Anne Whitehead and Angela Woods (eds), The Edinburgh Companion to the Critical Medical Humanities (Edinburgh: Edinburgh University Press 2016) 700 pp. £175 EPUB, PDF Hb. ISBN: 9781474400046
The Edinburgh Companion to the Critical Medical Humanities is a large and well-structured volume with a great deal of ambition. The idea of the project is to move beyond the mainstream ‘first wave’ medical humanities into a ‘second wave’ that is more critical of the dominant paradigm of biomedicine, yet more fully embedded within its research. Although heavily orientated towards the critique of biomedicine, it is balanced by essays that acknowledge the wonders of the body and its functions and some of the successes of technological medicine.
After an Introduction The Companion is divided into four parts with many illustrations scattered throughout. At the end of each part there is an afterword which summarises and comments on the preceding essays.
The initial Introduction sets out the agenda for the book. The three ‘Es’ of ethics, education and experience and the additional ‘E’ of empathy from the ‘first wave’ are introduced. However, the idea of this ‘second wave’ project is to expand into phenomenological and historical perspectives, exploration of Western and non-Western medicine, and the examination of relationships and institutions through different lenses. These lenses include social and political activism, feminist theory and the concept of ‘entanglement’. This latter is about going beyond binary oppositions into a realm of inter-relationality and new possibilities. The Introduction explains why the main body of the book is divided up into its respective parts and how the book can be navigated in alternative ways via a disciplinary, historical or spatial reading. Scholars in contemporary disciplines such as disability studies and animal studies are encouraged to examine materials with an alternative critical eye. Disciplines such as the social sciences and health geography are also championed.
Part One is entitled ‘Evidence and Experiment’ and its aim is to highlight the importance of subjective experience and some of the limitations of evidence-based medicine. The essays here challenge medical humanities scholars to move from pure interdisciplinary work into new ways of evidence production. Des Fitzgerald and Felicity Callard propose benefits to the ‘entanglement’ of the opposing cultures of the sciences and the humanities, rather than their integration. Annamaria Carrusi, in 'Modelling Systems Biomedicine: Intertwinement and the "Real"' suggests that modern models of systems biology are indeed ‘entangled’ rather than being simply positivistic. This leads well into Volker Scheid’s proposal, in 'Holism, Chinese Medicine and Systems Ideologies: Rewriting the Past to Imagine the Future', to open up non-modern and non-Western medical traditions through a genealogical examination of holism in Chinese medicine. Christoph Rehmann-Sutter and Dana Mahr, in 'The Lived Genome', suggest going beyond creating a biomedical framework of genetic disorders to create a framework that captures the experience of the ‘lived genome’ ie through the narratives of patients with these disorders. Their study of individuals with inflammatory bowel disease has revealed two different types of narrative, one of guilt and another of agency, which give us a better understanding into the nature of the lived experience. William Viney, in 'Getting the Measure of Twins', describes the link between the study of twins as ‘natural experiments’ or as ‘objects’ and eugenic ideologies such as those of the Nazis. Lauren Kassell, in 'Paper Technologies, Digital Technologies: Working with Early Modern Medical Records', describes the historical evolution of the medical record and her Casebook Project with its aim of transforming Forman and Napier’s seventeenth-century paper records into digital format in order to gain a better insight into the dynamics of the medical encounter. Jill Magi, Nev Jones and Timothy Kelly, in ' How Are/Our Work: "What, if anything, is the use of any of this?"' produce an experimental text relating to the first-person experience of psychosis as ‘evidence’ to be taken as seriously as any evidence in biomedicine. In her afterword, 'Evidence and Experiment', Patricia Waugh deftly brings together the implications of the ideas that arise in the preceding chapters.
Part Two of The Companion bears the title of ‘The Body and the Senses’. In this part, the critical medical humanities are challenged to go beyond the narrative. Suzannah Biernoff in her extensive essay 'Picturing Pain' includes a number of illustrations depicting ‘pain’ throughout history from Lacoon’s agony to the martyrdom of St Sebastian. She sees pain as a cultural phenomenon and aesthetic judgements as having socio-political causes and effects. She cites how in the nineteenth century Christianity and its acceptance of suffering conflicted with medicine’s idea of treating pain, while stoicism and humour were the dominant cultures in the trench warfare of the twentieth century. Anatomy lab resident artist Rachael Allen in Project ANATOME, described in her essay 'The Body beyond the Anatomy Lab: (Re)addressing Arts Methodologies for the Critical Medical Humanities' has gone beyond her previous work in support of medical education to dispute medicine's claim to sole ownership of knowledge about the body. Cynthia Klestinec, in 'Touch, Trust and Compliance in Early Modern Medical Practice' explores the role of touch versus sight and its associations with trust in the practice of medicine. Bethan Evans and Charlotte Cooper, in 'Reframing Fatness: Critiquing "Obesity"', celebrate fatness as activists and challenge preventative medicine’s nanny culture, whilst LIndsey Andrews and Jonathan Metzl describe, in 'Reading the Image of Race: Neurocriminology, Medical Imaging Technologies, and Literary Intervention', the dominance of the visual in present day medicine (as contrasted to Jennifer Richards and Richard Wisterich’s analysis, in 'The Anatomy of the Renaissance Voice' of the importance of the voice in Renaissance culture). They criticize Adrian Raine’s idea in The Anatomy of Violence of identifying criminals via brain imaging as potentially dangerous in its own way, by leading to social discrimination. Heather Tilley and Jan-Eric Olsén's historical examination of the writings of the traveller James Holman, in 'Touching Blind Bodies: a Critical Inquiry into Pedagogical and Cultural Constructions of Visual Disability in the Nineteenth Century', does not introduce him as blind and disabled, but as possessing compensatory haptic abilities. Jane McNaughton and Havi Carel propose, in 'Breathing and Breathlessness in Clinic and Culture: Using Critical Medical Humanities to Bridge an Epistemic Gap', new models of breathlessness that also take account of affect. In ' Morphological Freedom and Medicine: Constructing the Posthuman Body', Luna Dolezal discusses morphological freedom and the works of artists such as ORLAN in shaping her face for art and the ethics of the surgeons who helped her in her project. Jo Winning in her afterword, 'The Body and the Senses', hopes for the critical medical humanities to support a move towards a more sensate biomedicine.
Part Three of the book is entitled ‘Mind, Imagination, Affect’. This part begins with a ‘wondrous’ and affirming chapter, 'Medical Humanities and the Place of Wonder' where Martyn Evans encourages a sense of wonder in the embodied human nature and very importantly warns the medical humanities not to create its own dualism by promoting the experiential over the bodily self. He recognises our bodies and its materiality as the ground for our agency, and like Epicurus and Vladimir Nabokov, sees life as a short spark between two long periods of blackness. Edward Juler’s chapter, 'Man’s Dark Interior: Surrealism, Viscera and the Anatomical Imaginary', refers to art history and includes drawings by the surrealist artist Antonin Artaud representing creative alternatives to the predominant medical paradigm. Jonathan Cole and Shaun Gallagher, in 'Narrative and Clinical Neuroscience: Can Phenomenologically Informed Approaches and Empirical work Cross-Fertilise?', propose a cross-fertilisation between phenomenology and empiricism in their studies of gestures in their subject Ian and his experiences with deafferentation syndrome. Lisa Guenther questions the role of medical professionals in executions in the US, in 'On Pain of Death: The "Grotesque Sovereignty" of the US Death Penalty', and demands a stronger critical voice from the medical humanities, whilst Corinne Saunders, in 'Voices and Visions: Mind, Body and Affect in Medieval Writing', examines the role of culture in medieval time in the experience of hearing voices in such figures as Julian of Norwich and Margery Kempe. Peter Garratt, in 'Victorian Literary Aesthetics and Mental Pathology', explores depressive illness in the Victorian writings of J S Mill and John Ruskin, whilst Laura Salisbury, in 'Aphasic Modernism: Languages for Illness from a Confusion of Tongues', cites Virginia Woolf’s essay ‘On Being Ill’ as critical of literature for its lack of attention to illness experience (a phenomenon that is both ‘extraordinary’ and yet ‘common’). David Herman, in 'Trans-Species Entanglements: Animal Assistants in Narratives about Autism', relates contemporary books and films that use animal-assisted interventions in rethinking the notions of self in narratives about autism. Felicity Callard’s afterword, 'Mind, Imagination, Affect' makes us think about why some illness narratives are counted whilst others are dismissed.
Part Four of The Companion has the title of ‘Health, Care, Citizens’ and takes a broad perspective on health. Hannah Bradby’s 'Medical Migration and the Global Politics of Equality' examines the role of globalisation and the medical brain drain from developing countries, but does not see this as the deciding factor in poor life expectancies in these regions. Ian Sabroe and Phil Withington, in 'Language Matters: "Counsel" in Early Modern and Modern Medicine', explore the Renaissance notion of mutual ‘counsel’ and suggest an historical engagement with words to improve modern clinical encounters. Rosemary Jolly’s chapter, 'Fictions of the Human Right to Health: Writing against the Postcolonial Exotic in Western Medicine', is about how through fiction the personal illness experience may be seen to be intimately linked to collective health eg in Inuit peoples of Canada or amongst HIV sufferers in South Africa. Rebecca Hester, however, in 'Culture in Medicine: An Argument against Competence', argues against such notions as cultural competence as it may act as a way for biomedicine to stamp its authority. 'The Roots and Ramifications of Narrative in Modern Medicine' by Brian Hurwitz and Victoria Bates describes the development of the ‘Narrative Medicine movement’ and attempts to predict its future developments through such websites as ‘Healthtalk.org’. Anna Harpin’s essay, 'Broadmoor Performed: A Theatrical Hospital', on the history of theatre performances at Broadmoor Hospital describes the move from comedy to tragedy in enhancing the therapeutic environment. Lucy Burke’s and Sarah Atkinson’s chapters ('On (Not) Caring: Tracing the Meanings of Care in the Imaginative Literature of the "Alzheimer’s Epidemic"' and 'Care, Kidneys and Clones: the Distance of Space, Time and Imagination' respectively) examine novels and memoirs to explore ideas about caring (and not caring) in dementia and kidney transplantation. Atkinson in particular contrasts ‘caring for’ with ‘caring about’ and how new medical technologies create new ethical dilemmas. Stuart Murray in his afterword, 'Health, Care, Citizens', emphasises the importance of making critical humanities approaches central to the practice of medical humanities.
Whitehead and Wood's volume manages to succeed in its project to persuade the reader of the need for a new wave of critical medical humanities. The scope of the book is wide with a large number of references cited. It is likely to appeal to a wide range of scholars including practicing clinicians.
Sepehr Hafizi, University of Cambridge