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Medicine and the Arts

Commentary on Selections From “Good


Country People”

In “Good Country People” Flannery the place where the material meets the every doctor should consider these
O’Connor gives an intimate description spiritual. It is literally the place where her effects. This consideration is intrinsic
of a 32-year-old woman, Joy, who has pathology meets her person. She cares to the profession. Having been invited
lived most of her life with an artificial leg. for her leg as someone would her own into the most intimate details of our
O’Connor was herself acquainted with soul, and here Manley touches the most patients’ lives—made known through their
the limitations of disease; she died from intimate part of her. bodies—we must recognize the privilege
complications of lupus nine years after and treat it with the honor it deserves.
the publication of A Good Man Is Hard O’Connor presents most of her insights
to Find, the collection of stories including into Joy by considering her artificial leg O’Connor finishes the story with a
“Good Country People.” In fact, O’Connor and its impact on her relationships and characteristically unsatisfying ending.
alluded to the autobiographical nature disposition. Living with an artificial Manley Pointer steals Joy’s leg and leaves
of the story when she commented in the limb has impacted the young woman’s her in the barn loft, stranded. Joy is
Habit of Being, “What would you make out relationship with her mother, her fertile ground for Manley’s manipulation
about me from reading ‘Good Country neighbor, men, and one man in particular. because she herself does not understand
People’? Plenty, but not the whole story.”1 In understanding Joy’s relationship to her own vulnerability and weakness. While
her leg, we see her at times as arrogant, she appears to understand the physical
Joy’s relationships are principally defined vulnerable, resentful, distant, and intimate. limitations of her artificial leg, she has
by each person’s engagement with her never understood how it has impacted her
disability. To Mrs. Hopewell, Joy’s mother, At times, we physicians disconnect disposition or relationships. O’Connor
Joy has always remained a child. Her our patients’ anatomy, physiology, and does not resolve Joy’s difficulties—either
mother cannot bear the thought of Joy as pathology from their personhood. In the immediate problem of getting home
a grown woman because she “had never “Good Country People,” O’Connor does or her struggles with intimate human
danced a step or had any normal good not allow such a divorce between body interactions. O’Connor leaves part of Joy’s
times.” Mrs. Hopewell also attributes Joy’s and soul. Joy’s artificial leg defines more story unwritten. Likewise, our patients’
belligerent disposition to her leg. When than a physical limitation, it permeates stories remain unfinished. Disease is
her mother is near, Joy “stumps” around her relationship with each person. uncharted territory to many patients,
the house making an “ugly noise” with While not every moment of the story and they may be naïve to navigating the
her leg against the floor as a constant focuses on her disability, it is never fully changes it brings (as Joy is naïve to the
reminder of her loss. And Joy must endure removed, nor is it ever a neutral factor in effect of her artificial leg on her encounter
the perverse interest of Mrs. Freeman, the understanding who she is. with Manley). But, what is foreign to our
subtenant, who “had a special fondness patients is common to us. We physicians
for the details of secret infections, hidden Sometimes, those of us in medicine may can provide necessary perspective on the
deformities, [and] assaults upon children.” ignore the intimate link between our effects of disease in all domains of life.
patients’ bodies or diseases and their
The most intimate moments of the story, person. Ignoring this connection may arise While we physicians may face many
however, occur between Joy and Manley from any of a variety of causes. In medical pressures, we do patients a disservice when
Pointer, the Bible salesman. Even though school future physicians encounter an we ignore the deeply personal interplay of
she “looked at young men as if she could overwhelming amount of material, and health and disease in their lives. When we
smell their stupidity,” Joy ventures off with we, their educators, feel pressure to impart have compassion and provide insight, we
Manley when he shows an interest in her that vast knowledge. We must also reconcile can profoundly affect our patients’ bodies
and her wooden leg, which “makes [her] many agendas, looking for a place in the and improve their lives.
different.” Manley explains, “You ain’t like curriculum for ever more material. As
anybody else.” They make their way to clinicians, we may feel pressure from our Todd D. Morrell, MD
the loft of a barn. After some moments of managers, regulators, and others. We may
T.D. Morrell is assistant professor of medicine, Geisel
kissing and whispering, “he put[s] his lips also assume that the task of addressing the School of Medicine at Dartmouth, Hanover, New
to her ears” and requests, “Show me where patient as a whole belongs to someone else: Hampshire; e-mail: todd.d.morrell@dartmouth.edu
your wooden leg joins on.” Joy is clearly primary care, or psychiatry, or pastoral care.
shaken; she voices “a sharp little cry and References
her face instantly drain[s] of color.” Yet, if we doctors profess to be experts in 1 O’Connor F, Fitzgerald S. The Habit of Being:
the care of humans, then we must consider Letters. New York, NY: Farrar, Straus, Giroux;
O’Connor makes in these passages a clear our patients in light of who they are in 1979.
connection between Joy’s artificial leg and both their bodies and their persons. While 2 Nowak K. The distorted body. 2007. http://
her personhood. One scholar, Katarzyna some specialists or professionals may be www.flanneryoconnor.org/kndistorted.html.
Accessed November 23, 2015.
Nowak,2 writes that Manley’s interest may able to dedicate more time to considering
be erotic, but it is also a fascination with the impact of disease on the whole person, See facing page for selections.

Academic Medicine, Vol. 91, No. 3 / March 2016 353

Copyright © by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited.

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