The Dark Night 2 looks incredibly basic on a first examination. The most detailed part of it is the face, and even that is not anything to write home about. Davis says it was drawn, in pencil, on a separate piece of paper and attached to the canvas. But, with the consideration of feeling deeply isolated, an attached face makes perfect sense. The worst part of being unwell is dealing with concerned family members. In their concern and lack of understanding, they put the emotional work onto the sick person. No one expects them to look happy, but them looking upset or scared would be too much to bear. Davis is a mother and a grandmother. She had to pretend to feel okay and affix a mask to her face. The paper face looks fine. It is not happy, but at least it is not scared. No one wants to see mom or grandma scared. But, the paper is fragile. It could fall off and reveal the horror underneath. Or, worse, reveal the nothingness that long-term illness leaves a person in. 

The next detail the eye is drawn to is what Davis calls “the presence” behind the main figure. It is uneven, the lines are rough, and the colors are not fully blended. It is unclear if the presence is being lit by the bed, but since the lone figure is not, it probably is not either. It just does not make sense. But neither does fear. It overwhelms and envelops, especially when its victim is alone. Davis labeled it “a heavy cloak, an amorphous shape that wanted to inhabit me entirely” (Davis 12). It wants to take over and drag her down. Anxiety and doubt want to drag her down when she is alone, without the support of her family and friends. The boundary between it and the figure is unclear, anxiety becomes the sick when they are alone. The feeling is convoluted, unidentifiable, and inescapable. Loneliness opened her up to this, and connection is what will save her. 

The stark white bed forces a gaze to it. Is it a hospital bed, or an altar in a mausoleum? The lack of detailing, and its harsh lines, let it be either. It seems cold, uncomfortable, and unyielding. The gray mixed in lends to it seeming like a stone, Davis even calls it a slab. Is she afraid to die in this bed? The subtle highlights of red/orange bring it back to the hospital room. The fact that she has suffered in this bed. She spends nearly every moment here, it might as well be her casket. In the depths of night, in its darkness and isolation, she sleeps here. There is a case to be made that that is close enough to death. 

Another detail worth mentioning is the background. It is simple but fits well with the rest of the painting. It has the same colors as the presence, but in a darker shade. It shrouds the lone figure in the darkness and keeps her further alone. Darkness is the greatest isolator, it prevents humans from even seeing each other. It prevents her from seeing, or looking for, another human. Further, the background has red mixed in. Symbolizing her blood, and her suffering that forces her into this room. All in keeping her to her own sorrow in her attempts to heal. 

What is nearly glossed over is the figure herself. She is completely black and appears to be empty space. She should be the focus, but the viewer focuses on the things around her. The state of her face, the presence attempting to swallow her, her bed, and even the background. Concern is not for her, but for what is going on around her. Even in her own painting, she escapes human connection. She is alone, in a party of one, where she should be the main focus. Davis claims this ended with the love of her family. Perhaps it did, but doubtfully with the morning sun. The darkness–the loneliness–likely faded with her illness and her ability to rejoin regular society. 

Of course, what Davis has to say about her own painting matters in an analysis of it. She made it after a routine surgery led to an infection that had her hospitalized for a combined twenty-six days. She captioned the painting, "This painting reveals how invasive and pervasive this dark, cold, and unkind presence felt to me. It tells of a particularly ugly time" (Davis 11). In this caption, she never names the presence as fear or isolation. It has to be read in between the lines and seen in her art. She says she was “abandoned by God” (11), which is a powerful phrase to say about herself. God is a figure that brings comfort to many, and she no longer has that. She is on her own, fighting illness as a newly godless woman. The horror of that sentiment cannot be understated. She eventually finds, or feels refound, by God. Her last sentence states: "[The dark night] ended because of the love of my husband, my children, my grandchildren, my friends, and all those who prayed with and for me" (11). The painter kept loving and praying and refound her God and found her way through the fear of the unknown with this connection. 

Even Davis’s title, The Dark Night 2, disguises her fear. In the first Dark Night, she explicitly talks about feeling abandoned by her God. She ends the caption by asking what God was asking of her. In The Dark Night 2, the feeling continues. It is not unique or new, just the natural successor to being abandoned and lying alone. The night is dark, and the darkness is keeping her isolated within a hospital room. 

Courtney Davis’s The Dark Night 2 shows the great depths of her sadness from nightly isolation in an empty hospital room. The painting’s composition illustrates it plainly to an observer, and careful reading of the attached text lends to the understanding. Bringing it out further, most people who are ill feel the same. 

The isolation that Courtney Davis faced is clearly represented visually in The Dark Night, with tears drawn falling from her face, and a forlorn expression captured on her face. (Something that she describes was intentional in the caption saying, "The tears on my face are tears of confusion and fear" (Davis et al 4).) But what makes the painting especially interesting, is how Davis is depicted as completely nude, with a giant black half-cross that appears to be shielding her body. When reading the text captioning the image, Davis speaks about how she felt abandoned by God during her hospitalization. The environment of being placed in hospitalization and being in this forced isolation might have been a key factor to her feelings of being abandoned by God. The Dark Night is also painted during a period in-which Davis's time in the hospital seems to have started to become routine, and the immediate-shock of dealing with the diagnosis has settled. In the caption Davis also describes how the second God abandoned her, she was filled with this palpably unkind and cold presence. This feeling could be related to the depression, that's a result of the isolating and dehumanizing nature of going through medical environments. She captured this visceral emotion in the painting through the forlorn expression painted on her face, and the solidity in texture of the big black cross that shielded her. In the text she says when describing the presence, "Had I unknowingly invited this presence in? Or was it God Himself, this heavy weight?" (Davis, et al 4). The "heavy weight" in this context, could be the solid cross which appears to be shielding the lower half of her body, which could be describing her confusion over whether the heavy weight is God or something else. Another important visual symbol in this image, is how Davis chose to extend the cross beyond her lower abdomen, and layer it so that the head of the cross continues behind her neck in the background, behind Davis's face. Which works as a juxtaposition, that despite Davis's concerns about her faith leaving her, based on her own perception, she's essentially a part of the cross. 

The depression that Davis seems to have faced as a result of her separation from her ability to function as a present human being outside of the hospital, became an all-consuming presence in Davis's life. Something that was subdued during the day with the presence of her family around her, but at night took over her very being. She describes it saying, "During the day, when my husband or others were with me, this new presence lingered in the corner. At night, it sat at the edge of my bed, slowly crawling its way into my mind and body" (Davis, et al 4). Her choice of coloration seems to be strongly influenced by her strong depressive emotions, captured by the fluid blue brushstrokes through the art piece. The different shades of blue make their way through her body and background like the lingering presence of the depression she speaks about in the caption. The shades of blue have a presence everywhere in the painting, but are only limited away from the solid blackness of the cross. This could be an intentional choice by Davis, depicting the cross as something that's unreachable in her current condition and thus incorruptible to the depression that's corrupted her. It also brings up the question of if the cross is shielding her, or if her confusion with her faulty connection with God is manifesting in the cross crushing her. 

The artpiece and caption also serve as a reference point for medical providers to gain better understanding on the effects the depression might have on their patients. The religious anxieties Davis faces during this time period is also manifested into the artwork through the blue brushstrokes that are layered over her body. The different art styles and textures are an important part of gauging the message of the painting when analyzing the piece. In the caption Davis speaks about the crushing weight of the depression, saying, "I'd been plunged into a dark night that lasted for weeks and held no promise of dawn." This relates to the grainy art style of Davis and her background, and how even the viewer can take part in the unclearness that Davis might have felt about her future. 

The candid nature of Davis's painting, the metaphors embedded into the very core of the art, and the compelling caption, all create an interactive multimedia visual experience for the viewer, immersing them into the world of isolation that Davis had to go through as part of the isolation. The painting also gives medical providers critical insight into how the isolation of illness can sometimes bleed into different aspects of the patients identity- in this case her religious faith. Davis's struggles with her religion could be viewed as an internal coping mechanism she could have unconsciously done, to separate her faith from the sadness that had permeated her very selfhood. The honesty in which Davis delves into difficult subjects that most post-treatment patients distance themselves from, highlights her unique ability to expose her most vulnerable moments to educate her medical peers on the improvements patient-care still needs, to holistically nurture patients. 

Professor Paulin

GHHG 101

3 October 2023

The Metamorphosis of Sister to Caregiver: Impacts of Illness on Patients and their Caregivers

Illness is not a phenomenon of the physical body alone. Although disease strikes an individual body, the associated psychological, social, and economic ramifications of the experience infiltrate those around the ill, particularly the caretaker. Artistically capturing the experience of illness, The Metamorphosis explores the dynamic relationship between a patient and caregiver. Depicting a man who turns into a beetle and is eventually shunned and alienated from his caregivers, it serves as an analogy for the experience of going from healthy to ill. Although the metaphorical illness imposed on Gregor is the root of his metamorphosis, he is not alone in the transformation. Grete, taking on the role of the main caretaker, transforms throughout the novel as she grapples with the difficulties that the situation presents. Serving as a mirror for the realities of many caretakers, the novel advances the intersections between health, wellbeing, relationships, and human care through depicting a patient’s dependence on a caretaker, the feelings of shame surrounding caretaking, and the communicative limitations between a patient and caretaker.

Transformed into a beetle, Gregor’s capabilities to care for himself and his family vanish overnight. Gregor’s “little legs engaged in their struggle” to do the tasks once found easy by him (Kafka 29). Gregor suddenly requires dependence and care from those nearest to him. Yet, given the condition and disposition of both of his parents, the families' newly found responsibilities unequally fall into the lap of Grete. Overnight, Grete goes from being a teenager to becoming a main caretaker, a role with immense emotional factors. From feeding Gregor, keeping up his living space, and aiding in his comfort, Grete becomes responsible not only for herself, but her brother as well. The psychological burden of having to care for someone who she once knew to be healthy and independent, wore down Grete. Although her brother’s caregiver, Grete was caring for a creature who vaguely resembles the sibling she once knew. Ultimately, Grete was Gregor’s last connection to humanity and the “normal life”. Emotionally dependent on Grete to stay in touch with humanity, Gregor truly relied on his caretaker.

The novel's scope on Gregor, Grete, and their parents, illuminates the complexity of the impact of a single person's health on a family. In the idealistic sense, caregiving is understood as the practice of compassionate care, but in reality it is also a financial cost and emotionally difficult position. Mixing healthcare needs with financial and emotional concerns is a space of discomfort given the fact that patients are dependent on such care. Gregor’s sudden metamorphosis “plunged all of them into a state of utter hopeless-ness” (Kafka 63). The family suddenly loses their financial backbone on which they heavily rely upon. Considering the pride that Gregor took being the provider, “whenever the family came to speak of the necessity of someone earning money” he would mentally retreat “burning with shame and sorrow” (Kafka 66). His mother takes up “sewing ladies’ underthings for a dress shop” and his father starts working as a porter (Kafka 86, 87). However, the level of emotional depth which comes with Grete's role as caretaker proves more difficult than the role taken by her parents. Grete “took a job as a salesgirl, was studying stenography and French in the evenings so as possibly to move to a better position later on,” all in addition to being the main caregiver (Kafka 86, 87). Cognizant of the extent of his dependance on his sister, Gregor grows to be shameful of his condition and the realities it was imposing on his family. In an effort of compensation, Gregor often puts his sister's and parents' needs in front of his own. From wearing a sheet to ease Grete’s comfort with his appearance and accepting the inhumane treatment he was receiving from his father without retaliation, Gregor’s psychological condition deteriorates at their expense. From being a symbol of familial strength and achievement, Gregor becomes their burden. 

Kafka’s symbolic approach on the function of language reveals the importance of communicating illness, particularly between a patient and caregiver. A true understanding of illness does not come intuitively to people, nor caretakers, thus making the expectations of caretaking difficult to define. “Even though the others were no longer able to understand his words-though they had seemed to him clear enough” (Kafka 40). Although fully felt by Gregor himself, the experience of his condition is difficult to share, only adding to its misunderstanding. Unable to communicate his condition to his family, Gregor is isolated and ultimately abandoned by his caretakers. During Grete’s attempt to make Gregor's room more comfortable, Gregor retaliates to her action out of the inability to properly communicate. Unable to communicate the reason behind his action, Grete reads the situation incorrectly which damages their relationship. “[I]f only Gregor had been able to speak to his sister and thank her for all she was compelled to do for him, he would have found her ministrations easier to bear” (Kafka 67). Despite being thankful for Grete’s efforts, Gregor is unable to show his gratitude. A caretaker takes upon the role of providing care for a patient, but when the exact needs of the patient are unable to be communicated, it puts the caretaker in an area of gray matter. This gray area leads to a confusion on the understanding of the illness on behalf of the caretaker. Often speaking on behalf of Gregor, Grete represents his illness to the rest of her family. Gregor is not only dependent on Grete for his physical needs, but for how his new identity is communicated to his parents and others. However, his inability to clearly communicate and relate to Grete as a fellow human eventually leads to the destruction of Grete’s role as the caretaker. From being the main caretaker, Grete turns on her brother, and she suggests the removal of his presence in the family. 

A symbolic model for the realities of many caretakers, the novel depicts the relationship between a patient and caretaker. Through Gregor’s developing dependence on Grete, the growth of his feelings of shame, and limits imposed on communication, Kafka depicts the demands of caretaking and its impacts on the representation of illness. At the core, caretaking is more than taking care of a person; it is acting as an advocate, voice, and bridge between life and death. Given its psychological demand and unforeseeable responsibility, it is a noble work which can not always be done by all. 

Kafka, Franz. Metamorphosis. 1915. S.L., Arcturus Publishing Ltd, 2018.

The society that we live in encourages women to be silent and to hide their true feelings and sufferings. We must always fit in certain standards and act in a certain way. Audre Lorde is promoting through her story the importance of owning up to your past and to never hide from it. She is not afraid to hide that she lost a part of herself, but gained so much wisdom from this experience. Audre acknowledged the fact that cancer doesn’t define who she is, "The absence of my breast is a recurrent sadness, but certainly not one that dominates my life.” One can only imagine how painful it must be to lose a part of yourself, but the fact that she finds the interior strength to move on and start encouraging other women and giving them a voice is amazing. She really is a survivor, a “warrior with an honorable wound.”

Many women lose their breasts due to cancer every year and the doctors are always suggesting prosthesis or special bras for them. Why a woman should hide her true self? Why does this pressure exists? Audre Lorde talks about it very openly, "But I believe that socially sanctioned prosthesis is merely another way of keeping women with breast cancer silent and separate from each other.” Why does the society think that the companies' profit is more important than a woman’s self-esteem and self-respect? This is a very important global health humanities problem that should be addresses more frequently. The fact that this industry is not thinking about a woman’s mental health when she goes through this transformation, and only thinks about how to sell more prosthesis is very bad. As a woman, you have to adapt to a new body after an amputation; you have to look at yourself in the mirror and love the way you look after surviving an illness. “I would lie if I did not speak of loss. Any amputation is a physical and psychic reality that must be integrated into a new sense of self.” Especially during our times, where everyone promotes unrealistic beauty standards it is very hard to learn how to love yourself, but I believe that if the medical system will stop forcing women to get a breast reconstruction surgery or a prosthesis, women won’t think that there is something wrong with the anymore. 

It is tough to have to go to bed with the fear of dying. This is what thousands of women feel every moment because they are diagnosed with cancer and don’t know how long they will survive. What this story offers us is a new perspective on how we view life. Even if we are not ill, we should enjoy and cherish every little aspect of our daily lives. "Living a self-conscious life, under the pressure of time, I work with the consciousness of death at my shoulder, not constantly, but often enough to leave a mark upon all of my life’s decisions and actions. And it does not matter whether this death comes next week or thirty years from now; this consciousness gives my life another breadth.” Sometimes, people are focusing so much on superficial aspects of life and forget to live. At the end of your life, you only remain with your memories, not with money or other things. Everyone can learn from this kind of story and become more self-aware of what other people are experiencing. Maybe, after reading these kind of stories, people will become more affectionate and humane. 

It is not easy to redefine a society and Audre Lorde doesn’t want to do this. She wants to bring into discussion her story and her experience and how she managed to go through everything at that time. Even if she wrote her story a long time ago, it is still very actual to what are we experiencing nowadays and the Global Health Humanities sector is here to change many aspects of how people view illnesses and how sick people are being treated.

Citations: The Cancer Jounals, Audre Lorde

Intro: The image, “Transfusion”, in When The Nurse Becomes A Patient, by Courtney Davis, portrays how distorted and foreign the world becomes when battling an illness and how medical professionals often forget to treat patients like human beings. Through an abstract self-portrait of her lying on her hospital bed receiving a transfusion, she shares the struggles of the side effects of her illness, being hospitalized, and the brutal isolation that comes with both. She also offers commentary on what the image means and why she used certain colors and shapes in a passage that accompanies the portrait. 

The image is a mostly blue background with a white slab in the middle with a genderless human lying on top of the slab. Outside the room a yellow light shines. The red IV line draws attention to the center of the image and clashes against the other colors emphasizing the contrast of her pale body with the daunting red blood color. The naked body helps show how vulnerable her body felt when she was subject to the way that the transfusion made her feel and the physical attachment it had to her. Despite the fact that she shares that she was under several layers, she felt exposed mentally. In the passage she says, “my body lies naked–I felt thin and pale, stripped emotionally and physically”, explaining the exhaustion and lack of humanity she felt. The world outside her is a bright yellow that radiates happiness. However, she is bound to her white slab lying in a position that resembles a mummy, which serves as a reminder of her lack of life. Hospitalized people universally struggle with the feeling of vulnerability as it goes hand-in-hand with the feeling of being weak, especially if a patient has never felt weak before. In When The Nurse Becomes a Patient, this idea is specifically prominent because Davis had been a nurse and part of her identity was to be the one who provided weaker people with sympathy and services. No person is prepared or expects that they will be the one who will be bound to the white slab. The stark contrast from being a healthy person to the fragile person in the hospital bed adds more vulnerability than the experience of the uncomfortable transfusion alone. 

The lighter blue section of the image next to the white slab is meant to be an empty chair, she explains, “The blue form on the lower left represents the chair my husband sat in when he visited”. Her isolation becomes magnified in this image, she does not have a family member or medical professional around on a long night like this. Although her husband has clearly visited in the past, she feels that it is ultimately her alone in her battle at this moment. Her submission to the illness shows the mental health problems that having a physical illness can yield, like depression. Her hopeless narration states, “But that evening I was alone, watching the slow progression of the transfusion.” As a society, people often mistakenly encourage the idea that all that sick people need is faith or a smile. This narrative is severely demeaning and insensitive to those who go through prolonged hospital stays. In Global Health Humanities it is extremely important to remember that the amount of change that a person goes through while being hospitalized can cause anxiety, depression, or PTSD. The healthcare community needs to work to reduce the stigma around people developing mental problems after traumatizing experiences. People cannot be expected to endure long nights of treatment alone, as Davis did, and bounce back to their normal lives. In Metamorphosis, Gregor retreats to his room after realizing that he is no longer accepted in his new form. It is described that after he could not provide for his family anymore, he would escape to his room where he would “burn with shame and sorrow”(Kafka, 66). 

 

When I was first discharged from the hospital, I felt fragmented, uncertain, and not prepared to resume any kind of "normal" life. Within days my clinical symptoms worsened and back to the hospital I went, via ambulance, sirens wailing. More procedures were done; another round of tests revealed that I had developed a blood infection and a pleural effusion-fluid trapped between the lung and its covering, the pleura which were the results of surgical complications and the various medical treatments I'd received.

This painting depicts the raw fear I experienced when I was home in between my two hospitalizations. Still anemic despite transfusions, I felt my body changed and, metaphorically, broken apart. Normally slender, I now looked skeletal-there was no part of me that seemed familiar. Whose skin was this, whose hands? Whose legs supported me?

I gained new insight into how my patients might have felt when they were released from hospital to home: as terrifying as being in the hospital can be, being home, especially alone, is equally frightening. Worries loom large. Nothing is easy. The simplest chore, the most routine task, seems impossible. Everything becomes bright and out of focus, like that small piece of paper collaged into the painting, appearing to be a part of my hair but also a part of my jangled consciousness, a little bit of terror. I'm asking, "Where are the nurses with their tender hands? How will I survive, and what awaits me now?"
I just have worked on introduction!

Patient care is one of the subjects that has been widely discussed throughout history, and its improving has become a priority for all health care providers with the overall objective of achieving a high degree of patient satisfaction and treatment. The quality of patient care is essentially determined by the quality of medical care along with emotional support when the patient feels supported, heard, and seen. Cortney Davis, a nurse practitioner, author, and artist who usually writes about her experiences taking care of patients, underwent a medical illness where she became a patient instead of a caregiver. Her journey during this time led to a series of life-changing lessons. During his twenty-six days in the hospital, Davis experienced how different it looks when you look at a disease from a patient's and a caregiver's point of view. She learned that a patient becomes vulnerable during their illness and experiences pain, fear, loneliness, body and habit transformation, dependency, and the need for support from family and friends. She truly understood the depths of suffering—mental, physical, and spiritual—that gravely ill patients can experience. Despite Davis being a skilled writer, she found the details of her journey too intense and complicated to put into words and sentences. Therefore, she chose to use colors to express her inner feelings. Davis visualizes her feelings of loneliness, fear, disappointment, pain, body alienation, and what she went through during her illness journey in painting. The use of colors with different tones, facial expressions and body language made it easier for the reader to catch the main concepts and imagine what the author has learned during her journey.

“I now looked skeletal; there was no part of me that seemed familiar. Whose skin was this, whose hands? Whose legs supported me?” (Davis). This quote shows when Davis realized how her body transformed during her illness journey and that the simplest chore or routine that she used to do every day was impossible with her weak body.

Black was one of the first colors used by humans, and most of the time it has been the symbol of death, grief, mourning, occult, mystery, bleakness, heaviness, depression, rebellion, and fear. Because humankind instinctively fears darkness and anything that lurks in the night, they use this color to show their fear. Davis's black background shows she has a huge feeling of loneliness and fear. Besides, her facial expression and her body transformation (a scar on her head) in the painting depict that she has suffered from a lot of physical and mental pain.

When Davis was discharged from the hospital and has been at home between her two hospitalizations, she realized that she changed a lot during her illness and needed a caregiver to help her. This quote can clearly show her feeling: “Where are the nurses with their tender hands? How will I survive, and what awaits me now?” (Davis).