The patient in this story is the narrator, so the perspective we get in this story is clearly biased: we only know what the narrator reports. We learn from the patient, a young female who has recently given birth, that her primary caregivers are her husband John and John’s sister Jennie. The patient's relationship with each of them is untherapeutic and may even be the cause of further deterioration.
John, as the male and as a physician, is the dominant caregiver. Although the narrator has little power over her “treatment” and must listen to what John says, her initial attitude is one of skepticism. She explains that although both her husband and her brother, also a physician, believe that a regimen of rest and tonics will “cure” her, she is not so sure. However, as a woman who is suffering from depression in the 19th century, she must defer to the authority of her husband. The relationship is not based on mutual respect and trust, but on power and control.
The second caregiver is Jennie, whom the narrator describes as an “enthusiastic” and unambitious housekeeper. Although Jennie is solicitous and shows apparent concern, the narrator tells us that Jennie thinks that it is writing (the narrator’s profession) that has made her sick in the first place. As a result, the narrator must be secretive about her writing so that she is not caught – and reported – to her husband. Thus this second patient-caregiver relationship is not healthy either; Jennie is part babysitter, part spy.
Neither of these patient-caregiver relationships is healthy; both are based on uneven power dynamics, and each is further damaged by a lack of trust. It is no wonder that Jane (the narrator) gets progressively worse through the story, eventually having a psychotic split and descending into madness.
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