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  choose a passage from Carver’s story to analyze.  Address the quotation in terms of the language used (words and stylistic choices) as well as the ideas expressed in it.  Finally, attempt a comparison or contrast with other pieces of writing we have read in the course.Lecture (Unit 3—Part II) Storytelling in
Medicine (Carver)
Raymond Carver (1938-1988) is probably the most well-known American writer of short stories in
the twentieth century. After World War Two, his “minimalist” style of writing revolutionized
short fiction writing and has been used as a model in writing programs all over the
country. Carver’s background is working class. While he was born in Oregon, after graduating
high school he came to work in California. He held many mostly menial jobs. For example, he
was a janitor in a hospital. His poem “Autopsy Room” talks about his experiences from the
hospital morgue. He also married young and had children and battled alcoholism for many
years. While working he started to attend creative writing classes and he caught the eye of his
teacher, who encouraged him to start publishing (he published his first story in 1961). The story
we are reading in this course came out in 1983 in his third (and last) collection of stories,
Carver’s story “A Small, Good Thing” is the first piece of fiction we are reading. Fiction and
other literary genres offer sophisticated uses of language; therefore, one has to pay attention to
the language, impressions, and meanings in literary texts even more closely than in other
readings. Writers of literature usually work with some aesthetic goal in mind. They do not try
just to transmit information or argue a point. They “nudge” the reader towards philosophical
and emotional responses. In other words, in addition to explicit meanings, literature frequently
deals with implicit meanings. In some ways Carver, as a minimalist, is a master of implicit
meanings. Rather than telling us how characters feel he shows their reaction. In addition, look
in Carver’s story for not only the topics we have mentioned so far, but also try to decide
whether you can recognize in Carver’s story “storytelling in medicine” or “storytelling as
The story opens up on a Friday with Ann Weiss ordering a cake for her eight-year son Scotty’s
birthday. Notice how the story establishes an “everyday” atmosphere with meticulous details
about the cake shop. You can picture this shop and Anne ordering the cake from the
baker. Also observe how Carver develops the characters of Anne and the baker. Anne and the
baker do not communicate easily from the beginning. The baker, in fact, “makes Anne
uncomfortable”; he “was not jolly. There were no pleasantries between them, just the
minimum exchange of words, the necessary information” (93). When you read a bit into the
story, you will be able to re-interpret the uneasiness between Anne and the baker. . . there is
a class difference between them; Anne and her husband are comfortable, and the baker is
working class (even though he might own his small bakery); at one point, Anne says “he’d never
done anything else in his life besides being a baker” (94). Anne observes that he never had a
family, but she also obviously feels uneasy and at the same time superior to the baker.
On page 94, the story skips to Monday morning, Scotty’s birthday. The reader learns that, on
the way to school, Scotty gets hit by the car and, although at first he is able to get up and walk
back home, he loses consciousness and has to be taken to the hospital. The situation at first
doesn’t seem too serious; the party has to be cancelled, but it is said that probably Scotty has
“mild concussion and suffer[s] from shock” (95). The reader meets Dr. Francis for the first
time, and the story emphasizes that Dr. Francis said that there is “no coma’ (95). Notice how
this seems to be important to everyone; many narratives and texts that we will read in this class
emphasize the importance of “naming” the disease. Just giving a disease a name can have many
important consequences (both negative and positive).
The paragraph on pages 95 and 96 bears close inspection. In it, Howard decides to leave the
hospital to freshen up at home since Scotty’s condition seems to be stable. Pay attention to
how the story presents Howard’s agitation—in many ways he is portrayed as a typical “manprovider.” So far he has been able to provide for his family and keep them “away from any real
harm, from those forces he knew existed and that could cripple or bring down a man if the luck
went bad, if things suddenly turned” (96). Now the reader can see that Howard is losing
control—he is driving too fast and he cannot control his leg shaking. He really loses it when the
phone rings—he thinks it is the hospital calling, but instead it is an irate call from the baker
about the birthday cake that was ordered but not picked up. At this point, the baker is
established as “the creep” in the story.
Howard returns to the hospital about “midnight.” Observe how when one deals with a serious
illness, ordinary routines change and do not seem to matter. Sleep, food, and everything seem
to lose their necessity and meaning. Also, the scenes in the hospital are interesting because,
despite Howard and Anne’s education and relatively high social status, they are having trouble
navigating the complexities of medical care. They do not know what procedures are being done
to their son Scotty, or why they are being done.
On pages 97 and 98 we continue to see parents who are seriously perturbed with their son’s
illness. They try to reassure each other that everything will be okay, but they reveal extreme
agitation. For example, on page 98, Howard finally “felt a genuine fear starting in his
limbs.” The story portrays, extremely well, the parents’ agitation. At the same time, it shows
their attempts to reassure themselves so they would not over-react to the situation.
Dr. Francis returns and the parents cannot wait to ask him questions about their son’s
condition. Pay attention to page 99 where the doctor is described. His description as a welldressed man who “looked as if he had just come from a concert” clashes with the agitated state
of Anne and Howard. Look closely at what Dr. Francis says: “He’s all right . . . Nothing to shout
about, he could be better, I think. But he’s all right. Still, I wish he’d wake up. He should
wake up pretty soon.” Dr. Francis is not an uncaring doctor. He in fact, despite his
appearance, seems to care about Scotty. However, the way he is communicating with the
parents is just making them even more anxious. He says one thing, but then he contradicts
himself. Of course, doctors sometimes do not quite know what is wrong with a patient but they
have to phrase their doubts carefully. It is certainly a complicated balance that they have to
accomplish. Dr. Francis is not able to exhibit this mastery.
Imagine how Dr. Francis could have expressed himself better. What could or should he have said
to give to the parents more straightforward answers and help them believe that he is doing all
he could for Scotty?
Again, on page 100, you can see how the parents and the doctor wrestle with the word “coma”
and how the doctor wavers. On the top of page 101, Carver masterfully describes the parents’
mental state through their actions: “Howard sat in the chair next to her chair. They looked at
each other. He wanted to say something else and reassure her, but he was afraid, too. He took
her hand and put it in his lap, and this made him feel better, her hand being there. He picked
up her hand and squeezed it. Then he just held her hand. They sat like that for a while,
watching the boy and not talking. From time to time, he squeezed her hand. Finally, she took
her hand away” (101). Here, Howard is attempting to communicate with Anne and protect her
by holding her hand; eventually, it is clear that this is not working. Events are too serious for a
simple gesture like that to work. Faced with a serious health problem the parents are unable to
help their child. They do not quite understand the tests and the scans that are ordered; they
are left in “limbo.”
The wait for the parents continues. The nurses come and go, Dr. Frances shows up, and the
parents’ questions continue to be unanswered. At this point, the reader realizes that the
hospital can be a dehumanizing institution despite everyone’s best efforts. Anne and Howard
struggle between hope and despair, hoping that Dr. Francis will have some news for them every
time he comes to check up on Scotty; however, Dr. Francis dashes their hopes over and over
again. The parents also try to take care of ordinary things, like feeding the dog. They go back
and forth about who will go home and feed the dog, and eventually Anne consents to go.
While looking for the exit from the hospital, Anne enters by accident a waiting room in which a
black family waits for the news about their boy. Notice that this scene is central to the
story. It foreshadows Scotty’s destiny and it gives Anne and Howard’s story a social and cultural
dimension. Anne learns from the black family that their son Franklin is “on the operating
table. Somebody cut him. Tried to kill him. There was a fight where he was at. Not bothering
nobody. But that don’t mean nothing these days. Now he’s on the operating table. We’re just
hoping and praying, that’s all we can do now.” Remember that this story is written in the
seventies, not even a decade after civil rights were established. Anne and Howard are uppermiddle class whites, and Franklin’s family is black. Anne “want[s] to talk more with these
people who were in the same kind of waiting she was in. She was afraid, and they were
afraid. They had that in common” (107). At this point, Anne realizes that their destiny crosses
over cultural and racial boundaries; sometimes, traumas or disasters can make us realize our
common “humanity.”
At home, Anne feeds the dog and cleans up, trying to relax in the bath. However, the harassing
baker’s phone calls interrupt her and she keeps remembering Scotty as well as the black boy
Franklin and his family. When Anne returns to the hospital, it is already Wednesday morning
and Anne learns that the black boy passed away. She tries to talk to the nurses, and the story
records numerous, in many ways irrelevant, everyday details from hospital life.
When Anne enters Scotty’s room, Howard informs her that the doctors plan to operate on Scotty
because they cannot figure out why he doesn’t wake up. Page 112 contains Scotty’s death
scene. He briefly seems to wake up, but Anne and Howard’s hopes are quickly dashed: “The boy
looked at them, but without any sign of recognition. Then his mouth opened, his eyes scrunched
closed, and he howled until he had no more air in his lungs. His face seemed to relax and
soften then. His lips parted as his last breath was puffed through his throat and exhaled gently
through the clenched teeth.” Scotty’s death does not come totally unexpectedly—he was in a
state like a coma for several days and, despite all their efforts, the medical staff could not quite
determine what is exactly wrong with him and how to help him. Notice that in three decades
since this story was published, medical scan technology as well as access to scanners have
improved significantly; at least, for people who have insurance or in emergency
situations. While heartbreaking, Scotty’s death is quite quick; there are many protracted scenes
of dying in the world of fiction (such as, for example, the death of a child in Camus’s The
Plague). In fact, Carver’s ability to produce a strong emotional effect by using relatively simple
linguistic means is quite remarkable here. Is seems that the most protracted agony in this story
happens while the parents are waiting in the hospital room.
Look closely at the long paragraph on page 113 in which is Dr. Francis tries to comfort Anne. Dr.
Francis at this point is trying to comfort Anne as best as he can; he is hugging her. However, he
is not being very successful, because Anne is in the state of shock. In the same paragraph, see
how the story describes the different reactions from each parent. In which ways does the story
here affirm or contradict traditional gender behavior?
We have noted that in this story the characters sometimes use touch to comfort each
other. Does this strategy work or fail for them? How and why?
On page 114, the story reveals the relative cruelty of modern life and institutional dying. Dr.
Francis attempts to comfort Anne and Howard are short lived, and the parents are ushered very
quickly out of the hospital; of course, permission for an autopsy is requested.
In the next few pages, the story describes Anne and Howard’s reactions at home after Scotty’s
death. They are in a state of shock–they wander aimlessly and they do not quite know what to
do. Meanwhile, they are facing harassing phone calls, but it takes them a while to figure out
who is calling them.
The last five pages of the story, on pages 117 to 121, describe the confrontation between Anne
and Howard and the baker. When the parents show up in the bakery, and the baker realizes
who they are, the situation seems to be on the verge of violence. They are each angry at the
other, and because of their desperation, the reader feels that Anne and Howard might do
anything. However, see how the situation begins to change in the last paragraph on page 119,
when the baker realizes that Scotty, the birthday boy, is dead.
The baker’s character completely transforms himself, and he manages to go through a series of
actions (dropping his rolling pin, pulling the chairs around the table, and so on) to calm down
the parents and to begin defusing the situation. His apology seems genuine and Anne and
Howard are able to feel it. Look at that part of the story carefully to see how and why does the
baker manage to start the healing process for them.
Self-assessment for Carver’s story
Rather than just following the main logic of the argument as in an expository piece of writing, a
successful analysis of fiction needs to take into consideration the following elements of
fiction. You have certainly encountered them in your education before. In order to make sure
that you have a reasonable grasp of Carver’s story, identify the following elements in Carver’s
Setting: Time/Place
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