Misinterpreter of Maladies !

Sir, Jhumpa Lahiri is a freelance journalist whose collection of short stories, Interpreter of Maladies, was awarded the Pulitzer Prize for fiction this year (2000). One of her stories, The Treatment of Bibi Haldar, presents a 29 year old woman who suffers from episodes of convulsions. The clinical description suggests a diagnosis of epilepsy for several reasons. The convulsions appeared to have begun in childhood since they were stated to have occurred episodically for "the greater number of her twenty-nine years". The attacks were presumably infrequent; during his lifetime, her methodical father recorded only 25 major attacks (the period of dispersion, however, could not be determined from the tale). The attacks developed without warning; her father, and others, could not determine any logic behind the timing of the attacks beyond noticing a greater frequency of occurrence during summer. At least some attacks occurred while she was atone. During at least one attack, she suffered injury, including bitten lips and a broken tooth. The attacks were not exceptionally prolonged; one was described to last "over two minutes". There was no indication whatsoever of the episodes being precipitated by stress, or of her receiving secondary gain; in fact, her attacks resulted in considerable privation. Finally, the attacks were probably primary generalized seizures because they began with loss of consciousness and the convulsion. In striking contrast, some aspects of the description suggest a diagnosis of pseudoseizures. During attacks, the woman was variously described to moan, scream, pound her fists, grind her teeth, and wrestle with an adversary (perhaps a spectator who had attempted to limit the movements). The attacks were probably not stereotyped; at least some were characterized by a "shameless delirium" No post-ictal state was ever described. In the story, Lahiri is perhaps describing an epileptic woman with occasional pseudoseizures. It is also possible that the woman had only epileptic attacks, and that these attacks are being sensationalized deliberately as a result of poor observation, or as a result of poor interpretation of phenomena. The medical profession is cast in a poor light. Allopaths, including doctors in England to whom the woman's father had written, do not appear to have arrived at a diagnosis or an effective plan of management. Shockingly, a doctor at a polyclinic is reported to have conducted a series of blood tests and advised, albeit in exasperation, that marriage would cure the problem. In the contemporary world, the public expects good background research from media depictions. There appears to have been little background research in Lahiri's tale; this is a matter of regret because any competent medical professional, after a single reading, could have advised Lahiri about the inconsistencies in the description. The way the medical profession is portrayed is appalling. Even had the story been set several decades ago, as have some of the other stories in the book, Lahiri has no excuse antiepileptic drugs have also been available for several decades. Most unfortunate of all is the propagation of the myth that sexual intercourse will cure epilepsy. The culmination of the story is the cure of the woman after she becomes pregnant through one or more acts of intercourse with an unnamed person.