2025 Theses Doctoral

The Performativity of Diagnosis: Case Writing Between Medicine and Literature in Postwar Germany

Savage, Skye Shannon

This dissertation investigates the interrelation of medicine and literature across multiple vectors of form, history, agency, and epistemology. Written observational practices in medicine have long shaped both clinical care and the dispersal of disciplinary knowledge, from case studies to pathographies, patient files to anamneses. In the course of their historical development, in close conjunction with literary texts, these forms have become tied to particular practices of scientific reasoning and discursive structures of authority—structures which literary writing is also uniquely positioned to query and to collapse. In the first chapter, I provide an overview of both theoretical and historical developments in case writing and pathography in German-speaking areas by tracing the circulation of the story of the “mad” poet J. M. R. Lenz from the 18th through the 21st-centuries.

Having established this history, I turn my focus to the post-World War II era of Germany. In the second chapter I undertake an archival investigation into the patient files of a consequential Berlin psychiatric clinic, the Karl-Bonhoeffer-Nervenklinik. Establishing the “clinical writing scene,” I demonstrate how the roles of doctor and patient were linguistically constructed in the text of the anamnesis. The postwar KBoN files provide key insights into the clinical expression of war trauma and political persecution amidst strict biomedical understandings of psychiatric illness. In the third chapter, I assess the political uptake of medical language in the context of postwar antifascist writing. I contrast the varied approaches of Karl Jaspers, Alexander Mitscherlich, and Theodor Adorno as they sought to use or critique pathologizing language in the ongoing project of understanding and preventing another fascist outbreak. The fourth chapter addresses the work of Ingeborg Bachmann and contends that medical encounters and case writing are of primary significance in the development and narrative structures of the speech “Male Oscuro” and the unfinished novel The Book of Franza.

The fifth chapter offers a revised reading of the works of Surrealist writer Unica Zürn. Although produced in the context of institutionalization and medical crisis, I demonstrate that Zürn’s texts are observational, thus collapsing the epistemological hierarchies otherwise preserved by the formal separation of clinical and literary writing.