Woolf explores within this essay is why there is such a ‘poverty of
language’ when it comes to describing the experience of being ill. A phrase such as ‘I am in bed
with influenza’ does little, she says, to convey ‘the great experience; how the world has changed
its shape; the tools of business grown remote; the sounds of festival become romantic like a
merry-go-round heard across fields’.

Emily James writes that ‘Woolf asks how we may reconcile the patient’s illness with the doctor’s
medicine - and whether their respective vocabularies are in fact too far removed, too alien, for
translation’.

Whilst Woolf’s essay did not receive much critical attention during her lifetime, when it was
republished in 2002, there was renewed interest in the work, especially amongst doctors and
scholars of medical history. It is now perceived to have been a pivotal work in the development of
a patient-centred narrative medicine.

Woolf argues that a main consequence of the ‘poverty of language’ for describing the illness
experience is that the medical profession is lacking in empathy. The field of narrative medicine
seeks to utilise language and story to foster empathy, self-awareness, and sensitivity in the
physician, whilst validating the experience of the patient.
  
Further Reading

https://muse.jhu.edu/article/730822
https://medicalhealthhumanities.com/2017/10/03/on-being-ill/
#:~:text=Over%20the%20course%20of%20%E2%80%9COn,with%20sensations%20and%20energ
ies%20accessible
https://ejlw.eu/article/view/31394/28665
https://eprints.soas.ac.uk/26689/6/project_muse_730823%20%281%29.pdf
https://virginiawoolfmiscellany.files.wordpress.com/2013/09/vwm73spring2008.pdf

Discussion

• should a doctor be sympathetic or empathetic?

• Woolf dislikes sympathy
• argues everyone’s world is unique to them, cannot be accessed by others
• would stop us being productive if we constantly took on burden of others
• rejects performative aspect of sympathy
• but many people find solace in groups where people share similar experiences of illness
• not opportunity Woolf would have had
• do patients want to receive empathy?
• want acknowledgment that suffering is unique, authentically their own, yet don’t want to feel
alone

• most people would not be free to be ill, or free to be idle when ill
• experiences are particular to her social class, reflect her privilege
• Woolf enjoys contemplative, liberating aspects of illness
• time takes on different quality when seriously ill, live in present
• asserts universal experience about Hamlet in essay
• contradiction to idea that experience is unique, creates tension at heart of essay

• is it useful to discuss what illness Woolf suffered from?

• retrospective diagnosis can be dangerous
• need to understand why people are different
• does not contribute much to understanding of her work

• last part seems obscure, unrelated to rest of essay

• illness destabilises narrative trajectory
• recreates alienation of illness, intentionally or not?
• escapism of literature as form of recovery from illness

• how is the experience of illness expressed in other art forms?

• lots of memoirs, non-fiction, films, YA fiction about illness now, not much literature
• not treated as seriously as other topics
• ‘When Breath Becomes Air’ by Paul Kalanithi is very good portrayal of experience of illness,
combines perspective of doctor, patient, writer (able to articulate in literary way)
• easier to romanticise illness in visual art forms, aesthetic more important
• dialogue between different forms
• relationship between creativity and mental state for Woolf
• episodes allow her fresh insight, but cannot produce work during those periods
• love-hate relationship with her mental illness
• illness removes you from normal social expectations
• sensations valued over meaning when ill, can take literature and art more at face value
• mind enslaved to body, paradoxically gives mental clarity
• perhaps particular to her mental illness?
• Woolf provides vague generalised (and quite romantic) depiction of illness
• would she say the same about severe chronic illness?

• do other languages express illness better?

• other cultures do not separate mind and body so much
• Western philosophical idea
• medical vocabulary can be narrow
• pain scale is so subjective, don’t have anchor for how 10 feels, 5 feels etc.
• discussion of illness taboo in many cultures
• when there’s a word for an experience, more able to acknowledge/feel that, so language
influences lived experience
• will always be gap between good representation in language and experience

• break down divide between mental and physical pain

• two forms of pain linked
• only a matter of time before discovery of physical basis of the mind
• artificial separation created by philosophy etc.
• mind sees through lens of body

• what can we, as doctors, do to understand experience of illness better?

• different patients want different approaches
• hard for doctors to be source of information and sympathy
• not sustainable for doctors to be too close to patients
• outcomes of narrative medicine not quantitive, hard to prove their value