A romance with the concept of community has long characterized activist healthcare movements and has more recently been taken up by academic medical centers as a sign of virtuous civic engagement. During the late 1960s, the word community, as deployed by administrators at prestigious AMCs, became increasingly politicized, commodified and racialized. Here, we analyze how the concept of community was initially framed in the 1963 Community Mental Health Centers Act, the first legislation to establish community mental health centers in America. (...) We then examine the Health Policy Advisory Center’s analysis of the proposed Washington Heights Community Mental Health Center to be run by Columbia University’s College of Physicians and Surgeons, an institution that had historically neglected residents’ health needs. Community pushback against Columbia’s plan to build a multi-block center, amplified by medical students and residents critical of the professionalized community mental health movement, escalated in the late 1960s, leading the city’s planning board to reject Columbia and approve a community council’s plan for preventive and rehabilitative local services. These conflicting overtones of “community” still inform understandings of the word in medicine today; thus, a critical historical analysis of “community” is warranted. (shrink)

To assess the effectiveness of Visual Thinking Strategies in medical education curricula, a pretest–posttest experimental study design was used to evaluate the impact of participating in VTS workshops on first-year medical students. A total of forty-one intervention and sixty comparative students completed the study which included the analysis of clinical images followed by a measurement of word count, length of time analyzing images, and quality of written observations of clinical images. VTS training increased the total number of words used to (...) describe clinical images, the time spent analyzing the images, and the number of clinically relevant observations. (shrink)

This paper describes an innovative just-in-time health humanities programme to educate and provide support to COVID-19 frontline doctors-in-training. The programme incorporates small-group screening of the Netflix documentary, The Next Pandemic from the Explained series, followed by a one-hour facilitated discussion to explore themes surrounding the current pandemic and its impact on frontline doctors in a tertiary paediatric hospital in Singapore. Themes derived from the film included preparedness, blame, and the impact on healthcare workers and public, which were further discussed to (...) include concerns regarding current local readiness levels given global connectivity, the need for international cooperation, and the effects of blame such as racism and prejudice. The association with culture; the current impact on healthcare workers, physician-patient relationships, and the public including the role of social media, the government and associated public reactions were also explored. These rich discussions demonstrate the pivotal role health humanities has in times of uncertainty such as an emerging infectious disease outbreak by providing timely pandemic education and supporting reflective learning. (shrink)

The Healer's Art curriculum is one of the best-known educational strategies to support medical student professional identity formation. HART has been widely used as an elective curriculum. We evaluated students’ experience with HART when the curriculum was required. All one hundred eleven members of the class of 2019 University of New Mexico School of Medicine students were required to enroll in HART. We surveyed the students before and after the course to assess its self-reported impact on key elements of professional (...) identity formation such as empathy towards patients and peers, commitment to service, and burnout. A majority of students reported positive effects of the course on their empathy towards other students. This finding was significantly associated with self-reported willingness to have elected the course had it not been required. One-half of respondents reported positive effects on their empathy towards future patients. At least one-quarter to one-third of respondents reported positive influences on commitment to service, conceptions about being a physician, and self-perceived burnout. Students report benefits on their professional identity formation after participating in a required course on humanism. Empathy-building among peers is one valuable outcome of such curricula. (shrink)

Issues of race have traditionally been addressed in medical school curricula in a didactic manner. However, medical school curricula often lack adequate opportunity for the application of learning material relating to race and culture. When confronted with acts of racism in clinical settings, students are left unprepared to respond appropriately and effectively. Forum Theatre offers a dynamic platform by which participants are empowered to actively engage with and become part of the performance. When used in an educational context, Forum Theatre (...) can be a powerful tool for students to interact with a wide variety of social issues. This paper describes the process by which one medical school designed a workshop in the Forum Theatre style to equip students to respond to racism observed in clinical settings. Based on real student experiences, the Responding to Racism in the Clinical Setting workshop was designed to give students an opportunity to combine cultural humility, communication theory and conflict resolution skills in order to prepare for interactions in clinical stages of medical education. As a result of workshop evaluations, surveys, and written reflections, the authors propose that Forum Theatre is a novel teaching modality for incorporating issues of race and culture into medical curriculum. (shrink)

This article discusses the theoretical and practical experiment of creating, promoting and co-teaching a medical humanities course: Medicine, War and the Arts at a School of Medicine in the United States from the viewpoint of the students who took the class. Specifically, it analyses how three themes emerged in students’ responses to the oral, literary and visual stories of war and trauma in the course and how they revealed the subjective and ambivalent nature of all medical encounters with patients. The (...) conclusion is that actively encouraging students to view the role of the physician through the lens of historical and contemporary trauma enables them to contemplate the difficult question, “Who’s Your Enemy?” when caring for the sick and themselves. (shrink)

Curricular design that addresses residency physician competencies in communication skills and professionalism remains a challenge. Graphic Medicine uses comics, a medium combining text and images, to communicate healthcare concepts. Narrative Medicine, in undergraduate medical education, has limited reported usage in Graduate Medical Education. Given the time constraints and intensity of GME, we hypothesized that comics as a form of narrative medicine would be an efficient medium to engage residents.The authors created a novel curriculum to promote effective communication and professionalism, focusing (...) on empathy, compassion and cultural competency. A four-week curriculum was delivered in a neurology residency program. Excerpts from non-fiction graphic memoirs about neurological conditions were read, discussed, and paired with prompt-driven drawing exercises. Qualitative surveys were used to assess acceptability of comics, usefulness of comics to convey patient illness experience, and perception of patient needs for physician-patient communication.Ninety-seven percent of residents reported the sessions were a good use of their time. Residents identified new symptoms of neurologic disorders, articulated patient communication needs, and expressed increased empathy after participation. Residents participated in drawing exercises, but these were not formally analyzed. Graphic medicine is a well received format that may build communication skills and increase empathy. (shrink)

In comparison to other art forms, dance remains underrepresented in the medical humanities, especially within the academic medical setting. Several factors, including perceived lack of applicability to patient care, contribute to this pattern. This paper contends that, to the contrary, learners across the medical education spectrum stand to gain much from engaging with the movement arts, including improvement of clinically-relevant skills such as physical self-awareness, observation, communication, and mindfulness. This paper makes the case for the nascent subdiscipline of Movement and (...) Medicine, developed by the authors and piloted for inclusion in medical humanities curricula within a medical education context. Movement and Medicine employs a dance-inspired pedagogy to a) promote awareness of personal movement and embodiment tendencies and b) harness that awareness to gain more profound, sensory insight into the embodied experiences of others—experiences of health, illness, or otherwise. This work outlines the research, rationale, and philosophy behind Movement and Medicine; concretely defines the subdiscipline and situates it within the medical humanities landscape; proposes practical approaches to engaging with and applying this material; and describes a Movement and Medicine course developed for one American medical school. (shrink)

This paper introduces an innovative curricular approach—the Health Humanities Portrait Approach —and its pedagogical tool—the Health Humanities Portrait. Both enable health professions learners to examine pressing social issues that shape, and are shaped by, experiences of health and illness. The Portrait Approach is grounded in a set of “critical portraiture” principles that foster humanities-driven analytical skills. The HHP’s architecture is distinctively framed around a pressing social theme and utilizes a first-person narrative and scholarship to explore how the dimensions of the (...) personal and the structural are mutually constituted. We argue that when creator-educators adopt the Portrait Approach and its critical portraiture principles to design and teach the HHP, they enable learners to become proficient in synthesizing and analyzing—with both depth and breadth—the human and social dimensions of patients’ lives. This inventive curricular intervention provides a needed contribution to health professions education in that it utilizes health humanities methodologies to elucidate the multiple aspects of health, illness, disability, and healthcare. (shrink)

In recent years, collaboration between medical educators and art museum educators has emerged as an important trend. The museum environment can support a kind of professional reflection and conversation that is difficult to develop in a medical setting. Skills such as close looking, empathic communication, resilience, and cultural awareness may also be developed in the art museum when plans for the visit are developed with attention to their relevance to health professions. Working across disciplines requires identifying and cultivating a strong (...) partner as well as clear communication about goals and possibilities. The following tips were developed by museum educators based on their extensive experience working with medical students, interns, residents and faculty at Harvard Medical School and the University of Texas at Austin’s Dell Medical School over the past twelve years. (shrink)

This discussion seeks to highlight the ability of poetry to combat loneliness, a growing public health problem with significant negative health outcomes that potentially impact millions of Americans. We argue that poetry can play a very relevant role and have an impact in medicine. Through a brief literature review of previous studies on poetry in medicine, we demonstrate that poetry can not only combat loneliness but can also play important roles in helping patients, physicians, and other healthcare professionals/providers. Because of (...) the COVID-19 pandemic, we believe now is the perfect opportunity to utilize poetry because the benefits can be experienced even in solitude, which is why this is such a timely and pertinent issue today. (shrink)

This essay examines narratives about cadaver dissection through the lens of psychoanalytic theory in order to better understand the nature of medical students’ socialization into medicine and its implications for physician-patient communication. The theoretical framework provided by Julia Kristeva focuses attention on the nature of subject-formation in relation to abjection – that which reveals the contingent nature of the speaking self. Analysis of memoirs and other narratives by medical students demonstrates that students encounter the abject in the process of dissecting (...) a corpse, but are rigorously trained to map over this experience using the technical tools of biomedicine. Other students rely on dark and morbid forms of humor to develop a sense of emotional distance from their cadaver. This analysis reveals new insights about the nature of the gap between physicians and their patients. In particular, it indicates that this gap is not fixed or static but fluid and malleable. Physicians are always shifting between the symbolic realm of biomedicine and the affective, semiotic mode of encountering the abject. This malleability provides the key to training and educating medical students, socializing them in such a way that they are reflexive about this process of oscillation. How physicians handle the reality of their fluctuation between the semiotic and the symbolic is what will determine their ability to engage with patients. (shrink)

Despite the growing profile of ‘implementation science’, its status as a field of study remains ambiguous. Implementation science originates in the evidence-based movement and attempts to broaden the scope of evidence-based medicine to improve ‘clinical effectiveness’ and close the ‘implementation gap’. To achieve this agenda, implementation science draws on methodologies from the social sciences to emphasise coherence between qualitative and quantitative approaches. In so doing, we ask if this is at the expense of ignoring the dominating tendencies of the evidence-based (...) movement and consider if some of the methodologies being drawn on should be considered irreconcilable with evidence-based methodologies. (shrink)

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were (...) conducted with a diverse group of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge. (shrink)

This paper investigates the gendered and racialized discourse on Polycystic Ovary Syndrome in India. A complex metabolic, endocrinal and reproductive disorder, PCOS is one of the most common endocrinopathies in women of reproductive age today. Due to an unclear etiology, there is no single clinical definition for PCOS, contributing to a sense of confusion around the syndrome. India has one of the highest rates of PCOS in the world. Medical and social discourses on PCOS suggest the high rates are due (...) to the failures of Westernized lifestyle and diet in women from developing countries. Taking the example of India, I argue that the lack of a clear etiology creates a discursive vacuum and that PCOS in itself is not a gendered and racialized syndrome, but the discourse on it is. Through the figure of the “new Indian woman,” I address the socio-political anxieties of nationalism projected onto the female body and suggest that the discourse on PCOS in India is in reaction to a rising nationalist rhetoric. As a syndrome that presents through “masculine” symptoms, PCOS acts a unique entryway into the intersectional issues of gender, race, sexuality, class and national identities. An analysis of the Indian setting might shed light on PCOS discourses that are increasingly relevant globally. (shrink)

Body image research focuses almost exclusively on women or overweight and obesity or both. Yet, body image concerns among thin men are common and can result, at least in part, from mixed messages in society around how men qua men should dress and behave in order to look good and feel good. Stand-alone interventions to meet these different messages tend to provide men with little therapeutic relief. This conceptual paper draws on literature from the medical humanities; gender and body image (...) studies; the social psychology of clothing; and the author’s own lived experience to address this contemporary problem. The paper embraces visual culture as a resource that can frame discussion of how two sets of ‘performativity’ might reduce male anxiety about thinness. First, thin men could choose repeatedly to wear masculine-looking clothing, which could create their masculinity as a personal aesthetic that strengthens the confidence to harness masculine traits in healthy ways. Secondly, health and allied health service providers could promote and reinforce such dress behavior by offering advice that integrates aesthetic and functional aspects of clothing. Empirical studies are needed to test this dual model of performativity. (shrink)

This article experiments with multimedia storytelling to re-vision difference outside biomedical and humanistic frames by generating new understandings of living dis/artfully with illness. We present and analyze seven short videos created by women and trans people living with illness as part of an arts-based research project that aimed to speak back to hegemonic concepts of disability that create barriers to healthcare.1 We call for a welcoming in of disability studies’ disruptive and re-imaginative orientations to bodily difference to unsettle medicine’s humanistic (...) accounts. In turn, we advance medical post-humanistic approaches that call on disability studies to re-embody its theories and approaches. (shrink)

This article is about the relationship between reading, trauma and responsive literary caregiving in Britain during the First World War. Its analysis of two little-known documents describing the history of the War Library, begun by Helen Mary Gaskell in 1914, exposes a gap in the scholarship of war-time reading; generates a new narrative of "how," "when," and "why" books went to war; and foregrounds gender in its analysis of the historiography. The Library of Congress's T. W. Koch discovered Gaskell's ground-breaking (...) work in 1917 and reported its successes to the American Library Association. The British Times also covered Gaskell's library, yet researchers working on reading during the war have routinely neglected her distinct model and method, skewing the research base on war-time reading and its association with trauma and caregiving. In the article's second half, a literary case study of a popular war novel demonstrates the extent of the "bitter cry for books." The success of Gaskell's intervention is examined alongside H. G. Wells's representation of textual healing. Reading is shown to offer sick, traumatized and recovering combatants emotional and psychological caregiving in ways that she could not always have predicted and that are not visible in the literary/historical record. (shrink)

The essay examines Robin Cook’s Coma and Priscille Sibley’s The Promise of Stardust that dramatize the reified and disposable status of the brain-dead patients who are classified as nonpersons. The essay argues that the man-machine entanglement as depicted in the novels constructs a deterritorialized and entangled form of subjectivity that intervenes in the dominant biomedical understanding of personhood and agency that we notionally associate with a conscious mind. The essay concludes its arguments by discussing Alexander Beliaev’s Professor Dowell’s Head which (...) depicts human subjectivity as an essentially embodied and distributive phenomenon and interrogates the Cartesian mind body dualism embedded in the dominant biomedical narratives. (shrink)

Inspired by a passage from Kate Chopin’s The Awakening, this article considers the possibility of a “medical sublime.” It works through a history of the sublime in theory and in the arts, from ancient times to the present. It articulates therapeutic dimensions of the sublime and gives contemporary examples of its medical relevance. In addition, it develops the concept of sublime-based stress-reduction workshops and programs. These workshops bring the sublime out of the library and the museum into the lives of (...) the healthcare community—patients, families, clinicians, staff, concerned others—in the service of better navigating human vulnerability and finitude. Opening the cannon of aesthetic theory and the arts as resources for the human condition is at the heart of health humanities. The sublime can be an invaluable tool in this task. (shrink)

Contemporary legends – also called urban legends – are common throughout our society. Distinct from mere rumors passed around social media, anecdotes of pseudoscientific discoveries, or medical misinformation, contemporary legends are important because, rather than merely transmitting false ideas or information about medicine, they model distinct and primarily antagonistic patterns of interaction between patients and providers via their narrative components. And, while legends that patients tell about their distrust for doctors are fairly well-studied, less attention has been paid to the (...) kinds of legends that providers tell about patients. Many of these legends portray the likely patient as foolish, incompetent, and the ultimate source of his or her own medical condition. A partial solution to the challenges created by clashing, mutually belittling narratives can be found in the principles of narrative medicine, which strives to replace a received, stereotyped narrative with an individualized narrative constructed together by provider and patient. This paper will provide a definition of contemporary medical legends, analyze the unique narrative structure, develop a brief taxonomy of common themes, and describe how the structure and theme elucidate interesting and previously unexamined tensions within the provider-patient relationship. (shrink)

Spirit possession is a common phenomenon around the world in which a non-corporeal agent is involved with a human host. This manifests in a range of maladies or in displacement of the host's agency and identity. Prompted by engagement with the phenomenon in Egypt, this paper draws connections between spirit possession, and the concepts of personhood and intentionality. It employs these concepts to articulate spirit possession, while also developing the intentional stance as formulated by Daniel Dennett. It argues for an (...) understanding of spirit possession as the spirit stance: an intentional strategy that aims at predicting and explaining behaviour by ascribing to an agent beliefs and desires, but is only deployed once the mental states and activity of the subject fail specific normative distinctions. Applied to behaviours which are generally taken to signal mental disorder, the spirit stance preserves a peculiar form of intentionality where behaviour would otherwise be explained as a consequence of a malfunctioning physical mechanism. Centuries before the modern disciplines of psychoanalysis and phenomenological-psychopathology endeavoured to restore meaning to 'madness', the social institution of spirit possession had been preserving the intentionality of socially deviant behaviour. (shrink)

This article examines the racial politics that reshaped psychoanalytic psychotherapy and ushered in a community mental health paradigm during the U.S. Civil Rights Era. Policymakers in the 1960s adopted the language of social justice to condemn psychoanalysis for its inability to treat psychotics and its unwillingness to treat black patients; yet the community psychiatry model of treatment that replaced it compounded the denial of the black subject’s clinical needs. Challenging the extant historiography that appraises psychoanalysis as a victim of neoliberalism (...) and psychopharmacology, this paper examines how and why Freudian practitioners beat their own retreat from the specter of desegregation. (shrink)

Contributing to renewed scholarly interest in R. D. Laing and his circle, and in the radical therapeutic community of Kingsley Hall, London, this article offers the first article-length reading of Mary Barnes’ and Joseph Berke’s Mary Barnes: Two Accounts of a Journey through Madness. This text offers views of anti-psychiatry ‘on the ground’ that critique the 1960s utopianism of Laing’s championing of madness as a metanoic, quasi-psychedelic voyage. Barnes’ story, too, reveals tensions within the anti-psychiatric movement. Moving beyond existing criticism (...) of the text, Barnes, it is argued here, emerges as far more than an exemplary patient, victim or anti-psychiatric puppet. Particular attention is paid in this reading of Two Accounts to the following: the ways in which the spiritually inclined Barnes and the psychoanalytic Berke differ in this dual narrative text; the ways in which each differs from Laing; the metaphor of the journey; and the setting of Barnes’ story in the often conflicted, experimental household of Kingsley Hall. (shrink)

This essay begins with a metaphor describing who enters the field of humanities in medicine and healthcare and the types of work they do. The role of witness is discussed, underscoring tensions between witnessing and analyzing. The essay then turns to my own background as an example of how each professional in this field brings something distinct. I briefly describe the three basic principles of my work with narrative: the injunction to keep the stories in the foreground, the work of (...) amplifying and connecting stories, and the need for generous interpretation. The second half of the essay tells three illness stories, describing their importance to me over several decades. These stories are by Audre Lorde, Reynolds Price, and Stewart Alsop, dealing with problems of silences imposed on ill people, problems caused by physicians’ perceived lack of time, and dilemmas of the end of life, respectively. (shrink)

This article considers how seventeenth-century writer John Milton engages in modes of thinking that register the obstetric revolution occurring during the period. During a time when physicians were gaining entry to the birthing room, a medical rhetoric of childbirth was developing that cast childbirth in new pathological terms. Milton's A Masque Presented at Ludlow Castle demonstrates how childbirth was influenced by emerging obstetrical language and practice, as well as the ways in which a writer might question such influence. Finally, this (...) article also draws links between disrupted historical rituals of childbirth and modern anxieties about medically-centred birthing practices. (shrink)

In this paper, I utilise the tools of analytic philosophy to amalgamate mono-causal and multi-causal theories of disease. My aim is to better integrate viral and socio-economic explanations of AIDS in particular, and to consider how the perceived divide between mono-causal and multi-causal theories played a role in the tragedy of AIDS denialism in South Africa in the early 2000s. Currently, there is conceptual ambiguity surrounding the relationship between mono-causal and multi-causal theories in biomedicine and epidemiology. Mono-causal theories focus on (...) single, typically microbial, sources of illness and are most concerned with infectious diseases. By contrast, multi-causal theories allow for multiple factors to underpin a disease’s aetiology, including socio-economic and behavioural factors, and they usually focus on chronic non-communicable diseases. However, if these theories are taken to be strictly distinct, this prevents the inclusion of both microbial and socio-economic factors in a single explanation of any particular disease. This strict distinction became a problem when trying to explain the disproportionate prevalence of AIDS in southern Africa and ultimately contributed to the tragedy of AIDS denialism in South Africa. In tandem with viewing how the perceived divide between multi-causal and mono-causal theories underpinned AIDS denialism, I examine Thabo Mbeki’s specific role, while acknowledging that AIDS is being deprioritised on a broader international level. Overall, I will demonstrate that any long-term plan to eliminate AIDS will require viral and socio-economic factors to be considered simultaneously and that such a theoretical approach requires a clearer understanding of the underlying concepts of disease aetiology. (shrink)

Using the 2000-2010 South Korean historical medical dramas Heo Jun, Dae Jang Geum, and Jejoongwon as case studies, this article examines televisual reimaginations of Korean medical modernity as interpretative popular culture texts. Particularly in the areas of the anatomical sciences and surgery, modern medicine’s emancipatory potentials in these productions are set semi-fictitiously in pre-modern Joseon historical contexts. Dramaturgically challenging entrenched social hierarchies and ossified cultural taboos of Institutionalized Confucianism, these dramas’ progressive physician-protagonists emphasize the universality and impartiality of medical knowledge (...) in what is herein termed as Generative Confucianism. (shrink)

Using the 2000-2010 South Korean historical medical dramas Heo Jun, Dae Jang Geum, and Jejoongwon as case studies, this article examines televisual reimaginations of Korean medical modernity as interpretative popular culture texts. Particularly in the areas of the anatomical sciences and surgery, modern medicine’s emancipatory potentials in these productions are set semi-fictitiously in pre-modern Joseon historical contexts. Dramaturgically challenging entrenched social hierarchies and ossified cultural taboos of Institutionalized Confucianism, these dramas’ progressive physician-protagonists emphasize the universality and impartiality of medical knowledge (...) in what is herein termed as Generative Confucianism. (shrink)

Using the 2000-2010 South Korean historical medical dramas Heo Jun, Dae Jang Geum, and Jejoongwon as case studies, this article examines televisual reimaginations of Korean medical modernity as interpretative popular culture texts. Particularly in the areas of the anatomical sciences and surgery, modern medicine’s emancipatory potentials in these productions are set semi-fictitiously in pre-modern Joseon historical contexts. Dramaturgically challenging entrenched social hierarchies and ossified cultural taboos of Institutionalized Confucianism, these dramas’ progressive physician-protagonists emphasize the universality and impartiality of medical knowledge (...) in what is herein termed as Generative Confucianism. (shrink)

In this article I read textual metaphors of ‘untouchability’ in ‘post-AIDS’ representation as an erasure of structures that condition HIV stigmatization in India. Throughout, my discussion is contextualised by the political economy of HIV and AIDS, which has been productive of particular modern sexual subjects. In the film My Brother…Nikhil, the stigmatization of Nikhil, a gay Indian man living with HIV, is constituted through visual and verbal caste metaphors, which draw on existing subject positions that are elided as ‘traditional’, residual, (...) and receding. This stigma is resolved textually through parental acceptance of the gay protagonist and his partner, projecting stigma as traditional and modernity as the resolution. Such metaphors of ‘untouchability’ prevent the representation of queer Dalit subjects in contexts of HIV and AIDS. Yet if addressing shame and social stigma are key to HIV treatment and prevention programmes, caste cannot be set aside simply as a metaphor. Expanding to include textual representations of queer Dalit subjectivity, the article reads a novel, The Boyfriend, and a poem, “Gandu Bagicha,” to show ways in which caste stigma and homophobia intersect in contexts of seroconversion risk. (shrink)

This essay provides a critical survey of key Irish theatre productions that present queer men with HIV or AIDS as a central theme while also seeking to situate several of these productions within the controversial discourse of ‘post-AIDS’ as it plays out in Irish cultural and social discourses. Through this survey, this essay finds and critically elaborates how a discourse of AIDS as punishment is a common denominator in all of these plays; whether that be as a central metaphor in (...) the drama or conversely as a trope that theatre makers seek to disrupt. Throughout, this essay simultaneously attends to the ways in which non-realist, non-linear dramatic structures have proved to be better positioned to present the realities of living with HIV or dying with AIDS in Ireland since the emergence of the first Irish AIDS epidemic in 1982. By approaching ‘post-AIDS’ discourses through the lens of HIV and AIDS in Irish theatre, this essay critically analyses the insidious ways in which ‘post-AIDS’ Irish culture is bound up with neoliberal discourses of homonormative assimilation and cultural respectability, especially the figuring of HIV/AIDS as punishment for non-assimilation. (shrink)

This special issue, entitled “Post-AIDS’ and Global Health Discourses: Interdisciplinary Perspectives,’ emerged from a one day Medical Humanities symposium at the Leeds Centre for Medical Humanities, at the University of Leeds, England, on February 27th 2015. This special issue focusses on the perceived deprioritising of HIV and AIDS in the Sustainable Development Goals, or SDGs, that were launched in 2015. The SDGs function as policy benchmarks for all entities within the United Nations system and they supersede the Millennium Development Goals, (...) or MDGs, which expired in 2015. As the word millennium indicates, the MDGs were launched in 2000 and 2015 was designated as the benchmark year when the successes and shortcomings of the MDGs would be critically assessed. One key difference between the MDGs and the SDGs, which D’Ambruoso foregrounds, is that the writing process underpinning the SDGs involved lengthy consultations, and feedback, with communities and health care practitioners around the world. By contrast, because the MDGs were mainly written by government officials, policy makers and health care practitioners without consulting wider communities, the processes underpinning the SDGs consultations are more inclusive than the MDGs. What is most critical about the SDGs for this special issue, however, is that they reflect a clear shift away from ‘HIV exceptionalism’ and towards what critics have described as ‘post-AIDS’ rhetoric, specifically when one compares the MDG health goal 6 and the SDG health goal 3. (shrink)

This paper examines the relationship between medical technology and liminal states of “undeath” as presented in “The Facts in the Case of M. Valdemar” and the real-life case of Jahi McMath, who was maintained on life support for over four years following a diagnosis of brain death. Through this juxtaposition, “Valdemar” comes to function as a modern fable, an uneasy herald of medical technology’s potential to create liminal states between life and death. The ability to transgress these boundaries bears a (...) cost, however: both Valdemar and Jahi McMath lose the autonomy to direct their respective narratives. Yet, their utterances “from beyond the grave” highlight the precarious nature of their position and the ethical concerns therein. Poe’s literary performance of “undeath” therefore serves to caution real-life cases in which life support is used to sustain an individual reported to be brain-dead. Such application of life-sustaining technology complicates the fundamental binary of life/death, allowing its subjects to resist textual closure. Even as Poe’s work represents an imaginative interrogation of the scientific enterprise, this nineteenth-century story holds a mirror to contemporary medical practice, inviting a reconsideration of the ethics, language, and power relations surrounding the fraught relationship between death and medical technology. (shrink)

While foregrounding the historiography of HIV and AIDS in the South African context, this article analyses AIDS as simultaneously existing in three spheres: first, virtually – as the subject matter of electronically measurable research; second, academically – as a topic of research in the discipline of History; and third, actually – as a complex health concern and signifier that, via the field of Medical and Health Humanities, could allow for new collaborations between historians and others interested in understanding AIDS. Throughout, (...) the central focus is the discipline of History and the global trends that become evident when examining metrics about AIDS research, particularly those that show the hierarchies of knowledge ‘production’, the reinforcement of disciplinary boundaries, and the discrepancy between the amount of research ‘produced’ by scientific and humanities disciplines. Overall, the article suggests that ‘post-AIDS’ is not currently helpful to health historians working on South African and other majority world contexts. More specifically, the article reflects on what AIDS histories still need to be written, and I argue that Medical and Health Humanities could provide a space for historians to work within and across disciplinary boundaries given the ever evolving remit of AIDS histories, temporalities, and narratives. (shrink)

This paper reflects on the meanings of ‘post-AIDS’ in the Global North and South. I bring together contemporary arguments to suggest that the notion of ‘post-AIDS’ is, at best, misplaced, not least because its starting point remains a biotechnical one. Drawing on aspects of the sub-Saharan African experience, this essay suggests that, despite significant shifts in access to antiretroviral therapy, HIV continues to be fundamentally shaped by economic determinants and social and cultural practices. In this essay, I question the certainty (...) of the discourse of ‘positive progress’, which underpins the ‘post-AIDS’ narrative, and suggest that living with HIV and AIDS in our contemporary global context is a life lived with ongoing complexity, stigma and chronicity. I suggest that HIV in the Global North shares many characteristics with HIV in the Global South yet differs in significant ways, not least in the fact that a resource-rich context generates an environment where health and social care support is possible, and, mostly, usual. In both contexts, however, the experience of living with a highly stigmatized illness with no cure in both the Global South and North suggests that this is a point of shared experience. (shrink)

This essay brings together critical perspectives from the discrete traditions of artists’ books and the medical humanities to examine artists’ books by three contemporary artists – Penny Alexander, Martha A. Hall and Amanda Watson-Will – that treat experiences of illness and wellbeing. Through its focus on a multimodal and multisensory art form that has allegiances with, but is not reduced to, narrative, the essay adds to recent calls to rethink key assumptions of illness narrative study and to challenge utilitarian approaches. (...) In particular, it draws attention to the aesthetic and imaginative elements of illness communication by exploring how artists’ books represent lived experiences in a distinctively palpable way and offer an “intimate authority” that extends beyond narrative legitimacy or a form of struggle against the medical gaze. By interrogating narrative’s dominance in medical humanities research, the essay further expands awareness of illness experiences that resist conventional forms of representation, and of alternative reflective practices within healthcare education that encourage engagement with both mind and body. (shrink)

This article discusses a Leverhulme residency undertaken by the author Julie Brixey-Williams in 2003–4 at the Association of Anaesthetists of Great Britain and Ireland. Notions of medical visibility were explored through practice-led investigations under the umbrella title, Traces of the Invisible, that concentrated on making concrete, visible responses to the hidden or intangible elements of the anesthetist’s working life in areas such as sleep, breath, pain and genetic markers. Rosebud is a unique nine-foot concertina bookwork created after reading the entire (...) story of The Sleeping Beauty into an anesthetic machine. This essay expands upon the concepts and material responses that led to the making of the book with particular reference to how the book’s structure forms a relationship to language and the body-as-site, whilst operating as a sculptural object that raises the visibility of the anesthetic profession. Fairy tales and their telling, including stories of enchanted sleep, transformational qualities, magical languages and shaman healers, will be examined alongside. (shrink)

In recent years, I have developed an endurance running art-practice as part of a larger inquiry into the performative nature of human physical activity. In the Absence of Running is series of artworks made using images from medical arthroscopic interventions following the diagnosis of medial meniscus tears to the cartilage and osteoarthritis in both my knees. Faced with not being able to run or to make artworks using running in the long-term, I turned to the tools of medical intervention. If (...) a camera was going inside my knee for the purpose of surgery, I would use it for the purpose of art. The resulting videos and photographs led to a contemplation on the image and viewing practices not previously anticipated, not least on the now endemic uses of advanced imaging technologies as integral parts of surgical operations. Their reassembly as a stop-frame animation and artist’s book in physical and electronic form enabled a process of slowing down and re-engagement with the image and physicality of the book itself and processes and with practices of viewing. This was important in reasserting the sense of human agency in our relationship to images in a world where this appears to be increasingly absent. (shrink)

Artists’ books are challenging to photograph. They function as a unit of tightly conceptually-bound visual, textual and material elements in addition to a heightened self-awareness of the work's booksness. Binding, size, weight, and shape of the book, translucency, texture, thickness of paper, placement of images and/or text on the page or off the page interact with other graphic elements; they control, and direct the reader towards the expressive components of meaning which arise from pace, haptic experience, and visual or structural (...) stylistic choices. Most of such information gets sacrificed in the process of documentation. Here I discuss some of such issues of photographing artists books for this journal and my solutions to replicating each artists’ book within the physical and thematic constraints of this publication: I tried not only to visualize the books’ content but also to translate some of the experience of how that content makes itself meaningful to the reader. (shrink)

With an avid attention to the valuing of embodiment and a championing of the re-emergence of the body as site for discussions of knowledge and knowing, this essay shares aspects of my practice that engage a performative, haptic, situated engagement with the body through the artist’s book. The motivation for the creation of my bookworks was an interest in manifesting situated knowing and embodied ways of becoming. Engaging form, materiality, and bodily history, my artists’ books explore the processes and metaphors (...) of digestion and in one example, mindfulness practice. In libraries and collections with links to health, my artists’ books can be experienced in teaching and research contexts to examine the body, health, illness and wellbeing. This essay focuses on my books which communicate embodied knowledge in several ways: through phenomenological writing to give expression to my irritable bowel syndrome and how it impacts on my teaching practice in Reflection on Digestion; through bodily material of Entrail Troyen; through the image of the digestive system in On Innards, Reflection on Digestion, and Entrail Troyen, particularly the concertina form emulating the undulations of the intestines; and through images of found objects that resemble the bowels in Huwawa in the Everyday. (shrink)

This paper addresses the role played by artists’ books in illness and recovery.

Martha A. Hall’s artists’ books documenting her experience of living with breast cancer offer future health professionals a unique opportunity to sit in the patient’s position of vulnerability and fear. Hall’s books have become a cornerstone of our medical humanities pedagogy at the Maine Women Writers Collection because of their emotional directness and their impact on readers. This essay examines the ways that Hall’s call for conversation with healthcare providers is enacted at the University of New England and provides a (...) model for how such works might be used at other educational institutions to encourage empathy between practitioners and patients by engaging in conversations about anger, fear, and other common reactions to life-threatening illness. We explore the unruly nature of Martha A. Hall’s narratives of illness and care, as well as how the form of the books themselves engages the reader in a deep relationship with Hall’s personal pain and her humanity itself. We explore, too, the cumulative effect of these powerful books on readers who handle them regularly, as we do in our roles as professor and archivist. (shrink)

Direct-to-consumer pharmaceutical advertising is pervasive in the United States. Beyond its effect on consumer behavior, DTCPA changes the relationship between individuals and physicians. The author provides a brief history of pharmaceutical advertising in the United States. The author then analyzes the current commonly used marketing techniques of pharmaceutical companies and argues that pharmaceutical companies are “irrational authorities” in Erich Fromm’s sense of the term since they seek to exploit persons. Using concepts from various philosophers from the Continental tradition, with a (...) particular emphasis on the work of Michel Foucault, the author analyzes the power relations involved in DTCPA and ultimately argues that DTCPA subtly undermines the contemporary paradigm of patient autonomy while simultaneously depending upon it by treating health consumers as “dividuals,” that is, as porous entities to be manipulated. (shrink)