“The knowledge of a disease is a doctors compass; the success of the cure depends on an exact knowledge of the disease; the doctors gaze is directed initially not towards that concrete body, the visible whole, that positive plentitude that faces him- the patient- but towards intervals in nature- like negatives- the signs which differentiate one disease from another, the true from the false, the legitimate from the bastard, the malign from the benign.” Michele Foucault, The Birth of the Clinic.
In the medical tradition of the eighteenth century, illness was defined in terms of ‘symptoms’ and ‘signs’. These were determined from one another by their semantic value. The symptom is the form in which the illness presents, all are that is visible- a cough, fever, a rash, they allow the invisibility of illness to ‘show through’. The sign on the other hand ‘announces’. The sign performs the illness: The prognostic sign: what will happen, and the diagnostic sign: what is happening now. Between it and the disease is the doctor’s interpretation of a patient’s narrative and symptoms. Medicine produces historical knowledge of the body. Medical ‘gaze’ as Foucault names it is like a magnifying glass, which when amplified to one part, has the potential to call into question that which one might not otherwise perceive and simultaneously has the power to only magnify what it deems important. During a medical interview, we are conditioned to respond to only the questions that the Doctor asks us, nothing more. So conditioned, that the answers becomes the story that we tell. The patient becomes the portrait of whatever the doctor diagnoses. We frame the history of our illness in clinical terms, the chronology of events in or on the body, rarely delving into physical feelings or emotional connection to and awareness of the body.
What happens to the history of the body that does not go into the charts? Does the person who has never seen a doctor not have a health history? In the framing of the body in medicine, the paper of a chart is more of an archive than the body itself. There may well be agency then in the un-narrated history of the body. The history that does not show up in charts, but is narrated through a repertoire of physical embodiment and the performance of ‘self’, as either a healthy or sick person.
Think about it. Is your health 'history' a portrait of your health or a portrait if your body in dis-ease? Is viewing the body through a series of rupture the best approach for comprehensive medicine?
More on the inadequacy of language to express of pain later....
