Written Cancer Narratives : An Ethnomedical Study of Cancer Patients' Thoughts, Emotions and Experiences

Since the second half of the 20th century, cancer has become a dominant disease in Western countries, endangering people regardless of age, gender, race or social status. Every year almost eight million people die of cancer worldwide. In Finland every fourth person is expected to fall ill with cancer at some stage of his or her life. During the 20th century, along with rapid changes in the medical system, people s awareness of cancer has increased a great deal. This has also influenced the image of cancer in popular discourse over the past decades. However, from the scientific point of view there is still much that is unclear about the disease. This thesis shows that this is a big problem for ordinary people, as, according to culture-bound illness ideology, people need an explanation about the origin of their illness in order to help them cope. The main aim of this thesis is to examine the process of being ill with cancer from the patient s point of view, in order to analyse attitudes and behaviour towards cancer and its significance and culture-bound images. This narrative-based study concentrates on patients voicings , which are important in understanding the cancer experience and when attempting to make it more open within current cultural and societal settings. The Kun sairastuin syöpään ( when I fell ill with cancer ) writing competition organised by Suomen Syöpäpotilaat ry (the Finnish Cancer Patients Association), Suomen Syöpäyhdistys ry (the Finnish Cancer Union), and Suomalaisen Kirjallisuuden Seuran kansanrunousarkisto (the Finnish Literary Society Folklore Archive) was announced on the 1st of May 1994 and lasted until the 30th of September 1994. As a result, a total of 672 cancer narratives, totalling 6384 pages, were received, filled with experiences relating to cancer. Written cancer narratives form a body of empirical data that is suitable for content or textual analysis. In this thesis, content analysis is adopted in order to become familiar with the texts and to preselect the themes and analytical units for further examination. I use multiple perspectives in order to interpret cancer patients ideas and reasoning. The ethnomedical approach unites popular health beliefs that originated in Finnish folk medicine, as well as connecting alternative medicine, which patients make use of, with biomedicine, the dominant form of medicine today. In addition to this, patients narratives, which are composed of various structural segments, are approached from the folklorist s perspective. In this way they can be seen as short pathographies, reconstructions of self-negotiation and individual decision making during the illness process. Above all, cancer patients writing describe their feelings, thoughts and experiences. Factors that appear insignificant to modern medicine, overwhelmed as it is by medical technologies that concentrate on dysfunctional tissue within diseased bodies. Ethnomedical study of cancer patients writings gives access to the human side of cancer discourse, and combines both medical, and popular, knowledge of cancer. In my view, the natural world and glimpses of tradition are bound together with one general aim within cancer narratives: to tackle the illness and mediate its meanings. Furthermore, the narrative approach reveals that participants write with the hope of offering a different interpretation of the cancer experience, and thus of confronting culturally pre-defined images and ideologies.

Tibetan Written Images : A Study of Imagery in the Writings of Dhondup Gyal

Dhondup Gyal (Don grub rgyal, 1953 - 1985) was a Tibetan writer from Amdo (Qinghai, People's Republic of China). He wrote several prose works, poems, scholarly writings and other works which have been later on collected together into The Collected Works of Dhondup Gyal, in six volumes. He had a remarkable influence on the development of modern Tibetan literature in the 1980s. Examining his works, which are characterized by rich imagery, it is possible to notice a transition from traditional to modern ways of literary expression. Imagery is found in both the poems and prose works of Dhondup Gyal. Nature imagery is especially prominent and his writings contain images of flowers and plants, animals, water, wind and clouds, the heavenly bodies and other environmental elements. Also there are images of parts of the body and material and cultural images. To analyse the images, most of which are metaphors and similes, the use of the cognitive theory of metaphor provides a good framework for making comparisons with images in traditional Tibetan literature and also some images in Chinese, Indian and Western literary works. The analysis shows that the images have both traditional and innovative features. The source domains of images often appear similar to those found in traditional Tibetan literature and are slow to change. However, innovative shifts occur in the way they are mapped on their target domains, which may express new meanings and are usually secular in nature if compared to the religiosity which often characterizes traditional Tibetan literature. Dhondup Gyal's poems are written in a variety of styles, ranging from traditional types of verse compositions and poems in the ornate kāvya-style to modern free verse poetry. The powerful central images of his free verse poems and some other works can be viewed as structurally innovative and have been analysed with the help of the theory of conceptual blending. They are often ambiguous in their meaning, but can be interpreted to express ideas related to creativity, freedom and the need for change and development.