Beyond Imperturbability: The Nineteenth-Century Medical Casebook as Affective Genre

summary:

While nineteenth-century regular physicians were expected to project a circumscribed affect in the exercise of their duties, they were not always successful in maintaining this performance. Archival sources, particularly the manuscript casebook for private practice, reveal the slippage between the performance of appropriate affect and the felt, interior emotions of the physician. This essay frames the casebook as an affective genre, building on Gianna Pomata’s concept of epistemic genre. I argue that the nineteenth-century casebook, particularly when compared with the published case narrative, can reveal the disjunction or slippage between the expected performance of affect—that which Osler and others wished to prescribe for medical practitioners—and the felt reality or interiority of the physician. This article proposes the concept of affective genre and then explores its utility through close analysis of the casebook of a single practitioner, Andrew Bowles Holder, and selected examples from the casebooks of his contemporaries.