Elena Fratto's book provides a superbly researched and innovative analysis of the relationship between medicine and literature. Grounded in contemporary medical humanities, which combines literary theory and cutting-edge medical practice in order to promote healing and give patients a critical voice in their own care, Fratto's study explores the intricate, often unexpected ways whereby creative production and human health narratives co-create each other. Across four rich multidisciplinary chapters, Fratto demonstrates how Russian and European authors and their characters have sought to “rub against the grain of official and seemingly unassailable biomedical truths by claiming their own agency in telling the story of mortality, illness, and well-being” (3).
As Fratto notes, when the predominantly Anglophone field of the medical humanities discusses non-English language texts, it predictably focuses on a few usual suspects, such as Lev Tolstoi's The Death of Ivan Ilych or a well-known story by Anton Chekhov. While Fratto does integrate familiar texts into her enquiry, a triumph of the book is that her remit is much broader and introduces many largely unknown and intriguing works of Russian and European literature into medical humanities discourse. Each chapter pairs prominent literary texts, such as The Brothers Karamazov, with more obscure ones, revealing how the juxtaposition of the familiar and the unsung yields new insights into narrative agency, the human/nonhuman dichotomy, and medical ethics from the late nineteenth century to today. Fratto thereby achieves a principal aim of her study: to expand the canon of the medical humanities. New texts to explore include the Soviet public health propaganda play When the Babka Treats the People, She Ruins Them; the satirical play Doctor Knock, or the Triumph of Medicine, by French writer Jules Romains; and the Frankensteinian—but still freshly provocative—short story “Doctor Menghi's Drug” by Italian writer Italo Svevo.
Moreover, Fratto's very structure seeks to upend “dusty” (9) interpretations of canonical texts: the chapter entitled “The Grand Finale: Death as the Revelatory Ending” comes first and sets the hermeneutical stage for the rest of the study. Fratto begins with a discussion of Boris Eikhenbaum's final public speech. His talk focused on the importance of authors knowing precisely when to time an end, the truth of which was demonstrated when Eikhenbaum himself vacated the stage, sat down next to his daughter, and died alongside the applause. From here, Fratto elaborates an analytical structure that posits death as the prime motivating origin of plots, thus allowing us to understand seemingly disparate parts of a text's architecture as working in concert to execute a powerful, carefully planned conclusion. In this way, Fratto rectifies the heretofore unacknowledged debt of the medical humanities as practiced in the west to Russian formalist criticism. In addition to death as such in Chapter 1, the subsequent three chapters each examine a different “crisis of and challenge to human agency” (4), from the cruel scepter of an undeservedly early and uncertain death in Chapter 2: “End of Story: Temporality and the Prospect of the Ending in Ivan Ilych, Anna Karenina, and (Potential) Cancer Patients”; to chillingly restrictive biomedical rhetoric in Chapter 3: “Medical Enlightenment in the Early 1920s: Rhetoric and Diffused Authorship in Jules Romains's Knock and Soviet Public-Health Campaigns”; to the looming threat of the nonhuman in Chapter 4: “Time, Agency, and Bodily Glands: Metabolic Storytelling in Italo Svevo and Mikhail Bulgakov.” Fratto concludes with an Afterword that brings her analysis to bear on the COVID-19 pandemic, reaffirming that, during “health crises, be they local or global, individual or collective, the art of skillful and insightful storytelling emerges as the single most powerful antidote” (193).
As this study's scope is comparative, some readers may be disappointed that a beloved key passage from Fedor Dostoevskii or Bulgakov is missing from the investigation. However, Fratto constructs a robust yet portable methodological framework that readers can easily use to illuminate further connections between medicine and storytelling in their favorite texts. Fratto acknowledges that other works and cultural traditions could be added to her analysis. One such area for future research would be to probe what implications for gender and sexuality studies the Russian and European medical humanities propose, especially given the latter's focus on establishing authorial agency in order to (re)gain control of one's own story in the face of oppressive power structures.
Overall, Fratto's absorbing, timely study will be invaluable for scholars, the general reader, and anyone who is interested not only in Russian and European literatures, but also, in the nuanced ways medical narratives shape human lives, and vice versa.
