Hektoen International

A Journal of Medical Humanities

Emily, Usher, and American Gothic perspectives on mortality

Olga Reykhart
Liam Butchart
Stony Brook, New York, United States

Illustration by Aubrey Beardsley of the short story “The Fall of the House of Usher” by Edgar Allan Poe, 1894–1895. Accessed via Wikimedia.

In an editorial for Medical Humanities, Gillie Bolton notes that death is a common theme in literature and also in medicine. She writes, “Death, dying, and bereavement are dark threads running through all literature. Not only are they life’s sole certainties, along with birth; they are also the biggest mysteries of biological science.”1 Bolton further points out that literature and the medical record both attempt to capture the nuances of existence.2 Literature achieves this through the imaginative work of the author, and the medical record through a faithful recording of a patient encounter. Therefore, life, literature, and medicine are intimately connected, focused on the same fundamental experiences, but are necessarily subjective.

We will examine this intersection by exploring two short stories, “A Rose for Emily,” by William Faulkner, and “The Fall of the House of Usher,” by Edgar Allan Poe (hereafter “Usher and “Emily”). Both are examples of the Southern Gothic style, centering on similar themes of inevitability, death, and decay; however, the works have just “as many differences as similarities.”3 Both “Usher” and “Emily” foreground the inevitability of time, the sense that tempus fugit, forcing us to confront our own decay. Similarly, the human experience is corporeal; the structures that we inhabit are at the whims of time, and the decay of our homes parallels our own. Another shared theme between the texts is the sheer horror of mortality. In “Emily,” the titular Emily Grierson is a “sinister relic” who enthralls a whole community in her dissolution.8 “Usher” centers on the premortem burial of an ill woman who, in her death throes, kills her own brother.4

There are also intriguing structural similarities between the texts. First, both are framed narratives: the narrators know from the outset that the characters’ time is limited. Implicitly, the narrators appreciate the finitude of the main characters’ existence—and, by extension, the inevitability of death and decay. Intriguingly, this dynamic is replicated in the constructions of the characters’ spaces: in “Usher,” “the frame narrative . . . is demarcated by the narrator’s entrance into the titular edifice”; in “Emily,” Miss Grierson is poignantly framed by a window.5,6 The physical limitations set by the buildings further emphasizes the ephemerality of the story, combining the framed narrative with the frames of the two houses. Interestingly, both Faulkner and Poe offer medical treatment as a possible solution to human decay: Emily meets a druggist, and Madeline is treated by a physician. However, both fail to intervene in the unfolding tragedies, as the druggist yields to Emily and provides the poison for Homer Barron, and the physician fails to cure Madeline’s mysterious malady. The Southern Gothic genre, then, aims to clarify the limitations of medical knowledge and power, further consolidating the feeling of inevitability accompanying mortality.

Both texts also describe in detail the concomitant collapse of the dwellings of the ill-fated characters. Poe first explicitly describes the Ushers’ house as decaying; by the end, it is destroyed:

While I gazed, this fissure rapidly widened—there came a fierce breath of the whirlwind—the entire orb of the satellite burst at once upon my sight—my brain reeled as I saw the mighty walls rushing asunder—there was a long tumultuous shouting sound like the voice of a thousand waters—and the deep and dank tarn at my feet closed sullenly and silently over the fragments of the “House of Usher.”7

Emily Grierson’s house succumbs more slowly, but just as inevitably. Over the years, it falls into disuse: the pillows become “yellow and moldy with age and lack of sunlight,” the house a “stubborn and coquettish decay.”8 Just as the houses symbolically force the characters into the frame narratives that spelled their inevitable doom, they reflect their owners’ demises.

But, as Stone articulates, the stories’ settings are contrasting, too. We witness the violent undoing of the house of Usher, as an ominous “fissure rapidly widen[s]” across the mansion and with “the mighty walls rushing asunder” in a thunderous collapse.9 However, Miss Emily’s house remains quietly standing, both as its inhabitant locks herself inside and when she finally passes. Enduring the wave of newcomers after her death, the house reveals dark rotten secrets, hidden behind old doors and layers of “pervading dust.”10 There is no violence, only floating dust and a trace of the mummified body of a man “with a fleshless grin” who went missing years ago and has been slowly decomposing in the house, like Miss Emily herself.11

While in both texts the main characters suffer inevitable intrusions from their respective observers, these differ vastly in nature—anticipated and voluntary in the case of Usher as he invites his friend to cheer him, but entirely unsought by Emily, who closes her doors to the curious public indefinitely. Put in terms of an analogy, the texts’ narrators could be compared to physicians—silent, analytic, yet sympathetic outside forces who attend to the main characters. In “Usher,” the subject willingly invites this external presence, whereas the faceless ghosts of townsfolk watching Emily have no such invitation. In fact, the relationship between Miss Emily and the town can be further constructed as a physician-patient impasse: that of offering potentially unwanted intervention. They are in conflict over her taxes, and Judge Stevens will not agree to confront Emily when the neighborhood becomes malodorous.12 In place of delving deeper into the psychosocial components of the woman, uncovering and removing the true source of the smell coming from her property, four men “slunk about the house like burglars,” sprinkling lime to suffocate the stink.13 Usher, on the other hand, sends forth a letter inviting his old friend “with an earnest desire to see [him]” in hopes that his old personal friend’s presence might alleviate or even reverse his suffering; here, the narrator-cum-physician is attendant to the underlying causes of Usher’s dismay.14

The atmospheres of the texts presented by these narrators also differ drastically, despite their similar subject matter. The overarching sense of dejection of “A Rose for Emily” is woven through the text—in descriptions of the time and place, as well as in the disposition of the main characters. The account of the funeral is abundant with sullen hints of the public’s disregard, as the visitors are there not to pay respects, but to “see the inside of her house, which no one . . . had seen in at least ten years.”15 Even when alive, Emily is not constructed as a hopeful character. Her physical appearance as a “fat woman in black,” her lack of sociality, and her cold and ghostly presence—like when she is described standing in her window or staring at the pharmacist in icy silence—all convey a picture of a weary, deteriorating soul.16 This is distilled into the putrid smell of rotting flesh that she is unwilling to address: she is a character of slow decay. In contrast, Usher creates around himself a scene of a desperate struggle. The description of the setting in “Usher” is much darker than in “Emily,” with an “iciness, a sinking, a sickening of the heart” that the narrator feels upon taking one look at the “bleak walls” and “vacant eye-like windows.”17 The impending doom in this story takes the form of a silent terror, and the ghostly presence of Usher’s sister conveys a mood much more sinister than Emily does, who sternly yet absently watches her intruders from the window.

Thus, we see that mortality and decay are prominent in both Poe’s and Faulkner’s Southern Gothic tales. However, the two approach the omnipresence of death differently: Faulkner is concerned with slow decline, and Poe with violent death throes. The medical professional can see both of these paradigms reflected in patients; the human approach to death is variegated, even if the terminus is assured. However, it may be difficult to connect with patients who are experiencing death differently than the norm, and consuming texts that approach mortality differently can help broaden perspectives and improve patient care.18 But physicians are people, too—and death spares no one. Therefore, reading these stories—and all that discuss death—can help the people inside of the white coats prepare themselves, too.


  1. Bolton, Gillie. “Editorial: Death, dying, and bereavement.” Medical Humanities 30 (2004): 49.
  2. Carter, Albert Howard III. “Esthetics and Anesthetics: Mimesis, Hermeneutics, and Treatment in Literature and Medicine.” Literature and Medicine 5 (1986): 141-151.
  3. Stone, Edward. “Usher, Poquelin, and Miss Emily: The Progress of Southern Gothic.” The Georgia Review 14, no. 4 (1960): 433-443.
  4. Matta, May. “The Abyss of the Unknown in the Books ‘The Fall of the House of Usher’ and ‘A Rose for Emily.’” European Scientific Journal 14, no. 2 (2018), doi:10.19044/esj.2018.v14n2p273.
  5. Tarr, Clayton Carlyle. Gothic Stories Within Stories: Frame Narratives and Realism in the Genre, 1700-1900. Jefferson: McFarland, 2017.
  6. Dilworth, Thomas. “A Romance to Kill For: Homicidal Complicity in Faulkner’s ‘A Rose for Emily.’” Studies in Short Fiction 36 (1999): 251-262.
  7. Poe, Edgar Allan. “The Fall of the House of Usher.” Elegant Books, 1839, https://www.ibiblio.org/ebooks/Poe/Usher.pdf, 3, 25.
  8. Faulkner, William. “A Rose for Emily,” in Selected Short Stories. Modern Library, 2012: 47-59.
  9. Poe, “The Fall of the House of Usher,” 25.
  10. Faulkner, “A Rose for Emily,” 58.
  11. Faulkner, “A Rose for Emily,” 58.
  12. Trilling, Jeffrey, and Raja Jaber. “Formulation of The Physician/Patient Impasse.” Family Systems Medicine 11 (1993): 281-286.
  13. Faulkner, “A Rose for Emily,” 51.
  14. Poe, “The Fall of the House of Usher,” 4.
  15. Faulkner, “A Rose for Emily,” 47.
  16. Faulkner, “A Rose for Emily,” 49.
  17. Faulkner, “A Rose for Emily,” 3.
  18. Bolton, “Editorial,” 49.

OLGA REYKHART is a medical student at the Renaissance School of Medicine at Stony Brook University. After obtaining her BA in Biological Sciences from New York University, she has pursued her interest in biomedical research and its clinical application in the areas of gastroenterology and clinical bioinformatics. Her interests also include medical humanities and literary analysis.

LIAM BUTCHART is a third-year medical student at the Renaissance School of Medicine at Stony Brook University. There, he is an MD/MA candidate, pursuing a master’s degree in Medical Humanities, Compassionate Care, and Bioethics in addition to his medical degree. His research interests include psychoanalysis and mental health, literary theory and analysis, and medical education.

Summer 2020



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