Psychodynamic Tuberculosis: An Analysis of T.C. Boyle’s “The Fugitive”

“In my mind, this man is one of the most dangerous in Santa Barbara County, if he’s here.” — Dr. Charity Dean (qtd. In Scully)

Marciano] went down on his hands and knees, and there was no plan now but to find the darkest corner of the yard, the place where nobody had bothered to cut the grass or trim the shrubs, where the earth was real and present and he could let the blood come up and forget about the pills and Rosa Hinojosa and his mother and Rudy and everybody else,” author T. Coraghessan Boyle writes in his short story, The Fugitive. This moment illustrates a situation a majority of people will experience during their lifetime — the moment in which individuals must decide whether to continue with their initial, now faulty, plan or to suspend their pride for the alternative. Falling to his hands and knees, Marciano decides the latter — to end resisting his inevitable future and accept the reality of his cumbersome circumstances. In his short story, Boyle follows the life of Mariano, an oppressed, Mexican-American with a virulent strain of tuberculosis, on the run from his caseworker, Rosa, and his inevitable future in the “special ward for prisoners with medical conditions” (Boyle). The thought of his probable demise in a medical ward, coupled with the social and mental consequences of his disease, encourages Mariano to flee — in hopes of escaping his cumbersome reality. Perhaps Boyle’s goal was to provoke an emotional response from the reader in establishing this shared human experience. And if so, Boyle’s intentions could have been to reason Marciano’s abnormal behavior with psychological defense mechanisms. The point of view established limits the reader’s scope of understanding and reasoning; every detail, event, person, thought, and feeling is described through Marciano’s lens. Because Boyle limits the story’s perspective to that of solely Marciano, the reader develops an emotional connection with his character and understands his peculiar behavior from its underlying psychological factors.

To evoke an emotional response and establish a connection with the reader and Marciano, vivid imagery and intense diction work simultaneously to emphasize his unfortunate reality and the consequences it bears. The limited point of view is thus advantageous towards Marciano, encouraging sympathy from the reader. For example, following the meeting of Rosa Hinojosa and Dr. Rosen — in which Marciano receives specific instruction for a new treatment due to his failure to comply with the previous treatment — Marciano resorts to Herlihy’s, a local bar, in attempt to return to normalcy. Nevertheless, the infamous tuberculosis cough exposes his disease, and images of Marciano “[stripping his] mask” with a “[tightening] in his chest” illustrate his anxiety and thus exemplify the social consequences of his situation. Moreover, Marciano admits feeling “pathetic” and “humiliated,” comparing himself to a “charity case” and a “cockroach” — revealing an underlying insecurity and feeling of inferiority. Consequences of his drug-resistant strain of tuberculosis include physical pains like “breathing hard” and a “burning in his chest,” and heightened sensitivities, for he notices the “creaking” window frame, the “barking” dog, and the “shrieking” crickets while flustering to escape confinement (Boyle). The repercussions of his disease illustrated through descriptive imagery and diction cause the reader to sympathize for Marciano — recognizing his insecure and inferior feelings and rooting for an alleviation of his suffering.

The emotional connection towards Marciano intensifies due to a recurring motif that epitomizes his disease — the cough. Perceived through Marciano’s perspective, the cough serves as a constant reminder of his unfortunate reality. In his endeavors to achieve any sense of normalcy, the cough rudely interrupts. Marciano compares the “long dredging” cough to “the sea drawing back over the stones at low tide” — an indication of its lingering effect. An intangible antagonist, the cough succeeds in exposing Marciano at Herlihy’s, “so severe this time he thought he was going to pass out,” and while at work with Rudy — “right on cue.” Even in the safety of his home, the cough is “right there waiting to erupt” (Boyle) and thwarts Marciano’s moment of silence. The negative connotations attributed to the cough from his limited point of view strengthens the reader’s empathy towards Marciano, as the reader observes its irritating, embarrassing effects on his life.

Although limited by the thoughts, feelings, and actions of Marciano, the audience receives a front-row seat in understanding and analyzing the underlying factors of his behavior on a psychological level. To alleviate the external pressures and anxieties of his disease, Marciano unconsciously resorts to using multiple defense mechanisms in order to restore his sense of order. Termed by Sigmund Freud in his psychodynamic theory, defense mechanisms are “counterforces directed against the expression of drives and impulses… to protect the individual from being overwhelmed by the anxiety that would result from conscious recognition of unacceptable impulses” (Cramer). Used most explicitly, projection — “the misattribution of a person’s undesired thoughts, feelings or impulses onto another person who does not have those thoughts, feelings or impulses” (Grohl) — allows Marciano to defend against his glum reality. He unconsciously uses Rosa Hinojosa’s euphonic name and physicality to project his undesired thoughts of insecurity and sickness into sly, sexual remarks. Instead of being present and listening to the information vital in containing his disease, Marciano repeatedly says Rosa’s name, for its rhyme “made him feel better.” Distracted by her “big bust” and “liquid eyes,” he would have “liked to fuck [Rosa] if he weren’t so sick” (Boyle). Denial, another defense mechanism Marciano uses in order to cope with his sickness, is “the refusal to accept reality or fact, acting as if a painful event, thought or feeling did not exist” (Grohl). “[Fighting] down the scratch” and claiming to Rudy his sickness is “just a cold,” Marciano rejects the severity of his illness, wanting to dissociate completely from it. After making the bold choice to escape from the hospital, Marciano thinks of his mother. Because she was able to nurse him through a plethora of diseases that “[disrupted] his childhood,” he figured she could “nurse him through this, too” (Boyle) thus exhibiting regression — a “reversion to an earlier stage of development in the face of unacceptable thoughts or impulses” (Grohl). Without this exclusive perspective into Marciano’s thoughts and actions, the reader would not have been able to understand the psychological background of his behavior.

The limited point of view restricts the reader to a single perspective — Marciano’s. This invitation into his mind offers a direct experience of his perception. This exclusivity allows to reader to build an emotional connection with Marciano, empathizing with his fight against tuberculosis — a strain yielding consequential physical, mental, and emotional distress. His perspective offers an evaluation of not only his thoughts, but also his actions. To thwart external pressures, Marciano succumbs to multiple defense mechanisms in order to protect his self-esteem and deviate unwanted thoughts. If the story had been told from an outsider’s point of view, Rosa Hinojosa, for example, Marciano would be depicted as a careless, irresponsible criminal who chooses to put the California population at risk, more concerned about avoiding the “sterile white counter” and “man in thick-framed glasses” (Boyle) than for his life and the lives of others. Anger, disappointment, and fear would displace sympathy. Observation of his psychological defense unattainable. By transposing the “actual,” Boyle lets the audience find “common ground” (Boyle, qtd. in Treisman), — whether if they, too, have ever fallen to their knees, searching for the darkest corner, and allowed the blood to come up.


Works Cited:

Boyle, T. Coraghessan. “The Fugitive.” The New Yorker. July. 2016. Web. 8 Sept. 2016.

Cramer, Phebe. Protecting the Self: Defense Mechanisms in Action. Illustrated. Guilford Press, 2006. p. 7. 8 Sept. 2016.

Grohl, John M. “15 Common Defense Mechanisms.” Psych Central. N.p., 17 May 2016. Web. 08 Sept. 2016.

Scully, Janene. “Facing Alarming Rise in Tuberculosis, Santa Barbara County’s Control Efforts Shift to Latent Cases.” Noozhawk. N.p., 26 Oct. 2015. Web. 11 Sept. 2016.

Treisman, Deborah. “This Week in Fiction: T. Coraghessan Boyle on the Ethics of Disease.” The New Yorker. N.p., 27 June 2016. Web. 12 Sept. 2016.