In this essay, I invoke a translational turn in narrative medicine. My argument is grounded in two primary considerations: first, that illness is a fundamentally estranging experience resembling that of speaking a foreign language, and second, that discourses of and around health and disease have been dominated by narrative paradigms that have failed to capture the essentially translational (as in foreign and foreignizing) speech, or lack thereof, of those who suffer. This argument challenges the master plot of illness as narrative in favour of a disruptive idea of illness as translation.
To support my argument, I proceed as follows. First, I make a case for reimagining narrative medicine as translation by developing the idea that illness is essentially foreignizing. I then outline and discuss the features of narrative medicine’s revisited, translational design by analyzing an exemplary case of translational epistemology of health and disease avant la lettre: Margherita Guidacci’s Neurosuite (1999a). This is a collection of 80 poems recounting the poet-patient’s experience of incarceration in a psychiatric hospital, patterns of (un)communication with health providers, as well as the obscured, ‘opaque’ forms of psychiatric knowledge brought about by suffering.
Written by a woman in a non-anglophone language (Italian) and context (twentieth-century Italy), these poems shed light on the peripheries of narrative medicine, a discipline that, in addition to being dominated by a narratological reasoning that neglects “other modes of reflecting upon and representing experience” (Woods, 2011, p. 202), has remained largely Anglocentric (Wilson, 2023; Arnaldi & Forsdick, 2023). Analyzing these poems through the lens of translation studies enables me to connect the poet-patient’s experience of illness with ideas of foreignization against the triply non-normative background of Guidacci’s non-English, non-narrative, and woman’s perspective. The chosen psychiatric context thus highlights a further element of marginalization and estrangement (Yakeley et al., 2014; Arnaldi, 2024). Additionally, it provides an ideal setting for discussing the dynamics of narrativization, and lack thereof, in that consultation—a narrative-based process by definition—lies at the heart of psychiatric diagnosis and treatment.
Together, Guidacci’s poems offer a synthesis of the many ways in which a translational turn in narrative medicine may bring into focus and under the same lens the very values that inform the discipline, from its focus on ethics to its patient-oriented vision of healing. The poems also disclose how translation is inherently a self-critical concept and practice that invites us to question our beliefs and values, including the assumption that translating is always beneficial and harmless. As the analysis presented in this article demonstrates, there are times when we are called upon to preserve the incommunicable and the untranslatable as ethical and just forms of knowledge, especially in contexts of psychiatric suffering. This novel reading of Guidacci’s Neurosuite enriches our current understanding of her poetry as “highly spiritual” (Wood, 2005) to underscore the fundamentally therapeutic dimension of faith as a form of healing, as well as the role of translation as a way of engaging with the Other by definition, that is God.
I conclude by outlining the principles at the basis of a translational epistemology, including forms of epistemic obscurity, untranslatability and silence. I suggest that these principles can be deployed to study non-narrative accounts of illness which often take the form of poetic communication and lyrical storytelling. In this analysis, Guidacci’s poetry takes us “to the centre of the night” (nel centro della note) (Guidacci, 1999b, p. 175, my translation). It points to some of the ways in which a translational epistemology, one that privileges non-linear, non-hierarchical, complex and multivocal possibilities of knowledge can contribute to more just theories and practices of narrative medicine and narrative psychiatry, even (and especially) when the task of narrating and understanding those who suffer seems almost impossible to accomplish. As a medium for understanding non-narrative accounts of illness, translation accounts for the ‘black holes’ into which psychiatric knowledge may fall, not to celebrate ignorance nor to incite resignation, but rather to accommodate different modes of knowledge, including those produced in the midst of suffering. I therefore invoke a translational turn in narrative medicine, not with the intention to challenge or reinvent narrativity as an episteme, a genre, and a concept, but rather in the hope of foregrounding narrative medicine’s essential, translational nature that encompasses all of the above. I believe that concepts from translation studies and the languages of poetry should be systematically incorporated in narrative medicine, its theory, and practices, and I aspire for this article to contribute towards achieving this critical integration.
