Patients in Literature's Pages
Honors 1510

Fall 2019, Tues. 6:00-8:30 in CL 3504 CRN 30174, 3 credits
Course Calendar
Honors College
University of Pittsburgh

Instructor Dr. Nancy Pfenning, Senior Lecturer Emeritus at Pitt and Visiting Faculty at Brown
Office Posvar 1800B but Office Hours will probably be held in Cathedral 3506
Office Hrs. Time and location TBA or by appointment

Literary Works/Authors/Medical Conditions

The student who presents on each literary work (two students per week) will examine the work alongside an appropriate accompanying scientific journal article (pdf provided by Dr. Pfenning). The presenter emails classmates (cc Dr. Pfenning) at the latest by the preceding Wednesday afternoon, with a heads-up to read the article, plus suggestions of relevant parts to focus on. Presenters are encouraged to seek out and include a supplementary article, if their reading and thought processes trigger further investigation.
Note that the books, which have been purchased used [with grant money provided by Pitt's Discipline-Based Science Education Research Center (dB-SERC)], are lent to all class members free of charge, to be returned at the end of the semester. Students may opt to keep a book if they pay the instructor enough to have it replaced.
  1. Black Swan Green Chs. 1-2 by David Mitchell (stuttering)
    Psychological Health and Coping Strategies of Adolescents with Chronic Stuttering
  2. The Reason I Jump by Naoki Higashida (autism)
    CARS: Childhood Autism Rating Scale and explanation
  3. Hunger (Parts I-II, 1st 2 pages of Part III) by Knut Hamsun and The Long Winter (Chs. 22-24) by Laura Ingalls Wilder (starvation)
    They Starved So That Others Be Better Fed: Remembering Ancel Keys and the Minnesota Experiment
  4. The Heart Fails Without Warning in The Assassination of Margaret Thatcher by Hilary Mantel (anorexia)
    The Influence of Siblings on the Experience of Anorexia Nervosa for Adolescent Girls
  5. Cold Mountain (1st and 3rd chapters) by Charles Frazier ("soldier's nostalgia" aka PTSD)
    War Syndromes and Their Evaluation: From U.S. Civil War to Persian Gulf War p.1-2
    Did Civil War Soldiers Have PTSD? p.1
    Did Civil War Soldiers Have PTSD? p.2
  6. The Winter Soldier (chapters 1-8) by Daniel Mason (shell shock aka PTSD)
    War Syndromes and Their Evaluation: From U.S. Civil War to Persian Gulf War p.2-3
    What We've Learned In 160 Years Of Treating PTSD
  7. To Build a Fire (short story) by Jack London and A Sort of Miracle from Something Rich and Strange by Ron Rash (hypothermia)
    Everything You Need to Know About Hypothermia
  8. The Hours (prologue plus 3rd, 6th, and 7th Mrs. Woolf chapters) by Michael Cunningham (suicide; alternatives AIDS, postpartum depression)
    Perceived Burdensomeness and Suicidality
  9. Infinite Jest by David Foster Wallace (drug/alcohol addiction)
    relevant pages for both forms of addiction
    Alcoholics Anonymous: Faith Meets Science
  10. Infinite Jest by David Foster Wallace (entertainment addiction)
    The Netflix Effect: Teens, Binge Watching, and On-Demand Digital Media Trends
    Television Addiction
  11. The Emerald Light in the Air in collection of same name by Donald Antrim (electroshock therapy, maybe suicide)
    Electroconvulsive Therapy: Evidence and Challenges
    ECT Patients Perspective: Systematic Review
  12. A Long Way Down by Nick Hornby (suicide); omitted
  13. Enduring Love (Chapters 1-11; 3rd to 5th pages of Ch. 17; Appendices I & II) by Ian McEwan (stalker's syndrome)
    Appendix I at end of book: A Homoerotic Obsession, with Religious Overtones: A Clinical Variant of de Clerambault's Syndrome
  14. The Trials of Nina McCall (pages iv-9, 42-130) by Scott Stern (STDs)
    History of the Medical Treatment of Gonorrhea or
    Syphilis - Its Early History and Treatment Until Penicillin (Choose one or the other article; no need to read both.)
  15. Volunteers Are Shining Stars from You Think It, I'll Say It by Curtis Sittenfeld, and A Plague of Tics from Naked by David Sedaris (OCD)
    Developmental Aspects of Obsessive Compulsive Disorder: Findings in Children, Adolescents, and Adults
  16. The Smoking Section from When You Are Engulfed in Flames by David Sedaris (smoking cessation)
    Quitting Smoking
  17. Madame Bovary Part III Chapter 8, by Gustave Flaubert (arsenic poisoning)
    Acute and chronic arsenic toxicity
  18. Cancer Ward (Chs. 1-2, 4-7) by Aleksandr Solzhenitsyn (cancer)
    History of Cancer, Ancient and Modern Treatment Methods
  19. Still Alice(Sep03 to Jan04, June04, Oct04, Nov04, Jan05, Feb05, June05 to end) by Lisa Genova (Alzheimer's)
    Patterns of Cognitive Decline in Presymptomatic Alzheimer Disease
  20. The Father by Florian Zeller (Alzheimer's)
    The Evolution of Psychiatric Symptoms in Alzheimer's Disease
  21. Slaughterhouse Five(first half) by Kurt Vonnegut (battle fatigue aka PTSD)
  22. Combat Trauma, Memory, and the World War II Veteran
  23. The Names of the Dead (chs 1-6, 1st 8 pages of ch 7) by Stewart O'Nan (PTSD)
    PTSD and the Vietnam Veteran: The Battle for Treatment
  24. In Every Moment We Are Still Alive (to p. 63) by Tom Malmquist (Acute myeloid leukemia during pregnancy)
    Acute Leukemia during Pregnancy
  25. A Woman in Berlin (relevant excerpts) by Anonymous (rape survival)
    Silencing Reports of Sexual Assault: The Controversy Over A Woman in Berlin



This course guides students to value the information gleaned from two very different types of source--literary works and scientific reports--in the context of reading about patients who suffer from various conditions, such as Alzheimers, PTSD, anorexia, or OCD. While honing their ability to read such works with discernment, students also process the content both separately and in combination: How do the lessons learned in subjective narratives and objective scientific articles support one another? Are there inconsistencies? What role does the type of approach (informal/fictional versus formal/factual) play in our understanding of the condition and of the patient? Each week features presentations by two students, each of whom presents on what has been learned about the particular medical condition via those two types of work, then leads a class discussion afterwards. Non-presenting students must read all the featured literary works and journal articles in advance and submit relevant written questions/comments. A brief final paper that merges broader ideas from the course will be required at the end of the semester. All the reading materials are loaned to class members free of charge for the duration of the semester. Most of the assigned works are short stories or excerpted chapters, as opposed to entire novels.


Mandatory for all sessions; points will be deducted for unexcused absences.


Permission to enroll in an Honors level course.


Two or three (depending on class size) 35-minute presentations per student (and leading the accompanying 30-minute discussion); typically reading two literary works and two scientific articles weekly; handing in questions and/or comments about each literary work and article; final paper.


When a student has committed to being responsible for one of the next week's two presentations, he or she must have read the literary work and accompanying scientific journal article. The student then sends out a reminder to the class by Wednesday 2:00 pm, including suggestions on what parts of the article and/or literary work to focus on.

The non-presenting class members are responsible for thoroughly reading the research article and the literary work in advance. In addition, students must each prepare at least two written questions or comments pertaining to the article, two pertaining to the literary work, and two pertaining to how these writings support one another (or don't). Thus, a total of 12 (or optionally more) questions/comments will be handed in for credit at the class session. The presenter need not submit questions/comments on his or her own literary work and article.

As far as the presenting student is concerned, he or she summarizes the literary work's and article's contents, both individually (in either order) and synergistically. Then he or she facilitates discussion of pertinent issues. Discussion may be allowed to flow spontaneously, but in case it stalls, each presenter should come prepared with some questions or prompts to effectively solicit classmates' input. A draft of the presentation MUST be submitted to Dr. Pfenning by 2 pm Friday. 30% of presentation score will be deducted for each day that submission of a first draft is delayed.

Format of Class Time

  • 1st 10 minutes: : I recap previous week's presentations, letting students know if I noticed any interesting common themes in the questions/comments they'd handed in, also give previous week's presenters a chance to respond if there were any important issues that hadn't been resolved in that discussion.
  • 35 minutes: presentation #1
  • 30 minutes: discussion of #1
  • 10 minute break
  • 35 minutes: presentation #2
  • 30 minutes: discussion of #2


The following aspects will be taken into account for assigning a grade to each presentation: prompt submission of presentation drafts? well-prepared? interesting? well-presented? accurate reflection of information conveyed in each, the literary and scientific works? adequate attention paid to comparing and contrasting lessons learned from the two types of work? Finally, the ideas presented--especially regarding the literary work---should originate from the student, as opposed to being lifted from the internet.

Presentations 60%
Attendance/Participation 15%
Written Questions/Comments 15%
Final Paper 10%

Course Grade

90-100% A; 80-89% B; etc. Plusses are assigned to the students at the top of each grade range and minuses to the students at the bottom.

Final Paper

Requirements for the 2-to-5-page final paper is being discussed periodically in class. Here are some possible approaches:

  • Revisit the Discussion Prompts from first day of class, illustrating how they are or are not supported by various literary and scientific works that we read throughout the semester.
  • Knut Hamsun remarked that truth-telling was "unselfish inwardness." Discuss the relative merits and drawbacks of learning about a medical condition via first-hand versus second-hand accounts. Cite examples from the course's literary works, as well as some of the scientific articles.
  • A recurrent theme in many of the works we've discussed is failure of a patient and/or others to acknowledge the existence of whatever medical condition is the issue. What affect might this have on possible recovery? Are professionals sufficiently taking this phenomenon into account?
  • Another recurrent theme in many of the works we've discussed is the tendency for others to stigmatize or blame the person who suffers from whatever medical condition is the issue. Can this be mitigated? Are professionals sufficiently taking this phenomenon into account?
  • To what extent does someone suffering from a medical condition benefit from having at least one supportive ally? For which conditions covered in this course does outside support seem to be most beneficial? Least beneficial?
  • Other ways to structure a final paper: personification of illness; detachment from self as way of coping with illness; contrasting personification and detachment; what the language used to describe a condition tells us about current perceptions of that condition; imagining a gathering of authors or characters who would have plenty to talk about with one another, as often included in NY Times Book Review interviews...

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