Surface Tensions: Surgery, Bodily Boundaries, and the Social Self (review)

One question will not go away: how does the mind fit in the body? Though many criticize Descartes for separating the two, somewhat unfairly, they still quote him. In The God Delusion, Dawkins reiterates Paul Bloom’s suggestion that, “the idea that there is a me perched somewhere behind my eyes…is deeply ingrained in me and in every human being” (2007:209). This may be contentious—I escaped that ingraining—but dualism lives.

Recently, there has also been a philosophical backlash against overly cognitive approaches to mind, and self, by phenomenologically informed writers such as Varela (1993), Thompson (2010), Gallagher (2005), Noë (2005), and Clark (2011). For them, the mind is distributed in brain, body, and beyond, since we are always within a physical and, importantly, social environment, and our perception of self is as dependent on others as on our own self. This is beautifully captured in Merleau-Ponty’s aphorism, “I exist in the facial expressions of the other, as they exist in mine.” One way to reveal the truth of this is to go to people with problems or impairments of the body and to ask about their experience. An exploration of their loss, and their—and others’—responses to it, allows for a deep understanding of the importance of embodied experience.

In Surface Tension, Lenore Manderson provides a series of powerful narratives of medical loss, to explore the relations between self and society and its crucial dependence on the integrity of the body. From her sociological perspective, she follows people after amputation, mastectomy, and receipt of renal transplants, exploring her prefaced premise that, “illnesses are identified, interpreted and managed according to particular knowledge and belief systems, material circumstances [and] social institutions and relations. Bodily states, notions of self, and relations of the self to body are socially produced” (12). She begins, incidentally, by briefly outlining the nerve damage to her own left arm, weak for a decade or more after a radial nerve palsy (or a brachial neuritis, or inflammatory problem; she seems to have had treatment for all these).

She mingles individuals’ narratives of loss and reconciliation with her own sociological reflections as she goes beyond the immediate dramas of diagnosis and treatment, to the longer, subtler, more hidden experiences of what happens later as people rebuild their lives. She also relates the ways in which artists have seen and forsee medical improvements. Within their creative perspective, she suggests, lies a reflection of society’s attitudes toward impairment and its new treatments. Importantly, in the first chapter, she states that her interviewees “wanted their stories heard and told” (48). This sentiment is too right. Often there is an attitude that patients should be protected. One ethics committee in the UK refused permission for a project, interviewing people about their experiences of a condition, because they thought that talking about it might distress them.

Manderson begins with Drew Leder who, following Merleau-Ponty, wrote that though experience of the world and of others comes through the body and, in particular, through the sense organs, the body itself is not usually the “thematic object of experience.” The healthy body is taken for granted, and it enters awareness as an object when it goes wrong. Against this rather classical phenomenological view, Manderson cites the examples of yoga and Pilates to show how many people do live with the body as object. But physical impairments are different and often seen by others as a manifestation of the person’s more general disability, so-called leakage, something which has bedevilled people with disabilities for years. Diseases, conditions, and impairments happen to whole people, and affect their whole lives, in large part because of others’ responses to them.

She discusses the increasing uses of new body parts. Hips, cataracts, knees, shoulders, pacemakers, face transplants; the acceptance of more and more replacements is threatening to turn some into cyborgs—an idea taken up in numerous films and novels. Rather than responding to disease, others have...