Medical Humanities Posts Open!

unnamedNEWS AND NOTES: Positions open for the Medical Humanities journal (BMJ). Medical Humanities launched in 2000 and has since become a leading international journal that reflects the whole field of medical humanities.

Publishing original research, case studies, review essays and more; the journal aspires to encourage a high academic standard for this evolving and developing subject. The journal has recently broadened its scope by publishing an additional two guest edited Themed Editions a year focusing on key conversations in the field. Recent issues have included ‘Critical Medical Humanities’ and ‘Science Fiction and Medical Humanities’. Medical Humanities also offers an interactive blog with film, poetry and book reviews and regular updates on @MedHums_BMJ further contributing to the latest debate and dialogue.

The journal is currently seeking to fill two positions:

1.Editor-in-Chief Medical Humanities

Position: EIC

The Institute of Medical Ethics and BMJ are looking for the next Editor-in-Chief who can continue to shape Medical Humanities into a dynamic resource for a rapidly evolving field. Candidates should be active in the field, keen to facilitate international perspectives and maintain an awareness of trends and hot topics. The successful candidate will act as an ambassador for the journal supporting both pioneering authors and academics publishing their first papers. The candidate will also actively promote and strengthen the journal whilst upholding the highest ethical standards of professional practice. International and joint applications are welcomed. Interviews will be held on 24th March 2017. Term of office is 5 years; the role will take 12-15 hours a week. Contact Kelly Horwood (khorwood@bmj.com) for more information and to apply with your CV and cover letter outlining your interest and your vision for future development of the journal. Application deadline: 24th February 2017. Start date: June 2017

2. Blog Curator and Books Editor at Medical Humanities.

Position: Blog Curator/Books Editor

It is a single, combined role as all book reviews are published on the Blog. The role involves: Commissioning and editing content, including reviews, for the Medical Humanities Blog; maintaining the Medical Humanities Blog and updating it regularly (currently on a weekly schedule, but this could be flexible within reason); liaising with publishers to receive new titles and organise reviews of relevant books for the Blog; contributing to the editorial team (comprising the editor-in-chief, associate editors and BMJ Publishing staff) that leads and manages both the journal and Blog, including attending the annual editorial team meeting; curating the content of the Blog to reflect the journal’s identity, priorities and interests; working with social media platforms to provide a coherent online presence for Medical Humanities. The role is flexible and can be adapted according to the successful applicant’s interests and availability. On average, the role takes approximately 4-6 hours per week. If you are interested in the role, you are welcome to contact the Editor-in-Chief, Prof. Deborah Bowman, for an informal and confidential discussion. Her email address is dbowman@sgul.ac.uk.

Reducing the ignorance: stories in imperfect language

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This Monday we have a piece from Ekaterina Prosandeeva, MA, PhD Candidate at the University of Eastern Finland in the Philosophical faculty, School of Humanities. She writes, “My current doctoral work is concerned with the binary of norm and deviance and the conveyance of the subjective experience of mental illness in the contemporary English literature. The doctoral research is supported by the North Karelia Regional Fund of the Finnish Cultural Foundation.” You can contact her via email at ekatpr@student.uef.fi, or on Facebook or LinkedIn.

There is a tendency among the general public to consider narratives of mental illness a highly specialized sort of reading. Such an attitude solidifies the us/them binary: one denies what seems irrelevant to him or her claiming (or rather assuring oneself) that it is none of his or her concern. This is a vicious circle: on the one hand, the entire issue of ignorance arises precisely from a lack of desire to be concerned and, on the other hand, the refusal to be concerned is a direct consequence of being ignorant. I chose to study narratives of mental illness in part in order to break this circle and to demonstrate that a “non-involvement” attitude is limiting in many ways.

The first thing I found out in the course of my research is that our opinions and judgments are often formed by superficial representations of different disorders. It is remarkable that such representations operate both ways: some disorders are demonized to the extent that people suffering from them are pictured as extremely hostile others, while the names of other disorders enter our everyday small talk and thus depart from their actual clinical picture.

on-the-run-2
“On the Run”, Henry Cockburn’s artwork.

Schizophrenia is one of those demonized ones, the realm of fear and the unknown. When Henry Cockburn, the co-author of the Henry’s Demons memoir1, was deinstitutionalized he managed to resume his art studies. Henry told some of his fellow students that he had schizophrenia but the response he received was: “Oh, do you have a split personality?”2 It is likely that the young people confused schizophrenia with a multiple or dissociative identity disorder, as it is pictured by Daniel Keyes3, or else, shaped by a stereotype and a familiar word combination they had happened to overhear somewhere. Thus, stereotypes produce distorted representations of some conditions and further contaminate the labels produced by the always-already unreliable language that has its own limits.

The unreliability of language is the second important thing to take into account. We can look up schizophrenia in an etymology dictionary to find a literal translation from Greek— “a splitting of mind”. Thus it is fairly easy to confuse it with multiple identity disorder if one fails to get to the “splitting of psychic functioning” that Bleuler implied while coining the word schizophrenia.4 Or else, if one fails to look through, say, Cockburns’ Henry Demons or Daniel Keyes’ The Minds of Billy Milligan. Upon reading the mentioned stories, it becomes fairly hard to confuse Henry Cockburn and Billy Milligan.

24 identities of Billy Milligan.
24 identities of Billy Milligan.

While schizophrenia is a demonized diagnosis, one of those used in our idle talk on an everyday basis is depression. In his book (an extract also published in Unholy Ghost collection) William Styron compares “depression” to a slug, saying that it pretends to be non-malevolent and prevents a general awareness of its own horrible intensity.5 The etymology of depression is as ambiguous as that of schizophrenia with its seme of being “pressed down” or “weighed down”. The structure of the word and the inaccurate use of it scarcely give a full picture of clinical depression. Neither does the impersonal dryness of hospital records.

What can help then to reduce the ambiguity and lift the veil at least a little bit on mental illness? I believe that a story is what makes understanding possible and reduces the ignorance about human conditions. Jacques Derrida suggested an idea that the words are found “under erasure: the word is not accurate, he says, and we cross it out, yet it remains visible because we cannot do without it.6 Although “depression” is inaccurate and our stories are mediated by language, such stories convey the experience proving that it is not isolated and incomprehensible. It would be great luck to use a perfect language that could immediately and naturally convey our thoughts and experiences but we live in no fairy tale and we need to come to terms with the imperfect language we have and take incoherent stories into account. As Joshua Wolf Schenk says in his essay in Unholy Ghost, he hoped for a “direct communication” but when he spoke, “it was with stumbles and stammers”.7 A coherent speech can hardly represent a translation of a fragmented experience—even an incoherent one often fails. Furthermore, the majority of stories people may tell are far from being those of full recovery, though the latter are more often published. An assumption that only coherent narratives of full recovery count can be discouraging for a writer.

Therefore, the third and the fourth issues I would like to emphasize are the myths: that of coherence and that of a full recovery. In other words, illness stories are not and should not be the stories with happy ending. The last line of Henry’s Demons reads: “I sit under the tree which speaks to me and gives me hope”. I know a reviewer8 who claims that this line reminds him of a horror movie. Inappropriate as it is, this claim demands a “completed” story and underestimates the open-ended stories, no less worthy than the former.

Footnotes

1. Cockburn, Henry and Patrick Cockburn. Henry’s Demons: A Father and Son’s Journey Out of Madness. New York: Scribner, 2011.
2. Cockburn, Henry. “If I say I’m schizophrenic people reply, ‘So you’ve got a split personality’”. Independent November 27, 2012. http://www.independent.co.uk/life-style/health-and-families/features/henry-cockburn-if-i-say-im-schizophrenic-people-reply-so-youve-got-a-split-personality-8360497.html
3. Keyes, Daniel. The Minds of Billy Milligan. New York: Random House, 1981.
4. Bleuler, Eugen. Dementia Praecox: Or the Group of Schizophrenias. New York: International Universities Press, 1911.
5. Styron, William. Darkness Visible: A Memoir of Madness. New York: Vintage, 1990.
6. Derrida, Jacques. Of Grammatology. Trans. Gayatri Spivak. The Johns Hopkins University Press, 1997.
7. Schenk, Joshua Wolf. ‘A Melancholy of Mine’. Unholy Ghost: Writers on Depression. Nell Casey, ed. New York: Perennial, 2002. 242-255.
8. Garner, Dwight. Phantoms of the Mind, No Longer Schocking but No Less Haunting. The New York Times, Feb. 1, 2011. http://www.nytimes.com/2011/02/02/books/02book.html

Anti-Vaccination and Bioinsecurity

dailydose_darkstrokeThis morning we have a post from Travis Chi Wing Lau of the University of Pennsylvania, Department of English. You may contact him at laut@sas.upenn.edu.

Contemporary anti-vaccination debates have frequently been reduced to simplistic narratives of either neoliberal individualism, anti-science or anti-intellectualism, or religious fundamentalism. While this has enabled those in favor of vaccination (colloquially called pro-vaxxers) to dismiss the arguments of their counterparts, I want to resist this reductionist thinking, which not only ignores the historical underpinnings of anti-vaccination but also misses how the movement relates to equally sensationalized rhetorics of national security or what critical theorists have recently termed biosecurity.

Biological health, long tied up with the well-being of the nation, has now become deeply connected with national security concerns since 9/11. In response to the 2001 anthrax attacks, the Bush administration made the decision to initiate a mass smallpox inoculation of US citizens based purely on intelligence reports suspecting Russia of experimenting with their stores of smallpox virus. Crucial here is that there were no actual cases of smallpox in the US; rather, speculations and paranoia about smallpox potentially becoming the next global bioweapon merited swift preventative action. Postcolonial scholar Neel Ahuja rightly reminds us that such an event is all too familiar: “With steady media attention to health care policy, humanitarian intervention, abortion, prenatal genetic testing, drug patients, assisted suicide, animal rights, environmental regulation, and biosecurity, the idea of the vulnerable body as an object of governance—its transformation for better or worse through state policies, technological intervention, and ecological forces—is today quite conventional.”1 The US citizen’s body and the preservation of its health has become a means by which national security functions in the contemporary security state.

From the early inception of vaccination as a practice developed in England during the 1790s, national health has been mobilized as a justification for often invasive interventions into individual bodies. In fact, Edward Jenner’s project to make vaccination a nationwide practice inaugurated a culture war that debated the right of the state to literally puncture the bodies of its citizens with a lancet purely on the grounds that England was “threatened.” Conservative writers like Edmund Burke likened England to a body whose boundaries were being permeated by both metaphorical and literal contagions be it revolutionary ideas or smallpox and cholera epidemics. Working-class people, too often the target of mandatory vaccination programs enforced by state-appointed vaccinators, experienced the lethal consequences of hasty impulses toward such intervention deemed necessary for the self-preservation of the state. If the national body could be consistently imagined to be at risk, the state could be prescriptive about individual bodily practices (i.e. compulsory vaccination) and the relations between those bodies (i.e. quarantine). It is no surprise that during this period the anti-vaccination movement emerged out of a populist recognition of the state’s dependence on rhetorical and ideological mutations of “national health” as an explanatory mechanism for its violent interventions. The rise of vaccination always came with reservations as to what state medicine was truly trying to prevent or regulate.

Through a similar framing of the public as a population of vulnerable bodies constantly threatened within and without, US national policy depends largely on a logic of preemption and prevention. This anticipatory mode, characterized by virtual disaster modeling and the proliferation of agencies like the Department of Homeland Security, projects threat by underscoring the precarity of American bodies or their bioinsecurity in the face of diffuse threats like global terrorism.2 Particularly salient examples of this are Donald Trump’s campaign promises of constructing a wall to keep out Mexican immigrants or enacting a nationwide ban on Muslims. This impulse to “make America great again” by purging the country of individuals marked out as contagious or dangerous echoes the xenophobic overtones of the English vaccination debates during the late eighteenth century. Such political fearmongering prioritizes white American life as that which urgently requires securing against externalized others that are necessarily figured as parasitical or latent pathogens that can strike unexpectedly. Public health initiatives like Bush’s Smallpox Vaccination Program (SVP) literalize this paranoia by underscoring the vulnerability of the American body to deliberate infection by terrorists increasingly more difficult to identify and isolate in our globalized world. The vagueness by which such threats are defined allow them to be persistently and conveniently mobilized in national security discourses to a feverish pitch.

Rather than affirming the anti-vaccination position, I want to contextualize the anti-vax movement as one that directly challenges the state’s potential co-optation and (mis)use of medicine in the name of national security. A turn to the long history of the anti-vaccination movement since the eighteenth and nineteenth centuries3 reveals that vaccination’s prophylactic function has never been purely a biological issue but rather one of political importance involving the problematic relationship between body and state. We must linger on the question that anti-vaxxers rightly raise: can and should the state be able to monitor, regulate, or even make compulsory health interventions based on projected or imagined national threats?

Footnotes

1. Ahuja, Neel. Bioinsecurities: Disease Interventions: Empire, and the Government of Species. Durham: Duke University Press, 2016. vii.

2. See Brian Massumi’s Ontopower (Duke UP, 2016) for a thorough analysis of how this preemption operates in contemporary state politics.

3. See Nadja Durbach’s Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907 for a rich historical account of the development of the anti-vaccination movement in Victorian period.

“Not Dead Yet!” Medieval Medicine Beyond Monty Python

dailydose_darkstrokeToday’s author is Lucy Barnhouse, a Ph.D. candidate in the History Department of Fordham University, New York. Her dissertation, which she will defend this winter, examines the effects of religious status on the development of hospitals in the thirteenth and fourteenth centuries, and the place of hospitals in the religious and social networks of late medieval cities in the central Rhineland. She has presented on medieval medical history for lay as well as academic audiences, and has been involved with the Footnoting History podcast for the last three years. You can follow her on Twitter at @SingingScholar.

Teaching medieval medicine to undergraduates with widely varying degrees of background knowledge on both medicine and the Middle Ages might seem like an unenviable task. I found it, though, to be one of my most rewarding pedagogical experiences. The medieval, as I’ve discovered, can often function as a safe space for students to explore new ideas and reexamine old ones. Largely unknown, and imagined as definitely Other, it provides room for thoughtful engagement with large issues that might elsewhere be treated as resolved. Discussing medieval hospitals, for instance, can enable students to discuss many questions with contemporary resonance, e.g. how do we access care? What are spaces and places of healthcare, and what do we expect from them? Who is involved in administering hospitals, and what are the implications of how such institutions are involved in other networks, religious or civic… or both?

Author photograph of Bodleian MS Laud Misc 237, original recipes written on the binding leaf of a medical miscellany.
Author photograph of Bodleian MS Laud Misc 237, original recipes written on the binding leaf of a medical miscellany.

Due in part to the interdisciplinary topic, and in part to an early morning time slot that accommodated the needs of students taking labs, the class was a remarkably vibrant mix of humanities and science majors. This enriched our experience immeasurably, as science majors were able to see things in the sources that I was not. Having class discussions led by teams of students proved particularly fruitful. Students proved very ready to share their diverse experiences—and cultural expectations—of medicine, and to work through difficulties and uncertainties together. Such efficient functioning of the class as a body (pun intended) was, I like to think, facilitated by a personality quiz designed to diagnose humoral complexions! As a class, we turned out to be fairly evenly divided between the sanguine and the melancholic, with a few outliers. This assessment led to a lively discussion about the logic or illogic of diagnostic observation, the value of experience, and the dangers of prejudice.

Examining medieval ways of conceptualizing health and evaluating medical practitioners did not come without challenges or surprises. I’m sure that several of my former students still think of Willibald, an eighth-century bishop who smuggled balsam out of the Holy Land, as a drug dealer. But even the rather frustrating source discussion that established this consensus provided an illuminating challenge to my own categories of thought. I realize that, even to historians of medicine, the medieval might seem dauntingly unfamiliar. But the Black Death can provide an effective opening to conversations about compassion fatigue. Getting students to discuss how race and gender affect how bodies are imagined and feared is made easier by engaging with thirteenth-century examples. With diverse and visibly changing cultures of medicine and health, the Middle Ages make a great place to introduce students to the kinds of questions typical of work in the medical humanities.