She researches what narratives tell us about dying

Author: Susanne Wenger

A small university office, but a big topic: “Our lives are finite”, says Anna Elsner. “Everyone knows that, but the thought of our own death or that of a loved one remains hard to comprehend.” She has been fascinated by this discrepancy ever since her youth. Elsner is now investigating how people cope with the incomprehensible in texts, films and other cultural formats. She notes that although literature has been addressing dying for centuries, the number of testimonies has been increasing since the AIDS epidemic. Today, the once-taboo topic is booming – partly because of changes in the conditions in which people die, she explains.

Before medical progress enabled us to live longer and made more interventions possible, dying was quicker, fateful and God-given. “Today, there’s more time to reflect, often even with a serious diagnosis,” states Elsner. Dying is medicalized: about 80% of people in Switzerland die in hospital or a nursing home. Autobiographical writing thus becomes a means of coming to terms with the medical context. Literature and art also create “space for emotions, creativity and illogicality” in a secularized age, in Elsner’s view. Storytelling helps people to process personal experiences and at the same time addresses social issues.

Is pain still allowed to exist?

In conversation, the 42-year-old comes across as present and approachable, and has examples and references to hand right away. Even when she talks about her current research projects, including a cultural history of dying in France since the 1970s. “Palliative care emerged at that time, starting with the British hospice movement,” she explains. The aim of this concept is to alleviate the physical and mental suffering of the seriously ill – for many, it’s humane relief in a medical system that seeks to cure at all costs. Yet the French writer and professor of literature Philippe Forest, who wrote about his daughter’s death from cancer in the 1990s, speaks of a “palliative ideology.”

“He feels he is put under pressure to die and to grieve well,” explains Elsner. “He asks whether he is still allowed to feel pain and despair over such a loss.” She does not want to agree with Forest by criticizing palliative care, but seeks to “understand what insights literature provides about palliative care.” This also applies to the second topic she is currently focussing on: euthanasia. Or assisted suicide? “The terms already reflect attitudes,” she remarks. At first glance, black-and-white narratives predominate: people either stress self-determination or warn of problematic consequences. Elsner states: “Narratives shape the public debate on euthanasia.” Their influence extends into politics and legislation. Exactly how they do so is a subject she, along with an interdisciplinary team, is investigating in the European Research Council’s “Assisted Lab” project.

Unheard nuances

For two years, the researchers have been analysing over 300 art and media works from various countries and language regions, including from Switzerland: books, films, documentation, podcasts, blogs and social media posts. “The narratives are very nuanced,” Elsner points out. This was also the case for French author Anne Bert, who suffered from ALS and chose euthanasia in Belgium in 2017. She described how it was not easy for her to make the decision, although she did so consciously. However, this nuance went unheard. In the debate on euthanasia in the French parliament, Bert was cited as a heroic advocate of autonomy.

The researchers regularly make their results available in a publicly-accessible Online-database . With her expertise in literary studies, Anna Elsner is revealing something that also appeals to medical professionals in particular. Her main focus as an Associate Professor at the University of St. Gallen is “Medical Humanities”. “This includes taking a critical look at medical culture,” she explains. Medicine encompasses not only clinical knowledge, but also language, ethics and interpersonal interactions. Elsner networks with the healthcare sector through research, exchanges ideas with specialists, organizes workshops for doctors and works with palliative care units.

Research as an impetus for discussion

She is sometimes asked whether it isn’t depressing for a young researcher to focus so intensively on death and dying. It’s just the opposite, she says: “It sharpens our view of life.” She would like to “stimulate a discussion about how we want to die.” Personal experiences have shaped her interest: the accidental death of a cousin, the death of her mother-in-law who suffered from early dementia – and the different ways in which the medical profession accompanied these deaths. As the daughter of a theologian and a doctor, Elsner also witnessed at a young age her parents discussing the concept of humanity in medicine.

She loved reading, even as a child. She was drawn initially to the theatre, then started writing herself and later won essay prizes. In the end, she decided to study philosophy and literature. “I consider it a great privilege that I was able to make reading my profession,” she emphasizes. In her courses, she encourages students to read with precision “as a way of critically analysing key topics in medicine, literature and art”. She likes combining theory and practice, for example on visits with students to local institutions such as the St. Gallen Hospice or the Zurich Kunsthaus.

Professor and mother

Anna Elsner is fully committed to her academic career and is also the mother of a 12-year-old son and a 9-year-old daughter. Striking the right balance between work and family life remains a perennial topic for her and her husband, an economist. She has also introduced this concern as a member of the Young Academy since 2020. She welcomes the universities’ efforts to encourage dual careers, but knows from her own experience that “It’s complex.” Her husband recently moved to the University of Aix-Marseille and commutes between the French port city and the family’s home in Zurich.

“That means more care work for me,” says Anna Elsner openly. Thanks to a supportive environment and a guest professorship taken up by her husband in Geneva in the coming months, the situation is working out at the moment. Elsner strongly advocates “rethinking the perception of academic success and professionalism”. When the Swiss National Science Foundation honoured her in 2022 as the best young researcher with the Marie Heim-Vögtlin Prize, she had herself filmed in a video portrait with her children. She mentions the two consistently in interviews. “Children should be a visible part of an academic career,” she believes.