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Literary Voices Reflect on Health Care

The prose of some popular writers has turned up in an unexpected place. In the July/August issue of the journal Health Affairs, novelists Julia Alvarez (“How the Garcia Girls Lost Their Accents”) and Alexander McCall Smith deliver essays that reflect on their personal experiences with illness and health care. Their contributions are a part of the 10th anniversary of ‘Narrative Matters,’ a regular feature that maintains that health-policy debate must have room for the voices and experiences of regular people.Health Affairs

McCall Smith writes about the AIDS epidemic in Botswana, the country where his popular “The No. 1 Ladies Detective Agency” fiction series is based. “For me,” he writes, “as a novelist whose books…have been viewed as an introduction to a previously not very well-known country, the issue has been this: what should I say about AIDS? What role should AIDS play in a fictional account of the life of a country in the throes of the illness? Is writing about Botswana without mentioning the AIDS pandemic like writing about London during the Blitz without mentioning the fact that bombs were going off?”

Alvarez describes her parents’ decision to move back to their native Dominican Republic in their later years, prompting their four adult daughters to worry about how to take care of them from afar: “My sisters and I had to jerry-build a system because there were no services available on the ground,” writes Alvarez. “No home health aides, no meals on wheels, no visiting nurses, no assisted living places, no nursing homes — all those options that my American friends who are long-distance caregivers of elders here in the United States can tap, however uneven in quality or expensive in price they sometimes are.”

The issue also includes a personal essay by doctor-turned-non-fiction writer Abraham Verghese and by Fitzhugh Mullan, a doctor, health policy professor and the original editor of the first “Narrative Matters.” Explaining the importance of the series, current editor Ellen Ficklen writes in her introduction, “Stories help us hear, see and understand what is going on around us….they remind readers that policy decisions have human consequences.”

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