Literature and medicine are usually treated as opposites. Nicolette Fox ’27 is proving that they never were.
Fox, a French major with a minor in global public and environmental health, found her love for language in French literature classes at ԱƵ. While she began her college career as a pre-medicine student, her academic path has led to new aspirations, such as becoming a translator for the United Nations or embracing a career in narrative medicine.
Narrative medicine is an interdisciplinary approach to patient care, in which clinicians engage with literature, philosophy, creative arts, and the social and natural sciences to gain understanding of and empathy for patient experiences.
This summer, Fox is working on a student-initiated summer research project to analyze writers’ portraits of anxiety in 19th-century French literature, grounded in narrative medicine. Her faculty adviser, Assistant Professor of French Katherine Brown, has provided guidance as Fox analyzes the interconnected nature of literature and medicine, as well as gendered depictions of anxiety and hysteria.
Hysteria has origins in ancient Egypt around 1900 BCE, according to Fox’s research. Historically, it was a condition attributed to the female anatomy colloquially known as the “wandering uterus.” Later — in the 19th century — understandings of hysteria moved from purely physical to psychological causation. Female hysteria remained connected to extreme, seemingly irrational, emotions.
Conversely, men exhibited a narrower form of distress, rooted in social status or finances, with symptoms akin to generalized anxiety disorder. (“It’s one of the only appropriate ways for men to be anxious,” Fox says.) Male hysteria emerged during the World War I era but was rebranded as shell shock.
Fox’s project has several facets. For the first few weeks of the summer, she researched 19th-century medical studies related to anxiety, and she analyzed various pieces of literature to gather how authors depict abstract emotions. She discovered that poetry often uses language describing tension in someone’s chest, or a weight on their shoulders to depict symptoms of anxiety.
Madame Bovary, the novel by Gustave Flaubert, provides an example of literature influencing medical practices. The protagonist, Emma Bovary, becomes disillusioned with married life, leading to her tragic and hysteric downfall.
“She apparently did such a good job at representing a hysterical woman that medical researchers of the time called her character the truest hysteric,” Fox explains. “Doctors took elements from Flaubert’s writing to put into their own research as references for the lessons that they taught to students.”
The final portion of Fox’s project bridges history with the present. After tracing how 19th-century authors and medical writers depicted anxiety in parallel, Fox has gone on to examine whether those literary representations remain consistent with the ways in which the medical profession describes anxiety today.
It turns out that there are more consistencies between 19th-century literature and current medical descriptions of anxiety than Fox originally expected. In particular, mentions of chest pressure, trouble breathing, and pupil dilation were present in both time periods.
Fox will synthesize her findings into a paper, which she hopes to develop into an honors or high honors thesis for the Department of Romance Languages and Literatures. Her research poster will be shared on the department’s board located in Lawrence Hall, where students and faculty will be able to view her findings.
“It is important for your doctors to be able to diagnose you with accuracy and be able to spot symptoms and signs on a clinical level,” Fox says, looking back on her research and ahead to her potential career path. “But I think it’s also important to have doctors who understand, on an emotional level, how difficult a condition can be — to help patients work through what their diagnosis means for them and for their life.”