Humanities and the Human Race

After a Bioethics and Literature class one Monday morning, Towerview’s Caitlin Moyles sat down with Karla Holloway in her spacious Allen Building office, where they chatted about the relevance of her bioethics scholarship to Duke undergraduates, the complexity of words and how literature makes us more mindful people. Holloway is a James B. Duke Professor of English and holds appointments in the Law School and in the Women’s Studies and African and African American Studies departments. A Duke English professor of 19 years, Holloway also holds a law degree from Duke and spent the spring of 2008 as a fellow at Harvard University’s DuBois Institute. The book she completed during that fellowship, “Private Bodies, Public Texts: Race, Gender, and a Cultural Bioethics,” is the foundation of her current Bioethics and Literature class. In addition to teaching courses about law and literature in the English department and Duke School of Law, Holloway has authored eight books, including “Passed On: African-American Mourning Stories” and “BookMarks—Reading in Black and White, A Memoir.”

In “Private Bodies, Public Texts” you consider race, gender and cultural bioethics. What makes this scholarship unique in the field of bioethics?

There are many kinds of disciplinary bioethics, including narrative ethics, women’s ethics, and I presume that they all have a cultural context. Rather than being able to extract identity from medical ethics questions, my argument is that identity is always present. Unless we acknowledge that, we’re not attending to the way in which we operate in culture. We have made race and gender matter in culture. To pretend that medical ethics can consider questions of autonomy without understanding that identity matters…. I insist that it does. That’s where I’m a little bit different.

Could you give some examples of uses of modern science and medicine that you believe demand our ethical scrutiny?

Certainly clinical ethics for children. How do we do a clinical trial that involves children? How do we think about their vulnerabilities? That’s very important for me, as are the ways in which clinical trials are exported. That’s probably the most contentious area. The reason clinical trials in the United States are exported to other countries is most ordinarily [because] we don’t have to operate under the same federal guidelines. So what sort of efficiencies are we after that contract the ethical landscape that make populations more vulnerable? So I’m concerned about our exporting clinical trials, especially to countries in which the same cautionary regulations that happen in the United States don’t work, although the cautionary regulations in the United States should still endure a lot of scrutiny.

Could you talk about some of the bioethics conferences you have been invited to attend?

I’m remembering a [National Institutes of Health] conference in September on care at the end of life. I was on a panel with a group of physicians, and I was the humanities person on the panel. At some point, I remember asking the question, “At what point will we allow the end of life not to be an experimental site but a place of spiritual transition?” And I remember the audience saying, “Ohhh….” Everything cannot be a research opportunity. If we continue to think of every moment in one’s life as a particular kind of medical opportunity, then I think we forget the way in which laypersons, a humanist for example, would think about life. So we have to be careful about medicalizing life and death to the extent that everything is an opportunity for study, rather than everything being an opportunity for experience….

The foundation board that I’m on, the Bioethics Advisory Board, I’m one of six people on this board. The head of this board is at Duke, his name is James Tulsky, he’s a palliative care physician. There’s a philosopher and an English professor, two physicians and a lawyer, and us. The philosopher is well known in medical ethics, so his work has always been on this [humanities] side. I think I’m the person who always thinks about identity the most, in terms of the humanities. How someone’s presumption of what your identity is affects the medical treatment you get. I think that I want to be freer, to have identity be flexible, but medicine is not going towards flexibility of identity. If we can say, “This is a child between the ages of 3 and 10, then we can put them in a certain demographic.” If we can say, “This is a black person, this is an Asian person.” So the efficiencies of categories in medicine keep people pretty much bound to those identities. And I see a personal identity as more flexible than that. I don’t know who I am today, yet. I’ll figure it out before the end of the day.

How did going to law school influence the way you read literature?

First, I almost had to forget the way I read literature when I was in law school, because it requires such a different mindset for reading. And that was a really hard transition for me, because I had been reading as a literature person for so long. Now, because of the classes that I teach about law and literature, I look for the legal in a literary text. I look for an issue that revolves around contract. Or how rights are imagined. I was especially interested in books with trials in them. Whereas before as an English major, certainly I would read those books and enjoy them, but now I’m not only looking for a certain kind of, “Oh, I know where this story is going because of a dying testimonial.” In literature, the moment of dying is important, but in law it holds a truth value which I wouldn’t normally have ascribed to it. So I look for the intersections now, in a way that I didn’t before.

What do you mean by “truth value?”

A dying testimonial in law is held to be true. Whatever you say at the moment of dying, that can be used in a courtroom as a truth. Now, as a literary scholar I think, “Okay, at the moment of dying I can blame whoever I want!” But the law holds a really interesting notion around what you say at the moment of dying. It has to do with accountability, and that there’s no longer a stake that you have in the matter because you’re dying. So as a literature person, I’m saying, “That’s a moment to claim a stake!” I think I’m going to teach a whole course around dying testimonials one day because they’re so much fun. When you’re reading Faulkner’s “As I Lay Dying,” you can get a whole other discussion around that. And I did before I thought of, “Gee, what’s the truth value in what Addie is saying?” So there’s a lot of fun in law and literature, especially when you see the presumptions of one held up against the imagination of the other. So that’s what I like to look for now. See, you’re making me smile just thinking about it.

You’ve said that Owen Barfield’s “Speaker’s Meaning” had a profound influence on the way you think about words and language. What should all Duke students understand about the complexity of the words in our everyday lexicon?

I think in recent months I’ve ended a couple of tweets with “language matters.” Sort of like, “See, I told you, language matters.” I think our being conscious not only of the way in which we use words but the way in which they are heard is one thing that Barfield talks about. Your intent placed next to the listener’s intent, a lexical meaning versus a speaker’s meaning. I think it makes us have a responsibility to be more cautious around the words we use, to be intentional. To be cautious that words have social, cultural histories that may be heard very differently from the way you say them. That doesn’t mean that you have a responsibility for everybody’s social and cultural history, but if you’re thoughtful, and careful, then you will realize that potential. I think that Duke students, university students, young people and us elders have a responsibility to be mindful with our language. That’s one thing I’m very intentional about, even though I have learned in recent years how easy it is to pull someone’s language away from them. That surprised me. Part of that is our new Internet age and all of that. But it’s made me feel very good that I’ve always been an intentional language user. But my mother was an English teacher so I had no choice.

Can you give an example of a word that has a very complex meaning that people often misuse?

Let’s take one from class, the idea of vulnerability. I’ve actually written an essay about medical vulnerability. We’ve used it in medicine to mean, “These are vulnerable populations. We have to be careful when we develop policies around them, practice medicine around them.” But we don’t often think about how we are responsible for those vulnerabilities. Our own biases, our own judgments and stereotypes have created a vulnerability. It’s nothing intrinsic, in other words. Vulnerable populations is a good one because I still see that in medicine as, “Oh, we have to be careful about them,” without returning to, “I have to reexamine how I think about people.” I’d like medicine to be more responsive to its own instantiations of authority and judgment, to say, “Oh, I did that,” rather than, “It comes with a person.”

What do you hope students will take away from your English course, Bioethics and Literature?

That it’s complicated, and it’s OK. That although we are responsible in our professional lives—whatever they are going to be—to make a judgment, to know that we are selecting out a particular solution out of many possible solutions. And not to fool ourselves into thinking, “We’ve got the right answer here.” We’ve got the usable answer, perhaps, or the necessary answer…. There are many possibilities. We can’t go through life just engaging every one of those complexities. But at least we can know that it’s complex. I’d like students in this class to think, especially those who are headed into professions where they will have to make medical judgments or legal judgments, to know that they are correctly moving toward an answer, but that they recognize that there were other possibilities. I want us to stop fooling ourselves into thinking, “I’ve got it! This is it! This is the only thing.” But I don’t want to hamper our ability to perform.

As part of the Kenan Institute for Ethics’ project, “Good Question: An Exploration in Ethics,” Professor Michael Moses posed and responded to the question, “Can novels and films make us better people?” In the context of Bioethics and Literature, how would you respond to this question?

I would interrogate “better.” What does “better” mean here? I think novels and literature can make us more mindful. Mindfulness is a quality I really treasure. Having the time to think about a word, to think about its utility, its meaning. So I think that potential for being more mindful is certainly a good thing. It can make us aware of universes that we would not ordinarily imagine. There’s a line in astronomy for the known universe. And now scientists are saying, “We’re talking about the known universe.” So in my head, I think, “There’s an unknown one. How do I even think about that?”

I want to be able to think about that, and that’s what I think literature and novels allow us to do. They allow us to imagine things that would not be an ordinary encounter in our day. Certainly Octavia Butler’s “Bloodchild” is not an ordinary encounter. Or having a savior sibling [like Anna in Jodi Picoult’s “My Sister’s Keeper”]. Or having a school full of clones [as in Kazuo Ishiguro’s “Never Let Me Go”]. So what does it mean to place yourself in an extraordinary situation, and where do you go from there? That’s what I think literature and novels allow us to do. I pull back when people say, “I want to read things about me. I want to see myself in the book.” I’m saying, “Why do I want to see myself? I want to see somebody else, something I never would have imagined.” That’s what I like about fiction. It places me into a realm that I wouldn’t have ordinarily engaged.