There has been increased interest in what the philosophical subdiscipline of phenomenology can contribute to medical humanities due to its dual emphases on practicality and its attempt to understand the experience of others, thus positioning it as a potentially helpful conceptual toolkit to guide clinical care. Using various figures from the phenomenological tradition, most prominently Martin Heidegger and Martin Buber, the authors illuminate relevant philosophical concepts, employ them in various examples, and provide three principles revolving around empathy, communication, and listening (...) to patients’ individual values to guide medical professionals who practice the art of medicine in cancer care settings. (shrink)

Tragedy is a founding theme in disability studies. Critical disability studies have, since their inception, argued that understandings of disability as tragedy obscure the political dimensions of disability and are a barrier facing disabled persons in society. In this paper, we propose an affirmative understanding of tragedy, employing the philosophical works of Nietzsche, Spinoza and Hasana Sharp. Tragedy is not, we argue, something to be opposed by disability politics; we can affirm life within it. To make our case, we look (...) to an ongoing ethnography of two Canadian children’s rehabilitation clinics. Looking to the clinical experience of Canadian boys and young men diagnosed with Duchenne Muscular Dystrophy and those of their families, we show how this affirmative understanding of tragedy allows us to pursue the themes of disability politics within tragedy. Contrary to an optimism that would eschew tragedy at all costs or a pessimistic approach that declines to act in the face of tragic circumstance, we argue that a revised understanding of tragedy allows us to situate the occasionally-tragic clinical experience of disability in a philosophy of life. Both disability and tragedy point us to the shared entanglements that make life what it is. (shrink)

The authors conducted a qualitative analysis of thirty-seven issues of The DDU Review, a newsletter produced by residents of the Dual Diagnosis Unit, a residential unit for people who had diagnoses of developmental disability and serious mental illness in the Central State Hospital. The analysis of the newsletters produced between September 1988 and June 1992 revealed three major themes: 1) the mundane; 2) good behavior; and 3) advocacy. Contrary to the authors’ expectations, the discourse of medicalization—such as relations with physicians, (...) diagnoses, and medications—receive little attention. Instead, the patient-journalists focus on prosaic aspects of institutional life. The patients used their writing as a form self-definition and advocacy. The authors argue that even though it is tempting to consider the patients’ emphasis on good behavior as evidence of institutional control, internalized discipline, and medicalization, a more nuanced interpretation, which focuses on how the patients’ understood their own experiences, is warranted. Researchers must also recognize the ways in which The DDU Review reveals the patient-journalists’ experience of an institutional life that includes non-medical staff, varied social relationships among patients, and negotiated freedoms. (shrink)

Reality TV is immensely popular, and various shows in this media genre involve a storyline of infertility and infertility treatment. Feminists argue that normative and constructed realities about infertility and infertility treatment, like those in reality TV, are central to the emancipation of women. Such realities are able to steer viewers' perceptions of the world. This article examines the emancipatory significance of representations of women on 'infertility reality TV shows'. While the women in these shows all have 'abnormal' qualities, we (...) consider their portrayal as figurations of monstrosity. In the literature, monstrosity is understood as a way to challenge nonemancipatory norms by offering an alternative identity. Through a content analysis of seven reality TV shows, we identified four types of in/fertile monsters: the cyborg, the freak, the abject, and the childless. We show that these monsters are predominantly non-emancipatory as they all involve mechanisms of altering, excluding, or condemning infertility in relation to what is considered normal and acceptable womanhood. Therefore, at the end of this article, we make a plea for more diverse and emancipatory representations of infertile women in popular culture. (shrink)

Culture can broadly be defined as “the values, norms, and assumptions that guide human action”. In contrast with the broader civilian society, the experiences and environments within the military community create a unique cultural subset. The United States armed forces are unified by their primary mission to provide external defense, security, and protection, and each branch shares a unique core set of values and norms. Because this culture is so complex and unique, it can sometimes be a challenge for many (...) civilian professionals to work with this community, so having a strong competency in understanding military culture, as well as knowledge of specific conflicts and wars, one is not only able to begin to understand the lives and personalities of our soldiers but also able to recognize that this culture aids in survival. This paper will demonstrate and discuss the importance of competency in military culture when practicing music therapy or other interdisciplinary approaches within the process of group therapy with veterans. Other topics covered will include: issues of social transmission as it relates to transitioning into civilian society; the importance of being a witness to veterans’ stories; and facilitators’ ethical responsibilities when working with this population. (shrink)

“Toba Tek Singh,” which describes the exchange of mental asylum inmates between India and Pakistan in the wake of partition, was perhaps Saadat Hasan Manto’s most well-known short story. Manto’s work was coloured by his experience of mental illness, including alcohol addiction and possible depressive disorder. This essay attempts to use “Toba Tek Singh” as a lens through which to shine an integrative light on the role of mental illness in Manto’s work and life, by discussing his personal experiences, themes (...) of mental illness in the story, and the implications of his writing in the historical context of post-partition South Asia. (shrink)

“Toba Tek Singh,” which describes the exchange of mental asylum inmates between India and Pakistan in the wake of partition, was perhaps Saadat Hasan Manto’s most well-known short story. Manto’s work was coloured by his experience of mental illness, including alcohol addiction and possible depressive disorder. This essay attempts to use “Toba Tek Singh” as a lens through which to shine an integrative light on the role of mental illness in Manto’s work and life, by discussing his personal experiences, themes (...) of mental illness in the story, and the implications of his writing in the historical context of post-partition South Asia. (shrink)

“Toba Tek Singh,” which describes the exchange of mental asylum inmates between India and Pakistan in the wake of partition, was perhaps Saadat Hasan Manto’s most well-known short story. Manto’s work was coloured by his experience of mental illness, including alcohol addiction and possible depressive disorder. This essay attempts to use “Toba Tek Singh” as a lens through which to shine an integrative light on the role of mental illness in Manto’s work and life, by discussing his personal experiences, themes (...) of mental illness in the story, and the implications of his writing in the historical context of post-partition South Asia. (shrink)

Nineteenth-century psychiatrists ascribed to a model of health that was predicated on the existence of objective and strictly defined laws of nature. The allegedly “natural” rules governing the production of consumption of food, however, were structured by a set of distinctively bourgeois moral values that demonized over-indulgence and intemperance, encouraged self-discipline and productivity, and treated gentility as an index of social worth. Accordingly, the asylum acted not only as a therapeutic instrument but also as a moral machine that was designed (...) to remake lazy, indolent transgressors into useful, “decorous” citizens. Because the theory and mechanics underlying this machine seemed straightforward and self-evident to psychiatrists, they were confounded when the asylum failed to translate its ideals into reality. While psychiatrists tended to blame this failure on the intractable immorality and weakness of individual patients, particularly paupers and immigrants, a review of the various meanings and uses of food in the hospital reveals the fault lines that ran through the asylum’s ideological structure. (shrink)

PurposeMedical humanities is a field which implies collaborative work across disciplines although the degree to which this actually occurs is unknown. Our purpose was to determine the degree of joint work in medical humanities through analysis of authorship and acknowledgements in the two main medical humanities journals.MethodsObservational survey of authorship. We studied authorship data in all papers published in the two major general medical humanities journals between 2009 and 2018.ResultsTwo-thirds of papers had single authors, of whom a majority declared a (...) single disciplinary affiliation. The titles of 60.8% of papers explicitly suggested collaborative content of which 19.9% had multiple authors from more than one discipline ; of the remainder, almost half had a single, single-disciplinary author. One-third of papers referenced one or more people in the acknowledgements. Among papers whose titles suggested humanities or medical content only, authorship lists of 10.2% and 17.9% respectively demonstrated collaborative scholarship.ConclusionsDespite considerable involvement from both humanities and medical practitioners, there is still substantial scope for enhanced emphasis on collaborative seminars and exchanges in the medical humanities and editorial policies to promote transparency of the nature of collaborative work among disciplines. Journal editors and editorial boards should reflect on the opportunity to promote enhanced visibility of joint work in scholarship in the medical humanities through reflection and review of current editorial policies. (shrink)

Since the late 1990s, the use of contralateral prophylactic mastectomy to treat unilateral breast cancer has been on the rise. Over the past two decades, dozens of studies have been conducted in order to understand this trend, which has puzzled and frustrated physicians who find it at odds with efforts to curb the surgical overtreatment of breast cancer, as well as with evidence-based medicine, which has established that the procedure has little oncologic benefit for most patients. Based on the work (...) of Annemarie Mol and John Law, this paper argues that these efforts to understand increased CPM use are limited by the “epistemology problem” in medicine, or, in other words, the tendency to view healthcare controversies and decision making exclusively through the lenses of objective and subjective forms of knowledge. Drawing on public discourse about rationales for choosing CPM, we argue that this surgical trend cannot adequately be understood in terms of what doctors and patients know about breast cancer risk and how CPM affects that risk. In addition, it must be recognized as the outcome of how specific practices of screening, detection, and treatment do or enact the bodies of patients, producing tensions in their lives that cannot be remedied with better or better communicated information. Recognizing the embodied realities of these enactments and their effects on patient decision making, we maintain, is essential for physicians who want to avoid the paternalism that haunts breast cancer treatment in the US. (shrink)

In this article we examine the figure of the doctor in animated debates around public sector medicine in contemporary South Africa. The loss of health professionals from the South African public system is a key contributor to the present healthcare crisis. South African medical schools have revised curricula to engage trainee doctors with a broader set of social concerns, but the disjunctures between training, health systems failures, and a high disease burden call into question whether junior doctors are adequately prepared (...) or whether conditions of care extend beyond medical training. A concern with 'resilience' suggests a correct ethical relation to a putative obligation to provide care in a struggling system. By examining the ways in which trainee doctors are expected to 'cope' with the demands of medical practice, to adopt the correct moral posture in relation to the urgency of care, and to enact a desirable ethical relation to the broader social and political context of medical practice, we examine the picture of humanist concern that animates the subjectivities and techniques of the self called for by this training, and advocate for endurance as an alternative framework for understanding the political and ethical relations between doctors, patients and health systems. (shrink)

In this article I consider the role of passing and performance in the everyday lives of alkaptonuria and vitiligo patients. Race, LGBTQ, gender and disability scholars have long used the term passing to describe sub-groups of people within marginal populations who intentionally manipulate their bodies or alter their behaviour in order to claim identities that are not socially assigned to them at birth. In this paper I demonstrate the effectiveness of the passing strategies that patients use in order to mitigate (...) their disease symptoms and render them invisible, thus enabling them to pass as “healthy” or unaffected by their condition. I further consider how patients who choose not to pass utilise resistance strategies in order to generate awareness of their disease and encourage funding for it. I conclude by assessing the effectiveness of these strategies in determining whether or not patients can pass, and the ways in which this is aided or hindered by their social and economic status. (shrink)

In this article I consider the role of passing and performance in the everyday lives of alkaptonuria and vitiligo patients. Race, LGBTQ, gender and disability scholars have long used the term passing to describe sub-groups of people within marginal populations who intentionally manipulate their bodies or alter their behaviour in order to claim identities that are not socially assigned to them at birth. In this paper I demonstrate the effectiveness of the passing strategies that patients use in order to mitigate (...) their disease symptoms and render them invisible, thus enabling them to pass as “healthy” or unaffected by their condition. I further consider how patients who choose not to pass utilise resistance strategies in order to generate awareness of their disease and encourage funding for it. I conclude by assessing the effectiveness of these strategies in determining whether or not patients can pass, and the ways in which this is aided or hindered by their social and economic status. (shrink)

This essay applies Henri Lefebvre’s notion of the production of space, particularly his conceptualization of the tension formed by the perceived-conceived-lived triad to analyze how space is produced in wartime hospitals as demonstrated in Richard Selzer’s “The Whistlers’ Room.” Wounded soldiers participate in producing the triad of the social space of military hospitals through their multilayered performances as fighting soldiers serving the nation and as living human beings longing for human connections. Contradictory performances demonstrate the strategic positioning of wounded soldiers (...) as active producers of different social spaces. By representing the lived spaces produced by wounded soldiers, Selzer challenges the hegemonic representations of the conceived spaces of military hospitals. Selzer’s exploration of soldiers’ contradictory performances opens up opportunities for discussion of writing physicians who assume a similar role by positioning themselves strategically within the medical institution. (shrink)

Comics has always had a critical engagement with socio-political and cultural issues and hence evolved into a medium with a subversive power to challenge the status quo. Staying true to the criticality of the medium, graphic medicine critiques the exploitative and unethical practices in the field of healthcare, thereby creating a critical consciousness in the reader. In close reading select graphic pathographies such as Gabby Schulz's Sick, Emily Steinberg's Broken Eggs, Ellen Forney's Marbles: Mania, Depression, Michelangelo & Me and Marisa (...) Marchetto's Cancer Vixen, the present article delineates how graphic medicine interrogates the larger than life forces in the field of healthcare. Drawing specific instances from the aforementioned graphic texts, the essay demonstrates that graphic medicine scrutinizes the political economy of health under capitalism. In so doing, the article illustrates how the pharmaceutical corporations, insurance companies, medical technology, and healthcare corporations marketize and commoditize health in the neoliberal era. Finally, the article attempts to theorize how graphic pathographies, mediating subjective experiences, generate a new critical literacy through the conflation of the personal and the political in the verbovisual medium of comics. (shrink)

Direct-to-consumer television advertisements for Lyrica in the United States create narratives of gendered domestic normalcy to which women with fibromyalgia are encouraged to aspire through pharmaceutical intervention. This paper unpacks images and narratives within these advertisements to demonstrate that they rely on metaphors that represent gendered expectations in order to evoke guilt and provoke a desire for what Joseph Dumit calls “health as risk reduction,” and what I argue is an attempt to show disability being erased. Following Stuart Hall’s Encoding/Decoding (...) model of communication, viewers play a role in constructing societal expectations for women with chronic pain and for themselves. (shrink)

A number of studies show that when doctors become ill, there is often ambiguity in the division of roles and responsibilities in the medical encounter. Yet little is known about how the dilemma of the sick doctor has changed over time. This article explores the experience of illness among physicians by applying an historical, narratological approach to three doctor’s narratives about personal cases of cardiac disease: Max Pinner’s from the 1940s, Robert Seaver’s from the 1980s, and John Mulligan’s from 2015. (...) Drawing on Erving Goffman’s principles of social interaction, I argue that part of the challenge in the analysed narratives is because when doctors seek medical attention for themselves, the ensuing medical ‘drama’ suffers. I compare the three narratives to argue that the experience of becoming a patient while simultaneously remaining a doctor is a challenge that has changed over time. In Pinner’s narrative, the patient identity is both undesirable and inaccessible; in Seaver’s, role ambivalence between doctor and patient is the most salient feature; for Mulligan, his personal rather than professional experience of illness is the overarching theme of the narrative. Finally, I suggest that an awareness of how the medical drama often changes when doctors are patients might prove beneficial both for the doctor-patients and providers of medical care. (shrink)