Alana Skuse, Surgery and Selfhood in Early Modern England: Altered Bodies and Contexts of Identity

Alana Skuse, Surgery and Selfhood in Early Modern England: Altered Bodies and Contexts of Identity (Cambridge: Cambridge University Press, 2021), 209 pp. £22.99 Pb. ISBN: 9781108919395

Alana Skuse’s new book is catalogued under history by the Library of Congress and appears in the history list for Cambridge University Press. Her own methodological positioning is, by contrast, avowedly literary, although she regards her conceptual approach as essentially ‘integrative, […] drawing from medical history, disability studies, and phenomenology in order to focus intently on issues of embodiment’ (3). Certainly, anyone coming to this book for a historical account of early modern surgery and selfhood will be surprised, if not disappointed. For one thing, given the title, there is curiously little surgery in it, and surgeons themselves appear only occasionally and generally very briefly. The same is true, more or less, of patients, certainly when compared to Skuse’s previous book on cancer. Moreover, while she is sensitive to cultural context, Skuse eschews chronology or any meaningful sense of change over time. As she suggests in the introduction, ‘In light of the flexibility, which I argue characterised early modern approaches to embodiment, it seemed inappropriate to order this book in terms of chronology or even generic categories’ (12). This temporal licence extends not only to the overall structure of the book, but also to individual chapters, which, in some cases, range freely across the period from the fifteenth to the eighteenth century. At times, this can leave the analysis feeling a little unmoored, at least to those with a more expressly historical sensibility. But it also allows for a diverse range of texts and contexts to be explored. Indeed, if those coming to this book for a diachronic account of the impact of surgical practice on contemporary ideas of selfhood may feel themselves to be in the wrong place, those seeking a concise, perceptive, and theoretically sophisticated reading of some intriguing and engaging material, including a rich body of non-canonical literary texts, will be amply rewarded.

Skuse’s principal aim in Surgery and Selfhood is to explore the ways in which bodily alteration informed early modern English discourse about personal and social identity, or how ‘anomalous bodies shaped and were shaped by more metaphysical concerns’ (2). Although she is alert to the overlap with disability studies here, the book is a study of ‘altered bodies’ in the broader sense, including those, such as castrati, whose bodies were, in some ways at least, functionally enhanced by their supposed deficiency.

Surgery and Selfhood is structured into six case-study chapters or, as Skuse phrases it, ‘a collection of interventions’ (12). The first of these concerns the aforementioned castrati, who, as Skuse suggest, troubled established conceptions of masculinity by being at once nominally sexless yet also sexually alluring to women as well as often wealthy and successful. Their bodies were thus imbued with a unique blend of ‘erotic and commercial capital’ (12).

 In the second chapter Skuse turns her attention to the female breast, specifically its removal. As she points out, the two figures historically most closely associated with the absent breast were women who had undergone a mastectomy for cancer and the mythical Amazons. In this chapter, Skuse demonstrates, somewhat counterintuitively perhaps, that neither was commonly associated with the other in this period and that both were relatively absent from the contemporary literary imagination, suggesting that ‘early modern audiences had a problem with viewing sexually altered women “in the flesh”’ (49).

Chapter three explores early modern facial surgery, notably Tagliacotian rhinoplasty, demonstrating how the restoration of the nose, especially in the case of those suffering from tertiary syphilis could prose troubling questions about authenticity and deceit. As with Emily Cock’s recent work, Skuse also considers how the use of other people’s body parts, notably their skin, in the repair of nasal deformity could establish sensory and imaginative connections between individuals, as the body part retained a ‘sympathy’ with its former owner.

In chapter four, Skuse moves from faces to limbs, and specifically to the complexities and potentialities of prosthetics.  Opening with the silenced and mutilated figure of Lavinia in Titus Andronicus, she contends that early modern prosthetics were both inherently and necessarily practical, but also represented a performance (perhaps even a fantasy) of functionality, as epitomised by the numerous elaborate (and perhaps even imagined) prosthetic devices described and occasionally depicted in contemporary surgical texts.

Chapter five considers early modern ideas about the fate of the resurrected body, and the question of whether, and indeed how, the bodies of the dead would be restored to physical wholeness on the day of judgement. As Skuse demonstrates, such debates could produce exquisite philosophical arguments about God’s omnipotent command of the atoms but could also pose troubling questions, as exemplified the medieval ‘Miracle of the Black Leg’, about the fate of those whose limbs had been recycled for use by others and what, exactly, constituted one’s body. Meanwhile, in a short final chapter, Skuse explores some well-known early philosophical discussions about matter and sentience through the prism of the phantom limb.

Skuse’s analysis of this varied literary and historical material is consistently provocative and engaging. However, the very nature of the book, divided as it is into discrete, almost self-contained, chapters, tends to militate against the overall coherence of argument. Indeed, despite the undeniable riches of the individual close readings, I would be hard pushed to say exactly what I took away from the book as a whole, aside from the observation, repeated in several variations, that ‘early modern models of embodiment were unfixed, often dwelling on indeterminacy and change’ (55). This impression is not aided by the fact that Skuse tends to make her argument through the work of other scholars, rather than positioning herself in relation to, or even against, it.  Likewise, her engagement with the phenomenology of altered bodies is not always wholly convincing. For the most part the book is concerned with cultural semiotics and philosophical debate rather than lived experience. In chapter four, for instance, Skuse seeks to use the example of Lavinia to shed light on living with prosthesis, but the evidence is more allegorical than experiential, and the conclusion is that ‘“real” people with disabilities thought little about the relationship of their prosthesis to their natural body; but we cannot know for certain’. At other times I also wondered how much was gained by invoking an array of cultural theorists. In the same chapter, for example, we are introduced to Judith Butler’s concept of ‘drag’ as a way of thinking about the performativity of early modern prostheses, but this is quickly dropped never to reappear.

Despite these reservations, Surgery and Selfhood is an intriguing, engaging, and highly readable book that casts a lot of light on the complexities and ambivalences of early modern conceptions of the body. It makes a significant contribution to our understanding of the period, and I would recommend it to anyone with an interest in early modern literature and embodiment.

Michael Brown, Lancaster University