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i [Quentin]
temporary
and he [Father] you cannot bear to think that someday it will no longer hurt you like this now . . . you wont do it [commit suicide] under these conditions ... no man ever does that under the first fury of despair or remorse or bereavement he does it only when he has realised that even the despair or remorse or bereavement is not particularly important to the dark diceman and i
temporary
and he it is hard believing to think that a love or a sorrow is a bond purchased without design and which matures willynilly and is recalled without warning to be replaced by whatever issue the gods happen to be floating at the time no you will not do that until you come to believe that even she was not quite worth despair perhaps and i i will never do that nobody knows what i know . . . and i suppose i realise what you believe i will realise up there next week or next month and he then you will remember that for you to go to harvard has been your mothers dream since you were born and no compson has ever disappointed a lady and i
temporary
it will be better for me for all of us and he every man is the arbiter of his own virtues but let no man prescribe for another mans wellbeing and i
temporary
and he
was
the saddest word of all there is nothing else in the world its not despair until time its not even time until it
was
(220-222)

It seems to me that Faulkner is spelling out the dreadful consequences of this view that nothing lasts, that our loves as well as our hates are invisibly time-bound, can be "called" and "replaced" by "whatever issue the gods happen to be floating at the time," with the result that you wake up and simply discover, one fine day, that it is all over, it just
was,
although you said, thought, and needed it to be eternal. All is
temporary,
including self.

There is a heinous kind of mutiny on display here, a rebellion on the part of our deepest feelings, as if they wanted to show that we do not own them, that they live and die an indigenous existence of their own. Once again we see the "impostume" "That inward breaks, and shows no cause without / Why the man dies," but we also see, in Faulkner's novel, that this news is simply unbearable. We may feel that Quentin Compson chooses to commit suicide precisely in order to avoid the shameful metamorphosis that has been prophesied here. He fights "temporary" the only way he knows how. He kills himself to remain faithful to his deepest feelings, to remain himself. He acts on the famous "To be, or not to be" in the name of self-preservation.

I do not want to suggest that all suicides resulting from depression are secret forms of self-assertion. Many are doubtless final exits in order to leave pain behind. Nor do I have illusions about the arduousness and accessibility of Faulknerian prose as a tool for showing the utility of literature. I close with Faulkner's Quentin Compson because he is the modern age's rival to Hamlet in just this sense:
inside, it is all sound and fury.
Interior monologue thrusts us into the minds of tortured protagonists, and this difficult trip seems enormously worthwhile to me. First of all, it writes large for us what the tempest is like. And, even more signif-icandy, it offers an exit from
our
penitential arrangements into the field of vision of a character in literature. I do not know how to overstate this last point: art and literature provide for us a unique means of travel, of vicarious experience, of seeing the world with new lenses, of vacating— at least for a bit—the cramped quarters where we keep house. There can be no better medicine against depression.

It has long been said that Faulkner's world—unlike that of so many American writers who are future-oriented—is past-haunted, saturated by a sense of determinism. His characters are excruciatingly conscious of their doom. Robert Penn Warren once revised this notation quite memorably: Faulkner's characters, he said, are not simply conscious
of
their doom; their consciousness
is their doom.
Is it too much to say that depression can be understood along just these lines: consciousness as doom? Is this not precisely our modern fate?

Shakespeare wrote that "something is rotten in the state of Denmark," and I believe that what is rotten about modernity, what constitutes our own special plague, is excessive consciousness, a lifelong jail sentence in our own minds, the dreadful condition of being locked into our perceptual system and hence locked out of everyone else's. This is the death of love as well as the shrinkage of life. This is poison in the ear and in the heart.

And this is why literature matters. Art is that other place that can become ours, those other selves we also are. The experience of art is a precious exercise in freedom, in negotiating subjectivities and lives that are not our own. Strange as it may initially seem, Faulkner's tortured novel about a tortured young man is therapeutic and liberating along just these lines: as a magic venture
out
of our own precincts and
into
something rich and strange. The gift of emancipation that art offers is arguably most intense and most exhilarating when it comes to novels such as
The Sound and the Fury,
because Faulkner's very depiction of Quentin Compson is only readable if we agree to make the voyage, if we are prepared (in heart as well as mind) to make the great leap into his daunting text. There is no middle ground here. You do not browse Faulkner. Either you make the plunge (and inhabit Quentin's mind, "endorse" his sensations), or you are left where you started: on the outside, looking at prose that looks like gibberish. Should you, however, go
in,
you will encounter something not utterly unlike what Ali Baba found when he entered the cave: great treasure.

That treasure does not consist of nuggets of wisdom. Quentin has little of that to offer. The treasure is the trip itself, for it is perforce a trip outside yourself, outside the doom that is your consciousness, and into the capacious structures of art and literature, into the imagined world. Faulkner's novel is not a cheerful affair, but it is deeply life enhancing (even though Quentin dies), inasmuch as it operates like all the other artworks discussed in this book: it is an extension of your life, a way for you to partake, as Emerson said long ago, of the commonwealth, to enter into the great bloodstream that courses through history in the form of art. Yes, art is arterial. Bon voyage.

ACKNOWLEDGMENTS

"Nobody ... I spect I grow'd," Harriet Beecher Stowe's character Topsy replies, when asked who made her. It seems to me that this book too just "grow'd," evolving from a more academic study in the burgeoning field of "literature and medicine" into a broader account of the way feeling and pain are expressed in literature and art. But that evolution has its history and its helpers, and it pleases me to acknowledge them.

My work in literature and medicine began more than a decade ago, and I owe a debt to Dr. Timothy Rivinus who team-taught with me the first actual course I had ever given in that area. Since then, I have had the pleasure of working on these issues with the editors of the journal
Literature and Medicine,
most especially Rita Charon, who offered her encouragement and keen critical eye when I began writing in this field. I am also grateful to Carl J. Gerber of East Tennessee State University Medical School, Burke A. Cunha of the School of Medicine at Stony Brook, and Larry Zaroff of the Medical Humanities Program at Stanford for opportunities to present my ideas to medical audiences. I was fortunate, as well, to receive a research grant from the National Endowment for the Humanities, which enabled me to devote further time to this study; some of that time was spent in Stockholm where I had fruitful conversations with Carl Magnus Stolt and Rolf Ahlzen of the

Karolinska Institut in Stockholm, both of whom believe passionately in the connection between medicine and the arts.

Closer to home, I have had a chance to try out these ideas on a repeated basis with Brown University undergraduates, many of them pre-meds, all of them lively and critical, well versed at keeping their professor on his toes. Brown University has provided material as well as intellectual support, and I am grateful to Charles Auger and to Laurence Vanleynseele for the unstinting assistance they provided me in the preparation of my manuscript; I want also to acknowledge the grant made available to me by the Dean of the Faculty, in order to offset some of the expenses entailed in marshaling the visual images that make up part of my study. In that regard, Gun Lundberg of the Svensk Filminsti-tut, Lotta Edoff of Svensk Filmindustri, Tytti Soila of Stockholm University, and Karen Lerheim of the Munch Museum in Oslo were instrumental in helping me get the Bergman and Munch materials and permissions I needed. Another debt I am happy to acknowledge is to Thomas Rollins and The Teaching Company, where I had a chance to offer a series of lectures on these issues entitled "Using Literature to Understand the Human Side of Medicine," providing, like my Brown courses, something of an early trial run for this book.

Some of my debts are more far-flung. Asked by the Shakespeare Society to lecture on
Hamlet,
I had an opportunity to try out many of the ideas on depression that now appear in my conclusion; I am grateful to both Adriana Mnuchin and Nancy Becker for their encouragement in approaching the Bard along these lines. Shakespeare's entry into this book typifies the way it "grow'd" from a discussion of literature and medicine into a much wider and far-reaching inquiry about feeling itself, as the motor-force of art and literature. In that sense, this book constitutes, for me, something on the order of a culminating vision of why the arts matter, and what kind of role they play (or might play) in the most vital areas of our lives, especially in connection with pain, illness, and dying, but illuminating ultimately the entire arena of human sentience. Here, too, in seeing the larger picture, I have debts.

First and foremost, as my dedication suggests, I owe more than I can say to my wife, Ann, whose belief in literature as a fount of experience has been a guiding force throughout my career and my life. All of my books reflect her presence in my life, and none more so than this one, where her sanity, wit, and measure were indispensable. The tenor and scope of this book are what they are also because of the great good luck that I had in working closely with Kate Medina at Random House, who saw—often more sharply than I did—what the larger stakes and issues of this book were and might be. Kate's vision of the book, along with the equally illuminating and generous commentary offered by Sally Arte-seros, have played a signal role in the "growing" of this book, and have at once stimulated and sustained me through the long editing process. Likewise, Kate's very able colleagues at Random House, Jessica Kirsh-ner, Deborah Foley, and Vincent La Scala made much of the inevitable labor of turning a manuscript into a book something palatable and civilized. Here, too, I have been lucky, and can only hope that the final result is commensurate with the help I received in achieving it.

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Winesburg, Ohio
(London: Penguin, 1976). Artaud, Antonin. "Theater and the Plague." In
The Theater and Its Double,
tr. Mary

Caroline Richards (New York: Grove Press, 1958). Baldwin, James. "Sonny's Blues." In
The Urban Muse. Stories on the American City,

ed. Ivan Stavans (New York: Delta Trade Paperbacks, 1998). Barker, Pat.
Regeneration
(New York: Penguin, 1993). Barth, John.
Lost in the Funhouse
(New York: Bantam, 1969). Bergman, Ingmar.
The Seventh Seal.
In
Four Screenplays oflngmar Bergman,
tr. Lars

Malmstrom and David Kushner (New York: Simon and Schuster, i960).

-------.
Fanny and Alexander,
tr. Alan Blair (New York: Pantheon, 1983).

-------.
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Blake, William. "London." In
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David V. Erdman, ed.

(New York: New American Library, 1981). Bronte, Charlotte.
Jane Eyre
(London: Penguin, 1966). Buchner, Georg.
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Press, 1988). Burroughs, William.
Naked Lunch
(New York: Grove Press, 1959). Camus, Albert.
The Plague,
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The Heart of Darkness
(London: Penguin, 1985). Defoe, Daniel.
A Journal of the Plague Year
(Oxford: Oxford University Press, 1990). Dickens, Charles.
Bleak House
(London: Penguin, 1994). Dickinson, Emily.
Final Harvest: Emily Dickinson's Poems
(Boston: Little Brown,

1961).

Dostoevsky, Fyodor. "Notes from Underground." In
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tr. Ralph E. Madaw (New York: Dutton, i960).

DeLillo, Don.
White Noise
(New York: Penguin, 1986).

Eggum, Arne.
Edvard Munch: Paintings, Sketches, and Studies,
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Emerson, Ralph Waldo.
Essays and Lectures
(New York: Library of America, 1983).

Faulkner, William.
The Sound and the Fury
(New York: Modern Library, 1956).

-------.
As I Lay Dying.
In
William Faulkner: Novels, 1930-1935
(New York: Library

of America, 1985).

Fitzgerald, F. Scott.
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(New York: Scribners, 1933).

Ford, Ford Madox.
The Good Soldier
(New York: Vintage, 1951).

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