The Poetry of Dementia: Art, Ethics and Alzheimer’s Disease in Tony Harrison’s Black Daisies for the Bride
Lucy Burke [1]
The essay considers some of the ethical issues at stake in the transposition of the experience of Alzheimer’s disease into poetic form. Paying close attention to the complex relationship between ethical and aesthetic spectatorship, it argues that Tony Harrison’s film poem Black Daisies for the Bride raises important and difficult questions about the dynamics of ‘looking’ upon those dying from Alzheimer’s. It considers Harrison’s exploration of the role of poetry as a form that salvages and creates meaning out of the ‘unknowable’ experience of profound cognitive loss, examining his engagement with the ‘poetry of dementia,’ in the context of ethical arguments around personhood and relational identity in recent dementia studies.
Introduction
How do we look upon the dying, particularly those dying of a disease such as Alzheimer’s, and what is at stake in the transposition of this gaze into poetic discourse? We might put this question another way and ask how poetry might speak to a form of ‘unthinkable’ and ‘unknowable’ cognitive impairment, and to the ethical problems at stake in such an encounter. Elizabeth Bronfen’s discussion of Ferdinand Hodler's paintings of his dying lover, Valentine Gode-Darel, considers the tensions between an ethical and an aesthetic response to the artistic representation of dying. Bronfen's aim is to explore “the violence inherent in any aesthetic transformation of the experience of death” (44). In so doing, she discusses two conflicting responses to Hodler's works: one by a young male art historian and another by a female photographer who had been required to reproduce the images from the exhibition catalogue. For the former, the issue of the 'non-symbolic' real–on which Hodler's representations of the dying and dead Valentine are predicated–is of secondary importance to the question of their aesthetic value: “For him,” Bronfen notes, “these sketches and paintings were 'beautiful,' 'skillfully made'” (44). To this degree, the ethical implications of the portrayal of a real death merited no further exploration: “because he insisted that there was nothing violent about these paintings, he also rejected the validity of analysing them from this theoretical perspective” (Bronfen 44). The response of the female photographer was in direct contrast to Hodler’s disinterestedness. She described the job as “horrible” and expressed her pity “for the poor woman” (Bronfen 44).
Bronfen points out that what the photographer meant by “horrible” is difficult to determine–possibly referring to the images themselves, that which was represented, the way Valentine died, or the fact Hodler chose to paint her in such a condition. However, as she concludes, “this position is … informed by a diffuse identification with the pain of the model, a response that comes about through the exclusion of an aesthetic spectatorship” (Bronfen 44). She argues that these opposing responses to the representation of Valentine pose important questions about the ways we position ourselves as spectators in relation to images of death and dying:
Should one assume the position of a morally involved spectator, treating the represented body as though it were the same as the material body it refers to … Or should one assume the position of the aesthetically involved spectator, distanced, disinterested, treating the representation of a dying body only as a signifier pointing to many other signifiers? Can we formulate a position of spectatorship that could encompass both moments? (Bronfen 45)
This problem takes on particular complexities in relation to the representation of those with late-stage Alzheimer’s disease, owing to the ethical consequences of using subjects who can neither agree nor refuse to participate in such an aesthetic project. In attempting to work through this problem, one must ask what it would mean not to represent those with the disease, to shy away from the ‘representation’ of those at the limits of life on the grounds of their inability to give or withhold consent. To what extent would an adherence to one ethical injunction (the significance of consent) collide with an equally pressing ethics of recognition? (I refer here to Charles Taylor’s argument that non-recognition or misrecognition “can inflict harm or can be a form of oppression, imprisoning someone in a … reduced mode of being” (1994, 25). How far is a sense of ethical disquiet about using subjects who are unable to consent complicated by more diffuse anxieties about the consequences of an encounter with such vulnerability and dependency? Is the sense of impropriety, of discomfort, one which speaks more to a desire to separate and annex those with such a disease than one bound up with legal fictions of consent? In other words, who are we really protecting when we argue for or against the representation of those with dementia, the sensibilities of those who look or the ‘objects’ of this gaze?
I have asked these questions of Tony Harrison’s film poem Black Daisies for the Bride (1993), a text that, even after countless viewings, continues to trouble me and resist my attempts to make sense of this disturbance. The essay will argue that the poem offers a particularly complex response to the problem of aesthetic and ethical spectatorship, one that demands a movement between both of Bronfen’s ‘moments’ and ways of seeing, and that raises important and difficult questions about the dynamics of looking upon those dying from Alzheimer’s disease. It is also a text that makes a strong case for the significance of poetic discourse as a form that salvages and creates meaning out of the unknowable experience of profound cognitive loss. This is not, of course, an unproblematic claim, as I shall show. I will argue that the poem attempts to develop a way of thinking about self and other in relation to dementia that moves beyond the fiction of an autonomous subject position, a hard and fast boundary between spectator and the object of the gaze, in order to explore a form of relational selfhood. This refers to a model of subjectivity that views the subject not as reducible to cognitive function, as in the dominant medical paradigm, but as socially and culturally ‘embedded’ in a web of interlocutory narratives (Gillett 29-30; Benhabib; Taylor, 1989). It thus offers a way of sustaining the identity of the person with dementia–despite the losses associated with the disease–by foregrounding the significance of those familial, social, and cultural narratives that continue to recognise their particular dispositions and characteristics (Radden and Fordyce 85). However, I will also argue that in Black Daisies this insight is somewhat compromised by the gendered dimensions of Harrison’s construction of dementia and its subjects.
Although it won the 1994 Prix Italia–in the somewhat puzzling category of best documentary–and the best drama at the Mental Health Media Awards in 1994, the poem is perhaps less well-known than some of Harrison’s other works. I will therefore provide a fairly detailed account of the poem, but first I would like to contextualise my reading by saying something more about Alzheimer’s disease and its contemporary meanings.
Alzheimer’s Culture
Alzheimer’s disease started life at the beginning of the twentieth century–in the psychiatric ward in Frankfurt where Alois Alzheimer worked–as ‘a peculiar disease process of the cerebral cortex,' a description of the symptomatology of a middle-aged housewife, Auguste D; she presented in 1901 with significant problems as far as memory, perceptivity and orientation were concerned, along with aphasia, paranoia, auditory hallucinations, and unpredictable behaviour (Hoff 43). It was, in other words, a description of the symptoms of an unusual pre-senile dementia. This view of Alzheimer’s prevailed for most of the century, and the disease itself was considered relatively rare, as Jaber Gubrium puts it, “nearly medically dormant until the 1960s” (1987, 1). Its return to centre stage in the West as one of the ‘diseases of the century’ (Fox 59), through the 1970s to its current epidemic significance, has been explained by various scholars as one that is driven by the impulse to differentiate so-called normal from pathological ageing and is therefore enmeshed in various agendas – the disciplinary claims of the new field of geriatric medicine, the financial interests of pharmaceutical companies, arguments around the distribution of welfare funding and social care, and the campaigns of increasingly powerful lobbies such as national Alzheimer’s societies (Gubrium 1986; Fox; Lyman; Cohen; Estes and Binney).
What we have at the beginning of the twentieth century, then, is an understanding of senility – that is, cognitive impairment and memory loss–as an expression of ageing. It is part of an expectation of decline and degeneration in the elderly as in Shakespeare’s ‘seventh age’ of toothless oblivion:
second childishness and mere oblivion
Sans teeth, sans eyes, sans taste, sans everything (AYL 2.7.166-67.)
The designation of Alzheimer’s as an unusual pre-senile dementia indicates the extent to which a relationship between ageing and dementia was assumed. This is markedly different from the situation today, where ageing is subject to ever more precise demarcations (the ‘young old,’ the ‘old old,’ the ‘frail old’–terms that are not automatically coterminous with physical age), and in which senility, now recast as Alzheimer’s disease, has become a disease category, a pathology to be set apart from so-called healthy ageing. Old age becomes something benign but at a cost, as Cohen puts it, because “those relegated to the victimhood of Alzheimer’s now [have] to bear the dehumanizing brunt of a total and questionable pathology” (1998, 69).
That the boundaries between ‘health’ and pathology are far from easy to establish definitively is widely recognised, although the pursuit of such a clear-cut division is one aspect of current medical research and the motor of work to establish the various genes involved in late-onset Alzheimer’s (See Esiri and Nagi; Hughes et al; Small). The plaques and tangles in brain tissue that characterise the pathology of the disease are found, post mortem, on ‘normal’ as well as diseased brains and forgetfulness remains a received consequence of ageing, although this is increasingly fraught – always already a harbinger of doom, like the incidental cough in the Victorian novel. Cohen, writing on the production of a new category, “benign senescent forgetfulness” (BSF), “the heir to senility’s mantle of normal forgetfulness,” notes that “the line between the ambiguous normality of BSF and the unremitting pathology of dementia is itself not clear. How much forgetting is disease? How many plaques does it take?” (1998, 61). His point is not that we cannot differentiate between those who remain more or less fully functioning and those who do not, but that the boundaries between normal ageing and pathological ageing are more porous and unclear than we are often led to believe. That ageing remains the greatest predisposing factor for Alzheimer’s attests to this porosity – Alzheimer’s is not an inevitable feature of ageing, but the incidence of the disease increases exponentially with age.
As Lawrence Cohen’s work suggests, medical discourse provides the most powerful paradigm through which we make sense of impairment and decline in old age, organizing various forms of physical and cognitive loss, vulnerability and dependency into ‘measurable’ and ‘accountable’ narratives of pathological disease progression (See also Gubrium, 1987). We can clearly point to the organic ‘reality’ of Alzheimer’s disease by way of a host of evidentiary forms, Magnetic Resonance Imaging (MRI) scan evidence and countable plaques and tangles on the diseased brain (something Cohen suggests is part of the power of Alzheimer’s over other medicalisations such as vascular and multi-infarct dementia). Yet it is also the case that what is made of this knowledge, and how we incorporate pathology and medical ‘facts’ into our lives, enmeshes it in the social world of meaning-making and in other less ‘accountable’ problems: cultural perceptions of ageing and its burdens, anxieties around vulnerability and dependency, fears of dying, decline and loss of autonomy. To speak of dementia, as Cohen puts it, is necessarily social, “the language of legitimate pathology reflects not only the view under the microscope but the social construction of the person identified with the slice of tissue” (1998, 38).
How we think about Alzheimer’s not only matters in the sense that particular epistemic cultures construe it as a problem in distinct ways, but it also materializes and inevitably evaluates the body of the person with dementia (Cohen, 1998, 38). In Dementia Reconsidered, Tom Kitwood tells a story about an agency that requested a day centre to provide photographs of its clients in order to raise awareness and generate publicity about dementia. I will let Kitwood complete the anecdote:
Permission was sought and granted; the photographs were duly taken and sent. The agency, however, rejected them, on the ground that the clients did not show the disturbed and agonized characteristics that people with dementia ‘ought’ to show, and which would be expected to arouse public concern. The failure of the photographic exercise, from the standpoint of the agency, was a measure of the success of the day centre from the standpoint of the clients. Here was a place where men and women with dementia were continuing to live in the world of persons, and not being downgraded into the carriers of an organic brain disease. (1997, 7)
This anecdote foregrounds the ethical consequences of particular ‘descriptive’ categories and the ways of seeing that they prescribe. It is a story about representation and the ethical ‘problems’ to which it gives rise. In a book that seeks to develop an alternative conceptual framework through which to approach and evaluate the person with dementia, Kitwood uses this story to make a point about the ‘violence’ to personhood wrought by prevailing perceptions of dementia that emphasise impairment and pathology, in other words the ‘gulf’ between the ill and the healthy, rather than focusing upon what is shared and retained, a ‘celebration’ of “our common ground” (1997, 8). This is part of Kitwood’s critique of a ‘culture of care’ that he described in an earlier work as redolent of a “malignant social psychology” (1990), something “very harmful, symptomatic of a care environment that is deeply damaging to personhood, possibly even undermining physical well-being” (1997, 46). For him, like numerous other researchers in the human sciences, it is the “standard biomedical paradigm” (Kitwood, 1989), based upon diagnostic, neuropathological and genetic models of dementia, which plays a key role in producing this ‘malignancy’ by virtue of its focus upon impairment at the expense of a more holistic and ‘empathetic’ approach to the person. Rather than reducing those with the symptoms of dementia to their disease and rather than viewing cognitive decline as synonymous with the radical disintegration of the person, Kitwood argues for a new culture of person-centred care that nurtures, respects and validates the individual (1997).
For Kitwood, then, the issue of the failure or the success of the photography project is contingent upon the particular paradigm or culture of care to which one subscribes. The ‘ought’ that circumscribes the agency’s demand for images of agony and disturbance is attributed to a malignant culture of geriatric care, which seeks to pathologize those with dementia and reduce them “to the simplistic categories of some ready-made structural scheme” (Kitwood, 1997, 135). Of course, Kitwood’s whole argument can also be described as an ‘ought,’ as an ethical and political injunction to ‘see’ those with diseases such as Alzheimer’s differently, one which, he argues, is all the more difficult and all the more vital because it goes against the grain of prevailing cultural assumptions about health, illness, impairment and care. In this respect, his position is just as prescriptive as that of the agency desperately seeking its horror show images. In emphasising the complicity of particular ‘cultures’ with the erosion or the extension of personhood, his project not only underlines the significance of various representational or discursive forms by constituting and implicitly evaluating the ‘object’ they purportedly describe, it also links good care with good or ‘positive’ representation in a kind of ethical and aesthetic pact.
Kitwood’s work has played a hugely influential role in the ‘personhood turn’ in Alzheimer’s research in the Human Sciences, a body of work characterised by a critique of ethical shortcomings of medical models of the relationships between brain, mind and person. These models, in viewing mind and personhood as contingent upon cognitive function, are viewed by many as collusive in the erosion of personhood of those with dementia. If cognitive skills such as awareness, self-consciousness and memory are held up to be the defining attributes of the ‘person,’ (or in some instances, the ‘human’), then those with degenerative conditions such as Alzheimer’s are easily rendered nonpersons; bodies without selves, or the living dead, as the dominant horror show constructions of the disease would have it (Aquilina and Hughes 143). Much of the sociological and anthropological work in this field has pointed to the powers of medical discourse to effect this ontological transformation from person to Alzheimer’s ‘victim,’ condemning the person manifesting the symptoms of memory loss and cognitive impairment to a form of biosocial death (Leibing), annexed to a liminal space between the living and the dead. Karen Lyman describes the impact of diagnosis upon the person as often leading to “a self-fulfilling prophecy of impairment” (343), or what for B. F. Hofland is a form of learned helplessness (1988). The argument, in other words, is that diagnosis produces, rather than simply describes or reflects, a sick, ageing body.
Alzheimer’s, in this sense, might be described as a contemporary form of cultural production, as the site upon which new bodies and new modes of being are forged, and arguments around the limits and meanings of personhood in relation to cognitive decline are harnessed. There is much at stake, then, in the ways we imagine diseases such as Alzheimer’s, in the capacity of particular models of brain, mind and subjectivity to realise and de-realise the ‘personhood’ of those with dementia, and in the powers of particular forms of discourse to produce the malignant social environment of which Kitwood speaks. In their starkest expressions, the tropes of ‘physicalist,’ biomedical models of brain, mind and person discursively strip those with dementia of all vestiges of humanity or personhood, either by way of the familiar attribution of vegetable or “cabbage-like” qualities or by construing these subjects as animals. Thus, David DeGrazia compares the cognitive powers of a man with severe dementia to those of a dog, concluding that Al is “in short a sentient nonperson” (160), and Alzheimer’s researcher Peter Hyslop, in a quotation that haunts Charles Pierce’s memoir, describes the disease as rendering a woman into a “lower primate” (Pierce 54). Cast as a disturbance of the boundaries between the human and the nonhuman, Alzheimer’s, as Elizabeth Herskovits puts it, becomes a monstrosity, an object of both fear and loathing, violating social proprieties, familial relationships, norms of behaviour and social interaction.
As Laura Tanner has argued, “the way we as individuals and as a culture look at people with terminal illness raises questions about how the act of seeing can serve to naturalize assumptions about the dying body and the embodied subject” (19). This discussion foregrounds the significance of questions of aesthetic spectatorship of how we look at and ‘see’ those with dementia, as an ethical question bound up with particular models of subjectivity and personhood. Looking is never unmediated, but contingent upon particular epistemological frames that materialise the body of the object of that gaze in distinct ways. For all that, this can be forgotten or submerged in the logic of specific forms – the denotative claims of photo-realism for instance. The violence of Alzheimer’s as pathology and ontological category is in the policing of the boundaries between the diseased body and the healthy self, between dependency and the (illusory) autonomy of the well, between claims to personhood and recognition (Taylor, 1994) and its de-realisation in the language of biosocial death. There is much at stake in formulating an alternative way of thinking about and seeing dementia, particularly one that unsettles the ease with which such boundaries are drawn and maintained. It is with this in mind that I would like to turn now to Black Daisies for the Bride as a text that operates at these boundaries, articulating them, undoing them, and unsettling our gaze.
The Poetry of Dementia
First, a word about genre: closely associated with Harrison’s work, the film poem is a form in which meanings are produced through a kind of ‘dialogical’ tension concerning poetic language, visual image, soundtrack and music. More so than his other explorations of the form (the earlier poem V for instance), Black Daisies for the Bride plays on the imaginative possibilities this combination of verse, song and film affords, as a generically hybrid composite of a range of different representational modes and styles. It is a difficult text to describe in full, but I will endeavour to do so without, I hope, diminishing any of its complexity.
Filmed on location in the Whernside ward at Highroyds, a large Victorian mental hospital on the outskirts of Leeds in West Yorkshire, Black Daisies focuses primarily upon three women, Maria Tobin, Muriel Prior and Kathleen Dickenson, although others, chiefly Muriel Allen and Irene Parker, are also included in the poem. All the women are institutionalised because they are in the late stages of Alzheimer’s disease and increasingly physically as well as cognitively incapacitated. On the level of the 'non-symbolic real,’ then, we are confronted with five severely cognitively impaired, dying women and the dark, intransigent institutional space in which their days will end. This is portrayed throughout as a form of physical incarceration. The prison-like aspects of Highroyds are emphasised visually in images of black, impenetrable stone walls and locked doors to which the women have no access code. They are literally imprisoned as a consequence of their dementia, annexed to this liminal social space between the social world and the cemetery. “Death’s got the only door code out of Whernside Ward,” we are told, because it is their only means of escape.[2] However, on a symbolic level, imprisonment also serves as a powerful metaphor for the cognitive losses of Alzheimer’s and the incarceration and inaccessibility of the women’s selves in its wake.
Throughout the text various aspects of the women’s day to day existence (notably time spent in the seated areas and dining room of the ward) are filmed in documentary style footage, although these frames are manipulated to express the fragmentation of the subject through dementia – shots of wringing hands and tapping feet, inter-cut with the nurse’s swinging fob watch, attest to a violation of subjective integrity through visual synecdoche, and of the severing of physical ‘gestural’ memory from any meaningful context. The women, as the images of the watch suggest, are simply marking out time. Kath, for instance, repetitively and pointlessly wipes and cleans the surfaces of the ward, while Muriel Allen’s love of music is, the poem imagines, retained only in “twitching, twisting fingers / And in the beat of sneakered feet that she drums in the ward all day.”
Harrison's poetic ‘soundtrack,’ written in iambic pentameter, his typically strict metrical style, speaks to these visual images, to the present lives of the ‘women of Whernside’ and to their past, problematically encapsulated in the idea of two marriages–their original wedding day, contrasted with their symbolic marriage to Alzheimer’s, “the groom beside each white clad bride” who gives them their black daisy bouquets. (This image is picked up from the black flowers in the mosaic tiles of the hospital corridors). Rather than the simpler dialogical ‘voice’ that we see in V (organised around an imagined ‘conversation’ between the poetic voice and that of his skinhead alter ego), the poetry here is spoken in various forms, through song, and dialogue, by actors and non-actors. Some of the actual staff of the hospital speak lines of the poetry, as if in the natural rhythms of conversational exchange, at the same time as they engage in the everyday work of the ward, decorating a Christmas tree and speculating about what Christmas means to their patients (“Christmas always lets some memories through / Christmas can’t have too much meaning / when you spend your days spring cleaning”). A therapist – played by an actor–works with the women, singing songs and attempting to engage with them, but she also reflects upon the nature of Alzheimer’s, memory loss and mortality in conversations with staff and patients, and direct addresses to the camera.
Inter-cut with the ‘documentary’ images of the ward, a number of staged musical scenes imagine three of the women’s earlier selves (Muriel Prior, Maria and Kathleen) haunting the great, empty corridors of the hospital. Clad in wedding dresses modelled on those proudly displayed in their wedding photographs, the women here are played by actors who also play nurses. Those literally in possession of the access code to the locked doors of Whernside as members of staff are cast metaphorically as those who have the access code to the women’s lost memories, to their earlier characters and dispositions, as is illustrated with reference to Kath’s love of motorbikes and mountaineering and Maria’s opera singing. The substance of these scenes is derived from the comments of family members, whose voices are heard in brief, overlapping and disembodied fragments through the text, reflecting upon the women’s lives before and after Alzheimer’s. These staged wedding scenes segue into elegiac reflections upon the erosion of memory through dementia as the women disappear into the spectral gloom of the hospital corridors; the aisle they walk ends at the grave. “Nothing of that” sings Kath’s ‘younger self’; “None of it stays, motorbiking, mountaineering / lost in days I won’t see clearing / Those long green vistas all grey.”
The different scenes in the text – both documentary and theatrical – are connected through song, which plays a crucial role in the piece. Three songs in particular move in, out and between the words of the poem, seamlessly flowing into one another and inflecting each other’s original meanings: two popular songs from the women’s youth, ‘Daisy, Daisy’ and ‘Oh You Beautiful Doll,’ and Christina Rosetti’s elegiac Christmas carol ‘In the Bleak Midwinter.’ The tune and lyrics of the latter persistently push towards the incorporation of the youthful and romantic optimism of the former songs, subsuming them either lyrically or harmonically into the cadences and semantic nuances of a mournful reflection upon the covering of the Winter landscape in snow, a trope for death and memory, used here to communicate the losses of Alzheimer’s (“Snow was falling, snow on snow, snow on snow”). The tune of ‘Daisy Daisy,’ a popular song about a marriage proposal (“Daisy, Daisy, give me your answer do, I’m half crazy all for the love of you …”) becomes the ironic bearer of a lyrical text recording the losses of Alzheimer’s, “though the music keeps on playing, the notes won’t stop decaying.” The tune of ‘Oh You Beautiful Doll,’ sung to the patients in its original form, acts as a grim, almost obscene reflection upon the disjunction between the women’s past youth and their present. The text also returns, again and again, to fragments from an aria from Puccini’s Madame Butterfly, as recorded by one of the women, Maria, in the 1950s, a melody that remains with her only as a single note, “that one trilled A she sings all day / and she never remembers more”.
Working with and against the rhythm of words and music are the noises of the ward and the hospital that always threaten to disrupt the steady rhythm of the poetry, dissolving it into a kind of white noise of screams, moans and the oppressive siren-like hum of the hospital laundry van. The music is also interrupted by snatches of the women’s speech–Muriel Prior’s repeated “I love you, I love you, I love you” and the incoherent interjections of Muriel Allen, Maria and Kathleen, fragments of language that promise but elude meaning-making, such as Maria’s rhyming “Oh the babble of ewes, beautiful Jews” with which the poem opens.
As I hope this discussion indicates, Black Daisies for the Bride is less a poem about Alzheimer’s in the sense that it offers any discursive explanations of the disease, than it is a text that seeks to ask how poetry and cultural practices such as music and song might speak to, and make sense of the experience of dementia. The opening of the film sees the footsteps of the therapist walking down the corridor become the regular beat of Harrison’s iambic pentameter. The sounds of patients on the ward become part of this rhythm, as do the repetitive movements of swinging and tapping feet and hands. Poetic form is thus presented from the outset as that which organises and lends shape to the fragments of language, the unconscious gestures and involuntary bodily movements that characterise the symptomatology of the late stages of the disease. Yet Harrison appears also to be suggesting that there is a poetry to dementia, or even that dementia is a form of poetry in its stripping away of life narratives to reveal a core of ‘fragments’ that crystallise the dispositions and characteristics of those with the disease. Maria’s trilled A, Kath’s constant cleaning, Muriel’s “I love you, I love you” are presented as the distillation of all that they once were.
We might well view this with some suspicion, as an uncritical veneration of the poetic that salvages the humanity of the women at the very limits of its meanings, in other words, as an assertion of the essentially humanizing powers of poetry to find meaning in a disease associated with its very loss. It would be more accurate, however, to describe the text as operating at the critical edges of such an assertion. The language and noises of the patients, which at the opening of the text appear to have a rhythm, threaten at key points to disintegrate into anguished and incoherent screams, while the siren-like noise of the laundry van momentarily drowns out the rhythm of both verse and music, as if to expose the precariousness of poetic form, the struggle to maintain its ‘hold’ over the conditions on the ward.
We can trace this tension, too, through the use of confetti as a trope throughout the poem, as the notion of being “lost in the blizzard of days” recurs as a metaphor for memory loss in Alzheimer’s. Figured as a blizzard of confetti, the disease is presented as one that obscures meanings and understanding, and breaks up the integrity of the self, “shredding all remembered time.” Anthony Rowland reads these blizzards with reference to the nature of snow to form and reform itself and thus to the operations of memory (189). However, the blizzards in the film are not made of snow but the confetti one throws at a wedding and its significations are therefore more complex. To substitute confetti for snow is to substitute something artificial for something natural in a way that draws attention to the artifice of the text itself. The shreds of confetti clearly signify the assault of dementia upon memory and the self, but it is not simply a trope for this fracturing of memory, referring us also to the artistic rendering of this fragmentation (it is confetti rather than snow) through the theme of the black daisy brides. This underscores the artifice of the poetic text – its imposition of form upon the often un-containable and incoherent actuality of the ward. We see this in the final shots that depict a rubbish cart carrying away the bags of confetti used in the film and resonate on a number of levels. Linked to the trope of Alzheimer’s as a deathly marriage, the disposal of the confetti points to the graveyard as the women’s final destination and to the total eradication of memory in death, but it also points to the potential meaninglessness of artistic endeavour in the face of this – its transience, or failure to bring meaning more than temporarily to that which it portrays. The confetti signifies marriage to the disease and the disease’s decimation of memory, but it is ultimately presented as the detritus of filming, literally ‘rubbish’ to be disposed of and a metaphor at the end of meaningfulness.
While this scenario, I think, suggests a self-reflexive and at times ambivalent engagement with the limits of poetic form to recuperate the reality of Alzheimer’s, Black Daisies nevertheless asserts the powers of artistic practices to enable an imaginative encounter with the unknowable experience of profound cognitive impairment, and thus to sustain a form of personhood for its female subjects despite the cognitive losses of Alzheimer’s. This is explored in the text through the black daisy brides, spectral figures that bring together the past and the present of the women through the transposition of their wedding photo images into their lives on Whernside ward and their second ‘marriage’ to Alzheimer’s. The gendered dimension of the marriage trope is deeply problematic in casting the disease as predatory lover with his “black daisy buttonhole,” and the “white clad brides” as his passive and ultimately vulnerable victims (of which more below), but it serves to focus an imagined dialogue between younger and older selves on the nature of loss and the eradication of memory. As the younger Muriel Prior sings, “Some moments when I call I feel you hear me … My voice in your ear grows less, fading into the storm of forgetfulness”.
Harrison here deploys the rhetorical figure of apostrophe, a vocative address to an absent subject and a characteristic convention of the elegy. It is used to convey the disconnection of past memories from the present, and the splitting of the subject as a consequence of Alzheimer’s. The younger self both mourns and addresses what she is to become, “Muriel, Muriel – I’m the Muriel who wed, but your memories of being me are fled / You’ve forgotten when you married the anemones you carried / The sad thing is anemones go unnoticed above your head.” At the same time, this convention operates as that which connects the women with their lost memories as embodied by the brides. It is a connection that can only be imagined, and that is meaningful only for the audience. Its significance, then, is in reminding us of what the women once were in order to sustain and to make sense of what remains. The brides’ songs contextualise the fragments of speech and behaviour that would otherwise appear meaningless. They also serve to reconnect the comments of relatives (heard in un-attributed voice-over) to particular women, relocating them in relational or familial terms in the face of the dislocations – physical and cognitive – that Alzheimer’s renders.
It is important to note in this context that the black daisy brides inhabit the hospital corridors, rather than the ward itself. In terms of the text’s emphasis upon the incarceration of the women on Whernside ward, this speaks to the potential of poetry to imagine them outside the physical and mental constraints that Alzheimer’s and their institutionalisation in the hospital impose. It is poetry in this respect that possesses the access code to what is presented as an imprisoned subjectivity, momentarily liberating the women, if only imaginatively, from the ward. The artifice of this endeavour is foregrounded: “If we could give them voices we would hear them say / gather all your memories, savour everyday.” It is an assumed and conditional rather than a verifiable response–what ‘we’ imagine they would say if they could. The poetic text, in this sense, operates as a form of prosthetic subjectivity, reconstructing lost selves and perspectives that can now only be imagined rather than ‘known.’
The brides’ performances also enact the dissolution of the boundaries between subjects, troubling any ‘hard’ distinction between those who are carers and those for whom they care. Played by the same actors, the superimposition of roles and identities serves to connect the young women of the present with the older women with dementia, both a momento mori for the actors themselves in the sense that this is what any of us could become, and a momento vitae for the women with dementia through the recollection of their younger selves. The point is that there is not just a ‘looking at,’ but a deliberate play upon various forms of identification; one which is only possible in imaginative literature, where what Paul Riceour terms the ‘basic particularity’ of the embodied self can be momentarily suspended as we imagine inhabiting the consciousness of others and play out the connections between self and other (115). In the text, actors become nurses who become the patients’ younger selves in order to remind us of the continuities as well as the ruptures between past and present. This is also evident in the therapist’s recognition of her own mortality and vulnerability in the character of Muriel Allen:
Muriel Allen a therapist like me
Now beyond all forms of therapy
And if Alzheimer’s doesn’t spare a
Lifetime professional carer
And denies a mind of Muriel’s kind
And a therapist … no-one’s free
The therapist’s pain is clearly signalled; we see her sitting, tears running down her face as she finds herself trapped in her car amid a blizzard of confetti. Yet rather than an expression of nihilism in the face of the inevitability of impairment and death, the recognition that ‘no-one is free’ plays itself out as a point of contact rather than separation among those that work, live and die on Whernside. It becomes another way of asserting what is shared, rather than what divides the various women in the text. For all that Alzheimer’s represents a radical form of otherness, the text continually locates this potential within those that care and watch. When the therapist looks at Muriel Allen, she is also looking at herself. The image of her alone in her car speaks of her own, and of Muriel’s isolation and incarceration, and the confetti of “shredded memories,” of what must always be lost in death.
Writing of her work with Alzheimer's patients, Anne Davis-Basting describes the disease as producing “an extreme example of a ‘self’ that is relational, that is formed through interaction with others” and she argues that “the history and context of the traditional autobiography, in which a consistent “I” tells a chronological tale of selfhood, make it inhospitable to representations of the extremes of relational identity” (79). What is needed, she suggests, is a notion of selfhood that does not rely on memory, but is based upon the relational quality of the self (Davis-Basting 79). Black Daisies, it might be argued, offers one way of maintaining personhood through the embedding of subjects in a world of shared cultural references. What the women ‘are’ the text suggests, is not reducible to their losses, but something that emerges through an interaction with the shared cultural forms that speak our experiences. For instance, the popular song, ‘Oh You Beautiful Doll,’ continues to elicit a response from the women–Maria dances, Kath conducts and Irene sings along, retaining the tune if not the lyrics. Songs remain, and, more importantly, remain of value to the women, signs that ‘personhood,’ however damaged, is not entirely lost because a capacity to value remains (Jaworska 122). In this sense, cultural practices such as music and verse are presented as part of the ‘relational networks’ through which subjects are formed, media through which personhood is realised, regardless of degrees of cognition or self-awareness. Forms such as poetry, the text suggests, not only lend shape to, but continue the work of scripting the self precisely at those points where the capacity to tell a life story is diminished, materialising the subject of Alzheimer’s in relation to a far wider discursive realm than that of biomedical discourse alone.
Conclusion
As I hope the discussion has demonstrated, Black Daisies is centrally concerned with the question of how we look upon dementia. It is a text thatpersistently resists the impulse to establish hard and fast boundaries between viewer and viewed, subject and object, and it does so both by problematizing the boundaries between carers and patients and in refusing a stable viewing position for the audience–by virtue of its movement between ‘actuality’ and artistic representation, the ‘non-symbolic real’ and the imagined ‘symbolic’ realm of poetic discourse. This movement demands that we – as spectators – consider the relationship between the ‘real’ (the actual women, the actual ward, the actual hospital, the actual suffering) and the artificial or artistically imposed (the imagined brides, the songs, the blizzards of confetti that shower the corridors, the rhymes and rhythm of the music and verse). We are compelled to read the material aspects of the women’s confinement as metaphors – the dry stone walls that encompass the hospital, the access code and key pad to Whernside ward, are all tropes that express the ‘imprisonment’ of the women’s memories, the profound dislocation of subjectivity, the impenetrability of severe cognitive loss. Yet, we are also compelled to locate these tropes in material conditions. Highroyds was (it is no longer a working hospital) to all intents and purposes a prison, and death literally has the only access code to Whernside because there is nowhere else for the women to go, because this is what we do, as a society, to manage the disruptive behaviours of those with severe cognitive impairment at the limits of life. We are thus inescapably interpellated into the logic of ethical and aesthetic spectatorship, or perhaps more accurately, we are never allowed to relinquish the terms and conditions of both ways of looking in a way that foregrounds the relationship between them as an unsettling problem that can neither be forgotten nor evaded.
Of course, self-reflexivity about the artistic process, the fact that Harrison foregrounds this movement between the poetic and the ‘real,’ does not in itself resolve some of the more intransigent problems that Black Daisies presents. The reduction of the women’s lives to the so-called defining moments of their weddings may well offer a metaphorically productive way of making sense of the relationship between their past and their present, but it also threatens to subsume them, in all their particularity, into a sexist cultural narrative wherein marriage stands as the defining and decisive moment of female identity formation. The bridal trope that runs through Harrison’s text also conflates the vulnerability and dependency that Alzheimer’s brings with femininity, reproducing a banal but malignant cultural stereotype. This is one that arguably limits Harrison’s exploration of the impact of the disease upon the women, and that leaves little ‘space’ for an imaginative engagement with the experiences of men with dementia beyond a sense of a double violation of self and masculinity.
I would argue nonetheless that Black Daisies remains an important text in its refusal to avert its gaze from those with dementia, and in its exploration of the role of poetic discourse in this context. Poetry and song operate as forms of social “recognition,” establishing points of connection between the women and the social world from which those with Alzheimer’s are so easily separated through the language of biosocial death. Harrison finds rhythm and music in their utterances and movements and the film underlines the extent to which verse and song continue to speak to them however diminished their responses. Black Daisies makes a strong case for the ethical role of imaginative literature in this context. While the women cannot retrieve their lost memories, nor poetry accommodate the reality of their dying, Harrison suggests that their personhood can be sustained through the imaginative reconstruction of the person in the past as a means of reconnecting past and present, making sense of the fragments that remain as aspects of a particular and unique person, rather than simply as the signs and symptoms of disease.
Notes
[1] Dr. Lucy Burke, Department of English, Manchester Metropolitan University. This research is supported by the research leave programme of the Arts and Humanities Research Council (AHRC) UK.
[2] Tony Harrison, Black Daisies for the Bride. First aired on British television on Wednesday June 30, 1993, directed by Peter Symes. References are to this filmed version of the poem and consequently do not include line numbers.
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