Conclusion

This volume delineates the changing forms of the case study across disciplines and decades, mapping circuits of knowledge through which the sexed and gendered human subject became a persistently urgent topic of enquiry in the Western world. A History of the Case Study presents an analysis of case writing about the human subject from a critical juncture in its formation in the second half of the nineteenth century, when, as claimed by Michel Foucault, sexuality came to be regarded as a conceptual part of human nature. According to Foucault’s famous dictum, notions of sexuality ‘organized sex as a “fictitious unity”’ of distinct parts and functions, feelings and behaviours; new categories for describing and policing sex produced a new object of enquiry.¹

The case study became the genre par excellence for discussing human sexuality across the humanities and the life sciences. Through the first sixty years of the twentieth century, sexologists, psychoanalysts, lawyers, medical practitioners and literary writers continued to avail themselves of the highly malleable and flexible parameters of the case study, and to repurpose it for their own ends. As demonstrated in the foregoing chapters, notions of the modern sexed subject have thus become inseparable from the emergence and development of the case study genre itself: in the newer fields of psychoanalysis and sexology, in literature, in the law and in areas of legal and social reform, practitioners and theorists gravitated towards astoundingly similar modes of narration, each modifying the case study genre for their own disciplinary purposes. Our history of the case study has focused on key moments in the genre’s past, occasions when and where its conventions were contested from within particular disciplines. Such contestation has often involved reconceptualising the case study’s epistemological foundations. This volume has taken the reader on a transcontinental journey from the imperial world of fin-de-siècle Central Europe and the Austro-Hungarian Empire to the inter-war metropolises of Weimar Germany, and to the USA in the post-war years. At all of these moments, and in all of these contexts, the case study has been evolving; fostering transformation; migrating across cultures and the globe; instrumental in asking and prompting questions about the human subject – the sexed subject, the criminal subject, the segregated black subject and so on.

Today, the case study remains a nomadic genre, one that stubbornly refuses to find a definite home in a discrete discipline. In medicine and the social sciences, the past forty years have witnessed a turn away from the case study as a scientific method of enquiry: case writing is now situated at the opposite end of ‘best evidence’ randomised control trials.² The demotion of the medical case study to a method used mainly in clinical practice is a direct result of the scientific turn in these fields, which prioritises large sample sizes and serialisation. Evidence-based research methods have replaced the more discursive, even searching style of case histories or case studies. Still, in medical practice, for complex cases, recent years have seen a renewed interest in organising specialist meetings of the various medical experts involved in patient treatment. Such gatherings of experts return the patient to the centre of attention in clinical practice. Nonetheless, as Warwick Anderson argues, in the clinic the mechanism of creating an individual case file and adding to an archive is more significant than the contents of the repository.³

In psychoanalysis, a traditional stronghold of the case study genre, case writings continue to play a pivotal role in academic discourse; they remain part of the psychoanalytic training regime, and journal writing about patients is still a relatively common practice, even if such cases are not necessarily published. Characteristic of the fin de siècle, and focused on the presentation of new psychological phenomena, the long case study format has been superseded. This acknowledged, Peter Wegner has pointed to the fresh qualities of the modern psychoanalytic case study; its ability to encapsulate in a unique way the history of interaction between patient and analyst.⁴

The literary case study as an empirically based form of writing about criminologically or sexologically interesting cases was to suffer a fate similar to the medical case study. The realism of New Objectivity in Weimar Germany soon ceded ground to disparate strains of literary modernism: fascist modernism as found in the works of Ernst Jünger; the socialist-inflected modernism of Bertolt Brecht; and Thomas Mann’s more stylistically conservative modernism. Alfred Döblin’s brand of left-liberal modernism did not fare well in the post-war era and his literary case studies of the working classes did not capture the tastes of post-war readers. Instead, the works of Mann – his novels about the bourgeoisie – proved more popular with critics and publishers. Interestingly, as the more readable of the German writers, Mann maintained aspects of the tradition of the literary criminal case study elaborated by Erich Wulffen, and by Döblin in his unfinished novel from 1954, Bekenntnisse des Hochstaplers Felix Krull. Der Memoiren, erster Teil (translated into English in 1955 as Confessions of Felix Krull, Confidence Man: The Early Years). Like one of Wulffen’s expert case studies, and Wulffen’s several case stories about imposture, Mann’s unfinished novel was also inspired by Romanian con man Georges Manolescu.

The post-war European writer who owes perhaps the largest debt to Döblin is Günter Grass, winner of the 1999 Nobel Prize in Literature. In interviews, Grass repeatedly invoked Döblin as a forebear. However, Grass’s literary works are less influenced by Döblin’s experiments with empirical case writing and psychoanalysis than by his realism and irony. Instead, the literary case study derived from the courts and legal settings continues to find its more conventional home in contemporary crime fiction and the detective novel. Both have become transnational genres that occupy middlebrow and popular segments of the literary market. In the English-speaking world, the bestselling works of Lisa Scottoline, a litigation expert, currently exemplify popular writing in the case study tradition outlined in this book. In Germany, the works of Bernhard Schlink comprise the leading contemporary example of crime fiction developed from the author’s first-hand legal experience. As a professor of law, and a judge of the Constitutional Court, Schlink wrote his crime novels under a pseudonym, until in 1995 he published Der Vorleser (The Reader) about a Holocaust war criminal, which became an international bestseller. Der Vorleser is in many ways a fitting heir to the European literary case study of the early 1920s. At its core is a narrative about a codependent, sadomasochistic relationship between a young man and a strong, older woman. Like Döblin’s Die beiden Freundinnen und ihr Giftmord (Two Girlfriends Commit Murder by Poison) of 1924, Schlink’s novel also has a crime at its centre. However, in Der Vorleser ‘the crime’ takes the plural form of Nazi war crimes committed in occupied Poland.

Ferdinand von Schirach is another contemporary writer who has continued in Döblin’s tradition of the literary crime novel. Also a trained lawyer, Schirach shot to fame in 2009 with the publication of a collection of realistic short stories taken from his legal practice titled Verbrechen (Crime). Written in a detached, minimalist style reminiscent of Döblin’s Die beiden Freundinnen und ihr Giftmord, Schirach’s riveting combination of ghastly real-life cases and terse prose affirms the lasting appeal of the case study genre in the realm of crime fiction. Different from Döblin, however, Schirach’s latest explorations of the German justice system in the realm of fiction such as Der Fall Collini (The Collini Case) and Tabu (Taboo) have not found favour with literary critics, despite referencing the case study genre.

The medical case study in literary or fictional guise is proving to be a similarly long-lived case modality. The heirs to this strand of case writing are too numerous and dispersed to discuss here. Suffice it to say that ailing or troubled states of mind – or psychopathology, to use a psychiatric term – remain a staple theme in contemporary literature around the world. Traces of the case study genre are especially discernible in the writing about sickness and disability that takes the form of self-help books targeted at a popular audience, reflecting a trend that began to flourish during the 1960s. Pathography and autopathography are new forms of popular, empirically based writing (termed ‘life-writing’) about sickness, often written from the perspective of the affected victim or sufferer.⁵ Today, these first-person case studies fill row upon row of bookshop shelves, meeting a strong public desire – a desire not that far removed from those of readers in Wulffen’s and Döblin’s day – to communicate strange or miraculous cases taken from real life.

In broad terms, popular pathography has allowed the case study genre to maintain its prominence in the humanities and to retain its importance as a means of conveying topical, expert knowledge. The widely translated collections of case histories penned by recently deceased English neurologist Oliver Sacks are good illustrations of this trend; his works Awakenings (1973), The Man Who Mistook His Wife for a Hat and Other Clinical Tales (1985) and Musicophilia (2007) are all based on Sacks’s own medical practice, and present unusual neurological disorders. Self-help books, in turn, popularise expert knowledge from the patient’s perspective: the popularity of life-writing about illness reflects the much higher levels of knowledge about medicine in the wider population today. The same popularity is, of course, also a product of far greater levels of tolerance with regard to the spectrum of possible and acceptable sexual behaviours by comparison with 1900, when the writers of the first pathographies struggled to communicate expert medical perspectives to a lay readership.

While early sexologists and psychoanalysts resorted to illustrating their insights about sexuality through reference to ‘great men’ and individuals considered creative geniuses, today’s case studies about non-heteronormative sexuality and gender are often written in the first instance by journalists for the print media and by lay writers for social media. In mainstream media, recent years have seen a growing interest in personal stories about gender reassignment, which have been packaged as stories about transgender personalities and celebrities such as Olympian Bruce/Caitlyn Jenner. The case of Conchita Wurst, born Tom Neuwirth, the bearded gay transvestite who won the Eurovision Song Contest in 2014, captured the imaginations of LGBTI and music communities around the globe. Attesting to the enduring power of case studies that confound expectations of gender and sexual identity, Wurst’s story has been told through various case modalities – media reports, interviews, YouTube blogs and now in the conventional autobiography, Ich Conchita, Meine Geschichte. We are Unstoppable (2015). Sales of this memoir quickly prompted a second print run. Such success demonstrates that the case study as set forth by the patient or subject herself (rather than by the treating doctor, presiding judge or defending lawyer) has become the dominant form through which the lives of modern transgendered, transsexual and intersex subjects are narrated.

Another legacy of the art and science of case writing outlined in this volume can be observed in scholarly writing, whether in the disciplines of cultural history or of social sciences such as ethnography, linguistics and anthropology. The case study of an endangered indigenous language in Australia and the case study of foreign language pedagogy in the university classroom are just two of the varied types of case studies that have become staple forms of academic writing today. In tertiary teaching, the case study method has retained importance in psychology and psychiatry, as in medicine. Other fields, such as law and commerce, have moved on from the more traditional approaches to teaching through cases; those approaches tended to use case studies that presented dilemmas after the dilemmas had been resolved. The new ‘immersive’ case method teaching aims to train students to use the case study genre to imitate realistic situations as they unfold, in an attempt – according to the Harvard Law School – to promote students’ ‘legal imagination’.⁶

The academic disciplines of biography and autobiography have become especially privileged forms of case writing, and even when they subvert their own conventions the results are not that dissimilar to the modernist experiments that took place during the first few decades of the twentieth century. Moreover, some of Australia’s most prominent contemporary writers have built their reputations on case studies. Helen Garner’s The First Stone: Some Questions About Sex and Power (1995) dealt sympathetically with the controversial real case of a college master at the University of Melbourne who was charged with indecent assault. Subsequent books, Joe Cinque’s Consolation (2004), which explored the murder trial of a young law student, and her latest work, This House of Grief: The Story of a Murder Trial (2014), likewise based on a trial attended by Garner, all follow on in the case writing traditions established during the first half of the twentieth century.

Outside of the realms of scholarship and the media, case writing is today regularly undertaken for the purposes of public advocacy. Whether in case histories presented to official commissions investigating sexual abuse in the Church, or materials submitted to government enquiries into the effects of racism on black youths, the case study of the human subject and its relationship to institutional power is an enduring form for communicating the stories of individuals and groups; for making the stories public, as part of seeking significant change. Indeed, at present, the case study is perhaps most fittingly ‘at home’ in the spheres of public advocacy and popular media. Uniquely suited to conveying the singularity of individual lives and identity, the case study is a modern genre that has not yet outgrown its original purpose – that of placing sexuality, gender and certain extremes of behaviour such as violent crime directly under the spotlight. If it has been superseded by other scientific methods in medicine, the case study genre undoubtedly continues to offer writers, both lay and expert, a means for fathoming the riddle that is the human self.