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Archive for May, 2011

In respect of Foucault’s reconstruction of the emergence of the concept of the human being, Jacques-Alain Miller summarized Foucault’s particular insight (I paraphrase his essay that appeared in: Michel Foucault, philosophe. Edition Seuils, Paris, 1989) quite adequately, saying that

With the rise of human sciences as a whole, humanities, in mind, Foucault finds a definition of concept of man (aka human being) that they all agree on as their prerequisite. This human being, cannot be cognizant and conceived of (cannot be thought) in the preceding episteme of representation; it emerges only at the end of the 18th and beginning of the 19th century.

In agreement with the gist of this assessment, I have come to ask about the “body” of this human being. What of it? Does this new conception of man in the new episteme not also recreate, both suddenly and yet quite slowly, the concept of the body and, moreover, the idea of intervening in and on the body? Only now does the practice of aneasthesia demand systematization and authorization, and it will not be until 1846 that the public demonstration (depending, I might add, on the emergence, perhaps the construction, of just such a public for this new scientific practice to be systematized) established it as a practice and allows for new forms of intervention inside the body that were previously unthinkable to make on and into the living body. Not to mention the re-rendering of the discourse over concepts of what it means to be alive (and a life) and death, this is quite an event.   Indeed, there is “new body in town”, and, with regard to what is the continental part of that particular history, Canguilhem and Foucault, and after them Philipp Sarasin and Stefan Rieger, among a few others, have done a great job accounting for it. But I feel that is only half of that story. What about America and what about the transatlantic dialogue. For sure, there is a vast amount of literature documenting body pracitces. But the bodies they document are always already politicized, and I am looking for the concept of the body behind all that. And by that I do not mean an essence, far from it. I shun essentialism (and even if, at times, I have spoken of this whole affair being on of history of emtnaility, as well, I was also decidedly not being essentialist), because I live after Deleuze: Where others – phenomenologist, perhaps – are stuch with essentialism, I refer to the body as a multiplicity (Deleuze) or a heterotopia (Foucault). Once the new concept of man emerges, once the new kinds of interventions are made possible, the interventions become politicizable but they are not yet political. Yes, gender, race, ethnicity, spectacle are political categories, but the interventions into the body – surgery, the redressing of mental malady to lesion, and such – are first and foremost made on and into a body.  Before that fateful incision that the new episteme and its concept of man represent, the body itself was political and interventions into the body was political. Now, the intervention manages to politicize in the first place. Only by cutting into the body will what is political about it be revealed from within it, the intervention practices politicize the inerts of the body, but not before they take effect on and in it. There still is a body to be intervened in, only after the intervention can the political emerge, the body be an individual and, thus, political body. But this is not without a specific history, without prerequisite, nor without wider implication that reaches us even today:

A requisite of the transatlantic dialogue, the new conception of the human body, its practices and representations emerge as the interface between culture, society and (biomedical) science in the USA in the 19th century, particularly within the intellectual public of the New England states between 1846 and 1898. The existence and exigencies of this particular milieu (or civil sphere) as an epistemic culture help to illustrate and foster the claim, that the prerequisites that we deem typical for our present condition of the global information society and digital knowledge economies – prerequisites we find predefined in the motive and figuration of virtualization – are present and blossoming in the 19th century already; respectively, they are not the result of digitalization but, indeed, the conditions that enable social acceptance of the digital media of our present global epistemic information culture. The recovery and analysis of these enablingconditions is the goal of this study in the form of the application of the idea of heterotopological investigation of the problematization of the human body. 

In this project, I am applying the method, developed from discourse and cultural analysis, that I have succesfully tested, first in my dissertation, and since then revised towards increasing its effectivity and making it more robust. It operates on the idea that the notion of the event, originally suggested by Alfred N. Whitehead, Michel Foucault and Gilles Deleuze, can be empirically applied on the local level in a genealogical study to produce a series of mini-ethnographies for such events which will help us understand how those concepts and their scope of meaning were created and disseminated that (often subliminally) shape a public’s understanding and the integration of (biomedical) scientific practices, often until today: This process is, in the usually applied theoretical vocabulary, denoted as „the production of an epistemic culture and its epistemic object“ –  epistemic cultures here: a) historico-locally New England’s 19th century elite culture, and b) global knowledge society as health care consumers; epistemic objects here: ad a) the human body as a a heterotopia or object for controlled internal displacement, and ad b) the human body as a body multiple, aka its parts represented through abstracted data-packages and managed in predetermined care-pathways – however, the advantage of the transformation of methods I suggest lies in the expansion of the historical scope, intensifying the appraisal of agency and decision-making, and accounting equally for theoretical dynamics and social inertia in accepting that innovative practices and concepts cannot obtain without apriori structures of social acceptance. The conclusion of this project, next to its merit as study in the history and sociology of biomedical science and transatlantic production of scientific publics, is intended to continue towards the integration of a robust European paradigm of medical humanities and the social study of science&technology.

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This is a story about seafaring or adventurous folk. Our ship is sailing on the sea of stories, so to speak, and before we can set sail we need to find us or train us our navigator, our hermenaut. So, this is a story, too, about maps, and about map-making, and, of course, about charting new territories.

Map-makers of old, whether making maps of sea or land, so our lore has it, would leave a warning to those adventurers who dare and leave the territories already charted, depart from from trails well-trodden.

The makers would calligraph, perhaps even accompanied by illustration, HC SVNT DRACONES, “Here there be dragons”.

What, I ask, is a dragon?

A dragon is, the most simple answer would be, a known unknown.

Of course, the observant mind may digress and call on me to refer to all kinds of myth and folklore, imagery of snake-like beings, with wings or naught, fangs and claws, once leathery skin, once scales, rare cases even furry, and so forth.

There is much in existence for expressive unfoldedness of this metaphor that is known as dragon in Western and so many other cultures.

But for me, it circumscribes exactly what a known unknown is. The unknown, once we know of it as an unknown, fills us with a strange kind of anxiety: The kind of anxiety that conflates the urgent feeling of a dread before a threat, that may or may not be lurking, with an even stranger curiosity to meander, as if by some accident, way to deeply in that particular fray, just to find out what is there.

Sailing on or wandering off into territory uncharted, terra incognita1, we know that there is going to be some-thing, but what this curious and dreadful thing could be, and whether it would more satisfy our curiosity or our dread, we do not know. And if dread it were, we are yet donfident that somehow we could deal with it, bring it down, slay the dragon.

Hence, there be dragons (although sometimes, they can be quite friendly).

Dragons are something Foucault had an instinct for. He usually traveled about the spaces of our everyday practices, sniffing them out: Dragons are problematizations, and Foucault’s, his vocation (he was the voice in the wilderness), was to make them explicit, for those who are busy drawing them onto the maps.

He was, in other words, a hermenaut. Therefore, he had to give the known unknowns a name and point to where they may lurk, and, sometimes, because it is pretty dark where we have to go, it came in handy that he knew how to make candles, so we can bring some enlightenment.

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Footnote 1: “in-cognita”: unknown and not yet experience and conceived, though, also deemed not as impossible to do so, thus, not a terra non-intelligibila, for it is still terra, part of the Earth, of possibly cognizable, mappable space.

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I have, I must admit it, an instinct for dragons.

How unscientific, somebody might have the inclination to say. However, I’d like to think not.

Of course, I could escape the easy way, citing anthropologist David E. Jones’s wonderful book by just that title. But mine is not an anthropologist’s interest in lore and imagery. Therefore, let me begin by addressing the two problems that we find lurking in the title: “Instinct” and “dragons”.

What is an instinct?

An instinct, we learn from Gregory Bateson’s famous metalogues, is a principle that serves us an explanation, an explanatory principle. It explains, we learn, everything we want it to explain. There is, however, no explanation for explanatory principles. They are, he says, black boxes.  I have, respectively, a black box for dragons.

What are dragons?

We all have images in our head when we hear dragon. Most of us do not immediately think of those wonderful animals that live on the Komodo Islands, which have been named dragons for they seem to resemble what we know from fairy tales and folk-lore. This is what, for centuries, people thought of when “dragons” were mentioned: Mythical creatures.

So when reading works written by weird scholars like myself, beware in all your travels and navigation, for on the academic charts we are mapped as “here there be dragons”.

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An essential goal in my pursuit of the agenda of medical humanities and social studies of science is to make people aware that  this is an area that is notoriously underdeveloped in Germany, and, as a consequence, there is a sufficient lack of integration and a rather “annoying” fragmentation in this field in EU research.

Whereas there is a strong tradition of STS (Science&Technology Studies) in both Great Britain and France, and where the medical section of the British Sociological Association is both academically as well as financially successful, it has recently been announced that Germany’s spearhead institute in medical sociology in Frankfurt will be closed. In comparison to other European states, not to mention the US, there is little initiative in STS in Germany, which reduces the field to sociology and philosophy of science represented internationally only through a program in Bielefeld which is dominated by a group of Luhmann-style systems theorists. Scholars with a pragmatic and pluralist background are largely marginalized in this context. Similarly, scholars who try and bridge the humanities and medicine are often stone-walled. Just to cite the recent media-uproar when Prof. Hoppe, president of Germany’s largest Association of Physicians (Bundesaerztekammer), reminded his colleagues that medicine and its practice should be viewed not as a natural science like physics but as a science that must rely on experience (empirical science in the classic definition of the word). In combining this reminder with a call for taking seriously complementary methods and narrative medicine and, more importantly, the need for valid scientific study and strict standards of these practices, Hoppe’s mission, like my own, is to react to the increasing discontents in modern health care systems (decrease in care, health and insurance coverage versus increasing costs), the plethora of unchecked alternative treatments, and the rise in cultural diversity (which includes medical cultures) through immigration. Germany’s biomedical scene, however, continues to prove largely intolerant of having this necessary and pressing discussion. The reasons for this have a historic origin, which has been obscured by the length of time passing, and which can be illustrated by comparing the current situation of Germany and the US and in reconstructing the history of the transatlantic dialogue in biomedicine: In shining a light on the history of anthropology as a discipline, which is at the center of this development, we find that in its emergence in the organisation of the sciences in the latter half of the 19th and the early 20th century, a split occurred within the discipline between a focus on cultural anthropology and a focus on biological anthropology. When cultural anthropology began to thrive in the US, a significant number of ranking German scholars went there to develop the field from within what is now the humanities (Geisteswissenschaft) and includes medical philosophy, sociology&anthropology; whereas in Germany, anthropology is closer to the sciences (Naturwissenschaft) and in practice often reduced to a science of mechanistic explanations of human behavior and its cognitive and biological development.

Respectively, interdisciplinary critique and dialogue in Germany, while often advertised in general is not practiced in the particulars, and rather actively constrained by questioning the qualification or authorization of a scholar or researcher to make a statement in a disciplinary discourse considered “foreign” to her. This leads to two important discontents: Primarily, forms of innovation inspired by interdisciplinary scholarship are a resource that remains largely untapped; secondly, it is highly questionable that the important task of critical inquiry into the maintenance of standards and the implementation of best practices can be accomplished from within a discipline alone, quite on the contrary, systems of checks and balances often derive via consulting highly trained, detached observers who can much better identify the entanglement of the highly involved stakeholders and stockholders in a disciplinary discourse, while making explicit and translating the processes, stakes and concepts involved. With regard to the very active and growing STS community in the United States – including biomedicine and health care – and some EU members, and the fact that beginning on the conceptual level Germany’s academic landscape has created far more disciplinary pathdependencies (German keyword: Faecher-struktur), we must ask the question whether the success of these countries in dealing with a number of problems does not derive from their more pragmatic and reality-oriented approach. To name but one of certainly many possibles examples, we might like to compare the execution of regimes of hygiene practices in German and Dutch hospitals with regard to infections with multiple-resistant bacteria (MRSA). Despite ever more rigorous laws and bureaucratic administration, Germany fails in relative numbers where the more pragmatic Netherlands prevail (by a factor of 20!). What is, however, more disturbing, is the fact that there seem to be few to no efforts made to study the epistemic (knowledge) regimes that structure the incumbent practices comparatively towards a development of “better practices”. Considering that with 18 million people receiving treatment in German hospitals per year, current estimates range between 800,000 infections and between 20,000 to 40,000 related deaths, action seems imperative (to provide some kind of comparison: in 2009, ca. 4,200 people have died in traffic accidents in Germany, which has 50 million cars on its streets).

If interdisciplinary critique, research and implementation of better practices via STS and medicine studies can help reduce the number of MRSA infections alone (and they can certainly do much more than just that) by 10%, just think of the number of lives that will save. I let you do the maths.

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