REPRESENTATION OF WOMEN IN THE LITERARY AND MEDICAL DISCOURSE OF THE U.S. PROSE

REPRESENTATION OF WOMEN IN THE LITERARY AND MEDICAL DISCOURSE OF THE U.S. PROSE Yuliia LYSANETS Ukrainian Medical Stomatological Academy, Poltava (Ukraine), orcid.org/0000-0003-0421-6362 ISSN: 2411-6181(on-line); ISSN: 2311-9896 (print) Current issues of social studies and history of medіcine. Joint Ukrainian -Romanian scientific journal, 2020, No:2(26), P. 70-73 UDK 821.III(73)-3.09“19” DOI 10.24061/2411-6181.2.2020.181


Problem statement.
Representations of a literary image reflect the society's ideas and attitudes toward their real-life prototypes at a specific period. In particular, the features of representing the female images constitute an essential means for understating the national literature. The present paper focuses on the literary depiction of women in the literary and medical discourse of the U.S. prose.
The aim of the research is to develop the typology of women's representations in the U.S. literary works, focused on medical problems and themes. The material of the research is the body of prose works by the American writers over the period from the late 19th century until the early 21st century. The research methodology is based on the application of modern literary studies in the fields of narratology, receptive aesthetics and feminist literary criticism.
Presentation of the research material. In the course of the study, we found that female images within the framework of the analyzed material fall into several distinct categories. We examined the role of women as physicians, as nurses, and as patients. The theoretical significance of the research consists in the disclosure of women's representations in the American literary and medical discourse in the diachronic focus.
The first literary effort to focus on the role of women as physicians is found in Doctor Zay (1882) by Elizabeth Stuart Phelps. The heroine of the novel is a rural Maine physician, who faces a challenge of choice between marriage and career. Elizabeth Stuart Phelps was one of the first authors who included medical issues and the images of women doctors in her fiction, thus contributing an essential innovation to the American literature. Indeed, the author raises rather progressive feminist problems for her time, but very relevant nowadays: "There are new questions constantly arising," she went on, "for a woman in my position. One ceases to be an individual" 1 . As one can observe, Phelps designs the image of the "New Women" in her writings, who aspire and manage to succeed professionally. When Dr. Zay's patient falls in love and proposes to her, she answers: "You have been so unfortunate as to become interested in a new kind of woman. The trouble is that a happy marriage with such a woman demands a new type of man" 2 . Moreover, the author portrayed the female physician as a divine entity, with a clear intention to promote this profession among women: "She had the mysterious odic force of the healer, which is above science, and beyond experience, and behind theory, and which we call magnetism or vitality, tact or inspiration, according to our assimilating power in its presence, and our reverence for its mission" 3 . Besides, Dr. Zay constantly struggles with distrust and opposition from her male environment. Eventually, the protagonist rejects her patient's proposal

Art history
Історія мистецтва since she will not give up her career.
In The Bell Jar (1963) by Sylvia Plath, the author depicts a female psychiatrist Dr. Nolan, who symbolizes the new era in medicine and novel approaches to treatment. Esther Greenwood is the main character of a novel that goes to a psychiatric hospital after a suicide attempt. Dr. Nolan is an embodiment of social independence and respect as a professional, and thus she is an ideal of a woman to Esther aspires. The protagonist admits her affection of the female physician: "I liked Dr. Nolan, I loved her" 4 . Nolan understands the decision of the protagonist to resort to intrauterine contraception, which is interpreted in the novel as a manifestation of the woman's control over her own body and is manifested in the novel's autodiegetic narration: "I am climbing to freedom, freedom from fear, freedom from marrying the wrong person <… > I was my own woman. The next step was to find the right sort of man" 5 . Dr. Nolan plays a crucial role in Esther's recovery. She is a rather direct but deeply humane psychiatrist who helps her patient to cope with her alienation. It is Nolan who defines Esther's relationship with her mother as the factor that causes her depression: "' I hate her,' I said, and waited for the blow to fall" 6 . Instead, the doctor argues to Esther that her future should not necessarily follow her mother's life path.
Doctors (1988) by Erich Segal describes the endeavors of five medical professionals who graduated from the Harvard Medical School in 1962. Segal depicts the representatives of the so-called "Silent Generation" who are focused on their careers. There are polar opposite characters, like a merciful and compassionate Seth Lazarus, who illegally conducts assisted suicides in Chicago and is eventually brought to trial for murder, or Peter Wyman − a social climber whose only ambition is to win fame. Throughout the novel, the physicians exhibit a high level of resilience and endurance, encountering moral dilemmas, as the procedure of euthanasia (Seth Lazarus), and facing the social prejudices, such as sexism, represented by Laura Castellano. Laura has to struggle in the "male" competitive world of medicine and continuously prove her worth.
In Operation Wandering Soul (1993) by Richard Powers, the therapist Linda Espera tries to evoke hope in children through storytelling and play-acting. She believes that only empathy can heal not only the soul but the body as well. Thus, female physician practices recovery therapy at the pediatric ward. Moreover, the character's name is allegorical, since it stems from the Spanish "esperanza," meaning "the hope." Sidney Sheldon's Nothing Lasts Forever (1994) narrates the story of three female doctors struggling in the "male" world of Embarcadero County Hospital in San Francisco. Kate Hunter, Betty Lou Taft, and Paige Taylor constantly encounter gender discrimination in the clinical setting, just as they did during their medical education: "Where are all the other women?" "I think we're it". "It's a lot like medical school, huh? The boys' club. I have a feeling this place belongs to the Dark Ages" 7 . The heroines' struggle in the male world is vividly represented in the following passage, when the janitor is sincerely surprised that they are not nurses: "So you're gonna work at the hospital," he said. "Nurses, huh?" "Doctors," Kat corrected him. He looked at her skeptically. "Doctors? You mean, like real doctors?" "Yes, like real doctors," Paige told him. He grunted. "Tell you the truth, if I needed medical attention, I don't think I'd want a woman examining my body." "We'll keep that in mind" 8 . At the same time, Sheldon admires the physicians' self-sacrificing care of patients, their commitment to the doctor's duty to help people. For instance, Paige Taylor exhibits true heroism in her efforts to save the child patient, even without the permission from a religious father. Paige demonstrates the high level of humanism, involvement and professional flexibility which verges on law infringement. Despite the fact that Paige has formally "broken the law", she is convinced that she has done the right thing, since she prioritizes her patient's life above everything.
Harvest (1996) by Tess Gerritsen belongs to the genre of the medical thriller, where the physician usually acts as a persistent investigator. Hence, apart from being a skillful expert, Dr. Abby DiMatteo is endowed with the qualities of a detective. In essence, she is depicted as observant, curious, shrewd, intelligent, attentive to details, fearless, and diligently seeking truth and justice. She is described as a "walking encyclopedia," ready to combat clandestine plots. It is necessary to bear in mind that the medical thriller genre is aimed primarily at the suspenseful excitement of the reader, and the literary images of the physicians usually deal with terrifying cases of medical malpractice, unauthorized experiments, abhorrent crimes, and sinister conspiracies. In other words, injustice and wrongdoings in the 21st-century society are represented by opposing them to the heroic and all-round developed image of the physician.
Further, we found the peculiarities of representing women as nurses in the literary and medical discourse of the U.S. prose. For instance, in The Curious Case of Benjamin Button (1922) by F. Scott Fitzgerald, the nurse is depicted as a commanding ruler of the hospital. In the critical situation, when Mr.
Button is uncertain what to do, it is the nurse who directs his decisions and actions: "You're wrong. Mr. Button," said the nurse severely. "This is your child, and you'll have to make the best of it"; "You'll have to take him home," insisted the nurse -"immediately!" 10 ; "Come! Pull yourself together," commanded the nurse" 11 ; "Keep it on! Keep it on!" said Mr. Button hurriedly. He turned to the nurse. "What'll I do?" "Go down town and buy your son some clothes" 12 .
In Arrowsmith (1925) by Sinclair Lewis, Leora Tozer is a student nurse at the hospital, where the protagonist meets her and falls in love. For Martin Arrowsmith, Leora is a true embodiment of devotion and support. Moreover, she always reminds the protagonist of his actual values and does not allow to stray him from the path of research and virtue: "Are you going on for the rest of your life, stumbling into respectability and having to be dug out again? Will you never learn you're a barbarian?". However, Leora is depicted predominantly as Martin's devoted partner, whereas her career and professional skills of a nurse are always embedded in the secondary background.
In Johnny Got His Gun (1938) by Dalton Trumbo, Joe Bonham, a young American soldier serving in World War I, awakens in a hospital bed and gradually realizes that he has lost his arms, legs, and all of his face, but that his mind functions perfectly, leaving him a prisoner in his own body. Eventually, the nurse becomes the only person who manages to establish a connection with the protagonist using the Morse code. Yet, the nameless nurse does not possess any particular characteristics from the author, and her figure does not acquire any further development in the plot.
The Snake Pit (1946) by Mary Jane Ward, features a demonized and abusive image of the Nurse Davis, who is openly mocking the protagonist: "The wet and dry mops were different mops. A wet mop was a wet mop, even when it was dry. Virginia Mistook for a wet mop. Whenever Miss Davis approached, the Virginia mop held turned into being the wrong one. Miss Davis said the pugs were unmistakable, but Virginia mistook them easily" 14 . Indeed, the nurse deliberately interferes with Virginia's communication with the doctor and initiates her transfer to an insulator. As a result, the confrontation between the patient and the nurse is transformed into a Virginia struggle to recover: "Did you, at this wavering instant, come up against a Miss Davis who laughed you, sneered you, chilled you back into the dark?" 15 .
Perhaps the most well-known literary depiction of a nurse is found in Flying over the Cuckoo's Nest (1962) by Ken Kesey. Indeed, Nurse Ratched, also known as "Big Nurse," is a vivid image of a tyrannical head nurse at the mental institution. She exercises total control over the patients and even the doctors. Nurse Ratched symbolizes the oppressive mechanization and dehumanization of modern society. This effect is achieved through the descriptions of the nurse's unnatural appearance and "enamel-and-plastic" face 16 .
In MASH: A Novel About Three Army Doctors (1968) by Richard Hooker and The House of God (1978) by Samuel Shem, nurses are represented primarily as objects of male doctors' sexual entertainment. For instance, Shem's novel is pervaded with the descriptions of the protagonist's adulterous trysts with various nurses. Likewise, in MASH: A Novel About Three Army Doctors, numerous similar instances are depicted, with Major Margaret Houlihan being nicknamed by surgeons as "Hot Lips." In Critical Condition (2002) by Peter Clement, the nurse is also depicted as a powerful agent at the hospital. For example, the nurse Jo is represented as "the grandmotherly woman" speaking "in a voice that had iron determination of a marine" 17 . Moreover, nurses are often insensitive to patients and even capable of ruining a young doctor's career. Therefore, the author refers to nurses to as "she-beasts": "…he was appalled by her cold insensitivity" 18 ; "She spoke in a slow measured cadence nurses use when they want to make it clear they think the doctor's an idiot, and her face had Now don't bother me anymore! written all over it, just in case he didn't get the first message" 19 ; "in the hospital's food chain, the nurse can save a resident's ass, or destroy "the doctor in training wheels" 20 .
Finally, we examined the narrative role of women as patients. In Mary Jane Ward's semi-autobiographical novel The Snake Pit, the story unfolds around Virginia Cunningham, who is in a psychiatric hospital after suffering a nervous breakdown. The author of the novel, who underwent treatment at Rockland Public Hospital for eight months, was able to draw readers' attention to the shortcomings of the medical practices and administrative structure of psychiatric hospitals of the time. One should also emphasize the symbolism of the novel's name, where the hospital resembles a snake pit -a method of the death penalty, a place of unspeakable torment and suffering: "Shock treatment. Why bother with insulin, metrazole or electricity? Long ago they lowered insane persons into snake pits; they thought that an experience that might drive a sane person out of his wits might send an insane person back into sanity. <…> A more modern "they" had given V. Cunningham a far more drastic shock treatment <…> they had thrown her into a snake pit and she was shocked into knowing that she would get well" 21 . At the beginning of the novel, the heroine is unable to recall the circumstances of hospitalization; she hears a polyphony of nonexistent voices and does not recognize people previously familiar to her. To enhance the effect of embarrassment and depersonalization on the heroine, Mary Jane Ward employs a "split" narration from the third and first-person, and they are alternately incorporated into the story: "Who had got into the room? Stealthily she groped for Robert. I must out my hand over his mouth so he keeps talking out. But the bed was narrow and she was alone. The room was dark but she saw pale shapes rising up. One of the shapes said her name, and then she remembered that she was not at home. February to August" 22 . Even after recovery, before being discharged from the hospital, the dissociation of the heroine into "she" and "I" persists. Narrative instances are incorporated into a continuous stream of consciousness, and they are in the unbroken unity: "Terror of a world no longer familiar shook Virginia and she had to clutch her hands together to keep from snatching the paper from Robert. How can I go outside? I won't know what to say to people or how to look when they are talking. I won't know when to sit down, when to stand up… I've forgotten the simplest of the social amenities" 23 . The alternate modes of the hetero-and homodiegetic narratives effectively provide the eventfulness of the narrative and reveal the heroine's inner world. The "splitting" of the narrative into the third and the first person symbolizes the dissociative disorder of identity, the fervent search for one's own "voice" in different narratives.
The Bell Jar is the only novel written by Sylvia Plat, first published under the pseudonym Victoria Lucas in 1963 and later under the author's real name in 1967. Esther Greenwood is in a constant search for her own identity, reacting sharply to public stereotypes about the role of the middle-class woman: she is not satisfied with any of the supposed scenarios of lifemotherhood or the profession of a stenographer. The novel presents the experience of Sylvia Plath's stay at McLean Hospital for six months in 1953. Mental illness in Plath's novel is metaphorically conceptualized in the form of a bell jar -a vacuum space, separated from the "normal" world: "To the person in the bell jar, blank and stopped as a dead baby, the world itself is the bad dream" 24 ; "But I wasn't sure. I wasn't sure at all. How did I know that someday -at college, in Europe, somewhere, anywhere -the bell jar, with its stifling distortions, wouldn't descend again?" 25 ; "I felt surprisingly at peace. The bell jar hung, suspended, a few feet above my head. I was open to circulating air" 26 .
The novel Girl, Interrupted represents the experience of American writer Susanna Kaysen (born 1948), who was also at McLean Hospital in 1967-1977 for eighteen months after attempting suicide. The author's condition was diagnosed as an emotionally unstable personality disorder. The novel's narrative is composed of poignant memories, impressions, and reflections of Susanna Kaysen's autobiographical protagonist. In order to maximize the reader's immersion in the institutional world of the hospital and enhance the narrative's credibility, authentic extracts from Casey's medical history, correspondence between her doctors, results of examinations, and laboratory tests are incorporated. The character's madness in the novel is a parallel universe in which time stops, the laws of physics do not work and where anyone can quickly get: "… most people pass over incrementally, making a series of perforations in the membrane between here and there until an opening exists" 27 . Suzanne's auto-dietetic narrative reveals to the reader the author's concept of the concept of "disease," which has a pronounced intermediate component. Thus, at the heart of the novel is the name of Jan Vermeer's painting "Interrupted Music Lesson": "Interrupted at her music -as my life had been, interrupted in the music of being seventeen, as her life had been, snatched and fixed on canvas ..." What life can recover from that?" 28 .
Prozac Nation (1994) by Elizabeth Wurtzel also focuses on the author's life experience, namely her struggles with atypical depression. Hence, the main character's mental state becomes an integral attribute of her personality: "In a strange way, I had fallen in love with my depression. <…> I loved it because I thought it was all I had. I thought depression was the part of my character that made me worthwhile. I thought so little of myself, felt that I had such scant offerings to give to the world, that one thing that justified my existence at all was my agony" 29 . Notable is the image of the doctor in the novel. Unlike Nolan, who treats patients with compassion and understanding, Prozac Nation depicts a deliberately impersonated psychiatrist who is characterized by cold restraint in dealing with a patient: "That's fine, the doctor says, with just the right amount of condescension" 30 . In general, the main character's autodiegetic narrative reveals a distrust of the medical profession: "Or maybe I'll just find a twenty-four-hour bookstore and get a copy of Gray's Anatomy and memorize it become a doctor and solve all my problems, and everyone else's too" 31 .
Thus, the researched works reveal the gradual transformation of the image of a woman, which is reflected in the kaleidoscope of her roles (a doctor, a nurse, and a patient) and determines the different degrees of narrative representation in the literary-medical discourse of the U.S. prose. The image of a woman within the analyzed works covers an overtly negative image of a nurse, who is often commanding, and sometimes even abusive. Another tendency is to depict nurses as sex objects for male physicians. In the rest of analyzed works, nurses are generally represented as passive companions of men. On the other hand, the images of female doctors are endowed with numerous virtues: they are highly professional, empathetic, attentive and often strongly resolute to help their patients.
Moreover, the female physicians always struggle for their place in the male world, facing distrust and skepticism. Finally, the images of female patients reveal the unique autobiographical stories -the situations experienced by the authors and artistically re-imagined in the autodiegesis of the characters: narratives about mental illness, embarrassment, helplessness, and subsequently -about treatment, gradual recovery, and return to normal life. Within the analyzed works focused on female patients, it is worth noting the common tendency to include biographical elements in the narrative: the authors provide a fictional representation of their own experience of being in a psychiatric hospital and overcoming mental disorder, which becomes the center of meaning in the artistic text. The prospects for research are to explore further the narrative features of the medical discourse of fiction. The results of the study will improve the content of training courses in the world literature and form a methodological basis for the development of specialized courses, theme-based seminars, and academic syllabi.