Between the Lines

Caring and studies combine to challenge cancer's taboos

by Sean Kelly
Staff writer

Picture Compassion and curiosity are the motivating forces behind Ulrich Teucher's unusual career as a children's nurse, and as a scholar.

"I like working with people and caring for people. It's the inclination that I have," says the soft-spoken PhD candidate in Comparative Literature.

His thesis, "Illness and Metaphor: Narratives of Life," examines the use of metaphors of illness in autobiographical narratives written by people with cancer.

It combines arts and science in an interdisciplinary, cross-cultural project that challenges the taboos surrounding cancer and involves him in the debate about the role of psychological approaches to cancer therapy.

"Cancer is a situation that is almost impossible to articulate," says Teucher. "Self-identity is disrupted. The pain can be inexpressible, and one feels isolated because cancer evokes fear, and there are taboos against talking about it."

Teucher's thesis undertakes a systematic account of the use of illness metaphors in autobiographical cancer narratives like Audre Lorde's Cancer Journals and Christina Middlebrook's Seeing the Crab.

He also invited patients in Vancouver and Hamburg hospitals to write short descriptive narratives and used anonymous questionnaires to investigate how patients and non-patient groups in Canada and Germany characterize cancer.

His findings reveal interesting cultural differences and similarities between the North American and German samples.

For instance, German writers use a unique metaphor for cancer -- krake.

"It means octopus. You can hear how the sound of the German word embodies the danger and sense of fear of the tentacles grasping the body," says Teucher.

Battle metaphors are common among North American and German writers.

"You `fight an enemy,' you are `threatened,' you want to `achieve victory,' and so on," Teucher explains.

But some North American writers declare `total war' on their cancer, a phrase notably absent in German cancer narratives because of its objectionable connections with the Second World War.

Other people would rather not `do battle,' preferring to integrate the `enemy' within a narrative of acceptance.

Some writers show the uncertainty of their situation by recording unrelated episodes. Still others use multiple voices to represent how emotions change from moment to moment as one undergoes cancer treatment.

"And many people do not want to write or talk about their illness at all -- and that is how they cope," says Teucher.

Teucher is careful not to take a dogmatic position in the debate about psychological approaches to getting better.

"It's complex," he says with characteristic thoughtfulness.

He explains that some cancer patients and health care professionals believe that mental states play a crucial role in recovery. Such is the view of O. Carl Simonton, he says, a doctor who wrote the controversial book Getting Well Again.

But other cancer patients, and most doctors, counter that cancer is strictly a medical condition -- the patient will feel better when the cancer is cured.

"I believe that the attitude of the patient can help them cope with the illness. So in that respect, there is a psychological component to illness. However, it is impossible to prescribe certain metaphors or certain psychological approaches as cures, and it is impossible to say with authority that one's cancer comes from a certain psychological problem."

But Teucher is concerned that certain kinds of self-narrative, certain therapeutic psychological approaches, may do more harm than good.

Battle metaphors, for instance, sometimes provide a sense of control in a frightening situation. However, in battle, the combatant aims for victory, and must always be strong and brave. So battle narratives invalidate a whole range of emotions, and leave the patients feeling like `losers' where the cancer situation is uncertain or incurable, he says.

In other cases, people believe they are the cause of their own illness. If only they could find some kind of key within themselves, they could unlock the secret cause of the illness and become well.

"They therefore have the added anxiety of feeling responsible for their illness, even though the cancer could turn out to have environmental or hereditary causes -- we just don't know."

Teucher has seen the anxiety cancer evokes close up. Born in Switzerland, he spent 10 years as a health care worker in Germany, much of it as a children's nurse in a cancer ward.

Motivating children undergoing cancer treatment demanded creativity and spontaneity.

"We painted our hospital gowns because children associate white hospital gowns with pain. We raced wheelchairs and we got out big syringes and had water fights. Once, at 3 a.m. a child woke up and wanted to bake a cake. So, we baked a cake."

He took time off to travel in Asia, studying Eastern attitudes towards living and dying.

And having spent part of his early childhood in Illinois, where his physicist father took a temporary position at the University of Chicago, it was natural for Teucher to visit old friends in the U.S.

During these trips, he visited children's hospitals, often taking part in clinical routines, in order to learn new ways to care for patients.

On a visit to a cancer centre in nearby Seattle, Teucher traveled to Vancouver, where he fell in love with the blend of European and North American culture.

He immigrated to Canada in 1987, and began studying for a new career after he discovered Canadian regulations did not permit him to work as a children's nurse.

While intending to become a physiotherapist, Teucher met Ted Langley, a literature professor at Langara College.

"I was inspired by his passion. He helped me discover in literature the same interests that guided me as a children's nurse -- the struggle of people to find meaning in life in times of crisis."

Teucher decided to study literature, drawing upon his former career for inspiration. For his Bachelor of Arts graduating essay, he interpreted Boethius's Consolation of Philosophy as one of the first self-help books for re-evaluating life in the face of death.

He went straight into the PhD program, and the idea for his thesis came when he noticed that illness narratives were becoming more common but had received little critical attention.

"Ulrich's project is interdisciplinarity at its best. It is literary scholarship that relates to work going on now in psychology and in contemporary psychoanalysis," says Michael Chandler, a Psychology professor and one of Teucher's thesis supervisors. "The history of self-identity is to a great extent recorded in literature."

English and Germanic Studies Prof. Eva-Marie Kröller and Germanic Studies Asst. Prof. Steven Taubeneck complete the supervisory committee.

According to Kröller, Teucher's work makes special demands on the resources of the university because it is multilingual and because of his professional health background.

"Interdisciplinarity is the wave of the future. Students like Ulrich have diverse skills and a wealth of career experience to offer to future employers. It is a challenge to accommodate them, but the way they thrive at UBC is a credit to the university," says Kröller.

Teucher is happy to have found a way to combine his interests in literature and psychology with his experience helping ill people.

"Besides defining the literary characteristics of illness narratives, I hope my research helps seriously ill people come to terms with the problems of identity caused by their illness, and that it will help family members, friends and professional care workers to approach ill people with greater sensitivity."