There have been some great reviews over at the UK Medical Humanities Blog over the holidays. aj's post on James Frey's A Million Little Pieces is particularly interesting. aj liked the book a great deal, but the comments of the post feature an interesting discussion on the controversy about the book that arose out of the revelation that not all the "facts" discussed in the novel are nonfiction.
Giskin Day makes the following illuminating points:
One definition is a correspondence theory of truth in which, when writing non-fiction, everything you say should be corroboratable by documentary evidence. However, this is a rather narrow version of truth. Most of us believe you can learn something from fiction -- a kind of metanymic truth that requires no corroboration but tells us something about human nature or elucidates the power of imagination.
It is interesting that doctors that write memoirs are exempt from having to be accurate about people and places -- their duty of confidentiality means that they should not be utterly truthful. However, doctors writing memoirs do tend to include a metastatement that sets out the terms of fictionalisation to the reader.
The ethics of physician memoirs are fascinating. I think Suzanne Poirier, among others, has written quite a bit on this, but the obligations imposed by the physician's duty of confidentiality do raise intriguing problems of the nature Giskin describes. If details of the narrative must be changed to preserve confidentiality, questions of authenticity and truth inevitably bleed in to the picture. After all, is the writer really capable of judging whether a seemingly unimportant detail might in fact be important in the "voice" of the patient whose story is in part being related? And even if capable of doing so, how much "alteration" should the writer engage in? Fascinating questions.
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