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VERKÖRPERUNGEN
EMBODIMENT
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Christina Lammer
Kim Sawchuk
Cathrin Pichler
(HG.)
VERKÖRPERUNGEN
EMBODIMENT
Löcker
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Gedruckt mit freundlicher Unterstützung des
Bundesministeriums für Wissenschaft und Forschung sowie
der Stadt Wien, MA 7, Wissenschafts- und Forschungsförderung.
© Erhard Löcker GesmbH, Wien 2007
© für die Abbildungen: Barbara Graf
Covergestaltung: Catherine Rollier
Herstellung: Gemi s.r.o., Prag
ISBN 978-3-85409-442-5
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Inhalt
Danksagung
9
Christina Lammer, Barbara Graf und Kim Sawchuk
Prolog
Konturen
11
Christina Lammer
Einleitung
Die menschliche Stimme
25
Cathrin Pichler
Erfahrungsbericht
»Das will Auswege wissen«
55
Lisa Cartwright und Sharon Traweek
Nervöse Konvergenzen
69
Janet Price
Verlust denken
83
Kylie Thomas
Körper im Widerstand
99
Kim Sawchuk
Ironischer Empirismus und der Modellpatient
115
Christina Lammer
Tiefes Gespür
129
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Kyra Landzelius
Fragile Verkörperungen
151
Anastasia Karakasidou
Die Biopolitik von Krebs
169
Christine Holmberg
Feine Unterschiede
187
Rosie Read
Verkörperte Pflege
203
Agnieszka Koscianska
Alternative Heilpraktiken
219
Sarah Pink
Hausarbeit als Therapie
235
Linnet Fawcett
Haptische Geschichten
251
Laura U. Marks
Performative Wahrnehmung
269
Christina Lammer
Epilog
Bindegewebe
285
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In Gedenken an Gerburg Treusch-Dieter
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Dankesworte
Wir bedanken uns bei Linnet Fawcett für das Korrigieren der
englischen Beiträge. Catherine Rollier gilt unser Dank für das
grafische Konzept. Bei Louise Poissant und dem Centre interuniversitaire des arts médiatique (CIAM) in Canada bedanken
wir uns für die Vergütung von Spesen. Dem Social Sciences
and Humanities Research Council (SSHRC) in Canada sind wir
zu Dank für die Förderung der Forschung von Kim Sawchuk
über den Künstler Theodore Wan verpflichtet. Das Buchprojekt
ist im Rahmen der vom Fonds zur Förderung der wissenschaftlichen Forschung (FWF) sowie vom Wiener Wissenschafts- und Technologiefonds (WWTF) geförderten Projekte
moved BODIES und CORPOrealities entstanden, die Christina
Lammer an der Medizinischen Universität Wien (MUW) durchführt. Danke für die Unterstützung! Unser besonderer Dank gilt
allen beteiligten PatientInnen und InformantInnen. Ohne Sie
wäre dieses Buch nicht möglich gewesen. Vielen herzlichen
Dank, dass Sie Ihre Erfahrungen mit uns geteilt haben!
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Prolog
Konturen
Ein Leseband in der Form einer gezeichneten Linie zieht sich
wie ein Faden durch die Essays in diesem Buch. Die Künstlerin
Barbara Graf entwirft Konturen (2005-) und untersucht im
Rahmen des Forschungsprojekts CORPOrealities (2004-) an
der Medizinischen Universität Wien (MUW) Verkörperungen.
Eine menschliche Figur wird umrissen und in ihrer dünnhäutigen Leiblichkeit dargestellt. Innerlichkeit geht nahtlos in
Äußerlichkeit über. Ein Körper in Embryonalstellung fällt in
sich zusammen, zerläuft im Undefinierbaren, mündet in eine
Hügellandschaft, aus der sich eine nackte Frau herausschält. Sie
blickt auf sich selbst. Horcht in sich hinein. Vibrierende Bewegung kommt ins Bild. Von Wasser umspülte Formlosigkeit.
Inneres Rauschen. Klangwellen brechen. Ihre Hände verbergen
die Brüste. Berührungsängste. Haut wird abgezogen. Äußere
Konturen verschwinden. Muskel- und Drüsengewebe eines
eröffneten, versehrten Leibs. Frisch operiert. Bandagiert.
Chirurgisch wiederhergestellt. Taube, vernarbte Haut. Fragmente fügen sich zu einem klaren Spiegelbild zusammen.
Neuerliche Auflösungstendenzen. Andere Strukturen. Dellen,
Falten und fingerähnliche Auswüchse werden enthüllt.
Abstrakte Linien, denen ich mit den Augen folge. Ein in sich
verstricktes Organknäuel. Sich frisch entfaltende Integrität.
Stechenden Schmerzen zum Trotz. Wundmale zeugen von
Dramen. Geschichten aus dem Leben gegriffen. Leiden mitfühlen. Am eigenen Leib spüren. Sich in Geduld üben. Die Zeit am
Tropf überwinden. Mein persönliches Zeitempfinden. Ich bin
im Ausnahmezustand. Giftige Substanzen rinnen in mich hinein. Zellerneuerung. Knoten in der Brust. Dem Feind in mir
wird der Kampf angesagt. Jedes Mittel ist dazu recht. Politi-
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sierte Leiblichkeit. Biopolitik des Körpers. Weiße Flocken im
Hirn. Nehmen Besitz von mir. Das Gehirn ist leiblich. Verkörpertes Denken. Von mir aus. Mit einer Krankheit leben. Sich
selbst fremd werden. Neu erfinden.
Das Buch beginnt mit einer Assoziationskette, die sich aus den
Zeichnungen von Barbara Graf wie von selbst entspinnt. Ähnliche Assoziationen finden sich im essayistisch formulierten
und zu einer zweisprachigen Montage zusammengestellten
Textgewebe der Autorinnen aus unterschiedlichen wissenschaftlichen Bereichen in diesem Band. Das Thema: Verkörperungen. Jedem englischen Essay geht eine kurze deutsche
Zusammenfassung voraus, die ich geschrieben habe, um die
wesentlichen Inhalte zu skizzieren. Da in den Beiträgen sehr
unterschiedliche wissenschaftliche Ansätze anklingen, rege ich
in der Einleitung eine Diskussion über Die menschliche Stimme
an. Cathrin Pichler berichtet in poetischer Form über etwas
Unsagbares, schwer zu Beschreibendes und kaum Vorstellbares, über ihre jahrelangen Erfahrungen und Empfindungen
mit der Nervenkrankheit Multiple Sklerose (MS). Sie drückt
sich in der ersten Person aus, in ihrer Sprache und entwirft ein
eigenes Vokabular von Krankheit. Lisa Cartwright und Sharon
Traweek stimmen in Cathrin Pichlers Ouvertüre mit ein. Sie
dechiffrieren die in den Wissenschaften objektivierende
Textproduktion in der dritten Person als Selbstverleugnung
oder gar Akt hysterischer Mimikry. Eigene Erfahrungen werden
damit auf einen anderen Körper projiziert, während das verkörperte Wissen von sich selbst konsequent als unwissenschaftlich
abgetan und versteckt bleibt. Beide Autorinnen beschreiben
ihre individuellen Krankengeschichten als Nervöse Konvergenzen. Das von Janet Price entfaltete Textgeflecht nimmt eine
durchaus vergleichbare inhaltliche Kategorie auf. Sie reflektiert
darüber, wie sich ihr Blick auf die Welt und ihr Denken durch
MS ändern. Kann ihr teilweise gelähmter Leib wieder zurück in
Bewegung gedacht werden? So lautet eine ihrer provokanten
Fragen, mit denen sie den Verlust ihrer körperlichen und geisti-
Prolog
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gen Fähigkeiten nicht nur vorstellbar macht, sondern sich vielmehr den Grenzen des Denkbaren widersetzt und diese überschreitet. Über Körper im Widerstand berichtet auch Kylie
Thomas. Sie arbeitet an einem Projekt mit HIV-positiven
Frauen in Südafrika. Die erkrankten Südafrikanerinnen erzählen ihre Lebensgeschichten in Bildern. Sie malen ihre persönlichen Empfindungen. Ihre Porträts werden öffentlich ausgestellt und verkauft. Eine politische und zugleich symbolische
Geste der berührenden Art. Mit dem Künstler und Fotografen
Theodore Wan beschäftigt sich Kim Sawchuk. Wan wirft einen
distanzierten und ironisierenden Blick auf sich selbst und positioniert sich in seinen Selbstporträts in einem Krankenhaus, in
dem er zudem auch als medizinischer Fotograf arbeitet, als
Modellpatient. Er posiert in Röntgenapparaturen und am Operationstisch, verschwindet unter chirurgischen Tüchern. Seine
künstlerischen Impulse erwachen in einer Krisensituation. Der
Künstler ist selbst schwerkrank. Er stirbt 1987 an Krebs.
Welche Bedeutung hat das Invasive in der Biomedizin? In meinem Text untersuche ich minimal invasive Operationen in der
interventionellen Radiologie, wo der menschliche Blutfluss
diagnostiziert und behandelt wird. Ich verstehe das Geschehen
im chirurgischen Operationstheater als Choreografie mit allen
Sinnen, als performativen Akt, der den die Interventionen
durchführenden RadiologInnen Tiefes Gespür abverlangt. Mit
einem anderen über Leben und Tod entscheidenden Hightechgebiet in der Biomedizin beschäftigt sich Kyra Landzelius.
Sie arbeitet in einer Intensivstation für Frühgeburten. Das
Wesen Mensch zeigt sich in diesem Bereich angeschlossen an
Maschinen, Schläuche und künstlich beatmet. Wie wirken sich
diese Verbindungen zwischen Mensch und Apparatur auf die
Beziehungen zwischen Eltern und Kind aus? Welche
Bedeutung hat Mutterschaft? Fragile Verkörperungen werden
hinterfragt. Krebs als böse Wunde und die Biopolitik des
Körpers in einer onkologischen Station auf der Insel Kreta
(Griechenland) werden in Anastasia Karakasidous Essay the-
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matisiert. Krankheiten wie Krebs werden mit der Moderne als
Kriegsschauplätze behandelt. PatientInnen besiegen ihre bösartigen Geschwüre und werden als Helden gefeiert. Auch
Christine Holmberg arbeitet mit Brustkrebspatientinnen. Ihre
Auseinandersetzung mit einer krebskranken Kollegin eröffnet
aufschlussreiche Einblicke in die emotionalen Beziehungen
einer Ethnografin mit ihren InformantInnen. Holmberg argumentiert für eine Technik der Teilnahme der ForscherInnen am
Leben der Beforschten, um gesellschaftliche Phänomene zu
verstehen. Ein Reflektieren eigener Empfindungen während der
Feldforschung, ebnet neue Wege, um die komplexen Lebenszusammenhänge kranker Menschen nachzufühlen. Das Leben
in einem Pflegeheim in Prag (tschechische Republik) erforscht
Rosie Read. Weltliche und geistliche Schwestern kümmern sich
um die BewohnerInnen des Heims. Nonnen entwickeln andere
Beziehungen zu den zu pflegenden Personen, als ihre zivilen
Kolleginnen. Die Verkörperung von Pflege unterscheidet sich
diesbezüglich durch divergierende Moralvorstellungen. Mutterschaft als Geisteshaltung spielt eine wesentliche Rolle.
Alternative Heilpraktiken in Polen analysiert Agnieszka
Koscianska. Sie erzählt über zwei spirituelle Bewegungen: The
Legion of Small Knights of the Divine Mercy, eine katholische
Gruppierung und die Brahma Kumaris, die sich am
Hinduismus orientiert. Die Ethnologin setzt sich zudem intensiv mit der weiblichen Identität in Polen auseinander, mit der
Bedeutung der polnischen Mutter. Als Raum der Sinne definiert
Sarah Pink das eigene zu Hause. Sie begleitet mit der
Videokamera 40 InformantInnen in Spanien und Großbritannien bei der Hausarbeit. Ordnung in den eigenen Haushalt
und Lebensraum zu bringen, wirkt sich nach den Erfahrungsberichten ihrer InterviewpartnerInnen durchaus angenehm auf
das Wohlbefinden aus. Provokant und zugleich paradox klingt
auch Sarah Pinks Resumé, in dem sie Hausarbeit als Therapie
bezeichnet. Haptische Geschichten schildert Linnet Fawcett,
die als Ethnografin genüsslich ihren eigenen, über den Eis-
Prolog
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laufplatz kurvenden Leib als sportliches Forschungsinstrument
einsetzt. Dynamische Verkörperungen sind für diesen performativen Ansatz zentral, in dem Eis laufende Figuren buchstäblich die Hauptrollen spielen. Im abschließenden Essay von
Laura Marks geht es um subjektiv verkörperte Wahrnehmungsweisen im klassischen Denken des Islam. Wie beeinflussen haptische Bilder und abstrakte Linien, die im 19.
Jahrhundert im Westen Einzug halten, die Ästhetik und die
Kunst in Europa? Das neue Wahrnehmungsverständnis, das die
Kuratorin und Kunstwissenschafterin entspinnt, ist vom
Subjektiven und vom Performativen durchwirkt. Subjektive
Wahrnehmung und performative Verkörperungen sind in diesem Buch untrennbar miteinander verbunden, wenngleich das
Band, das Barbara Graf gemeinsam mit den Autorinnen entwickelt, an manchen Stellen bis zum Zerreißen gespannt wird
und an anderen nur lose, offene Enden inhaltlich ins
Textgewebe anbindet. Ähnlich einem Teppich, entstehen
Muster und Farbnuancen, die sich einprägen.
Christina Lammer
Wien, Juli 2007
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Konturen
Zeichnungen (2005-)
Auf der Suche nach einer möglichen Darstellung von
Leiblichkeit und der Visualisierung von Körperempfindungen
bin ich immer wieder bei der Unmöglichkeit angelangt, eine
zeichnerische Form zu finden, die dem Undarstellbaren
Ausdruck verleiht. Das hat mich dazu geführt, eine abstrakte
Gestalt einzuführen: die Kontur einer Figur, eine paradoxe
Existenz. Diese schwarze Linie, die es nicht gibt, dient mir im
Ablauf der Zeichnungen als Referenz und ist in stetiger
Transformation begriffen. Die Kontur wird deformiert, schrittweise aufgelöst, in biomorphe Strukturen übergeleitet oder zu
einem Einzelteil der Körpers transformiert. Organische Innenund Außentexturen umschreiben die abstrakte Linie. Die
Leerstelle der Kontur wird umwickelt und schlüpft in eine
Bandage hinein. Die Körperlinie verwickelt sich zu einem
Knäuel und verdichtet sich zu einem kleinen schwarzen Punkt.
Die Kontur erscheint auf einer gefalteten Leinwand und kehrt
auf die Ebene des Zeichenblattes zurück. Zur Fläche geworden,
löst sie sich blasenartig auf, verflüchtigt sich auf dem weißen
Papier und entwickelt sich von neuem. Spurensuche mit dem
Zeichenstift. Grenzen und Oberflächen von Integrität und
Identität des Körperselbst werden abgetastet. Die Zeichnungen
KONTUREN sind ein offenes System, in das stetig neue
Sequenzen eingefügt und zu einem filmischen Ablauf montiert
werden.
Barbara Graf
Wien, Juli 2007
210 Zeichnungen, Tusche auf Papier, 21 x 29.7cm
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Barbara Graf lebt und arbeitet als frei schaffende Künstlerin in Wien und
Kairo. Erfindung der Anatomischen Gewänder: Position zwischen
Skulptur, Kleidung als zweite Haut, Reflexionen über medizinische
Visualisierungen und soziokulturell definierte Körperbilder. Studium
1985-90 an der Universität für angewandte Kunst Wien. Seit 2003
Gastdozentin an der Hochschule für Gestaltung und Kunst Basel, Institut
für Mode-Design. Seit 2004 Lektorin an der Universität für angewandte
Kunst Wien, Institut für Kunstwissenschaft, Kunstpädagogik und
Kunstvermittlung-Textil. Seit 2004 künstlerische und wissenschaftliche
Mitarbeit am Forschungsprojekt CORPOrealities (WWTF). Zahlreiche
Ausstellungen im In- und Ausland.
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Prologue
Contours
The contributors to Patient Embodiment invite readers to think
through the body rather than thinking about the body.
Embracing and tussling with the very concept of embodiment
the articles that comprise this collection neither treat bodies as
objects to be picked apart nor as blank slates upon which the
social is inscribed. Instead, readers are asked to contemplate the
stubborn yet mutable materiality of their own physical existence within dynamic contexts. From this purview bodies are
considered as they exist in fluid interactions with others, as they
transform over time across a variety of geographical locations,
cultural spaces and institutional domains. In this spirit, bodies
may be conceptualized as an unstable material locus of transversal exchanges of energies and flows that may become a site
of philosophical reflection. We open the book with Nervous
Convergences, co-authored by Lisa Cartwright and Sharon
Traweek, which creatively stages a dialogic intertwining of
their converging yet separate stories of disease, false diagnoses
and encounters with the medical system. Intellectually reflecting from one’s lived experience is a critical component of Janet
Price’s Out of My Mind. Price compellingly conveys a state of
continually altering subjectivity, her struggles with memory
loss, and her strategies for living and writing in and through
multiple sclerosis. These two brilliant analyses of inter-subjective, corporeal complexity reminds one that when embodiment
is discussed, as Price suggests, one must »not stop at the shoulders« but consider the head, the brain, the mind as an integral
part of embodied being and its evanescent becoming.
The relationship between practices of visualization and
embodiment is another thread linking several of the papers in
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Patient Embodiment. Kyrie Thomas’ Bodies of Courage movingly describes how South African women living with HIV/AIDs
are involved in creative and empathic artistic self-portraits to
bring their lives into visibility and out of silence in order to
resist »social death.« Produced in a series of workshops, their
visual testimonies invite us to consider, with care, the singularity of the stories embodied in their paintings offered as both a
gift and as a critique of existing social conditions and stigmas.
In a different exploration of self-portraiture, I examine ChineseCanadian artist Theodore Wan’s practice of acting as the subject
of medical photographs that pass as both art and documentation
of medical procedures. Wan’s corporeal experiments in becoming a patient involves positioning himself willingly as both
the object of the medical gaze and as the photographer. This
allows for an embodied apprehension of biomedicine’s procedural modalities from the inside out. Whilst Wan’s work
emphasizes the distal relations induced by technologies of
mediation for those who become patients, Christina Lammer’s
Horizontal Cuts and Vertical Penetration compares the tactile
activities of surgeons who cut across the surface of the skin to
penetrate the body’s surface, and those of radiologists who use
filaments to probe what Drew Leder so aptly terms the recessive body. Focusing on the movement of wires that penetrate and
visualize the vascular system of the blood’s flow, Lammer’s
remarkable, detailed ethnographic work charts the haptic
choreography involved in these new techniques of visualization
and the reactions of patients to these procedures. In so doing we
may better understand how the act of representation, so essential in these circumstances, is a visceral and performative act.
An apprehension of the volatile materiality of the body’s vicissitudes is captured in Corporeal Slippages, by Kyra Landzelius.
Landzelius’ writing evokes, in experimental prose fashion, the
multiple corporealities that incarnate the preterm baby’s emergence into subjectivity and personhood in multiple worlds where
technological systems are called upon to finish gestation: the
Prologue
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family, medicine, the hospital, the media. In yet another exploration of the operations of biopolitics and echoing other papers in
the collection, Humanizing Cancer and the biopolitics of disease
in Crete, Greece, by Anastasia Karakasidou addresses the zones
of slippage between the individual bodies and the body politic.
Karakasidou’s ethical anthropology of a new cancer ward at The
Regional University General Hospital of Herakleion explores
and critiques the classical philosophical terms zoë and bios to
provide an account of the ward as a »zone of indistinction« between »bare animal life« and our life as bio-beings implicated
and responding to a variety of environmental conditions. Dealing
with the same disease, cancer, Christine Holmberg’ Researching
Breast Cancer analyzes how encounters with breast cancer
patients blurs the boundaries between the diseased and those
who are well. Health, as she asserts, is only a temporary state in
biomedicine. Tracing as she does the psychodynamics of self and
other at work in the context of doing ethnographic interviews,
Holmberg articulates how hospitals and caregiving are charged
with the power to differentiate and violate the body’s boundaries
by a series of performative acts that, at an institutional level,
bring the patient as subject into being.
Several articles delve into embodiment within institutional settings. Agnieszka Koscianska’s Alternative Healing Practices
studies two female-led spiritual communities in Poland giving
a fascinating glimpse into the world-view of alternative health
care. The compelling reasons that holistic medicine have taken
hold in Poland are contextualized cogently with reference to
cultural ideals of emotional proximity and maternal behaviour
as a form of social resistance in the context of an ailing health
care in this post-socialist country. Embodied Caring/Caring for
Bodies, by Rosie Read, complements this close look at institutional systems of care in Eastern Europe with an account of
health care work in a Czechoslovakian nursing home run by
Borromeo nuns. Read’s descriptions of daily routines and practices, such as showering and feeding, brings into relief compe-
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ting definitions of health care provision: on the one hand, it is
characterized as the work of compassionate and oft-time martyrs; on the other it is understood that workers must keep
distance from their patient. As she perceptively points out these
philosophies of care, one based on religion the other primarily
secular in origin, are played out on the bodies of the elderly
patients in the home.
These experiments in bodily methods of knowing and an epistemology of the body are likewise explored in three texts that are
unique within a collection that is primarily concerned with biomedicine. Linnet Fawcett’s evocative prose brings to life the
movements and gestures of the recreational ice-skater in Haptic
Tales. Drawing upon sensuous scholarship as a methodology
for understanding the feel of this leisure activity and Roland
Barthes’ notion of the figure, Fawcett’s writing palpably embodies the rhythms of skating: it leaps, glides and spins. Sarah
Pink’s Therapeutic Housework likewise explains her sensuous
ethnographic method to apprehend housework, which may produce both a sense of physical well-being and personal renewal.
Key to this novel approach is an empathetic and physical sharing of these experiences with her informants. We end the collection with Laura U. Marks’ discussion of the sensorial aspects
of Islamic painting. Weaving philosophy and art history, Marks’
The Haptic Transfer and the Travels of the Abstract Line is an
historical account of the impact of Islamic art on mid-nineteenth century European painting. Deftly reflecting upon a perceptual position that is »embodied, multisensory, contemplative and subjective« Marks describes how these values were
given material form in Islamic ceramics, textiles, paintings and
poetry. At once abstract and corporeal these embodied dimensions of thinking and spectatorship on the creation of »abstract
lines and haptic spaces« points to an aesthetic that is performative, rather than representational.
The majority of the above-mentioned articles carefully critique
biomedicine and the treatment of patients within culturally spe-
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Prologue
cific institutional contexts, a concern that invokes at least one
of the English meanings of the word »patient.« But the articles
also conjure another sense of the term, patient. If patient is
taken up as an adjective, then patient embodiment may express
an attitude or comportment of the body that requests that we
slow down, pay attention and engage with our surroundings and
environments. For these reasons, and more, it is important to
signal that this is an international collection, most of it feminist,
which brings together work from different regions and locales.
Whilst many of the essays take personal experience as a point
of departure in so doing they do not merely reflect upon their
own private situation. In advocating for research that is patient
and embodied many of the works in this collection draw upon
forms of ethnography to understand the world view of subjects
by living, working, talking, playing, and listening to them for a
protracted period of time. Such an ethnography or auto-ethnography highlights the physical ways that subjects move through
daily lives and routines, and treats the researcher as an embodied being. As such this modality of research instigates a theoretical engagement with the very meaning and possibility of the
body. This understanding of the body as an empathic, fluid entity as Donna Haraway once famously argued, evokes bodies
that are »material semiotic actors« (1991, 208) living in particular locations, at specific historical moments.
Kim Sawchuk
Montréal, Québec, July 2007
References
Donna Haraway. (1991) The Biopolitics of Postmodern Bodies. Simeans
Cyborgs and Women: The Reinvention of Nature. New York:
Routledge.
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Einleitung
Die menschliche Stimme
Ich lehne meine einleitenden Worte an das Monodrama La Voix
Humaine (1932) von Jean Cocteau an. Der Text von Cocteau
bietet Francis Poulenc Material für die gleichnamige
Komposition einer tragischen Oper als Einakter (1959).1 Eine
Frau telefoniert mit ihrem Liebhaber, der sich von ihr trennt.
Am Schluss des Gesprächs stranguliert sie sich mit der
Telefonschnur. Als Metapher – verkörpert durch die Diva –
zieht sich der dramatische Stoff durch die Erzählstruktur dieses
Essays. Der Selbstmord mit einem Kabel erzeugt widersprüchliche Bilder. Ingeborg Bachmann benennt in ihrem Roman
Malina (1971) das Telefon als Draht zur Welt:
Im Kasten liegt, in einer Plastikhülle, noch ein anderes schwarzes
Kleid, es ist schwarz oben, mit bunten Längsstreifen unten, es ist ein
altes Kleid, in dem mich Ivan zum ersten Mal gesehen hat. Ich habe
es nie mehr angezogen und aufbewahrt wie eine Reliquie. ... Ich
gehe zurück ins Bad und schaue in den Spiegel, das Kleid knistert
und rötet mir die Haut bis zu den Handgelenken, es ist furchtbar, es
ist zu furchtbar, es muss ein höllischer Faden gewebt sein in dieses
Kleid. ... Und wie lange lebe ich schon, mit einem toten Telefon?
Darüber tröstet kein neues Kleid. Wenn der Apparat schrillt, ruft,
stehe ich manchmal noch auf mit einer unsinnigen Hoffnung, aber
dann sage ich: Hallo? mit einer verstellten, tieferen Stimme, weil am
anderen Ende immer jemand ist, den ich gerade nicht sprechen will
oder kann. Danach lege ich mich hin und möchte gestorben sein.
Aber das Telefon läutet heute, das Kleid scheuert meine Haut auf,
ich gehe beklommen zum Telefon, verstelle meine Stimme nicht,
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aber wie gut, dass ich sie nicht verstellt habe, denn das Telefon lebt.
Es ist Ivan. Es konnte ja nicht anders kommen, es musste ja endlich
Ivan sein. Nach einem Satz schon hat mich Ivan wieder erhöht, mich
aufgehoben, meine Haut besänftigt, ich sage dankbar zu, ich sage ja.
Ja, ja habe ich gesagt. (338-339)
Die tragischen Frauenfiguren, die Cocteau und Poulenc in
ihrem Stück und Bachmann in ihrem Roman entwerfen, ähneln
sich. Ich beziehe sie auf das eigene ethnografische Arbeiten mit
Nervenkranken und darauf, welche Gefühle Die menschliche
Stimme in mir hinterlässt. Ich evoziere ein Selbstgespräch und
entwickle das schreibende Ich2 als inneren Dialog: »Erst die
Annäherung der Kulturtechniken des Schreibens und
Sprechens erzeugte – hinsichtlich des verstehenden Hörens von
Stimmen – die komplementäre Kulturtechnik des Lesens«
(Macho 2004, 48). Stimme definiere ich im phänomenologischen Sinne als wesentliche Ausdrucksform des Menschen.
Über die Stimme und ihre Vibrationen erfahre ich, wie es
Anderen geht. Ich erhebe keineswegs den Anspruch auf die
authentische Wiedergabe der Empfindungen Anderer. Niemand
kann in die Haut eines anderen Menschen schlüpfen. Vielmehr
bringe ich mein eigenes verletzliches Ich zum Klingen, indem
ich mich – im Text zwangsläufig verdopple und – von fremden
Stimmen berühren lasse. »Ich ist ein Anderer« (ebd., 44).
Annäherungen. Mit den Nuancen der Stimme, ihren Modulationen und Klangfarben, werden Worte als semantische
Träger von Bedeutungen mit subjektiven Charaktereigenschaften sprechender Personen verbunden. »Die gesprochene
Sprache als ›Behausung‹ des Menschen stellt die ›ursprüngliche‹ Form des immersive environments dar. Sie ist der existenzielle Lebenssaft, in dem das Ich schwimmt und von dem es
auch gefangen gehalten wird« (Braun 2001, 238). Stimme fungiert als persönliches somatisches Instrument. Mit jedem
Atemzug. Sie verflüchtigt sich. Sie täuscht. Stimmbegabung.
Die in diesem Buch enthaltenen Verkörperungen münden in
Einleitung
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eine Polyphonie ethnografischer Szenarien zwischenmenschlicher Erfahrungen und Empfindungen, die auf vielfältige und
individuell unterschiedliche Weise Erinnerungen zum Ausdruck bringen.
Was die Stimme ausmacht, ist, was an ihr mich aufgrund ihres
nahen Verstummens erschüttert, so als ob sie alsbald Erinnerung
wäre und nichts anderes sein könnte. Dieses Phantom-Wesen der
Stimme ist die Modulation. Die Modulation, durch die sich jede
Stimme abgrenzt, ist das, was im Begriff ist, zu verstummen, ist jene
Klangspur, die sich auflöst und verflüchtigt. (Barthes 1988, 108)
Die Stimme gehört zur Leiblichkeit, wenngleich sie gegenwärtig
mit Hilfe technischer Geräte von der sprechenden Person unabhängig – sogar über den Tod hinaus – als Klangspur reproduzierbar wird. Der Klang der menschlichen Stimme ruft Aspekte
der Körpersprache, konkrete Ausdrucksweisen und bestimmte
Situationen mit Anderen in Erinnerung. Sie stellt eine Gegenwärtigkeit vergangener Momente und Gefühle dar. Stimme ist
weiblich. »Die Sprache ist die Mutter – la mère/mer und mem,
das Wasser –, die einerseits nährt, andererseits aber auch nicht
freigeben kann« (Braun 2001, 238). Roland Barthes geht in
Fragmente einer Sprache der Liebe (1977) von einer zweigeteilten Körperlichkeit aus, vom eigentlichen Körper und seiner Teile
sowie von der Stimme: »Was ich mit meiner Sprache verberge,
spricht mein Körper aus. Ich kann nach Belieben meine
Botschaft zurechtstutzen, aber nicht meine Stimme« (229). Sie
bleibt mit den individuellen Persönlichkeiten der Erzählenden
untrennbar verbunden. Das Transkribieren von Interviews, den
Klang vergangener Erzählungen im Ohr, wird als performativer
Akt analysiert, als vom Sprechakt ausgehender Hörakt, der subjektive Situationen und Erfahrungen buchstäblich in Fleisch und
Blut eingehen lässt und in greifbare Nähe rückt.
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Die Echo-Figur, die dem Mythos entsprungen ist, gehört zu dem
Ensemble von Stimmen im Kontext der Metamorphosen. Bei Ovid
ist die Stimme – die menschliche Stimme – in nicht wenigen Fällen
dasjenige, was jenen bleibt, die ansonsten ihrer menschlichen
Gestalt beraubt werden, sei es als Strafe oder im natürlichen
Vorgang körperlicher Vergänglichkeit. (Weigel 2004, 59)
Der eigene Leib fungiert als Echoraum und inspiriert das
schreibende Ich der Ethnografin dazu, ein Textgewebe zu entwerfen, welches die Wirklichkeiten und Erfahrungen von
InformantInnen als performative Spuren in einem subjektiv
erlebten räumlich und zeitlichen Kontinuum zum Ausdruck
bringt.
Der Leib als Echoraum
Wie ein Gesang durchdringen die erzählten Lebens- und
Leidensgeschichten eigene Stimmungen, Gemütsbewegungen
und Gefühlsregungen.
Und darin bin ich ... unvergleichlich, meine Stimme ist verbunden
mit meiner eigenen Lebensmasse wie keine andere Stimme, die ich
vernehme. Aber wenn ich dem Anderen, der spricht, genügend nahe
bin, um seinen Atem zu hören, um sein Aufbrausen und seine
Erschöpfung zu spüren, so kann ich das ungeheuerliche Entstehen
seiner Lauterzeugung fast so miterleben wie mein eigenes. Wie es
eine Reflexivität des Berührens, des Sehens und des Systems
Berühren-Sehen gibt, so gibt es auch eine Reflexivität zwischen
Vorgängen der Lauterzeugung und Gehör; jene schreiben sich
klanglich ein, und jeder Stimmlaut weckt ein motorisches Echo in
mir. Diese neuartige Reversibilität und das Auftauchen des
Fleisches als Ausdruck verweisen auf die Einfügung des Sprechens
und Denkens in die Welt des Schweigens. (Merleau-Ponty 1994,
189-190)
Einleitung
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Ich werde in der Folge Die menschlichen Stimme und wie sie
sich in mir ausbreitet, anhand von Interviewmaterialien untersuchen. Andere Stimmen. Fünf Gespräche mit Multiple Sklerose (MS)-PatientInnen – die Erfahrungsberichte sind im
Rahmen des Buchprojekts Multiple Sklerose: ein Lesebuch
(2007) zusammengestellt worden, das der Wiener Neurologe
Fritz Leutmezer geschrieben und herausgegeben hat – bilden
die tonale Basis für mein phänomenologisches, phonografisches Selbstreflektieren, das permanent zwischen einem eigensinnig durchklingenden Phantomwesen in der ersten Person
und dem schreibenden Ich als sein Double hin und her
schwingt. Dass die Stimme etwas ganz Persönliches ist, bestätigt auch der Komponist und Musikwissenschafter Thomas
Dezsy, dem ich anonymisierte Gesprächsfragmente als Hörproben3 zur Verfügung gestellt habe. Die fünf Stimmen – von
drei Frauen und zwei Männern unterschiedlichen Alters – sind
vollkommen verschieden. Dezsy hört in den für ihn fremden
Stimmen etwas anderes als ich, die jede einzelne Tonspur mit
sprechenden Personen, die ich während ihrer persönlichen
Erzählungen kennen lerne, und ihren Empfindungen verbindet.
Die interviewten PatientInnen unterscheiden sich in ihren
Dialekten. Manche sprechen Deutsch nicht als Muttersprache.
Eine junge Frau kommt aus Norddeutschland und drückt sich
mit einem entsprechenden Akzent aus. Kulturelle Unterschiede
machen sich im Klang der Stimme und in der individuell subjektiven Ausdrucksweise bemerkbar. Alter und Geschlecht der
Erzählenden sind wesentliche Merkmale, in denen sich die
stimmlichen Töne voneinander unterscheiden. Die menschliche
Stimme als persönliches Instrument zu interpretieren, um
Affekte, emotionale Bewegungen und Verkörperungen während narrativer Interviews in der ethnografischen Forschung
besser zu verstehen, befindet sich, zumindest meine medizinsoziologischen Arbeiten betreffend, noch in der Konzeptphase.
Jede/r der gehörten PatientInnen leben in speziellen
Lebenssituationen und Kontexten. Ihnen begegne ich mit
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Respekt. Ihre Aussagen lassen sich schwerlich verallgemeinern. Die Empfindungen von MS-Kranken entziehen sich der
Sprache. Wie als nicht Betroffene über das Erleben von
Krankheit schreiben, welches sich nicht einmal von den
Betroffenen selbst in Worte fassen lässt? Literaturwissenschaftliche, musikethnologische und performative Ansätze fließen in meine Überlegungen ein:
Voice is both a noun and a verb. As a noun, it is a mechanism for
conveying the spoken word. As a verb, voice implies agency, motivation. It always requires a direct object: »She voiced a concern«;
»he voiced his agreement«; »they voiced their opinions.« And, as a
verb, voice is attached to a subject, a person from whom the voicing
emanates. Voice is thus deliberate, purposeful, and personal. The
term disembodied voice, by contrast, usually refers to something
supernatural or ethereal and is a cause for awe or fear, precisely
because it removes from our sight or direct perception the embodied, identifiable agent. (Poirier 2002, 48)
In Voice in the Medical Narrative (2002) zeigt Suzanne Poirier
wie die persönliche Stimme in der klinischen Routine oft von
einer formalisierten und professionellen Sprache überstimmt
wird. Gerade für die Diskussion bioethischer Werte interpretiert
die Literaturwissenschafterin die Leugnung der subjektiven
Artikulation als problematisch. Poirier bezieht sich in ihren
Ausführungen auf Mikhail Bakhtin und seine Definition des
Romans, der multivokale Vorstellungsräume eröffnet: »The
novelist invites characters and narrators to talk together, debate, misunderstand each other, compromise, and disagree« (53).
Das Zusammenwirken von Stimmen und ihre Kombination
ermöglicht demnach eine komplexe Weltsicht, die kulturell und
gesellschaftlich gesetzte Grenzen zu überschreiten vermag. Ich
stelle den Dialog zwischen Menschen und damit auch
Interviewsituationen als etwas Subjektives und Haptisches dar,
um mit Laura Marks und Linnet Fawcett zu argumentieren. Die
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Einleitung
Stimme ist Teil unserer leiblichen und zutiefst subjektiven
Verfasstheit und Konstitution. Ich lasse mich von den Stimmen
meiner InterviewpartnerInnen berühren und verwende meinen
eigenen Leib als dünnhäutigen Echoraum. Dies erfordert ein
bewusstes Lenken der Aufmerksamkeit auf stimmliche Klänge
und auf Körpersprache. Anders zuhören. Empfindungen und
Gefühle werden in einer Vielfalt von Stimmlagen, Gesten und
Mimikry artikuliert. Die Interviewfragmente, in die ich mich
einhöre, sind inhaltlich vorausgewählt. Sie klingen in meinen
Ohren nach. Charaktere. Vermittelt durch die Kopfhörer meines digitalen Aufnahmegeräts. Wie drücken die fünf von mir
interviewten Personen ihre Empfindsamkeiten und Emotionen
aus? Welche multivokale Resonanz – im Sinne von Einfühlung
und Verständnis – erzeugen ihre Krankengeschichten in mir?
Vom Eigenen zum Fremden
»Ich habe sie, aber sie hat mich nicht,« Multiple Sklerose. Mit
einem Gedicht drückt einer der von mir interviewten Männer
aus, wie er sich mit der Nervenkrankheit fühlt. Er definiert
gleichzeitig eine wesentliche Grundkategorie der phänomenologisch geprägten Medizinsoziologie, die davon ausgeht, dass
wir uns durch Krankheit selbst fremd werden. Unser verkörpertes Dasein in der Welt – ich bin – artikuliert sich als »ich habe
einen kranken Körper.« Dieser wird zum Gegenstand permanenter Aufmerksamkeit. Ich selbst existiere im Verhältnis zur
gesellschaftlichen und kulturellen Umgebung, in der ich lebe.
Maurice Merleau-Ponty bezeichnet einen »Roman, ein Bild,
ein Musikstück« als »Wesen, in denen Ausdruck und
Ausgedrücktes nicht zu unterscheiden sind, deren Sinn nur in
unmittelbarem Kontakt zugänglich ist und die ihre Bedeutung
ausstrahlen, ohne ihren zeitlich-räumlichen Ort zu verlassen«
(1974, 181). Er vergleicht in diesem Sinne den Leib mit einem
Kunstwerk.
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So wie die gesprochene Sprache nicht allein durch die Worte bedeutend ist, sondern auch Ton, Gesten und Physiognomie, und wie
diese Sinnesergänzung nicht mehr nur die Gedanken des
Sprechenden offenbart, sondern die Quelle seiner Gedanken und
seine fundamentale Weise zu sein, so ist auch die Poesie, selbst
wenn sie beiläufig eine erzählend-bedeutsame ist, wesentlich eine
Modulation der Existenz. (Ebd.)
In ihrer Studie Versuch über den Schwindel (2001) setzt
Christina von Braun die Diva mit dem Gekreuzigten gleich
(240). »Worin besteht ... die Gemeinsamkeit? Der eine mit seinem gemarterten Leib, die andere mit ihren gemarterten
Nerven; der eine mit seinem Versprechen der Auferstehung, die
andere mit ihren Aufsehen erregenden Versprechen? Und vor
allem: der eine mit seinem Anspruch auf einen ›göttlichen
Vater‹, die andere mit ihrem Anspruch auf eine göttliche
Stimme?« (ebd.). Das Krankheitsbild MS wird im Rahmen dieses Texts exemplarisch eingeführt. Genderfragen werden ins
Spiel gebracht. Die Entwicklung der Nervenkrankheit aus
medizinischer Sicht, in der wissenschaftlichen (säkularisierten)
Vatersprache formuliert: »Im Detail sind viele Vorgänge, welche zur Entstehung von MS führen, noch gar nicht geklärt. Man
geht heute aber davon aus, dass ein primär banaler (unbekannter) Erreger das Abwehrsystem in der Kindheit stimuliert«
(Leutmezer 2007, 19f.). In den Definitionen, die der Neurologe
Fritz Leutmezer verwendet, um seinen PatientInnen zu erklären, was ihnen fehlt, spricht er von einem Erreger, der »mit der
Oberfläche von Nervenzellen eine große Ähnlichkeit haben«
muss, »wodurch das Immunsystem aktiviert wird und nicht nur
den Erreger, sondern auch die Nervenzellen zerstören will«
(ebd., 20). Von einer Ununterscheidbarkeit zwischen Fremd
und Selbst, von täuschender Ähnlichkeit wird ausgegangen.
»Die Nervenzelle selbst besteht, ähnlich einem Stromkabel, aus
einem Kern (Axon) und einer isolierenden Hülle
(Myelinscheide)« (ebd. 20). Diese Myelinschicht wird vom
Einleitung
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Abwehrsystem angegriffen. Entzündungsherde bilden sich im
Gehirn oder Rückenmark und diese führen, je nach ihrer Größe
und Lage, zu dauerhaften Beschwerden und Behinderungen. In
der medizinischen Fachsprache wird ein systemimmanenter
innerer Dialog deutlich, in dem das Eigene (Nervenzelle) vom
Fremden (Erreger) getäuscht wird. Die vom Arzt entworfenen
Charaktere dieses Interagierens sind jedoch keine sprechenden
Personen, sondern winzige Partikel im Leib, die buchstäblich
Krieg spielen.
What is involved here is a very important, in fact a radical revolution in the destinies of human discourse: the fundamental liberation
of cultural-semantic and emotional intentions from the hegemony of
a single and unitary language, and consequently the simultaneous
loss of a feeling for language as myth, that is, as an absolute form of
thought. Therefore it is not enough merely to uncover the multiplicity of languages in a cultural world or the speech diversity within
a particular national language – we must see through to the heart of
this revolution, to all the consequences flowing from it, possible
only under very specific sociohistorical conditions. (Bakhtin 2000,
367)
In Anlehnung an Mikhail Bakhtin in The Dialogic Imagination
(2000) sind medizinische Fallgeschichten, Erzählungen von
PatientInnen und auch das Generieren ethnografischer Texte als
dialogisch strukturiert vorzustellen, gehören demnach dem
Genre des Romans an. Im vom Neurologen beschriebenen körperinneren Dialog zwischen Nervenzellen und Erreger spiegelt
sich kulturell und ideologisch ein biowissenschaftlich objektivierter Diskurs wider, der zahlreichen Modulationen unterworfen wird. Bis hin zum Gespräch zwischen Arzt und Erkrankten.
Fritz Leutmezer nennt folgende Symptome, die mit der
Nervenkrankheit MS auftreten: Bewegungsstörungen, Gefühlsstörungen, Sehstörungen, Müdigkeit, Blasenfunktionsstörungen, Darmfunktionsstörungen, Störungen der Sexualfunktion,
34
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Gedächtnisprobleme und Depression. Im Alltag derer, die mit
der Krankheit leben, gehen die Beschwerden häufig mit einer
fundamentalen Veränderung des subjektiven Zeit- und
Raumempfindens einher, welche durch die zuvor genannten
körperlichen Störungen – Lähmungen, Krämpfe, Koordinations-, Gleichgewichts- und Sehstörungen, fehl gesteuerte
Sensibilitäten und Gefühle, Probleme mit der Verdauung und
Blasenschwäche – verursacht werden. MS-kranke Menschen
sind mit einer fortschreitenden Verlangsamung der eigenen
Bewegungen, alltäglicher Handlungen und Reaktionen konfrontiert, die ihr Denken, ihr Dasein in der Welt, ihren eigenen
Rhythmus, ihre Wahrnehmung und ihr Gefühl für sich selbst
massiv verändern. Bedrohliche Transformationen, die zwangsläufig zu einer selbstverständlichen Verinnerlichung des
Dialogs mit ÄrztInnen und dem biomedizinischen Diskurs führen. Das Vakuum der Muttersprache – Sprachlosigkeit – wird
vielfach von der Vatersprache der Biomedizin ausgefüllt, die
zumindest Erklärungsmuster und ein Vokabular bereithält, den
durch die Erkrankung sich zusehends verändernden eigenen
Körper zu begreifen.
Die Buchstaben hatten dem Körper die Zunge entrissen; sie hatten
sein Gestammel – des Gebets oder der Liebe – in abstrakte Zeichen
übertragen. Lesen, sammeln konnte man diese Zeichen, mit distanziertem Auge betrachten, sie blieben sogar erhalten, wenn der sprechende Körper, der sie niedergeschrieben hatte, schon längst unter
der Erde lag. Aber man konnte sie nicht auf der Zunge zergehen lassen. Die Zeichen des Alphabets waren nicht zu schmecken, zu riechen, nicht einmal zu hören. Die phonetischen Zeichen verboten
dem Körper, Lust wie Schmerz zu empfinden: War das Alphabet
eingeschaltet, so wurde der Körper ausgeschaltet. Aber der Körper
ließ sich diese ›Bevormundung‹ nicht ohne weiteres gefallen:
Ebendeshalb betrat zeitgleich mit der Alphabetschrift die Hysterika
die Bühne des abendländischen Geschehens – sie trat an, der Zunge
einen neuen Körper zu verleihen. ... Die Hysterika ergriff das Wort
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Einleitung
mit ihren Verrenkungen, Krämpfen und Erstickungsanfällen. Ihre
Symptome sprachen eine Sprache, die jeder sehen und vernehmen
konnte. Und alle Symptome erzählten die dieselbe Geschichte: die
Geschichte von der herausgerissenen Zunge, vom Körper, dem die
Sprache entzogen wird. (Braun 2001, 240-241)
Eine herausgerissenen Zunge – der Verlust des Sprechens in
Worten und Sätzen – taucht als dramatische Figur bei
Shakespeare ebenso auf wie in den psychoanalytischen
Krankengeschichten. Die Behandlung von MS – medikamentös, psychologisch und durch Physiotherapie – gehört zu den
täglichen Verrichtungen der Erkrankten, die buchstäblich in
Fleisch und Blut übergehen. Das eigene Körperbild beginnt
förmlich zu zerrinnen. Das Verhältnis zu sich selbst und zur
soziokulturellen Umgebung – die eigene Performance – wird
für die Betroffenen zunehmend unbegreifbar und befremdend.
Die menschliche Stimme bekommt etwas Flüchtiges.
Vergänglichkeit. Der Leib wird dünnhäutiger.
Fünf Stimmen
Vier der Interviews finden in verschiedenen Wiener Kaffeehäusern statt und eines bei der Patientin zu Hause.4 In den
Gesprächen wird nicht nur die individuelle Krankengeschichte
beschrieben, sondern auch die Biografie nimmt einen wichtigen
Stellenwert ein, um mehr über jede einzelne Person und ihr
Leben zu erfahren. Wie beeinträchtigt MS Menschen in ihrem
Alltag? Wie empfinden sie sich selbst oder wie verändert die
Krankheit die eigene Wirklichkeit und die Wahrnehmung des
sozialen Umfelds? Wie beschreiben sie ihr Erleben? Wie reden
sie über etwas, wofür es keine Sprache gibt? In den von mir
(subjektiv) ausgesuchten Interviewpassagen – ich reflektiere
die eigene Verletzlichkeit beim Zuhören – werden konkrete
Empfindungen oder Missempfindungen geschildert. Mich
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Christina Lammer
interessiert, wie diese Gefühle ausgedrückt und verkörpert werden. Ich habe nur jene Tonspuren ausgewählt, die mich persönlich berühren. Der Echoraum, den ich hiermit anhand meiner
eigenen Dünnhäutigkeit vorstelle, dient als Ausgangspunkt für
weitere Überlegungen. Welche Assoziationen ruft Die menschliche Stimme beim Transkribieren des Tonmaterials in mir in
Erinnerung? »Irgendwo werden Leiber geöffnet, damit ich
allein sein kann mit meinem Blut. Meine Gedanken sind
Wunden in meinem Gehirn. Mein Gehirn ist eine Narbe. Ich
will eine Maschine sein. Arme zu greifen Beine zu gehen kein
Schmerz kein Gedanke« (Müller 2001, 552-3). Von insgesamt
sieben Stunden aufgenommener Gespräche bearbeite ich für
diesen Essay 100 Minuten. Ein methodischer Prozess des
Sezierens und Komponierens. Meine eigene Stimme klingt an
manchen Stellen in den Aussagen / Tönen und Verkörperungen
durch, um den Verlauf des Dialogs – die Stimmungen währenddessen – anhand von Textfragmenten nachzuvollziehen.
Eine Partitur entsteht.
25jährige Bühnenbildnerin / 35 Minuten:
KRIBBELN:
...die ganze rechte Seite hat gekribbelt / ich konnte kaum laufen /
war schwach / konnte meine Hand nicht kontrollieren / Sensibilität
war weg / meine Hand kribbelt immer / mein Fuß auch / die rechte
Seite kribbelt / im Gesicht kribbelt es / die Haut / bei der Hand und
beim Fuß geht es tiefer / im Gesicht kribbelt es oberflächlich / hab
extreme Probleme beim Schreiben / konnte lange nicht einmal einen
Stift halten / muss mich toll konzentrieren / ich konnte mir nichts
merken / nicht einmal eine Telefonnummer wählen / kaum war
meine Hand bei der Tastatur, hatte ich die Nummer vergessen...
LEERE IN MIR:
...mein Vater gestorben / Auslöser / ab dem Zeitpunkt ging es mir
schlecht / er war auf einmal tot / ich hab mich isoliert / konnte nur
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Einleitung
37
mit meiner Schwester gut reden / kein Kontakt mit anderen Leuten /
konnte mit diesem Schmerz nicht umgehen / Anderen konnte ich das
nicht mitteilen / bis heute / wenn ich darüber spreche, befinde ich
mich auf einer anderen Ebene / spreche ich über den Tod / fühl ich
das nicht wirklich / fühlt sich wie Angst an / alles leer / in mir drinnen...
UNTER WASSER:
...Druck im Kopf gespürt / verunsichert / Probleme mit dem Lesen /
keine Schmerzen / unter Wasser / ich war nicht ganz da / hab nicht
gut gehört / Menschen, mit denen ich gesprochen hab, waren weiter
weg / hab mich wie unter einer Glocke gefühlt / hatte Angst / das
geht nicht mehr weg / ich gehe immer mehr von der Welt weg / dieser Zustand hört nicht auf / als ob ich mich immer weiter entferne...
NICHT MENSCH:
...bei den Untersuchungen kam ich mir manchmal nicht wie ein
Mensch vor / Untersuchungen mit Stromschlägen / Sensoren am
Kopf / Stromschläge an der Hand / am Fuß / wie lange dauert es,
bis der Reiz im Gehirn ankommt?
KÖRPERVERTRAUEN:
...man verliert das Vertrauen in den Körper / stark enttäuscht...
60jährige Pensionistin / 7 Minuten:
TAUBE BEINE:
...plötzlich schlecht gesehen / Untersuchungen / ein Auge ist
schwarz / an Verkabelungen angeschlossen / am zweiten Auge ein
Fleckerl / Computerauswertungsbild / Beine gefühllos / von unten
rauf / immer mehr / bis zum Unterleib / war richtig unangenehm /
hab mich angegriffen / war mir selber unangenehm / beide Beine
waren wie taub...
ANGEGRIFFENE KABEL:
...bei mir ist die beschädigte Schicht beim Schlüsselbein / dort ist
das Kabel angegriffen / die Nerven...
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Christina Lammer
UNVORSTELLBAR MÜDE:
...über lange Strecken spür ich gar nichts / zu Beginn hab ich die
Müdigkeit gespürt / bin nicht Auto gefahren / mich nicht getraut /
bin von einer Minute auf die andere so müde / man kann sich das
nicht vorstellen / manchmal hätte ich mich am liebsten am Boden
gesetzt / ich konnte einfach nicht mehr...
38jähriger Frührentner / 15 Minuten:
EINBILDUNG:
...kognitiven Störungen ausgetestet / Computerprogramm / misst das
Gedächtnis / wie viel kann man sich merken? / nachgeprüft /
Langzeit- und Kurzzeitgedächtnis / Einbildung? / kann nicht sein /
es ist / für mein Alter ist das Ergebnis zu schlecht / generell / telefonieren immer mit Zettel / sofort alles aufschreiben / ist sonst weg /
ich brauch soviel Kraft fürs Konzentrieren auf das Gespräch / bleibt
keine für die Speicherung / ich leg auf / kann mich nicht mehr erinnern / weg ist’s / ich spiele Gespräche geistig durch / merke ich’s mir
leichter / wenn ich jemanden anrufe, schreib ich mir alle Fragen
vorher auf / vergesse die Hälfte / dreimal anrufen, macht kein schönes Bild...
KABELBRAND:
...ein Nerv betroffen / etwas fällt aus / Kabelbrand / sobald das
Kabel kaputt ist, leuchtet kein Licht mehr / alles kann betroffen sein
/ bei mir schon genügend betroffen / Schübe / rechte Hand / wieder
die rechte Hand / man kann nie sagen, wo’s beim nächsten Mal auftaucht / bei mir gibt es nicht viel, was nicht betroffen ist / meine
rechte Seite ist schlechter / hab auch links Ausfälle / bei den schleichenden Zuständen ist es schwer zu sagen, wann der Zeitpunkt
gekommen ist, sich Kortison zu holen / bei einem Schub, wenn’s
jeden Tag schlechter wird, muss was gemacht werden / wenn ich’s
nicht mehr aushalte, hole ich mir Kortison / meine Schmerzgrenze
ist hoch / beim Duschen niedersetzen und ausrasten / so nicht
mehr...
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NEBEL:
...Haustiere / Meerschweinchen / das ist das Haupthobby / soviel
Kraft bleibt nicht übrig, um Sport oder so etwas zu machen /
Krafteinteilen / Müdigkeitssyndrom / wirkt sich unterschiedlich aus
/ als ob man Fieber hätte / in der Früh bin ich benebelt / manchmal
geht’s gleich weg / manchmal hängt der Nebel ewig / Kraft ist am
Nachmittag aus / ich kann mich nicht mehr konzentrieren / passieren mir pausenlos Fehler / ich stoße Dinge um / mir fällt nichts ein
/ alles wird langsamer / irgendwann merkt man’s / ich merk es / die
Anderen wahrscheinlich auch / mit dem Kopf / körperliche Ausfälle
beherrschen / gibt Tricks...
WIND:
...wenn ich meine Befunde und Tests hernehme / alles betroffen / bin
ich ganz unten / in dem Bein hab ich keine Reflexe mehr / die Nerven
sind bis hinauf beschädigt / hier kann man mir ohne Schmerzen Blut
abnehmen / die Hand ist schmerzunempfindlich und taub / wenn ich
mich kratze, spür ich nichts / extremer Schmerz kommt durch / so
lange man sieht, was man angreift, kann man sich fast einbilden,
man greift es an / wenn ich dieses Glas in die Hand nehme, spüre
ich es nicht wirklich / beim Schreiben ist das auch so / wie viele
Bewegungen machen Sie beim Schreiben? / das Problem sind die
Bewegungen, die ich zugleich mache / eine Bewegung auszuführen,
ist kein Problem / zugleich mehrere Bewegungen zu machen / an vieles gleichzeitig denken / extrem schwierig / den Stift halten / drükken und bewegen / was man schreiben will / wissen / wenn ich hinausgehe, merke ich wie viel sich bei den Augen bewegt / was das an
Kraft kostet / Wind / Sachen, an die man nicht denkt / der Körper
muss allerdings darauf reagieren / hat man zu Hause nicht / stehende Wände / nichts bewegt sich / draußen bewegt der Wind einiges /
das Auge arbeitet...
PEINLICHKEIT:
...mein Hirn / wenn das nicht funktioniert, funktioniert nichts / wird
immer irrsinnig peinlich / ich red / finde die Worte nicht / das falsche Wort kommt heraus / hab mir gerade das andere gedacht / in
Gesprächen peinlich...
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Christina Lammer
60jährige Fotografin / 21 Minuten:
ZACK:
...bin gern mit Stöckelschuhen gegangen / gleichzeitig mit beiden
Beinen umgeknickt / zack / ganz plötzlich / bei längeren Strecken /
Lähmungserscheinungen / war mir eigenartig / hat nicht so funktioniert...
HORROR:
...ich hab einfach die Angst, dass ich verblöde / mir ist wichtig /
nicht zu verblöden / ist mir ein Horror...
IM AUGENBLICK:
...ich leg mich hin / konzentrier mich auf das, was ich höre / das ist
wie in der Fotografie / in der Fotografie sehe ich zweidimensional
/ alles auf einer Ebene / gleichzeitig / mach ich jetzt ein Foto / sehe
ich das Bild da hinten / das Fenster / was sich darin spiegelt / Du
bist darauf / alles auf einem eingerahmten Feld / beim Hören befindet man sich unglaublich im Jetzt / ich höre genau / unten auf der
Straße schreit ein Kind / ein Vogel zwitschert / die Putzfrau redet /
im Radio spielt was / die Katze miaut / alles auf einmal / ich konzentriere mich auf das Jetzt / den Augenblick / ja, das entspannt
mich / keine heilende Wirkung / Eindruck / solche Krankheiten bringen mit sich / aufgrund der Prognose viel mehr im Augenblick zu
leben / das ist von großem Vorteil / das ist eine ungeheure
Bereicherung / Erweiterung der Lebensbetrachtung / ein Aspekt
davon / betrifft eigentlich jeden Menschen, der älter wird / klingt
banal / die Tatsache oder die Kenntnisnahme / das Leben ist endlich
/ so etwas Üppiges / Wichtigkeiten verschieben sich / ich nehme die
Welt gelassener wahr...
ABBRÖSELNDE GEBORGENHEIT:
...Abschied von einem klaren Bild nehmen / mit einem klaren Bild ist
man in bestimmten Wertigkeiten und Lebensbetrachtungsweisen viel
geborgener / man weiß genau, wie es sein sollte / das bröselt ab /
körperlich marode sein / ungeheure Verminderung des Selbstbewusstseins / eine Reduzierung der guten Selbstwahrnehmung...
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Einleitung
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EINZIGE SCHAM:
...ein permanentes Überwinden von Angst / ich lern zusehends mehr
/ nicht nur auf irgendwelchen Flughäfen oder in fremden Städten
mit dem Rollstuhl / in Begleitung / unterwegs / auch in Wien / tu mir
noch ein bisschen schwer / ich gehe mittlerweile so schlecht / alle
erschrecken / wie ich daher komm / gescheiter / ich fahre mit dem
Rollstuhl / ist mir zusehends weniger ein Problem / ein langer
Lernprozess / mit einer Selbstverständlichkeit mit dem Rollstuhl
daherzukommen / ich genier mich / eine einzige Scham...
BEWEGUNG IM RAUM:
...wäre ich Pressefotografin / könnte ich meinen Beruf nicht mehr
ausüben / ich bin Architekturfotografin / das kann ich noch / die
Architekturfotografie ist etwas sehr Statisches / Ruhiges / ich kann
für ein Foto lange Zeit brauchen / der Zeitbegriff ist in diesen
Umständen präsent / in der Form von Langsamkeit / meine
Krankheit evoziert mehr Konzentration / mehr Wahrnehmung im
Raum / mehr Empfindlichkeit / mit der Krankheit nehme ich die Welt
beim Fotografieren mehr wahr als vorher / die Sicht auf die Welt ist
nicht mehr so idealisiert / um vieles differenzierter als sie früher
war / nicht nur Horror und Schönheit / alles Mögliche dazwischen /
ich kann mich schwer präziser ausdrücken / muss die Müdigkeit
subtrahieren / Raumwahrnehmung findet durch Bewegung statt /
Bewegung im Raum und außerhalb des Raums / kann ich viel
schwerer als früher / insofern ist die Wahrnehmung des Raums
reduziert / die Müdigkeit nimmt mir Lebens- und Wahrnehmungszeit
weg / die Wahrnehmungsschärfe ist gesteigert / gleichzeitig wird
durch die Müdigkeit / eingeschränkte Bewegung / etwas weggenommen / fehlt und ich vermisse das immer wieder...
LANGSAMES STERBEN:
...eine immer schlechter werdende Krankheit / ich werde nicht mehr
Ewigkeiten leben / weiß nicht, wie ich damit umgehen soll / ich sterbe so langsam / Horrorvorstellung / MS ist eine der langsamsten
Todesarten / an einer anderen Krankheit stirbt man halt / an einem
Krebs / irgendein Organ funktioniert nicht mehr / wenn Muskeln
nicht funktionieren / stirbt man nicht so schnell / dauert lang / ich
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Christina Lammer
wünsch mir heftig / nicht an dieser Krankheit zu sterben / Krebs /
Herzkasperl / ja / ist so / ich hab nichts dagegen, wenn ich Krebs
krieg / da sterbe ich schneller...
SCHÄRFERE WAHRNEHMUNG:
...nicht viele Auswahlmöglichkeiten / entweder ich bleib zu Hause /
versteck mich / ich geh hinaus / zeige meine Reduktion der Öffentlichkeit her / das ist jetzt so / ich bin sogar stolz darauf / fotografiere vom Rollstuhl aus / manche Dinge sind von unten aus interessanter / ich hab mich immer noch nicht daran gewöhnt / die Sachen
von unten zu sehen / manchmal stehe ich auf / die Wahrnehmung ist
schärfer geworden / metaphorisch / Leiden miteinbezogen / ich hab
früher viel idealisierter fotografiert / Teil meiner Arbeitsqualität /
ich sehe unten Sachen, die ich oben nicht wahrnehme...
FREMDBESTIMMUNG:
...die Behinderung ist Teil meiner Identität / ja / auf jeden Fall / fühl
mich ein bisschen ferngesteuert / fremd bestimmt / habe keinen
Einfluss auf meinen Körper / was versteht man unter Identität? / die
Veränderungen durch die Krankheit / wie ich mich selber in der Welt
fühle / Stücke meiner Identität / ich hab eine veränderte Sicht auf die
Welt / auf meine Umgebung / diese unerträgliche Milde in mir / mich
kann nicht so schnell etwas aufregen / das ist schon nahezu unappetitlich / zahnlos / mich erschüttert nichts / so ist das in diesem Leben...
ABSCHIEDNEHMEN:
...banal / sich mit Tatsachen des Abschiednehmens auseinanderzusetzen / den Tod authentisch akzeptieren / gehört zum Leben /
unmittelbar damit konfrontiert / selbst betroffen / mich bedroht das,
wenn es jemandem sehr schlecht geht...
42jähriger Grafiker / 22 Minuten:
IM KOPF:
...in den Beinen Gefühlsstörungen / auf der Haut kein Gefühl / kribbelig / bis zum Bauch hinauf / von den Fußsohlen / hab ich immer
noch / ein ganz leises Gefühl / bin leicht in Panik geraten / wenn es
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Einleitung
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mir wirklich schlecht geht / schlechte Sachen im Kopf / hab MS
schon gehabt, ohne zu wissen, ob ich es wirklich habe / eine Zeit
lang hab ich mir gewünscht / MS zu haben / zu wissen / was mit mir
los ist / in der Anfangszeit war es schlimm / nicht zu wissen / was
mit mir ist / könnte schlimm sein / könnte nichts sein...
PERSÖNLICHER WEG:
...ich muss mit der Krankheit zurechtkommen / meinen persönlichen
Weg finden / der einzige Nachteil beim Spritzen ist / rein psychisch
/ ich kann nicht vergessen / krank zu sein / werde jeden Tag daran
erinnert / aufpassen / du bist krank / musst spritzen / kann die
Krankheit nicht vergessen / andererseits weiß ich / das ist das einzige / hilft / kleineres Übel...
UNGEWISSHEIT:
...ob ich mich an die Ungewissheit gewöhne? / was wird passieren?
/ niemand weiß das / kann rausgehen / mich überfährt ein Auto /
nicht viel anders / bei Menschen / die nicht MS haben / gesund
sind...
SCHRITT FÜR SCHRITT:
...ich muss beim Gehen denken / links / rechts / ungewöhnlich / bis
jetzt bin ich einfach gegangen / ohne darüber nachzudenken / hat
mich erschreckt / kommen diese Gedanken / aha / das wird jetzt
schlimmer / vielleicht bleibt es so / zum Glück ist es zurückgegangen...
KÖRPER ALS TEIL DES ICHS:
...meinen Körper lerne ich durch die Krankheit definitiv besser kennen / hab mich mit dem Körper nie richtig beschäftigt / wie beim
Gehen / war selbstverständlich / mit der MS hab ich gelernt, auf den
Körper zu achten / zu hören, was mir der Körper sagt / was der
Körper mit dem Rest von mir oder mit dem Kopf macht / den Körper
als Teil des Ichs zu betrachten / nicht nur als etwas, das man mitschleppt / als Teil von mir / ich bin nicht nur Kopf / die Füße gehören dazu / was passiert bei einer Entzündung? / Prozesse / wenn ich
in den Füßen etwas spüre, sind sie in Ordnung / Information wird
vom Kopf falsch übermittelt / dadurch hab ich gelernt, mit der
Müdigkeit besser umzugehen...
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UNVERSTÄNDNIS:
...jede Auseinandersetzung mit der Krankheit war ein schwieriger
Prozess / immer noch so / manchmal ist es für diejenigen schwieriger, die nicht in der Situation sind / sie können oft gar nicht verstehen / wissen nicht, warum manche Sachen jetzt anders sind / warum
er plötzlich so müde ist / niemanden sehen will...
EMPATHIE:
...Einfühlungsvermögen / das sind zwei Prozesse / der persönliche /
wie viel kann ich empfinden? / wie viel will ich empfinden? / wenn
ich etwas empfinde / was heißt das für mich? / dem Anderen gegenüber? / was mach ich mit einer Information? / vielleicht stimmt sie
gar nicht...
TOTALE ABHÄNGIGKEIT:
...was mir Angst macht / totale Abhängigkeit von den Anderen / ich
will nicht richtig darüber nachdenken / vieles, wovor ich Angst
hatte, ist nie eingetreten / eine Zeit lang hatte ich vor allem Angst /
hat keinen Sinn / kann nicht vor allem Angst haben / müsste ich
Schluss machen / wollte ich nie / will ich nicht / mich umbringen /
keine Lösung...
Wehrlose Feinnervigkeiten
Das schreibende, denkende und sich bewegende Ich wird von
einem Taubheitsgefühl – von einer innerlichen Sprachlosigkeit,
um nicht zu sagen, einer tiefen Schreibhemmung – beeinträchtigt. Arm in Arm spaziere ich mit einer MS-kranken Freundin
und Kollegin durch den Innenhof ihres Hauses.5 Wir sprechen
über Ereignisse der vergangenen Tage, unsere gemeinsame
Arbeit, zu schreibende Texte, zu überlegende Konzepte und
Projekte. Alltägliche Probleme. Gleichzeitig konzentrieren wir
uns auf jeden einzelnen Schritt, den wir gehen. Sie spürt eine
unvorstellbare – für mich als Gesunde nicht nachvollziehbare –
Schwere in den Beinen. Ihr linker Fuß lässt sich kaum heben,
klebt am Boden. Potenzierte Schwerkraft. Mit einer Hand um-
Einleitung
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greift sie den Stock, auf den sie sich stützt. Mit der anderen hält
sie sich an mir fest. Die Langsamkeit, mit der sie sich fortbewegt, wird ihr zum Gefängnis. Mit jeder Bewegung spüre ich
die Bedrohung, die von diesem physisch bedingten reduzierten
Tempo ausgeht. Ich habe Mühe, das Gleichgewicht zu halten,
einen Fuß vor den anderen zu setzen und die Freundin »in
Bewegung zu denken,« wie Janet Price in ihrem Essay für die
Verkörperungen schreibt. Ich schwanke. Einfühlung tanzen?
Aus dem fremden Raum der Nervenkrankheit ausbrechen!
KRIBBELN. Existenzielle Modulationen erfassen den Leib
gleichermaßen wie die Stimme. LEERE IN MIR. Angst.
Isolation. Einsamkeit. Der Kontakt mit Anderen bricht ab.
Sprachlosigkeit. UNTER WASSER. Gefühle, sich immer weiter von der Welt zu entfernen. NICHT MENSCH. Untersuchungen. Auf Maschinen geschnallt. Angeschlossene
Sensoren. Der Körper wird in Röhren geschoben, die das Innere
abtasten und in Bilder verwandeln. KÖRPERVERTRAUEN.
Enttäuscht vom eigenen Leib. TAUBE BEINE. Gefühllos.
Paralysiert. Schleier vor den Augen. ANGEGRIFFENE
KABEL. Die Umhüllung der Nerven löst sich auf. UNVORSTELLBAR MÜDE. Lähmende Erschöpfung durchdringt das
Dasein. EINBILDUNG. Messbares Gedächtnis. Kein Raum für
Speicherung und Erinnerung. Vergessen. KABELBRAND.
Erfasst beinahe jeden Körperteil. Schübe oder schleichende
Zustände. NEBEL. Hängt ewig. Fehler passieren. Ausfälle mit
dem Kopf beherrschen. WIND. Die Augen bewegen sich draußen. Stehende Wände. Gefangen. Innerer Stillstand. PEINLICHKEIT. Nichts geht, wenn das Hirn nicht funktioniert.
ZACK. Beine knicken um. Gleichzeitigkeiten. HORROR.
Angst, zu verblöden. IM AUGENBLICK. Zuhören. Sich im
Jetzt befinden. Zur Entspannung. Heilt nicht. Hoffnung.
Verschiebung der Wichtigkeiten. ABBRÖSELNDE GEBORGENHEIT. Abschied von klaren Bildern und Wertigkeiten.
EINZIGE SCHAM. Rollstuhlfahren. Angst überwinden. Wie
komm ich daher? Leute erschrecken, wenn sie mich sehen.
46
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BEWEGUNG IM RAUM. Gesteigerte Konzentration und
räumliche Wahrnehmung. Dazwischen. Horror und Schönheit.
Dauer. LANGSAMES STERBEN. Schnellere Todesarten.
Krebs. Herzinfarkt. SCHÄRFERE WAHRNEHMUNG.
Hinausgehen oder sich drinnen verstecken. Neue Perspektive.
Unten. Gewöhnung. Leiden in die Wahrnehmung einbeziehen.
FREMDBESTIMMUNG. Mit einer Behinderung leben.
Ferngesteuert. Teil der eigenen Identität? ABSCHIEDNEHMEN. Der Tod gehört zum Leben dazu. IM KOPF. Nicht wissen, was mit mir ist. Panik. PERSÖNLICHER WEG. Eine
Krankheit, mit der ich zurechtkommen muss. UNGEWISSHEIT. Was wird passieren? SCHRITT FÜR SCHRITT. Nicht
selbstverständlich. Beim Gehen mitdenken. KÖRPER ALS
TEIL DES ICHS. Was sagt mir mein Leib? Ich bin nicht nur
Kopf. Die Füße gehören zu mir dazu. UNVERSTÄNDNIS.
Prozesse der Entfremdung. Von mir und von der Welt. EMPATHIE. Was heißt Einfühlung? Den Anderen gegenüber. Für
mich. Unlösbar. Ich kann nicht in die Haut Anderer schlüpfen.
TOTALE ABHÄNGIGKEIT. Nicht darüber nachdenken.
Verdrängen. Angst vor der Sinnlosigkeit. Sich umbringen?
Szenenwechsel: Der Wiener Neurologe und Psychiater Paul
Schilder spricht in seiner Studie The Image and Appearance of
the Human Body (1950) von einer flexiblen Organisation des
eigenen Körperbilds. Die Stimme spielt dafür eine wesentliche
Rolle. Als Teil der eigenen Existenz breitet sie sich – als akustisches Bild des individuellen Körpers – in der Welt aus.
The sound produced by me is not completely independent of me.
It still remains a part of myself, and we are again dealing with
the spreading of the body into the world. … The organization of
the body-image is a very flexible one. (Schilder 1978, 188)
Diese Öffnung der Person und ihres Körperbilds in Richtung
äußere Umgebung – sich ausdrücken – findet ihre Gegenbewegung in Eindrücken, die aufgenommen werden. Die Körperhis-
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Einleitung
47
torikerin Barbara Duden geht in Der Frauenleib als öffentlicher
Ort (1991) davon aus, dass von ForscherInnen, ob beim Quellenstudium oder in der Ethnografie, »eine wehrlose Feinnervigkeit,
eine neugierige Dünnhäutigkeit für fremde sinnliche Wahrnehmung« erfordert wird (51). Sie stutzt »gelegentlich beim
Pendeln von der Bibliothek in den Alltag« und »für einen
Augenblick befremdet« sie die eigene »gläserne Haut« (ebd.).
Die Arbeit mit MS-Kranken verlangt, ob von den Behandelnden
oder von mir als Ethnografin, eine einfühlsame Empfindsamkeit
dafür, wie die betroffenen Personen ihre Beschwerden und
Erfahrungen ausdrücken und ihre Wirklichkeiten beschreiben.
Der französische Neurologe J.M. Charcot (1825-1893) hat »die
Erkrankung als erster systematisch beschrieben« (Leutmezer
2007, 16). Auf seine »Arbeiten über die Ursachen« ist auch »der
Name Multiple Sklerose« zurückzuführen (ebd.). Die
Vernarbungen im Körper, die sich durch die Krankheit bilden,
rufen bei den PatientInnen durchwegs unterschiedliche Krankheitsbilder hervor. Verschiedene Erlebnisse werden geschildert.
Der französische Kunsthistoriker Georges Didi-Huberman
beschäftigt sich in Erfindung der Hysterie (1997) ausführlich mit
Charcots wissenschaftlicher Forschung. Aspekte des Performativen und des Imaginären spielen eine zentrale Rolle.
Immerhin hat Charcot eingeräumt: Das therapeutische Mirakel geht
aus einem Wunder hervor, von dem die Körper als hysterisierte
erfüllt sind. Die wundersame Heilung, das ist keine Heilung, sondern ein Symptom, ein hysterisches Symptom. ... Erschaffen und
zerstören, darin besteht genau die Freiheit, die sich einem Regisseur
in der Wiederholung bietet. Die Leçons du mardi sind außerdem
genau wie Theaterstücke geschrieben, neu geschrieben eher, mit
Repliken, Monologen, Regieanweisungen, Selbstgesprächen des
Helden et cetera. ... Dieses Theater ist auch das Theater der
Klassifizierung von Wörtern, der Klassifizierung von Gegenständen/Subjekten (sujets), es ist das Theater der Macht, Taxonomien
von leidenden Körpern herzustellen. (270-273)
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Die kulturgeschichtlichen Implikationen, auf welche DidiHuberman in seiner Analyse von Fallberichten, Vorlesungen
und Fotomaterialien hinweist, hinterlassen bis in die Gegenwart
Spuren in der Behandlung psychiatrischer und neurologischer
Erkrankungen. Eine Vatersprache. In der Biomedizin wird der
Leib zum in seine Einzelteile zerlegten Experimentierfeld.
Narben hören
Ich schlage einen performativen Ansatz vor, der die persönlichen und individuell gefärbten Geschichten von MSPatientInnen sprachlich in Erinnerungsbilder übersetzt, deren
Ursprung in der Akustik der menschlichen Stimme – in der
Muttersprache – liegt. Meine Aufmerksamkeit gilt den alltäglichen Verkörperungen von Personen, die mit dieser Nervenkrankheit leben. Im Vortrag Die Wunde hören (2005), den
Georges Didi-Huberman in Wien gehalten hat, beschreibt er die
»große Kunst der Klage« als »tiefen Gesang« des Menschen. Er
fragt, »ist sein [des Menschen] in jedem Augenblick bedrohtes
Leben nicht zunächst und vor allem ein Sein-zum-Schmerz«
(2)? Der Kunsthistoriker unterscheidet im Wesentlichen zwei
Arten von Schmerz:
Wer seine Klage singt, haucht sie mit seinem (musikalischen) Atem
aus. Der Schmerz besitzt ihn nicht mehr in der destruktiven, austrocknenden Weise des Pathologischen, sondern auf die merkwürdig flüssige und konstruktive Weise des Pathetischen: das Wort
nicht im abschätzig ironischen Sinn verstanden, sondern in dem
Sinn, den die Griechen diesem Wort beilegten ... , um der künstlerischen Kraft einen Namen zu geben, die es erlaubt, den Schmerz in
großen ‚Pathosformeln’ auszudrücken. (4)
Die hier verwendeten Interviewfragmente werden wie
Klagelieder behandelt, wobei der Stimme – im Sinne verkör-
Einleitung
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perter Empfindungen – besondere Aufmerksamkeit geschenkt
wird. Eine Technik der metonymischen Verdichtung des erzählten Stoffs wird entwickelt. Geht MS tatsächlich symbolisch mit
dem Verlust der Zunge einher? Entzieht sich die Nervenkrankheit jeglicher aussprechbaren Übersetzbarkeit? Die einzelnen Lebensgeschichten – die »tiefen Gesänge« – werden
zerschnitten. Übrig bleibt eine berührende Essenz in der Form
von aneinander gehängten Satzteilen und Wortfetzen, die für
sich sprechen. Ein Text als Vehikel. Bewegung wird evoziert.
Gleichzeitig eine unerträglich schmerzhafte Verlangsamung,
welche mit der Krankheit MS häufig einher geht und den Alltag
der Betroffenen durchdringt. In Anlehnung an Heiner Müllers
BILDBESCHREIBUNG (1985). Das sich verflüssigende konstruktive Pathos wird in der Form von gehörten und aufgeschriebenen Metaphern als persönlicher menschlicher Grundstoff – ausgehend von der zuhörenden, verletzlichen ersten
Person, die sich im schreibenden Ich auflöst – darstellbar. Die
Übergänge von einer Vatersprache des Pathologischen und
einer Muttersprache des Pathos verschwimmen. Verletzungen
und ihre zurückbleibenden Narben werden hörbar. Im
Echoraum: »Der Raum der Laute hat – um es mit einer
Metapher anschaulich zu machen – die Form einer Höhle. ...
Ein geschützter, aber nicht hermetisch abgeschlossener Raum.
Ein Hohlraum, in dessen Innerem Rauschen, Echos und
Resonanzen kreisen« (Anzieu 1996, 224). Der Leib als
Kunstwerk: »Blase, Chromosom, Gehirn, Organ, Charakter,
Meerestier...,« beschreibt eine junge an MS erkrankte
Bühnenbildnerin6 ihre Diplomarbeit, in der sie sich »aus gegebenem Anlass, mit meinen eigenen MRT-Bildern vom Gehirn
und von der Halswirbelsäule« beschäftigt, um eine »räumliche
Übersetzung« zu schaffen (2006, 1-2; nicht veröffentlichtes
Konzeptpapier).
Meine Arbeit umfasst drei verschiedene Elemente, die sich inhaltlich mit meiner Körperwahrnehmung in Bezug auf die MRT-
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Untersuchungen und deren Ergebnisse stützt. Es gibt eine dreidimensionale, transparente, amorphe Form, die in ihrem Inneren
zweidimensionale MRT-Bilder enthält. Der Ausstellungsraum, in
dem sich das Objekt befindet, ist über vertikale Linien architektonisch begrenzt. (Ebd., 2)
Das Kunstobjekt – eine organisch anmutende überdimensional
große Blase, in den kühlen Nichtfarben von transparenten
Röntgenbildern – schwebt in einer Zelle ohne Außenwände. An
durchsichtigen Schnüren befestigt, hängt die Blase an vier
Metallständern, die im Boden des Ausstellungsraums verankert
sind. Ein monströses Chromosom bildet, gefangen im Raum,
einen imaginären Corpus. »Ich möchte einen Körper kreieren,
der etwas Wesenhaftes aufweist. Dieses Wesen sollte von
wuchshafter Struktur sein. ... Blicke treffen sich darin« (ebd.).
Vertikale Metallverstrebungen durchschneiden die räumlichen
Vorstellungen. Gewaltmomente werden in der Betrachtung
evoziert. Die medizinischen Bilder ziehen sich als Band in der
Form einer »Endloswirbelsäule« über die vernarbte und verletzlich wirkende Haut des Objekts (ebd., 3). Den biomedizinischen Diskurs als Machttypus, im Sinne Michel Foucaults
Biopolitik des Körpers, blendet die Künstlerin ein, indem sie
ihren eigenen kranken Leib und die Fotos von seinem Innern
exemplarisch einsetzt. Sie stellt sich selbst als Modellpatientin
dar. In seiner Studie Le Moi-peau (1985) entwirft der französische Psychoanalytiker Didier Anzieu Das Haut-Ich (1996) als
»phantasmatische Wirklichkeit« (14). In der Realität des Ichs
als Vorstellungsraum verbindet sich demnach die Haut mit
anderen Sinnen: mit einer »Lauthülle« (Hören), einer »thermischen Hülle« (Wärme- und Kältewahrnehmung), einer
»Geruchshülle« (Riechen), einer »Schmerzhülle« (Schmerzempfinden) sowie mit der »Vertauschung der Geschmackseigenschaften« (Vertauschung von Speise- und Luftröhre).
Metaphorisch betrachtet, eine Flöte. Die Hierarchie der Sinne,
in welcher dem Gesichtssinn wesentliche Bedeutung zukommt,
Einleitung
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löst sich in Anzieus Ansatz weit gehend auf. Er erwähnt den
Marsyas- und den Pan-Mythos. In beiden Mythen, wobei Pan
die Dublette von Marsyas darstellt, wird die Haut mit einer
musikalischen Hülle verknüpft: mit dem Flötenspiel. »Auf den
Sieg von Apollon über Marsyas (der mit einer doppelten Flöte
spielt) folgt der Sieg des griechischen Gottes über Pan in
Arkadien (dem Erfinder der Flöte mit einem Rohr oder Syrinx)
und erhöhte die Bedeutung des ersten Sieges noch« (67). Lisa
Cartwright und Sharon Traweek beziehen sich in ihrem Essay
in diesem Band auf den Mythos Pan und Syrinx in Verbindung
mit Verletzungen des Rückenmarkkanals, die von der Symptomatik her, einer MS täuschend ähneln und entsprechend
schwierig zu diagnostizieren sind. Eine Täuschung spielt auch
in dieser mythischen Überlieferung eine wesentliche Rolle, »...
Pan, als er glaubte, Syrinx schon ergriffen zu haben, anstelle
der Nymphe Sumpfschilf im Arme hielt; wie, während er dort
seufzte, die bewegte Luft im Rohr einen dünnen Ton erzeugte,
der einer Klage glich« (Ovid 1994, 57). Das Musikinstrument
einer Flöte ersetzt die – Stimme der – Frau (Nymphe). Marsyas
wird zur Strafe die Haut abgezogen. »Man erzählt sich nämlich,
dass die Haut des toten Satyrs beim Klange seiner
Heimatmelodien erbebte, dass sie indessen taub und unbeweglich blieb, wenn der Künstler eine Weise zum Preis des Apollo
anschlug« (Frazer 2000, 516). Die Häutung als Metapher findet
sich auch in den Erzählungen von MS-Kranken. Sensibilitätsstörungen: Stacheldraht bohrt sich in die Knöchelgelenke.
Haare im Gesicht stechen wie Nadeln. Dem eigenen Körperbild
als Haut-Ich geht eine akustische Hülle voraus, die sich im
Sprechakt mit jedem Atemzug manifestiert. Das Aufbrausen
des Atems und seine Erschöpfung werden spürbar. Ein motorisches Echo schwingt mit jedem Stimmlaut in mir mit. Breitet
sich in mir aus. Teilweise versagt die Stimme abrupt.
Manchmal bin ich taub für mir fremde Laute. Gespräche gehen
unter die Haut. Nervenkrankheiten wie MS hinterlassen hörbare Narben. Gefangen in den neurologischen Krankenakten.
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Gespeichert im Aufnahmegerät der Ethnografin. Jederzeit
abrufbereit. Obgleich flüchtig. Erinnerungsspuren.
Auf der Suche nach einem Bild, das den Echoraum spürbar
macht, den ich in der Form eines Essays über Empfindlichkeiten erzeuge, stoße ich auf die Skulpturen special reports
(2000) der Künstlerin Azade Köker, mit der ich im Rahmen
eines Ausstellungsprojekts kooperiert habe. Sie schafft dünnhäutige, vernarbte Körperhüllen. Im Kopf verwandle ich diese
menschengroßen, verletzlich anmutenden Gestalten zu akustischen Objekten, die – jedes einzeln für sich – ein eigenes
Klagelied singen. Ich setze die Kopfhörer auf. Stimmen als
Narben im Ohr. Spüre nach. Kopflose honigfarbene Figuren.
Hängen von der Decke. Zähflüssig rinnen die Melodien durch
meinen Leib. Zwischen Schädel und Restkörper eröffnet sich
eine Leere. Ein Echo spiegelt sich im Schwarz der auf weißem
Grund tanzenden Buchstaben. Das schreibende Ich taumelt,
stagniert mit einem Seufzer. Ein Riss in der Leitung. Die
Verbindung bricht ab.
Notes
1
Der Komponist und Musikwissenschafter Thomas Dezsy hat mich auf
das Stück Die menschliche Stimme von Jean Cocteau und Francis
Poulenc aufmerksam gemacht.
2
Vgl. Ingeborg Bachmann und Heiner Müller.
3
Die Hörproben sind Teil eines gemeinsam geplanten längerfristigen
Forschungs- und Musiktheaterprojekts über Die menschliche Stimme.
4
Insgesamt wurden für das Buchprojekt Multiple Sklerose (Leutmezer
2007) sieben Interviews mit PatientInnen und zwei mit Neurologen
geführt. Ein Erfahrungsbericht von einer Patientin konnte nicht verwendet werden. Sieben Gespräche wurden bis auf eines, das bereits im
Mai 2005 stattfand, alle im Frühling 2006 durchgeführt. Die Stimme
von Cathrin Pichler ist nicht in diesem Essay enthalten, da sie selbst
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Einleitung
als Mitherausgeberin der Verkörperungen einen persönlichen
Erfahrungsbericht schreibt.
5
Cathrin Pichler ist die erwähnte Freundin und Kollegin.
6
Um die Anonymität der jungen Frau zu schützen, die zwischen 2004
und 2006 bei mir an der Universität für angewandte Kunst
(Angewandte) in Wien mehrere Seminare zu Körperlichkeit in der
Medizin besucht hat, wird ihr Name in diesem Essay nicht erwähnt.
References
Anzieu, Didier (1996) Das Haut-Ich. Frankfurt am Main: Suhrkamp.
Bachmann, Ingeborg (1980) Malina: Roman. Frankfurt am Main:
Suhrkamp.
Barthes, Roland (1984) Fragmente einer Sprache der Liebe. Frankfurt am
Main: Suhrkamp.
Braun, Christina von (2001) Versuch über den Schwindel. München und
Zürich: Pendo.
Didi-Huberman, Georges
(1997) Erfindung der Hysterie. München: Fink Verlag.
(2005) Die Wunde hören (Vortragstext). Wien: Da Ponte Institut.
Duden, Barbara (1991) Der Frauenleib als öffentlicher Ort: Vom
Missbrauch des Begriffs Leben. Hamburg: Luchterhand.
Emerson, Caryl und Holquist, Michael (2002) M.M. Bakhtin: Speech
Genres and Other Late Essays. Austin: University of Texas Press.
Frazer, James G. (2000) Der goldene Zweig: Das Geheimnis von Glauben
und Sitten der Völker. Reinbek: Rowohlt.
Haß, Ulrike (2005) Heiner Müller: Bildbeschreibung, Ende der
Vorstellung. Berlin: Theater der Zeit.
Holquist, Michael (2000) The Dialogic Imagination: Four Essays by M.M.
Bakhtin. Austin: University of Texas Press.
Hörnigk, Frank (2001) Heiner Müller: Werke 4, Die Stücke 2. Frankfurt
am Main: Suhrkamp.
Köker, Azade
(2000)
special
reports:
Installationen,
Objekte.
Ausstellungskatalog. Berlin: Bildhauer Foyer Constanze Pressehaus.
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Christina Lammer
Leutmezer, Fritz (2007) Multiple Sklerose: Ein Lesebuch. Wien:
Eigenverlag.
Macho, Thomas (2004) Die Stimmen der Doppelgänger, 39-56, in: Brigitte
Felderer (Hg.), Phonorama: Eine Kulturgeschichte der Stimme als
Medium. Berlin: Matthes & Seitz.
Merleau-Ponty, Maurice (1994) Das Sichtbare und das Unsichtbare.
München: Fink Verlag.
Ovid (1994) Metamorphosen. Stuttgart: Reclam.
Poirier, Suzanne (2002) Voice in the Medical Narrative, in: Rita Charon
und Martha Montello. Stories Matter: The Role of Narrative in
Medical Ethics. New York: Routledge.
Schilder, Paul (1978) The Image and Appearance of the Human Body. New
York: International Universities Press.
Weigel, Sigrid (2004) Echo und Phantom – die Stimme als Figur des
Nachlebens, 57-70, in: Brigitte Felderer (Hg.), Phonorama: Eine
Kulturgeschichte der Stimme als Medium. Berlin: Matthes & Seitz.
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Alexander Kluge
Es sind nun schon mehrere Monate in denen mich ein
Erfahrungsbericht zum Thema MS, dem Thema meiner
Krankheit, beschäftigt. Nach mehrmaligem Scheitern, einen –
wenn auch nur kleinen, ausschnitthaften – Bericht meines
Erlebens niederzuschreiben, versuchte ich meinen Widerständen,
die von Versuch zu Versuch stärker wurden, auf die Spur zu kommen. Warum verloren sich die Gedanken immer wieder in einem
unentwirrbaren Amalgam von Erinnerungen, die Ereignisse,
Worte, Bilder, Sätze und Erlebnisse ineinander fließen ließen
und nichts mehr festzuhalten erlaubten? War die Menge des
Erlebten zu groß oder zu Angst- und Leid besetzt, als dass man
sie noch einmal als Text zur Wirklichkeit hätte bringen können?
War die Geschichte dieser Krankheit schon zu lange geworden –
waren zehn, vielleicht sogar zwanzig Jahre nicht mehr darstellbar? Oder lag die Unmöglichkeit in der Darstellung selbst – hatte
meine Sprachlosigkeit mit Sprache zu tun? Ich denke, sie hatte.
Nicht bloß im Sinne von Verständigung – dem bekannt unlösbaren Problem, einen abweichenden körperlichen und mentalen
Zustand (mental-körperlichen Status müsste man eigentlich
sagen) verständlich und verstehbar zu machen, sondern ganz
grundsätzlich im Gebrauch der Sprache für gelebte Erfahrung:
»Eine der am meisten irreführenden Darstellungsweisen unserer Sprache ist der Gebrauch des Wortes »ich«, besonders dort,
wo sie damit das unmittelbare Erlebnis darstellt...« schreibt
Ludwig Wittgenstein, bezeichnenderweise am Beginn seiner
Auseinandersetzung mit der Darstellung des Schmerzes.1
Vor allem aber hat Sprachlosigkeit mit Identität zu tun: Sprache
ist im Feld lebendiger Wirklichkeit angesiedelt, gehört zu
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einem (meinem) Teil der Identität, der noch intakt erscheint,
einem Ort, entgegengesetzt zu dem lebensfernen Feld der
Krankheit, ihrer Zerstörung und einem entfremdeten Teil von
Identität. Sprache gewährt manchmal Zuflucht.
Die Unterscheidung von Sprache und Dasein, von erhaltener
und verlorener Identität musste bewahrt werden – das begründete die Unmöglichkeit gerade jenen zerbrochenen Teil der
Identität mit »ich« zur Sprache zu bringen.
Um die »Taxonomie des Leidens« (Georges Didi-Hubermann)
nicht resignierend dem medizinischen Vokabular zu überantworten, habe ich mich für einen Umweg entschieden: ich leihe
mir die Sprache eines Anderen; ganz so wie man im Diskurs
wichtige Gedankengänge mit Zitaten untermauert oder bestätigt.
Es sind dies Auszüge aus dem Journal eines englischen Naturwissenschaftlers – eines »Naturalisten« wie sein Titel lautete –,
der vor nicht ganz hundert Jahren über sich und seine
Erkrankung geschrieben hat. Bruce Frederick Cummings (1889
– 1919), Paleontologe und Insektenforscher schrieb unter dem
Pseudonym W.N.P. Barbellion.2
December 22, 1912
Paleontology has its comfortable words too. I have revelled in my
littleness and irresponsibility. It has relieved me of the harassing
desire to live, I feel content to live, dangerously, indifferent to my
fate; I have discovered that I am a fly, that we are all flies, that
nothing matters. It’s a great load off my life, for I don’t mind being
such micro-organsism – to me the honour is sufficient of belonging
to the universe – such a great universe, so grande a scheme of
things. Not even Death can rob me of that honour. For nothing can
alter the fact that I have lived; I have been I , if for ever so short a
time. And when I am dead, the matter which composes my body is
indestructible – and eternal, so that come what may to my ›Soul‹,
my dust will always be going on, each seperate atom of me playing
its seperate part – I still have some sort of a finger in the Pie. When
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I am dead you can boil me, burn me, drown me, scatter me – but you
cannot destroy me: my little atoms would merely deride such heavy
vengeance. Death can do no more than kill you...
August 1, 1915
I am getting married ......on September 15th.
It is impossible to set down here all the labyrinthine ambages of my
will and feelings in regard to this event. Such incredible vacillations, doubts, fears. I have been living at a great rate below surface
recently. ›If you enjoy only twelve months’ happiness,‹ the Doctor
said to me, ›it is worth while.‹ . . .
This power in me is growing daily more automatic and more repugnant. It is a nasty morbid unhealthy growth that I want to hide if I
cannot destroy. It amounts to being able at will to switch myself in
and out of all my most cherished emotions; it is like the case in Sir
Michael Foster’s Physiology of a man who, by pressing a tumour in
his neck could stop or at any rate control the action of his heart.
August 12, 1915
Fourteen days hence I shall be a married man. But I feel most dejected about it. When I fell down the other day, I believe I slightly concussed my spinal column, with the result that my 1913 trouble has
returned, but this time on the left side! Paralysis and horrible vertigo and presentiments of sudden collapse as I walk.
September 1,1915
My 26th birthday. In London again. Went straight to the Doctor and
reported myself. I quite expected him to forbid the marriage as I
could scarcely hobble to his house. To my amazement, he apparently made light of my paralysis, said it was a common accident to bruise the os coccyx, etc.
November 8, 1915
The record nauseates me. I am nauseated with myself and my selfcentredness. . . . Suppose I have been ›whizzing‹ as I call it – what
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then? They are but subjective trifles – meanwhile other men are
seeing great adventures in Gallipoli and elsewhere. ... How I envy
all these men who are participating in this War – soldiers, sailors,
war correspondents – all who live and throb and are not afraid. I am
a timid youth, ansemic, wear spectacles, and am frightened by a
Zep3 raid! How humiliating! I hate myself for a white-livered craven: I am suffocated for want of more life and courage. My damnable body is slowly killing off all my spirit and buoyancy. Even my
mind is becoming blurred. My memory is like an old man’s exactly.
November 27, 1915
Today, armed with a certificate from my Doctor in a sealed envelope and addressed ›to the Medical Officer examining Mr W. N. P.
Barbellion,‹ I got leave to attend the recruiting office and offer my
services to my King and Country. At the time, the fact that the envelope was sealed caused no suspicion and I had been comfortably
carrying the document about in my pocket for days past.
Of course I attended merely as a matter of form under pressure of
the authorities, as I knew I was totally unfit – but not quite how
unfit. After receiving this precious certificate, I learnt that K– was
recruiting Doctor(–), and he offered to ›put me thro’ in five minutes,‹ as he knows the state of my health. So at a time agreed upon, I
went to-day and was immediately rejected as soon as he had stethoscoped my heart. The certificate therefore was not needed, and
coming home in the train I opened it out of curiosity. . . . I was
quite casual and thought it would be merely interesting to see what
– M – said. It was. ›Some 18 months ago,‹ it ran, ›Mr Barbellion
shewed the just visible symptoms of – – ‹ – and altho’ this fact was
at once communicated to my relatives it was withheld from me and
–) – M – therefore asked the M.O. to respect this confidence and to
reject me without stating on what grounds. He went on to refer to
my patellar and plantar reflexes, by which time I had had enough,
tore the paper up and flung it out of the railway carriage window. I
then returned to the Museum intending to find out what – – was in
Clifford Allbutt’s System of Medicine. I wondered whether it was
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brain or heart; and the very thought gave me palpitation. I hope it is
heart – something short and sharp rather than lingering. But I believe it must be – – of the brain, the opposite process of softening
occurring in old age. I recall M – ’s words to me before getting married: that I had this ›nerve weakness,‹ but I was more likely to succumb to pneumonia than to any nervous trouble, and that only 12
months’ happiness would be worth while. On the whole I am amazed at the calm way in which I take this news. I was a fool never to
have suspected serious nerve trouble before......
November 28, 1915
As soon as I woke up in this clear, country air this morning, I
thought: – – . I have decided never to find out what it is. I shall find
out in good time by the course of events. A few years ago, the news
would have scared me. But not so now. It only interests me.
December 5, 1915
I believe it’s creeping paralysis. My left leg goes lame after a short
walk...
Je länger ich Barbellions Journal studiere, desto mehr
Bekanntes finde ich, die Erfahrungen wie die Gedanken sind
ganz ähnlich, manches gleicht Spiegelungen des selbst
Erlebten, der eigenen Reaktionen.
Multiple Sklerose – so hieß die Krankheit bereits Ende des 19.
Jahrhunderts – war und ist ein Tabu. Der Name wird verschwiegen, im Text in Auslassungen – –, verschwiegen vor
dem Publikum, verheimlicht vor dem Patienten, verheimlicht
zunächst auch vor seinem sozialen Umfeld. Verheimlichen
möchte man auch das Erlebte, verheimlichen ‚was einem
geschieht, Barbellion will es »verstecken, wenn er es nicht zerstören kann«.
So mysteriös, so unfassbar, so fremd und Besitz ergreifend ist,
was man erlebt und erfährt – hat es einmal einen Namen, eine
Bezeichnung erhalten, ist man zunächst erleichtert – es ist
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›wirklich‹, nicht bloß Einbildung oder Wahn. Dennoch wachsen Zweifel, Ängste und Unsicherheit, alles gerät ins
Schwanken, das Ich verliert das Gleichgewicht, gleich dem
schwankenden Körper: man will es gar nicht genauer wissen –
»nie« will man es wissen, schreibt Barbellion, dann aber sucht
man im Lexikon und findet es »interessant«, hochinteressant
am Ort wissenschaftlicher Abstraktion, weit entfernt allerdings
vom Ort des erlebten Ausgeliefertseins und des Erschreckens.
Manchmal gelingt es für kurze Zeit zu flüchten, gleichsam zu
einem früheren Selbst zurückzukehren: ›vielleicht ist es nicht
wahr, es kann doch nicht wahr sein‹ – es kehrt ein Körper
zurück, der Raum und Zeit empfindet, der Seins- und
Daseinsempfindungen hat, ein Körper, der nicht mehr »abgetrennt« von seinem Ich ist. – Barbellion beschreibt eine solche
Rückkehr – bis zum langen, schweren Rückweg in sein
»Gefängnis«.
August 29, 1915]
It is fine to walk over the elastic turf with the wind bellowing into
each ear and swirling all around me in a mighty sea of air until I was
as clean-blown and resonant as a sea-shell. I moved along as easily
as a disembodied spirit and felt free, almost transparent. The old
earth seemed to have soaked me up into itself, I became dissolved
into it, my separate body was melted away from me, and Nature
received me into her deepest communion – until, UNTIL I got on the
lee side of a hedge where the calm brought me back my gaol of
clay.4
Der »abgetrennte«, fremd gewordene Körper wird zunehmend
zum Drehpunkt aller Wahrnehmung und Empfindung. Er
beschränkt die Möglichkeiten des Ausdrucks, erzeugt Ängste
und lässt Identät brüchig werden. »Der verdammenswerte
Körper tötet langsam allen Geist und jeden Auftrieb« sagt
Barbellion. Die Welt wird fremder und zugleich entfremdet sich
das Selbst, es ist nicht verloren aber immer weniger und weni-
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ger erreichbar. Man lebt oder existiert in einer (welt)fremden
Sphäre, entfernt von der Wirklichkeit – »unter der Oberfläche«
nennt es Barbellion.
Zugleich ist nach außen – in der Wahrnehmung Anderer und der
umgebenden Welt – Identität mit dem Körper und seiner
Präsenz verbunden; dieses Wissen fügt der brüchigen Identität
die Demütigung hinzu und zerbricht sie schließlich. – Ein anderes, fremdes Selbst entsteht, die Krankheit wird zur Identität.
Barbellion beneidet alle die, die in den Krieg gehen konnten,
alle, die in diesem Krieg »leben und keine Angst haben.«
January 20, 1917
I am over 6 feet high and as thin as a skeleton; every bone in my
body, even the neck vertebrae, creak at odd intervals when I move.
So that I am not only a skeleton but a badly articulated one to boot.
If to this is coupled the fact of the creeping paralysis, you have the
complete horror. Even as I sit and write, millions of bacteria are gnawing away my precious spinal cord, and if you put your ear to my
back the sound of the gnawing I dare say could be heard...
March 8, 1917
As, for all practical purposes, I have done with life, and my own existence is often a burden to me and is like to become also a burden
to others, I wish I possessed the wherewithal to end it at my
will.With two or three tabloids in my waistcoat pocket, and my
secret locked in my heart, how serenely would move among my
friends and fellows, conscious that at some specially selected
moment – at midnight or high noon – just when the spirit moved me,
I could quietly slip out to sea on this great Adventure. I would be
well to be able to control this. The time, the place, and the manner
of one’s exit. For what disturbs me in particular is how I shall conduct myself; I am afraid lest I become afraid, it is a fear of fear. By
means of my tabloids, I could arrange my death in an artistic setting,
say underneath a big tree on a summer’s day, with an open Homer
in my hand, or more appropriately, a magnifying glass and Miall and
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Denny’s Cockroach. It would bet he stage-managing my own demise and surely the last thing in the self-conscious elegance!...
August 7, 1917
I become dreadfully emaciated. This morning, before getting off the
bed I lifted my leg and gazed wistfully along all ist length. My flabby gastrocnemius (calf muscle) swung from the tibia like a gondola from a Zeppelin. I touched it gently with the tip of my index finger and it oscillated....
September 3, 1917
My bedroom is on the ground floor as I cannot mount the stairs. But
he other day when they were all out, I determined to clamber
upstairs if possible, and search in the bedrooms for a half-bottle of
laudanum, which Mrs – told me she found the othr day in a box, a
relic of the time when – had to take it to relieve pain.
I got off the bed on the floor and crawled around on hands and knees
to the door, where I knelt up straight, reached the handle and turned
it. Then I crawled acrosss the hall to the foot of the stairs, where I
sat down on the bottom step and rested. It is a short flight of only 12
steps and I soon reached the top by sitting down on each and raising
myself up to the next one with my hands.
Arrived at the top, I quickly decided on the most likely room to
reach first, and painfully crawled along the passage thro’ the bathroom by the easiest route to the small door – there are two. The
handles of all the doors in the house are fixed some way up above
the middle, so that only by kneeling with a straight back could I
reach them from the floor. This door in addition was in the top of a
high but narrow step, and I had to climb on to this, balance myself
carefully, and then carefully pull myself up towards the handle by
means of a towel hung on the handle. After three attempts I reached
the handle and found the door locked on the inside.
I collapsed on the floor and could have cried. I lay on the floor of
the bathroom resting with head on my arm, then set my teeth and
crawled around the passage along two sides of a square, up three
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more steps to the other door which I opened and then entered. I had
only examined two drawers containing only clothes, when a key turned in the front door lock...
I closed the drawers ad crawled out of the room... I whistled, and
said that being bored I had come up to see the cot: which passed at
that time all right.
September 4, 1917
I am getting ill again, and can scarcely hold the pen. So good-bye
Journal – only for a time perhaps.
Barbellions Journal zeigt es: auch die Sprache ist schließlich
kein Ausweg, bloß Umweg. Sie lässt wohl eine zweite Wirklichkeit entstehen, erlaubt Distanz zum Körper aber kein
Entfliehen und schon gar keine Erlösung aus jenem gelebten
Dasein. Alle Flucht wird zur Illusion, dem Körper einmal wirklich entfliehen zu können, wird zum großen Phantasma, vorgestellt in immer neuen Bildern und Inszenierungen und scheint
doch zu scheitern, weil solches Fliehen zwar zur Sprache
kommt, aber in der Imagination verharrt, unbeweglich wie der
Körper.
Michel Foucault erinnert an die Seele als Möglichkeit des
Flüchtens: »Doch die wohl hartnäckigste und mächtigste unter
diesen Utopien, mit denen wir die traurige Topologie des
Körpers auszulöschen versuchen, ist der große Mythos der
Seele. ... Die Seele funktioniert in meinem Körper auf wundersame Weise. Sie wohnt zwar darin, kann ihm aber auch entfliehen. Sie entflieht ihm, um die Dinge durch die Fenster meine
Augen zu betrachten. Sie entflieht ihm, um zu träumen...«5
Was aber, wenn die Seele schon immer in das seltsame Dasein
enfremdeten Selbsterlebens miteingebunden ist? Foucault
bemerkt die Macht des Körpers gegenüber der Seele: »Doch in
Wirklichkeit lässt sich mein Körper nicht so leicht reduzieren.
Schließlich besitzt auch er seine eigenen Quellen des
Fantastischen«.6
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Cathrin Pichler
Diese Quellen verschließen sich wohl mehr und mehr und Seele
wie Körper finden sich in einem »Sein-zum-Schmerz« (DidiHubermann), das Barbellion in Worte fasst, die ich nicht anders
formulieren könnte und wollte:
The reason I do not spend my days in despair and my nights in hopeless weeping simply is that I am in love with my own ruin. I therefore deserve no sympathy, and probably shan’t get it: my own profound self-compassion is enough. I am so abominably self-conscious that no smallest detail in this tragedy eludes me. Day after day
I sit in the theatre of my own life and watch the drama of my own
history proceeding to its close.
Notes
1
Ludwig Wittgenstein: Philosophische Bemerkungen (1930), Frankfurt
a.M. 1964, S.88
2
W.N.P. Barbellion (Bruce Frederick Cummings 1889 – 1919) war
Autodidakt, mit 22 Jahren errang er über einen Wettbewerb einen Platz
als Naturwissenschaftler im Natural History Museum, South
Kensington. Wahrscheinlich litt er bereits zu diesem Zeitpunkt an
Multipler Sklerose.
Barbellion war »Naturalist«, Anhänger einer Philosophie, die die
Gesetze der Natur zum leitenden Prinzip machte.
Seine Schriften und vor allem sein Journal, das im Jahr seines Todes
als Journal of a Disappointed Man erschien, erlangten grosse
Berühmtheit. Seine Schreibweise wurde u.a. mit James Joyce verglichen; zu dem Journal schrieb H.G.Wells in seinem Vorwort: »Fate
has overtaken him«.
Barbellion verwendet einige nicht mehr gebräuchliche englische
Worte, ebenso wie Begriffe (z.B. ›whizzing‹, ›blurr‹), die metaphorisch erlebte Empfindungen und Körpererfahrungen verdeutlichen.
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3
Zep bedeutet Luftangriff der Deutschen mit Zeppelin auf London.
4
gaol in clay bedeutet Kerker aus Lehm bzw. Gefängnis des irdischen
(körperlichen) Daseins
5
Michel Foucault: Die Heterotopien – Der utopische Körper, Frankfurt
a.M. 2005, S.27
6
Ebd., S.28
Cathrin Pichler – Studies in communication science, psychology, sociology and art history – University of Vienna; Dr. phil. 1973 (»Aesthetic
communication – analytical and empirical approaches«); Research in social sciences – Key researcher Institute for Conflict Research, Vienna;
Academy of Science, Vienna (1977 – 1985). Since 1985 exhibition works
and lecturing. Curator of Visual Arts of the Ministery of Education and
Arts (1992-1994); Visiting professor – Hochschule für Angewandte Kunst
and Academy of Fine Arts, Vienna (1995-2002); Chief curator –
Kunsthalle, Vienna (1996-2000); Works as festival and museums council;
Lecturing (selection): University of Vienna, University Klagenfurt,
Technical University, Vienna, Jan van Eyck Academy, Maastricht.
Exhibitions (selection): »Kunst mit Eigen-Sinn«, Vienna 1985;
»Wunderblock – A history of the modern soul« (with Wolfgang Pircher,
Jean Clair), Vienna 1989; »Passed Future – Czech modernity 1890-1918«,
Vienna 1993, Kassel and Prague 1994; »L’Ame au Corps« (with JeanPierre Changeux, Jean Clair), Paris 1993; »Identità e Alterità« (with Jean
Clair), Biennale di Venezia, 1995; »The Sixth Sense«, Austrian pavillion,
Frankfurter Buchmesse, 1995; »Engel:Engel«, Vienna, 1997, Prague
1998; »Hommage à Antonin Artaud«, Vienna 2002.
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Nervöse Konvergenzen
Schreibt Cathrin Pichler einleitend darüber, wie sie sich selbst – außer sich
und dennoch exemplarisch für Andere – fremd wird, seit sie mit der unheilbaren Nervenkrankheit Multiple Sklerose (MS) lebt, entwickeln Lisa
Cartwright und Sharon Traweek in ihrem Essay ähnliche Szenarien. Beide
Autorinnen erfahren jahrelange medizinische Falschdiagnosen. Sie leiden
an Verletzungen des Rückenmarks. Lisas neurologische Ausfälle werden
auf ein stressiges Leben zurückgeführt. Bei Sharon wird zuerst fälschlicherweise MS diagnostiziert. Magnetresonanzaufnahmen befördern
schlussendlich bei Lisa eine Syringomyelie (SM) zutage – zwei Jahre nach
dem Sportunfall, bei welchem sie sich die Wirbelsäule verletzt. Nahtlos
wechseln Lisa und Sharon in ihren Ausführungen von der dritten zur ersten
Person. Sie setzen ihren kritischen und analytischen Hebel an der eigenen
wissenschaftlichen und feministisch orientierten Sozialisation an, durch
die hindurch sie gelernt haben, Objektivität sorgfältig von Subjektivität zu
trennen. Beide vermeiden während ihrer akademischen Karrieren konsequent dieses Thema zu berühren oder gar rational – als machtpolitischen
und ideologischen Diskurs – zu erforschen und gegen den Strich zu bürsten.
Sharon zitiert selbstkritisch einen Text (1999), in dem sie über sich als
Patientin in der dritten Person schreibt. Außer sich. Sie projiziert buchstäblich eigene Erfahrungen auf einen anderen Körper. Ein intellektueller
Akt hysterischer Mimikry? Während eines Vortrags spürt sie eine Seite
ihres Leibs nicht mehr, kann sich gerade noch bewegen. Ein Neurologe
diagnostiziert ihren Zustand als Hysterie und erklärt seinen Studierenden,
dass es sich bei den beschriebenen Symptomen um Stress einer Frau mittleren Alters handelt, die an exzessivem Erfolg leidet. Lisas Ärzte führen
ihre Schluck- und Atemprobleme, die Gefühlsstörungen auf der Haut und
den zuckenden Finger auf ihren psychologischen Zustand zurück. Sie ziehen in Erwägung, die Frau mit Antidepressiva zu behandeln und lehnen
ihre Anfrage ab, Magnetresonanzaufnahmen zu machen. Außer sich.
Veränderungen des Leibs und seiner Organe spiegeln sich im Körperbild
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Christina Lammer
wider. Die körperliche Verfassung, in der sich Personen mit
Nervenkrankheiten wie MS, SM oder Verletzungen des Rückenmarks
befinden, passt nicht mehr mit dem eigenen mentalen Schema und mit dem
gewohnten Selbstbild zusammen, definiert Elizabeth Grosz jenen Prozess
der Fremdwerdung, der in der neurologischen Fachliteratur als
Depersonalisierung (depersonalization) bezeichnet wird. Gefühle werden
folgendermaßen charakterisiert: das eigene Leben wird von außerhalb –
des physischen und/oder mentalen Leibs – beobachtet. Alleine diese
Aussage wirkt provokant und zugleich irritierend. Trifft sie nicht den
symptomatischen Kern dessen, was wir als forschende, denkende, schreibende, neugierig lesende und beobachtende... Frauen und Männer verkörpern? Die Trennung zwischen Objektivität und Subjektivität geht
WissenschafterInnen sprichwörtlich in Fleisch und Blut über. Wessen
Geschichten erzählen wir? Verleugnung der eigenen Person zugunsten der
Konstruktion einer als objektiv konstruierten wissenschaftlichen Wahrheit,
die zwangsläufig stets Illusion bleibt. Eine Erzählung von vielen.
Lisa Cartwright is Professor of Communication at the University of
California at San Diego, where she is also on the faculty of the programs
in science studies and critical gender studies. She is the author of Moral
Spectatorship and Images of Waiting Children (both forthcoming from
Duke University Press) and Screening the Body: Tracing Medicine’s Visual
Culture (University of Minnesota Press, 1995) and co-author with Marita
Sturken of Practices of Looking: An Introduction to Visual Culture (Oxford
2001).
Sharon Traweek is Associate Professor in the History Department at
UCLA. She is the author of Beamtimes and Lifetimes: The World of High
Energy Physicists (Harvard University Press, 1988). She is completing
books on Japanese big science, and crafting cultural studies of science,
technology, and medicine. She has numerous articles in anthropology,
Asian studies, communications, cultural studies, history, and women’s studies.
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Lisa Cartwright and Sharon Traweek
Nervous Convergences
MS/SM, or, inter-biographical remarks
on subjectivity, spinal cord injury and diagnosis
After fifteen years of inhabiting intersecting intellectual spheres in feminist science and technology studies, we learned by
chance that we had both experienced years of medical misdiagnosis leading up to a late surprise diagnosis of severe spinal
cord injury. We both, unbeknownst to one another, struggled to
account for our mysterious experiences of progressive limb and
organ function loss. Both of us were belatedly subject to imaging studies that revealed severe compression of the spinal cord
in the cervical region. We both underwent surgery to remove
and replace portions of our spines. Sharon was initially diagnosed with MS (Multiple Sclerosis), a diagnosis she lived with
for 15 years before her injury was correctly diagnosed. Lisa, at
about the same time, was given the diagnosis of SM (syringomyelia, a condition resulting from a lesion of the spinal cord)
through an MRI taken two years after the injury that caused the
condition. It had been previously suggested that her neurological problems were a result of a stressful life.
As feminists working in science studies on issues of gender,
health, and biomedicine, we found our experiences uncannily
reflected not in one another’s public research but in one another’s private medical narratives, stories constituted through
mistakes in attribution that we carefully shielded from the
public eye. As we learned about this convergence of our misdiagnosed neural pathology belatedly, we registered another nervous convergence. Not only had we shared a condition for
which we were belatedly diagnosed, we also shared the expe-
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rience of hiding our physical symptoms and conditions from
public view. We saw ourselves as having experienced a kind of
silent experiential mirroring, humorously reflected in our mirrored pair of neurological diagnoses: MS and SM. But this
coincidence remained invisible during its most intense manifestations. Our mutual silence was in part a product of the pressures against professional disclosure and a reaction to the stigma
of living a physical disability whose exterior signs remained
ambiguous and which for years went unnamed or labeled with
that bane of feminist scholarship, hysteria. There was no title,
no disability classification, to which we could lay claim with
confidence and without shame.
First person medical narratives
In the remarks that follow, we slip between the »I« and the
»we« to refer to experiences one or the other or both of us has
had, and to reference writing that one or the other or both of us
has produced. This is our attempt to weave together our stories
from both sides of the split position we occupy as women who
live with an accommodated spinal cord injury, and as women
who occupy the positions of researcher and research subjects in
the realm of the body and health. In playing with voice,
authorship and agency in the text below, we wish to enact a
movement away from a politics that privileges experience in
narratives of disability, even as we offer reflections on our own.
In a talk given in April 2005 at Lancaster University, Janet
Price remarked that feminist work on the body has always set
its sights from the neck down. We second that remark with the
observation that psychoanalytic feminism sees the body from
the neck up. Hysteria is alive and well as an informal diagnostic
category used in neurology for those of us with disorders that
have neurological manifestations in the in-between, the liminal
and transitive space between mind and body. Whereas in
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psychoanalysis somatic symptoms are interpreted as displaced
manifestations of psychic pathology, in Lacanian feminism
attributions of somatic pathology are interpreted as hostile projections, discursive inscriptions foisted upon the bodies of
women. How, then, can we begin to have a dialog on the nervous system, given this history? In 1987, Deleuze and Guatarri
asked:
Is it really so sad and dangerous to be fed up with seeing with your
eyes, breathing with your lungs, swallowing with your mouth, talking with your tongue, thinking with your brain…? Why not walk
on your head, sing with your sinuses, see through your skin. …
Where psychoanalysis says, stop, find your self again, we should
say instead, »Let’s go further still. … Find your body without
organs. Find out how to make it. It’s a question of life and death«
(Deleuze and Guattari 1987, 151).
We read this text with irony, remembering experiences that led
us to document moments like the one below, where we felt the
strongest nostalgia for the organization of the nervous system
that would allow us to do the everyday, to experience swallowing with the mouth and breathing with our lungs without registering failures in the system, without registering anything at
all:
In the last few weeks my digestive symptoms have come to the foreground, but one of my fingers continues to twitch, my feet and
ankles demand attention at random moments. My lungs and throat
spasm in the mornings. Sometimes the twitching is visible on the
surface of my skin. I stare at the pulsing flesh to reassure myself that
when the twitching is internal and not visible on the surface it too
must be real. When I swallow and find that once again I have eaten
with my respiratory tract, I remind myself, as I reflexively cough the
food out of my windpipe, that becoming a body without organs is a
question of life and death that does not require my conscious input.
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There is a certain shame to feeling unable to live up to the
vision of a body without organs even as a radically reorganized
body presents itself to us as our own. Of what value is a testimonial like the one above? We are so conditioned by our
experience in the academy to believe that any violation of the
canons of ›objective‹ discourse means that the account is ›personal‹ or ›confessional.‹ In what follows, a passage from an
essay titled Warning Signs: Acting on Images« published in an
anthology of feminist and techno-scientific perspectives on biomedicine in 1999, I deliberately avoided using any references
to ›emotional states of mind.‹ In that essay I explicitly used this
strategy to emphasize that we academic researchers have been
quite powerfully socialized to be very uncomfortable even raising the question of how we differentiate ›subjectivity‹ from
›objectivity‹. The intensity of our socialization is strongly correlated with the intensity of our desire to avoid this subject. It
is almost impossible, paradoxically, for a fully initiated academic researcher to be willing to explore this subject rationally. I
wrote that this essay is about the intellectual constraints of that
canon and the implications for our research; it is not about me.
I wrote in 1999:
Doctors at a major research hospital told an informant, a female graduate student, that she had permanent cervical damage to her neck
from an earlier car accident. Some advised her that the deterioration
could be slowed by wearing a brace the rest of her life; the head of
the department said that if she were to train herself to have perfect
posture at all times, she could go without the brace. About ten years
later while giving lectures at another university she found herself
numb on one side, but able to move.
A prominent neurologist at a major research and teaching hospital
diagnosed her problem as hysteria, explaining to his students that
this hysteria was due to what he called the stress on a middle-aged
woman suffering from »an excessive level of success.«
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Intellectual acts of hysterical mimicries
The displacement of an experience onto another body: The
French neurologist Jean-Martin Charcot described the stage of
hysteria called attitude passionelles in which the patient gives
herself over to mimicry. Some patients, however, also scream in
connection with their sentiments, and some make long speeches
(comp. ARG Owen 1971, Hysteria, Hypnosis and Healing).
Another neurologist who knew the informant called the first doctor
to say that the patient did not »somatize stress«; with this new information the first doctor then ordered further diagnostic tests: CAT
scans, MRI, spinal taps, and so on. According to the doctors, those
first tests and ones done two years later revealed that her neck or
»cervical region« was damaged, just as the doctors had argued
twelve years earlier after her serious car accident; furthermore, they
said she had two of four signs of MS, now known to be exacerbated
by the stress of pregnancy. Her neck’s cervical region had joined her
reproductive cervical region as a contested discursive site. (Traweek
1999)
Elizabeth Grosz describes changes to the body and its organs as
a result of disease as they are reflected in changes in body
image. Her point is followed by reference to depersonalization,
in which the subject loses interest in bodily zones or the whole
of the body (Grosz 1994, 76 and 84-5). Disease, Grosz
explains, typically is progressive, producing an unstable and
changeable body that is always out of sync with prior mental
images of the body. This temporal mismatching of material
condition and one’s own mental schema is partly responsible
for depersonalization. Depersonalization is a term introduced
by neurologist Ludovic Dugas in 1898. The Merck’s Manual
defines depersonalization as: »Persistent or recurrent feelings
of being detached from one’s body or mental processes and
usually a feeling of being an outside observer of one’s life.«
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While on a trip to Penn State to give a couple talks I began to
have numbness in one arm and some vision problems. Charcot
included anesthesia as one of the somatic manifestations of
hysteria. When I returned to Houston I was referred to a neurologist at the University of Texas Medical Center. After asking
me many questions (in front of various medical students) about
my trip and the onset of my symptoms he turned to the medical
students and said that clearly my »success« was »too stressful
for a middle-aged woman.« I laughed and interrupted him, saying that perhaps he didn’t know that giving invited talks, especially named lectures, was one of the pleasures of academia, not
one of the stresses, but the doctor was not deterred. Hysteria
came to signify the nature of the communication between doctor and patient. If the patient could convince the doctor of the
authenticity of the illness behind her condition she might escape the diagnosis of malingering or hysteria. At the same time,
in another place:
As my respiratory system gave out my chronic cough turned
into pneumonia. The new partner of my internist, trained in the
psychosocial aspects of medical practice, grilled me on my
psychological state and suggested that stress was a major factor
in the searing pain at my skull base and in the twitching and
loss of sensation that accosted my limbs. Accurately identifying
the panic that had set in as a result of my somatic losses, she
attempted to treat me with antidepressants, attributing the pain
to stress and turning down my request for an MRI. I was beside
myself.
Later, as planned, I called a Rice anthropology grad student
who was also a faculty member in neurology at Baylor
University Med Center. She immediately asked me to hang up
and wait for her to return my call; when she did she said she’d
spoken with the doctor and he now wanted me to have further
diagnostic tests. I asked why he had changed his mind; she said
she’d told him that I did not »somatize stress.« I had no idea,
but she said she’d known me for five years and knew her
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assessment was correct. The American Psychiatric
Association’s DSM (Diagnostic and Statistical Manual) IV
offers this definition of depersonalization:
... a feeling of detachment or estrangement from one’s self . The
individual may feel like an automaton or as if he or she is living in
a dream or a movie. There may be a sensation of being an outside
observer of one’s mental processes, one’s body, or parts of one’s
body.
... Various types of sensory anesthesia, lack of affective response,
and a sensation of lacking control of one’s actions, including
speech, are often present. The individual with Depersonalization
Disorder maintains intact reality testing (e.g., awareness that it is
only a feeling and that he or she is not really an automaton).
Over the course of months as I lost control over my hands, my
feet, and my ability to swallow and to use my voice, I was interested to find that although I did »lose interest« in my body it
demanded my attention. Loss of control generated a psychic
response of fearful hypervigilance in response to the mismatch
of material and psychic schemas. I was inclined psychically to
detach from my uncooperative fingers, hands and feet. I watched
and felt muscles flicker with detached fascination, unable to will
them to stop as they signaled imminent failure. My hands became clumsy objects, dissociated from my controlled body as if
they were the hands of another less capable subject, or as if they
were parts externally attached to my body. To »lose« one’s limbs,
in this slow and gradual sense, is to experience as process the
death of a part that, confusingly, remains deceptively present and
visually consistent. My response was emotionally to divest
myself of those parts when they performed badly. I was losing
my voice and, it seemed, also my mind, not to the pain, which I
could bear, but to the panic of not knowing its cause.
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Pain and panic
Panic is a term that derives from the actions of Pan, the god of
woods and fields and of flocks and shepherds who appears in
Ovid’s Metamorphoses. Pan is variously described as a diminutive, goat-like man, horned and ugly, and possessing limited
intelligence. Born to a mother so startled by his coarse features
that she fled, abandoning her son, Pan wandered the woods
preying on nymphs who, like his mother, spurned him. Pan, like
the other gods who dwelt in forests, was dreaded by those
whose occupations drew them to the woods at night, for the
darkness and loneliness disposes the mind to superstitious terrors. Blamed for inciting fear among animals spooked by
imperceptible causes, Pan is also the figure who, in the wake of
his amorous pursuit of Echo, spread madness among the shepherds. In their collective state of Panic terror the shepherds tore
Echo to pieces so that all that remained was her voice.
After some months an MRI was ordered. It was discovered that
I had sustained a spinal cord injury. The bones of my cervical
spine were pressing in on the cord itself. But there was something more. The severity of the cord compression had caused a
blockage in the flow of spinal fluid. This fluid was unable to
wend its way around the dam that the collapsed cervical bones
had thrown in its path. Over the course of the 16 months since
a fall to my neck during a martial arts class, blocked spinal fluid
had broken its way into the interior of the cord, where it had
formed a reservoir. This subterranean pool of spinal fluid inside
the cord had silently and gradually grown with the natural pressure of the fluid continually seeking a path.
Syrinx is the medical name for the pool of fluid in my spinal
cord. The cough that had come with my pneumonia was functioning like a hydraulic pump. With each cough, more fluid
would gush into the syrinx, causing pressure changes that registered as a jolt of headache pain. I needed neurosurgery to retract
the dam of collapsed bone from the cord. But no surgery could
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repair the damaged nerve fiber that comprised the cord itself,
and it was too risky to drain the interior pool that had formed
deep inside those delicate fibers, a territory typically cordoned
off from surgical contact.
Could I describe the pain as intractable? The term was more
apposite than I could have imagined. The term intractable
comes from the Latin intractibilis, meaning not to be touched or
handled. The spinal cord, in medical practice, is most often not
to be directly touched or handled. Surgeons of the spine work,
for the most part, around and outside the cord. The cord itself is
surgically penetrated only in the most rare cases. Penetration of
the cord in injury is a grave problem. More than almost any
other entity in the body, the cord is intractable in the sense that
is it off limits to touch. The term intractable in medical parlance
means not treatable. Conditions of the spinal cord are not exactly untreatable. Rather, they are ideally treated obliquely,
without direct touch to the cord. My surgeons chose not to
handle my spinal cord itself but rather to cut, to remove, to
grind to a paste, and to reconfigure the cervical bones that
caved in upon it. In reconfiguring my bones, they were successful in treating, in removing, much of my pain. Thus, in the
end, the pain was not intractable.
Living under the sign of MS: While living in Houston in the late
80s I experienced some odd symptoms and after some tests I
was diagnosed with »probable MS.« There are four conditions
that must be met for a diagnosis of MS. I definitely had two of
them and a third looked likely. Later the diagnosis changed to
»likely MS« (three out of four conditions). A full MS diagnosis
typically takes ten to twelve years. Interestingly, MS is differentially diagnosed in upper middle class women and people
living above the 30 parallel. It was first diagnosed in
Hausmann’s Paris, along with agoraphobia.
Part of my reason for moving to UCLA was that this university
center has an important center for MS research and clinical
practice. In the late 1990s two important drugs had finished cli-
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nical trials and had become available. They arrested the
development of new symptoms. I was getting another clinical
work-up when the neurologist became suspicious of the MS
diagnosis. She did many studies and eventually did a ›grand
rounds‹ presentation on my case; the various experts had differences of opinion, so the tests continued. Finally, one of
UCLA’s neurosurgeons agreed with my neurologists and I had
surgery to remove two discs between the cervical bones in my
neck.
Conclusion
In Thousand Plateaus Deleuze and Guattari thought about the
psyche and challenged psychiatry and psychoanalysis, fields
based in neurology. But they consider not at all the role of the
spinal cord and nervous system in the production of a body
without organs. During the 1990s, years the American
Psychiatric Association dubbed the Decade of the Brain, neurology took seriously the production of its own material versions of a body without organs, facilitated by evidence accruing
since the 1950s that the brain and nervous system were not rigid
and hardwired but plastic and malleable. By the 1980s it was
clear that adult nerve fiber was capable of changing form and
making new connections. This sea change in neurology made it
possible to imagine the redistribution of intrasubjective
relationships among organs, the nervous system, and sensory
experience through neural prosthetics designed for people with
injuries or progressive diseases of the spinal cord.
Why do we write and conduct our research as if we did not
know ›in the biblical sense‹? Pondering this denial has led me
to rethink imaging, representation, strategic discourse, and
engagement in techno-science/biomedicine and in our own
research. I have learned from speaking on this subject that
many of us still want to insist that the distinctions between sub-
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jectivity and objectivity are simultaneously natural, normal,
obvious, and require vigilant defense. Many still believe that
subjectivity is the name for unreflected experience and that
objectivity is the proper name for carefully investigated claims
adjudicated by qualified researchers. I must say that I am quite
uninterested in writing to you here about anyone’s unreflected
experience, including mine, and I am quite eager to explore
with you how we actually construct and investigate our claims
and seek the adjudication of qualified experts. We think we can
do it better. I recall my earlier words: Through my body I have
learned a very great deal about techno-science and biomedicine; so have you. Our third person accounts in the passive
voice do not allow us to report on what we have learned. That
intellectual politics of silence constructs artificial barriers
among our multiple ways of knowing. If we rejected that politics of silence, we would be obliged to report on what we have
learned, how we have learned, and how our multiple ways of
knowing are related to each other. We would have to write and
think more carefully. We would have to raise the standards of
research and argument. Our subject is too important to use the
old conventions and traditional practices. In our current canonical ways of writing we must not and we cannot ask these questions. I have deliberately written this as an essay in order to
avoid the intellectual constraints required by the literary form
of the ›journal article‹. As we feel our way through all these
dilemmas and as we learn to write about our imaged, monitored, discursive bodies, I think we must explore how we can find
patterns, make theories, write across the rules, and take action.
Our research will be better; it will become more powerful and
more important, too. We need to write histories of those gaps in
our arguments, those silences. Why have we slashed our minds
from our bodies; why do we compulsively separate our ways of
knowing; why do we deny that knowers have subjectivities?
What did we think was at risk? The construction of those barriers and the containment of our risk are moral economies and
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personal questions and intellectual issues. Should we not investigate that activity? We all know our discursive sites are unstable and without closure. Our lives are inconclusive discourse
sites and they are without predicable endings. Does that mean
that we are unable to think? How do we learn to make narratives about new kinds of images? What are our narrative
ethics: whose stories are we telling? As I construct my interpretations about these scientific, technical, and medical images
whose stories am I entitled to tell and whose images can I
show? What are the research ethics and the narrative ethics if I
ask whose story am I telling? Whose American Psychiatric stories am I entitled to tell? Are there theories somewhere in my
narratives of embodied images?
References
Association (1994) Diagnostic and Statistical Manual of Mental Disorders.
Fourth Edition.
ARG Owen (1971) Hysteria, Hypnosis and Healing. The Work of J-M
Charcot. New York: Garrett.
Cartwright, Lisa and Goldfarb, Brian (2005) On the Subject of Neural and
Sensory Prosthesis. In Smith, Marquard and Morra, Joanna (ed.). The
Prosthetic Imagination. Cambridge, MA: Cambridge University Press.
Deleuze, Gilles and Guattari, Félix (1987) A Thousand Plateaus.
Capitalism and Schizophrenia (transl. by: Massumi, Brian). B&T.
Merck and Co (2006) The Merck’s Manual of Diagnosis and Therapy:
<mmanual/section15/ chapter188/188e.jsp>
Traweek, Sharon (1999) Warning Signs. Acting on Images. In Clarke,
Adele and Olesen, Virginia (ed.). Revisioning Women. Health and
Healing. Feminist, Cultural and Technoscience Perspectives. New
York: Routledge.
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Verlust denken
Wie Schneeflocken bedecken Plaques die Magnetresonanzaufnahme (MR)
ihres Gehirns. Janet Price leidet seit den späten 1980ern an Multiple
Sklerose (MS). Seit kurzem spielt ihr Erinnerungsvermögen und wie dieses
durch die sich schleichend entwickelnde Krankheit verändert, eine wesentliche Rolle in ihrem Leben. Beim Schreiben dieses Essays ist sie sich allzu
bewusst, welchen Schaden MS an und in ihr anrichtet. Ihre Denkprozesse
verlangsamen sich durch die kognitiven Schwierigkeiten, die bei ihr mit
dem Verlauf der Nervenkrankheit einhergehen. Selbstkritisch und ohne
Pathos reflektiert sie in der ersten Person, wie sich ihr theoretisch inhaltliches Denken und ihr Blick auf die Welt – ihr Dasein an und für sich – mit
MS ändern. Janet möchte gerne glauben, dass die winzigen Löcher in
ihrem Gehirn sich nicht auf ihre Bewegungen, ihre Empfindungen, ihre
Wahrnehmung, ihre Gefühle und ihr Gedächtnis auswirken. Sie macht sich
nichts vor. Jedes Loch könnte einen potentiellen Verlust eines Teils von ihr
nach sich ziehen.
Über die Jahre schreibt Janet Price häufig gemeinsam mit Margrit
Shildrick, einer engen Freundin und Kollegin. Unterschiedliche Denkmuster, Erinnerungen, Arten der Selbstwahrnehmung und Verkörperungen
treffen aufeinander. Jede Veränderung bei einer der beiden Frauen, bringt
zwangsläufig auch Transformationen bei der anderen mit sich. Ohne
Margrit zu schreiben und zu denken, ruft Janet nicht nur ins Bewusstsein,
dass die Kollegin physisch nicht anwesend ist. Vielmehr empfindet sie
einen epistemologischen Verlust darin, wie sie ihre Gedanken und Ideen
formuliert. Ihr verkörpertes Selbst, das mit jeder Zeile buchstäblich mitschwingt, wird ein anderes. Neueste Forschungsergebnisse in der
Neurologie besagen, dass sich das Gehirn nach Schäden, welche durch
Schlaganfälle, MS oder andere Traumen verursacht werden, durchaus wieder neu konstituiert. Gelähmte Gliedmaßen können wieder zurück in die
Bewegung gedacht werden. Neuronale Netzwerke bilden sich heraus und
erwecken durch entsprechende technologische Innovationen zerstörte
Körperfunktionen zu neuem Leben. Was heißt das, wenn das Gehirn sich
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Christina Lammer
nach einer Schädigung selbst reorganisiert? Mit Elizabeth Grosz (1994)
schlägt Janet vor, unsere Hirne anders zu denken. Berührt wird die Geist /
Körper-Dichotomie, dessen intellektuelle Auseinandersetzung zunehmend
unbequem wird. Das Gehirn ist allerdings ein inneres Organ und Teil des
Körpers. Als solches konstituiert es uns und unsere Welt, wird durch unsere Erfahrungen und unser Handeln geprägt. Biologie, Psychologie und
Philosophie überlappen, wenn das Hirn als Teil unserer leiblichen
Verfasstheiten begriffen wird. Gedächtnisverlust als Spurensuche? Als
imaginatives Geschehen, rekonstruiert durch den Akt des Erinnerns.
Dieser Prozess der Wiederherstellung impliziert sowohl das Körperbild als
auch das Andere. Wobei das Körperbild, phänomenologisch gesprochen,
die Grenzen des (materiellen) Leibs überschreitet. Objekte wie Krücken,
Prothesen oder andere Objekte des täglichen Lebens werden förmlich in
die eigene Wahrnehmung inkorporiert. Unser Körperschema verändert
sich mit anderen Erfahrungen. Die Autorin betrachtet Subjektivität durch
den partiellen Verlust ihres Gedächtnisses. Sie durchdringt damit die
Grenzen des Denkbaren.
Janet Price – I live with my partner in Liverpool, England, the city that was
my grandparent’s birthplace. I moved here for work in the late 1980s and,
soon after, I developed multiple sclerosis, a variable and unpredictable
cause of disability. It focused my attention on experiences of and responses
to our changing bodies and on how far traditional feminist health writing
and practice meet the needs of our bodies’ unreliability. Amongst my writings are articles and two co-edited books, Vital Signs: Feminist reconfigurations of the bio/logical body and Feminist Theory & the Body: A Reader
with Margrit Shildrick, by Edinburgh University Press, the co-authoring
part of a practical, political and theoretical investigation of the boundaries
of our bodies. Alongside my writing, I also do occasional teaching in UK
and India where I have ongoing links to Indian women’s organisations working around health and sexuality, links developed over the past 25 years. I
am also actively involved with an arts and disability organsiation in
Liverpool that works to challenge the exclusion of disabled people from the
production and appreciation of the arts. I travel to visit friends whenever I
am able. And I garden to maintain my sense of wellbeing.
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Out of My Mind
Thinking through loss
Memory has come to play an increasingly pertinent role in my
life recently. As I tried to write this paper, I was all too aware of
the damage that Multiple Sclerosis has inflicted upon me; of the
difficulties in cognition I face as a result of the slowness of
thought processes through my brain. It’s not so easy to pick up
on examination – the psychological tests record me as »high
functioning,« but I remain very aware of the gaps and challenges. I surround myself with academic books and papers, knowing that on a good day I can understand most of what I read – or
at least have some idea of why I can’t grasp a particular theoretical point. But to make use of ideas, I have to be able to hold
and synthesise them, compare one theory with another, recall the
details of the arguments: only then is it possible to apply them in
new ways. And this is where my memory fails me – in the
moment by moment retention of concepts central to the piecing
together of a theoretical argument, in the creation of a flow of
words that produces new ways of looking at the world.
I would like to believe that the MS isn’t creating holes in my
brain but if I look closely at my MRI scan, I can see a snowflake scattering of plaques, what I take to be evidence of the
insidious damage that touches upon an unknown host of nerve
cells and pathways. The plaques look so innocent – they’re such
gentle white specks. And yet each one could mean the potential
loss of a part of me: my movements, my sensations, my memories.
Over the years, much of my writing has been done with Margrit
Shildrick, a close friend and colleague who, in the face of my
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certainty of my imminent if not already present total brain
failure has supported me to go on theorising. Our writing together, as we have said previously, is an ethico-political act as
much as it is a choice determined by academic interests and
friendship. Margrit, a woman who is identified as non-disabled,
and I, identified as disabled, write together. In so doing, we
bring into play differing patterns of thinking, personal memories that contribute towards our sense of self, and individual
modes of embodiment. As we have written elsewhere:
The very fact that we are very differently embodied at this point in
time encourages us to explore not only those aspects that cannot be
assimilated one in the other – the radical differences that no amount
of disavowal, or rights, or empathy can veil – but also the ways in
which we are mutually constituted, mutually dependent for any
sense of self. Put very simply, as one of us changes, so does the
other. (Price and Shildrick 2002, 64)
So I grapple as I write with a feeling of diminished memory, of
an altered subjectivity, aware that the sense of loss is not
simply about the material absence of Margrit, but about a fundamental epistemological shift in how I frame thoughts and
ideas. And as I have faced what seemed to be endless encroachments on my ontological boundaries – as my body crumbled with MS so too, at times, did my sense of myself – I have
turned to the argument that it is through the constant reiterations of performative acts we establish our sense of self. And
the uncertainty of MS has been transformed in my thinking,
though not without difficulty, from an assault on my body and
my identity to what Eve Sedgwick (1994) has called an adventure in applied deconstruction that »can offer crucial resources
of thought for survival under duress« (12).
Rosemarie Garland-Thomson (2002) has recently argued that
disability can be understood as »a culturally fabricated narrative of the body«: that it is, for example, not only, »a set of prac-
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tices that produce both the able-bodied and the disabled« but
also »a way of describing the inherent instability of the embodied self« (6). Her work reflects a recent constituent focus on
bodies within disability that has been achieved in the face of
dis-ease amongst those who hold to the social model1, a way of
theorizing disability that one of its leading proponents, Mike
Oliver (1996), claims has »nothing to do with the body« (35).
From his perspective, disability is purely social: the effect of
economic structures, social organizations and environmental
layouts that exclude disabled people. This social model implicitly values all disabled people the same. Despite advocating an
analysis that holds disability to be the consequence not of personal or embodied attributes but rather of (social) prejudice and
discrimination, there are, nevertheless, clear hierarchies in the
disability world. And those with learning disabilities, brain
damage, mental health problems – in fact any disruptions that
have more to do with mind and thought than with movement
and perception – are low in the disability pecking order. One
consequence of this is that there has been limited academic
exploration of this area. As the organizers of a recent conference on Representation and Autism remark, »Disability
Studies has largely overlooked the culture and discourses of
cognitive disabilities«(2005).2 When in the past I tried to make
sense of the vagaries of my changing world, I drew on writers
such as Elizabeth Grosz (1994) who, eleven years ago, in
Volatile Bodies, lamented:
Feminists, like philosophers, have tended to ignore the body or to
place it in the position of being somehow subordinate to and dependent for all that is interesting about it on animating intentions, some
sort of psychical or social significance. (vii)
And yet only six years on from that, in an edited collection on
Deleuze and feminist theory, Eleanor Kaufman (2000) was
lamenting the exact opposite:
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It seems fair to state in contemporary feminist philosophical
discourse, it is the body and not the mind that holds sway. While the
body has been studied with all its attendant complexities, the mind
is skirted around with much more caution, and this for a good
reason (135).
This recent lack of attention to the embodied mind and more
specifically, in line with my own concerns, to ways of explaining the world of decreasing and unreliable memory, strikes
me in ever-new ways. Alongside the vagaries of my own
memory, I face my grandfather, now 93, struggling with advancing Alzheimers whilst grieving for the loss, two years ago, of
my Nana. They had been married for seventy years and over the
final few, it was she who had stemmed his memory loss, created and held his new memories for him, recalled the old ones
with him. Without her, the day-to-day has become an increasingly confusing, difficult and frightening space and time to
negotiate. He sits in the lounge of his residential home, fully
dressed at three in the morning, wondering why nobody one
else is coming for lunch. He greets my mother on her visits with
queries about when Nana is coming back. Together, my Nana
and he acted to make and hold the other. As Margrit and I said
of our writing together, I saw daily in my grandparents that they
were »mutually constituted, mutually dependent for any sense
of self« (Price and Shildrick 2002, 64). As one of them
changed, so did the other. And when one died, the other’s
memories, gestures and movements seemed to be irreversibly
altered – have never been the same again.
Thinking the brain otherwise
Whilst I grieve for the changes in my grandfather and fight the
frustration of my own memory changes, scientists tell us of the
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wonderful advances they are identifying in brain functioning,
of their realisation that the brain does not reach a point of stasis as we arrive at early adulthood, but that it can respond, as
does the rest of our body, to changes in the environment and to
damage it encounters. Neurologists are excited about the concept of cortical reorganisation, as revealed through evidence
that »the adult brain is capable of substantial plastic change in
such areas as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience«
(Flor 2003, 66).
What this means is that in the face of damage due to strokes,
MS, direct trauma, events which cause injury or even the death
of neurons, the brain can reorganize itself to take over the functions that are lost. Further, the brain can be trained to reconstitute itself: limbs paralyzed by a stroke can be »thought« back to
movement through a training process; people with paralysis
from the neck down are learning to utilize electrodes implanted
on the surface of their brains to move cursors on computer
screens, turn lights on and off, or to manipulate the fingers of a
robotic arm (Sample 2005, 4-5). Thought institutes brain changes that potentially lead to regained limb function. Locations
shift, old neuronal pathways are reactivated, novel networks
and connections are created. The potentials for new ways of
mobilizing embodied movement, perception and thought, are
enormous. And all this through work with an entity that for
many years was treated as fixed in its neurological layout.
But what are the implications of a brain that can reorganize
itself after damage? Perhaps more than any other part of the
body, the brain has been constituted in terms of an unchanging,
ahistorical biology. Yet in the face of this new science, the brain
one is born and grows to adulthood with is no longer the brain
one lives with forever. It is therefore not enough, in Grosz’s
(1994) terms, to think of the brain’s biology as historically
given, nor as »a base on which cultural constructs are founded,
nor indeed as a container for a mixture of culturally or indivi-
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dually specific ingredients« (191). We have to learn to think our
brains otherwise. And yet, we have largely avoided examining
the implications of Grosz’s argument. Linked to the mind in
Western thought, to the site of memory, to that which is held to
make us human, the brain remains for the most part unexamined in recent feminist thinking about corporeality.
Embodiment appears to stop at the neck. Anything above this,
or more specifically, anything that lies within the skull, is too
dangerous to address, directly confronting as it does the uncomfortable question of the mind/body dichotomy. The brain is
body – and yet it is also the seat of the mind. The brain is an
internal organ – and yet it exerts its influence over the external
in every move we make. It constitutes us as well as our world
and is reformed and reconstituted by our actions and experiences. It is necessary for mediating our perceptions of the world
to form memories. It is body – and yet it is closely implicated
in the construction of our psyche, our corporeal schema, and
our subjectivity.
These claims bring me into disputed territory – into the overlap
between the biological, the psychological and ultimately the
philosophical. Yet the intersections that emerge between these
worlds point us towards questions that challenge the Cartesian
mind/body dichotomy whilst, simultaneously, offering possible
routes around the almost instinctive (and at times unhelpful)
anti-reductionism that has characterized some of the recent theorizing about embodiment.
Earlier notions of the brain as computer – as a rational information-processing machine – still play a powerful role in the
neurocognitive sciences. Likewise, locationism – with its mapping of specific aspects of human behaviour, perception and
memory onto related brain areas – has been a tenacious element
of consecutive models of cognitive function (from the phrenologists, through Freud, to the neurocognitive systems of today).
However, increasingly, thought is conceived of in ever more
complex ways, no longer a simple model of a machine and
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wiring with inputs and outputs, or even of a one-to-one mapping between human thinking and the computation of a machine (Wilson 1998, 107). Despite the great influence still exerted by the older explanations of information processing, memory encoding and memory retrieval, these ideas have given
way to buzz words such as networks, connectivity and systems.
These connectionist systems rely upon the notion of parallel
distributed processing, layers of input, output and hidden units
across which activity is propagated and transformed. Models of
differential forms of signals have been developed but the salient
and most noteworthy feature of a connectionist network is that
it has the ability to learn.
My aim here is not to rehearse in great detail the advances in
cognitive psychology but rather, to return to trace the question
of memory, learning and memory loss. What also needs to be
emphasized is that the alternative ways in which memory is
understood – either as a neurological trace, mapable through
new functional PET brain scans, or as a cognitive trace, plotted
through a deepening understanding of the ways in which information is processed and utilized – cannot be laid neatly one on
the other. Biology and psychology (to say nothing of philosophy) do not coincide.
Wary of both attempting a neat overlay with biology and of the
tendrils of locationism that swirl through cognitive psychology,
Elizabeth Wilson (1998) picks up not on the neurological but
on the cognitive or psychical trace, coming to it through the
writings of Freud and Derrida. The psychical trace, like the
neurological trace, was traditionally held to be a locatable presence, a fixed entity. Identifiable memory stores within the
mind/brain were thought to hold short-term traces that decayed
and gave way to long-term storage areas. Connectionist models
of cognition, in contrast, hold that memory is not »the property
of the unit or group of units, i.e. a store but rather the effect of
relational differences in the activation between units and across
a network« (161). The connectionist trace thus serves to displa-
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ce the psychical effect into the »space between connections«
(161). Yet despite the displacement of the trace in connectionist
models, arguments continue about the question of location.
Some scientists have argued that the network/PDP is locatable/localizable by function within the brain. It is this fixed
presence that Wilson hopes to escape from.
In thinking of location and displacement of the trace and
memory, I return once again to my grandparents, and to the
phenomenological extension of the self through which each
used the other as a holder of their memories. Research with
people developing Alzheimer’s has demonstrated how objects –
ornaments, for example – can similarly serve as keepers of
memories, acting in this case as inanimate depositories, extensions of the self which provide a crucial point of reference and
reminder. If these are moved in or removed from a room, a
whole raft of memories are lost or displaced with them. But, as
with my grandparents, it is not solely inanimate objects that
perform this task. Within couples, roles alter as respective
memory changes lead to shifts in time-space orientation. A
woman had been an active traveler, her husband less so: as her
Alzheimer’s advanced and she forgot long-familiar routes, he
began to act as her map, recreating the knowledge that she had
carried for so long to enable her to continue to travel, her orientation extended to and encompassed by him. Memories meander: they appear to be extendible and mobile, not necessarily
locatable in one place or even in one person. Now it is possible
to describe these phenomenological encounters, to map the
ways in which memories are mutually constituted between
people. But is there a way in which we could explain it in cognitive terms, in terms of the trace? What follows is a tentative
exploration of thinking memory and loss, of possible ways in
which memory might be understood to reside within the mindbody-self.
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(Re)tracing memory through the body
Wilson (1998) adapts earlier analyses to propose an understanding of the trace as both place and movement, thus mobilizing
it and freeing it from what she terms the »stultifying effects« of
»disavowing its debt to an economics of force« (167). Drawing
on Derrida’s application of the notion of breaching to his analysis of memory, psyche and difference – breaching, here, being
both the force that forges a pathway and the space generated by
this force – Wilson offers a concept of the trace that radically
disrupts the idea of locatable memory stores. The limits to
memory’s materiality and mobility are deferred: »neither fully
present nor absent, neither freely mobile nor totally static, the
psyche’s placement remains undecideable« (186). The formation of this undecideable trace, as memory, is not simply the
reproduction of what already exists. Rather, memory (as différance) is an imaginative event, reconstructed in the act of
remembering. Implicated in this re-creative process are both the
body – or more extensively the body image – and, as I have
suggested, the other.
This rethinking of cognition necessitated by the idea of the connectionist network and the trace as movement/structure raises
questions about how the potential limits of the networks are
conceived, and whether such limits can in fact be thought. If, as
Wilson (1998) suggests, the trace’s relations of energy and
space »surpass the imperative for a graspable location« (196),
what are the implications for the cognitive trace’s relation to the
mind and to the brain/body? The mind and the psyche are noncoincidental with the brain within the understanding of cognitive psychology; if, in addition, »knowledge is material but
unlocatable in any direct sense« (161), one implication is that,
unlike the neurological trace, it may not be necessary for the
psychical trace to remain in any sort of direct contact with neuronal networks, with the brain. What I’m offering here is an
ultimate rejection of location.
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In phenomenological terms, the body image can extend beyond
the material limits of the body – is co-extensive not with its
gross limits, but with the self’s field of potential actions. We are
capable of incorporating objects into our perceptual faculties
such as the cane used to support the walker, or the stick used to
scratch her back. Our corporeal schema is malleable, changing
through time and space. This, as Grosz (1994) has argued in
relation to the body’s biology, addresses »an open materiality, a
set of (possibly infinite) tendencies and potentialities which
may be developed, yet whose developments will necessarily
hinder or induce other developments and other trajectories«
(191). But what if the concept of a psychical trace that extends
this open materiality is taken to encompass the phenomenological body, and to suggest that the body itself can hold memories? Through the undecideable economies of the psychic trace
– its movements and the paths it negotiates – can the psychic
trace’s potential location be held to extend beyond neuronal
pathways to both the materially embodied subject and its corporeal schema?
In phenomenological terms, perception serves to mutually constitute bodies – the fleshy creation of interpenetrating unbounded beings/entities. As the psychic limits of the body are not
necessarily coincidental with the material body and as one body
serves to constitute another, could it follow that the undecideable force/location of the psychic trace can lead to the mutual
constitution of thought? – To a set of memories that can move
by and through another? – Exist for another? The mutual constitution of one body, one self, by another involves not only the
materiality, but also the cognitive aspects, of the self – the physical and the psychical, the imbricated and undecideable.
Perhaps, thus, are created the memories of my grandfather –
memories that were once formed and held together with my
Nana. Without her presence, her constant input to these memories, he now feels incomplete. As the loss of a limb can produce
phantom pain, perhaps the loss of my Nana has produced
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»phantom memories« for my grandfather – memories that are
distorted, painful, incomplete and out of place, but still
eminently recognizable.
But this is all speculative. To return to my starting point – my
own loss of memory. Why does it worry me so? In part, because
I have the sense that, without coherent memory, I lose something, some would argue, my identity. Rosalyn Diprose (2002)
draws on Nietzsche in saying that »memory makes the self constant and apparently unchanging through time by projecting the
same body into the future« (22). I need ways of making sense
of the instability of memory, but without splitting myself ontologically, mind on one side of a shaky divide, body on the other.
I am no longer in search of a stable identity, have no belief that
to find one will provide security in the face of the impact of
disease. My security comes, if from anywhere, from a recognition of instability, from knowing that things refuse to line up
together. And this instability for me is a necessary way of
understanding disability. To return to Garland-Thomson’s description of disability as the inherent instability of the embodied
self, I suggest that we need to pay as much attention to the
instability of cognition and memory as of body.
But I am also in search of a way forward in the face of such
changes. My memories and my materiality are mutually constitutive, the one structuring the other, perception and experience
cohering together – but both unsteadily so. To live with my
fluctuating memory, my sense that I cannot project the same
person into the future as much because of my uncertain memories as my disruptive body, I need to look beyond myself. I have
argued that those around me are part of the answer to my sense
of loss and, much as I trust them to support my changing body,
to hold me, for example, if I am unsteady on my feet, so I must
find ways to trust them, entrust them with making and holding
my memories. This is a process Margrit and I had explicitly
started in our writing together but that I have come to recognize
happens day to day with those around me. Ten years ago I star-
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Janet Price
ted to address the incoherence of my bodily boundaries. This
paper is a tentative start in thinking subjectivity through the
uncertainty of my cognitive limits.
Notes
1
David Pfeiffer (2002) defines 9 different models or paradigms in disability studies, including the social model, largely used in the UK. This
differs from the social constructionist model utilised in the USA.
(«The Philosophical Foundations of Disability Studies« in Disability
Studies Quarterly, Spring Vol 22.2: 3-23)
2
Recent edited collections have included work on mental health & psychiatry and cognitive impairment, still largely unaddressed outside the
clinical field. See Nancy Potter’s (2005) chapter, »Liberatory
Psychiatry and an Ethics of the In-Between« in Shildrick, Margrit and
Mykitiuk, Roxanne (eds) Ethics of the Body: Postconventional
Challenges, Cambridge, Mass: MIT Press, and Licia Carlson’s (2005)
»Docile Bodies, Docile Minds: Foucauldian Reflections on Mental
Retardation« in Tremain, Shelley (ed) Foucault and the Government of
Disability, Ann Arbor: University of Michigan Press.
References
Diprose, Rosalyn (2002) Corporeal Generosity. On giving with Nietzsche,
Merleau-Ponty and Levinas. Albany: SUNY.
Flor, Herta (2003) Cortical reorganisation and chronic pain: implications
for rehabilitation. Journal of Rehabilitation Medicine. May (41 Suppl):
66-72.
Garland-Thomson, Rosemarie (2002) Integrating disability, transforming
feminist theory NWSA Journal 14.3: 1-32.
Grosz, Elizabeth (1994) Volatile Bodies: Towards a Corporeal Feminism.
Bloomington: Indiana University Press.
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95
Kaufman, Eleanor (2000) Towards a Feminist Philosophy of Mind. In
Buchanan, Ian and Colebrook, Claire (eds.). Deleuze and Feminist
Theory. Edinburgh: Edinburgh University Press, 128-143.
Oliver, Michael (1996) Understanding Disability: From theory to practice.
London: MacMillan Press.
Price, Janet and Shildrick, Margrit (1998) Uncertain Thoughts on the
Dis/abled Body. In Shildrick, Margrit and Price, Janet (eds.). Vital
Signs: Feminist Reconfigurations of the Bio/logical Body. Edinburgh:
Edinburgh University Press, 224-249.
Price, Janet and Shildrick, Margrit (2002) Bodies Together: Touch, Ethics
and Disability. In Corker, M. & Shakespeare, T. (eds.)
Disability/Postmodernism: Embodying Disability Theory. London and
New York: Continuum, 62-75.
Sample, Ian (2005) Meet the Mind Readers. The Guardian, Life Section
31/03/05: 4-5.
Sedgwick, Eve (1994) Tendencies. London: Routledge.
Society for Critical Exchange (2005) Representation and Autism: Writing,
Cognition, Disability Conference Call.
Wilson, Elizabeth (1998) Neural Geographies: Feminism and the
Microstructure of Cognition. New York and London: Routledge.
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Körper im Widerstand
Über sprechende Körper von HIV-positiven Südafrikanerinnen erzählt
Kylie Thomas in ihrem Essay. Spuren von Verletzungen, Wunden,
Krusten, Narben oder Muttermale auf der Haut werden oft versteckt.
Erfahrungen des Krankwerdens sind nur in ihrer Doppeldeutigkeit zu
begreifen. Der Leib wird einerseits zum Sprechen und andererseits zum
Schweigen gebracht. Gerade Aidskranke sind gesellschaftlich stigmatisiert.
Kylie wirkt dieser Stigmatisierung mit ihrer Forschungsarbeit entgegen.
Frauen mit HIV/Aids, aber auch erkrankte Männer, wenngleich sie nicht an
diesem Projekt teilnehmen, erleiden häufig vor dem physischen einen
gesellschaftlichen Tod. In einem Vorort von Kapstadt (Südafrika) zeichnen
und malen aidskranke Frauen ihren eigenen Leib. Die junge Forscherin
schreibt über gesellschaftliche Tötung. Sie analysiert die Bilder von HIVpositiven Südafrikanerinnen, die beim Malen ihre verkörperten
Erfahrungen mit der Krankheit kreativ artikulieren. Das Ergebnis sind
Körperporträts, die zeigen, was es für jede einzelne Frau bedeutet, mit Aids
zu leben. Diese Darstellungen erfordern Mut. Gleichzeitig bieten sie die
Möglichkeit, individuelle Lebensgeschichten künstlerisch umzusetzen. Im
Südafrika der Gegenwart sind Erzählungen rar, die den Menschen ins
Zentrum setzen. Stimmen der Kranken bleiben vielfach ungehört.
Kylie Thomas schlägt einen Ansatz der Körperkunst im Widerstand vor.
Sie arbeitet mit dreizehn malenden Aidspatientinnen, die in Khayelitsha
leben, am Rand von Kapstadt. Die lebensgroßen Körperbilder sind Teil
eines kollaborativen Kunst- und Erzähltherapieprojekts. Die beteiligten
Frauen leben gemeinsam in der so genannten Bambanani Women’s Group,
die von einer Hilfsgruppe der Initiative Medecins Sans Frontieres geleitet
wird. Gezeigt werden Narben, Wundmale, infizierte Organe, Hautkrankheiten, gebrochene Herzen und schwangere Bäuche. Das Schweigen
des Leibs wird bewusst gebrochen. Die Bilder veranschaulichen beeindruckend, dass der Körper keineswegs isoliert von seiner gesellschaftlichen Umgebung betrachtet werden kann, sondern eng mit der Welt
der Anderen verbunden ist. Was bleibt auf den Körperbildern ausge-
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Christina Lammer
blendet? Sexualpartner. Ehemänner. Liebhaber. Vergewaltiger. Der
infizierte Leib wird ausschließlich durch seine sichtbaren Male – Spuren
der Infektionskrankheit Aids – repräsentiert. Männliche Körper und
Gewaltaspekte erzeugen durch ihre Abwesenheit etwas Gespenstisches.
Die Porträts verdeutlichen, dass die Auswirkungen der Infektion weit über
die physische Krankheit hinausgehen. Das Virus durchdringt den Leib der
betroffenen Frauen gleichermaßen wie ihr Bewusstsein. Bei jedem einzelnen Porträt wird der Körper nicht als Oberfläche, sondern als endlose Tiefe
dargestellt. Die Erzählungen gehen durch die leiblichen Schichten hindurch. Verkörperte Lebens- und Krankengeschichten werden entfaltet.
Soziale Ungleichheit wird biologisch ins Bild gerückt. Erfahrungen von
aidskranken Frauen als Zeichen ihres individuellen Widerstands – gegen
gesellschaftliche Ausgrenzung, Gewalt und Tötung – werden gehört.
Reproduktionen der Bilder werden ironischerweise am Verfassungsgerichtshof in Südafrika ausgestellt und verkauft. Eine symbolische Geste.
Selbstporträts von durch Krankheit stigmatisierten Körpern im Zentrum
der Südafrikanischen Rechtssprechung. Frauen besetzen einen Ort der
extremen Verletzlichkeit und Gewalt. Individuell und systemimmanent
symptomatisch. Sie charakterisieren mit ihrer Kunst das Leben in
Südafrika in Zeiten von Aids.
Kylie Thomas is a doctoral candidate in the Department of English at the
University of Cape Town in South Africa. Her dissertation focuses on HIV
and AIDS, representation, and social death. In 2001-2 she worked with
Jonathan Morgan on an art and narrative therapy project for people living
with HIV and AIDS, the Memory Box Project. Together with Meg
Samuelson and Nobantu Rasebotsa, she compiled and edited a collection
of creative writing, Nobody Ever Said AIDS: Stories and Poems from
Southern Africa (Cape Town: Kwela Books, 2004).
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Bodies of Courage
Reading self-portraits
of South African HIV positive women
By surveying these scars from my head down to my feet, I have
sketched a possible autobiography, summarized in an archaeology
of the skin. The only thing that matters in one’s personal story is
whatever has been ciphered on the body and thus continues to talk,
to narrate, to simulate the incident responsible for its inscription.1
Severo Sarduy
That the body speaks has become a commonplace assertion;
that the body can be read is another. But bodies are also spoken
for and the particular meanings of the lives of bodies – the intimate coding of skin, bruises, birthmarks and wounds – are often
erased. The experience of becoming ill can be understood as an
instance in which the body both speaks and is effectively silenced. The pathologisation and stigmatization of the sick body is
often understood and experienced as the unmaking of the body
and the self.2 For the person living with HIV/AIDS, this unmaking can be particularly acute. The physical symptoms of
AIDS conjoined with the stigma that is attached to HIV/AIDS
means that people living with HIV/AIDS often endure a metaphoric or social death prior to physical death. Through an analysis of a series of images made by HIV positive women of their
own bodies, this paper explores the experience of »social
death« and how the articulation of embodied experience can be
understood as a form of resistance. These body portraits offer a
way to understand the specificities of each woman’s life and her
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experience of living with HIV. In the first section of the paper I
briefly consider the social context in which these images were
created in order both to draw attention to what is at stake for
HIV positive black women in representing their own bodies,
and to draw attention to the courage such representations
demand. In the second part of the paper I focus on the images
themselves, and discuss the complex life-narratives that these
images »speak.« The power of these »speaking bodies« lies in
their insistence on the recognition of the human in the HIV
positive body. In contemporary South Africa such representations are crucial and remain all too rare.
Claiming the body:
black women, sexuality and HIV/AIDS
In her essay, »Toward a Genealogy of Black Female Sexuality,«
Evelynn Hammonds (1997) argues that a »politics of silence«(175) and »commodification of Otherness«(178) have
overdetermined the attempts of black women to represent their
own sexuality. She argues that while black female sexuality has
been the site of intense scrutiny, at the same time it has been
made unspeakable for black women themselves. Hammonds
suggests that the material effects of the unspeakability of black
female sexuality can be clearly seen in the AIDS epidemic, in
which the needs and experiences of black women have not been
recognized:
The position of black women in this epidemic was dire from the
beginning and worsens with each passing day. Silence, erasure, and
the use of images of immoral sexuality abound in narratives about
the experiences of black women with AIDS. Their voices are not
heard in discussions of AIDS, while intimate details of their lives
are exposed to justify their victimization. In the »war of representation« that is being waged through this epidemic, black women are
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the victims that are the »other« of the »other,« the deviants of the
deviants, irrespective of their sexual identities or practices. The
representation of black women’s sexuality in narratives about AIDS
continues to demonstrate the disciplinary practices of the state
against black women. The presence of disease is now used to justify denial of welfare benefits, treatment, and some of the basic rights
of citizenship for black women and their children. (179)
Though Hammonds refers here to the position of black women
in the United States, a similar argument can be made with
respect to South Africa where, of the approximately six million
people living with HIV/AIDS, more than half are women.
While the rights of women have been officially recognised by
the South African Constitution, the vulnerability of women to
infection with HIV is an indicator of the precarious place they
continue to occupy within the emerging social order.
Stigma and discrimination affect all people living with
HIV/AIDS in South Africa, but for women an HIV diagnosis
often serves to compound their marginalisation and vulnerability to violence and abuse. To cite but a few examples: in 1998,
a woman named Gugu Dlamini was beaten to death in
KwaMashu, KwaZulu Natal by members of her community
who claimed that she was »degrading her neighbourhood«
when she disclosed her HIV positive status on local radio.3
Four suspects were arrested for her murder but were released
due to lack of evidence. Gugu Dlamini’s family were afraid to
testify in court because they too had received death threats.4 A
young school teacher named Mpho Motloung was murdered in
Meadowlands, Soweto in August 2000. On her body was a note
that read »HIV positive AIDS«. According to police,
Motloung’s husband killed her and her mother, shot her father
who was admitted to hospital in a critical condition, and then
killed himself.5 In December 2003, Lorna Mlofane – a member
of the HIV/AIDS activist group, the Treatment Action
Campaign – was raped and then beaten to death in Khayelitsha
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Kylie Thomas
in the Western Cape after she told the men who raped her that
she was HIV positive.6
What all three of these murders highlight is the paradoxical
position of many women in South Africa: they are subject to
violence and rape, which increases their risk of HIV infection,
and then they are punished by means of violence and rape
because they are infected with HIV. While not all HIV positive
women in South Africa suffer violent physical abuse, the context in which they find themselves is one of systemic violence:
a context characterised by poverty, stigma, and a lack of access
to medical treatment and care. As the murders cited above indicate, women’s bodies are cast as both threatening and contagious in contemporary South Africa – a framing that supports
Hammonds’ (1997) contention that the bodies of black women
have been identified as sites of degeneracy and disease, and that
such stereotypes about black female sexuality have proliferated
in the context of the HIV/AIDS epidemic (172, 179). To disclose one’s HIV positive status in such circumstances is to put
at considerable risk one’s psychological and physical wellbeing. At the same time, disrupting the »politics of silence« is
crucial if the struggles of HIV positive women are to be recognised. The images I discuss in the next section challenge those
regimes of representation that render the experiences of black
HIV positive women invisible.
An art of the body in resistance
In Inventing AIDS, Cindy Patton (1990) describes the ways in
which the experiences of people living with HIV/AIDS in the
early years of the epidemic were swallowed up by the discursive
networks in which they were enmeshed; have been »captured by
science, the media, the politicians« (131). In such a climate, she
argues, it was not surprising that »The only remaining form of
speaking was that which fell between the legitimated discourses,
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something approaching the discourse of art, but an art of the
body in resistance« (131, my emphasis). The question of how to
speak the experience of living with HIV/AIDS remains a critical
one in contemporary South Africa. In a context where individual lives have been overshadowed by the highly politicised debate
about access to anti-retroviral treatment7, one might well ask
what »an art of the body in resistance« can speak that the more
»legitimated« discourses cannot. The paintings that form the
focus of the remainder of this paper foreground the effects of
HIV/AIDS on the individual bodies of thirteen HIV positive
women living in Khayelitsha, an informal settlement outside of
the city of Cape Town. The images were created as part of a collaborative art and narrative therapy project I worked on over the
course of two years. 8 Women from two support groups run by
Medecins Sans Frontieres in Khayelitsha took part in a project to
draw attention to how access to anti-retroviral therapy affected
their lives. These women formed a collective called the
Bambanani Women’s Group and created life-size images of their
bodies. In these images artistic depictions of scars, wounds,
birthmarks, infected organs, skin disorders, broken hearts, pregnant bellies and personal perceptions of HIV tell the stories of
their lives. These are indisputably individual stories, each one as
unique as fingerprints, each one as singular as the body whose
story the image tells. At the same time, these highly personal and
personalised narratives show how bodily experience is always
also an experience of the world – of the intimate intersections of
the life of the body and the socio-political context in which that
body is situated. The paintings transgress the silences imposed
on HIV positive bodies and serve as visible markers of the forms
of injustice to which HIV positive women are subject. These
»bodies in resistance« »speak out«, to and against those who
would silence them.
Produced over the course of several workshops that focussed on
how the body holds life stories, the resulting paintings are rich
and multi-layered – suggesting that working through and with
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bodily memories provides a particularly powerful entry point
into the narrative of a person’s life. These images create a visual
language, a kind of »biological symbolism« that reveals how
embodied experience is mediated by the intertwining of the corporeal and the imaginary. This powerful symbolic shorthand is
evident in Nomawethu’s image that shows her broken heart surrounded by flames.9 She explained the image in this way:
Now you see I put that heart. You see there are flames there. The red
colour. My heart was broken. It was 1998 in June when I found out
that my sister was died and killed herself. She drank some paraffin
spirits and threw a match and catch alight then she died in Jooste
[hospital]. I saw her there in hospital. Her mouth was gone and her
breasts. She did try to talk to me and say you must look after my
child then she died. I can’t forget that. It was because her husband
was with another woman. He died last year of this HIV illness. I was
angry and sad when she died because she support my family. She
was the only one to give us a bread and I was so sad because she left
a seven year old girl who we look after now. It broke my heart. I was
crying from 1998 June till December 1999.10
Nomawethu’s anatomically correct »broken heart« is a testament to the way in which psychological trauma is experienced in and through the body. Like Noloyiso’s carefully rendered
lungs, which she depicts filled with water surrounded by a
storm raging inside her body, Nomawethu’s image fuses the
symbolic and the literal, the physical and the psychic. This
fusion was facilitated by the portrait making process itself
which provided an external body to serve as a screen onto
which the inner life of the body could be projected. At the same
time, this external body – in its dual capacity as the boundary
of the self and the place where the world and the self meet –
becomes, in these paintings, the site where the boundary between the inside and the outside of the body dissolves. This fluidity between the inside and the outside, between the world and
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self, is also to be found in the way that each mark on the body
leads to the story of how that body came to be marked, and in
the way that the story of each person told through her body
incorporates the bodies and stories of others. For many of the
women, the story of their bodies is bound to the stories of their
children and their images contain representations of their children’s bodies. For example, one of the central images in many
of the paintings is that of the unborn foetus. This representation
of the foetus living within the centre of the body affirms the
body as a site that generates and produces life, and counters the
idea of the HIV positive body as the locus of death. Of the thirteen women in the collective, ten were mothers and several of
the women chose to depict themselves as pregnant. In Ncdeka’s
painting the over-sized figure of a baby is shown superimposed
over her body. Both inside and outside of Ncdeka’s body, this
figure represents her baby who died of AIDS at three months
old. The larger-than-life-sized body of Ncdeka’s daughter conveys the enormity of the impact of her death on her mother and
the place she continues to occupy in Ncdeka’s memory.
Ncdeka’s image illustrates how she continues to experience the
trauma of the loss of her child at the level of the body; her baby
hovers above her like a phantom limb.
Indeed, what the markings on Ncdeka’s painting of her body
and all the other women’s bodily paintings illustrate is how the
body, rather than being immune to the outside, is intrinsically
connected to the world in which bodies move. HIV infection is
a sign of the sociality of bodies, of the life of the body in the
world with others. The stories that these images of bodies tell
expose the ways in which bodies act and interact, and the ways
in which the bodies of women in particular are often violently
acted upon. In this light, what is striking about these images is
not so much what is there, but what gets left out. Conspicuously
absent from these paintings are sexual partners, husbands,
lovers and rapists; the infection of the body through the body of
another is only represented in these paintings through the pre-
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sence of HIV itself. In the absence of these ghostly male bodies,
aspects of the violence to which these women’s bodies have
been made subject remain invisible, and their lives as a result
can only be partially understood. It is thus necessary to read
with care the stories that are linked to each incision, wound and
broken heart; only in reading the paintings in this way can the
violence that these women have encountered be understood.
These portraits clearly convey that the effects of infection with
HIV reach beyond the body. While illness is revealed as only
one aspect of each person’s life, the portraits do indicate how
the experience of being ill radically transforms how people perceive their own bodies. In particular, the images made by those
who have been extremely sick show how overwhelming the
appearance of the symptoms of AIDS can be. For example,
Nondumiso’s depiction of the presence of the virus all over her
skin effectively conveys her sense of having been physically
disfigured. Moreover, in significantly magnifying the virus that
covers her body, she indicates that she perceives her entire body
to be marked by HIV/AIDS. It is interesting to consider the
extent to which the virus has entered both the body and the
consciousness of each person, depending on the stage of infection they have experienced. The images made by Noloyiso,
Bongiwe and Nondumiso, all of whom had been extremely sick
and were taking anti-retroviral therapy at the time of creating
their portraits, contrast with the images made by those women
who had not yet developed the symptoms of AIDS. In the images made by those who were relatively healthy, the virus is
depicted as affecting only a small part of their bodies or is
shown outside of the bounds of their bodies. For Thozama, a
woman who had not yet become ill, the virus is depicted as a
fire that has not yet begun to consume her. She shows herself
hovering above flames that burn just beneath her feet. For
Bongiwe, the person she was when she was severely ill and
before she began to take anti-retroviral medication is still inside
her body. In contrast to the images made by those women who
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have had babies and who depict their pregnant bodies,
Bongiwe’s painting is of her body pregnant with her own sick,
smaller self. In the interview I conducted with her she said:
This small person inside my stomach: it’s me. This picture shows me
when I started using ARV’s. I was small and so tiny. I was weighing
46 kilograms. It was March this year. Then I started using ARV’s and
I gained a lot of weight. I have improved a lot. I am weighing 58 kilograms now. So this big body around the small body is me now. When
I look at that small person there I feel so sad. But now, I feel happy
but at first I was so sad. I thought of many things, that I might die.
Anything might happen to me. I was scared at that time because I was
losing a lot of weight. That was in March, not so long ago. Now we’re
in July. It was quick that I got better. Very quick. 11
Bongiwe’s self-portrait within a self-portrait, conveying as it
does the tiny person she literally became as the virus caused her
body to physically waste away, also shows that she perceived
herself at this stage in her life as helpless and small. The emaciated body that was hers’ prior to gaining access to treatment has
not been swallowed up by time and forgotten, but is shown as
living on inside the larger figure of her healthy self.
Like Bongiwe, Noloyiso had been extremely sick with tuberculosis. She imagines the virus as a storm inside her body, complete with a bolt of lightening tearing across her stomach. Her
image of raindrops fills the entire middle section of her body
and conveys how she felt her body to be completely overwhelmed by her illness. As for Nondumiso, her depiction of the
virus’s lurid flowering over her skin is not a literal depiction,
but one that effectively conveys the trauma she experienced as
her skin changed colour. »I feel like going underground«, she
told me when I asked her how she felt about the ways in which
HIV had affected her body.12
In general, the tendency of these women to depict the presence
of the virus both in and on their bodies in ways that render it
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highly visible can be read as indicating their acute awareness of
the stigma attached to HIV/AIDS in South Africa. If these
women symbolise HIV through the thorough coding of the
body as visibly HIV positive, it is not only because they have
experienced physical symptoms that affected every part of
them; it is also their way of making manifest the social symptoms that equally affect them – symptoms like widespread discrimination and the creation of a climate of fear which make
living with AIDS a psychologically, as well as physically, harrowing experience.
In other words, these are images in which the vulnerability of
the body at all levels is exposed. In these images the surface of
the body has been peeled away, those layers of skin and blood
and bone that make one body discrete from another lifted off to
reveal the individual meanings of the person who lives that
body. In each case, the body is not a surface but an endless
depth. These stories are not simply told from the outside in, nor
is the inside of the body exteriorised. Rather, the divisions between the outside and inside of the body no longer hold. The
body is not the envelope inside of which the narrative ›I‹ is
enclosed; the self is the body and the story told is an embodied
story. Because of the ways in which these stories are told they
do not allow the reader to travel along the surface but draw us
in, beneath the skin. There is something transgressive about this
practice, this telling which does not close the reader out, which
makes the body of the reader porous to the telling itself. For as
prevention campaign messages perpetually reiterate, HIV positive bodies are bodies whose bounds we must not, in any event,
cross. The body portraits discussed here refuse such restrictions. The stories of lives that they tell are told not only through
bodies, but are embodied stories that are re-embodied by those
who read them. This, then, is the scandal of HIV positive bodies
that speak: their speaking is the means for the dissolution between the body that speaks and the body that listens. To bear
witness to these bodies is to be affected by them: it is to iden-
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tify with – to associate inseparably with – rather than to identify as – to name and to distance. These are images that radically disrupt the forms of representation that determine how
people living with HIV and AIDS are perceived in that they
draw the viewer into the space of the HIV positive body. These
paintings make visible what is invisible; they depict internal
organs, living, dead and unborn children, traumatic experiences, loss, sexual violence and HIV itself. As such, they are acts
of resistance against the regimes of erasure that seek to make
the lives and bodies of people living with HIV and AIDS in
South Africa invisible. The women whose bodies are depicted
in these images stand exposed in the face of a society, indeed a
global community, which largely ignores and thereby condemns them. The courage necessary to make and to display
these images in this context should not be underestimated. In
many of these images the arms of the person depicted are
raised: a position that can be read as openness but which is
equally a sign of defencelessness – the position of a person
being arrested, a position that arrests. Either way, it is a position
that exposes the vulnerability of the body, one that does not
conceal or defend the body but opens the body to scrutiny. The
intention of these bodies is to be seen and to face them is
discomforting in that they lead to a series of questions about
power and injustice that cannot be easily resolved.
In short, the images created by these women powerfully convey
what anthropologist and physician Paul Farmer (1999) has termed »biological expressions of social inequalities«(262). The
women who created these images have laid bare their inner
lives and their most intimate embodied experiences in order
that their rights and the rights of others in similar circumstances might be recognised. To some degree they have succeeded:
reproductions of their portraits have been purchased by the
Constitutional Court in South Africa and are part of a permanent public exhibit. The presence of these images of HIV positive bodies at the symbolic centre of the South African justice
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system is an important gesture in a context where the rights of
people living with HIV/AIDS have been so often overlooked.
Yet in spite of the power of these images and the recognition of
the plight of people living with HIV/AIDS that their visibility
signifies, the women who made them continue to occupy a
space of extreme vulnerability to the violence, both individual
and systemic, that continues to characterise life in South Africa
in the time of AIDS.
Notes
1
Severo Sarduy, Christ on the Rue Jacob. Suzanne Jill Levine and Carol
2
On the concept of the unmaking of the body and the self see Elaine
Maier (trans.), San Francisco: Mercury House, 1995.
Scarry’s The Body in Pain: The Making and Unmaking of the World,
Oxford University Press, 1985.
3
See the article by Bareng-Batho Kortjaas and S’Thembiso Msomi, »Mob
kills woman for telling truth«. Sunday Times, 27 December, 1998.
4
See »Dlamini’s afraid to testify in court«, Dispatch Online, Friday,
January 12, 2001.
5
»AIDS test sparks family killing«, Online Mail and Guardian, 23
August 2000.
6
See »Men in Court for rape and murder of Cape AIDS activist«, Mail
and Guardian, 12 January 2004.
7
The official response to the HIV/AIDS epidemic in South Africa has
been characterised by confusion and denial. In November 2003, after
several years of tireless campaigning by treatment activists, the South
African government announced the adoption of a comprehensive plan
to provide treatment and care for people living with HIV/AIDS. In
spite of this, the majority of those who require anti-retroviral therapy
continue to await treatment.
8
The full series of thirteen body images and stories based on interviews
conducted by my colleague, Jonathan Morgan, and myself have been
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Bodies of Courage
published under the title, Long Life: Positive HIV Stories, Jonathan
Morgan and the Bambanani Women’s Group, Cape Town: Double
Storey Books, 2003. Jane Solomons facilitated the art making process
and Kali van der Merwe designed the book. Copies of the recordings
of the interviews I conducted with members of the Bambanani
Women’s Group are housed at the Centre for Popular Memory at the
University of Cape Town.
9
I have made use of only the first names of the members of the
Bambanani Women’s Group as some of the participants have not
publicly disclosed their HIV status.
10 Interview with Nomawethu, Khayelitsha 2002.
11 Interview with Bongiwe, Khayelitsha, 2002.
12 Interview with Nondumiso, Khayelitsha, 2002.
References
Farmer, P. (1999) Infections and Inequalities: The Modern Plagues.
Berkeley: University of California Press.
Hammonds, E. (1997) Toward a Genealogy of Black Female Sexuality:
The Problematic of Silence. In Alexander, J. M. and Mohanty, C. T.
(eds.) Feminist Genealogies, Colonial Legacies, Democratic Futures.
London: Routledge, 170-82.
Patton, C. (1990) Inventing AIDS. New York: Routledge.
Sarduy, S. (1995) Christ on the Rue Jacob. San Francisco: Mercury House.
Acknowledgements
I would like to thank Christina Lammer for inviting me to contribute to this
book and for her encouragement, the members of my writing group for
their comments, and the participants of the »Spectacles and Visibilities:
Literary and Cultural Images of AIDS Post-1996« panel at the 2003
NEMLA conference in Boston, where I presented an earlier version of this
paper. I am also grateful to Kim Sawchuk for her insightful editing.
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Ironischer Empirismus und der Modellpatient
Der Leib als Operationsfeld. Von der medizinischen Fotografie des kanadischen Künstlers Theodore Wan, der zu Lebzeiten – er stirbt 1987 an
Krebs – als Fotograf im Krankenhaus arbeitet, handelt Kim Sawchuks
Essay. In seinen Selbstporträts, die er zwischen 1978 und 1980 in Spitälern
aufnimmt, zeigt sich Wan selbst als Patient. Für eine Fotoserie bemalt er
seinen Körper an markanten Stellen mit Desinfektionsmittel. Seine Haut
wirkt durch diese Behandlung durchscheinend. Die Autorin weist auf eine
dünnhäutige Leiblichkeit hin. Eine Empfindlichkeit. Als ob Wan sich
selbst und seine Befindlichkeiten mit einem subversiven Röntgenblick
betrachtet und empirisch durchschaut.
Eine andere Serie der Fotos zeigt den Künstlerkörper eingespannt in die
Maschinerie eines Panoramaröntgenapparats. Auf weiteren Fotografien
verschwindet er nahezu gänzlich unter chirurgischen Draperien. Ein abgewinkelter Arm liegt nackt am Operationsfeld. Chirurgische Positionen
werden eingeblendet, wobei Theodore Wan einen distanzierten und
zugleich ironisierenden Blick auf sich selbst als Modellpatient richtet. Er
setzt sich exemplarisch für andere PatientInnen aufs Spiel und dechiffriert
den
klinischen
Diskurs
in
unterschiedlichen
biomedizinischen
Praxisfeldern. Kim betont, dass Ironie in Wans performativer fotografischer Praxis keineswegs parodistisch angelegt ist, sondern vielmehr mimetisch. Mimesis – im Gegensatz zu Parodie – arbeitet mit der Generierung
einer konventionellen Formensprache von Innen heraus. Damit werden
existierende Gegensätze innerhalb einer gegebenen Situation oder
Institution dargestellt und kritisch beleuchtet. Empirismus, um einen zweiten Begriff einzuführen, mit dem Kim Sawchuk in ihrem Beitrag über
Theodore Wan operiert, genießt in der Arbeit von Gilles Deleuze eine
Wiederbelebung. Ideen als Auswirkungen unserer Erfahrung? Mit seinem
zum Modellpatienten-Werden erforscht der Körperkünstler eine Art von
verbotenem Wissen. Er rührt im Erkenntnisverbot und ironisiert die unterschiedlichen Behandlungsweisen des menschlichen Leibs in der
Biomedizin. Narzissmus gerinnt in den Porträts zu einer Untersuchung des
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Selbst, die alternative alltägliche Interaktionen mit Anderen bietet. Neue
Formen der Auseinandersetzung mit der Welt, in der wir leben. Wan verwendet die medizinische Illustration und Dokumentation als Rahmen, um
jenes System zu studieren, in welchem der Körper in der Krise administriert wird. Nach eigenen Aussagen, entstehen die klinisch kodierten
Fotoserien durch expressionistische Impulse: aus einem emotionalen
Ausbruch von einer persönlichen Krisensituation heraus. Das verbindet
den Künstler mit dem Wiener Aktionisten Günter Brus, dessen Schaffen er
kennt und auf den er sich ausdrücklich bezieht. Brus will mit seinen selbst
verletzenden Aktionen, die er in den späten 1960ern durchführt, buchstäblich aus sich heraus. Aus der Haut fahren. Ein Exorzismus haftet diesen
künstlerischen Arbeiten an. Gleichzeitig haben Wans Fotos geradezu einen
klinisch kühlen Touch. Diese Doppeldeutigkeit macht den ironischen und
kritischen Charakter seiner Selbstporträts aus und die Faszination, die sie
auslösen.
Kim Sawchuk is an Associate Professor in the Department of
Communication Studies, Concordia University, Montreal, Quebec. She is
the co-editor of severel edited collections, including Wild Science: reading
feminism, medicine and the media (2000) and When Pain Strikes (1999).
She is currently completing a book manuscript entitled Biotourism: medical imaging in public culture. She is the incoming editor of the Canadian
Journal of Communications.
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Ironic Empiricism and the Model Patient
The medical photography of Theodore Wan
Between 1978 and 1980, the Canadian artist Theodore Wan
produced a body of stunning black and white self-portraits
taken within medical settings. Wan, who worked as a commercial medical photographer and as an artist, intended to produce
pictures that could be deployed, convincingly, within the institutional milieu of a hospital or within a contemporary art gallery. During his lifetime Wan successfully did both.
In his artist’s statement for his 1978 Master of Fine Arts thesis
show, entitled »No photography beyond this point please,« Wan
had this to say about the ironies of the treatment of the body
within biomedicine:
Medical science is a field concerning the health and sickness of the
human body. It is also a facet of life that society does not want to
face. Therefore it is ironic that a field vitally connected to man’s life
is at the same time so divorced from man’s daily experience that it
becomes foreign and exotic. My venture into the medical field
results from a fascination for this forbidden knowledge. It provides
a great deal of information about the body as well as a framework
for my own work. (90)
To better understand the treatment of the body within clinical
surroundings Wan developed a set of methodical procedures for
producing images including using the formal language of
instructional training for medical personnel as a visual template. His work as a commercial medical photographer gave
him access to equipment and machines, a profound understan-
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ding of the medical procedures for manipulating the body, and
the possibility to collaborate intimately with hospital staff.
Crucial to Wan’s process was that he performed the role of the
model patient in these photographs. This placement of the self
at the centre opened up a profound investigation of the subjective experience of becoming a patient, a procedure that can be
thought of as ironic empiricism.
Irony, parody and mimesis
Irony, notes Linda Hutcheon (1990), is not only about saying
one thing and meaning another. Irony also introduces the possibility of a double voice »that allows speakers to address and at
the same time slyly confront an official discourse: that is, to
work within a dominant tradition but also to challenge it –
without being utterly co-opted by it« (1-2). Whilst satirists
adopt a position of pure outsider-ness with regard to the object
of their criticism, poking fun at people, events or ideologies that
they disdain to re-affirm their superiority, the ironic position
acknowledges that one is an insider and draws upon shared affinities with the object of one’s humor. Though satire draws upon
some of the same elements used by irony, such as verbal or physical hyperbole, satire – unlike irony – underscores distance rather than commonality. Whereas satire is a critique from a presumed outside, and as such comes from above, irony is a critique that emerges from within, sometimes appropriating a
generic form.
I want to emphasize that irony, in the case of Theodore Wan’s
performative photographic practice, is not parodic, but mimetic. While both parody and mimesis demand that a performer
knows the genre and its subject inside out, parodies generally
have a humourous intent. Mimickery, on the other hand, in its
conscious adoption of a potion or pose of another, is not necessarily driven by the desire to amuse. Whereas parody is an imi-
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tation bordering on a satirical send-up of the generic conventions of a given form, irony uses mimesis both to borrow the
generic conventions of form and to work closely from within.
Irony’s main aim, thus, is not to send-up a situation or an institution, but rather signals existing contradictions within a given
situation or institution.
In empiricism, an epistemological position that has been the
hallmark of the natural sciences since the time of Francis
Bacon, knowledge is guided by natural world and the idea that
there are laws of nature to be discovered through experimentation. Whilst heavily critiqued for a number of reasons, including its association with the will to dominate nature through the
application of the scientific method (Adorno and Horkheimer),
empiricism has recently enjoyed a philosophical revival in the
work of Gilles Deleuze involving as it does an emphasis on and
an interest in the senses. At the core of empiricism, as Claire
Colebrook (2002) states, is the notion that »ideas are the effect
of experience« (80). In this contemporary reading of empiricism the human subject, writes Colebrook, is the effect of »a
series of experiential connections« (81). By becoming a model
patient Wan explored the tensions existing within this realm of
»forbidden knowledge« practicing a critical aesthetic strategy
of using his toned, fit and youthful body to probe biomedicine
and conceptual art systematically from the inside out.
Investigating the self
While Wan’s work cannot be reduced to his biography, his
emphasis on self-investigation suggests that some details of the
context in which he lived and worked are warranted. Theodore
Fu Wan was born in Hong Kong in 1953 and immigrated to
Canada with his mother and brother in 1967. Wan graduated
from the University of British Columbia with a bachelors in
Fine Arts in 1975. During this time, he invented the fictional
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personae Mr. Normal, wandering around Vancouver (and art
school) in a cardigan and tie in an epoch when tie dye shirts and
extreme bell bottoms were de riguer. It was at this time that
Wan was first hired to use his photographic skills as a medical
illustrator. Wan attended NSCAD in 1975 until graduating in
1978 with an MFA. In the mid-seventies he discovered the existence of the town of Theodore, Saskatchewan. Noting the
similarities to his own name, he renamed himself Theodore
Saskache Wan in 1977. He went on to found Main Exit Gallery
in Vancouver, where he worked between 1980-82. Through the
mid-eighties he continued his photographic projects, but exhibited very little. Theodore Wan died from cancer on the 21st of
May in 1987. Ironically, he was not sick at the time that he created these photographs, but was diagnosed almost a decade
after he completed this series.
Displaying the body
Wan’s performative process of self-portraiture, committed as
they are to both ironic juxtaposition and learning through experience is not a parody or a satire of medical morays or conceptual art: it is an experiment in setting oneself up as both photographer and as ideal subject, the model patient. As Wan’s archive indicates, he studied Alexander’s Book of Instructional
Anatomy (1976, 2003) to know how to position, drape and paint
the body with a sterile mixture in preparation for surgery. To
achieve »the look and polish which are indigenous to medical
photography« (Wan) Wan used the same large format camera
and various lighting techniques associated with medical illustration. Wan’s fidelity to, yet subtle twisting of, these conventions of medical instructional photography were combined with
the conventions of displaying the body in classical sculpture
and photography. If the former paid strict adherence to the
empirical norms demanded by the sciences the latter reflected
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the aesthetic norms of modernism. For example, Wan’s crisp,
clean black and white photographs, almost always presented as
a series, consistently invoke the structure of the grid and while
at first glance they seem excessively formal this formalism was
not without a wink and nod to the viewer.
Wan loved the wry pun as is most evident in the aforementioned
Name Change project. Not only did he change his name, but he
produced a series of postcards and electron scanning microscopic self-portraits of his semen flying across a grid. In scanning
electron microscopy, a grid indicates how much the image has
been magnified to give the viewer the scale. In the case of these
self-portraits, it also acts as a visual inter-textual reference to
the surveyed grid used to colonize and map the Prairies, the grid
used to measure humans in anthropology, and the grid as a formal device in abstract and conceptual art. These connections,
signaled at the level of form, allow Wan to traverse and re-territorialize this structure of the grid and to blatantly indicate the
highly demarcated geographic space of settlement and colonization. This project thus critiques his positioning as an immigrant from China in the myth of the Canadian multicultural
mosaic, where everyone is supposedly equal. This latter
discourse, as others have written, whitewashes a history of
racism and exclusion in Canada (Gagnon 2000). While Wan
never openly discussed these issues, both his adoption of the
personae of »Mr. Normal« in the early 70’s and Name Change
project makes this point in visual terms.
Expressionistic impulses and cool detachments
As Wan cryptically wrote of his projects, he needed to find a
way to give himself the »permission,« within the bounds of
conceptual art, to explore the body and these lived affective
contradictions of a subject manipulated, bombarded, branded
and judged. This gave Wan permission in another regard: to use
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the techniques of medical illustration as a »framework« to
study this system for organizing and administrating the body in
crisis. In his notes on the genesis of his medical series, Wan
cryptically writes that these highly codified photographs were
generated under expressionistic impulses:
an emotional out burst from a personal crisis: (basic positions) of
being put into a situation and being manipulated; (dental x-ray) of
being bombarded by invisible rays; (being under pressure); (name
change) of being passive, laughed at and being branded, yet wanting
to move forward beyond self-pity; (arm placement) of being judged.
(91)
In terms of the affective irony to be found in the photographs,
Wan said that the images: »…can serve as exorcism. My works
involved an objectification of certain emotional states. This
objectification also renders them as a past, hence offering a
point of departure.« Wan does not elaborate on what personal
crises instigated these sentiments and I’m not sure if it is completely necessary to know what he intended. What is crucial is
that an adherence to a formal and strict logic – to the discipline
and rigour of medicine and formalism – became a method to
experiment with overcoming a heightened affective response.
To achieve the affective tone of cool detachment laced with
humour, Wan worked within these strictly codified boundaries.
By following the rules, one could see what (and if) extra-medical and aesthetic meanings signifying specific emotional states
could be induced out of these conditions of constraint.
In a 1989 lecture at the Vancouver Art Gallery Chistopher
Dikeakos commented on Wan’s strategic use of formalist
detachment as a means of critique: »The enigmatic brilliance of
this work has a coolness, a detached, disinterested sensibility,
all purposeful strategies through the use of formalist techniques
to reveal the irony of situations and context.« Dikeakos, who
was Wan’s close friend and the trustee of his estate, added that
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this »enigmatic quality is really a calculated, logical strategy
with a specific purpose to reveal and critique.« (1, Feb 15,
1989) Wan’s subtle use of irony is achieved by strictly adhering
to the rules of composition inherent to both conceptual art and
medicine. As Dikeakos states, Wan’s »cool detachment produces a critique through irony.« It does so by staging a performance for the camera in which the affective state is simultaneously its opposite: cool detachment becomes the locus of
heightened intensity through the insertion of minute details. In
the photographic series Bridine Scrub for General Surgery, for
example, this irony is conveyed in the direct look at the camera;
in a single gesture of greeting and farewell. Bound by Everyday
Necessities I and II it emerges in the touch and look of the
nurse; in the rice krispie box on the table; in the sequence of
movements in the machine that manipulate the model patient
(Wan) towards the simple taken for granted tasks (when we are
well) of eating and urinating; in the arm reaching out from the
sheet as a flurry of activity takes place around him. Wan achieves this affective intensity through a commitment to a meditative state of submission. The title Bound by Everyday
Necessities and the images both point to the contradictions of
being bound up for one’s own good. Patients are strapped into
these awkward positions because their bodies have undergone
some kind of extreme trauma. These are extraordinary circumstances, depicting as they do a subject bound up in the machine
and the hierarchical machinery of the hospital, who is also
unable to escape banal everyday necessities, like eating and urinating.
Bridine Scrub for General Surgery provokes the tension between intensity and banality at work. It is not just that these
photographs represent a state of calmness. They induce it in me.
But they also confront me. Naked except for the antiseptic
covering parts of his body, Theodore Wan looks directly into
the camera. In looking at the camera directly, he looks beyond
me – the viewer – over my head. If I look back, as his raised
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arm invites me to do, as a spectator I now occupy the position
of the photographer, looking at him. In the act of looking, I
become complicit with the camera’s gaze. There is a movement
back and forth that establishes subjectivity out of a seemingly
neutral objectifying process through which Wan himself is rendered both object and subject. Wan’s photography becomes not
just a way of representing, but a way for spectators to experience these contradictions of these shifting subject positions
through the act of looking.
For Dikeakos, Wan’s irony produces a duplicity of meaning and
purpose that allows the photographer to produce an excess of
potential meaning within a restricted economy of means. While
one of the key characteristics of irony is this duplicity of meaning, duplicity in this context is not the same as deceit. Indeed,
the etymology of duplicity points to the idea of doubling and
duplication. Fittingly, irony is not only a singular event in
Wan’s work, but layered in the photographs so that it is experienced by the interested spectator at multiple levels. It is textual, affective, aesthetic, situational and subjective.
Enduring performances
This photographic practice within the realm of biomedicine
resonates with Wan’s earlier experiments with endurance performance and photography. Here I refer specifically to his 1975
Hornby Island performance, where he lay suspended by ropes
over a bible and read from the Book of Ecclesiastes on vanity.
Wan’s use of his body to explore a number of affective states
does not negate the conceptual or the intellect, but takes the
embodied self as the starting point for testing the limits of all
kinds of control. The Theodore Wan Collection, housed in the
Archives of the Vancouver Art Gallery, reveal that Wan was
well-aware of the connection of his work to the body-based performances of artists like Vitto Acconci, who set up rules to test
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the limits of corporeal movement pushing the performer’s ability to endure a given situation. There is also archival evidence,
in the form of books, letters and notes, of his interest in the
work of the Wiener Aktionismus group and in particular of
Günter Brus another endurance performance artist testing the
limits of corporeal control.
Wan also acknowledged his debt to Marcel Duchamp’s notion
of »the ready-made« that is, the idea that artists could name
found objects as art by their recontextualizing them. Indeed, he
used found footage of film showing a doctor ritualistically dressing in preparation for surgery, claiming it as his own. Wan was
proud that his work could have a practical purpose and that the
same image could be exhibited in either a gallery or a hospital.
As he wrote to the Art Bank, »one of my works was given to a
nursing school instructor as a teaching aide, two others were
installed in the Victoria General Hospital in Halifax as medical
illustration.« (91) Ironically, Wan’s success at inserting his
work back into the medical system meant that the work itself
was lost and destroyed when renovations were done to the
ward: they were not seen as art works, but as out-dated pedagogical tools.
What differentiates Theodore Wan’s works from standard medical illustration is their compositional clarity, as Christine
Conley noted in her 2005 talk on Wan at the University of
British Columbia. Conley, herself a former nurse now working
as a curator, perceptively notes that in standard medical photography there is often an arm out of the frame, a foot dangling,
a section of the photo out of focus, the contrast levels are not
sharp, exacting or clear. In contrast, all of Wan’s photos are
marked by their fastidious attention to details: they are wellcentered, perfectly in focus, the contrast levels and lighting are
perfectly adjusted, and yet they manage still to within the mandatory guidelines of standard medical photography.
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Strict rules and subtle exposures
By focusing on his own body Wan risked the charge that his
photographs would be read as narcissistic. He defended his
decision by arguing that »all self-portraits by nature are somewhat narcissistic, but there are different levels of narcissisms.«
For Wan, such an interrogation of the self could produce its
very opposite: it could be a way to reach out to others. »On a
more admirable level narcissism can be a form of self-investigation. It can be used to achieve a self-understanding through a
route which provides an alternative to everyday interaction with
others« (artist statement).
What piques my interest over and over again when I encounter
Theodore Wan’s pictures is his deliberate cultivation of a
unique approach to biomedicine that brings together two tendencies: one, a respect for empirical methods understood as an
epistemological attitude that begins with the systematic observation and engagement with the world; and two, a lacing of this
empirical method with an ironic critical edge. Wan’s fascination
and dependency on the knowledge offered by medical science
and conceptual art is mobilized to examine a contradiction that
is shared. Both are at once so »connected« to and so »divorced
from daily experience.«
This interplay between of a strict set rules and the subtle exposure of the contradictions of these rules renders Theodore
Wan’s photographs into a site of intellectual exploration and
aesthetic critique. Grounded in the dual strategies of irony and
mimesis, Wan’s relentless pursuit of a corporeal photographic
practice that de-objectifies photography through a heightened
objectification is what makes me do a double take every time I
see his work.
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References
Adorno, T. and M. Horkheimer. (1976) Dialectic of Enlightenment. Trans.
John Cumming. New York: Continuum International Publishing
Group.
Colebrook, C. (2002) Gilles Deleuze. London; New Fetter Lane.
Conley, C. (2003) Theodore Saskatche Wan. In Theodore Wan. Halifax:
Dalhousie Art Gallery, 2003, 11-41.
Dikeakos, Chris. (1989) Theodore Wan Lecture. Vancouver Art Gallery,
February 15, 1989. Theodore Wan Collection, Archive of the
Vancouver Art Gallery.
Gagnon, Monika Kin. (2000) Conundrums: Race, culture and Canadian
art. Vancouver, BC: Arsenal Pulp Press.
Hutcheon, L. (1991) Splitting Images: Contemporary Canadian Ironies
London: Oxford University Press.
Meeker, M.H. and J.C. Rothcock (1976; 2003) Alexander’s Care of the
Patient in Surgery, 11th Ed, Philadelphia: Mosby.
Wan, T. Appendix B, »Statements by the Artist«. In Wan. Op. cit. 90-94.
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Tiefes Gespür
Die Einführung neuer Technologien in Chirurgie und Radiologie führt zur
Verschiebung der Bedeutung dessen, was gemeinhin unter invasiv verstanden wird. In meinem Essay thematisiere ich minimal invasive Eingriffe in
der interventionellen Radiologie. In diesem Klinikbereich werden die
Blutgefäße untersucht und behandelt. Bewegte Röntgenbilder vom
Blutfluss helfen den behandelnden RadiologInnen meterlange Sondierungsdrähte und Katheter durch Adern zu navigieren und winzige
Prothesen in den Leib einzuführen. PatientInnen sind während der
Behandlung zumeist bei vollem Bewusstsein, werden örtlich betäubt und
sehen auf Bildschirmen ihr durchleuchtetes Inneres. Eine seltsame
Fernsehsituation im Operationstheater eröffnet ungewohnte Einblicke.
Augen haften auf Monitoren, während sich Hände mit unterschiedlichen
Objekten und Hightechmaterialien blind in den inneren Gefäßen vorantasten. Eine taktile Ordnung wird deutlich.
Ich erzähle von inneren Lebendigkeiten und wie diese in einem radiologischen Fachgebiet, am Rande der Chirurgie, medial vermittelt und zugleich
– in Echtzeit – durch konkretes medizinisches Handeln verkörpert, artikuliert und umgesetzt werden. Ein intermediales Szenario wird ethnografisch
beschrieben, eines, das unmittelbar an der Integrität des menschlichen
Körpers ansetzt. Eine Choreografie mit allen Sinnen. Invasivität nimmt
unterschiedliche Bedeutungen an: PatientInnen verbinden das Invasive mit
sichtbaren und schmerzhaften Verletzungen, die große Narben hinterlassen. Gemeinhin werden minimal invasive Operationen als weniger gefährlich und belastend für die Behandelnden wahrgenommen. Krankenhausaufenthalte verkürzen sich durch die neuen diagnostischen und therapeutischen Methoden. Ökonomische Faktoren sind wesentlich. Von welchen Körperkonzepten ist die Rede? ChirurgInnen haben ein anderes
Erkenntnismodell vom menschlichen Körper, als etwa RadiologInnen.
Während der chirurgische Leib räumlich (dreidimensional) gedacht wird,
zeigt sich in der Radiologie ein flacher (zweidimensionaler) Bildkörper.
Die Integrität jeder Person, ob Operateurinnen oder Operierte, hängt aller-
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dings mit einer phänomenologischen Leiblichkeit zusammen. Das bestätigen die Erzählungen und Erfahrungsberichte von Behandelten und
Klinikpersonal gleichermaßen. Welche subjektiven (ontologischen)
Spuren hinterlassen minimal invasive Operationstechniken? Mit der
Einführung digitaler Medien in der Radiologie nehmen vertikale Konzepte
des Invasiven signifikant zu, während auf einer horizontalen Achse –
Schnitte in die Haut und in darunter liegende Schichten, die große Wunden
und spätere Narben hinterlassen – effektiv minimal invasiv operiert wird.
In der interventionellen Radiologie durchgeführte Operationen hinterlassen kaum sichtbare Spuren auf der Körperoberfläche. Dennoch erleben
PatientInnen die Interventionen am eigenen Leib als durchaus intensiv und
nicht gerade harmlos. Ihre Erfahrungen und Geschichten lassen invasive
und minimal invasive Behandlungsweisen in einem neuen Licht erscheinen.
Christina Lammer lebt und arbeitet als frei schaffende Soziologin,
Kommunikations- und Kulturwissenschafterin in Wien. Sie beschäftigt
sich mit der Visualisierung des menschlichen Körpers in der Medizin, in
der bildenden Kunst und im Film. Christina Lammer realisiert an der
Universitätsklinik für Radiodiagnostik in Wien ein Forschungsprojekt mit
dem Titel: Der unSichtbare Körper. Preise und Förderungen: SciENCE for
creative industries-Preis: CORPOrealities (WWTF 2004), Charlotte
Bühler Habilitationsstipendium moved BODIES (FWF 2004), Hertha
Firnberg Nachwuchsstelle (FWF 2000), Dissertationsstipendium der
Österreichischen Akademie der Wissenschaften (OEAW 1996-97), Junior
Fellowship am Institut für die Wissenschaften vom Menschen (IWM
1997). Beim Löcker Verlag erschienen: Günter Brus. Kleine Narbenlehre.
Wien: 2007.
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Horizontal Cuts & Vertical Penetration
The flesh and blood of image fabrication in the
operating theatres of interventional radiology
Prologue
The surgical and radiological practices of how blood flow is
being explored, rendered visible and treated are the subject of
this essay, which draws upon ethnographic research conducted
in the operating theaters of interventional radiology at the
University Clinic of Radiology / General Hospital in Vienna. I
am particularly interested in notions of invasiveness and how
they are permanently transformed in this clinical area.
Continual inventions of new technologies in surgery as well as
in radiology lead necessarily to a decomposing of what terms
like invasive, minimal- and non-invasive mean. However, the
meanings of invasiveness for patients and radiological personnel are shifting – this notion is crucial – because it marks a cultural and epistemic turn in medicine, which is already far
advanced. In the operating theatres of interventional radiology,
surgical and digital imaging proceedings melt into one another
and transform the integrity of the patient’s body through particular ways of staging and through a specific choreography between the physicians’ hands and eyes.
Beneath the surface flesh, visible and tangible, lies a hidden vitality that courses with me. Blood is my metaphoric term for this
viscerality. »Flesh and blood« expresses well the chiasmatic identity-in-difference of perceptual and visceral life. The expression
itself appears in certain dictionaries as if one word. To be »flesh
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and blood« is clearly to be one thing, a life entire unto itself.
(Leder 1990, 66)
During my fieldwork with patients and interventional radiological personnel, I observed various forms of invasiveness:
what patients experience as invasive, how surgeons define
invasive, how they look inside the body and how radiologists
use the term in their daily routines at the clinic. I consider the
cultural and social meanings of invasiveness that are mirrored
in a division of labour, which draws a sharp line between tactile and optical perceptions, between bodies and moving video
pictures. Mutual interactions like looking and being looked at,
touching and being touched, perceiving and being perceived,
experiencing and being experienced, form the core of my research interest. Notions like invasiveness are deeply informed
by this mutuality, which I analyse in radiological operating
theatres.
Why am I obsessed by the shifting meanings of invasive, minimal-invasive and non-invasive in the medical context? One
reason why I started my fieldwork at a radiology department
was my naive hope that I would not be confronted with wet
bloody bodies: I cannot stand to see blood. Today I interpret my
fears as a significant reflection of an existing taboo, which I
could not face at the very beginning of my research although it
became crucial for my project. The body is entirely entered and
this conforms with »the two-layered notion of mimesis that is
involved – a copying or imitation, and a palpable, sensuous,
connection between the very body of the perceiver and the perceived« (Taussig 1993, 21). According to Michael Taussig, the
eye is an organ of tactility, the optical unconscious, which
generates a sensual mutuality. If so, then what are the eyes of
radiologists in the context of a vital visceral body? I became
intrigued by these radiological eyes that penetrate and are penetrated and by the illuminating and illuminated hands at work in
the operating theatres of interventional radiology.
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Putting invasiveness into question was the suggestion of Prof.
Dr. Johannes Lammer1, head of the interventional radiology
unit at the University Clinic in Vienna. He was interested in
how patients experience the radiological interventions they
undergo and whether these operations are perceived as invasive
or not. We developed a case study together, which I conducted.
In this essay I concentrate on our interactions with three female
patients who allowed me to accompany them during all these
procedures. I was with them during their interviews with the
radiologist and I taped part of their interventions and operations
with my video camera, which is one of my primary ethnographic tools. After the operations I visited each of these women –
Anna, Barbara and Carina2 – at the hospital. Although their
bodies and the ways they are treated as patients are central for
this particular case study, I will not regard them as separate
from either the medical personnel or from the involved technical machineries. On the contrary, I have witnessed the mutuality of bodies, material components and apparatuses in the operating theatres. Within these chiasms, the notion of invasiveness
unfolds a variety of permanently shifting meanings.
If verbally expressed, repressed and text based narratives are
used for explaining minimal-invasive procedures, then what are
synonyms for invasiveness and how are they brought into play
during the work with patients? How is the body and its visceral
structures, which will be diagnosed and treated later on, being
talked about? My sources stem partly from the Internet, from
data I collected during fieldwork and from (taped) interviews
with interventional radiologists. My ethnographic work does
not only analyze what is overtly said. Working with digital
moving images, which I produced as a participant observer,
enables me to study nonverbal and bodily processes, the
choreography of hands, tools, eyes, light and technical devices
which also speak in this setting. In the medical context, notions
like minimal-invasive are mainly understood as related to concepts of a virtual body space and not to the living bodies of
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patients and radiological personnel. These forms of invasiveness and how they are fabricated and embodied refer neither to
sensuous (somatic) conceptions of a human visceral body nor to
peri-diagnostic lesions, which leave mainly invisible, nevertheless, deep and impressive traces on the patient’s side.
Flesh and blood-less narratives
While most of the surgical and interventional radiological procedures are executed within a well-defined operational volume, the
anatomical details of this volume are not perceived by the operator.
This is due to the fact that potential access routes are limited to
minimize tissue damage. This limits the »navigational freedom« of
the operator. Furthermore, the visualization of the anatomy is limited to the exposed surfaces, beyond which the human eye cannot
penetrate. (Satava 1998, 101)
Reading medical texts on minimal-invasive interventions I
recognized that authors, surgeons as well as radiologists, rarely
talk about flesh and blood, even though they deal with inner
bodily tissue and fluids in their daily routines with patients. In
the book Cybersurgery, edited by Richard M. Satava, flesh and
blood are not mentioned in the index nor are these words a
strong presence in the main text of this volume, approximately
two hundred pages in length. What textual traces do penetrating
eyes leave then, in the aftermath of their operations? A bloodless virtual body is imagined, yet as Drew Leder writes »as
›blood‹, or recessive being, I find a consanguinity with processes that far outrun the traditional boundaries of self« (1990, 68).
By contrast, in the discourse of telemedicine, the lived body is
self-effacing. Invasiveness is a rather technical term, well informed by military vocabulary. One can find words like operation,
intervention and invasion in the medical context as well as
when watching and reading war reports in the daily news.
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When Richard M. Satava speaks about penetration, he does not
have surgeons’ hands at work in his mind, exploring inner
structures. Furthermore, he refers to technical eyes, which
penetrate bodily tissue, losing occasionally their »navigational
freedom« because of other anatomical details blocking the way.
On the Stanford University’s Treatment Center website
(http://www.radiologicsurgery.com/ treatment_intro.html),
interventional radiology is explained:
Here, you will find information about important medical advances
in interventional radiology – sometimes called the surgery of the
21st century. Interventional radiologists are specially trained doctors who use X-rays and other imaging techniques to »see« inside
the body while they guide narrow tubes (catheters) and other small
instruments through the blood vessels and other pathways of the
body to the site of a problem, treating a variety of medical disorders without surgery. Procedures performed by interventional
radiologists (IRs) are generally less costly and less traumatic to the
patient, involving smaller incisions, less pain, and shorter hospital
stays.
In short: minimal-invasively performed operations are to be
understood as less dangerous and burdensome to patients than
conventional surgeries.3 At least two different (epistemic) concepts of the body are in the play here: a three-dimensional surgical body model as well as a two-dimensional radiological one
banned on computer screens. And here it is crucial to underscore that surgeons have a different understanding of the body’s
inside than radiologists.
Prof. Lammer:
In interventional radiology, I perceive the picture in toto. Similarly,
I have to observe how the patient behaves. Does s/he become very
quiet? Is breathing difficult for him or her? Does s/he start slightly
coughing? That’s more difficult and complex. I cannot only con-
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centrate on the X-ray, but furthermore keep my eyes, ears and antennas open to the patient.4
Nevertheless, surgical and radiological labour techniques melt
into one another. For physicians, who are trained in surgery,
exploring the body’s inside with their hands, instruments and
tools, working with pictures in only two dimensions is quite
unusual and rather difficult. Navigating through real bodily
structures, palpating, stripping away and dissecting tissue,
includes particularly practiced and embodied skills. The treated
body is perceived as a container, covered by its skin, which signifies a concrete outer boundary. Beneath every visible sheath,
another one shines forth–or to put it as Michael Taussig does,
»the magic of contact, and that of imitation« (1993, 21) is being
fabricated through horizontal cuts, creating orifices, which enable operators looking inside the body. Radiologists, in comparison, literally peer through bodily segments and organs. A vertical invasion is being performed. They deal with a transparent
body proper, with »the photographic image as being the result
of membranes lifting off the original« (1993: 21), perceived as
a two-dimensional picture surface on several monitors. »Within
medical culture, the body becomes the locus that corporealizes
culture, enculturates bodiliness« (Young 1997, 2). Bodies are
cut open and penetrated in a variety of ways.
Prof. Lammer:
One has to feel tactile resistance. If moving the catheter forward is
becoming more difficult, this is an alarming sign. Can I see anything
significant on the picture? There is as well something wrong, if the
patient is in pain.
The processes at work in interventional radiology are highly
invasive for patients as well as for radiological personnel and
myself as an ethnographer. The deepest structures of the inner
body, the blood vessels of a living individual, are touched and
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manipulated from inside out. Although the artificial orifices
through which the vessels are entered with fine wires and catheters are only tiny, this does not necessarily mean that interventions in this particular radiological field, at the very boundary
of surgery, are minimal- or even non-invasive. The size of the
actual skin cut, which is visible on the surface body, red traces
of running blood, are in the public understanding of the human
body tightly bound on the notion of invasiveness. The bigger
the horizontal cut the more invasive the operation is usually
imagined.
Invisible writings on the body
Prof. Lammer:
Patients do not like to have visible traces like big scars after their
operation. This is a very important issue for them.
In her book Presence in the Flesh, Katherine Young writes:
»Cuts and scars are writings on the body« (1997, 86). Young
shows in a convincing way how the ontological status of the
body and its skin is being stripped away during surgical interventions. For this, she draws on Drew Leder’s notions of an
ecstatic and a recessive corporeality:
But in the act of perception, my surface absents itself. I reconstitute
myself at the focus of my perceptual objects, my body becomes, as
Leder puts it, ecstatic, and, as I do so, my body withdraws from my
awareness, recedes, disappears, and becomes, in Leder’s term,
recessive. (87)
Is the making of patients in surgery immediately comparable
with the performed proceedings in the operating theatres of
interventional radiology? I distinguish horizontal practices of
invasiveness performed by surgeons from vertical penetrations
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conveyed by radiologists. During conventional surgeries,
patients are anaesthetized. Whereas in the radiological operating theatres (most of) the treated persons are fully conscious
during the intervention.
Prof. Lammer:
This can cause a problematic exchange. If it is only a standard examination, for which one does not need to fully concentrate, then talking with the patient is fine. But if it is a more complicated examination, then I have to explain this to the patient: »I am sorry, but I
need full concentration by now, so that I don’t make a failure.«
During the intervention, most of the patients – they have a lot of
expectations and fears – are very quiet anyway. After the examination, they are often astounded by how harmless all this was. Then
they start talking and questioning.
The situation in the operating room is highly ambiguous. The
patient of flesh and blood is present and similarly self-effaced.
S/he is bodily ecstatic and recessive at the same time, hearing
every single noise in the room and being listened to, touching
the hard metal surface of the operating table and being touched,
maybe perceiving two-dimensional moving pictures of one’s
own body’s interior and being perceived and palpated from inside out.
Moving fluoroscopy film pictures on screens depict the meter
long wires, catheters and material components that are being
navigated in and pulled out of blood vessels. Grey shades, fine
lines on an artificial video landscape, cover the symbolic redness of blood, which is linked with the significance of invasiveness. Since the invention of computer technologies in radiology, digital-imaging techniques transform the visceral living
body in a virtual one, which can be perceived in real time on the
monitors. These projected body structures enable radiologists
to navigate through the vascular system of patients with the
help of a previously technologically created virtual space. The
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notions of invasiveness and how they are used in interventional
radiology are deeply informed by models of a rendered visible
(virtual) surface body, although real skin, the ontological status
of the (vital) self, remains mostly unseen (Lammer 1999). Thus,
the chiasm of the corporeality in vivo and its pendant in vitro
gets increasingly explicit. Moving X5-ray pictures replace the
recessive body and similarly create new ecstatic ones.
Twentyfour hours before the examination takes place, patients
meet the physician who will perform the operation. Especially
for young radiologists, who are not very experienced in having
intensive contact with patients, this first meeting before the
intervention is of immense importance.
Prof. Lammer:
In interventional radiology, everything is done directly on the
patient and the procedures are invasive and most of them include
therapeutic aims. Patients have high expectations, are anxious and
often very nervous. One has to tell younger colleagues how they
shall inform patients and what to say. They need to learn to see the
patient as an acting person and not only as a material body proper,
which they shall examine and treat on the following day.
How are terms like invasiveness mentioned whilst the doctor
informs his or her patient? Anna, whose examinations revealed
an aneurysm of the abdominal aorta, is being operated on with
interventional radiological methods on the following day. The
woman (in her eighties) actually decided to see a doctor because she had pain in her back and in her left knee. Then the aneurysm was diagnosed and her surgeon sent her to his colleagues
in interventional radiology. Until her aorta was fixed, he would
not operate her knee.
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Being (a) patient6
Prof. Lammer enters, introducing himself to Anna and greeting
the both of us: »Have you already mentioned your request?«,
»Yes«, I have. With a friendly gesture, he asks us to follow him
to his office. He takes a little white object out of the shelf,
showing it to Anna: »This is the [prosthesis], which we will
place in your abdominal aorta tomorrow morning.« She nods
and listens attentively, although the questions she has are not
directly related to the explanation of the radiologist. The woman is more worried about when she can see the anaesthetist.
She would like to be under full anaesthesia while her intervention is being performed. Her ontological status – her self – permanently intersects with what Prof. Lammer tries to explain,
still holding the tiny object, consisting of two pieces, which
looks like a pair of pants, in his hands.
For Anna the visceral flows he is talking about are not accessible. She did not even feel that something was wrong with her
aorta. The aneurysm did not cause pain or perhaps it did, however, in other regions of her body. The mutuality of her ecstatic
and her recessive body becomes obvious in the ambiguity of the
situation (Leder 1990, 11-68; Young 1997, 7-45). It is difficult
for her to imagine that this little thing is being set into her interior, although she fully accepts that this is necessary and shall
happen. »You know what has to be done«, she responds in the
direction of the physician. Although not explicitly said, existential questions of life and death are in the air. The radiologist
continues describing the proceedings: »We will have to make
two [horizontal] cuts, a very small one and another one of a few
centimeters. The bigger part is being inserted through the larger
orifice and the smaller piece through the tiny opening.« His
descriptions sound rather mechanical, strongly referring to a
surgical body concept including mainly horizontal cuts into the
skin. He does not relate to the complex vertical connectedness
of bodies and images, which Taussig explains thus: »Body and
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image have to interpenetrate so that … tension becomes bodily
innervation« (1993, 23). Together with Anna, Prof. Lammer
answers the questions on the standardized form, which both of
them shall sign. The most important section of the information
sheet includes risks like allergies against contrast or a particular
medication.
Physicians undertake full responsibility for the person who will
be operated on by them. Talking with patients has not only the
function of letting them know about the intervention. The operating surgeon also needs to gain detailed information about
individual physical reactions on the patient’s side. This enables
him or her to react adequately during the examination. It is a
situation of mutual consent: Anna has to permit her body to be
operated on, manipulated, palpated, examined, detailed, visualized in toto and treated by radiological (and surgical) personnel. Prof. Lammer has to prove that he and his team will be
doing a good job, with the aim of solving life-threatening problems the aneurysm could cause in the near future. In addition,
he has to inform her about possible risks. Their signatures on
the form confirm a mutual understanding between them. Anna
has no more questions and Prof. Lammer accompanies us back
to the reception area. »Until tomorrow morning«, he says,
shaking hands with both of us.
I will now introduce Barbara and Carina, two patients in their
thirties who allowed me to video tape their operations. Like
Anna, I meet them one day before the intervention(s). Both
have a large myoma (13 cm and 17 cm) in the uterus, a benign
growth, which will be therapeutically removed the next morning. With a rather new technique, the blood vessels, which
nurture the myoma, are being filled with tiny smooth plastic
pearls inserted through an injection–another way of (vertically)
penetrating the body. A successful therapy can eliminate parts
of the tumour and alleviate inconvenient symptoms only a few
months after the procedures. It turns out that both women are
quite well informed about this particular method. Prof. Lammer
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enters, greeting and introducing himself. Barbara and Carina
immediately start questioning the radiologist about concrete
details of the operation, about risks, how long the actual proceedings can take and how painful this will be for them. Both
are rather nervous and anxious, expressing these feelings verbally: »I am afraid that I won’t be able to sleep tonight«; »same
with me. I am terribly nervous«; »for how long do we have to
stay at the hospital?«; »what kind of medical treatment will be
provided?« The physician patiently explains everything using
easily understandable vocabulary. After answering most of the
questions, the three of them put their signatures on the standardized forms.
Horizontal cuts
»Incisions are surgical inscriptions. They mimic the body’s own
capacity to reify, perforate, and proliferate surface« (Young
1997, 86). In the morning before the intervention, I see Anna in
her hospital bed in the wakeup zone of the department, nervously waiting for the proceedings to begin. At first sight, I can
hardly recognize her as she is lying in a bed. This is a quite
unusual situation for me, meeting a person at the bedside
without having a close relationship with him or her. I feel
ashamed although I get the impression that she does not feel uneasy at all, at least not because of my company. I realize that
being in a hospital causes immediate transformations of how
people would normally behave, act, communicate and articulate
themselves. Everyday life at the clinic has its specific rules,
which are followed depending on the role one has to play.
In the operating room: I question Anna whether she recognizes
me hidden behind a mask and with a cap on. »Your dark eyes
are still visible«, she responds. In the meantime, she receives a
cross-stitch from the anaesthetist, putting her body from waist
down completely numb. It is a complicated intervention, which
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is why this form of anaesthesia is appropriate and more convenient for her. She finds the stitches painful – unfortunately
she needed more than one to infer the serum at the right location in her spine. Usually, before operations in interventional
radiology patients are anaesthetized only locally through an
injection.
The room is comparable to a surgical operating theatre. The difference is that additional diagnostic equipment like a moveable
X-ray tube and several monitors are present. Anna has already
taken her position on the small operating table and is covered
with surgery clothes. A bottle full with a transparent fluid hanging on a metal stand is connected to her blood system through
a catheter, which directs the liquid into the arm vessel. A
needle was introduced beforehand. On her chest and on one of
her fingers some sensors with fine wires are being fixed and
link her organism to an apparatus, through which breathing and
heart frequencies are displayed on one of three monitors.
Bodily functions are transformed into colourful curves and tiny
blinking symbols.
Two radiology assistants enter, exchange a few words with
Anna and start their preparations. Coming from the opposite
side of the diagnostic theatre, two scrub nurses and two surgeons join them. Because they are from another department,
they introduce themselves before the preparation and sterilization procedures begin. Each team (radiology and surgery) has
its own table with instruments and material. I observed a strict
division of labour between the teams.
Which is to say, an indefinable tactility of vision operates here too,
and despite the fact that the eye is important to its channeling, this
tactility may well be a good deal more important to our knowing
spatial configuration in both its physical and social aspects than is
vision in some non-tactile meaning of the term. (Taussig 1993, 26)
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Prof. Rand, one of the radiologists, shows up right after the surgeons have prepared Anna’s blood vessels, where the prosthesis (in two parts) is accurately placed later. Prof. Lammer joins
the team after another hour. For describing and analysing the
procedures in the radioscopy theatre, I borrow the notion of an
ontological choreography, which Charis Cussins has developed
(1998: 166-201). She investigates and shows how one’s subject
position is negotiated within the clinical settings and the power
of technologies. Cussins uses the term agency to refer to actions
through which persons make themselves up and are being made
up.
Finally, the surgeons are finished with the preparation of the
blood vessels around the aneurysm. Prof. Rand can begin with
the imaging processes and with the introduction of contrast
through a catheter, which is inserted into the blood system.
During these procedures – the liquid contrast enhancement already flows through the vessel – he gives breathing commands in
the direction of Anna’s face, which he cannot see from his position: »breathe in«, »breathe out«, »breathe in« and »don’t breathe«, »don’t breathe«, »don’t breathe«…»and breathe further«.
Similarly, he pushes the button for the production of fluoroscopy
images with one of his legs. Although I am still in the operating
room, observing the scenery with my own eyes and through the
tiny screen of my video cam, I can hardly speak with Anna. Her
head disappears behind a curtain of sterile clothes and her mouth
is covered with an oxygen mask.
Vertical penetration
Skin as a living sensual organ, according to Horst Ruthrof
(2000), implies bodily experiences and a non-verbal vocabulary. In interventional radiology, the tacit mutuality between
radiologist and patient is crucial. The radiologist moves material through millimetre thin vessels. His or her tactile skills
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are of enormous importance for the success of the operation. In
this respect, skin – touching and being touched – functions as a
mediator between patient and doctor. I experienced the play of
hands and eyes, of bodily (human) and technical (nonhuman)
parts as highly uncanny. At first sight, it was not clear to me
what was happening during these interventions. The eyes of
radiologists rest on screens above their heads and their hands
work as close as necessary at the tiny but nevertheless bloody
orifice. With sensible movements, metre-long wires and catheters are repeatedly being inserted and pulled out of the blood
vessel. Fingers on the (usually only locally) anaesthetised
wound search through the inner body with the help of video
images, which enable navigation, verifying problematic zones
on monitors.
A tiny orifice connects the hands of the operator with material
components, which are introduced into the vessels. An assistant
supports the efforts of the treating radiologist, handing instruments and material. Used bloody wires, catheters and balloons,
which are pulled out of the body, land in a garbage can. Another
member of the team is responsible for the imaging devices and
for video recording. In addition, s/he reframes and edits the
taped images after the actual procedures are finished. The division of labour draws a sharp line between hands and eyes, between tactile and optical perceptions, between operating field
and moving video pictures.
Anna’s operation lasts for almost four hours. During this period, she partly falls asleep. The radiologists continually wake
her up with breathing commands and with asking how she
feels. They also inform her how long the proceedings will continue. We exchange a few sentences before the operating room
nurse transports her back. She has to stay for a few more days
under the permanent supervision of machines and clinical personnel. She does not feel very well right after the intervention,
although from a medical perspective everything went fine. She
is »glad that it is over« and wants to get some sleep.
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The following morning I wait for Carina in the waiting zone of
the department. She arrives several minutes later in her hospital bed. I accompany her and the male nurse into the operating
room before I leave to costume myself. Two radiological assistants introduce themselves. I videotape the different stages of
preparation and sterilization, and the organization of the table
with material and instruments like injection needles. Carina is
injected with a painkiller and an antibiotic before Prof. Lammer
can begin with the intervention. One of the assistants explains
how she should use the pain pump and puts Carina’s finger on
the button she has to push when things become too painful.
Then the apparatus would immediately induce more of the
liquid pain reliever.
Prof. Lammer tells her »You will feel a stitch now«. I can see
the expression of pain on her face. Her position on the operating table allows Carina to see one of the monitors. I put the
screen a bit closer in her direction so that she can watch the
same abstract moving X-ray pictures that the radiological personnel are looking at. Because she cannot see the operating
field, she questions me from time to time as to what is being
done. I try to describe what is happening, but sometimes I cannot find the right words. Prof. Lammer would then continue my
sentences, explaining accurately and in a simple way what he is
doing. The operation lasts only for one hour and the woman
feels very happy that it went well and that she is done.
Barbara is already nervously waiting in the operating room.
Pain relievers make her rather tired. She is curious about the
pictures on the monitor. The injection of the local anaesthesia is
painful for her and it turns out that her body is reacting more
sensitively than Carina’s. She senses where in her vessels material components are being inserted, where the contrast is and
where the tiny plastic pearls plug the blood flow. These are
bearable feelings. Fascinated, she watches the moving pictures
on the screen. Occasionally she falls asleep. Her operation lasts
twice as long as Carina’s and there is twice as much plastic
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material being injected into her vessels. She is relieved when
the procedures finally are finished. She had imagined the intervention would be more painful. Before she is brought back to
the convalescent room, Barbara questions whether she could
see the videotape. I do not hesitate to pass her my camera.
Seeing the recorded material, she becomes even more interested in these pictures of her own operation.
I see Barbara and Carina back to their room in the morning of
the next day. Barbara asks me whether I could send her the
videocassette with her fluoroscopy pictures and Carina would
like to have a still photograph from her intervention. Of course,
I am happy to send them the material as a souvenir. Lunch is
being served and I leave, but it is clear (though unsaid) that we
will keep in touch.
Epilogue
With the invention of digital imaging technologies in radiology
vertical concepts of invasiveness, penetrating bodies from inside out, significantly increase. However, on a horizontal axis,
cutting into skin and tissue, bringing scars and bloody writings
on the corporeal surface, invasions effectively decrease.
Operations performed in interventional radiology leave hardly
visible traces nevertheless, as this ethnographic account reveals, this particular kind of minimal-invasiveness as intensiveinvasive is never far from our flesh and blood.
Notes
1
Prof. Lammer and myself are not related by blood. We met first time
at the hospital (May 2001), when I visited him to introduce myself and
to ask him whether co-operation for doing ethnographic fieldwork at
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the department would be possible.
2
The names of patients are fictitious. I gave the women other names (in
this article) to maintain their anonymity.
3
I have no comparable data about cost and economic details of minimalinvasively conveyed interventions in Austrian hospitals.
4
Interview excerpt (September 2001), translated by myself.
5
Chi = X: in the Greek alphabet.
6
In an earlier article on Patient Bodies I developed the notions patience
and patients and how these are anchored in the medical context more
extensively (Lammer 2002, 90-107).
References
Cussins, C. (1998) Ontological Choreography. In M. Berg and A. Mol
(eds.). Differences in Medicine. Durham: Duke University Press.
Duden, B. (1990) Der Frauenleib als öffentlicher Ort. Köln: Könemann.
Katz, P. 1999. The Scalpel’s Edge. The Culture of Surgeons. Boston: Allyn
& Bacon.
Lammer, C. (1999) Die Puppe. Eine Anatomie des Blicks. Vienna: Turia +
Kant.
(2002) Patient Bodies, in: E. van Dongen and S. van der Geest (eds.).
Medische Antropologie. Tijdschrift over Gezondheid en Cultuur.
Amsterdam: 90-107.
Latour, B. (1999) Pandora’s Hope. Cambridge: Harvard University Press.
Leder, D. (1990) The Absent Body. Chicago: University of Chicago Press.
Polanyi, M. (1966) The Tacit Dimension. USA: Library of Congress (catalog card number 66-21015).
Ruthrof, H. (2000) Body in Language. London: Cassell.
Satava, R. M. (1998) Cybersurgery. Advanced Technologies for Surgical
Practice. New York: Wiley-Liss.
Taussig, M. (1993) Mimesis and Alterity. A Particular History of the
Senses. New York: Routledge.
Young, K. (1997) Presence in the Flesh. The Body in Medicine.
Cambridge: Harvard University Press.
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Acknowledgements
I especially would like to thank Prof. Dr. Johannes Lammer and Prof. Dr.
Peter Pokieser, both radiologists in leading positions at the Medical
University Vienna (MUV) / General Hospital, who offer me all the support
I need during fieldwork. I also wish to acknowledge the patients and radiology personnel for their cooperation. Without them, my research would be
impossible.
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Fragile Verkörperungen
Körperlichkeit wird in Kyra Landzelius’ Essay über Frühgeburten als
etwas Gleitendes und Flexibles beschrieben. Babys schlüpfen durch multiple Welten ins Dasein. Als historische Figur fristet die oder der
Frühgeborene ein Leben in einer biomedizinischen Hightechumgebung,
angeschlossen an Apparate und Medien, in virtuellen Gemeinschaften und
– neben der Verwandtschaft – als Cyberfamilien. Die winzigen fragilen
menschlichen Wesen werden als Notfälle geboren und sind von Maschinen
abhängig, die sie am Leben halten. Zu schwach für den ersten Schrei.
Andere erheben ihre Stimmen für sie. Die verbleibende Schwangerschaft
wird maschinell ersetzt: Katheter, Schläuche, Nadeln, Pumpen und
Prothesen versorgen die zu früh Geborenen mit Luft und Nahrung.
Künstliche Brutkästen halten sie warm.
Frühgeburten durchleben leibliche Exkursionen durch unbekanntes
Territorium der Subjekt-Objektbeziehungen. Baby und Technologie bilden
eine Einheit, die durch geringste Bewegungen unterbrochen und gestört
werden kann. Der Inkubator fungiert als technologische Ersatzmutter, als
steriler und dennoch wärmender Bauch. Mütter, deren Schwangerschaft
durch eine verfrühte Geburt unverhofft aufhört, beschreiben ihre Gefühle
mit Worten des Verlusts und Verlangens. Manche berichten, dass sie sich
um einen Teil der Schwangerschaft betrogen fühlen, diese gerne »zu Ende«
(des neunten Monats) gebracht hätten. Welche Identitäten werden in einem
solchen Szenario konstruiert? Kyra Landzelius argumentiert, dass Rollen
wie Mutter und Baby destabilisiert werden. Raum und Zeit geraten für alle
Beteiligten durcheinander und stören die emotionale Entwicklung und die
Bindung zwischen den Eltern und ihrem Kind. Kyra untersucht die semantischen Texturen, die im Spiel sind, in einer Amerikanischen
Intensivstation. Sie führt Dutzende von Interviews mit Müttern und
Vätern. Die Wissenschaftsforscherin verortet Kategorien wie Zuneigung in
taktilen Choreografien, in zärtlichen Berührungen, in verkörperten Formen
von Vertrauen. Diese affektiven Handlungen und Interaktionen sieht die
Autorin in der hochtechnologischen Welt der Frühgeborenen gefährdet.
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Wochenlange Krankenhausaufenthalte. Trennung von den Eltern. Wie entwickelt sich eine Bindung zwischen Mutter und Kind, wenn Apparaturen
und Distanzmedien dazwischen geschaltet sind? Was bedeutet diese spezielle apparative Welt, die Umcodierung der Mutterschaft, für die
Entwicklung der Identität eines Menschen? Kyra Landzelius beschäftigt
sich zudem mit den Homepages und virtuellen Gemeinschaften, die
Betroffene kreiert haben. Mit den Geschichten, die erzählt werden. Mit
Zeichnungen und Bildern, die eine traumatische Situation zum Inhalt
haben, welche in unserem emotionalen Repertoire schwer vorstellbar ist.
Die Apparatemedizin schafft Cyberkreaturen. Sie erzeugt affektive
Bindungen und Interaktionen zwischen Neugeborenen, traumatisierten
Müttern und Vätern, Leben spendenden Maschinen und ÄrztInnen, die
eine gemeinsame Mission teilen – zwischen Lebendigkeit und Sterben.
Frühgeborene eröffnen unheimliche Vorstellungen davon, was es gegenwärtig bedeutet, eine Person zu werden.
Kyra Landzelius is a medical anthropologist working in science and technology studies. A lecturer and researcher at the University of Gothenburg,
Landzelius earned her Ph.D. at the University of Pennsylvania before
moving to Europe. She is presently a Lise Meitner Postdoctoral Scholar
and a Visiting Fellow at the Institute for Advanced Studies on Science,
Technology and Society (Graz). Her research on preterm babies and the
history of neonatology has appeared in Social Science and Medicine;
Culture, Medicine and Psychiatry; and The Journal of Material Culture.
She is currently working on a book provisionally entitled: Via Prosthetic
Worlds: The Multiple Inventions and Technological Uncanny of the
Preterm Baby.
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Corporeal Slippages
Trans-acting the preterm baby via multiplications
Corporeality slips… through our fingers, our fantasies and our
flesh… Corporeality unites us and divides us, betrays us and defines
us… Corporeality comes and goes, goes and comes into existence,
incarnating time, transacting spaces…
This is an essay about the multiple corporealities1 that incarnate the preterm baby, and in so doing, ontologize baby’s coming
into existence in and across multiple worlds: fantastical worlds
of phenomenology and myth, epistemology and praxis; quotidian worlds that encompass and bridge the landscapes of techno-science and kinship, virtual community and cyborg family,
folklore and politics. This is a journey that takes us into and
through the corporeal slippages that transact a person’s multiple
becomings – becomings that are manifest in a spectrum of identities the sum total of which bring into being the preterm baby,
the preemie. An exciting new historical actor appears on stage
in the figure of the preemie: one inaugurated by biomedicine,
interrogated by media, christened by a curious public. From the
moment of entrance, the preemie chaperones an impressive
array of non-negotiable personae: state-of-the-art patient, pioneering kin, politico-legal controversy, infamous celebrity, million-dollar baby – a feat of biomedical engineering and a newly
minted biological organism. In navigating the emergence of
these manifold personae, this essay situates the preemie self
within a galaxy of primary attachments in order to map the travels and travails of preemie family in their quests to know, and
come to initiate, preemie kin.
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E-mergences and partings
Born emergency into a customized universe of technological
others and prosthetic wonders, the premature infant born-toosoon and its incubator habitat pose nothing less than a marvel: an
extreme version of human-machine co-dependence, a cyborgian
madonna-child befitting the 21st century. This iconic/dyadic
invention pays testament to today’s extraordinary accomplishments in the turbulent and ambitious arena of artificial life support, life simulation, life substitution and life surrogacy. At present, biomedical expertise has fair chances of keeping alive a
human born at 23 weeks gestational age; measured against a normal pregnancy of 38-40 weeks, this clocks in at nearly half our
species-specific timetable. But just what does it mean when baby
comes half-a-tenure early – sized to a hand, weighing but a
feather, mid-point in production, too young to even cry? One
might say that the human scale, that »becoming« itself, is radically re-spun: fundamentally problematized in the silent figure of
the unannounced and unfinished newborn. With a relay of catheters, tubes, electrodes, shunts, needles, pumps and so on and so
forth entering and exiting and orbiting baby, inter-articulating it
with multi-functional delivery-systems and various black box
recording devices, there seems little doubt that the preemie
debuts with anomaly. After all, this precocious and fragile creature is acutely dependent (with varying degrees of intensity)
upon a vast array of mysterious and intimidating artifacts; what
I have elsewhere (Landzelius 1999) called »charged artifacts«,
implying the word with triple intent: as artifacts »charged« with
vital tasks, artifacts invested with emotional energy or affective
»charge«, and artifacts which impose »charges« upon us, challenging us to recognize technological agency and our co-dependencies therewith. The services of vital machines are required to
assist preemie with thermo-regulation, respiration, circulation,
metabolism, organ-work and a vast array of other physiological
functions; called upon, in short, to finish the job of gestation.
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Perversions and excursions
Given such a procession, the preemie and her entourage of
serious prostheses can be said to present a corporeal perversion
of the very terms of ontic purity: a radical deviation from some
(albeit idealized) aboriginal state, some expected order of bodily integrity presumed to reside in the autonomy and indivisibility of a (pre-)packaged self that (it is assumed) we all are born
with and bound by. Preemie and entourage can also be said to
represent a corporeal excursion, of sorts, into uncharted territories of subject/object relations. These territories are home to
such conjunctive forms and hybrid performances as we witness
in the body-double that enfolds preemie plus incubator, a composite body intensively if temporarily coordinating/choreographing these two corpora towards a common goal, a singular
movement; the delicate (and precision) pas-de-deux of baby
and technology transacting a dance of life. The uncharted territories that accommodate corporeal excursions (taking form in
amalgamated bodies) accordingly give shelter to radical experiments in techno-mediated relations, referring here to not just
the human-machine »interface,« but to the challenges posed by
machine(s) as embodied actors that mediate, complicate, facilitate and otherwise become aspectual of human-human intersubjective relationships and communicative projects. As we
shall see, the incubator et al. pose many a challenge to the
taken-for-granted »normative« mother-child relationship, first
among them being its functional substitution for the maternal
role. The incubator et al., as Ersatz-womb, is itself consequent
to yet another corporeal perversion that catalyzes and underwrites the preemie odyssey. The perversion in question involves
the untimely decoupling of pregnancy’s own body-double: that
gestational riddle whereby two are one, one forms two, in a
steady crescendo set to march at deliberate tempo, a universal
pace. Under premature conditions, this riddle or set-up – what
Kristeva (1986) describes as a split self/not-self maternal iden-
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tity – slips all too quickly into delivery’s duality, that is, into the
task of birthing one (or more) individual(s). In most cases, the
preemie’s early debut precipitates abruptly and without warning, and of course from that moment onward the separation is
permanent. A preemie mother with whom I spoke (during the
course of three years of ethnographic fieldwork in a US tertiary
medical center) described her feelings about a precocious birth
in words of loss and longing. Many reported feeling »cheated«
out of a much-anticipated experience, many grieved about the
disruption and the forfeiture of pregnancy’s »somatic agenda«;
some, seeking closure, even expressed futile yearnings to return
to and »finish« the gestational project.
Longings and translations
Under such a scenario, identity-constructions and role expectations vis-à-vis motherhood (and babyhood) are destabilized.
They necessarily reshuffle into new equations. With baby radically other (than expected) – utterly engulfed in prosthetic matters and vitally dependent upon such mattering – maternity is at
risk of being demoted, dislocated, estranged, wounded.
Customarily and rather unavoidably, mother herself is relegated
to a satellite status in the hospital environment – situated on the
outer orbits of action, she has little input, lacks critical knowledge, is threatened with irrelevance, may even be a patient or
recent patient in her own right. All of this (i.e., the baby’s prematurity, the machines’ vitality, the mother’s marginality, the
hospital’s sterility) makes the spatiotemporally disordered and
out-of-place preemie a tricky subject for the magic of attachment formations. The problematization of mother-child bonding introduces us to another challenge that characterizes and
underwrites the preemie odyssey.
My work experiences in an American neonatal intensive care
unit (NICU) and the dozens of interviews I have conducted with
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preemie mothers over the years, amply attest to just this: That
many a preemie mother is challenged to form and perform
attachment projects with babies tiny, frail, sickly, perhaps on
the threshold of viability. To ponder a mother’s (a father’s)
plight, might we explore the semantic textures of bonding and
attachment? Turning to etymology, we find to bond has cognates with to bind – a pairing that seems to signify mutual linkages to something physical, kindred connotations of something inescapable. Plundering further, our word origins discover/ uncover that attacher (old French) means to stake: to
plunge, sink, hold fast, commit. In thus considering the etymological umbrage of both words – to bond and to attach – we
might concede that a materiality of sorts lingers. This lingering
materiality leads one to reflect that few terms of emotion so
prominently feature the local/locale: in a manner of speaking,
attachment yearnings are fixed. Whilst positioned and repositioning in a constant state of flux, agendas to form attachments nonetheless may seek to be grounded, to rest, to be certain, to feel at home. Conceived another way, attachment might
be sensed as so many slippages of corporeality into emotional
fields and vice versa, precipitating a cascade of corporeal
translations via fantasies, fingers, flesh. If we thus grasp attachment to be rooted in tactile choreographies – in the touch of
love, the reach for discovery, in embodied pathways to fathom
the other intimate – it seems self-evident that such choreographies are interpolated, even violated, by the technological apparatuses of incubator et al.
After all, the vulnerable preemie (precouciously detached and
cast from her uterine home) is precommitted – delivered, as she
is, always-already into a thicket of attachment(s). I here refer to
the techno-attachments (the heart monitors, thermo-regulators,
mechanical ventilators, pharmaceutical dispensers, and like
artifactual others) that bind and are coterminous with baby. The
material and semiotic relays that cross-link baby’s body with
the techno-bodies of vital machines are so seamless and essen-
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tial, and in their mission so intimate, that it is difficult to precisely locate the corporeal divide, to establish just where one
body leaves off and another begins; difficult in fact to say just
who is animating whom? As suggested, it takes an entire
army/symphony of manufactured surrogates to bring preemie
into being. This makes preemie’s first home, an ecology of
cybernetic connections. It is, in effect, a maze way of feedback
events, of subject-object relations, that hold and cradle baby,
attacher: staked – and with survival at stake – to mechanical
surrogates and smart prostheses. Any somatic longings to bond
that mother/father might harbor are conceivably sidelined in/by
this milieu: complicated by the preemie’s vulnerable essence,
intercepted by the equipment’s massive presence. In short, the
(life-saving) therapeutic itinerary thwarts the (kin-fostering)
attachment itinerary.
How then, we might ask, can/does bonding proceed despite and
across distances dividing mother and child, distances that separate and cleave bodies of longing, distances that mute and convolute maternal passions, sabotaging expression? Taking the
form of weeks, likely months of prolonged hospitalization, such
distances are temporal as well as spatial. Such distances are
equally conceptual and existential: in the first instance, implying the vast and barely-comprehensible stretches of (a new
mother’s) profound alienation from normative expectations
(her own and those that society visits upon her); in the second
instance, arising from the harrowing (and unpredictable) journey of/into uncertainty itself – the inevitable encounter with
those exquisitely unanswerable questions about survival and
future normality, about what biomedicine (ambitiously if never
with certainty) calculates to be viability. Parents must navigate
the daunting challenges of such foreign terrain, whilst themselves riding the emotional roller coaster of grief, shock, joy,
yearning, hopes and fears that typify the newborn period.
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Fixations and relocations
Under these circumstances, to bond becomes a frustrated/frustrating agenda, yet for many parents it nonetheless remains a
determined one. My ethnographic fieldwork suggests that
parents devise creative strategies and pathways in their quests
to grasp connections. Some of these strategies are unreflective,
some methodical, but all oblige new orientations towards preemie person and her lifeblood entourage. What many of these
quests to (re-)capture intimacy seem to entail is the discovery
of new means to reconfigure the geometry of bonding – means
that enlist new behaviors as well as new modes of thinking.
Mothers, for instance, tend to reorient (the idea of the) motherchild pair in ways that discursively and behaviorally incorporate that third party actor (namely the incubator et al.) – inaugurating, in the process, a triadic arrangement. Such incorporative overtures found expression in mothers’ narratives and
actions, as I observed them taking place in the intensive-care
nursery. In conversation, for example, incubators and infants
were often coreferential to an extent that metonymy was frequently in play. Not only did mothers routinely become adept at
learning the functions of the various life-support appliances,
but it was common for these women to rely upon the machines
as communicative others providing front-line information about
their babies (Landzelius 1999). Accordingly, maternal attention
was frequently first riveted to black-box recording/reporting
devices as the primary points of reference regarding child.
Alongside linguistic performances, other pathways to bonding
are to be found in the realm of praxis. One such involves the
popular practice of placing toys, stuffed animals, family photographs, ribbons, greeting cards, etc. into baby’s incubator
chamber. Elsewhere (Landzelius 2001) I have interpreted these
decorative acts as gestures to embellish and even »humanize
the machine«, gestures that in so doing arguably seek to »detonate« the liminality of these »artifactual others«. These acts can
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be viewed as attachment initiatives that work in part (and vicariously) by »instilling« a maternal presence in the alien and
alienating hospital setting. To condense this line of reasoning, I
am suggesting that items of material culture linked to kinship
and birth rites de passage are imbued with emotional valence
and enlisted into service as totems and talismans to carry forth
mothers’ corporeal/affective longings. Nestled in incubator
units, these items signify and become symbolic proxies for
home, community, lineage Mom and the like – possibly representing, in the latter case, maternity’s own corporeal slippage
into signifiers of affection, a symbolic slippage that answers
many a mother’s fantasies, many a yearning in her flesh and
fingers. In addition to qualifying these practices in terms of desires to »soften« the incubator et al. – to make it more »cozy«,
»colorful«, »warm« and »welcoming«, to quote the women I
interviewed, some mothers also explained that these acts helped
them »feel closer« to baby. This suggests that through pictures
and playthings, some women take comfort in imagining themselves at their child’s side.
Rehearsals and projections
It is into a qualitatively other realm of imaging and imagining
that I would like now to venture, to chart yet another pathway
to bonding that preemie parents blaze. This takes us from reality to hyper reality, from the concrete context of situated actions
and embodied interactions to the virtual context of textualized
actions and computer-mediated interactions. We move from
therapeutic exhibits of preemie in hospital, to digital exhibits of
preemie online.
For it is into a cyberspace meeting place that preemie parents
venture: to re-image and re-imagine the preemie other. In a
non-dimensional, x-dimensional techno-scape / electro-scape,
they seek out and perform attachment via networks of solidari-
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ty and haphazard community. Coming into existence through
the media of personal »Preemie homepages« linked into organized Preemie Web-rings, these networks draw parents –
drawn, with so much at stake – to forge / find / fashion understanding. It is online that parent-pioneers venture to share their
stories with allies anonymous, with strangers-turned-confidantes, turned shoulders to lean upon: countless virtual shoulders
collectively shouldering the burden of preemie alterity.
Let’s loiter at one of the most prolific, most visited and (at 13
years and counting) most long-lived of Parents of Preemies
homepages, Tommy’s Cybernursery. This homepage justly proclaims its status as »an original«, nevertheless its tenor and content mirror its »peers«; as such, it is highly representative of an
emergent genre of Preemie homepages. Such similarity traverses linguistic boundaries; although the homepage I consider
here is in English, I have found preemie homepages and Webrings to be strikingly uniform whether written and posted in
Swedish, Dutch, French, Norwegian, German, Russian or
Spanish. Upon logging in to Tommy’s Cybernursery2 we meet
Tommy, »a micro-preemie born @24 weeks gestational age.«
This tidbit of information, written here exactly as on the homepage, immediately introduces us to the most oft-recited event
on preemie sites – the »born emergency«. For Tommy, this
refers to his grand, if precarious, entrance (too soon and
unfinished) into the arms of mechanical surrogates, to be
nursed by techno-science and its expert midwives. Like so
many preemie origin stories, Tommy’s begins with chaos, an
abrupted placenta, hypertension, gushed water, rushed labor. A
world-transforming / life-transforming chaos, and then eureka!
Little Tommy’s arrival, ooh so tiny, so frail, arriving thin, yellow and pale with brain bleeds and a collapsed lung. Reading
on, we find ourselves immersed in the highly detailed account
of Tommy’s biomedical rescue: we learn about »intubations«
and »ECMO«, about »oxy hoods« and »bilirubin«. And on we
go … into a landscape dotted by clinical hieroglyphs, by nomi-
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nal windows that open (onto) the esoteric and erudite world of
neonatology and its healing arts. If we venture forth into other
preemie homepages, we soon come to realize that impenetrable
yet weighty acronyms tend to populate preemie narratives:
NICU & ROP, degree III IVH & NEC3. For the neophyte, there
is usually a point-and-click glossary to aid our deciphering.
These homespun (yet aiming accurate) glossaries are another
ubiquitous feature of Parents of Preemies homepages and Webrings, allowing us to better enter the world of Ryan, our pioneer
for surfactant therapies; and Marco, a candidate for NIDCAP
and kangarooing; and Gloria, who travels from warming bed to
isolette to incubator, and back (alas) to warming bed, after
weathering a NEC relapse.
It is thus through a forest of symbols that increasingly tech-savy
readers are made privy to the medical facts – to diagnoses, prognoses, protocols and pharmacologies – as well as to the story’s
narrative – to Tommy’s struggles with yet another malady (yet
another set-back in his medical odyssey / oddity) and to mom’s
/ dad’s naked reflections and heroic coping. Deeply sentimental
yet dripping with science, preemie stories are an odd mixture of
the foreign and the familiar: juxtaposing first surgeries with
first birthdays, medical marvels with everyday chatter.
Can these juxtaposed expressions/confessions be understood as
a slide into heteroglossia: the endearments of kinship and the
registers of biomedicine meeting in Bakhtinian collision,
bespeaking a montage of essentially incompatible worlds?
Does this tossing about of medical acronyms have something of
the magical about it, something approaching incantations and
hocus-pocus power? If so, might it be ventured that these ritualistic recitations of medical jargon enact rehearsals of sorts:
transporting parents away from cognitive dissonance and sheer
impotence? Enunciation being an aboriginal form of appropriation: by wrapping a common tongue around logos, we thereby
lay claim to name, as Foucault, Derrida, Orwell and eloquent
others have reminded us. One might conjecture too whether
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these thickly layered narratives – heady with fact and with
poignancy – call into mnemonic rehearsal the preemie’s phenomenal odyssey?
Drawings and illuminations
But not just words tell the Preemie adventure: back at Tommy’s
homepage we find the bonanza of graphics that characteristically transact the preemie’s tale. Here, photos innumerable
bring us Tommy: at day 2, day 3, day 10; at weeks 4, 12, 20; at
11 months of age with first haircut; at each birthday 1 through
12. Across the Preemie Web-ring, NICU photos chart preemie’s
passage into life, and preemie’s life passage(s). This charting,
seemingly de rigueur, is where we find preemie exquisitely
chaperoned by her vast cast of vital prostheses. We observe
preemie under blue therapy lights, preemie receiving transfusions and veritably swaddled in bandages, not only encapsulated in her life-support chamber but escorted by descriptive captions. Given the tendency for parents to adopt / appropriate the
preemie subject position, these captions come typically »narrated« by the protagonist. Accordingly, Tommy’s voyage is spoken through Tommy: »Here I am with a nasal intubla«; »Here’s
a picture of me being taken off the ventilators«; »Mom’s first
time holding me, age 6 weeks.« There is also the proverbial
»The day I came home from hospital« photo: a snapshot replete
with the entire NICU pageantry. In other words, photo after
photo on these parents of preemies homepages show baby in /
on / with / at the machinery. Often enough, there are photos showing just the machinery, just the incubator, ventilator, warming
lights, etc., posed too with their descriptive captions. Photo
after photo as so many variations on a theme: the wizardry of
gadgets that save lives, the poignancy of newborns in various
stages of inchoateness, the incredible precision of therapeutic
management. Photo after photo, in an extraordinary family
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album, drawing extraordinarily uncanny beings, inexplicable
worlds and – drawing us – into the hospital odyssey.
To virtually wander through this preemie gallery is (for me) to
wander into a cave of awe and mystery, to travel through an
online gallery / galaxy where cyber paintings (like cave paintings?) take pilgrims on a cosmological journey. Here tales are
told from the beginning of time, tales that revere the miracles of
nature, tales that applaud the feats of man the conqueror. In the
case of preemies, of course, these stories are not etched in red
ocher on stonewalls, hidden and barely illuminated; they are
encoded, rather, on silicon chips and telecast for all the modern
world to see. In both cases, however, one gets the impression
that these stories carry messages for posterity as well as offer
ponderings for contemporaries. In both cases, they are records
of intentions. This leads me to wonder: what motivates these
baroque exhibits of preemie-plus-prostheses? What visions
drive these parent-authors?
Eco (1999) bids us to observe Galileo at his microscope – the
celestial explorer, drawn to a primitive lens with a mission to
discern Saturn, the ringed planet. Unprepared for what he saw,
a perplexed Galileo, proto-astronomer, was drawn to draw and
redraw, to sketch image after image of the curious object/subject so like and unlike other planetary bodies. And through so
drawing, Galileo eventually came to know. Could it be that
parents of preemies are, in their own way, early explorers of the
cyborg, drawn to screens electronic to discern Preemie (with its
prosthetic entourage, a ringed human)? Parents of preemies,
proto-cyberians, drawn to draw and re-draw, to enlist imago
after imago of the curious subject/object so like and unlike
other humanly bodies. And through so drawing (is it their hidden hope?) they/we may come to know?
Such a reading makes NICU photos a keen recitation of the
preemie’s techno-scientific coming-into-being, graphic reminders of her (our) existential come-and-go in the age of digital
reproductions. In their way, too, homepages constitute a form
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of questing: they launch voyages to forge / find / fashion attachments. For, are such expeditions not equally personal / collective embarkations upon an alternative, inventive, socially mediated pathway to bonding? In this dance, preemies and preemie
parents entangle in kinship choreographies that move them to
reposture intersubjectivity and its complexly transacted (human
and machine) embodiments. It is a dance that bends the dynamics of proximity and distance: inviting new figures / new artifacts into parents’ longings to realize itineraries of attachment.
Mediating the medium
We have here explored multiple slippages of myriad corpora –
artifactual / ethereal, emotional / electronic, hieroglyphic / graphic slippages. Slippages travel via media and matter. Slippages
chaperoned by things and by fantasies. Slippages transact
bodies into and out of space and time.
I conceive these corporeal slippages as innovative journeys of /
into attachments in plural: attachments that bind, bond and
stake together frail newborns, traumatized parents, vital machines and a cadre of medical experts / expertise which are all
bound together in a life / death mission; all bound also in phenomenal quests to grasp the profound ontology that Preemie
beckons us witness. This is nothing less than the coming into
existence of the at-once proximal and distant – the radically
other, the exquisitely self. This is the Preemie, not (just) as
novelty, anomaly, or exception, but rather, as a brand new category of person in our midst.
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Kyra Landzelius
Notes
1
I borrow this word and inspiration from the work of Christina Lammer.
2
I have chosen not to detail the address of Tommy’s homepage, in large
measure because its identification is not vital to the gist of my essay.
My reasoning is also related to my ongoing grapplings with the ethical
challenges that virtual ethnography poses, in problematizing the very
nature of the research subject/text and the researcher’s relationships
and accountability to our many (known and anonymous) online »informant.« Tommy’s homepage is squarely in the public domain: meaning
here that it – like all of the homepages and webrings that I have studied in several languages – is freely available via the world-wide-web
and does not require a password for access. While I have sought and
received permission from parents to quote and reproduce pictures from
personal homepages that they post in the Webring, I nevertheless must
weigh a direct ethical responsibility to the babies who animate these
homepages. I thus seek to balance research obligations to maximize
the protection of subjects, with obligations to verify data and to further our inquiries into sociocultural phenomena and human meaningmaking endeavors in the historical moment.
3
To clue the reader in on some of these abbreviations:
ROP: retinopathy of prematurity, an eye disorder caused by oxygen
pressure; it can lead to blindness.
IVH: intra-ventricular hemorrhage, or bleeding in the brain; it is graded by degrees I through IV according to severity.
NEC: necrotizing enterocolitis, an aggressive intestinal infection that
can cause permanent bowel damage. NEC can be fatal.
References
Eco, U. (1999) Kant and the Platypus: Essays on Language and Cognition.
London: Seker and Warburg.
Kristeva, J. (1986) Stabat Mater. In Moi, T. (ed) The Kristeva Reader. NY:
Columbia University Press, 160-186.
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165
Landzelius, K. (1999) Screening Preterm Babies: From Cyborg Wombs to
Virtual Attachments. In Lundin, S. and Åkesson, L. (eds)
Amalgamations: Fusing Technology and Culture. Lund: Nordic
Academic Press, 84-103.
Landzelius, K. (2001) Charged Artifacts and the Detonation of Liminality:
Teddy Bear Diplomacy in the Newborn Incubator Machine. Journal of
Material Culture, 6(3): 323-344.
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Die Biopolitik von Krebs
Das Modell moderner PatientInnen basiert auf Ideen der Aufklärung:
Vernunft, Freiheit des menschlichen Subjekts und Kontrolle über die
Natur. Anastasia Karakasidou untersucht Krebs auf der Insel Kreta
(Griechenland) unter biopolitischen Vorzeichen. Sie verbindet theoretische
Ansätze von Giorgio Agamben (1995) und Michel Foucault (1963) mit den
Erzählungen krebskranker Menschen und ihren ÄrztInnen. Subjektive
Erfahrungen werden zum Ausdruck gebracht. Krebskranke gelten als die
modernen PatientInnen: vernünftige Individuen, die auf die Autorität ausgebildeter SpezialistInnen vertrauen und diese akzeptieren. Auf einer
Krebsstation werden das nackte Leben des individuellen Körpers und die
wissenschaftlich definierte Lebensqualität miteinander konfrontiert.
Gegen die Krankheit wird buchstäblich Krieg geführt.
In Kreta wird von Krebs als die böse Wunde gesprochen. Die Wunde kann
unterschiedliche Formen annehmen. Eine Frau in den 1930ern hat eine
Wunde in der Brust. Die Nachbarn einer Frau mit Hirntumor in den
1950ern sprechen von einem Schmetterling in ihrem Gehirn. Westliche
Medizin und Biopolitik werden in Griechenland Mitte des 19. Jahrhunderts
eingeführt, nach der Gründung des Landes als unabhängiger Nationalstaat.
Frankreichs biopolitisches Projekt gilt als Vorbild. Im Krankenhaus wird
ein Mikrokosmos an der Grenze von Macht und Wissen im Austausch zwischen ÄrztInnen und KrebspatientInnen deutlich. »Kann es nur eine Zyste
sein?« Ein typisches Gespräch. »Das wäre wie ein Lottogewinn.« Einem
Buben erklärt ein Onkologe die Chemotherapie: »Besser wir tun etwas und
es ist nichts, als wir tun nichts und es wird etwas.« Mit dieser zweideutigen Vernunft werden kranke Personen davon überzeugt, ihr Einverständnis
zur Behandlung zu geben. Entscheidungen über Leben und Tod, die den
Betroffenen keine Wahl lassen. MedizinerInnen verkörpern die Autorität
von Wissen. Sie haben die Kontrolle über medizinische Testergebnisse und
teilen nur Ausschnitte ihrer Kenntnisse mit den Erkrankten und ihren
Familien. Anastasia Karakasidou vergleicht den onkologisch tätigen Arzt
mit dem Priester. Die Wissenschaft der Moderne ersetzt den sakralen Ort
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Christina Lammer
des Religiösen. Das nackte Leben im krebskranken Leib wird sprichwörtlich in die Hände der medizinischen Autoritäten gelegt. Leben und Tod
werden faktisch in einen Mantel der Wissenschaftlichkeit gehüllt. Ihre
politischen und symbolischen Bedeutungen verschwinden unter dieser
Hülle der objektiv konstruierten Erkenntnisse. Persönliche und subjektive
Leidensgeschichten der Krebskranken bleiben paradoxerweise häufig
ungehört. Die Biomedizin mystifiziert hingegen die Machtbeziehungen
einer gesellschaftlichen Ordnung durch die Einflussnahme auf erkrankte
Individuen in Gestalt einer Wissenschaft der Körper und der Dinge.
Krankheit bedient die ideologischen Notwendigkeiten einer Sozialordnung, in der Menschen, die Krebs überleben, als Kriegshelden gefeiert
und ermutigt werden, denen zu helfen, die ihren Kampf noch vor sich
haben.
Anastasia Karakasidou has a Ph.D in anthropology from Columbia
University. She is an Associate Professor of Anthropology at Wellesley
College. Anastasia Karakasidou has published a book entitled Fields of
Wheat, Hill of Blood: Passages to Nationhood in Greek Macedonia, 18701980, and on issues of nationhood and ethnic conflict in Macedonia and
the Balkans. She is involved in writing a book about cancer entitled
Cultures of Cancer in the Global Village.
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The bio-politics of the disease in Crete
Prologue
In one of his most famous works, Politics, Aristotle posited the
dictum that man is a political and cultural animal. Human
nature, Aristotle suggested, was based on a fundamental juxtaposition between zoe and bios. Zoe, as reflected in the Greek
word zoon meaning ›animal‹, refers to that ›bare life‹ animallike essence within us. Bios derived from the Greek, signifying
›quality life‹ and our cultural capacity to communicate and to
form larger aggregate social units. The polis, or political unit
which is a culturally based social formation, acquires its legitimacy, indeed its definition, insofar as it is distant from an
animal-like ›base‹ existence in nature. Culture, in this sense,
civilizes nature by distinguishing our species and human experience from that of other (non-political) animals. One may see
this historical philosophical distinction in our contemporary
dealings with disease. The treatment of disease must, on the one
hand, address our primitive instinctual concern with the preservation of our selves and species – our zoe. On the other hand,
the way that disease is treated is within the context of a historical bios, and the culturally-derived ideological formations that
support the ›quality life‹ in social collectivities.
For Michel Foucault, biological modernity meant that both the
individual organism and the species became the focus of a
society’s political strategies. The life of our species, he argued,
is wagered in politics, with bio-power among the most fundamental paradigms of modern society. As Foucault saw it, the
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modern Western scientific state created an unprecedented
degree of integration between the techniques of subjective individualization and objective totalization. As Foucault observed,
the development of the ›clinical gaze‹ in the eighteenth century
marked an important turning point in this process, making
disease both perceptible and statable. The sovereign power of
the empirical gaze dispelled the shadows of ignorance, as »doctors described what for centuries had remained below the threshold of the visible and the expressible« (Foucault 1973: x).
Through the clinical experience, the concrete individual is
opened to the objectivizing language of rationality, and the
patient becomes a field of scientific investigation (Foucault
1973: xiv). The model modern patient is based on the Enlightenment ideals of rationality, liberation of the human subject and
control over nature.
Bio-political power
Giorgio Agamben (1995), however, suggests this politicization
of ›bare life‹ (the decisive event of modernity) occurs in a ›zone
of indistinction,‹ where living beings are transformed from the
objects to the subjects of bio-political power. Agamben applied
this theoretical framework to the empirical context of Nazi concentration camps, however one may observe this ›zone of indistinction‹ in bio-politics of the modern cancer ward.
Anthropologists have studied the cultural perceptions and social constructions of the disease, noting how cancer stands as a
social metaphor (Sontag 1990). Following Arthur Kleinman
(1988), there have been a number of ethnographic works that
approach cancer from the point of view of the sufferer, with the
patient as storyteller (e.g., Gordon 2000; Killoran 2000). They
performed narrative analyses of suffering, and mortality, of the
myriad subjective experiences that characterize the human condition in ›dis-ease‹ (Chavez et al. 2001). They also looked at the
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homologizing processes of power and discipline at work in
modern doctor-patient relationships (Hunt 1998), particularly
the loss of personal autonomy that often results from the clash
with medical authority (Balshem 1992); and, on the experience
of aggressive or intrusive medical diagnostic and therapeutic
methods (Good 2001).
This paper represents my efforts to contribute to the anthropology of cancer, a perspective that complements the study of the
biology of disease1. In the summer of 2002 and again in 2003 I
conducted ethnographic work on a cancer ward on the The
Regional University General Hospital of Herakleion (PEPAGNI) on the island of Crete. Crete, according to rumors throughout Greece, has very high incidence of cancer, higher in all the
EU some people maintained.2 PEPAGNI is attached to a
famous medical school and has a new cancer ward.
The cancer patient can be regarded as the quintessential modern
patient: the rational individual who should accept the authority
of the trained specialist, whom in turn is working for the good
of society and humankind. In the cancer ward, a ›zone of indistinction‹ for the bio-politics of modernity, one may observe
this complex dynamic of submission and resistance of the ›bare
life‹ and the individual body to the ›quality life‹ of modern
science and technology. Such wards can be understood as a site
of subjective individuation where the modern cancer warrior is
taught to wage war with the physician against his own diseased
body. Yet, as I learned in the course of my research in Crete, the
struggle of patients is not only against a disease but for their
humanity within a system of objective totalization in which
western medical technology is regarded as the only effective
treatment. Before turning to the words of patients and doctors,
it is important to know something of this island and its people.
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The bad wound
Roughly 8.300 square kilometers in area, Crete is Greece’s largest island. Tall mountains stretch for most of its 260-kilometer
east-west length, with numerous high plateaus that overlook
low-lying coastal plains. With abundant flora and fauna, this
»rich and lovely land« of Homer’s Odyssey is now famed for
the fruits and vegetables produced for international markets,
and regarded by many Europeans as a modern vacation paradise. Crete’s three largest towns are home to one-third the island’s
population of 600.000, who have been characterized in history
accounts and literary works as a proud and rugged people, defiant of external authority and deeply concerned about family
honor (e.g. Kazantzakis 1965; Herzfeld 1985).
In the past, Cretans were known to fight and die bravely in battles of national liberation (Mourellos 1931) or in family vendettas (Mavrakakis 1983). Today they still die bravely, though now
increasingly from cancer. During the first half of the twentieth
century, the island’s residents clearly knew of cancer and perceived it as a different and dreadful disease, the ›bad wound‹
(kako mimi). Some elderly residents recalled a few cases, including a woman in the 1930s who had the ›wound‹ in her breast;
or another with a tumor in the 1950s, whom neighbors thought
had a ›butterfly‹ in her brain.
Western biomedicine and bio-politics have been operating in
Greece since the mid-19th century, after Greece established
itself as an independent nation-state. This biomedical project
followed France’s protoype for modernizing medicine
(Korasidou 2002). The establishment of modern medicine
included attendance at medical school in Athens, clinical training abroad for physicians, the creation of hospitals, a war on
the »quacks« and folk medicine, the promotion of doctors in the
country, and the creation of a form of medical policing to report
on disease incidence and mortality,
Established in the mid-1980s, PEPAGNI is regarded as one of
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173
the best medical schools in the country, boasting not only
famous physicians and surgeons but also modern chemotherapy
and radiation treatments. Inside the hospital, there is no sign to
indicate the oncology ward, and yet everybody knows where it
is. The out-patient chemotherapy department resembles a beauty parlor, with patients seated in chairs much like at a dentist
office, receiving their treatment. The radiation rooms are small
and dark. ›Beware of Radiation‹, a signs warns silently.
On a typical day, doing field research at PEPAGNI, I accompany the oncologist and his four residents, whose principal concern is to check the side-effects of radiation therapy, on their
rounds of the crowded ward, where not a single bed is empty.
The first room we visit has seven beds of males, young and old,
frail men, pale men, their legs swollen, their head hairless. Here
we witness people with small-cell carcinomas, from smoking,
adenocarcinomas in their lungs from asbestos exposure, colon
cancers from too much grilled red meat consumption and metastatic liver cancers. If there is no fever, diarrhea, or vomiting,
the doctor pronounces that the treatment is going well and advises that patients to continue with their chemical cocktails.
Something and nothing
Exchanges between doctors and patients reveal the microphysics of bio-power in operation on the ward. »Can it be only a
cyst,« asked a frightened patient. »That would be like winning
the lotto,« the doctor replies. There is a young boy, no more
than twenty years old, to whom the doctor explains chemotherapy cryptically. »It is better to do something when it is nothing,
instead of doing nothing and waiting until it becomes something.« The something and the nothing: such dualistic rationales encourage the compliance of the individual subject to the
objective totalization of modern scientific medicine. Would you
rather have something for nothing, or nothing for something?
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For the cancer patient, this can only be a deal with the devil.
Here the mini-circuit of modern scientific medicine is cloaked
in a discourse of secrecy, mysticism, and power. The doctor
appears to be the authority of knowledge, which he has control
over the patient’s medical records which he shares neither with
the patient nor with the patient’s family members.
We move on to another seven-bed room of women. A young
patient with breast cancer is worried. »What is going to
happen?« she asks, fiddling nervously with her fingers. An old
lady says that she is ready to go home and die. Another is crying. Yet another complains of headaches and numbness in her
arms: »It is like putting your hands in ice,« she explains. There
is an Irish woman, whose lung cancer had metastasized to her
brain. »I feel well,« she says. »I don’t know why they are
keeping me here with the rest of them.« A breast cancer patient
with a liver metastasis, her eyes yellowed, tells the doctor. »I
am fine.« Another, in denial, insists there is nothing wrong with
her. Nearby is a 73 year-old woman who kept the lump on her
breast secret for fifteen years. The cancer eventually surfaced,
»performing its own mastectomy«, and she is now in the final
stages of the terminal illness. »The cancer ate the breast,« the
doctor told me frankly.
In the hallway, I encounter a woman in her fifties. Nervously,
she recounts in Cretan dialect to another patient’s husband how,
a year ago, she had an enlarged lymph node close to her left
breast. When she came to the hospital, they wanted to start her
on chemotherapy. »I escaped them,« she said, her eyes beaming. She ran away home. Feeling well, she continued to work
in the fields, until one day she collapsed and felt an itch all over
her body. »Here I am again,« she concluded sadly. When she
realized I was eavesdropping and suspecting I might be a medical professional (I was wearing the white robe, after all) she put
an end to her narrative and disappeared. I saw her the next day,
an IV in her arm, docilely receiving her chemotherapy. The
heroic defiance of the previous day was gone. »As soon as they
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put the chemical in my body,« she remarked, »the itch disappeared.« She had been compelled to sign a release for the chemotherapy treatments. They had insisted the treatments were safe,
though their side effects were severe.
Within the cancer ward, some patients are more empowered
than others. One is a school-teacher from Rethimnon (another
major town in the island), with a master degree from the local
University. She follows the directions of the specialists attentively, proactively informs herself about her treatments, and
urges other women not to fear. She is the model patient in the
ward, whom the doctors wish the others would emulate – despite the fact that doctors often hide from cancer patients the
truth about their condition. Most die lonely and painful deaths.
»This pain, this pain,« moaned a woman in her forties who was
dying of colon cancer, her abdomen and legs swollen, little hair
left on her head, dark circles around her eyes. »I have to have
another operation,« she told me. »I will go to Athens.« Outside
in the hallway, her husband tells me that is not true. »We keep
giving her hope that something can be done. But there is no salvation.« He feeds her some jello and tends to her needs.
Priests of the body
Modern doctors function not unlike a therapeutic clergy, priests
of the body (Foucault 1973:20). In modern society, science has
usurped a sacred place once dominated by religion, while biomedical research and health care have come to command a
large share of the economy. The oncologist is an authoritative
source of information, explanation, or even comfort. The medical specialists of modern science offer promise or at least the
hope of a cure (Good et al. 1993, 1995). We have faith they will
heal us.
The discourse on hope in the practice of oncology in the United
States has been examined thoroughly by Mary-Jo Good and her
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research team (1990). As Good’s research indicates, in America
the oncologist maneuvers the delivery of »bad« news to the
patient in order to ease the shock and the fear. In Crete I observed a different set of strategies. Oncologists here envelop
their knowledge in, what James Patterson calls a »conspiracy of
silence.« In the Cretan cancer ward one can observe this flow
of power, from the doctor to the patient. The patients look at the
doctor straight in the eyes when they address him. He has become their sovereign authority, and they desperately search his
face and eyes for reassurance, encouragement, and solace. The
former’s sovereignty gives them de facto access to the medical
records documenting the history of the biological life of the
individual with cancer. Unlike their American counterparts, the
doctors that I encountered might also readily offer causalitybased explanations for the cancers they treat. With only a few
notable exceptions, the Cretan cancer patient does not have the
opportunity to become a skilled and knowledgeable individual
or the practitioner of his/her own illness (Kleinman 1986).
Instead the zoe, the »bare life« of the cancerous body remains
under the control of the man of science and his technology.
These practices of withholding information in some instances,
and offering scientific explanations in another does not, however, usurp the overall structure of medical authority over
patients. Doctors working at this oncology ward still retain their
authority as the sole professionals capable of treating the
disease and managing the cancerous bodies of their patients.
Life and death may present themselves as brute facts that must
fall under the mantle of science yet they are deeply political and
symbolic for both patients and doctors. In a fairly affluent and
architecturally preserved town outside the city of Herakleion,
people live with the daily fear of cancer. Few feel any solace or
encouragement from the fact that they enjoy some of the best
medical care available in the Greek countryside, with easy access
to hospitals, doctors, and specialists in Herakleion (although the
most affluent travel to Athens for advanced medical treatment).
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The new local clinic in the town is a clean and modern structure,
and it is staffed by a state-assigned doctor, trained in the west of
Europe, who is assisted by nurses and various specialists who
visit periodically. She also works at the hospital in Herakleion,
which facilitates her local patients’ access to its resources. She is
proud of the »health cards« she has established for every individual in the community, mimicking the ›filing‹ system that had
been employed by the police for decades to monitor suspected
communists in the post-WWII era. Yet her efforts at epidemiological monitoring and her micro-techniques of control have done
little to stem her concern about the rising rates of cancer incidence in her town. »I had seven people die from cancer in the last
two weeks,« she told me in the summer of 2002. »I am going to
go crazy. I will suffer from depression.«
Resisting one’s fears
This doctor wants people to resist their fears and come to her
for early detection and treatment. She recognizes that those
diagnosed with the disease typically go through stages of reaction, typically denial, followed by anger, then coping, and
finally battling or wrestling with the disease. She tells of how
she once locked a patient in a room of her clinic: although she
suspected he suffered from cancer, the patient had refused to go
to Herakleion for tests to confirm the preliminary diagnosis,
until she use forcible detention to pressure him into cooperation
and compliance. She also administers morphine to patients at
what she calls the town’s ›pain clinic‹, visiting the homes of
those too ill or weak to move. I accompanied her to the home
of one dying cancer victim. She was the only person he wanted
to see. »Help me, doctor, help me,« was all he could find the
strength to utter.
The oncologist appears as an expert, and as a scientific expert
in possession of facts presents itself as morally »neutral« they
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seem to be autonomous of any moral agency. Yet, the very language of medicine, particularly the language used within the
context of cancer treatment is far from morally neutral. In the
local clinic, or the oncologist’s office, or in the hospital’s cancer ward, the patient hears the diagnosis of his/her ailment: that
is precisely the moment when the »voluntary servitude of individuals comes into contact with objective power« (Agamben
1995, 6). These are spaces of exception, where »bare life« is
controlled the biopolitics of the modern scientific state. One
hears this bio-political language explicitely in the discourses,
which couch disease in terms of war.
Ever since President Richard Nixon declared ›war‹ on cancer in
1971 (Rettig 1977), the metaphor of ›battle‹ has provided the
dominant paradigm for popular understanding of the disease.
Cancer is perceived as an enemy invasion that attacks and
besieges the body as »uncontrollable, lethal, and deceptive traitor that destroys the person from within« (Hunt 1998:30).
Biomedicine promises to empower individuals with scientific
knowledge to fight cancer, but the ›battles‹ of this ›war‹ tend to
be fought on the basis of individual engagements (see
Whiteman and Slevin 1996). Today, the metaphor of war continues to dominate rhetorical discourse in contemporary approaches to cancer and its treatment in Western medicine
(Ehrenreich 2003). The body is the homeland ›battlefield‹ in
which the fight against disease is waged. Targeting cancer cells
as foreign invaders, chemotherapy »blasts« away, while radiation therapy offers pinpoint, laser-guided relief (Love 1991).
Such therapies, however, remain painfully crude and woefully
inadequate for many patients.
The search for »a cure for cancer« has become a pervasive part
of contemporary global culture, though notions of causality and
agency are construed in diverse and culturally specific ways
(Chavez et al. 1995, Martinez et al. 1998). In the West, knowledge and understanding of the disease, as well as modes of
response, have come to be based on scientific studies focused
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largely at the cellular, molecular, atomic, and epidemiological
levels (Altman 1998, Weinberg 1998, 1999). Modern biomedical science promises to free us from the fetters of primitive fear
of disease through modern rational therapies and diagnostic
techniques. These therapeutic techniques, however, entail their
own processes of discipline and compliance that render the
model modern patient ever more dependent upon biomedicine.
In a sense, our primitive desire for health and self-preservation
has been replaced by an increasingly precise knowledge of
afflictions, though not always their causes (Taussig 1980).
Modern biomedicine has profoundly increased our knowledge
about cancer, and its treatment, but not its causes.
Epilogue
The real efficacy of Western science and biomedicine in analyzing, diagnosing, and treating disease has given it a firm paradigmatic hegemony throughout much of the world. Its ability to
yield objective quantifiable data through controlled experimental
procedures has helped to demystify the ›agency‹ or causal mechanisms behind cancer. At the same time, technological advances have prompted development of new diagnostic tools, procedures, and therapeutic strategies that have become a standard
regime for cancer management, based largely on industrial pharmacology, radiology and nuclear medicine, and genetics. The
biomedical paradigm frequently decontextualizes cancer from its
environmental and social milieu, individualizing it within a specific body. Paradoxically, it does so whilst erasing the unique stories of individual suffering and the voices of patients who do
resist. Illness, accordingly, is an entirely biological phenomenon
and its treatment a technical intervention to a mechanical problem. The body is never purely mechanical. The human body, we
came to learn from evolutionist theories, has wisdom of its own,
helping it to respond adaptive to all sorts of changing situations.
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Michael Taussig (1980) has argued that modern biomedicine
manipulates the ›language‹ of our bodies, concealing it within
the scientific realm of biological signs and meaning. But in so
doing, it also hides or denies the human, social and political
relations embodied in such signs and indicators, in definitions
of symptoms, and in therapeutic strategies. In this sense, biomedicine mystifies the power relations of the modern social
order through the ›reification‹ of the patient’s consciousness »in
the guise of a science of physical things.« Taussig maintains
that, »in this way disease is recruited into serving the ideological needs of the social order, to the detriment of healing and our
understanding of the social causes of misfortune«. (Taussig
1980, 4)
The current discourse on cancer depicts cancer ›survivors‹ as
war heroes and encourages them, as comrades-in-carcinogenesis, to keep up the good fight. They are not to waver in the
face of adversity but must maintain a positive psycho-emotional perspective. As the words of the cancer patients I heard on
the ward made clear, there is another struggle going on: the
struggle to maintain a sense of human dignity in the face of the
devastating effects of both cancer itself as well as the chemical
and radiological therapies modern science directs into our vulnerable bodies. For modern biomedicine does not really cure
cancer. It can only help to prolong life.
Notes
1
Fieldwork research in Crete was conducted in the summers of 2002
and 2003.
Funds were provided by a Staley grant, the Mellon
Foundation and Wellesley College Faculty award. My gratitude is
expressed to those colleagues who provided assistance and intellectual inspiration: Jean Comaroff,
Mary-Jo Good, Kostas Gounis,
Christina Lammer, and Sally Merry.
2
<biostats.med.uoc.gr>
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References
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Feine Unterschiede
Zwei junge Sozialwissenschafterinnen arbeiten mit Brustkrebspatientinnen. Eine von ihnen für ihre Diplomarbeit und eine für ihr
Dissertationsprojekt. Eine von beiden ist selbst Brustkrebspatientin.
Christine Holmberg entwickelt in ihrem Essay eine berührende Erzählung
eigener und zugleich für sie befremdender Erfahrungen. In der
Zusammenarbeit mit ihrer krebskranken Kollegin spürt sie am eigenen
Leib, was sie von jenen Frauen unterscheidet, mit denen sie während ihrer
ethnografischen Tätigkeit in der Onkologie Näheverhältnisse und
Vertrauen aufbaut. Sie ist keine von ihnen. Die Ethnologin eröffnet eine
Diskussion über die Dynamik zwischen Forscherin und Erforschten. Sie
beschreibt ihre eigenen Gefühle und nimmt einen teilnehmenden
Standpunkt ein, von dem aus sie mit krebskranken Frauen und ihren
ÄrztInnen mitfühlt. Wobei sich die Brustkrebspatientinnen, die sie während ihrer Feldforschung kennen lernt, auf den ersten Blick kaum von ihr
unterscheiden. Der einzige Unterschied, der sich jedoch als markant
erweist, ist jener, dass sie bis zum heutigen Tag keine Diagnose Brustkrebs
erhalten hat. Erst nach der Diagnose werden Patientinnen Teil einer biomedizinischen Ordnung, die sie berührt, in der Kleidungscodes vorherrschen, eine bestimmte Sprache gesprochen wird und existenzielle
Entscheidungen getroffen werden, die über Leben und Tod bestimmen.
Das psychoanalytische Subjekt, argumentiert die Forscherin, schließt die
Trennung zwischen Ich und Anderem. Eigene Lebenserfahrungen und
Erinnerungen mischen sich mit den Erzählungen anderer Personen, sind –
expemplarisch dafür nennt Christine Holmberg die Beziehung zwischen
PsychoanalytikerInnen und AnalysandInnen – untrennbar affektiv damit
verbunden. Sie bezieht diese komplexen emotionsgeladenen Beziehungen
und Übertragungen auf die ethnografische Methodik der Feldforschung
und auf ihren Kontakt mit Brustkrebspatientinnen. Frau Ohl, die bereits
erwähnte Kollegin, die selbst Brustkrebs hat, berichtet über ihre
Erfahrungen. Sie ist sich sicher, dass die Entwicklung der Krankheit etwas
mit ihrem Lebensstil zu tun hat, beschäftigt sich folglich intensiv mit Yoga
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und Meditation. Sie ändert einige ihrer Gewohnheiten, um »spirituell zu
wachsen« und gegen die Erkrankung anzukämpfen. Hoffnung und
Verzweiflung wechseln einander ab. Jeder medizinische Test ist mit Ängsten verbunden. Sind die diagnostischen Ergebnisse positiv im Sinne von
neuen Metastasen, die sich an anderen Stellen im Körper gebildet haben,
führen sie zwangsläufig bei der jungen Frau zu Gefühlen von
Hoffnungslosigkeit. Beruhigende biomedizinische Erklärungen geben
wieder Kraft weiterzumachen. Frau Ohl realisiert bald die Ausweglosigkeit
und bereitet sich innerlich darauf vor, dass sie eher früher als später sterben wird. In ihrer Geschichte sind Hoffnung, Heiterkeit und Verzweiflung
eng miteinander verwoben. Leiden wirft einen in eine chaotisch diffuse
Gefühlswelt. Um soziale Phänomene zu verstehen, wird von EthnografInnen eine Technik der Teilnahme notwendig, die eine totale
Einbeziehung der eigenen Person verlangt. Die Bewusstmachung der eigenen Empfindungen und Gefühle während des Forschungsprozesses und
durch das ethnografische Schreiben, Erinnern und Reflektieren, eröffnet
neue Wege, um die Bedeutungen von Krankheiten wie Brustkrebs und die
Menschen, die damit leben, besser zu verstehen.
Christine Holmberg is a researcher at the Charité – Universitätsmedizin
Berlin, Department of Social Medicine, Epidemiology and Health
Economics. She holds a doctoral degree in social anthropology from
Humboldt University in Berlin, Germany and a master’s degree in religious
studies and European ethnology from the Free University and the
Humboldt University in Berlin. Prior to pursuing her doctoral studies, she
worked in palliative care nursing in Germany and Israel. Christine
Holmberg’s doctoral work investigated the effects of screening techniques
on the »healthy« woman’s transition to »patient«, upon being diagnosed
with breast cancer without having any experiential symptoms. She seeks to
understand the changes of personhood and subjectivity in this process. Her
continuing research interests include the construction of medical knowledge and understanding the effects of expanding medical technologies on
medical practice and on the experience of patients as well as healthy populations. She is also interested in the integration and application of anthropological knowledge in policy and health communication.
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Researching Breast Cancer
Understanding sameness and otherness
In current biomedical practice health is only a temporary state.
The only secure state is a diseased state. Everyone is susceptible to disease – the question is just what kind of disease it will
be. These points of possible identification through disease highlight methodological challenges medical anthropologists face
when studying illness. Anthropological research is juggling
subject and object positions in its study of the other. When
anthropologists study disease in a society that is dominated by
a biomedical framework this juggling has to become central.
Subject and object positions can change anytime in this field,
the researcher is as susceptible to disease as the researched
other. I argue that one has to incorporate this feature of biomedical conceptualization of health and disease into anthropological research to study the experience of disease with
anthropological methodology. This poses challenges for the
anthropologist researching disease and suffering. While it is a
challenge for every anthropological study on suffering, it is
easier recognized and accounted for in circumstances in which
the researcher and the researched share a socio-cultural
background and have the same gender. As I suggest, conceptualizing the dynamics of researcher and researched in psychoanalytic terms of transference and counter-transference, and
embracing the emotional dimensions of the liquid subject /
object positions one’s research encounter allows one to grasp an
understanding of the field of suffering, in this case breast cancer.
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Breast cancer in Germany
In Germany today, screening healthy individuals for early
disease onset of breast cancer is considered the gold standard
for best treatment outcomes. This practice is based on notions
of some cancers such as breast cancer having a latency period.
The assumption is that treatment is more effective if breast cancer is caught early, rather than after the disease has advanced
and possibly spread. Within this understanding of disease and
its treatment, feeling healthy isn’t equal to being healthy.
Within the biomedical paradigm, technological measures are
needed to verify a health or declare disease. This conception of
disease is predicated on a society that is willing to undergo
medical testing even while healthy. In order to avoid screening
an entire society for all diseases with a latency period, risk factors have been identified that put certain population groups into
higher risk categories for the development of particular
diseases. These groups are urged to undergo screening for the
diseases. For breast cancer the main risk factors are gender and
age. Throughout the course of the 20th century and into the 21st
there have been a steady increase in health-promotions, such as
advertising, urging healthy and symptomless women to undergo regular self- and clinical examination of their breasts to
ensure the early detection of cancer. As a result of these campaigns, women in Germany today know that they are at risk for
developing breast cancer and breast cancers are often detected
before a woman feels bodily ill.
For the women I am talking about, the shift from the experience
of breast cancer as a disease with palpable symptoms and breast
cancer as a disease without symptoms has significant implications: before they were told that they were sick they considered
themselves healthy, as healthy as I considered myself. As a
white female anthropologist who grew up in Germany these
women were not others, indeed, in a biomedical framework the
women and I are very similar. Biomedicine as a modern insti-
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tution tends to erase differences (Rabinow 1986). Biomedical
taxonomies would not differentiate between the women I study
and me.1 Through a biological lens our female bodies are capable of going through the same processes that are medically
called breast cancer. So the difference between the women and
me was mainly that I wasn’t diagnosed yet and if lucky will
never get this diagnosis. As a participant (female) observer who
studies breast cancer I am an outsider. The patients I work with
perceive me as a healthy person.
I initially thought that the hospital setting enfolds another kind
of otherness upon breast cancer patients. When I first arrived at
the hospital for my fieldwork I was appalled by how patients
were constantly acted upon and how their personal boundaries
were constantly ignored by hospital staff. Nurses and doctors
talked for them, made decisions for them and often gave reassurance to them by touching them. What is permissible in the
setting of a hospital ward would be questionable if done in
other locations. The following ways mark interactions on this
hospital ward:
1. Touching. Patients were touched often and extensively. A lot
of suffering has no language. Touch is one way of expressing
recognition of the person’s suffering.
2. Clothing. Patients and personnel wear different clothes. Staff
members are dressed in white or green uniforms, whilst patients
are in their nightgowns. They become part of the institutional
setting by changing into the appropriate clothes.
3. Language. While the same words are used in a hospital than
elsewhere, the meaning of this discourse differs significantly
from everyday speech. What they talk about and how patients
and doctors talk with one another is particular to the setting at
a clinic.
4. Framing of decisions. Decisions are framed as life and death
determinations. Once a resolution is made it may retrospectively be considered either as lifesaving or death bringing.
Through these particularities in the hospital the patient is
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brought into being – unlike me as a medical anthropologist, and
my own expectations of these women I worked with. The role
of the patient has been characterized extensively. Hospitalized
patients are unable to participate in the activities of everyday
life. Longer clinic stays cause isolation. For the individual
breast cancer patient this particular mode of being excluded
from the rest of the world imposes a focus on herself, her health
and feelings. These are threatening side effects caused by the
disease. Thus her social reality – normally unquestioned –
becomes shaken. The security of having a future is extremely
destabilized. In this situation sick persons often have a higher
degree of loss of self-control. They are much more sensible and
have a strong egocentric apperception (Siegrist 1974, 144).
Hospital patients are considered seriously ill, dependent on
other people’s help. However, the analysis of what it means to
be a patient cannot stop here. The diagnoses of diseases with a
latency period that are actively screened for, such as breast cancer, are made on women who seem and often feel healthy. The
crisis therefore is not begun with bodily symptoms but with the
speech acts of the physicians. As I have argued elsewhere,
women who are diagnosed with breast cancer become liminal
persons who experience a hovering between life and death
through the speech acts in encounters with physicians during
the process of diagnosis (Holmberg 2005). The separation from
the everyday world, as described above, starts through these
interactions with the physicians. Only then do they become ill.
The initiating point of becoming a patient is the diagnosis, not
a previously conceived bodily ailment. So how, in this situation, do all interacting persons in the hospital agree upon the
rules and shape of hospital life? An in-depth understanding of
hospital life and disease experience has to take all of these
aspects into account. For the remainder of this paper I will
focus on the aforementioned sameness as well as the differences of the researcher and the researched to discuss a prerequisite of studying suffering with anthropological methods.
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Dissolving boundaries
In an ethnographic study, subject and object positions dissolve
because anthropological knowledge can only be created through
a mutual social experience (Hastrup 1995). The evolving ethnography develops out of interactions and the writing about these.
Marilyn Strathern (1999) characterizes ethnographers as immersed subjects. This immersement often evaporates in anthropological writings, despite the fact that the researcher’s subjectivity
has been the focus of discussions of power. This critique has
been two-fold: first the ethnographer is conceived of as an agent
who creates partial truths in ethnographies (Clifford and Marcus
1986) and secondly the ethnographer as a research instrument
has been questioned by psychoanalytic anthropology (Devereux
1984). Despite these objections, anthropological writing seems
to remain dominated by a Cartesian subject in which reality only
exists through the intellectual (Bowman 1997, 37). To counter
this tendency Glenn Bowman suggests substituting the Cartesian
subject by a Lacanian notion of subject. This is not autonomous
and separated from the world. The subject is created in interactions and disputes, thinks its subjectivity as a social fact
(Bowman 1997, 45). Thus I is an other (Pagel 1999, 21, translation C. Holmberg). Thinking my anthropological subjectivity
with Lacan’s subject-construction, the other is like myself in so
far as he or she does not simply have an identity. A repertoire of
identities is built up through the subject positions set out in the
discourses he or she encounters in negotiating his or her life. The
other is not, then, fundamentally different from myself (as an
ethnographer among others) – is not Other – but shares with me
the need to construct its subjectivity out of elements provided by
its concourse with others in the social world. The difference between myself and others lies in the specific characters and consequent configurations of the social facts we encounter« (Bowman
1997, 45). The psychoanalytic subject breeches the division and
distance between I and other.
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The psychoanalyst Theodore Jacobs conceptualizes the »relationship between the minds of two participants in the analytic
situation« (1990, 117) as the instrument of analysis. Both are
tuned into each other in a specific way to understand the »subconscious communication of the other« (Jacobs 1990, 119). It
is a particular state of mind, a degree of regression, in order for
both to understand the unconscious communications of the
other through free association. This state is unconscious but
observations of the state can be described near the end of the
encounter or shortly thereafter. The analyst has to concentrate
his attention to the analysand’s communication and on the analyst’s internal perceptions. He then has to be observant of the
suspension of activity between these two objects of his attention. By being in this particular state of mind of the analyzing
instrument, not only the analysand can freely associate. Equally
the analyst can do it, drawing on his own memories. »… [T]he
memories of the patient and those of the analyst arise independently but interweave and overlap. The analyst ›knows‹ his
patient not only through the process of being able, for brief
periods, to identify with him, but through his own parallel life
experiences. It is through his own memories and the affects
connected with them that, in large measure, he understands his
patient’s inner experiences« (Jacobs 1990, 132).
An ethnographic study is not a therapeutic situation.
Nevertheless both create knowledge and understanding of
other points of view through interaction between two or more
persons. If the anthropologist wants to learn about the other
s/he similarly has to open up with all her or his senses and
immerse her or him in the field. S/he has to tune in on the other
and scrutinize her or his own perceptions, feelings and tensions
as well as reactions to the field. Emotions are important in the
world of disease and suffering and therefore are also crucial in
ethnography. Indeed, it is these emotions and the chaos involved that are a major force in (ethnographically) making up
worlds of health and illness. In my research it seemed crucial to
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utilize field notes, remembering all tensions and feelings from
the encounter. Field notes had a cathartic effect. For instance, I
would cry routinely, engage in the particular emotions I had
during my interactions in the field, including them in my subsequent ethnographic writing.
George Devereux (1984) suggests taking the difficulties and
resistance of the researcher as starting point for analysis and
knowledge creation in the social sciences. In psychoanalysis
the terms transference and counter-transference contain the
influence of analysand to analyst and vice versa. Transference
depicts the affects and ideas of the analysand as he projects
them on the analyst who reacts by counter-transference. Only
once the analyst has learned to identify and interpret the counter-transference and transference s/he will be able to grasp the
world of the analysand and learn to understand her or his point
of view. Transference of the analyst keeps unnoticed when one
shifts away from the »immediacy of the moment« (Schwaber
1992, 355). The analyst tries to lead the analysand to a truth that
she or he already knows. In these situations the perspective of
the analyst is at stake: The tendency to create distance in
moments of great emotionality closes the world of the other –
at least temporarily.
Transference and counter-transference are part of an ethnographic encounter and are vital in advancing or hindering understanding and knowledge production. The anthropologist needs
to include her- or himself in the writing of field notes. Only in
extensively recording my observations as an immersed ethnographer, taking my own reactions and emotions seriously, enables me to create ethnography with all senses about the mutual
social experience of researcher and researched. Sharing feelings with the researched persons but also being aware of the
limits such an undertaking involves, respecting individually
different situations of breast cancer patients as well as of their
physicians, trying to get as close as possible to the manifold
truths and realities of these women and doctors – without vio-
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lating their personal boundaries – is challenging. Biomedicine
has equalizing tendencies as one of its core features. This has to
be taken into consideration and worked with in studying this
particular research field.
Ms. Ohl
To clarify what I mean, I will narrate an encounter of one of the
patients with whom I worked. Ms. Ohl and I had a very similar
life-story. We were the same age when we met. I was in the process of researching for a doctoral thesis on the experience of
breast cancer in anthropology. She had been thinking about writing a Master’s thesis on the subject in sociology. We both had
moved from a small university town during our studies and had
a hard time finishing our Master’s degrees. We both had difficulties with the freedom of studying at a German university.
The difference – and as it is an existential difference – was that
I had eventually finished my Master’s degree and moved on to
a PhD and she was diagnosed with breast cancer. When our
paths crossed she was dying. This was the woman through
whom I lost my critical distance to the biomedical world – nine
months after I had started my research.
Ms. Ohl was first diagnosed with cancer five years prior to our
meeting. She felt quite positive about the whole process and she
expressed that she used this experience of disease as a way to
grow. She was sure there was something in her life style and her
way of psychologically processing things that had given her the
disease and she was ready to conquer these. She did Yoga and
other forms of meditation and changed some of her habits:
I quickly realized that the disease was not the actual problem. It was
a sign only, showing the way to real problems in life one needs to
address. To enable healing one has to address these issues. So I did. I
didn’t care about operation and all that. ... I was growing spiritually.
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As she said, at first she felt blessed for this opportunity. This
changed when she went to see the doctor for breathing problems a couple of years later and found out that the disease has
metastasized. She told me of standing there thinking:
So, this is my death sentence. It was a horrible situation. There was
no doctor to explain – just the word metastases. And I knew when
you have metastases you will die. Well, next time I came to the clinic, they were great. They comforted me and said that I should relax.
Metastases are not metastases. One needs to look at the situation
more closely and see. And it didn’t look that bad.
Then the whole process began. Tests, tests, tests, and it was found
out that my spine also has metastases, small but everywhere. During
that time I was given chemotherapy every three weeks five days in
a row. I was in a state somewhere between animal and human.
…
After all this was over, they realized nothing had changed. [She cried.]
Of course, that meant, we need to continue. But I didn’t want to do
it anymore. The doctor then talked to me very seriously and said that
my chances are still there – with chemotherapy. And then they put
me on another chemotherapy, which I could do from home. That
was fine. Basically that is the story ever since. I live in a nightmare
with its ups and downs.
The cycle of hope and despair repeats itself. When chemotherapy works, the woman is hopeful. The treatment can be
stopped for some time. This is followed by the discovery of a
tumour in another part of the body. The cycle starts over again.
Emotionally a pattern is repeated: a tumour is found, followed
by total desperation, more conversations with the physician,
chemotherapy and hope. As Ms. Ohl stated:
So this chemotherapy worked. We actually got the tumour removed.
They told me I would do four more cycles just to be sure and I am
done. I was happy. Two days later I go to my regular gynaecologi-
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cal check-up and they find a tumour on the ovaries. I just didn’t
know what was happening with me. I didn’t fully grasp it. TWO
DAYS LATER. I was drugged. There were two weeks of uncertainty of what they were and then chemotherapy.
Then treatment, treatment, treatment, tests, didn’t work, treatment.
Again tests – new metastases in the stomach and the liver. So this
became the new war zone. Again treatment, treatment, treatment,
sometimes I run away but I always come back.
Ms. Ohl’s life-story shows the biomedical logic in detail and in
its extreme. Every exact test brings news of new metastases and
a continuation of treatment. Treatment necessitates more tests,
which then find something yet again. This is followed by
despair, biomedical explanations and once again hope. There is
no exit anymore but there is always hope. Ms. Ohl eventually
realized that she would die sooner rather than later. She tried to
prepare for dying, keeping her power and hope for going on:
I still think, maybe this nightmare will be over some day. Some day
they will tell me, I can stop and go for a year without. That is my
dream. Just be away for it for a while. Of course it is also possible
to get away from it all – but statistically – it is improbable. It is
much more likely that worse things will happen – unimaginable –
but then again, if it happens, I will live with it.
In her story – engulfed by the biomedical logic – hope, laughter,
and despair are closely intertwined. Through this interview, I
became part of her story. This was the moment when I realized
and understood the difference: I am not a breast cancer patient.
Byron Good (1994) argues that medical students learn to experience the world in an altered way by focusing with a particularly trained medical gaze on the body. Breast cancer patients
(in my study) also come to perceive the world differently. They
go through a comparable process but not so much by training
but through trauma (Holmberg 2005).
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My shift of understanding was possible through counter-transferences, my own transferences in the conversation with Mrs
Ohl as well as through my own subsequent experiences. I had
been in the field for one year. During this time I had gathered
information on the way the hospital works, had observed diagnosis and treatment phases and had done a lot of interviews
with patients and personnel. In addition, after the conversation
with Mrs. Ohl, my own body became object of interest. Its selfevident existence was eliminated as I turned my therapeutic
gaze upon it.
For a couple of weeks the distance between the persons I
worked with at the hospital and myself shrank. I became mired
in my experiential world and felt as a total outsider in everyday
life. At the same time I did everything I always did – just with
one difference – I did not belong to the social world around me
anymore. It became irrelevant. I was neither here nor there. I
had no place. These sentences resonate with the metaphors
some women used to describe their experiences of the diagnosis.
My experience eventually led me to understand the difference
between the other and myself. As Jacobs has argued the analysist understands his client through his own life experiences.
Similarly my experience described above enabled a deeper
understanding of other people in my field of research. Once I
fully accepted the clinic as real, I could learn about hospital life
and analyze the materials I had gathered.
Conclusion
For doing ethnography in the biomedical field of breast cancer
I needed to immerse myself in the stories and emotions instigated by my encounters at the clinic. Suffering throws one into a
chaotic scattered world of affects. Not an easy experience for
me in my role as researcher. Investigating breast cancer in-
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cludes liminality. Colin Turnbull (1990) argues, »if we are to
understand total social phenomena, then something more than
objective study is required. … what is needed is a technique of
participation that demands total involvement of our whole
being« (1990, 51). It is the embodied analysis of counter-transference and one’s own transference that can lead to an understanding of the other. This asks of us that we consciously live
our sensations and feelings during the research process, reflecting them as one crucial part of our ethnographic writing. Thus
the other – exemplarily in the form of a disease like breast cancer – becomes both equal to us and distinct from us.
Notes
1
This is only partially true. Two genes have been identified that correlate with a higher risk of developing breast cancer and there are several statistical risk models that calculate if a woman is at increased risk
for developing breast cancer. But the breast cancer linked to genes
only account for a small amount of all breast cancers that occur and the
discriminatory accuracy of the statistical models isn’t overtly high. So
most breast cancer still occur without any of the known risk factors –
thus all women remain at risk.
References
Clifford, J. and Marcus, G.E. (eds.) (1986) Writing Culture. The Poetics
and Politics of Ethnography. Berkeley: University of California Press.
Devereux, G. (1984) Angst und Methode in den Verhaltenswissenschaften.
Frankfurt am Main: Suhrkamp.
Good, B. (1994) How medicine constructs its objects. In Medicine, rationality and experience. An anthropological perspective. Cambridge:
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Cambridge University Press, 65-87.
Hastrup, K. (1995) A Passage to Anthropology between Experience and
Theory. London: Routledge.
Holmberg, C. (2005) Diagnose Brustkrebs. Eine ethnografische Studie
über Krankheit und Krankheitserleben. Frankfurt und New York:
Campus-Verlag.
Jacobs, T. (1990) The Use of the Self. Countertransference and
Communication in the Analytic Situation. Guilford (CT): International
Universities Press.
Rabinow, P. (1986) Representations are Social Facts: Modernity and PostModernity in Anthropology. In: Clifford, J. and George E. M. (eds)
Writing Culture: The Poetics and Politics of Ethnography. Berkeley,
CA et al.: University of California Press, 234-261.
Schwaber, E. (1992) Countertransference. The Analyst’s Retreat from the
Patient’s Vantage Point. International Journal of Psycho-Analysis 73
(349), 349-361.
Siegrist, J. (1974) Lehrbuch der Medizinischen Soziologie. München.
Strathern, M. (1999) The Ethnographic Effect. In Property, Substance, and
Effect. Anthropological Essays on Persons and Things. London:
Athlone Press, 1-28.
Turnbull, C. (1990) Liminality: a synthesis of subjective and objective
experience. In Schechner, R. and Appel, W. (eds.) (1990). By means of
performance: intercultural studies of theatre and ritual. Cambridge:
Cambridge University Press, 50-81.
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Verkörperte Pflege
In ihrer Ethnografie untersucht Rosie Read die Beziehungen zu
PatientInnen von weltlichen Schwestern und Nonnen in einem Pflegeheim
in Prag (tschechische Republik). Sie zeigt alltägliche verkörperte
Pflegepraktiken. Ihr Essay handelt von der Bedeutung von Gefühlen im
medizinischen Kontext. Die Wende 1989 und das Ende des Sozialismus
gehen mit einer Reform des Gesundheitssystems in der Tschechei einher.
Dieser Reformprozess schafft einen neuen kulturellen Raum, in dem seit
langem etablierte Praktiken und Werte in der Gesundheitspflege herausgefordert werden. Rosie Read arbeitet in einem Heim in Prag als
Pflegeassistentin und entfaltet ihre ethnografischen Beobachtungen und
Argumente von einem persönlich involvierten und an alltäglichen
Arbeitsprozessen teilnehmenden Standpunkt aus.
Körperpflege: eine der ersten Aufgaben des Tages ist die Pflege des
Körpers. PatientInnen sind zu duschen. Sie werden ins Badezimmer transportiert, viele von ihnen in Rollstühlen, ausgezogen und von einer der
Schwestern gewaschen und heruntergebraust. Dem Körper gilt die vollste
Aufmerksamkeit. Der Duschraum ist gefüllt mit älteren Frauen, die sich
nach und nach diesen Reinigungsritualen unterziehen. In der Zwischenzeit
werden die Betten gemacht. Frisch gewaschen und angezogen werden die
HeiminsassInnen wieder in ihre Zimmer gebracht. Bald ist Zeit zum
Mittagessen. Nach dem Essen beginnt die ruhigste Phase des Tages.
BesucherInnen werden empfangen. Die Schwestern plaudern mit ihren oft
schwerkranken Anvertrauten, die vielleicht sogar im Heim sterben werden.
Lebensgeschichten werden erzählt. Diese Erzählungen gehören zum
Alltag. Eine der Schwestern bespricht mit einer Frau, die an Darmkrebs
leidet, was sie abends für ihre Familie kochen wird. Blumen werden neu
zusammengestellt. Ein Foto wird abgestaubt, auf dem das Enkelkind einer
Heimbewohnerin zu sehen ist. Die Beziehung zwischen (weltlichem)
Pflegepersonal und PatientInnen berücksichtigt auch persönliche und emotionale Facetten. Rosie Read betont, dass vor der Wende, als Pflege und
Medizin frei für jedes Mitglied dieser sozialistischen Gesellschaft zur
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Christina Lammer
Verfügung stand, vorrangig auf gesundheitliche und körperliche Aspekte
Wert gelegt wurde, während seit 1989 eine Verschiebung stattfindet.
Soziale und private Bindungen sind verstärkt Teil des Kontakts zwischen
individuellen Schwestern und ihren PatientInnen. Im Gegensatz dazu,
spiegelt sich exemplarisch im Duschritual die staatlich institutionalisierte
Pflege wider. Schwestern haben dennoch ihre Lieblingspatientinnen. Diese
sentimentalen Verbindungen gelten als Privatsache, während Körperpflege
zu den vertraglich vereinbarten Pflichten einer Pflegeperson gehört.
Hingegen zeichnet sich bei den pflegenden Nonnen ein anders Bild ab.
Mutterschaft als Geisteshaltung ist für sie von zentraler Bedeutung.
Geistliche Schwestern bieten den Personen im Pflegeheim ein emotionales, spirituelles zu Hause und sorgen für die nötige physische und gesundheitliche Pflege. Arbeit und Familie – öffentliches und privates Leben –
bilden für Nonnen eine selbstverständliche Einheit, während weltliche
Schwestern diese Bereiche trennen. Unterschiedliche Moralvorstellungen
sind im Spiel. Diese moralischen und kulturellen Kategorien strukturieren
die verkörperten Arbeitsprozesse ziviler und geistlicher Schwestern im
Pflegeberuf auf sehr verschiedene Weise.
Rosie Read is a social anthropologist based at the Institute of Health and
Community Studies, Bournemouth University. Her research has explored
nursing work in the Czech Republic, particularly focusing on gender, work
and changing ideologies of nursing care in the context of postsocialist
reforms and social change. Her current work examines volunteering within
the Czech Republic. She is also working on a research project exploring
the labour and experiences of British prison nurses.
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Embodied Caring / Caring for Bodies
Two models of patient care
in a Czech nursing home
This essay is an exploration into caring practices in a Czech
nursing home, where I conducted ethnographic fieldwork in
1998-9. I examine the relationships between nurses and patients
through an investigation of care as manifested in a number of
everyday embodied practices. These practices supported and
recreated divisions between physical and emotional models of
patient care. I explore what these categories signified to different nursing home staff; in particular, why it was that one group
of nurses (civil nurses) saw these divisions as entirely appropriate and beyond moral question, whilst another (nuns) contested them, also on distinctly moral grounds.
My discussion offers a particular perspective on a key theme of
this book, namely, the role and status of emotions within medical contexts. In this essay, I concentrate on the perspective of
medical workers, examining how nurses and nuns had different
and contested views as to how far emotional identification with
patients could be expected from them as a formal part of their
job. The question of whether it is exploitative to require care
workers and service sector employees to manage and manipulate their emotions for the benefit of customers, clients or (as in
this case) patients has long concerned feminist scholars (see for
instance Hochschild 1983, Adkins 1995, Adkins and Lury
1999, Kittay and Feder 2002, Fineman 2005). Through my
ethnography I reveal how contestations over emotional labour
and accusations of exploitation unravelled in the nursing home.
I argue that at their core, these were disputes about the
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meanings of public and private forms of behaviour, and crucially, the boundary between them.
The nursing home was located in Prague and was owned and
managed by Borromeo nuns. It provided short and medium
term nursing care for elderly infirm patients. Nursing staff on
the wards comprised both nuns and so called civil nurses (nurses who were regular employees, not nuns), both of whom possessed some degree of nursing training, qualification and experience. This nursing home came into existence at a time when
the Czech health service was undergoing significant reform in
the years following the end of state socialism in 1989. Like
other structures of social security, the health system was
deemed to be in need of radical decentralisation in the 1990’s
(Garcés et al 2003, Marée and Gronewegen 1997, Nash 2003).
This process made it possible for new groups or organisations,
such as religious orders, to receive government backing to set
up health care services for the public. As I demonstrate throughout this essay, this process also created a cultural space in which
long established practices and assumptions within the health
care service were opened to challenge.
To begin, I provide two ethnographic vignettes that offer a
glimpse into daily lived reality on the wards. These are written
from my own point of view, as a researcher carrying out participant observation in the nursing home by working as a nurses’
assistant.
Caring for bodies: the showering process
It’s 8am in the nurses’ office. Four women – five including
myself – are seated, sipping coffee, eating bread rolls and chatting. Half an hour ago, we served breakfast to the patients in
their rooms, now we are taking a short break. The stanièní or
head nurse is seated at a desk, reading through the night shift
report, noting points for the nurses’ attention.
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«Apparently Brandová had a bad night – her leg is hurting still.
Make sure you have a look at it when you do the bandages.
Nìmcová is still having problems breathing. Keep an eye on
her too. Kubaèáková had to be changed three times.« She
breaks off and looks at the clock. Then she glances as us.
»Time’s getting on girls,« she says.
We stand up, preparing ourselves for the next task of the day:
showering the patients. In this process each of us will have a
particular role. We walk out of the nurses’ office and up to room
one, the first room at the top of a long corridor with patients’
rooms to one side. Once in room one, Iveta and Karolina walk
purposely towards a patient sitting in bed, and manoeuvre her
legs to one side so they are touching the floor. The old lady
looks uncertain. »What’s happening?« she asks. »Showering,«
says Iveta. Her tone of voice is neutral and firm, ensuring minimum discussion or resistance. She and Karolina stand on each
side of the patient. Placing their forearms under her shoulders
they lift her into the wheelchair next to the bed in one swift,
efficient movement. »There’s your first,« says Karolina, gently
pushing the wheelchair in my direction. They then proceed to
the next patient, who will be similarly moved into a wheelchair,
or brought to his or her feet, in readiness for being taken to the
shower room. This latter task is my responsibility. As Iveta and
Karolina proceed, I assist patient after patient down the corridor for their daily shower. Many travel by wheelchair, and some
walk – usually with a stick, or holding on to my hand. In the
shower room I remove all their clothes and their slippers. This
means they are completely naked when Irena, wearing a waterproof apron and Wellington boots, moves them onto the
showering stool to be soaped down, shampooed and rinsed.
Over the next twenty minutes the shower room becomes full of
patients, most of them naked, their nightdresses and slippers
scattered about. Sometimes someone will complain that he or
she is cold, but mostly they wait their turn, keep their thoughts
to themselves. Once they have been washed, Irena and I
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examine patients’ bed sores, evaluating which require dressing
and/or bandages. I then have to dry them, dress them, and take
them back to their beds, which Iveta and Karolina will have
already changed and neatly remade. I find myself struggling to
remember whose slippers are whose, which nightdress is
which, and muddle on, until eventually Karolina comes to my
aid. »We’ve finished the beds, so I’ve come to help you!« she
says. She quickly and efficiently dries legs and arms, pulls
nightdresses over heads, locates slippers, and whisks patients
away in their wheelchairs. Like many of the other nurses,
Karolina prides herself on being sikovná: competent, able,
adept at managing key nursing tasks. With her help, we near the
end of the task.
Embodying care: Iveta and Mrs Doškáøová
It is after lunch – the most relaxed period of the day. While
patients rest or gently doze in their rooms, the nurses sit in the
office, flicking through magazines, drinking coffee and talking.
Iveta stands and beckons to me. »Let’s go and see Doškáøová,«
she says. We walk down the corridor to room 9. Mrs Doškáøová is in the second bed from the door. She immediately smiles
at Iveta. »Here’s my poppet,« says Iveta affectionately. »How
are we today?« »Not bad,« says Mrs Doškáøová. This patient is
one of Iveta’s favourites. She has been in the nursing home for
around nine months, and will probably die here, as she is terminally ill with bowel cancer. Her son visits her regularly. Iveta
enquires after him and Mrs Doškáøová relates how he is still
trying to find work following his recent redundancy. Iveta
listens, holding Mrs. Doškáøová’s hand, nodding sympathetically. They agree that current times are difficult – work is not as
secure, nor as easy to find as it used to be. Then Iveta lifts the
mood by adding that Mrs. Doškáøová’s son is smart and able
(sikovnej) and will surely find new work soon. »Yes, I’m sure
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you’re right,« Mrs Doškáøová replies, smiling and patting
Iveta’s hand. Conversation turns to Iveta’s own family life. She
relates news of her children and husband, and what she plans to
cook for them that evening. Whilst Iveta talks, she carefully
tidies Mrs Doškáøová’s personal belongings in the small cabinet next to the bed, clearing away some old chocolate wrappers,
rearranging the flowers which Mrs Doškáøová’s son brought
her, wiping some grease from a framed photograph of Mrs Doškáøová’s grandson. Some time later, after family news has been
thoroughly exchanged, we prepare to return to the afternoon’s
tasks. As we leave, Iveta picks up a small bag of clothes from
Mrs Doškáøová’s wardrobe, and offers to take them home to be
washed. Mrs Doškáøová accepts, but offers her some money in
exchange. Iveta refuses the money and insists that this is no
trouble. »You are so kind!« says Mrs Doškáøová. To express her
gratitude, she offers us both a chocolate.
Forms of care in context
As suggested by the above vignettes, nurses’ daily practices
incorporated contrasting ways of relating to patients, and
patient care varied according to the nature of the situation. In
this section I discuss how each vignette relates to a different
model, or principle, of caring obligation, as well as how each
signifies, for the nurses, an alternate aspect of the feminine self.
The showering of patients was one of several routine tasks,
which the nurses performed on a daily basis. These tasks were
carried out in a regimented fashion, typifying the kind of institutionalised rationality that Foucault (1991) has identified as
central to the organisation of modern institutions. The object of
these tasks is always the correct physical and medical maintenance of patients’ bodies, and this is achieved through the rigorous ordering of time and space. Thus, the showering process
resembled a production line, with each of the nurses handling
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one aspect of the product to maximise efficiency. As I became
part of this system, I too learned how to see patients in the
course of these tasks, focussing my attention almost exclusively on their physical bodies.
Whilst the form of this ritual may not be culturally specific, its
meaning to those involved in it must be understood in the
broader historical context of the Czech health care system. The
provision of universal, free health care for all Czechoslovak
citizens was established after the Second World War by the
communist government (Heitlinger 1987: 75). Socialist health
care tended to focus on the physical and biological aspects of
health and illness, rather than on the social and environmental
ones. Throughout the socialist period, government officials and
medical practitioners utilised scientised and apparently objective forms of address in engaging with the public over health
matters. The health system was also highly centralised and
therefore not especially responsive to its users. Patients tended
to be treated as passive recipients of health care, rather than
active consumers of it, and contesting medical opinion and
treatment was difficult.1 At the same time, the right to free
health care was a key component within a broader vision of
socialist modernity, in which poverty and exploitation were to
be eradicated, and the state undertook to ensure a high standard
of living for all citizens through the universal provision of
housing, education, employment, social security, and health
care. Free health care provision became widely incorporated
into the everyday expectations of many citizens.
Many nurses in the nursing home had trained and worked most
of their lives in major hospitals across Prague. They understood
their primary duty to patients to involve the provision of medical and physical care through efficient performance of such
rationalised tasks as showering, feeding, allocating medicine,
and maintaining an ordered and hygienic environment.2 The
institutionalised, de-personalised nature of these activities was
not considered morally problematic, since the actions them-
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selves were not an expression of a personal relationship, and the
identities involved were not seen in terms of the individual, but
rather in terms of the collective. In other words, the physical
tasks were rituals in which institutionalised systems were visible and paramount. Nurses’ lack of concern for individual
patients’ needs and sensibilities, their heightened awareness of
the meaning of teamwork, their concern for efficiency, and the
pleasure they took in their own competence and expertise – all
of these were part of a consciousness that came of working on
behalf of a broader, collective entity called the health care
system.3 The physical care they provided reproduced the health
care system, and ultimately, the state. For the nurses, routine
physical care provided in and through routine tasks reflected
the relationship between patients and public institutions, rather
than ›private‹ or personal ties between individual nurses and
patients. The showering ritual institutionalised state care par
excellence.
How, then, to square these understandings of nursing care as
de-personalised physical labour primarily concerned with the
rationalised processing of elderly bodies, with the second vignette, which suggests a rather different picture of the nursepatient relationship? Iveta relates to Mrs Doškáøová in a highly
personalised manner, enquiring about family relationships,
giving attention to her personal belongings. The patient is not
approached as an objectified and dependent physical body;
instead, Iveta holds Mrs Doškáøová’s hand, and both women
are attentive to the other’s facial expressions.
Many nurses had favourite patients, with whom they would sit
and talk, and for whom they developed strong feelings of affection and concern. However, these relationships were only fully
recognised during quiet periods of the day, in between the routine
tasks. They were rather intimate moments: moments which stood
in sharp contrast to those more public performances of feeding,
showering and bed changing which involved the entire ward.
Such personalised, affective relationships were therefore contai-
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ned in both temporal and spatial ways. In an important sense, they
were not part of nurses’ work as waged labour: for whereas nurses were well aware of their contractual obligation to care for
patients’ physical needs, they considered their relationships with
favourites to be a private matter, and of personal choice. How,
and in what manner, they chose to develop these sentimental connections was left up to the individual nurse and her patient.
Moreover, whilst routine nursing tasks allowed the nurses to
express a positive, autonomous sense of self-as-worker, the practice of sitting with favourite patients was a context for the extension of a more relational side of these nurses’ identities: a context
in which the self emerged in and through personal ties. Such relationships with patients bore a strong resemblance to family relations, or at least to those enduring forms of social obligation and
exchange. Patients were treated as if they were relations, close
friends or neighbours. Through creating discrete and contained
spaces in which kin-like relationships could be recognised and
performed, nurses extended kinship into the work place.
However, the worlds of work and the worlds of kin were kept
separate and distinct. In this way, nurses’ embodied practices continually reconstituted a spatial and moral public-private divide –
the morality and values associated with each remaining intact.
Caring as vocation: the nuns
Although the majority of nursing staff were civil nurses, the
nursing home was owned by the Borromeo order of nuns. The
Mother Superior was the most senior manager of the nursing
home, and Borromeo nuns sometimes worked on the wards
with civil nurses. I now show how the nuns’ vision of caring
obligations to patients troubled the civil nurses, radically disrupting as it did the clear distinctions civil nurses maintained
between public and private, as well as physical and emotional,
categories of care.
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The institution was home to around 15 nuns. The oldest generation had taken vows before the socialist era, the youngest had
done so after the end of socialism in 1989, and a middle generation had entered convent life under socialism, almost always
in secret. The latter group tended to assume positions of authority and influence within the institution and the congregation as
a whole. Inevitably, nuns’ perspectives of patient care were
shaped within quite different historical and contemporary circumstances and experiences than those of civil nurses. For one,
the concept and practice of the nuns’ vocation necessarily collapsed conventional boundaries between kin and work, personal and public. Nuns renounced marriage and biological
motherhood, but embraced the role of spiritual motherhood in a
broader sense. Second, their fourth congregational vow was to
provide merciful love to the most needy and most wretched.
The establishment of the nursing home provided a context in
which this vow could be fulfilled, through caring for elderly
patients. In an information-leaflet about the nursing home the
Mother Superior described what this task entailed as follows:
Many elderly patients live through the closing moments of their
lives in our home. At this point in his life a person needs, above all,
care and the quiet, loving presence of others. This means, more than
anything else, to be in attendance, to attend the ill person and his
family during this difficult period in life’s path. Many people in contemporary life have inadequate help, company, and love from other
people. A person is destitute when, in the midst of old age, illness
and death, they have no one.
As part of their vocation, nuns offered patients in the nursing
home emotional and spiritual, as well as physical, care. For the
nuns, work and family were part of a unified whole, and there
was no contradiction in representing the institutionalised care
of the nursing home in highly personalised spiritual or emotional terms. Although the Mother Superior, as manager of the
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nursing home, did not expect civil nurses to share the nuns’
faith, she did require that nurses had what she called ›a good
relationship‹ with patients, particularly the ability to empathise
with them, and to comfort them in their distress. According to
her, good nursing consisted of more than medical and technical
skills; it also involved social and emotional identification with
patients. In other words, for the Mother Superior nursing too
was a vocation for which some had a natural ability, and some
did not.
Fractured caring / re-locating emotional care
Nuns’ and civil nurses’ different perspectives of institutionalised care were not always directly discernable in daily life in
the nursing home. In large part, this was because there were
relatively few nuns who worked on the wards on a regular
basis. Nevertheless, many civil nurses were uneasy about the
nuns’ views about patient care, and at certain times, tensions
did arise. When they did, they generated confusion and conflict
over the proper role of the nurse, the kind of care that was
appropriate, and in particular, the extent to which emotional
identification could be considered a formal part of the nurse’s
duties.
For example, every so often the head nurse reminded staff on
the wards that the managers did not like to see nurses sitting in
the office to take their break, preferring them to spend their coffee time sitting with and talking to patients in their rooms.
These instructions tended to generate indignation amongst
many of the civil nurses. They saw this as exploitation: a crude
attempt to increase the workload by eliminating the few times
of the day when nurses were spatially separate from patients; a
»preference« that, if heeded, would ensure that the nursing staff
were constantly available and never off duty. These sentiments
were intensified by the knowledge that the nurses’ salaries had
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not kept pace with dramatic post-1989 price rises. Civil nurses
remarked that they could earn better money doing unskilled
labour in the commercial sector than as professional nurses in
the state sector. In the face of this inconsistency, why should
they take on more work for no extra pay?
Controversy over what constituted appropriate forms of care
also erupted when certain civil nurses did not have their annual
contracts renewed because the management team felt they did
not have »a good relationship« with patients. This happened
three times over the course of one year of fieldwork. Each time,
it resulted in heated discussion in the staff room, and considerable bitterness amongst civil nurses. Many concurred that an
explicit requirement to perform emotional care was not only
exploitative, but unprofessional and inappropriate. The primary
duty of the nurse was to help patients get better, not to empathise. Indeed, distance (odstup) between the nurse and patient
was argued to be necessary and desirable, since it helped create a context in which nurses could act in the patient’s best medical interests. Of course, as we have seen many civil nurses did
practice highly personalised forms of care on an informal basis.
At stake here, however, was the principle – the formal definition of, and boundaries that should constitute, the nursing obligation. What the civil nurses were contesting was the implication that emotional care should become a routine, standardized
part of the job.
These tensions were lived out in an embodied way. After the
dismissal of colleagues, when civil nurses felt most aggrieved,
they would stop going to sit with their »favourites« for a number of days, stating that they had little energy or inclination to
do so. Instead, during those quiet afternoon periods, they would
defiantly busy themselves with unambiguously physical tasks
like recording patients’ temperatures and weight, or cleaning
wheelchairs and other medical equipment. These small-scale if
pointed attempts to regain control over labour were not highly
organised, and nor were they even long lasting, but while they
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did last they were intensely and sincerely felt by the civil nurses who engaged in them. At these times, the division between
physical and emotional forms of care were highlighted. Nurses
who continued to sit with »favourites« were regarded by some
of their colleagues with suspicion, and lay themselves open to
direct accusations that they had sided with the management
and/or the nuns, and had gone against their colleagues.
Unfortunately, these kinds of practices on the part of the nurses
had the effect of reinforcing certain negative perceptions that
the nuns had of them: for instance, that they were merely
demonstrating their own laziness and apathy, as opposed to
taking these actions out of a sense of professionalism. The personal investments they did make with their patients went largely unrecognized, and civil nurses were seen by the nuns to be
doing no more than the »bare minimum« of physical tasks. One
nun explained this in terms of »bad habits« formed under the
socialist system, when guaranteed employment operated as a
disincentive for workers to invest effort in, and make a commitment to, their work. This explanation re-worked the common stereotype that socialism had made people passive and
idle. However, in this particular case it also highlighted the
nuns’ inability to recognise the kinds of moral and spatial
distinctions between public and private that so infused the civil
nurses’ working practices.
Conclusion
In this essay I have argued two main points with regard to
caring practices in a Czech nursing home. Firstly, I have asserted that different models of care were reproduced chiefly
through embodied practices. It was via daily routines and rituals such as showering, making beds, feeding patients, and visiting favourites that nurses recreated the public / private divide.
Secondly, I have shown how controversy arising from, and con-
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testation over what constituted emotional labour and identification were linked to nuns’ and civil nurses’ different understandings of public and private forms of behaviour and moral obligation. These moral and cultural categories structured civil nurses’ and nuns’ notions of appropriate emotion and embodied
practice in very different ways.
Notes
1
Whereas in liberal capitalist states, the dominance of conventional
medical discourse has been historically challenged in a range of ways
by pressure groups and health service user associations, such interventions were all but ruled out in the socialist context, in which the state
exerted considerable formal control over the formation and activities
of such groups.
2
See also Heitlinger (1987, 1998) and Benoit and Heitlinger (1998) on
the working practices of Czech nurses in the socialist period.
3
Equally, the patients neither expected nor demanded personalised care
or individualised service in the course of the showering process. They
too understood and for the most part accepted the implicit distinctions
between public / physical and private / personalised forms of care.
References
Adkins, L (1995) Gendered Work: Sexuality, Family and the Labour
Market. Buckingham: Open University Press.
Adkins, L and Lury, C (1999) ›The Labour of Identity: Performing
Identities, Performing Economies‹, Economy and Society, 28(4): 598614.
Benoit, C and Heitlinger, A (1998) ›Women’s Health Care Work in
Comparative Perspective: Canada, Sweden and Czechoslovakia/Czech
Republic as Case Examples‹ Social Science and Medicine, 47(8):
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Rosie Read
1101-1111.
Fineman, S (2005) ›Appreciating Emotion at Work: Paradigm Tensions‹,
International Journal of Work, Organisation and Emotion, 1(1):4-19.
Foucault, M. (1991) Discipline and Punish: The Birth of the Prison,
London: Penguin Books.
Garcés, J, Ródenas, F and Carretero, S (2003) ›Observations on the
Progress of Welfare-State Construction in Hungary, Poland and the
Czech Republic‹, Post-Soviet Affairs, 19(4): 337-371.
Heitlinger, A (1987) Reproduction, Medicine and the Socialist State.
London: Macmillan Press.
Heitlinger, A (1998) Czech Nursing During and After Communism, in
Vittorio Olgiati, Louis Orzack and Mike Saks (eds) Professions,
Identity and Order in Comparative Perspective. Onati: International
Institute of the Sociology of Law, pp.123-148.
Hochschild, A (1983) The Managed Heart, Berkeley: University of
California.
Kittay, E.F., and Feder, E.K., eds (2002) The Subject of Care. Feminist
Perspectives on Dependency, New York: Rowman and Littlefield
Marrée, J and Groenewegen, P.P. (1997) Back to Bismarck: Eastern
European Health Care in Transition. Aldershot: Avebury.
Nash, R (2003) Restating the Family: Kinship and Care in the Czech
Republic. Unpublished PhD thesis: University of Virginia.
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Alternative Heilpraktiken
Mutterschaft wird auch in Agnieszka Koscianskas Essay über alternative
Heilpraktiken in Polen thematisiert. Sie beschäftigt sich mit zwei spirituellen Gruppierungen, The Legion of Small Knights of the Devine Mercy und
die Brahma Kumaris. Das Gesundheitssystem in Polen befindet sich in
einer permanenten Krise. Spitäler sind schlecht ausgestattet. ÄrztInnen
und Pflegepersonal bekommen geringe Gehälter. Dies führt zu einem privat organisierten Service und einem System informeller Zahlungen in
öffentlichen Krankenhäusern. Da PatientInnen vom öffentlichen
Gesundheitssystem nicht viel zu erwarten haben, wenden sie sich alternativen Behandlungsmodellen zu.
Das Grundmodell weiblicher Identität in Polen bildet die Mutterschaft: die
polnische Mutter. Demnach gehören zu den Aufgaben und Pflichten von
Frauen viel mehr als die Verantwortung über die Privatsphäre zu übernehmen, sondern etwa auch der Militärdienst. Die polnische Mutter ist für die
Familie verantwortlich und gleichermaßen für die Gemeinschaft und den
Staat. Ihr Widerstand und ihre Aktivitäten erfolgen jedoch im Stillen, durch
Gesten und Rituale, weniger mit Worten und Parolen. Agnieszka
Koscianska untersucht diesen stillen weiblichen Widerstand – gegen ein
wenig funktionierendes öffentliches Gesundheitswesen – in alternativen
Heilbewegungen. The Legion of Small Knights of the Devine Mercy ist eine
religiöse Bewegung, die sich als Teil der katholischen Kirche versteht,
welche allerdings von kirchlichen Instanzen nicht anerkannt wird.
Mitglieder der Legion glauben daran, dass Jesus ihnen immer noch den
Weg weist und Zeichen gibt. Schwester Zofia gilt als Gründerin der
Bewegung. Ihre Visionen und Offenbarungen begannen in den späten
1980erjahren. Gebetsgruppe vertreten die Ansicht, dass Frauen gläubiger
als Männer sind. Frauen sei das Wissen um das Gebet von Gott gegeben.
Eine Zeit des Friedens stehe bevor und Polen sei der auserwählte Staat.
Schwester Zofia habe die Gabe zu heilen. Von ihr geweihtes Wasser wird
als Medizin verwendet. Brahma Kumaris ist die zweite Bewegung, über
die Agnieszka Koscianska berichtet. Ihre Wurzeln liegen im Hinduismus.
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Christina Lammer
Die Gruppe wurde 1936 in Hyderabad (Pakistan) von Dada Lekhraj
gegründet, einem reichen Diamantenhändler, der im Alter von 60 eine
Serie von Offenbarungen hatte. Nach dem Tod Lekhrajs erweitert sich die
Bewegung. Schwester Halina gründet eine Brahma Kumaris-Gemeinschaft in Polen. Die Bewegung praktiziert Raja Yoga und arbeitet mit
Naturheilmitteln. In Indien leitet die Gruppierung Spitäler, während sie im
Westen eine andere – stärker politisierte – Form annimmt. Alternative
Heilpraktiken setzen dem öffentlichen Gesundheitssystem etwas entgegen.
Die spirituelle Verbindung zwischen HeilerInnen und PatientInnen versteht die Autorin als wichtige sozialpolitische Kritik. Zudem werden
wesentliche Implikationen bezüglich Geschlechtsidentität und Frauenrollen deutlich. Existierende Konzepte von Frausein werden in diesen
Organisationen aktiv hinterfragt. Eine starke und dennoch stille Stimme
wird laut, die traditionell im öffentlichen Diskurs in Polen ungehört bleibt.
Agnieszka Koscianska is a Ph.D. candidate at the Institute of Ethnology
and Cultural Anthropology, Warsaw University. Her research interests
centre on gender, religion and social resistance, as well as on new religious
movements in Poland. She is a co-editor of Kobiety i religie (Women and
Religions, 2006) and the forthcoming volume Gender. Perspektywa antropologiczna (Gender. An Anthropological Perspective. A Reader).
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Alternative Healing Practices
Two female-led spiritual communities in Poland
In this paper I focus on the alternative healing practices of The
Legion of Small Knights of the Divine Mercy and the Brahma
Kumaris – two spiritual communities1 that have been active in
Poland since the mid-1980s. I analyse these communities’
respective healing practices, which are both based on emotional
proximity and maternal behaviour, as a genre of resistance in
post-socialist. Before analysing in detail these two groups’ activities, I briefly describe the context of their activity to situate
them within broader issues concerning the healthcare system in
Poland. Given that the communities I am looking at are predominantly female, I also briefly examine a key gender issue in
Poland – namely, the nuanced and multi-layered meaning of
motherhood – and introduce a genre of analysis through which
women’s resistance in Poland can be better understood.
The healthcare system in Poland
The public health service in Poland has been in a state of permanent crisis since the socialist period. Although Poland became modernised under communist rule following the Second
World War, the public healthcare system remained a weak point
of the state. Polish medical sociologist Marek Latoszek (2000)
insists that, though the socialist principle that a public healthcare service must be accessible to all lay at the core of the
Polish healthcare system under socialism, this principle was
never fully realised (5). A lack of funds meant that the health-
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care service could not meet even the basic needs and expectations of patients. Hospitals and clinics were badly equipped,
and medical staff had very low wages. These conditions led to
the development of a private medical service and a system of
informal payments within public clinics and hospitals.
In general, the public healthcare system has not improved since
the fall of Communism in 1989. It can take patients over a year
to get an appointment. In urgent cases, patients are often forced
to go to an expensive private clinic, or must resort to bribing a
doctor to see them more quickly. In 1999, a general reform of
the public healthcare system took place. According to public
opinion surveys, 85% of patients claimed that the reform made
access to the healthcare system even more difficult (Ostrowska
2002). This crisis within the medical service can be understood
as part of a broader crisis that has hit the post-socialist state, and
in which the new Polish state is seen to be failing when it comes
to meeting its welfare responsibilities. This situation has triggered off numerous waves of resistance. Since 1989, Poland
has witnessed a constant round of strikes and demonstrations on
the part of medical staff, mostly nurses, and has been bombarded with patient claims. In addition, medical doctors, as well as
nurses, have been leaving Poland to seek better working conditions in other European Union countries. Patients, for their part,
have been looking to alternative modes of treatment.
The Polish Mother and Female Resistance
In Poland, a basic model of female identity is built around
motherhood. However, motherhood means much more than the
biological fact of being a mother. Motherhood refers to a notion
of the Matka-Polka – the Polish Mother – which is a term that
dates back to the nineteenth century, and that is connected to the
participation of women in the Polish struggle for independence
during the Partition Period, which followed the fall of the
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Polish state in 1795. Within this model of Polish womanhood,
a woman’s duties encompass various kinds of skills and obligations, which often go far beyond the private sphere, and have
even included military participation. The Polish Mother is
responsible not only for her family, but for the broader community i.e. the nation. She is also treated somewhat ambivalently by Polish feminists: on the one hand, the model of the
Polish Mother is seen as enabling women to become active
members of the national community and to enjoy the prestige
that comes of such an involvement; on the other hand, this
model ends up limiting the choices open to women in terms of
how they can participate in public and private life. What is clear
is that this model speaks to a form of active agency in and
through which Polish women are encouraged to take action
against those who threaten their families and/or the national
community.
As for the kind of protests that have resulted of this call to
action, they have often been silent: the women involved in them
relying on gestures and rituals, rather than on words, to get their
message across. For example, women protesting during the
1860s in the context of the Partition Period wore black dresses
to express their mourning over the loss of the Fatherland2.
Susan Gal (2002), commenting on the way that for a number of
feminists, women’s silence within the public sphere is »taken to
be a result and a symbol of passivity and powerlessness« (213),
suggests that this link needs to be seriously questioned. To this
end, she provides examples of women’s acts of resistance that
are both silent and powerful, and discusses various genres of
women’s resistance – among them those that rely on gesture
and ritual, as in the example above where wearing a black dress
becomes an act of protest. My research into alternative healing
speaks to this genre of resistance as it relates to the ongoing crisis in the Polish healthcare system.
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The Legion of Small Knights of the Divine Mercy
The first healing group that I consider in this paper, The Legion
of Small Knights of the Divine Mercy, is a religious movement
that claims to be part of the Roman Catholic Church, but which
the Church hierarchy prefers not to recognise. The group adheres to the Divine Mercy devotion that was founded in 1930
by Saint Faustina, and that was strongly promoted by Pope
John Paul II. Legion members believe that Jesus continues to
give new signs of guidance. The faithful organise new prayer
communities and new people may have powerful visions of the
Merciful Lord. The Legion founder, Sister Zofia, falls into this
latter category – she was a poor, uneducated woman who had
such a vision. Her revelations started in the late 1980s.
According to Legion members, Jesus dictated those rules that
regulate their activity. In general, to be fully devoted to the
Divine Mercy one must be humble and truthful. Moreover,
members are expected to organise prayer communities in their
respective parishes. On the whole, those people who enter the
Legion are already very devout Catholics, and the Legion gives
them an additional opportunity to pray together. Their prayers
have several main objectives: to deliver guidance to the clergy
and the Roman Catholic Church, to free souls suffering in purgatory, to convert sinners and the non-faithful, and to establish
world peace.
A key element of The Legion of Small Knights of the Divine
Mercy is their female leadership. Though Sister Zofia and her
followers do not call for women priests within the Church, they
do believe that women are more faithful than men, and that they
have a special role to play in our contemporary world. This role
revolves around prayer – as one of my informants stressed,
»Women have a great gift from God, they know how to pray«
– and the coordination of family-oriented activities. Another
fundamental aspect of Sister Zofia and her followers’ doctrine
is its focus on millenarianism. Following the word of Jesus as
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it is spoken in the revelations, Legion members believe that an
era of peace is approaching and that we currently live in a time
of purification. In Sister Zofia’s frequent invocations of nationalistic ideology that accompany this millenarian belief, the
Polish nation is presented as the chosen nation (Koscianska
2005). Finally, it should be emphasised that Sister Zofia does
more than merely preach: she is known for her healing skills,
and the water she blesses is considered by many to be medicine.
Some of her disciples have equally gone on to acquire these
healing skills.
Brahma Kumaris
The second healing group that I consider in this paper, the
Brahma Kumaris, are of Hindu origin, and resemble the Legion
on two points: their millenarian ties and their view of the role
of women within the movement. The group was founded in
1936 in Hyderabad, in the province of Sind – now part of
Pakistan – by Dada Lekhraj: a rich diamond merchant who, at
the age of 60, experienced a series of powerful revelations. He
took the name Brahma Baba and established the Brahma
Kumaris (BKs) spiritual community. He then proceeded to
reformulate the Hindu circle of time. According to the Brahma
Baba’s teachings, we are currently living in the Confluence Age
– a period of transition between the Iron Age and the Golden
Age, i.e. between the end of the circle, between humanity’s
downfall and paradise restored. In other words, we are living
just before the end of the world, and it is the Brahma Baba’s followers who will lead us into the new world. Another key aspect
of Dada Lekhraj’s spiritual vision is that he encouraged young
girls who were followers to take on important responsibilities
within the community, and promoted women to positions of
leadership in both spiritual and administrative terms. These
women are now called Dadis – or »older sisters« (Howell 1998,
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Skultans 1993). After Lekhraj’s death the movement expanded
into the West. Sister Halina, a Pole, who lived in Canada as a
teenager in the 1970s, established the BKs community in
Poland. There, she encountered the BKs and became a member.
In the early 1980s she returned to Poland with a mission, managing over the next two decades to set up BK communities in all
of the country’s major cities (Koscianska 2003).
Raja Yoga is an important practice within the BK movement,
considered to be more of a style of life than a simple meditation
technique. Within the Raja Yoga lifestyle, early morning meditation sessions are accompanied by strict vegetarianism, ritualised
cooking procedures, bodily discipline (which includes a special
set of hygienic practices, light sporting activities and relaxation
techniques), celibacy, and an engagement with a number of activities that are focused around the transformation of the world.
This is not to say that the BK movement has remained unchanged since its inception in 1936. In the early days, the primary
focus of members was spiritual development, and this was
accompanied by a rejection of the outside world, an extremely
orthodox approach to the various practices, and strict obeisance
of all rules. Since the early1980s, however, a marked secularisation has taken place within BK branches outside of India
(Howell and Nelson 2000, see also Wallis 2002). In part, this
process of secularisation is linked to the movement’s increasing
engagement with healing practices based on a combination of
natural medicine and Raja Yoga practice. Whereas in India, the
BKs manage two hospitals (one, which they built themselves, at
their Mt. Abu headquarters and a second, in Bombay, which the
government has placed under BK supervision), BK-style healing
in the Western world takes a different form. Its healing potential
is also more politicised, the BK movement clearly offering – in
Poland, anyway – those patients and ordinary people who are
interested in natural healing an important alternative to those
health services currently being offered by an under-funded and
over-stretched public healthcare system.
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Members and reasons of commitment
Both the Legion’s and the BKs’ membership and sympathisers
consist primarily of women. These women come from all levels
of social strata, though the BKs consciously direct their activities towards those situated at the upper end of the social scale
(e.g. artists, journalists, businesswomen). Exact membership
numbers are hard to discern; in both cases, however, the number of dedicated members is low. That said, both groups are
very active when it comes to promoting their alternative views
of health culture, and the number of sympathisers has been
rising steadily. Within each group, the concept of membership
means something quite different: becoming a BK requires conversion and a total reorganisation of one’s lifestyle, whereas to
become a Legion Knight entails the radicalisation of one’s religiousness. Likewise, the reasons people are drawn to one group
or the other, or are willing to commit to one or the other, vary.
For the purposes of this paper, however, I focus on something
that binds members and sympathisers of both groups: that is,
the centrality of illness to their life-stories and their identities.
The illnesses that draw people to the groups are both physical
and psychological, and in most cases a new member’s desire to
commit to the movement is connected to the care and help she
has received from an existing group leader or member. In some
cases, a new member has actually been healed in the course of
this care and help; in others, knowledge has been imparted that
enabled the new member to minimise, or at the very least gain
a better understanding of, her suffering. In the case of the
Legion, especially – its organisational structure being more
centralised than that of the BKs – many people become dedicated followers after coming into contact with, and enjoying proximity to, Sister Zofia, whom they credit with having solved
their health problems. Though the focus here is on those who
become members of either group as a result of an illness, it
should be noted that the healing potential that comes of a com-
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mitment to one of these groups is equally acknowledged by
those members who are healthy: these latter believe that because of their membership in, and dedication to the practices of,
either the Legion or the BKs, they have avoided various illnesses.
Holistic medicine
Whereas Western biomedicine sees the body as a complex and
independent mechanism, the holistic medicine practised by
both the Legion and the BKs is based on the assumption that the
body’s health depends on various elements, including the soul,
the mind and the environment. According to the teachings of
the groups that I studied, there are three basic reasons for physical illnesses: negligence of the body, spiritual problems and
most importantly (as reflected in the emphasis on millenarianism in both movements), the general condition of the world
and humanity. Though both movements are primarily concerned with the spiritual aspects of illness and healing, they do
see the body and soul as bound the one to the other. Much stress
is therefore placed on the maintenance of a healthy body.
Without such maintenance, the body is perceived as an obstacle
that gets in the way of the soul. The BKs’ belief in sexual abstinence means that they see the downfall of humanity as linked
to bodily acts of a sexual nature. As one of my informants put
it:
Humankind has too much sex. It doesn’t matter if you do it as a couple or during an orgy. This is an abuse ... a violation against your
own body and one that causes numerous diseases like, for instance,
breast cancer or prostate cancer.
The AIDS epidemic is also understood to be the result of humanity’s downfall. Legion members, for their part, frequently refer
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to Satan, whom they see as being particularly active at the present time. Because they believe that Satan can enter into a person, various means of protection exist to prevent this eventuality, such as blessed water, holy icons, and prayer.
In both movements, healing practices are based on the establishment of a relationship between healer and patient that
emphasises proximity and an emotional connection. Legion’s
Sister Zofia, for example, uses her hands, through which energy is believed to flow, to heal those who are ill. Other healing
aides include the holy cross, prayer and water that she has blessed – one hand touching the places on a person’s body that
require healing whilst she prays and holds a cross in her other
hand. Quite apart from their healing qualities, Sister Zofia
recommends water and prayer as important means to sustain
health. In cases where a disease cannot be cured, she urges the
patient to offer her suffering to God. Sister Zofia also gives
general blessings. Before such a blessing she treats the patient
kindly, taking the time to talk to her in private. She then asks
the patient to kneel down and puts her hands on the patient’s
head. At this point, the person being blessed often collapses on
the floor and lies there for several minutes – a sign, according
to Sister Zofia, that the Holy Spirit has entered the patient’s
body. Informants in my study spoke frequently of their desire to
get close to Sister Zofia, even in the context of a big Legion
meeting. As one member attending such an event put it, »I
remember that I wanted just to touch her dress, because I
thought that her grace would be passed to me.« Another informant attending the same meeting described how Sister Zofia
healed her:
She has a great grace. She healed me. I will not deny. I had two big
cysts on my knee, walnut’s size. My knee was horribly swollen. And
that hurt me for a long time. When we went to the meeting, to
Czêstochowa [the main Polish pilgrimage centre], I couldn’t kneel
down, and she appeared suddenly next to me, and started to massa-
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ge my knee. And when I came back home, that was nothing in my
knee. It doesn’t hurt me anymore.
What emerged over and over again in the interviews was the
emotional engagement that Sister Zofia’s patients felt towards
her – an engagement often expressed as a form of love. They
also spoke of their feeling that she was like a mother to them.
Healing skills
As suggested earlier, many of Sister Zofia’s followers develop
these same healing skills and have revelations of their own –
thus carrying on the practices of patient healing and care already established by Sister Zofia. Grazyna is one such follower
and like Sister Zofia, she is known for her healing skills and her
ability to bless the waters. During the course of our interview
she told me how she gets calls from perfect strangers – generally people who have heard about her from a friend or relative
who know somebody she treated. Though Grazyna specialises
in psychological problems and family issues, she also helps
those who suffer from physical illness. In the latter case, she
will often conduct a preliminary meeting with a patient or his
or her relative on the telephone; then, if she finds it necessary,
she will meet with the patient in person. She usually invites
people to come to her place, but on occasion she will visit a
patient in his or her home. Like Sister Zofia, these visits consist
of prayer, of a laying of hands on the parts of the patient’s body
which are unwell, and of an explanation for the suffering being
endured.
In the case of the BKs, no direct medical interventions are made
as in India. However, because Raja Yoga is believed to solve all
problems of the body and soul, those who do have health problems are encouraged to meditate and to strictly adhere to all
other practices that are constitutive of it. During meditation ses-
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sions, leaders pass on healing energy through eye contact or
through specially prepared food. Group meditation sessions, for
example, often end with a ritual that involves both. During this
ritual, which is accompanied by quiet music and takes place
under soft lighting, each participant approaches the spiritual
leader, sits in front of her and receives from her a drishti and a
toli. Drishti is a very special type of gaze: it translates as »the
one who stares,« and through it positive divine energy is passed
on via the leader’s eyes. This energy may be healing energy or
more generally empowering energy, and it is given not only to
people, but also to food. According to one of my informants,
this energy has the power to improve food that has not been prepared in accordance with the BKs’ rules. As for the toli, this is
a very sweet cake that is prepared in a highly ritualised fashion.
Like the drishti, the BKs believe that in giving her followers the
toli, a leader passes on positive divine energy. The ritual of
giving toli and drishti is believed to facilitate spiritual development, and is seemingly the most powerful aspect of group
meditations. The energy that each participant receives is meant
to facilitate the attainment of peace of mind, as well as heal –
or sustain the health of – that participant’s body. In the course
of my fieldwork I heard numerous accounts from members who
had been healed as a result of this form of meditation. In both
cases emotional proximity is employed within healing process.
Healers act according to Polish expectations of maternity. Thus
healing is always combined with transmission of a sacred
knowledge. Strong emotional contact and boundless trust provide a very good opportunity for facilitating the knowledge
concerning the end of the world.
Concluding remarks
According to informants attending a Legion meeting led by
Sister Zofia, Jesus delivered a special message to them. He said:
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You are older people, you are retired and don’t have a lot of money.
Don’t go to medical doctors! I will take care of you, I will heal you.
I will give you a grace. I need you. I will keep you healthy and alive
for a long time.
This statement is especially important within the context of an
ailing Polish public healthcare system. Communities such as
the Legion and the BKs, which offer an alternative medical
practice based on healing modes that revolve around physical
proximity, emotional attachment, and spiritual sharing between
healer and patient, can be understood as an important social and
political critique. In each case, the healing practices engaged
with shape and reflect alternative visions of the contemporary
world and relations within that world. These two spiritual
groups, though fundamentally opposed on some issues, are
similar in that they both promote a form of radicalism that aims
at a total upheaval of society, and that in so doing creates considerable tension between followers and the outside world of
members’ families, the state and the Church. The healing practices of these groups also have important implications for gender identities – suggesting the need to re-think existing concepts of femininity in Poland. In these organisations,
leaders/healers, who are always women, are often described as
mothers. Building emotional relations, which is clearly considered to be motherly behaviour within Polish culture, becomes
a genre of resistance. Although these women do not consider
themselves feminists, they have significant agency in the construction of a worldview that empowers both female symbolic
elements and women’s social position. At the same time, however, their actions resonate with the Polish Mother model: by
practising alternative modes of treatment they manifest their
dissatisfaction with the state politics, and simultaneously take
care of their families, friends and the nation on their own. In
other words, these healing practices – when understood as a
form of social resistance – help to create a strong silent voice
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231
for those whose words are traditionally not heard within
Poland’s public discourse
Notes
1
The ethnographic data on which this article is based was collected
during the course of my fieldwork, carried out between June 2001 and
December 2002. I also draw on material collected by students at the
Institute of Ethnology and Cultural Anthropology, Warsaw University
for a research project entitled Female Religious Leadership, which I
directed between April 2001 and January 2003.
2
For more on the Polish Mother, see Pine 2001.
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Puttick, E. and Clarke B.P. (eds.). Women as Teachers and Disciples in
Traditional and New Religions. Lewiston, Queenston, Lampeter:
Edwin Mellen Press.
Wallis, J. (2002) The Brahma Kumaris as a »Reflexive Tradition«: responding to late modernity. Hants: Ashgate.
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Hausarbeit als Therapie
Mit Hausarbeit Ordnung ins Leben bringen? Therapeutisch wirksame
Verkörperungen der speziellen Art. Sarah Pink analysiert in ihrem Essay
40 Videointerviews, die sie in Großbritannien und Spanien im Rahmen
einer ethnografischen Studie zu den Themen Lebensstil, Haushalt und
Reinigen geführt hat. Aus dieser Forschungsarbeit geht hervor, dass
Hausarbeit als eine Form von verkörperter Therapie wahrgenommen wird.
Zu Hause aufzuräumen und zu putzen, bringt Wohlbefinden ins Leben.
Sarah Pink bezieht sich auf jüngste Studien der Ethnologie der Sinne und
schlägt vor, Arbeiten im Haushalt als verkörperte Erfahrung mit allen
Sinnen zu verstehen. Mit Veränderungen in der privaten sinnlichen
Umgebung geht eine persönliche Erneuerung einher.
Das eigene zu Hause ist ein Raum der Sinne, der durch Erfahrungen und
entsprechende Praktiken, die dort stattfinden, definiert wird. Unterschiedliche Sinneswahrnehmungen sind eng miteinander verbunden. Gerüche,
das Hören, Schmecken, Riechen, Spüren und Sehen sind nicht voneinander zu trennen. Wie definieren Menschen selbst ihre Empfindungen und
Erfahrungen? Dem geht Sarah Pink mit ihrer Videokamera nach. Sie
besucht ihre InformantInnen zu Hause, wird herumgeführt, in alltägliche
Praktiken eingebunden und lässt sich alles zeigen. Ihr wird aus dem Leben
und davon erzählt, was üblicherweise hinter den Kulissen oder vielmehr
hinter verschlossenen Türen stattfindet. Video nimmt zwar nicht die sinnlichen Verkörperungen von Hausarbeit auf, erlaubt jedoch Einblicke in
individuelle Artikulationen und Ausdrucksweisen. Die Kamera erzeugt
Erinnerungsspuren für die Ethnografin, die sich bei der Betrachtung des
Materials wieder in die jeweilige Situation hineinversetzt fühlt. Ein
gemeinsamer Grundtenor zeichnet sich in den ethnografischen
Annäherungen vom zu Hause ab: Hausarbeit wird dann erledigt, wenn den
Leuten danach ist. Die Autorin unterscheidet diesbezüglich jedoch zwischen Hausfrauen und unabhängigen Personen. Ordnung oder Unordnung
in den eigenen vier Wänden wird als Teil eines gesunden Lebensstils und
einer angenehmen Atmosphäre empfunden. Im eigenen Heim spiegeln sich
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die Identität und das Gefühl für sich selbst wider. Therapie wird gemeinhin als ein Prozess begriffen, der zum eigenen Wohlbefinden und zu einem
gesunden Leben beiträgt. Der Körper und die Gefühle werden angesprochen. Aufräumen und die entsprechenden körperlichen Aktivitäten, die
damit einhergehen, erzeugen emotionales Wohlbefinden und sind in dem
Sinne durchaus therapeutisch wirksam. Hausarbeit ist in der Gegenwart zu
einer verkörperten – verinnerlichten – Praxis geworden, die Menschen einsetzen, um sich selbst und ihre alltäglichen Stimmungen zu verändern.
Sarah Pink is Reader in Social Anthropology in the Department of Social
Sciences at Loughborough University. Her academic and applied anthropological research has been mainly in Spain and England, focussing on the
visual and other senses, gender, media, domestic life, the home and currently the slow city movement. Her books include Women and Bullfighting
(1997), Doing Visual Ethnography (2001, 2007), Home Truths (Berg 2004)
and The Future of Visual Anthropology (Routledge 2006). She is particularly interested in the sensory aspects of experience, knowledge and practice and most of her work involves combining the verbal, (audio)visual and
textual in her practices of research and representation. Her current research
is about the development of the Cittàslow (Slow City) movement in the
UK.
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Therapeutic Housework
Sensory experience and emotional renewal
This paper grows out of a comparative applied visual ethnographic project developed with Unilever research in 1999 entitled Cleaning, Homes and Lifestyles. As part of this project, I
developed collaborative video interviews with forty informants
in Britain and Spain. The sample was divided in half between
the two countries and by gender. It was further selected to
represent a range of different age groups and domestic arrangements (e.g. living alone, house sharing, family units) specific to
the demographic profile of each country and focused mainly on
participants of white British and Spanish ethnicity. This process
allowed me to gain a better understanding of people’s relationships to their homes. It is the insights gleaned through this
research that inform this current discussion about housework,
and the idea that it can be understood as a form of embodied
therapy that brings about feelings of wellbeing1. Using both
therapy and wellbeing as lay terms rather than as part of the terminology that would be used by a therapist, my aim is not to
define housework as therapy per se, but to explore how people
represent their embodied sensory experiences of housework as
being therapeutic, transformational and/or as engendering of a
sense of renewal.
Drawing on recent work in the anthropology of the senses, I
suggest that doing the housework should be understood as a
sensory embodied experience. In modern western cultures the
knowledge that informs housework practices and the strategies
actually employed are constructed as responses to specific visual, tactile, olfactory and other sensory experiences, which vary
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amongst individuals. Understood in this way, housework can be
seen as a process of sensory transformation of the home
through which an individual, whilst simultaneously managing
her or his sensory environment, (re)constitutes her or his (sense
of) self. For example, when talking about doing their housework, my informants often spoke of it as a process of »purging«
or creating (a new sensory) order that produced a sense of personal renewal, a more »confident« self, or a feeling of being
able to »go forward« – that is, as a route that enabled them to
pass into a new emotional state. An examination of informants’
narratives reveals the extent to which certain practices associated with housework are intimately connected to these moments
of passage and renewal. Housework, thus, can be seen as an
instance where sensory experience and practice becomes central to processes of personal transformation. These processes, I
argue, are at the same time assertions of self-identity and constitutive of particular emotional states. I also argue that they are
related to a contemporary cultural context where self-reflexivity about one’s personal development, counselling and other
forms of therapy are increasingly popular.
Sensory home and sensory housework
Within the existing literature on the anthropology of the home2,
the emphasis is on the material home, which has inspired concomitant attention to the tangible and visible aspects of domestic practices within the home (e.g. Gullestad 1993, Drazin
2001, Clarke 2001). Notable exceptions focus on smell, taste,
touch and sound in the evocation of domestic memory (Hecht
2001), the role of taste in the production of sentiment of home
(Petridou 2001) and radio »soundscapes« (Tachhi 1998). This
work, however, usually focuses on one sensory modality in isolation, at a time. My approach builds on this to see the home
and domestic objects, practices and services as part of a wider
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sensory embodied experience in which the senses are interconnected in complex ways, and essentially inseparable, in spite of
the manner in which they are culturally categorised and defined. In my book Home Truths (Pink 2004) – a monograph
about changing gender identities in the sensory home – I suggest that in combination with the definitions outlined above,
home is a sensory space: a space defined by the sensory experiences and practices that take place within it.
The idea of the sensory home draws on recent work in the
anthropology of the senses that emphasises the importance of
recognising the interconnectedness of different categories of
sensory experience (e.g. Seremetakis 1994, Ingold 2000). In so
doing, and contrary to the arguments made by contemporary
cultural theorists such as Martin Jay this body of work challenges the notion that vision dominates the ways we understand
our everyday experiences in modern western contexts, and
urges us to attend to how people select and use different sensory
categories to represent and understand their pluri-sensory experiences. Ingold’s (2000) work, for instance, suggests that the
categories of sensory experience we use in discourse to represent our experiences to others are based on experiences in
which vision and hearing (and by implication also touch, taste
and smell) are inseparable or even indistinguishable. He sees as
problematic those philosophical discourses that assert vision’s
hegemonic status in modern society without paying any attention to »how people actually see« – in other words, those
discourses that fail to account for »actual practice« (286,
emphasis in original). My own research focuses specifically on
how people use sensory categories to represent (both in talk
and, in the context of video, through embodied performances)
their knowledge, experiences and practices of housework. This
means a focus on the process by which people convert the prereflective level of experience that Turner (1986) calls mere
experience and that I suggest equates to some degree with
Ingold’s understanding of sensory experience, into what people
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define as an experience. As regards the latter, I am concerned
with how such experiences are defined in terms of the specific
sensory modalities – vision, touch, smell, sound and taste – that
characterise the modern western sensorium.
The notion of the sensory home thus understands the modern
western home as a space that is continuously created and transformed through housework practices that are constructed according to culturally specific sets of knowledge and sensory categories, and through which people define their experiences of
home. Within such a home, I see housework as a sensory practice that is contingent on individual social actors’ willingness to
engage with and assimilate particular sets of sensory knowledge and to use these to inform how and when they actually
practice housework activities.
Other people’s sensory experience
The literature in the anthropology of the senses reveals that there
are two main approaches to understanding other people’s sensory
experiences. The first is through a type of participant observation
in which the researcher acknowledges and tries to expose her or
himself to informants’ current or past sensory experiences (e.g.
Stoller 1989, 1997, Okely 1994, Seremetakis 1994). Such an
approach, practitioners argue, allows them to arrive at a suitable
level of empathetic understanding to be able to comprehend
these experiences in some form. The second approach, advocated by Desjarlais (2003), rejects participant observation in favour
of interview-based ethnography that revolves around informants’
own narrations. Suggesting that we can understand other
people’s experiences through their descriptions of those experiences, Desjarlais argues that methodologically, the phenomenal
encompasses the discursive: »Life as lived and life as talked
about, are like interwoven strands of a braided rope, each complexly involved in the other, in time« (6). My own investigation
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builds on both approaches in that I attempt to empathetically
share some of my informants’ embodied sensory experiences
and practices by doing fieldwork with them in their homes whilst
adding video to the process of telling-talking. This latter, as a
method, involves showing-touring and embodied enacting
through video tours / interviews which are conducted as my
informants guide my camera and myself around their homes. As
such, our collaborations combine spoken narrations of their sensory experiences with acts of visual display and exposure to their
homes’ various sounds, smells and textures. My informants narrate their everyday lives whilst making reference to multiple
forms of sensory engagement. This, in turn, becomes a spatial
narrative as we move through their homes. Videotape did not
capture these sensory experiences. Rather, it allowed me to
audio-visually record visible manifestations of them as they were
articulated through informants’ embodied actions. Because
informants knew they were being recorded on videotape, they
often performed »for the camera« – much in the same way that
people perform oral narratives for the tape recorder. In my capacity as a researcher, I used these videotapes as media through
which I could remember, evoke, and try to understand my informants’ embodied and emotional experiences. As researchers we
know that we cannot get into the heads or under the skins of
other people – we cannot think their thoughts, feel their emotions
or sense what they sense with their bodies. However, in using
these kinds of video techniques in combination with discussions
with, and first hand experiences of, people in contexts in which
they experience, feel and act, we can get close enough to their
lives to enable us to at least attempt to represent them to others.
Reflexive house-workers
In Home Truths (Pink 2004) I discuss at some length how a number of British informants – determined to define their self-iden-
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tities as people whose domestic lives were not governed by routine – insisted that they did their housework in response to their
own emotional states. As such, they asserted that they used the
housework to serve them rather than them serving it. The latter
being how they perceived the situation would be for a housewife,
whose life they assumed would be structured by domestic
routine. This narrative of housework serving my informants (as
opposed to them serving it) can be understood in two ways. First,
housework can be seen as an activity that has therapeutic ends
and that engenders, on its completion, a sense of emotional wellbeing and a transformed state of mind. Second, it can be understood as something one only does when one »feels like it«. Both
interpretations, I feel, enable people to accomplish tasks similar
to those that a housewife might engage with, whilst simultaneously asserting a non-housewifely identity. I now draw on an
example discussed in my book not to reiterate the analysis already provided there, but to develop further this notion of therapy and emotional and sensory transformation.
Malcolm was in his early thirties when I interviewed him in
1999. He lived in a rented flat that he shared with another man
but for which he had primary responsibility. Like several other
British informants of similar status, in our interview he was
explicit about his own sense of who he was and the life stage he
was in at that particular moment in time. Interestingly, this high
level of self-reflexivity is, according to social theorists (e.g.
Giddens 1991), part and parcel of contemporary forms of
modernity, especially the kind found in Britain. And certainly,
Malcolm’s project of living in his home was very much bound
up with a project of self. He saw his life in his flat as being part
of a process of creating a healthy life-style, a sensorially comfortable atmosphere, and a sense of physical and emotional
wellbeing on an almost non-existent budget. Below, he describes what he encountered on moving back into the flat after a
period during which other people had lived there, and how he
set about transforming it:
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Malcolm:
They hadn’t hovered up in the whole time, because there wasn’t a
hoover. They didn’t pick anything up so you can imagine 4 months
of that, with 3 lads, and all my stuff, which had been put in this
trunk, and in a cupboard, had been turfed out, thrown in the corner
of the room and used as a rubbish pile. All my clothes were amongst
beer cans and cigarette ends and bits of screwed up paper and tissue
paper and things like that and I got back in the middle of February
– it was sub-zero, there were no light bulbs in the place. All I could
see is this darkness with all this sort of hair and paper and old socks
and piles of rubbish, and evidence of one person still living here but
he was in a foot of old clothes and cardboard boxes and magazines
and stuff. And he wasn’t living there, he was out at the time so I
didn’t know if anyone was still here and the bathroom had six bin
bags in it that they hadn’t bothered to throw out and the kitchen had
a mouse in it and again, the same amount of bin bags all broken
open, so that there was all this kind of smell all around the kitchen.
Sarah:
They hadn’t taken the rubbish down.
Malcolm:
No, and milk bottles, sort of mouldy milk and things, so, I mean that
did bother me to the point where I spent the first two or three days
completely cleaning top to bottom just to sort of get it back again.
For me, Malcolm’s need to »get it back again« refers to re-establishing the sensory balance that he felt was appropriate to
have in his home so that he ›be himself’ in that domestic space.
This in itself is the reference to the therapeutic aspect of housework I want to describe, however it is an important prelude
because it demonstrates, perhaps in a more extreme way than
for most of my informants, how a place in a desired emotional
and embodied experience is lived might be created. Now that
the flat was back in a state that he felt he identified with, however, he told me that:
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Malcolm:
I think it expresses a lot that’s me. There’s a lot of sort of stuff that’s
found and then utilised to make things more homely. For instance these
things were found in a skip and I’ve made little tables out of them,
they’re basically unaltered. These curtains were found in a skip. This
is a bit of old sewage pipe curtain rail here, no it’s kind of drainage pipe
from a plumbing erm job that I found, it was off a skip like. I spraypainted it. These match, the matting wallpaper was found as well.
Malcolm’s homemaking was part of a process of identity construction. At the same time, he used his more everyday practices in the home to create certain shifts in mood and to reinforce the emotional wellbeing that he sought to create through
his manipulation of his sensory and material environment.
However, as his comments below show, he – like other informants who saw themselves as »independent« – was careful to
emphasise that this housework was not governed by any notion
of housewifely domestic routine:
Malcolm:
I don’t have a routine, yes, it [the flat] tells me. It [the flat] calls, it
says, now it’s time. And it’s usually to do with whether I’ve got a
spare hour and then I’ll do it. And sometimes it gets left a day too
long and other times it doesn’t.
Instead, his impulses to clean were part of a negotiation between his perception of the flat needing to be cleaned («it tells
me«) and the emotional narrative he was engaged in at the time.
Indeed, like other informants, Malcolm described how his housework, rather than being driven by any sense of routine, served
his emotional needs:
Sarah:
Yes, I mean do you ever clean to avoid doing other things? If
you’ve got a, if you’re meant to be…
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Malcolm:
I’ve definitely been guilty of that. I used to do that, definitely, when
I was at college doing exams. I used to spend days cleaning and
avoidance.
Particularly interesting was, that he continued to point out that:
Malcolm:
…it’s good to clean before making phone calls to sort of like prospective employers and, yes. It puts me in a frame of mind, an
ordered frame of mind I suppose.
Sarah:
Does that show you something you feel about yourself?
Malcolm:
Yes, I suppose so, yes. I’m a more efficient, ready to communicate
person.
Like other informants who felt that cleaning before working
from home, or starting a student essay, helped them to feel
ordered, Malcolm’s comments clearly demonstrate how the
embodied sensory process of housework and its sensory material results serve ends that can transform one’s emotional state.
The notion of therapy
Anthropological work on the senses has shown how both sensory categories and the way sensory experiences are represented are culturally shaped (see Howes 1991 and 1993, Classen
1993, Guerts 2002). Moreover the ways these categories are
used to understand, inform and describe experiences and
actions might vary amongst individuals (see Desjarlias 2003,
Pink 2004) depending on, for example, their gendered identities
and the ways they are situated in specific sets of power relations. Like sensory embodied experiences, emotions are also
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»phenomena that are shaped, experienced and interpreted
through social and cultural processes« (Lupton 1998: 2). As
Lupton shows, the ways individuals understand and express
emotions also vary according to gender and other aspects of
identity.
Therapy, defined in the New Oxford Dictionary (2001) as a
»treatment intended to relieve or heal a disorder« (1923), usually involves a process through which a person is made to feel
better or good, and that generates in that person a sense of wellbeing. Some forms of therapy attend to both body and mind,
treating the two as related in the process of recovery. For example, Sharma and Black (2001) note that beauty therapists
»defined beauty therapy in terms of work with feelings as well
as with the body« (original italics) (915). My informants defined housework in a similar way – seeing it as both a physical
activity that they experienced in terms of different sensory categories, and as a felt emotional experience. This lay tendency to
link embodied and emotional experience appears to be widespread. For example, Lupton’s (1998) interviews with forty-one
Australian informants suggested to her that amongst other
things, they saw »emotions as coming from within the
self/body« and »emotion as the interrelation of mind and body«
(69). A sensory embodied experience might be seen to trigger
off emotive memories, or an emotional experience may be described as having a physical dimension.
One can thus see how the process of sensory transformation
that housework entails could be interpreted simultaneously as a
process of emotional transformation. This linkage opens up the
possibility of locating housework within a therapy narrative. In
other words, housework is a process through which feelings of
emotional wellbeing are achieved through the sensory transformation that the embodied experience of the activity and results
of housework entail.
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The self-reflexive individual
and embodied emotions
Lupton (1998) has emphasised the centrality of issues of »intimacy and emotional expression« at the end of the twentieth
century. She notes the proliferation of self-help books on »how
to identify one’s feelings and communicate them to others, and
how to understand others’ emotions« and the enormous amount
of time the mass media devotes to »conveying and dissecting
the emotions of others, reporting on events that are seen to have
emotional significance and evoking emotional responses from
their audiences« (6). To a certain extent, I feel that when my
informants spoke about housework in a manner that equated it
to therapy, they were engaging in this kind of self-reflexivity.
Indeed, some informants referred to the interview context itself
as having parallels to the form of self-revelation that they might
engage in when talking to a counsellor, and others commented
on what they had learnt about themselves through the talk and
actions they had engaged in during the interview. I contend that
our use of video further facilitated some of these reflections: in
addition to talking, informants also performed with and for the
camera. This encouraged them to think not only about their feelings, but equally about the embodied practices that were related to them. This, in turn, made the embodied aspects of emotionally transformational practices all the more explicit.
In concluding, I suggest that in the context of contemporary
modernity, where self-help and self-reflexivity are everyday
practices and many people seem determined to demonstrate
control over their lives by rejecting existing models of domestic
routines3, housework has become one of the embodied practices through which individuals construct their self-identities and
transform their everyday moods.
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Notes
1
In this paper I draw from just a few of the British interviews to make
my argument. The work in its totality appears in my book Home Truths
(Pink 2004)
2
Here I refer specifically to and locate my work within the anthropology of the home rather than the wider anthropology of home. The former refers to the anthropological study of how people live their lives
within material physical structures they call ›home‹. The latter takes a
broader focus on the concept of home.
3
Although this, as I note in Home Truths (Pink 2004), does not mean
that they do not form different routines of their own.
References
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Classen, C. (1993) Worlds of Sense: Exploring the Senses in History and
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Desjarlais, R. (2003) Sensory Biographies: lives and death among Nepal’s
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Drazin, A. (2001) A Man will get Furnished: Wood and Domesticity in
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Geurts, K. L. (2002) Culture and the Senses: bodily ways of knowing in an
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Gullestad, M. (1993) Home Decoration as Popular Culture: Constructing
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Varieties of Sensory Experience: A Sourcebook in the Anthropology of
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Ingold, T. (2000) The Perception of the Environment. London: Routledge.
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Okely, J. (1994) Vicarious and Sensory Knowledge of Chronology and
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Petridou, E. (2001) The Taste of Home. In D. Miller (ed) Home
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Seremetakis, L. (1994) The memory of the Senses: Historical Perception.
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Theory. London: Routledge, 214-229.
Sharma, U. and P. Black (2001) Look Good, Feel Better: Beauty Therapy
as Emotional Labour. Sociology, 35(4): 913-931.
Stoller, P. (1989) The Taste of Ethnographic Things: the senses in ethnography. Philadelphia: University of Philadelphia Press.
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Haptische Geschichten
Eine Eisläuferin schreibt und forscht über Bewegung. Linnet Fawcett setzt
ihren Körper am Eis als Forschungsinstrument ein. Sie erzählt bewegte
Körpergeschichten, indem sie Kreise am Eis dreht und ihrer Leidenschaft
freien Lauf lässt. Stimmungsräume werden erzeugt, wobei sich die hitzigen Gefühle auf glatt gefrorenem, kaltem Boden abspielen. Der sportliche
Leib bleibt bei diesem Forschungsansatz in Bewegung. Wissen wird dabei
an Form rückgebunden und nicht notwendigerweise an Inhalt. Klänge und
Rhythmen sind spürbar. Leibliche Wissensformen lösen sich wie von
selbst aus ihren verinnerlichten Praktiken heraus und sind in ein anderes
Licht getaucht. Sport wird in diesem Essay mit fließenden Verkörperungen
von Spaß und Vergnügen verknüpft, nicht wie häufig in anderen akademischen Ansätzen ausschließlich auf soziale und ideologische Bedeutungen
bezogen.
Linnet Fawcett erweitert Gilles Deleuzes und Felix Guattaris Konzept von
Affekt, indem sie sich damit auseinandersetzt, wie Eis laufende Körper miteinander und in ihrer materiellen Umgebung interagieren. Die Ethnografin
spiegelt sich selbst im Eis als Figur der Sportlerin wider. Affekt unterscheidet sich wesentlich von Gefühlen, ist ein unpersönlicher und dennoch
dynamischer Zustand und gehört zu keinem der Sinne. Wie ein Nordwind,
der über die Tundra zieht. Affekte gehen durch und durch, bezeichnen die
Bewegung und Modulationen als verkörperte Ereignisse. Welche
Bedeutung haben Körper in Bewegung? Der eigene Leib verschmilzt mit
Körperbewegungen anderer Eislaufenden, öffnet sich den mitreißenden
Affekten, schwingt mit und wird ein anderer. Eis laufende Körper gehen
eine nonverbale und haptische Konversation ein. Ohne Choreografie gleiten sie aufeinander zu, berühren sich vielleicht und entfernen sich wieder
voneinander. Linnet Fawcett bricht mit der Trennung zwischen Sehen und
Handeln, die ethnografisches Forschen oft charakterisiert. Sie entgegnet
mit einer Ethnografie, in der haptische Wahrnehmungsweisen und Geschichten, die daraus resultieren, zentral sind. Damit provoziert sie eine
fundamentale Wende in unserem Denken über Sport und Bewegung. Die
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Wissenschafterin versteht sich selbst als »exzessive teilnehmende
Beobachterin«. Das Aufschreiben von Forschungsdaten als affektiver
Prozess? Laut Roland Barthes wird die Liebe als affektive Dynamik
gemeinhin als Gegenteil von einer erzählten Geschichte erfahren. Eine
Figur wird entworfen, die Barthes mit der Erfahrung von Liebe assoziiert.
Figuren kreieren – im Text, sofern dieser (beim Lesen) funktioniert –
Empfindungen. Stimmen einer sich bewegenden Gemeinschaft von
Eislaufenden werden durch Figuren buchstäblich zum Leben erweckt.
Linnet Fawcett has recently completed her PhD in the department of
Communication Studies at Concordia University in Montréal, Québec. Her
current research centres on gender and affect in the context of recreational
ice-skating, and asks what it means for aging female bodies to become
movement through a participation in alternative sporting activities.
Equally concerned with how we write these moving bodies into an academic text, she draws on feminist and poststructuralist theory to explore
more visceral, sentient, and poetic ways of engaging with both sports and
communications scholarship.
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Haptic Tales
Researching and writing movement
through the skating body
Skating is my bubble. When I’m in the bubble, I don’t have any
worries. I don’t think about the job, the kids, money, the mortgage,
the shopping – all that stuff you think about the rest of the time. Of
course, my daughters don’t understand why I have to skate. When I
explain to them how moving to the music and having a rhythm
going makes me feel so good…well, you know kids, that all sounds
so weird to them. I mean, they don’t like the idea that »mom« moves
her body at all, let alone moves to the rhythm… [laughter]
Jo, age 46, dental receptionist
This skating, it’s a passion. It’s like being a drug addict. When I
can’t get to the rink, I put my head in the freezer just to smell ice,
just to feel the cold of ice. Or I put ice cubes in my mouth, just to
taste the sensation of ice.
Lena, age 36, computerspecialist
Circulating round and round at the Atrium – an ice-skating rink
that sits in the middle of a busy food court in an office buildingcum-commercial centre in downtown Montreal, Quebec – I
chew the fat with fellow skaters, and without much prompting
the skaterly stories emerge. These are stories that speak of an
obsessive and drug-like passion: a love for an activity that
affords a respite from worldly concerns through the pleasures
of rhythmic bodily movement, a craving for the hard materiality of ice. These are stories that speak to those enigmatic and
ethereal »spaces of affect« (Stivale 1998): bubbles that, rather
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than encasing, provide gateways to freedom; freezers that, by
virtue of their frosty countenance, stand in for skating rinks.
And yes, these are also mobile stories – stories recounted in
transit to nowhere, if you’re talking linearly, through to infinity
and beyond, if you’re talking existentially. These are stories in
motion that are all the more textured for being shared while
actively engaging in the activity itself, rather than spoken into
a microphone in a more structured interview situation. They are
stories about movement that are all the more nuanced for being
told to a skater-cum-researcher who shares the passion, who
understands the obsession, and is thus not a them, but a one of
us.
As a researcher interested in spaces of affect – that is, in spaces
that are in a constant state of flux and transformation as a result
of »the fleeting, yet intense circulation of feeling« that is produced when people, through movement, enter into an »active,
performative dialogue« with others and their immediate
environment (Stivale 1998, 164-5) – I ask how one goes about
evoking affect when out there in the field, and when writing up
one’s research. This line of questioning is not without its obligatory provocateur: namely, the surprisingly static way in
which the body in movement has been conceptualized in much
existing sports-related scholarship, thereby robbing it of all
affect. And nor is this hunt for elusive affect without a mission:
that being to restore movement to movement; to set the sporting
body into motion as opposed to make it representative of
motion.
I should mention that it isn’t so much representation as a means
of coming to know that I’m challenging here, as how those in
the academy tend to think about what constitutes knowledge,
and hence go about doing the representing. In short, knowledge
needs not always be connected to content – to what something
means. It can equally be connected to form: to how something
sounds, to those rhythms and cadences – a particular kind of
verbal pacing – that can, both in themselves and in the manner
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that the researcher pieces them together, illuminate and inform.
In other words, we can represent in ways that tap into other
modes of knowing – more sentient and bodily modes of
knowing. We can make representations that appeal to the senses as well as to the intellect – though given the concerted effort that has gone into validating sport as a viable realm of academic study, I would suggest that this is not a move that sits
easily with many sports scholars. My concern, however, is that
in our haste to prove just how serious and socially meaningful
sport is, we have neglected to consider its joys, its flows, its
equally important moments of meaningless-ness. In nailing
sport down and making it a discipline to be reckoned with, we
have rendered it stiff, sterile, and bodiless. Emptied of risk,
adventurousness, and a sense of play, what we are left with is a
corpus that, with some notable and exciting exceptions1, sits
heavily and which, in opting to stay in the rut, has lost its
groove.
In an attempt to generate ideas around how we might insert
some of this groove back into scholarly writing about sports,
the first part of this paper addresses how the notion of affect, as
informed by the poststructuralist thinking of Gilles Deleuze and
Felix Guattari, applies to my conceptualization of how skating
bodies interact with each other and their material surroundings
out there on the rink. I then go on to outline my methodological approach to ethnographic fieldwork – an approach that is
inspired by pro-wrestler-cum-academic-researcher Laurence de
Garis’s (1999) notion of a performative or sensuous ethnography, and that draws in part on a haptic sensibility to navigate
my scholarly way through my chosen terrain. I argue that in
using my own body as a primary research tool whilst doing my
fieldwork as opposed to merely discussing the body in abstract
terms, I actively address the oft-bemoaned absence of the visceral and the sentient in scholarly writing about sport. Suggesting
that the real challenge, however, is to write these moving
bodies such that the prose itself actually evokes a sense of
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movement, I use the third part of this paper to discuss my
choice of Roland Barthes’ favoured writing trope, the figure, as
an effective means of momentarily freeze-framing the voices
and actions of my informants without losing the texture and
momentum of on-ice dynamics. I conclude this paper with one
of these figures.
Affect and hapticity: building a kinetic
conceptualization of rink dynamics
Affect is to be distinguished from feeling in that it is impersonal
and creates no lasting attachments: it does not belong to anybody, and its modus operandi – much like a northerly wind
sweeping across the tundra – is to pass through, create a stir, but
take no prisoners. Likewise, affect does not belong to any one
of the senses, but operates »across« the senses (Seigworth
2003, 81). It can best be understood as a »force« (Colebrook
2002, 27) or as an »intensity«(Deleuze and Guattari 1987, xvi).
As such, affect is dynamic, transitory and continuously variant:
it surges, explodes and fades away (for its passage is invariably
kinetic) not as a series of individuated events, but as a »continuous line of variation as a body passes from one [experiential]
state to another« (Deleuze in Seigworth 2003, 82). In this passage between bodily states, the body’s capacity to act is augmented or diminished (Deleuze and Guattari 1987, xvi), and
this has a knock-on effect on other bodies’ capacity to act and
to be acted upon in turn. Though, as Gregory J. Seigworth
(2003) warns, the tendency at this stage might be to »equate
affect simply with the emotions of life events« and the vagaries
of our various everyday encounters, he is quick to remind us
that »affect is, more properly, the movement and modulation of
these encounters or events across the flesh and through the
body« (88, my emphasis). In this respect, it could be ventured
that affect is the very changing-ness of change, which is why
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Deleuze and Guattari link it so closely to the processes of
becoming.
For Deleuze and Guattari, life itself amounts to nothing more
than »the dynamic interaction of affects and a constant becoming-other« (Colebrook 2002, 60). We are not first and foremost beings who, having been created, then go on to feel and
perceive – in other words, to be alternatively caressed or cajoled, buttressed or buffeted by the forces of affect. Rather, our
very being-ness is constituted in and through the affective
investments and connections we make: »It is from affects that
distinct beings are formed« (Colebrook 2002, 61). What the
ongoing flow of affect through our bodies and »across« our
senses also means, though, is that being-ness is never static –
we (along with everyone and everything else, for that matter)
are constantly in a state of becoming. And because a becoming
has the identity »of a multiplicity of elements that somehow
cohere without entering into a regular, fixed pattern of organization« (Bogue 2003, 34), it follows that the slippery force
behind any becoming – affect – does not yield easily to classification or containment.
That said, therein lies much of affect’s allure, and if an ongoing
fascination with that which cannot be captured, pinned down or
restrained is what sustains my interest in affect, it is perhaps no
coincidence that affect and I first found each other down at the
skating rink: a blossoming passion for trick-skating3 quickly
turning into a scholarly exploration of what it means for bodies
to be in movement. Whilst skating, I had discovered, you can
merge your body with other bodies: you can open yourself to
the passing through of affect – to a becoming-other, if you like
– by allowing your individuated body to give over to a bodily
in communion with others and all of the physical elements that
constitute your immediate surroundings. As for exploring this
phenomenon in a scholarly manner, I soon realized that it
obliged the researcher to spend endless hours lurking around at
the rink, ostensibly doing ethnography. What she took into the
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field with her were not pen and notebook, tape recorder or camcorder. Rather, her gear consisted of high-end hockey skates, a
pair of rhinestone-studded gloves, and various combinations of
athletic pants and flashy sleeveless t-shirts. As for the ethnography itself, it consisted of leaping, swirling and spinning her
midlife female body across ice on a set of razor sharp blades…
Oh yes, and of weaving in and out of those other skating bodies,
the better to observe her subjects, as she did so.
It’s not all high-octane stuff, however, and in those quieter
moments as I circled round and round at my local rink, that key
word to any communicative act – conversation – began to take
on a whole new meaning. To Converse: literally, »to turn
around« – from the Latin verser – »together« – con (Funk and
Wagnalls 1980, 296). This, I came to understand, was precisely what I and the other skating bodies out there on the ice were
doing – conversing. Moreover, we were conversing not through
talk but through non-choreographed motion and haptic sense.
Jennifer Fisher (1997) provides a compelling explanation of
how haptic sense differs from the other five senses we engage
to navigate the world:
Haptic perception can elucidate the energies and volitions involved
in sensing space: its temperature, presences, pressures and resonances. In this sense, it is the affective touch, a plane of feeling distinct
from actual physical contact. (6).
If I was aware that this kind of haptic perception was certainly
operating in the way that many of us skaters navigated the rink,
not to mention each other, as we became a swirling mass of
kinetic energy – as our individual bodies became but one element in a fluid interplay of ice, blades, music, air and other
bodies – it also struck me that bringing such a haptic sensibility to my fieldwork could help to break down the seeing versus
doing divide that characterizes so much ethnographic research.
In fact, I would venture that an engagement with hapticity gives
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us access to a way of knowing – to a unique form of bodily wisdom, if you like – that not only enriches and deepens our understanding about the body, but provokes a fundamental shift in
how we think about movement and sport. Maxine SheetsJohnstone (in Parvianien, 2002) suggests that this process of
thinking in and through the moving body is »founded upon a
kinetic bodily logos« (13). Within such a logos, »movement is
the mother of all cognition« (14). This means that we are not
first and foremost beings who then go on to move; rather, our
sense of self and the world around us is constituted in and
through tactility and motility. In such a conception of the thinking and knowing subject, it is »our tactile-kinesthetic bodies«
that serve as »epistemological gateways« (14). Quite simply,
»we learn by moving and by listening to our own movement«
(16).
Embodied ethnography:
breaking down the seeing versus doing divide
Laurence de Garis (1999) might not use the term hapticity to
describe his invoking of an »affective touch« when it comes to
doing his fieldwork, but he is more aware than most sports
scholars of the need to bring one’s own body into the research
process. In his bold and insightful »Experiments in Pro-wrestling: Toward a Performative and Sensuous Sport Ethnography«,
he calls for an overthrow of traditional ethnographic approaches to sport in favour of more bodily-engaged ones.
Countering the objectivity through keeping your distance stance
of proponents of the former, he calls for a »kinetic ethnography« in which the academic researcher becomes a »visceral
performer« who climbs, quite literally, into the ring. What this
leads to are new ways of data collection in which other senses
apart from our eyes and our ears are engaged, and through
which our whole body becomes a kind of sensory sense-making
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device. Not only does this shift the focus away from the perennial question of where we stand in relation to our subjects to the
less asked (though equally important) question of how we come
to know as ethnographers. It also forces a much needed discussion on how we bring those bodily sense-ations into our prose
when writing up our research findings. For like de Garis, I am
wary of those researchers who believe that they are engaging
their senses when they write about the senses. In clearly distinguishing between »an ethnography of the senses« and »sensuous ethnography,« de Garis helps us to understand the crucial
difference between intellectualizing the senses – a process that
merely perpetuates the Cartesian mind/body split – and incorporating the senses into our research methods and writing up
processes.
So here is my positioning out there in the field: I am an avid
trick-skater; I am a regular down at the Atrium; and I am an
excessive4 participant observer studying the culture I also play
a part in shaping. No doubt, all the traditional ethnographic
alarm bells are going haywire. But I want to argue that such a
performative positioning actually works for me, not only
because I have visceral access to the intimate knowledges of
skaters and their practices, but also because this excessiveness
actually draws my subjects to me. Quite simply, I’m a bit of a
skating oddity: a recreational midlife miscreant out there on the
ice turning tricks. As a result, people want to talk, ask questions, show off their moves, tell me their skating stories. From
condescending conventional skaters to aspiring trick-skaters to
casual passers-by: all are only too eager to communicate their
thoughts, feelings, reactions, compliments and critiques. And
these, in turn, become part of my field notes. In other words,
through conducting my research not as a researcher but as an
excessive performing body, I instigate what de Garis refers to
as »a polyphony of cooperatively evolved voices« (68).
Furthermore, in drawing attention to myself as a performer participant, the all-knowing, all-seeing »transcendental subject«
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(MacAloon 1992) ethnographer is de-centered. The co-conversations that result of this process of authorial merging and positional blurring, however, introduce a whole new set of challenges at the writing-up stage.
Writing affect: from rink to page
First among these challenges – and to return to the definition of
conversation offered earlier – it is no longer a case of simply
»turning around together.« It now becomes a question of negotiating who, amidst that polyphony of voices, gets credit for
saying what; if, when dealing with ideas that evolve cooperatively, the ownership of these ideas can be determined; and how,
in the event that they can, this ownership ought to be textually
conveyed. Secondly, and at a more conceptual level, one grapples with the seeming paradox of trying to capture in writing
what Joyce Carol Oates (1994), when talking about the boxing
ring and the very visceral practice enacted within it, describes
as »that place beyond words«(14). Is it even possible, I find
myself asking, to make the skating rink come alive such that the
reader feels what it is to find freedom in a rhythmic bubble, to
crave the taste of ice, to turn tricks out there on that »large glass
on which desire circulates« (Sontag 2000, xxviii)?
As it turns out, Roland Barthes’ A Lover’s Discourse:
Fragments (1978) – a treatise on how love as an affective process as opposed to a narrative story is experienced – provides
the inspiration required to take on this twofold challenge.
Barthes’ oeuvre does not attempt to put forth a philosophy of
love. As Barthes insists and the structure of the book suggests,
there is no desire here to capture the meaning (or even a meaning) of love. Rather, Barthes’ aim is to build an assemblage of
affect around his chosen topic: to evoke its impulses, its agonies, its ebbs and its flows through pasting together relevant
fragments of discourse drawn from theory, literature, personal
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experience, and exchanges with others into a number of short
texts that, in each case, evoke a figure that Barthes associates
with the experience of love: for example, absence, ravishment,
I-love-you, and jealousy.
For my own part, a collection of about twenty key words – or
figures – have emerged in the course of my fieldwork as those
which are integral to the experience and practice of skating:
amongst these, glide, stumble, leap, and bruised. Each accompanying text is comprised of fragments of discourse culled from
conversations with my informants, from personal reflections on
their words and the research process in general, and from resonant theoretical and literary quotes, and each attempts to conjure,
in its totality, a sense of how the figure in question feels. In other
words, the purpose of these texts is to provoke a visceral response in the reader. If the reader feels, on reading the figure spin,
a physical sensation of dizziness or nausea or hunger, or experiences a fleeting moment of fluttery intoxicating abandon, then
the text could be said to be doing its work. For indeed, these texts
are designed to work: in recreating a sensation of movement
through affect, they are meant to make you feel something as
opposed to tell you about something. What is also significant
about these texts is that the voices of different speakers, be they
ordinary skaters or well-known theorists, merge together to form
one continuous train of feeling. This freeing of individuals from
the burden of authorship opens up, on the one hand, an equalizing space of expression that helps to foster this loosening of
meaning’s grip on words; on the other hand, it does not sit well
with academic convention, which means that I – if not Roland
Barthes – must, as the figure below indicates, make certain concessions as regards scholarly sourcing. Nor does it follow that
words once spoken will necessarily ›sound‹ the same when
transferred to written form – a point that is particularly brought
home to me when presenting one of these figures orally, as opposed to leaving it to the »writerly reader« (Barthes, 1977) to
inscribe her own bodily rhythms and cadences into it.
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Stumble:
Michel de Certeau: The opera allows an enunciation to speak that in
its most elevated moments detaches itself, continues alone after the
orchestra has fallen silent, follows the curve of the melody a
moment longer, vacillates, slowly slips away from its path, gets lost,
finally disappears into silence.
Jo: See, I had to wear figure skates – girl’s skates – as a kid. But now
I’ve changed to hockey skates. Yahoo! Have you ever broke out and
made a run for it on girl’s skates? Well, I tell you, those picks will
catch you out and send you flying.
Aldo Rossi: Fragment, frammento, means a small chip, which has
broken out of a larger body. Which leads one to ask whether an
accumulation of fragments, rather than being termed a mere rubbish
heap, should not actually be called the city of the future.
Sandra Bartky: Of course, the properly feminine body exhibits a
specific repertoire of gesture, posture, and movement. This body
must learn to display its charms, but discreetly. The properly feminine woman must never allow herself to sprawl into the available
space. She must avoid the looseness in body comportment that is the
mark of the loose woman.
Andrea: I mean, I was just tripping all the time on those stupid
picks. It’s a conspiracy, man, a conspiracy, these girls have to wear
figure skates, boys get to wear hockey skates thing.
Laurie Anderson: So you’re walking… And you don’t always realize it but you’re also always falling. With each step… you fall. You
fall forward a short way and then catch yourself. Over and over…
you are falling… and then you catch yourself falling. And this is
how you are walking and falling at the same time.
In selecting the Barthesian figure to convey physical movement
and bring the voices of my mobile community to life, I heed
Laurel Richardson’s (1997) suggestion that, as researchers, we
must find ways to make speech into an »embodied activity.«
Borrowing from Michel de Certeau (1984), and in spite of the
transference challenges outlined above, I am equally interested
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in what these »speaking voices change in the dark grotto of the
bodies that hear them« (162, my emphasis). As for the actual
nuts and bolts involved in building these figures, the voices that
appear alongside my own and the more recognizable theorists,
philosophers and literary types are those of regular skaters at
the rink. These are the people who I am primarily interested in
– people who are passionate about and dedicated to skating,
regardless of how good they are at it. The figures have slowly
emerged out of conversations I have had with Atrium regulars
about skating, whilst skating. As we circulate, I ask them questions about how skating makes them feel, why they do it, and
what place skating has in their lives. I pay equal attention to
what they say about a particular aspect of the activity and its
significance to them, as to how they say it – the pace they speak
at, the way they string words together, in short, their delivery.
In writing up my field notes directly after one of these on-ice
dialogues, I try to capture both content and form. However,
what they say is often at odds with the way they say it and in
these cases, as I’m incorporating their words into a figure, I
always go with the form. This means that a skater may be talking to me about the figure glide, but because her delivery does
anything but evoke a sensation of the glide what she says about
this figure might end up quite another figure – in stumble, for
instance, as Jo’s description of gliding in her bubble does
above. In general, I have observed that those whose denotative
description of a particular figure manages, in the telling, to connote that figure as well are those who, in a bodily way, comfortably inhabit that figure on ice. In other words, people skate
like they talk and talk like they skate. To best understand how a
person skates is sometimes not to listen to what they have to say
about skating, but to listen to how they say it.
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Notes
1
For example, Brian Pronger’s seminal work on homoerotic desire in
the locker-room (1999) and disciplinary regimes of the body in training (2002) leaves me breathless and inspired. His sumptuous interweaving of challenging philosophical and political concepts into the
everyday world of sporting environments serves to remind us of just
how exciting reading about sport can be. Likewise, the DeleuzeGuattarian prose of Synthia Sydnor positively soars: and this, whether
she is talking about skysurfing (2003a) or statues that celebrate urban
sporting legends (2003b). In her ability to bring movement to quite
literally, the monumental, Sydnor confirms that writing sport need not
be a stationary affair.
My thinking around notions of the visceral, and the way I engage with
this concept both theoretically and methodologically in this project,
are influenced and informed by Kim Sawchuk’s extensive work in this
area.
3
Trick-skating is a form of freestyle recreational ice-skating that pushes
the limits of the hockey skate (not to mention the limits of the mid-life
female body) through the execution of acrobatic figure skating moves
on its pick-less, rounded blade. This exciting new grassroots sporting
movement is allowing a growing number of recreational ice-skating
women to explore their artistic on-ice potential without having to give
over to the sequined and hyper-feminized world of women’s figure
skating. Amongst them, I am particularly indebted to Kim Sawchuk
and Janice Donato. Both have been an infinite source of inspiration:
Kim for her on-going philosophical discussions both on and off ice;
Janice for having got me into trick- skating in the first place, and for
having paved the way for the rest of us through her enthusiastic and
talented lead.
4
I pick up here on John Fiske’s (1992) notion of the »excessive reader«
(46), whose sheer zeal for a particular media product and/or status as
a fan will make her/him the most likely kind of media consumer to
respond to a researcher’s call for audience feedback. However, as
Fiske warns, these exuberant responses should not be confused with
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those of the »average« reader – a warning that, in my role as excessive researcher, I readily acknowledge, but with which I am equally prepared to play around.
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Völckers, Hortensia (eds.). ReMembering the Body, Vienna: Hatje
Cantz Publishers, 102-13.
Seigworth, Gregory J. (2003) Fashioning a Stave, or, Singing Life. In
Slack, Jennifer Daryl (ed.). Animations (of Deleuze and Guattari).
New York: Peter Lang.
Sontag, Susan (2000) A Barthes Reader. London: Vintage.
Stivale, Charles (1998) The Two-Fold Thought of Deleuze and Guattari.
New York: The Guilford Press.
Sydnor, Synthia (2003a) Soaring. In Rinehart, Robert E. and Synthia
Sydnor (eds.). To the Extreme: Alternative Sports, Inside and Out.
Albany: State University of New York Press.
(2003b) Urban(e) Statuary Times. In Wilcox, Ralph C. et al (eds.).
Sporting Dystopias: The Making and Meanings of Urban Sport
Cultures. Albany: State University of New York Press.
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Performative Wahrnehmung
Haptische Bilder und abstrakte Linien aus der Kunst des Islam bringen im
19. Jahrhundert eine neue Wahrnehmungsform in den Westen. Geometrische und pflanzliche Ornamente religiöser Herkunft stillen den interkulturellen Hunger und verändern die westliche Betrachtung von Ästhetik
tiefgehend. Das Neue im Wahrnehmungsverständnis – zumindest in
Europa – drückt sich im Subjektiven und Performativen aus. Traditionelle
arabische Schriften klassischer Philosophen, Theologen, Wissenschafter
und Literaturkritiker begründen eine subjektiv verkörperte, kontemplative
Wahrnehmungsposition mit allen Sinnen. Diese Schriften existieren im
Baghdad des neunten, Kairo des zehnten und Cordoba des elften
Jahrhunderts häufig neben anderen Künsten wie Keramik, Textilem,
Malerei, Poesie und mehr. Verkörperte Erfahrung ist Teil davon, ein guter
Moslem zu sein. Der Leib gilt als integraler Bestandteil des menschlichen
Glücks. Materielle Erfahrungen sind mit der Würdigung Gottes verbunden.
Im klassischen Denken des Islam geht die Wahrnehmung mit subjektiver
Verkörperung einher. Gott bleibt im Glauben des Islam allerdings abstrakt
und unbeschreiblich. Nur im Sunni Islam und im Sufismus sind Heilige,
Schreine und figurative Bildnisse erlaubt und vermitteln religiöse
Erfahrungen. Das heißt, diese beiden Glaubensrichtungen des Islam führen
dazu, dass Kunst sowohl verkörpert als auch abstrakt sein kann. Kunst aus
dem Islam weckt Aufmerksamkeit durch ein Zusammenspiel verkörperter,
subjektiver und performativer Qualitäten. Laura Marks zeigt in ihrem
Essay, dass Abstraktion im Islam kein Weg ist, das Göttliche zu repräsentieren. Vielmehr fungiert engagiertes Handeln als performativer Akt der
Anbetung. In der Optik etwa dient die Kontemplation der Erkenntnis von
Form. Demnach ist die menschliche Wahrnehmung subjektiv zeitabhängig.
Dieses Denken impliziert ein Subjekt, das die Fähigkeit besitzt, in sich
selbst hineinzuhorchen und zu blicken. Interessanterweise tauchen europäische Wahrnehmungskonzepte erst einige Jahrhunderte später mit
Experimenten zum Sichtbaren und zur Perspektive auf. Die Renaissance in
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Europa etabliert ein relativ unkörperliches und objektives visuelles
Wahrnehmungsmodell, das sich bis ins 19. Jahrhundert hält. Zugleich entwickelt sich im Westen eine neue Kunst, die viel mit der Ästhetik im Islam
gemeinsam hat: charakteristisch dafür sind der haptische Raum und die
abstrakte Linie. Laura Marks definiert das Zusammenwirken von Haptik
und Abstraktion als performativ. Die subjektive und imaginäre Teilnahme
der BetrachterInnen sei wesentliche Voraussetzung für das Performative.
Ähnlich wie das haptische Bild und die lebendige Interaktion zwischen
Figur und Grund, löst die abstrakte Linie den betrachtenden Blick aus sich
selbst heraus. Bewegung wird privilegiert und das Ego befreit. Islamische
Muster üben eine unendliche Anziehung aus, die mit religiösen
Vorstellungen – der Unerreichbarkeit Gottes – im Einklang stehen. Die
Kraft der poetischen Bilder liege in ihrer Fähigkeit, versteckte
Bedeutungen zu durchdringen und das Unsichtbare an die sichtbare
Oberfläche zu bringen. Das Ornament hat in diesem Sinne eine liturgische
Funktion. Islamische Architektur lenkt die Blicke eher in Richtung existenzieller, verkörperter und performativer Erfahrungen, als zur ikonischen
Analyse. Laura Marks schlägt entsprechend einen phänomenologischen
Ansatz vor. Wie gelangt die Ästhetik des Islam in den Westen? Biomorphe
Formen der abstrakten Linie finden sich im Jugendstil und in der Art
Nouveau. In Wien entwickelt der Kunsthistoriker und Kurator für textile
Kunst Alois Riegl eine Theorie des interkulturellen Transfers plastischer
Qualitäten. Teppichmuster werden in die Malerei integriert. Haptische
Oberflächen lösen den Fokus unserer Augen auf. Der Prozess einer
abstrakten Linie mittels bewegter Blicke zu folgen, enthüllt eine
Subjektkonstruktion, die einem Knäuel Garn ähnelt. Ein Lebensfaden oder
vielmehr eine verkörperte Subjektivität wird freigelegt.
Laura U. Marks is a writer and a curator of artists‚ media. She is the
author of The Skin of the Film: Intercultural Cinema, Embodiment, and the
Senses (2000) and Touch: Sensuous Theory and Multisensory Media
(2002), as well as many essays. She has curated experimental media for
festivals and art venues worldwide. Laura Marks is the Dena Wosk
University Professor in Art and Culture Studies at Simon Fraser
University, Vancouver.
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The Haptic Transfer
and the Travels of the Abstract Line
Embodied perception from classical Islam
to modern Europe
In European art from the mid-nineteenth century, painting
began to let go of figuration in two ways. Color and texture
began to lift off the forms they described, allowing haptic images to rise to the surface of the painting. Line unfurled from the
figures it demarcated and leapt into abstract life. Abstraction in
painting reached out to the senses of a perceiver, who had to
consult her inner faculties in order to respond in a subjective
and, often, embodied way. The haptic image and abstract line
(see Deleuze and Guattari 1987), the major formal elements of
Western modernism, arrived to the West in considerable part
through the influence of Islamic art.
What I call the haptic transfer and the travels of the abstract line
facilitated the spread of Islamic aesthetics to the West in a time
of genuine intercultural hunger, deeply altering the recipient
society. The occurrence of these tendencies in the nineteenth
century accompanied a new understanding of perception––new,
that is, in Europe; it had been developed by Islamic thinkers as
early as the ninth century. Thus we can say that the haptic
image and abstract line ushered a new form of perception into
the West (for I contend that form itself gives hints to the perceiver as to how it may best be perceived).
The haptic transfer and the travels of the abstract line, as in the
well-known geometric and vegetal ornament of Islamic religious architecture, facilitated the spread of Islamic aesthetics to
the West in a time of genuine intercultural hunger, deeply alte-
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ring the recipient society. Developed by Islamic thinkers as
early as the ninth century, the haptic image and abstract line
ushered a new form of perception into the West.
Islamic traditions of embodied perception
Writings by Arab classical philosophers, theologians, scientists,
and literary critics establish again and again a perceptual position that is embodied, multisensory, contemplative, and subjective.1 These writings often coexist with and make sense of the
arts – ceramics, textiles, painting, poetry, music, and more –
that flourished in and beyond the caliphates of ninth-century
Baghdad, tenth-century Cairo, and eleventh-century Cordoba.2
Two tendencies in Islamic classical thought especially support
and require some notion of perception as embodied. To begin
with, embodied experience is part of being a good Muslim.
Islamic philosophy generally adopted the Aristotelian conception that the body is integral to human happiness, and not, as in
the Platonic and Christian traditions, the cage of the soul
(Behrens-Abouseif, 199, 69). Islam actively discourages asceticism. Ultimately, especially in mystical strands of Islam, body
and world must be transcended, but meanwhile, Islam understands humans to be God’s regents on earth. Sensuous experience, properly regulated, is part of the appreciation of the
beauty engendered by God. So material experience is a route to
the transcendental, to the appreciation of (the ineffable) God.
Indeed, poetry, architecture, music and wine are often praised
in the courtly society of classical Islam as refined pleasures in
their own right. These writings also indicate a multisensory aesthetics, as courtly literature frequently refers to the participation
of fragrances, gustatory delicacies, fountains, music, and visual splendor, in aesthetic experience (Hourani 1991, 196).3 AlKindi’s (d. 866) books on music, adopting Greek doctrines that
related elements and humours to notes and rhythms, recom-
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mended a multisensory therapy combining music, colors, and
perfumes (Hourani 1991, 196) – a sort of proto-aromatherapy
Gesamtkunstwerk. The perceiver in classical Islamic thought is
not only embodied but also subjective.
At the same time, Islam in principle permits fewer mediators to
the transcendental experience than does Christianity, especially
Catholicism. Without figural representations of the divinity, let
alone its incarnation, the believer in Islam is confronted with a
steep route toward spiritual knowledge. Images do not mediate
or prop this experience so easily. Instead they assume the
abstraction, ineffability, and unknowability – but also beauty
and goodness – of God. I must note that there are many variations in Islamic use of figurative mediators. Unlike the more
severe Sunni Islam, Shi‘a Islam (with the mediating figure of
the imam) and Sufism permit saints, shrines, and figurative
images that mediate religious experience. Sunni Islam, while
rejecting anthropomorphism, permits a conception of a personal God, which is in turn a mediator with the inconceivable
divine (Nagel 2000, 245-50). The result of these two qualities
is that Islamic art has a tendency to be both embodied and
abstract. The attention invited by Islamic art tends to be embodied, subjective, and performative.
Islamic aesthetics offers many ideas about the power of abstract
pattern for spiritual contemplation, as well as disincentives to
realism. Figurative images are not eschewed altogether, but
their dependence on a higher order is emphasized. The radical
abstraction of Islamic art is the result of the view, carried down
from radical Mu‘tazili atomistic philosophers of ninth-century
Iraq, that God, being indivisible, has no attributes. Thus any
attempt to identify the properties of God in art risks blasphemy
(Khalidi 1985, 84). It is impossible to conceive of God. Even
less radical strains of Islam enjoin an imaginative engagement
with the infinite in religious contemplation. Abstraction is thus
a way not to represent but to perform the engagement with the
infinite that is the act of worship.4
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As Gülrü Necipoglu has demonstrated, Islamic rationalist
philosophy in the classical period placed great importance on
the »internal faculties« that mediate between perception and
intellect (Necipoglu 1995). Al-Kindi (801-66), Al-Farabi (d.
950), and later Ibn Sina (Avicenna, 980-1037) enumerated
inner faculties such as imagination, memory, and estimation or
judgment. These views were greatly expanded in the work, both
philosophical and experimental, of Ibn Al-Haytham (b. Basra
965, d. Cairo 1039), known in the West as Alhazen. AlHaytham introduced the intromission theory of vision in his
Kitab al-Manazir or Treatise on Optics. Translated into Latin in
the twelfth century, probably by Gerard of Cremona (d. 1187),
it remained the major work on optics until Kepler in the seventeenth century (Lindberg 1976, 58-60; on the question of translation see 209-210). This great polymath’s writings on perceptual psychology and aesthetics, synthesizing Neoplatonic and
Islamic perspectives, explicate a conception of subjective,
embodied, and multisensory perception. Perception for AlHaytham consists of a compound of sensations that are mentally compared – for example, the sight, sound, and smell experienced by a man sitting on a riverbank listening to music and
admiring lovely women (Nasir 1969, 85).
In the Optics, Al-Haytham posited that there are two modes of
perception, immediate and contemplative. The former is
accomplished by the senses alone, the latter requires the internal faculty of judgment. He argued that contemplation is necessary for the recognition of form, for it requires memory and
comparison, carried out in what he called the faculty of judgment. Form is thus a psychological concept, not a given in
nature; and ascertainment can only be relative, to the limits of
sense perception (Sabra 1994, 170-171). Al-Haytham’s understanding of perception is time-based, deductive, and subjective.
He listed 22 visible properties (e.g. light, color, distance, solidity) that singly or in combination determine the appearance of
things. However, each of these is determined by inference, by
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mental comparison (Sabra 1994, 177-178). So in Al-Haytham’s
Optics, almost all of perception takes place internally. Because
of its emphasis on judgment, this theory of perception implies
a subject who is educable and capable of introspection.
Al Haytham, born in Basra, spent some years working for the
Fatimid court in Cairo (when he was not feigning insanity in
order to avoid imprisonment by the mad caliph al-Hakim II).
Necipoglu (1995) suggests that he was thinking of the arabesque and geometric patterns proliferating in the architecture of
this city when he came up with his theory of subjective perception, as these vertiginous patterns, she writes, »presuppose a
private way of looking« (204). Oleg Grabar (1992) similarly
remarks upon the relativism of Haytham’s criteria for beauty:
»He assumes that qualitative decisions of beauty are based on
what would be called today the user’s or the observer’s context,
not on intrinsic properties of artifacts« (232). Art historians thus
agree that Al-Haytham’s perceptual psychology was in tune
with the abstract art of his time.
The fall and rise
of embodied perception in Europe
As religious conservatism waxed across the Islamic world, the
rationalist philosophy and experimental science that produced
these understandings of subjectivity and perception waned.
They traveled westward, however, in the great movements of
translation of Arabic manuscripts into Latin in medieval
Europe. It is now generally acknowledged that the European
intellectual renaissance was largely fueled by this intercultural
movement. What’s interesting to note is that a »European« concept of perception did not arise until some centuries later, with
the rise of experimentation in visuality and perspective. During
the medieval period of translation, Arab-Islamic notions of
embodied, multisensory, and subjective perception echo in the
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aesthetics of Europe. For example Doris Behrens-Abouseif
(1999), citing De Bruyne’s 1947 treatise, L’Esthétique du
Moyen Age, suggests that Roger Bacon’s statement that full aesthetic pleasure is simultaneous satisfaction of all the senses may
have been Arab influenced, and that Thomas of York »used
Arabic sources to emphasize the psychological and subjective
character of beauty« (42).
As A.I. Sabra (1994) notes, the extreme subjectivity of AlHaytham’s theory of perception was due to an error (85-118).
Although his theory of vision arose from experiment, he did not
take account of the activity of the lens in focusing light rays in
the eye. Such a perceptual experience would certainly have
required mental judgment on the part of the perceiver to distinguish among all the resulting images: hence Al-Haytham’s
emphasis on subjective judgment, which was taken up by
European medieval theories of vision. Byzantine and medieval
art, eliciting an embodied and multisensory response, might be
said to combine Christian iconography with an Islamic visuality (see Mondzain 2004; Classen 1998). It was to be corrected
by Johannes Kepler with his theory of the retinal image based
on a comparison of the eye to a camera obscura. Kepler’s intervention, though still grounded in the medieval tradition, prepared the way for a more objectivist model of the eye’s role in
perception (Lindberg 1976, 207-208).
In the late nineteenth century, as biologists were beginning to
recognize the highly subjective nature of vision, Henri Bergson
was one of the major philosophers to try to redefine the subject
of perception as an alert and flexible »center of indetermination« (1988 [1896], chapter 1 passim.). In his Matière et mémoire of 1896, Bergson establishes his model of embodied perception, an ever-widening, quasi-hermeneutic circuit in which
perception calls up memory and memory enriches and refines
perception. But as Jonathan Crary (1992) points out, Bergson’s
theory of perception was an ideal of perception, posited with a
certain anxiety for a subject that is already slipping away.
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Industrial and urbanized Europe was increasingly to be producing perceptual situations that dazzled, overwhelmed, or
crushed the perceiver, or simply left no time for the deliberate
dialectic between perception and internal faculties.
Like Al Haytham and other Islamic philosophers, Bergson describes an ideal subject suspended somewhere between an internal point and the external world, between memory and perception, between interiority and dispersal. Their worries about the
dissolution of communicability in their newly industrialized
cities inform a certain urgency to define perception as a subjective foray into an objectively knowable world. In the Islamic
ideal of subjective contemplation, the interior journey aided by
one’s internal faculties could intersubjectively confirm the existence of the empiricial world, but ultimately confirmed the
existence of an objective, abstract order: that of divine creation.
Evidently this solution would not work for the late-nineteenth
century European philosophers.
It is all too well agreed that the arts and sciences of the European
Renaissance established a model of visual perception as relatively disembodied and objective, which lasted into the nineteenth
century. Only then did experimental optics newly reveal visuality to be embodied, subjective, and subject to external and internal conditions (see Crary 1992). And then, in a revisionist history that is itself now well known, perception was newly understood to take place in a subject permeable to bodily, psychic, and
social experience. Thus we may say with a soupçon of chauvinism that it took European optics four centuries (after Kepler) to
first improve upon, then return to, the subjective perception Al
Haytham delineated in the eleventh century.
It is interesting that around the same time, the mid- to late nineteenth century, Western art entered a period of abstraction that
newly elicited a subjective, synaesthetic, embodied, and temporal approach on the part of its spectator – an approach we
may call performative.5 Characterized both by haptic space and
abstract line, the new art of nineteenth-century Europe had
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many formal commonalities with Islamic art, while the psychology inaugurated by Bergson and others has much in common
with Islamic theories of perception.
Performative aesthetics in Islamic art
Abstract line and haptic space are performative, rather than
representational. They require the imaginative and subjective
participation of the beholder to bring their effects into being,
beckoning each pair of eyes to follow in their own fashion. Like
the haptic image, with its lively interaction between figure and
ground, the abstract line draws the beholder out of herself. In
favoring movement, the ego is thus disentangled. Repeating
infinitely, as in the well-known geometric and vegetal ornament
of Islamic religious architecture, the abstract line invites the
beholder to try to feel the ungraspable infinity of God. Thus
Ernst Gombrich (1979) thoughtfully reverses an Orientalist cliché, calling Islamic overall patterns an expression not of horror
vacui but of »amor infinity« (80). Yet as Sayyed Hossain Nasr
(1987) insists, this infinity is in a constant play with the void.
»There is an aspect of nothingness or void which lies in the
very nature of the whole created order and which is a direct
consequence of the fact that, in an absolute sense, only God is
real. ... The arabesque enables the void to enter into the very
heart of matter« (186; see Burckhardt, 231-235).
Nasr, as more sober art historians have grumbled, takes a
romantic and ahistorical view of the mystical effects of Islamic
art. His description of an ecstatic loss of self in the contemplation of the abstract line echoes Sufi mysticism. And indeed
many Westerners are drawn to Islam’s mystical variant in
search of a loss of self, as Sufism describes the love for God as
a moth’s love for the flame. But other figures in the history of
Islamic aesthetics suggest a more guarded play of subjectivity
in the contemplation of abstract pattern.
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The principles established by Al Haytham, accepted and elaborated upon by later rationalist philosophers such as Ibn Rushd
(known in West as Averroes, d. 1198), demonstrate that in
Islamic aesthetics the active engagement of the beholder is the
subject of the work. Rushd, for example, emphasizes that a viewer constructs a series of subjective virtual worlds: »the principle of [the viewer’s] cogitation about things indeed consists in
rendering present all the different kind of images of the imagined possibilities concerning the thing on which he is cogitating,
as if he were seeing what he is cogitating on« (quoted in
Gonzales 2001, 63). Rushd’s aesthetics, as developed here in
his commentary on Aristotle’s De anima, emphasizes the subjective actualization of virtual states. This aesthetic describes
artwork that has nothing to »say« – that does not require interpretation per se – but holds out an invitation to the beholder.
Thus we can think of abstraction and ornament as performative.
Ornament obtains a certain license from Islamic theology. The
Qur’an cautions artists not to compete with God, who is the
only creator. In accordance with the conservative ›Asharite
doctrine that came to dominate Sunni Islam, the world is finite,
created by God out of nothing, and to which nothing can be
added. In such a world, originality consists not in invention but
in skilful new variations on a theme (Behrens-Abouseif 1999,
100; see Sperl 1989). Humans can only embellish the excellence of already existing creation. This is one of the reasons that
ornament flourished in Islamic art: rather than creating from
nothing, it reveals new connections. A conservative tendency in
theology yields a lively engagement on the part of the viewer of
art or hearer of music or poetry. Baghdadi literary theorist ‘Abd
al-Qahir al-Jurjani (d. 1078) exemplified this tendency of
Islamic aesthetics when he wrote that in all arts and crafts, »the
more widely differed the shape and appearance of their parts
are and then the more perfect the harmony achieved between
these parts is,« the more »fascinating« and praiseworthy the
resulting work will be (Necipoglu 1995, 189). The power of
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poetic imagery, Al-Jurjani wrote, is its »ability to penetrate hidden meanings and thus reveal invisible things« (ibid). Veiled
poetic speech »invites the recipient to search or the hidden
pearl«; it is thus more precious than direct rational speech
(Behrens-Abouseif 1995, 104). Value is placed on works of art
that beguile the viewer or listener to imaginatively explore
them.
Ornament, according to Oleg Grabar (1992), may have a ludic
or a liturgical function: »Both have prescribed rules of behavior
and of utterance from which one should not deviate, but in a
liturgy the outcome is always known in advance, whereas in a
game it is not« (207). Iconography is liturgical; »evocative
manipulation« is a game: »It recalls meanings without compelling them. It transfers the decision of how to understand a work
of art to its viewer or user« (207). Ornament provides not an
anarchic field for the play of perception, but the rules of the
game, the abstract structure in which subjective perception acts.
»Ornaments are recursions that keep going by recalling previous and anticipating further forms,« so Niklas Luhmann
(2000, 120) writes. Luhmann captures here the algorithmic qualities of ornament, whereby one theme, for example a geometric form, can be varied endlessly by simple iteration and
change. It also indicates the performative way in which ornament is perceived: looking at a single form, we can anticipate
its variations, where it came from and where it is going, as it
were. As such, looking at ornament (or indeed listening to
music or poetry with an ornamental structure) is a personal
exercise in unfolding its possibilities in time.
While meaning does not lie in the object alone, I think that we
can analyze an object in terms of the kinds of reception it might
afford. Islamic art implies certain forms of drawn-out attention
and subjective contemplation, which in turn are in a certain way
suggested by the work. This is why non-figurative Islamic art
often yields unsatisfying conclusions for those who, like Eva
Baer (1998), deploy iconographic interpretations and are more
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amenable to phenomenological approaches. Valerie Gonzales’
(2001) interpretation of the Hall of Kings at the Alhambra
shows how Islamic architecture lends itself to existential,
embodied, and performative experiences more than to iconic
analysis. While other art historians have interpreted the
Comares Hall of the Alhambra as a literalization of its inscriptions about seven heavens, Gonzales »experiences« the hall
phenomenologically: decoration leads the eyes up to the starstudded dome, the dome as a body of potential metaphors, to be
explicated subjectively. Such a work invites a performative,
embodied approach.
Westward travels of Islamic aesthetics
By the mid-nineteenth century, the path to Granada and beyond
was heavily trodden by Orientalist pilgrims. In 1856, the British
design reformer Owen Jones published his pattern book The
Grammar of Ornament, which included 454 Islamic motifs,
including a chapter on the Alhambra (Sweetman 1987, 175).
This and other pattern books were read avidly by artists, architects, and designers (both professional and amateur) and their
motifs were applied widely, together with Jones’ propositions
on ornament derived from his study of »Moresque« patterns.
Jones noted, for example, the patterns’ equilibrium whereby
»the tendency of the eye to run in any one direction is countered
by lines going in another, so that wherever the eye strikes ... it
is inclined to dwell« (Jones as quoted in Sweetman, 176).
Jones’ description of aesthetic pleasure strongly echo AlJurjani’s, and Jones’ pattern books made it easy for artists to
adapt the playful and fascinating patterns of Islamic art to their
own projects.
Both art nouveau and straightforwardly Orientalist architecture
dealt with modernization by seeking inspiration from beyond
Europe. As John Sweetman (1987) details, world’s fairs, train
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stations, and the architectural follies of rich clients featured
»Alhambresque« ornament. The life force of the abstract line
twined into the biomorphic forms of Jugendstil and art nouveau architecture and design. Architects turned to Islamic models
for the new iron and glass buildings of the industrial age, the
train station and the shopping arcade (Sweetman, 119-127).
William Morris, leader of the British Arts and Crafts movement, incorporated these and other Islamic patterns into his
designs for textiles and wallpaper. Morris supported the South
Kensington Museum in its acquisition of the famous carpet
from the shrine of Sheikh Safi at Ardabil. This museum, which
became the Victoria and Albert Museum, would be the model
for the Vienna Museum of Art and Industry where Aloïs Riegl,
art historian and curator of textiles, developed his theory of the
intercultural transfer of plastic qualities.
A complex carpet of Eastern Iranian or Indian origin appears in
several of the paintings of John Singer Sargent, literally underlying the tendency toward abstraction in this painter’s work.
Sargent loved this carpet, calling it »more beautiful than any
painting« (as quoted in Sweetman, 1987, 227). He often tried to
imitate its complexity in his paintings and lamented having to
obscure it with his model: »Whenever I put my model on it, she
covered something infinitely more beautiful than herself, so I
gave up [trying to incorporate the pattern of the rug] and merely did a sort of map of the carpet for the pattern« (ibid).
Islamic art was one of the levers that European artists applied
to naturalism in order to release abstraction. The development
of the internal faculties in Islamic aesthetics proved influential
to another current of late nineteenth-century art. Paul Gauguin
lent Georges Seurat a so-called »Turkish painter’s manual« by
the Turkish poet and ambassador Sünbülzade Vehbi (s. 1909).
This manual advised to paint from memory, rather than from
what is visibly present, invoking the authority of the Islamic
visual tradition that appeals to the imagination (Necipoglu
1995, 210). Vehbi’s writings enjoin the poet to draw inspiration
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from the form’s artifice: »First he should be skilled in signification’s art that he might know the delicate, hidden point of
poetry’s meaning. / Metaphor and metonymy, the real and the
figurative flow endlessly through the riverbed of poetry. /
Without knowing the most lovely form of a simile’s aspect, to
what shall the heart-adorning face of poetry be compared?«
(Vehbi, n.d.)
Henri Matisse, Paul Klee, and other modern painters incorporated the abstract line of the arabesque into the surfaces of their
canvases, liberating the abstract line from its subservient role to
figural representation. And thus the abstract line moved from
Baghdad to Paris, a stowaway in rugs and a discreet mimic in
figurative canvases, until it could move freely again.
A tension between embodiment and transcendence describes
the modern painting of the late nineteenth and early twentieth
centuries, as well as the art of Islam with its embodied subject
contemplating the infinite. They hold in common a light conception of the subject, as something that is meant to be dissolved and unwound, much as haptic surfaces dissolve our
eyes’ focus and the process of following abstract lines unravel
our subjectivity like a ball of yarn. Like figure and ground alternating into each other, they play with the tension of immanence and transcendence in the fabric of an embodied subjectivity.
Notes
1
Not without internal differences: Ontological differences between the
unknowable universe of the ‘Ashari atomists and the interconnected
emanationism of the Greek-influenced falsafa, as well as differences
between Sunni, Shi‘a, and Sufi beliefs, informed religious and state
policy, and in turn art and aesthetics. The Islamic engine that powered
European experiments in abstraction was not a primitive and unreflected decorative sense but a self-sufficient art system. Whether direct
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Laura U. Marks
relations existed between aesthetic thought and artistic practice in classical Islam is hotly debated by art historians. I join those who argue
that Islamic art absorbed and informed aesthetic and theological
reflection.
2
I mention these three caliphates that were centers of power and learning, and the centuries of their prime: the Abbasid caliphate, which
founded the new city of Baghdad and ruled there from 749 to 1258; the
Fatimids of Cairo, 909-1171; and the Umayyads of Spain, 756-1031.
They are among many others whose influence and competition extended across the Islamic world.
3
See the richly sensuous The Thousand and One Nights. This book is
based on stories translated from Pahlavi into Arabic in the early centuries of Islam and gradually collected in Baghdad in the tenth and
twelfth centuries.
4
The emphasis on performativity in worship also results from the rejection of reason in favor of faith in the influential writings of Abu’l
Hasan Al-Ashari (d. 935) and Abu Hamid Muhammad Al-Ghazali
(1058-1111).
5
It’s important not to lump all European art into the model of
Renaissance perspective, for there are many kinds of embodied perception solicited by works of different periods. Baroque art, for example, certainly can’t be said to elicit a distanced and disembodied spectatorship; indeed Necipoglu (1995) compares the overwhelming yet
subjective effect of Baroque art with that of Sunni architecture of the
classical period.
References
Baer, Eva (1998) Islamic Ornament, Edinburgh University Press.
Behrens-Abouseif, Doris (1999) Beauty in Arabic Culture, Princeton:
Markus-Wiener Publishers.
Bergson, Henri (1988[1896]) Matter and Memory, trans. Nancy Margaret
Paul and W. Scott Palmer, New York: Zone.
Burckhardt, Titus (1987) Mirror of the Intellect: Essays on Traditional
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The Haptic Transfer
283
Science and Sacred Art, Albany: SUNY.
Classen, Constance (1998) The Color of Angels: Cosmology, Gender and
the Aesthetic Imagination, New York: Routledge.
Crary, Jonathan (1992) Techniques of the Observer: On Vision and
Modernity in the Nineteenth Century, Cambridge, MA: MIT Press.
Deleuze, Gilles and Félix Guattari. (1987) A Thousand Plateaus,
Capitalism and Schizophrenia, trans. Brian Massumi, Minneapolis:
University of Minnesota Press.
Gombrich, Ernst (1979) The Sense of Order: A Study in the Psychology of
Decorative Art, Oxford: Phaidon.
Gonzales, Valerie (2001) Beauty and Islam, London: I. B. Tauris.
Grabar, Oleg (1992) The Mediation of Ornament, Washington: National
Gallery of Art and Princeton: Princeton University Press.
Hourani, Albert (1991) A History of the Arab Peoples, New York: Warner.
Khalidi, Tarif (1985) Classical Arab Islam: The Heritage and Culture of
the Golden Age, Princeton: Darwin.
Lindberg, David C. (1976) Theories of Vision from Al-Kindi to Kepler,
Chicago: University of Chicago Press.
Luhmann, Niklas (2000) Art as a Social System, trans. Eva M. Knodt,
Stanford University Press.
Mondzain, Marie-Josée (2004) Image, Icon, Economy: The Byzantine
Origins of the Contemporary Imaginary, trans. Rico Franses,
California: Stanford University Press.
Nagel, Tilman (2000) The History of Islamic Theology from Muhammad to
the Present, trans. Thomas Thornton, Princeton: Markus Wiener.
Nasr, Seyyed Hossain (1987) Islamic Art and Spirituality, Albany: State
University of New York.
Necipoglu, Gülrü (1995) The Topkapi Scroll: Geometry and Ornament in
Islamic Architecture, Santa Monica: Getty Center for the History of
Art and Architecture.
Sabra, A.I. (1994) Optics, Astronomy, and Logic: Studies in Arabic Science
and Philosophy, Aldershot, UK: Variorum.
Sperl, Stefan (1989) Mannerism in Arabic Poetry: A Structural Analysis of
Selelcted Texts, Cambridge and New York: Cambridge University
Press.
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Laura U. Marks
Sweetman, John (1987) The Oriental Obsession : Islamic Inspiration in
British and American Art and Architecture, 1500-1920, Cambridge:
Cambridge University Press.
Nasir, Nasser Ahmad (1969) »Ibn Al-Haitham and His Philosophy«, in
Said, Hakim Mohammad (ed.) Ibn Al-Haitham: Proceedings of the
celebrations of 1000th anniversary, Karachi: Hamdard National
Foundation. Sünbülzade Vehbi, n.d.,The Kaside on Poetry, trans.
Kemal Silay, http://mypage.iu.edu/~ksilay/vehbi.html
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Epilog
Bindegewebe
Die Essays in den Verkörperungen entspringen weiblicher
Produktivität1. Kopfarbeiterinnen sind am Werk und entwerfen
unterschiedliche Denkansätze. Der menschliche Körper wird
keineswegs aus einem einzigen inhaltlichen Knäuel versponnen, sondern aus vielen Theorie- und Forschungskonzepten, die
im Buch miteinander verknüpft werden. Medien-,
Kommunikations- und Kulturwissenschafterinnen, Medizinethnologinnen, Kunsthistorikerinnen und ethnografische
Filmemacherinnen beschäftigen sich mit Embodiment und bieten Einblicke in ihre Forschungsschwerpunkte. Die Künstlerin
Barbara Graf eröffnet mit ihren Zeichnungen – mit der abstrakten Linie, die sich in Worten und im Medium Text fortsetzt –
Denk-, Vorstellungs- und Assoziationsräume. Die Bilder sind
keineswegs illustrativer Blickfang, sondern vielmehr ein inhaltliches Bindegewebe, das alle Sinne berührt. Die subjektiven
und durchaus körperlichen Verfasstheiten der Autorinnen bleiben nicht ausgespart. Sie werden als eine Form des inneren
Dialogs reflektiert und als wesentlicher Beitrag wissenschaftlicher und künstlerischer Arbeit zur Diskussion gestellt. Wobei
Die menschliche Stimme – der Sprechakt an und für sich –
buchstäblich in eine Polyphonie mündet: medizinische
Erzählungen in der ersten Person, mutige Selbstporträts von
Kranken, Ironie, Empirismus und ModellpatientInnen, das
Geblüt in der klinischen Behandlung, Geburten in der
Hightechmedizin, böse Wunden und Biopolitik, Techniken der
Anteilnahme in der Ethnografie, Körperpflege und Mutterschaft, Konzepte des Weiblichen, Hausarbeit als Therapie,
Sensibilitäten, bewegende Geschichten und performative
Ansätze erzeugen einen bunten Stoff, welcher sich weit über
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Christina Lammer
Körper-, Landes- und kulturelle Grenzen hinausspannt. Mit
dem Ziel, den »sozialen Knoten« zu lösen, setzen wir auf den
»Gebrauchswert des Weiblichen« (Treusch-Dieter 19922). Die
Autorinnen in diesem Band legen mit ihrem Denken und
Fühlen Spuren. Im Augenblick. »Und dieser Anfang,« ... den
»ich ohne jeden kulturpessimistischen Beiklang radikale
Endlichkeit nennen möchte, ist eine ganz neue Chance. Nur
müsste sich diese Gravitation hin zu Möglichkeiten der
Gegenwärtigkeit mit einer anderen Einstellung zu Geburt und
Tod verbinden lassen« (ebd.). Momentaufnahmen. Jede
Beschreibung entspricht einer Übersetzung, einer schriftlichen
Übermalung oder metonymischen Verdichtung. Daraus entfaltet sich ein Geflecht vielfältiger Verkörperungen. Draperien aus
Bild und Text ver- und enthüllen den menschlichen Leib. Sie
liegen teilweise eng an oder hängen wie lose Gewänder auf den
Gliedern. Das schreibende Ich verbirgt sich an manchen
Stellen. In einem amorphen Phantasiegebilde, ähnlich einer
Hügellandschaft, zeichnen sich langsam vor meinen Augen die
Konturen eines weiblichen Körpers ab. Ein liegender
Frauenakt. Kopf abwärts. Sie betrachtet sich selbst. Brust.
Arme. Bauch und Nabel. Von den Beinen sind in dieser Lage
nur Zehen zu sehen. Die Umrisse verschwimmen. Das Bild zerfließt. In einem Meer von Gedanken und Vorstellungen.
Christina Lammer
Wien, Juli 2007
Notes
1
Zwischen den Zeilen dieses Buchs schwingt das geistige Vermächtnis
von Gerburg Treusch-Dieter – meiner wissenschaftlichen Lehrerin und
Freundin – mit. Die Verkörperungen sind der Schauspielerin, Autorin
und Soziologin gewidmet. Sie verfasste zahlreiche Studien zur weib-
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287
lichen Produktivität, zu Mythen, Biopolitik und zum menschlichen
Körper. Gerburg Treusch-Dieter verstarb am 19. November 2006 an
Krebs.
2
Zitate aus einem Interview mit Gerburg Treusch-Dieter (1992). Online
nachzulesen unter: www.rudolf-maresch.de/interview/20.pdf, www.
treusch-dieter.de.
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