[A] real book reads us. I have been read by Eliot’s poems and by Ulysses and by Remembrance of Things Past and by The Castle for a good many years now, since early youth. Some of these books at first rejected me; I bored them. But as I grew older and they knew me better, they came to have more sympathy with me and to understand my hidden meanings.
—Lionel Trilling, “On the Teaching of Modern Literature”
When he was first diagnosed with prostate cancer, Anatole Broyard, the well-known literary critic for the New York Times Book Review, wrote, “[W]hat I want in a doctor…[is]…one who is a close reader of illness…. I want to be a good story for my doctor, to exchange some of my art for his.” 1 This highly articulate patient recognized that we comprehend our own and each other’s lives through the stories that define us. Constructing time-bound, causal patterns enables us to make sense of primary experience. The narratives we build shape the ways we come to know ourselves and each other and create the symbolic space within which we make all our moral choices. 2 Broyard understood that, with his illness and its attendant physical and emotional suffering and difficult moral decisions, he would need a competent reader as desperately as he would need a competent physician.
Of all the literary elements that come into play when we read or hear a narrative, it is the reader’s role that is most often undervalued when we explore the meaning of a story. We readily acknowledge the critical importance of plot, context, voice, time, and character, but what difference does it make who is doing the reading? What happens to us and through us when we read? Why and how do so many different meanings emerge from the same narrative when different readers from different times and places experience it? What consequences might an understanding of reader roles have for the practice of biomedical ethics? We believe the consequences are enormous because it is the reader’s role in the narratives of moral deliberation that most directly and powerfully connects the experience of literature with the deliberative processes of biomedical ethics.