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)