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April 1, 2011 / polc01

Watch that character jump! From page to life

Carmen Pol

How does an author grasp a reader into their story; what is it that makes a fictional construct truly great? For me, it’s when an author makes a character real, believable and relatable. When you step into their world and see things from their eyes.

The story of ‘M’ in The Itch is one of tragedy. Her life starts off promising: university graduate, blossoming career, married young, two beautiful children. It all sounds great… Then bam! Her life starts collapsing around her, piece by piece.

Firstly, her marriage starts to ‘disintegrate’ as Atul Gawande puts it so eloquently.

But she and her husband began fighting. There were betrayals.

She lost her home, began drinking and met someone else.

After a while, he brought some drugs home, and she tried them. The drugs got harder.

She contracted HIV, no longer saw her children, and was not able to work.

By all accounts, her life appeared bleak. And Gawande represents this with tone and emotion. He has the ability to state something simply, with so much feeling. He uses short, straightforward sentences that say so much more than a long winding paragraph. His point is clearly heard – without unnecessary words.

After a bout of shingles on ‘M’’s scalp (a HIV side effect), she begins to feel an itch constantly:

She had two good, quiet years in which she began rebuilding her life. Then she got the itch…“I felt like my inner self, like my brain itself, was itching,” she says. And it took over her life just as she was starting to get it back.

Gawande masters at drawing empathy and understanding from a reader.  The dialogue, for example, bridges the gap for readers to connect with ‘M’’s plight. Her voice and words add to the realism of the situation – as if she is speaking directly to us.

Also, the ‘itch’ is virtually given its own persona in Atul’s writing. It becomes the enemy and causes ‘M’ (the protagonist) to scratch through her own skull, into her brain.

The use of the letter ‘M’, rather than a name supplies a sense of mystery, anonymity. This can serve to catch attention, without putting a reader at a distance. I personally enjoy an enthralling comic book with a masked superhero. That sense of mysterious identity, and living vicariously through the character. Anonymity allows you to say what you want, how you want. And that is how ‘M’’s story is told.

“The Itch” painted such a vivid picture in my mind of ‘M’’s life that I simply had to read on. Partly that is because humans are terribly curious creatures; but it is also an art for written word to cause such a physical reaction. Very effective methods, by an unforgettable author: and a character is brought to life.

GAWANDE, A. 2009. The Itch, New York, The Best American.




Leave a Comment
  1. Winnie Octavia Tjang / Apr 1 2011 3:06 am

    Hi Carmen,

    I like the way you write your titles. It kinds of grab my attention and start reading. The first few paragraph you start off with simple but precise summary of the story written. I like the way you write 1 idea per paragraph at the beginning of how the character life starts to fall apart by listing them in short sentence of what had happened to the character. Although the author gives “M” as the name of the character, but he/she manage to make the character real in this story as if it is happening in the real world. Just like you mentioned the name itself already give a sense of mystery, and grab attention to the readers. I am one of them i guess. 🙂

    • Carmen Pol / Apr 7 2011 3:22 am

      Hi Winnie!
      Thanks for your encouraging comment.
      Yes, I really liked the way Atul Gawande used “M” instead of a name. Like a secret identity.
      It had the exact same affect on me, it got me interested right away!!

  2. Anke van Eekelen / Apr 1 2011 4:01 am


    What a great job you did in your blog to reflect on Gawande’s story of “M” and “The Itch”! I find your title excellent, touching on the core of his technique to use a story, easily imaginable to have been taken from real life, in order to explain a medical issue. The story is so realistic that you cannot avoid feeling sympathetic towards “M” and her misery. I agree with you that “the Itch’ also comes across as a persona in the story; a great approach to use if you want the reader the remember this aspect of the disease of interest. We probably all start agreeing with Muza about how good of a health science communicator A. Gawande is. But that said, I think you also have great writing skills, incredible word choices and effective ways to engage the reader in your blog. Look forward reading more of your work as well.


    • Carmen Pol / Apr 7 2011 3:26 am

      Thanks Anke!
      Yes, I have to say I really enjoy reading Gawande’s work, I have definitely been converted! Only receiving half the story was quite a tease, he is so talented and I turned the page and a part of me died inside when I couldn’t finish the story (will have to talk to Muza about reading the rest). And I agree with you that the “itch” having it’s own persona did pique my interest toward the disease, not to mention Gawande’s amazing writing style.

  3. Yvette Yi Hui Leong / Apr 7 2011 5:46 am

    Hi Carmen,

    An intriguing piece of work – well done! I like the way you’ve made it personal. I felt like you were directly addressing me and telling me how you felt, how you empathised with “M”. Your summary of the reading was engaging, concise and complete; the flow of the article was great and easy to read. Your title also captured my attention as it created an action image in my mind (you invited me to “watch” something happen), and inspired curiosity to find out what you were going to write about next.

    The only negative comment I might make would be that I wish you had made it clearer what the science was that was being communicated through “M”‘s story. Was it about the effects of HIV? Was a warning against drugs? I couldn’t tell from your article.

    On that same note, why did “M”‘s life take such a drastic turn? Was this addressed by the author and what implications does this information have for the reader?

    Overall a great article, Carmen.


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