Charlotte Lock reflects on the role of interdisciplinarity in her research on approaches to knowing, visualising and experiencing the heart. This article is part of a collection of posts from attendees at the 2024 Medical Humanities International Summer School for PhD researchers in Vadstena, Sweden, coordinated by the Centre for Medical Humanities and Bioethics at Linköping University, in collaboration with the Institute for Medical Humanities at Durham University.
How do different knowledges come together and what happens when they do? These questions were posed to us during the 2024 Medical Humanities International Summer School. We were invited to reflect on interdisciplinarity – what it looks like to bring together different bodies of thought, different methods and different approaches. We were asked how these knowledges might relate, intersect and, in doing so, how they might open new possibilities or close doors for research.
This same question – which sits at the heart of many interdisciplinary debates – drives my PhD research on patient experience of heart imaging. I trace some of the many ways of knowing the heart and their entanglement, through investigating the embodied experience of the transthoracic echocardiogram (an ultrasound scan of the heart) for adults with congenital heart disease. The heart is imbued with complex emotional, medical, and personal meaning, which makes its understanding particularly open to the entanglement of different knowledges. I propose that thinking through these different accounts of the heart might help us unpack not only how knowledge “hang[s] together” (Mol 2002, 5), but how to navigate interdisciplinary thinking.
Historian Fay Bound Alberti (2010) points to an ambivalence in how we understand the heart: simultaneously as a site of emotion and as a pump. The heart has a long history of being considered the site of emotion, and even subjectivity and soul. For example, Aristotle saw the heart not only as the source of blood and heat, but as the locus of the “sensory soul” (Goodhart 2014). Such thinking shaped humoral theory until the late 17th century, linking emotional states to bodily changes, until the heart came to be more commonly thought of as a pump in the 18th and 19th centuries. This emerged from new understandings of blood circulation and mechanistic approaches to the body within medicine and science (Bound Alberti 2010).
We arrive then at an apparent duality – a heart that is the locus of our emotional world and the heart which functions as a pump. However, what seems, perhaps, to be a shift from emotion to pump can instead be understood as a co-presence. The heart’s ties to emotion continued long after the 1600s, in religious symbolism, in linguistic use and in body language – we talk about our heartbeat in relation to emotion, and gesture to it when speaking from the heart (Goodhart 2014).
More recently, research has bridged the divide through emphasising the connection between heart function and emotions, speaking to the critical medical humanities’ call for a move beyond the binary of affective art and pragmatic science (Whitehead and Woods 2016). For example, exploring the long-term impact of emotion on heart function (Goodhart 2014); the high levels of neuron activity in the heart and its surroundings (Shildrick 2021); how the heart can create emotions (Harding 2022), as well as its ties to sensory experience, personhood and memory (McIntyre 2020).
It is within this context that I situate my own work, which explores some of the multiple ways of knowing, visualising and perhaps even experiencing the heart. In her book Matters of the Heart: History, Medicine and Emotion, Bound Alberti (2010, 160) offers a “series of sections or slices of the heart,” and closes with the reflection that we continue to puzzle over how these different hearts relate. At the start of the PhD, I began with the question: how can – and later, should – we reconcile this seemingly de-personalised anatomical organ with a notion of the heart as a site of feeling and emotion? How do these different accounts – or slices – of the heart sit alongside one another and what happens when they collide?
We might say that this idea of intersection and collision speaks to a quandary at the heart of interdisciplinarity. In the words of Annemarie Mol (2002, 5) – how do these different knowledges “hang together”? In The Body Multiple (2002), an ethnography of atherosclerosis within a hospital, Mol suggests that different versions of a disease might coincide harmoniously or clash problematically – in conflicting results, reports, or measurements. It is amidst a clash that one object must be prioritised, where the concern is: “what will count as the reality in a particular site” (Mol 2002, 48, original emphasis). In the realm of interdisciplinarity, we think about how we might handle this meeting – or clash. How might certain forms of data, research, or approaches not “count” in particular spaces, or simply be favoured differently, and what happens when this is the case?
In the context of my research, I have explored how we might think across these varied knowledges of the heart. In investigating how knowledges of the heart “hang together,” I am fundamentally interested in the heart’s multiplicity. For example, within the echo room, how does the echocardiographer’s verbally-explained heart, the moving ultrasound image of the heart, a patient’s embodied experience, their emotional selfhood and the beating felt within the chest come together – or sit apart? Through tracing some of the many ways of knowing the heart, I have considered how it is variously imaged, felt in the chest, read about in clinical letters, described in different contexts and turned into data, and explored the moments where these different hearts collide. Methodologically, this act of researching multiplicity has involved using a range of different (creative) methods intentionally, to think with people about how they conceptualise the heart and what happens during an echocardiogram.
In this way, I am staging a conversation which attempts to think across the visual image of the heart, the echocardiographer and cardiologist’s medical expertise, and the patient’s lived experience. In attending to how they are entangled, I claim that to think about this medical encounter involves grappling with the intersection of these many different forms of knowledge and expertise. In doing so, I have arrived at a place where I am not trying to reconcile these many different hearts, but rather hold them together. This has consequences not only for how I research methodologically, but for the ways I analyse and present my research: for example, rather than exploring my data from each method separately, I try to offer slices that cut through different perspectives, deliberately threading accounts together. Interdisciplinarity – as with the heart – for me, has come to be about tracing how knowledges intersect, thinking relationally and working with the multiplicity and tensions that emerge.
The Medical Humanities International Summer School 2024 provided room to explore this messy, challenging, possibility-filled space where knowledges meet: What happens when different realities collide? What counts as knowledge in different contexts? I left without neat answers to these quandaries, but rather an appreciation of what entanglement might mean and how we can begin to work with it, both in the context of interdisciplinary working and in thinking through the multiplicity of the heart.
About the author
Charlotte Lock is an NINE DTP Doctoral Researcher in the Department of Geography at Durham University. Her work focuses specifically on patient experience of ultrasound imaging of the heart for adults with congenital heart disease. She is particularly interested in how lived experiences of healthcare encounters are shaped by medical imaging technologies, drawing on creative, participatory and embodied approaches. She is also a Medical Humanities Fellow and Postgraduate Co-Convenor for the Geographies of Life Research Cluster in the Department of Geography at Durham University.
References
Bound Alberti, Fay. 2010. Matters of the Heart: History, Medicine, and Emotion. 1st ed. Oxford University Press.
Goodhart, Anna. 2014. “The Relationship between Heart and ‘Inner Self’ from Aristotle to Current Clinical Practice.” Medical Humanities 40 (1): 61–66. https://doi.org/10.1136/medhum-2013-010392.
Harding, Sian E. 2022. The Exquisite Machine: The New Science of the Heart. MIT Press.
McIntyre, Hugh Farrell. 2020. “Pump, Person and Parfit: Why the Constitutive Heart Matters.” Medical Humanities 46 (4): 384–93. https://doi.org/10.1136/medhum-2020-011849.
Mol, Annemarie. 2002. The Body Multiple: Ontology in Medical Practice. Duke University Press.
Shildrick, Margrit. 2021. “Hauntological Dimensions of Heart Transplantation: The Onto-Epistemologies of Deceased Donation.” Medical Humanities 47 (4): 388–96. https://doi.org/10.1136/medhum-2020-011982.
Whitehead, Anne, and Angela Woods. 2016. “Introduction.” In The Edinburgh Companion to the Critical Medical Humanities, edited by Anne Whitehead and Angela Woods, 1–31. Edinburgh University Press.
