- Response to Section III:Dis-embodiment
This trio of essays treats the reader to three seemingly distinct yet fundamentally complementary visions of how to think about human health and disease. Stephen Rachman tells us about the tightly bounded (both geographically and conceptually) worlds of the Cantonese artist Lam Qua and the American medical missionary Peter Parker in early nineteenth-century Canton. Robert Goler unpacks the imagined world of "The Case of George Dedlow," a quadruple amputee from the American War between the States who was created in 1866 by the young (and soon to be famous) Philadelphia physician S. Weir Mitchell. David Kirby critiques how the 1997 science fiction movie Gattaca addresses contemporary ideas about eugenics, race, and society in a futuristic world where a person of any skin color or racial/ethnic background can get a good job, as long as he or she has the right genetic makeup.
These three essays carry us from distant past to distant future, from worlds of distorted and absent body parts to worlds of idealized and perfect body parts. Each world utilizes the latest and best science and technology of the day to create and track the illusion of progress or perfection. Although distant in time and space, these worlds were created with the facade of verisimilitude that masks the fact that they do not exist outside of the creator's mind. In their critiques of these worlds, all three essays remind us of the power of art to re-create beauty as well as to make us cringe from the horror of unspeakable wounds. They allow the reader to witness vicariously the medical messiness of these unpleasant, disordered worlds and force us to reexamine our notion of archetype.
I will focus on how these essays deal with the tension between generalizability and specificity, on the one hand, and theory and practice, on the other, on how they reflect the tension between lofty ideals and the inherent messiness of life, of medicine, and of health [End Page 201] care. Health-care workers today are acutely aware of the metaphorical and literal messiness of the medical world, that variability is part of physicians' professional socialization. Each year I teach a class in law and medicine to law and medical students. Far more important than the differences in content and knowledge that the students of these two professions bring to the class is the difference in their approach. For example, when faced with a dilemma such as "How should we manage treatment at the end of life?" law students are prone to give theoretically rich yet practically unusable answers. After considerable reading and contemplation, they often produce a simple answer: "When medical therapy is futile, you should stop." They then close their hands and sit back, confident that they have produced an effective solution for the problem at hand. Medical students, on the other hand, having drunk deeply from the well of individuality, have come to expect and to revel in medical messiness, and, despite a solid grounding in any number of relevant disciplines, if asked to describe their general approach to a patient will often say quite sincerely, "There is no general approach. Each patient is unique." Indeed so, but if a physician (or a physician-in-training) truly started at first principles each time she or he entered the examining room, each encounter would take a long, long time! That tension between the theoretical and the applied, the archetypal model and the infinitely variable person, the tidy ideal and the messy reality of human existence is part of the underlying theme for each of the essays in this section.
Lam Qua's dramatic paintings of Parker's patients give us the possibility of idealized perfection, portraying figures who will never succumb to their disease; they are frozen in time and space. Yet at the same time he was making these medical images, Qua was producing vast quantities of standardized images in a factory-like system. That he participated in such mass production was used as evidence that he was not a true "artist" in the fanciful, idealized sense. By being able to produce repetitive images for sale, Qua both...