In defining what it means to be human (in any age), the sciences and the humanities inevitably flow into and through each other. This is the guiding assumption of Medicine, Health and Being Human, and one which places Lesa Scholl’s edited collection at the forefront of recent efforts to trace the entanglements – rather than the oppositions – of the medical humanities. An emerging critical approach, it has been most notably described in the seminal Edinburgh Companion to the Critical Medical Humanities (Whitehead and Woods 2016: 1-31), for which Scholl expresses considerable admiration. Several hundred pages lighter, the present volume is nevertheless animated by a comparable desire to introduce a wider array of historical, cultural, and political perspectives to the site of the clinical encounter. Ranging from the medieval world to the present, and from pharmacology to art history, the collection offers an impressively broad range of themes and topics from a selection of essays that are both confidently interdisciplinary and attempting to move beyond a limited Anglo-American focus.
It is in the first of the three themed sections that this ambitious reach is most visible. From Julien of Norwich’s relationship with sound, through Thomas Willis’s pathology of the soul, to contemporary faith-healing in Brazil, the essays in Part 1 move from medieval to modern in their explorations of mind, self, and spirit. Following a broadly comparable critical strategy, the chapters by Michelle Pfeffer, Bonnie Millar, Hazel Morrison, Patrick Seniuk, and Hannah Lesshafft are all concerned with the historical emergence of particular ideas about health and illness, and their ensuing effects on subjectivity. Focussing on the distinction between having a disorder and being disordered, Senuik writes with perspicacity on clinical and conceptual shifts in western psychiatry during the twentieth century. Framing his discussion within the history of the Diagnostic and Statistical Manual of Mental Disorders (DSM), Senuik describes how recent psychiatric diagnosis has – for the most part – continued to be influenced by a lingering Cartesian dualism. The key exception to this being the DSM-V, which Senuik argues demonstrates the transition to a dimensional diagnostic framework more compatible with the need for phenomenologically-sensitive understandings of mental experiences, such as depression.
The nature of the medical gaze and its discontents also forms a particular focus of the second section of the collection. From the Penny Dreadful to the examination of nursing manuals in the Great War, the essays by Jennifer Greenwood, M. Renee Benham, Anna Gasperini, Corinna Wagner, and Catherine Jenkins in Part 2 explore how the ideologies of medicine, and its representation in literature and the arts, are shaped by the often-overlooked intersections of gender, race, and class. Looking at the dynamics of technology within these debates, Jenkins’ impressively detailed chapter explores the role and impact of medical imaging from the X-ray to the fMRI. For all of the diagnostic benefits which imaging technologies offer, the assumption of their objective truth value has transferred authority from the human patient or physician, to the machine and its operator. This fetishization of the image can, as Jenkins’ notes, have a detrimental effect on both the patient-practitioner relationship and overall health outcomes – even beyond the immediate site of the clinical encounter (see Beck 2010: 763; Farah 2012: 575).
The interest in the visual extends into the third and final section of the collection; with Carmen Voinea’s opening examination of fairy-tale tropes in South Korean plastic surgery documentaries followed by Kathryn Bird’s chapter on extraordinary anatomy. Bird’s essay begins with the story of Charles Byrne, the so-called “Irish Giant”, whose remains were snatched on their way to the sea by the eighteenth-century, surgeon-anatomist John Hunter. Byrne, who was penniless, suffering from acromegalic gigantism, and only 22 at the time of his death, had no desire to become a curio – and the display of his skeleton at the Hunterian Museum continues to be a matter of fierce contemporary debate (Doyal and Muinzer 2011; Smith et al 2012; Knott, 2018). For Bird, both Alasdair Gray’s Poor Things (1992) and Hilary Mantel’s The Giant, O’Brien (1999) help to shed light on the way that morphological, social, and economic stigmatization – like that of Byrne – can make patients particularly vulnerable to medical authority and injustice.
Bird is particularly alert to trends that forward the literary imaginary as a straightforward force of empathetic or caring humanism, ready to ‘cure’ the biomedical sciences of any tendencies towards depersonalization. In this way, her essay stands out in a third section which largely falls back on traditional narratives of empathy, ethics, and education: with April Patrick, Uzo Dibia, and Andrea Rodríguez-Prat and Xavier Escribano’s contributions focussing largely on the ability of literature to represent the humanity of the patient (in a depersonalised medical world), and to increase empathy and understanding in medical and health care practitioners. Though undoubtedly interesting in their own right, these essays – on breast cancer in short fiction, the physician in fiction, and the power of communication in end-of-life care – are slightly at odds with Scholl’s claim that her project follows Whitehead and Wood’s vision, in venturing beyond such humanizing emphasis in the quest for ‘entanglement’ (Scholl 2018: 3).
In a collection with as effective and encompassing a scope as this one – and as many contributors from different fields, professions, and career-stages – such differences in perspective are perhaps inevitable, and it is hard to see this particular quibble preventing the enjoyment of any potential reader. It is clear that Medicine, Health and Being Human will be of interest to those who have been keenly following the development of the critical ‘second wave’ in the medical humanities (Whitehead and Woods 2016: 1). Covering an immense amount of ground, the collection offers a number of insightful and fresh contributions to popular fields of research – particularly those surrounding the historical legacies of the biomedical sciences; the intersections of gender, race, and class in the clinical encounter; the increasing impact of biotechnologies; and the evolving status of different bodies in the age of biomedicine.
About the reviewer:
Natalie Riley is a doctoral researcher and teaching assistant in the Department of English Studies at Durham University. Funded by the Wellcome Trust, she is currently completing her thesis on contemporary literature and the mind sciences. She is the coordinator of the PG and ECR Network at the Institute for Medical Humanities. She tweets @LitSciNat.