An English major bound for med school? There’s a thesis topic for that.
Rachel Sturley came to Princeton with a curiosity about biology and a love for literature that started, respectively, in the tide pools of coastal Massachusetts and the New York subway.
The daughter of biologists, Sturley spent summers at the Science School at the marine facility at Woods Hole while her parents did research. “We’d learn how to tell if a crab was pregnant, and who’s eating who,” Sturley said. Back home in New York City, Sturley routinely missed her stop on the 1 Train on her daily ride to high school because her nose was stuck in a novel. At Princeton, she entwined the worlds of literature and the lab in meaningful ways on her path towards becoming a physician.
Sturley has completed all her required pre-med coursework while pursuing her major in English. Her senior thesis, titled “‘The Body Intervenes’: Narrating Illness at the Turn of the 20th Century,” looks at how writers and artists portrayed their own experiences with illness. “Illness disrupts the story that we want to tell ourselves about our lives,” Sturley said. “Illness also requires that we use narrative to reconstruct and rehabilitate that story.” She wanted to examine the challenges, and the necessity, of expressing physical pain and disease.
Sturley’s thesis focuses on the 1918 Spanish flu, tuberculosis and “female invalidism” (a term used to describe women’s disorders ranging from premenstrual stress to depressive episodes) on the eve of modern medicine. “The Body Intervenes” is a quote from a Virginia Woolf essay called “On Being Ill,” written following the 1918 pandemic about her experience with the disease. “The body will show up in literature no matter what you do,” Sturley said.
Toggling between ‘Little Women’ and organic chemistry
Sturley paved the runway toward her senior thesis — and conquered those pre-med requirements — by taking two humanities classes and two STEM classes every semester. In addition to her English major, she is pursuing certificates in gender and sexuality studies, and humanistic studies. She enjoyed the contrast of having an essay to write one week and a STEM test the next, or a literature precept one day and a lab the next. “I ascribe most of my success in my STEM classes to the way I was thinking in my literature classes and vice versa,” she said. “They were motivating me differently and using different parts of my brain.”
Those two tracks converged sophomore year when, for the first time, she considered analyzing medicine through a literary lens. For her final paper in the course “Coming-of-age Literature,” Sturley chose to write about Beth in “Little Women,” who (famous spoiler alert) dies of scarlet fever.
“Thinking about Beth’s experience with illness as it's presented on the page foreshadowed the kind of analysis I engaged in with my thesis,” she said. “How does her illness shape her character? How does that explain the kinds of things that she says, or how other characters interact with her? Beth’s illness is central to her identity.” While writing about Beth, Sturley was in her second semester of the yearlong “Organic Chemistry” course. “Orgo” is considered the most intense pre-med course, and on top of that, it was being taught virtually due to the pandemic. Lectures were pre-recorded, labs were held via Zoom. The course includes four exams released at 8 a.m. and due at 8 a.m. the next day.
“It was very, very intense,” Sturley said. “You sleep in the middle and dream of the problems.” She admits she liked taking these exams: Analyzing an orgo problem was not unlike analyzing literature. She said both require identifying various structures and how they might connect, as well as considering multiple points of entry. Two other courses drew Sturley into the interdisciplinary field of medical humanities. In “Ancient Plots, Modern Twists,” the readings included the novels “Blindness,” about a city devastated by an epidemic of blindness, and “Station 11,” set amidst a fictional swine flu pandemic. “The Art and Archaeology of Plague” examined archaeological evidence for and art historical depictions of plagues and pandemics from the Black Death to COVID-19, which was at its height as she studied.
Using literary tools in a medical setting
Her junior paper in preparation for her senior thesis included an analysis of “In the Land of Pain,” French novelist Alphonse Daudet’s attempt to capture on the page the extreme pain he felt from tabes dorsalis, a degenerative disorder with no cure.
Maria DiBattista, the Charles Barnwell Straut Class of 1923 Professor of English and a professor of English and comparative literature, advised Sturley on her JP and senior thesis. She suggested Sturley begin her thesis research the summer after her junior year with a visit the Wellcome Collection, a medical humanities archive in London. With funding from the Office of Undergraduate Research and the Global Health Program, Sturley spent 10 days there, poring over turn-of-the century literature, journal articles and physicians’ ledgers.
Other professors helped, too. Elena Fratto, an assistant professor of Slavic languages and literatures who teaches a course called “Medical Story-Worlds,” pointed Sturley to scholarship establishing a known incompatibility between language and pain. “Artists have been grappling with this since Greek tragedies,” Sturley said. “The title character in Sophocles’ play ‘Philoctetes’ is in great pain and just screams on the stage. There aren't any words he can bring to it.”
A summer internship as a research assistant with Richard Schwartzstein, a 1975 Princeton graduate and head of the pulmonary and critical care division at Harvard University’s Beth Israel Deaconess Medical Center, allowed her to interview and collect narratives of ICU patients for a clinical study on mechanical ventilation and dyspnea (difficulty breathing). She and Schwartzstein spoke often about why being an English major was valuable for this kind of work.
Sturley remembers a patient who had been intubated many times but on one occasion was struggling to express how it felt different so the doctors could help.
“She told me, ‘All of a sudden, I couldn't breathe right. It felt like I was falling off a building,’” Sturley said. “My literature brain got fired up with that metaphor. I thought, what does that mean for this patient and how can it help her doctors? Doing this narrative work helped demonstrate how important using literary tools in a medical setting can be.”
Her thesis analyzes the work of seven writers and artists — from a pair of Edvard Munch self-portraits painted while he had the Spanish flu and after he recovered, to the 105-volume journal of Marie Bashkirtseff, a Ukrainian artist and aristocrat who lived in France, written while she had tuberculosis, to the diaries of Alice James (sister of novelist Henry James), chronicling her years-long suffering from what was then called “women’s hysteria.”
DiBattista believes Sturley’s deep study of literature and art will make her a better physician. “Whether reading a poem, diary, or fictional narrative, or scrutinizing a painting for its handling of space, use of color and of course treatment of the human figure, Rachel attends to the details that ‘tell the story’ she is eager to understand,” DiBattista said, showing “remarkable intelligence, sensitivity — and patience!”
Sturley, who met regularly with Kate Fukawa-Connelly, director of Princeton’s Health Professions Advising, plans to take a two-year gap before medical school to attend Columbia University’s master’s program in narrative medicine. While she’s still undecided about the type of medicine she might want to practice, she said her orientation in the medical humanities is steering her toward specialties like pediatrics and OB/GYN, among others, “that allow for a lot of close patient interaction and developing longstanding relationships.”