The Almost Person: Myth, Narrative and The Doctor

Paul Ricœur describes selfhood as the product of a communal narrative. Communal narratives structured as symbolic myths provide a narrative identity and an ethic of selfhood. The psychologist Jerome Bruner, for instance, places the source of such a narrative identity in the family, where ‘canonical stories’ are formed. ‘Home’ becomes a mode of discourse, a way of recognizing ourselves in the narratives given to us by others. This paper will draw on these concepts of narrative identity in order to investigate the problems to selfhood which face the character of The Doctor in the BBC series Doctor Who. I will identify The Doctor as a character who acts within a self-constructed narrative vacuum, reading the character by contrasting two types of personal myth-making, one ‘real’, as in a lived narrative, and one ‘counterfeit’; a conjured myth to replace and obscure the lived self. The paper will pay particular attention to the twenty-first century reincarnations of Doctor Who. I will argue that the writing of Russell T. Davis and later Steven Moffat in particular directly address this tension of myth and selfhood, as The Doctor struggles between his self-imposed role as a modern Prometheus and the insistent haunting and return of his own story. In these incarnations, his companions become mirrors to The Doctor, bringing with them their own narrative and ethical identities. In turn, it is through his companions that The Doctor is able to build his own lived narrative of sorts, which challenges his self-created ‘mythology’. In contrast to the weeping angels, whose horrific agency manifests only when not apprehended, the Doctor’s story continues to become more real the more he is ‘perceived’, both by the human race and by the viewer.

Urinary diversion in elderly patients

BACKGROUND Bladder cancer represents one of the ten most prevalent cancers worldwide. More than 400,000 people worldwide are newly diagnosed every year. Within 2 years after diagnosis, 80 % of patients with muscle invasive bladder cancer without treatment die. METHODS The aggressive local surgical approach with a cystectomy is the therapy of choice. The median age of patients with de novo bladder cancer is 70 years. Thus bladder cancer is a cancer of the elderly. For demographical reasons, the number of eldery patients undergoing radical cystectomy will rise in the next few years. The type of urinary diversion is a major factor influencing perioperative morbidity and quality of life in these patients. Incontinent urinary diversions are preferentially used in daily practice. CONCLUSIONS There are only a few contraindications for orthotopic neobladder; however, age alone is not a contraindication. Patient selection and a nerve sparing approach are crucial in men and women to achieve excellent functional results with orthotopic neobladder in elderly patients.