The Literary Remedy: Therapeutic Creative Writing

fictionreboot2Today’s Friday Fiction features the work of Sharon Dempsey, a journalist and author who facilitates writing workshops for those affected by illness. In her work today, she shares how writing becomes an act of patient empowerment, fiction serving as a voice and a means of controlling and absorbing the chaos of illness.

medhum Fiction|Guest Post By Sharon Dempsey

Medicine, in essence, is a transaction of stories. The patient’s telling of symptoms, the interpretation of evidence and investigation on the part of medic, is the basis of the diagnosis process.

To seek expression out of illness is a natural reaction, yet the power of story is not fully harnessed in medicine. Health and disease are concerned with life and death, and are closely connected to the physical, social, psychological and spiritual nature of humans. So often we have focused on cure over care. Narrative medicine seeks to redress this imbalance.

My personal interest lies in the the relationship between story and medicine: to look at how we use narrative in illness and to how we might use creative writing and literature as an effective means of communicating, to help voice the concerns of the patient, and to help the physician to understand the impact of lived experience of illness. When patients take ownership of their illness narrative and are active in seeking the information they need, they gain greater insight into how they can best make decisions regarding their treatment. In short, to understand and speak about their illness experience is to be empowered in the face of illness and mortality. Research has shown that writing about traumatic, stressful or emotional events can be beneficial for both physical and psychological health, in non-clinical and clinical settings. To tell a story is a most human transaction.

My awareness of this relationship between literature and writing to illness and medicine came through personal experience: in caring for my son Owen who was diagnosed with an ependymoma brain tumor at the age of two. Despite surgery, chemotherapy and radiotherapy, Owen died when he was six. I found solace in writing and reading. My experience of grief and bereavement led me to see a direct correlation between my ability to cope with what I was reading and how I was able to express my grief through writing.

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Cancer Focus Workshop

Part of my work now, twelve years after Owen’s death, involves designing and facilitating therapeutic creative writing workshops for patients affected by cancer. Delivering the workshops has reaffirmed my belief that writing and reading literature generates a sense of well-being and helps the participants to deal with the emotional repercussions of cancer.

Being part of a creative writing group has many benefits. Through writing, participants can take control of their illness and process the changes that the illness and treatment has made to their lives. This is what the illness narrative is about: the writer can find expression for emotions and feelings, and this in turn allows them to feel validated, to be understood and to gain self awareness, while providing a platform to share with other like-minded people.

Gary Hunter, a participant of our workshops, states that they enable him, “to articulate feelings that might otherwise remain unexpressed”–

“In a way, writing gives me back a modicum of control over my situation and helps me deal with my diagnosis and the effects of living with cancer. I have a creative outlet for my frustration, uncertainty and anger,” he said.

After a workshop, Gary felt “a sense of achievement, especially when [his] work has been enjoyed and praised”; Moreover, the workshops provided him “an excellent and welcome forum for expressing one’s feelings and concerns in a secure, confidential and non-judgmental environment, in the company of people who understand the cancer experience.” Through his fiction and memoir writing,  Gary has explored cancer’s impact on relationships, self-image, faith and even the loss of faith. Other participants have shared that the workshops offer healing, empathy, release, inspiration, validation and empowerment.

The monthly workshops that I facilitate are run by a charity called Cancer Focus Northern Ireland, and provide an opportunity to reflect on personal experience in a safe, supportive environment. We state that no previous writing experience is required, and the workshops are open to relatives and carers of those affected by cancer, too. Illness never affects only the patient, even though  illness narrative is often the expression of the patient’s lived experience of illness. Through communicating illness, the patient (and their families and perhaps even their doctors) gains a sense of control, finds comfort in expression and consolation in being heard. This sense of seeking clarity and meaning through writing is present in my creative writing workshops, even though cancer is not the primary focus of our writing. We have explored memoir, flash fiction, poetry, script writing, journal writing, and nature writing and we are about to embark on a genre series starting with crime writing. The act of creating and writing is more important than the subject, yet themes and set exercises provide a structure to conduct the writing. Our work is a means to an end in itself – our creative self- expression. Yet I can see there is much to be gained for physicians and carers, too, as they witness the power of storytelling in action.

As writers, the patients can bring order to their world. They can employ creativity, punctuation, grammar, structure and format to a world of confusion, emotional turmoil and often sadness. Twelve years after my son’s death, I still write for him and about him. It’s my treatment.  In facilitating and participating  workshops, I have recognized the value of humanizing the medical experience, and honoring the shared story.

Sharon Dempsey is a journalist, health writer and creative writing facilitator based in Belfast, Northern Ireland. Follow @svjdempz


Friday Feature: Death by Elephant? Torture in 19th c India

fictionreboot2It’s surely one of the most gruesome capital punishments ever devised. But it gets worse, warns Tessa Harris in the second part of her blog on India’s historic torture practices. Tessa pens the bestselling fiction series The Anatomist’s Apprentice…see what has turned up in her research, where medicine and fiction intersect with cultural practice.

By Tessa Harris

Westerners have an American to thank for uncovering many of the rich and magical treasures of the Orient for the first time. Henry Clarke Warren, (1854–1899), was a scholar of Sanskrit and Pali, and became the first man to translate a number of Buddhist texts into English. These were later published in the Harvard Oriental Series. His translations provide a fascinating source of Buddhist history and thought. They revealed to the Western world the philosophies, doctrines and practices of a little understood religion, whose roots went back 2,500 years to India.

Along with the tremendous diversity, color and myths familiar to many of us today, however, Warren’s translations also revealed a darker side to Indian society. They exposed the methods of torture that were frequently practiced by rulers on their enemies or simply on petty criminals for perverted pleasure. Astonishingly, some of these disturbing customs even carried on well into the 19th century.

One of Warren’s translations, a Buddhist scripture called the Milinda Panho, belonged to the second century AD. It catalogued various methods of torture, referred to as ‘miseries’. As you’ll see, however, calling them ‘miseries’ is an understatement.  Warren helpfully included footnotes to this list by way of explanation, so we have, for example, the Kettle of gruel. This is when “they cut open the skull, and with a pair of tongs take up a heated iron ball, and throw it in; whereby the brains boil, and run over.”

In the Rahu-mouth torture, according to Warren: “they keep the mouth open by means of a peg, and burn a candle inside. Or, beginning from the roots of the ears, they dig out the teeth, so that the blood gushes forth, and fills the mouth.”

In the blades-of-grass torture, “they begin at the neck, and cut the skin downwards in blade-like strips as far as to the ankles, and then let them fall.” Warren’s translation continues: “Then they put a halter on the man, and drag him forward, so that he stumbles and falls over the blade-like strips of his own skin.”

Of course after such suffering you might imagine that death would be a sweet release. But in parts India, up until as late as the 1800s, that was never easy, either.

According to George Ryley Scott’s “History of Torture”, published in 1940, one method, peculiar to the sub-continent, was to tie the condemned man against a tree, smother him in honey and allow red ants to eat him alive. Another, apparently equally ravenous insect, was the carpet beetle.

By comparison you might be forgiven for thinking that death by elephant would be a preferred option for a condemned prisoner. For hundreds of years, this method of execution was employed by many rulers in South-east Asia. In India the practice was known as ‘Gunga Rao’. The huge, majestic animals symbolized the power that kings and chiefs exercised over local populations. As in the West (with hangings, principally), public executions were designed to engender both fear and curiosity in those who witnessed them. The elephants, were, however, specially trained so that they could not only crush a man with single blow, but also torture him slowly, pulling him limb from limb before dispensing with him, usually by standing on his head.

For one of the most graphic accounts of this custom, we turn to an English journalist.  In 1821, Thomas Byerley published the following report of an execution in Baroda in 1814. He relates how, when a slave murdered the brother of the local chieftain, he suffered the direst consequences.

About eleven o’clock the elephant was brought out, with only the driver on his back, surrounded by natives with bamboos in their hands. The criminal was placed three yards behind on the ground, his legs tied by three ropes, which were fastened to a ring on the right hind leg of the animal. At every step the elephant took, it jerked him forward, and every eight or ten steps must have dislocated another limb, for they were loose and broken when the elephant had proceeded five hundred yards. The man, though covered in mud, showed every sign of life, and seemed to be in the most excruciating torments. After having been tortured in this manner for about an hour, he was taken to the outside of the town, when the elephant, which is instructed for such purposes, was backed, and put his foot on the head of the criminal.”

There are dozens of accounts from European travelers about this gruesome practice and its many variations. In 1868, a French traveler even reported that the elephants were trained to slice criminals to pieces with “pointed blades fitted to their tusks”.

With the growth of British power on the sub-continent, however, the custom declined. These would be replaced instead by colonial rule, which had its own abuses, though most of them not so vivid to the imagination. By 1914 the author Eleanor Maddock wrote that in Kashmir “many of the old customs are disappearing – and one of these is the dreadful custom of the execution of criminals by an elephant trained for the purpose.”

One of these ‘old customs’ took much longer to disappear, however. And remarkably, although rare, it is still practiced occasionally in rural areas of India today, despite being illegal. We are talking about the Hindu practice of sati or suttee, otherwise known as the custom of a widow killing herself, usually by self-immolation. (There are, however, recorded cases where the woman was drowned or buried alive with her husband’s corpse.) Although abhorrent to most modern thinkers, the future for a widow in India up until relatively recently, was bleak. Forced to hand over her husband’s possessions to his family, she was left destitute, alone, forced to shave her head and ostracized if she did not take her own life.

If sati was performed, it appears the widow would sometimes be drugged before throwing herself on the blazing funeral pyre; sometimes she was forced onto it by family members. There are accounts, too, of some women sacrificing themselves apparently willingly, then, as the flames took hold, recanting and trying to run away.

Fanny Parkes, the wife of a minor British civil servant during the early 1800’s, has given us an extraordinary account of a sati burning that took place in 1828. It went ahead despite all attempts to prevent it, short of forbidding it, by the local British magistrate. The outcome of the extraordinary story is that the badly-burned widow was taken into custody by the British government and subsequently cared for. In 1861 a general ban on sati for the whole of India was issued by Queen Victoria. Even so, the custom did not die out completely and, even though the practice has been outlawed in modern India, there are still isolated reports of burnings in remote villages to this

Author Bio: Tessa Harris
Copyright Maureen McLean 2011After studying History at Oxford University, Tessa Harris began a journalistic career in Lincolnshire. She progressed to a London newspaper, and later a feature writer on Best magazine. After two years, she was made editor of a regional arts and listings publication, and later deputy editor on Heritage magazine. In 2005 she was made editor of Berkshire Life magazine. Tessa always had literature aspirations, and in 2000 won a European-wide screenplay writing competition for a work later optioned by a film company. The script was set in 18th century London and subsequent research led Tessa to the invention of Dr Thomas Silkstone, an American anatomist and the world’s first forensic scientist. More books.

Shadow of the Raven: Nominated for the Romantic Times Reviewers’ Choice Best Mystery Award 2015

4617911690_238x346American anatomist Dr. Thomas Silkstone hunts for justice amid a maelstrom of madness, murder, and social upheaval. In the notorious mental hospital known as Bedlam, Dr. Thomas Silkstone seeks out a patient with whom he is on intimate terms. But he is unprepared for the state in which he finds Lady Lydia Farrell. Shocked into action, Thomas vows to help free Lydia by appealing to the custodian of her affairs, Nicholas Lupton. But when Silkstone arrives at the Boughton Estate to speak to Lupton, he finds that another form of madness has taken over the village.


From potters to plastic surgeons: Guest Post by Tessa Harris

fictionreboot2In the first of her two-part blog, Tessa Harris reveals how a particular form of savagery gave birth to rhinoplasty in India more than 3,000 years ago

By Tessa Harris, author of ANATOMIST’S APPRENTICE

We’ve all heard of the expression ‘to cut off your nose to spite your face’, but historically in parts of Asia, and in particular in India, this practice was engaged in for a very long time. In the course of my research for my latest novel, part of which is set in Hyderabad, I delved into the terrifying world of torture and execution in 18th century India. Even I – someone very used to the horrors of the anatomist’s dissecting table – winced when I came across the extraordinary and frequently brutal practices of the period.

For thousands of years it seems that both law enforcers and armies in India were keen on punishing those they saw fit by cutting off their noses for a variety of ‘crimes.’ These ranged from adultery and theft, to just being on the opposing side in a war. Then again, even today, there are cases of such mutilation being practised against women in Afghanistan. In 2010, Time magazine featured on their front cover the disturbing image of an 18 year-old who had her nose cut off by the Taliban for fleeing her abusive in-laws, and only earlier this year, another young wife made world news when her husband punished her in a similar way.

The first recorded account of nasal amputation was in 1500 BC in the Hindu epic Ramayana when Prince Lakshmana cut off the nose of Lady Surpanakha. However, the lady’s brother, King Ravana, came to her rescue and arranged for reconstruction.

In the case of adultery, the practice was so widespread that it would be performed either by the injured party or by a chuckler or local cobbler, presumably because he had the appropriate tool for the job.

In India there are also many recorded instances of conquering armies depriving their enemies of their olfactory organs. As Dr Richard Seltzer puts it in his book Confessions of a Knife: “It was not uncommon for a conquering Indian army to commit metropolitan rhinocide, putting to the sword the nose of every man, woman and child in the vanquished city.”

An Italian traveller and surgeon, Manucci (1653-1708 AD) related that when horsemen passed through their forest, the inhabitants of Mysore would often run at them, place their hands on their horses’ quarters and spring up at them from behind to cut off the Mughal enemy riders’ noses! This they did with a specially designed iron instrument shaped like a half-moon. This form of physical humiliation was taken a step further when, in the 18th century, the Naik of Mysore offered a reward for every enemy nose and upper lip brought to him by his soldiers. The Sikhs of Punjab also followed this custom.

Depriving large numbers of people of their noses did, as you might imagine, caused many problems to the local population, but help was at hand from an unlikely source. For several hundred years a small band of potters put their dextrous hands to work operating on unfortunate victims. Their skill spawned the branch of plastic surgery known today as rhinoplasty. (The term ‘plastic’, has nothing to do with the modern synthetic material, but derives from the Greek ‘plastikos’, meaning to mould or shape.) The caste of koomas or khumars, were apparently performing this reconstructive surgery as long ago as 1000 B C. Based on their skill at working with clay, they developed a technique using a skin graft taken from the forehead to ‘regrow’ the nose. However, it was not until the late 18th century, when two English surgeons witnessed the reconstructive procedure for themselves that the West became aware of such practice and adopted it.

In the brutal wars between the formidable Hyder Ali and his son Tipu Sultan against the British during the mid-to-late 18th century, it was a common practice for the Indian soldiers to cut off their enemies’ noses. During one of the campaigns five men – one cart driver and four Indian soldiers serving the British army – fell into enemy hands. Treated as traitors, their punishment was to have their noses and right arms cut off. Thus mutilated, they were sent back to their British masters.

The English commanding officer obviously heard about their appalling injuries. By chance, a few days later, he met a merchant whose nose had been cut off as a punishment for adultery. This man had, however, been fitted with a substitute made by a doctor from the potter caste. Impressed by the surgery, the officer sent for the physician in question and asked him to reconstruct the noses of his mutilated men.

An illustrated account of the first operation appeared in the Madras Gazette. Performed near the city of Pune, it was observed by two English doctors, Thomas Cruso and James Findlay. The article was given a much wider audience when it was reproduced in the Gentleman’s Magazine of London in October 1794. The first part of the operation is described as follows: “A thin plate of wax is fitted to the stump of the nose so as to make a nose of good appearance; it is then flattened and laid on the forehead. A line is drawn

The Indian method of rhinoplasty. Wellcome Library, London. Published: 1816.

around the wax, which is then of no further use, and the operator then dissects off as much skin as it had covered, living undivided a small slip between the eyes. This slip preserves the blood circulation till a union has taken place between the new and the old parts.”

The accounts went on to describe in detail how the scar of the stump of the nose was paired off, and the skin from the forehead was twisted and inserted into this incision. The remaining complex procedures were carried out over the next month or so. For five or six days after the operation, the patient was made to lie on his back, and on the tenth day, bits of soft cloth were put into the nostrils to keep them sufficiently open. The article concludes cheerily: “This operation is always successful. The artificial nose is secured and looks nearly as well as the natural nose, nor is the scar on the forehead very observable after a length of time.”

Such a description inspired a young English surgeon by the name of Joseph Carpue to reproduce the operation in London in 1814. This reconstruction, which involved using a flap of skin taken from the forehead, was to become known in Europe as “Carpue’s operation” even though it had originated in India. A German surgeon, called von Graefe, performed similar plastic operations of the nose using skin from the arm.

After such successes plastic surgery became widespread throughout Europe. Today, all replacement operations using a flap of skin in the immediate area of the loss are known as Indian plastic surgery. It’s a positive bi-product of a terrible custom. In other cases of physical punishment, however, there were no good outcomes, and far worse practices increased the suffering of victims. In the second installment, I shall delve further into some of these forms of penalty and execution. But be prepared! It isn’t always easy reading…

Copyright Maureen McLean 2011Secrets in the Stones, by Tessa Harris, is the sixth novel in the Dr. Thomas Silkstone Mystery series. It is published by Kensington and is out now.Tessa Harris is an English journalist and historian. She is the author of six novels in the Dr. Thomas Silkstone series, featuring an 18th century American anatomist working in London. *Winner of the Romantic Times Reviewers’ Choice Best First Mystery Award 2012

3Shadow of the Raven 
 The Lazarus Curse
The Devil’s Breath

The Dead Shall Not Rest
The Anatomist’s Apprentice