Benjamin Gagnon Chainey //
As part of the latest CHCI Alliance Medical Humanities Summer School, held last June at the Columbia Global Center in Paris, I presented a paper entitled “Towards a transhistorical medico-literary deconstruction of empathy,” where I conducted a comparative analysis of the bodily, linguistic and epistemological tensions between the concept of “experience” of three major figures of the French history of medicine and literature. When the panel came to a conclusion, someone asked me a question and pointed out that my approach was perhaps not transhistorical, but rather plainly historical. Indeed, I was not suggesting that one concept or another unwaveringly cruised through time. My starting point, which consisted of putting in tension authors from the 19th and the 20th centuries, was historical in its aim of comparing their distinctive way of intertwining the experimental methods of literature and medicine, to reflect on the modulations of “empathy” as an ambivalent relation to the Other. I realized, following this important question, that I need to dig in it further and to reflect on my conception of history.
In this post, I will first synthesize my argument, namely that a diachronic intertwining of, on one hand, 19th century’s Claude Bernard’s “experimental medicine” and Émile Zola’s Experimental Novel, with on the other hand 20th century’s Hervé Guibert’s AIDS “total embodied creation,” can help us realize that “empathy” is more than the overused buzzword contemporary medical critics turned it into. In a second movement, I will articulate my general thoughts regarding the critical path I intend this part of my research to take, and identify what I gained from the feedback I received during the Summer School.
The diachronic experimental echoes between Claude Bernard, Émile Zola and Hervé Guibert
Commonly called by historians the “Century of the Scientists,” the French 19th century witnessed the development of “experimental medicine,” propelled by the research of renowned French physiologist Claude Bernard. This scientific turn in the medical methodological path stripped medical practice from its ancient theoretical, philosophical and theological traditions to align it on the methodological trajectory of the “pure sciences,” such as physics and chemistry. Medical knowledge, therefore, was no longer a traditional art anchored in a bookish, subjective and abstract apprehension of reality. It became an experimental praxis founded on the observation of objective facts—a method that is still dominant in our contemporary hospitals and medical schools under the term of “evidence-based practice.”
In a way, Claude Bernard even foretold that “experimental medicine” would become the only legitimate and relevant path for the linear progress of medicine toward finding successful cures, in the 20th and 21st centuries. In fact, Claude Bernard wrote this prediction like a universal oracle in the first pages of his seminal Introduction to the Study of Experimental Medicine, published in 1865:
It is thus obvious even to uninformed minds that medicine walks towards its definite scientific path. Solely through the natural process of its evolution, it progressively leaves the area of systems to adorn an analytical form and, in doing so, gradually adopts the investigation method common to experimental sciences.
For Bernard, even the most ignorant person in 19th century France was in the position to admit the obvious: that medicine would definitely leave its abstract form, cultural subjectivity and artistic identity, which was built on a humanistic mind and certainly not based on real and true Nature. This positivistic and “definite scientific path” would ineluctably propel medical practice to new scientific heights, gradually and simultaneously “de-humanizing” the caring doctors and suffering patients “for good”.
Paradoxically, while striving to experiment the true and real side of Nature, medico-scientists of the time ironically forgot—or stopped feeling?—that the “Human” is not a contradiction to “Nature” nor “History.” Human nor Nature should never be apprehended in the dangerous illusion of a linear conception of historical progress, as the “medico-scientific” horrors perpetrated during World War II teach us. History is never totally history; it always resonates from untimely echoes, which need to be considered as we draw the complete portrait of human nature, moving through time and space. I feel it is an autotelic illusion to pretend we can strip the sciences, medicine and history from their human anachronical subjectivity, even if they strive to stabilize their knowledge of the human body and mind thanks to “evidence-based practice.”
Although I strongly believe in the crucial importance of tangible evidence, as an active clinician at a rehabilitation hospital, I think we need not epistemologically and historically allude that there is no evidence without its part of doubt, as infinitesimal as it may be. The key word of “evidence-based practice” should not be “evidence,” but “based”: we may start from evidence, but maybe to better deconstruct and therefore understand and nuance the “facts” it claims to unproblematically present.
The tensions between objectivity and subjectivity raise the complex question of interdisciplinarity and of the porosity of frontiers between each field of expertise. It is not a disavowal of the legitimacy of one field by another, as some overly dialectical critics insensitively tend to schematize. In that sense, even if Claude Bernard advocates for a medicine devoid of subjectivity and intuitive, emotive abstraction, he is not insensitive to what overflows science, both in nature, culture and history. A biographical fact of interest to us is that Claude Bernard, of whom collective memory seems to only have registered his medico-scientific legacy, “first thought dedicating himself to theater” (Sournia 211). Before becoming a prominent physician, Claude Bernard was a man of letters, and perhaps his literary and theatrical sensitivity contributed to making his want of scientific objectivity less of an utter disavowal of what goes beyond medical science. Instead, he adopted a posture of humility with respect to the epistemological limits of medicine:
Claude Bernard always establishes a clear distinction between what belongs to science and what is foreign to it: “Science does not have as an object to either prove or disprove God, it is independent from that question. The materialism that states that there is nothing beyond matter is outside of science.” (Sournia 211)
The interdisciplinary tensions on the perspective are not new either. As an example, the influence of the “experimental method” grew stronger during the second half of the 19th century, and overflowed the borders of medicine to contaminate, among other spheres, the world of literature at the time, where the method had its lot of both praise and critics. In particular, French naturalist writer Émile Zola, known for his monumental fresco “Les Rougon-Macquart,” wanted to literally apply, as he exposed in his Experimental Novel (1893), Claude Bernard’s experimental medicine method to creative writing. Émile Zola’s Experimental Novel indeed strives to elevate Bernard’s experimental medicine methodology to the art of the novel. For Zola, there is no doubt: literary creation not only has the power, but also the duty, to become medico-scientific research in full right, expressing the essential epistemological oscillation between medical science and literary art through time : “Since medicine, which used to be an art, becomes a science, why wouldn’t literature itself also become a science, thanks to the experimental method?”
For Zola, echoing Bernard, true scientific rigor is never exempt from artistic trial and error, or any discovery is only achieved at the price of hesitation and doubt, and it is always but the symptom of all that remains to be discovered in the future. Any piece of knowledge, as objective and self-evident as it may be, opens in its margin a part of Unknown, and it is precisely that territory—the unruly Unknown—that Zola would want literature to audaciously take over, guided by “experimental novelists.”
[We must] build on the land conquered by science, until the end of it; after that, and only there, facing the unknown, exercise our intuition and get ahead of science, at the risk of being mistaken at times, happy if we can bring document to solve problems. […] There is there a noble part to play [as pioneers], and writers have the duty to fulfill it. […] It is not about, I repeat once again, creating from scratch a science of man, as an individual and as a social member; it’s about getting out, little by little, and with all necessary precaution, from the darkness where we find ourselves enclosed, happy when, amidst so many mistakes, we can affix some truth. We experiment, this means that we must, still for a long time, use falsehood to reach truth. That is the sentiment of the strong (Zola 95).
This pioneering conception of literature as a motor of knowledge creation, building on the ground claimed by other disciplines that arrogate scientific and historical facts, also resonates a century later, in the work of Hervé Guibert, a French multidisciplinary author who died HIV+ in 1991, at the apex of the Western AIDS pandemic. Well before his seropositivity, Guibert had great interest for embodied experience/performance, an interest that was almost prophetic of his future illness and of the auto-pathographic project that would consume him more than a decade later. In 1977, Guibert erected his own body as a material to be labored, like a foreign body from which emerged the ‘how’ of beauty and the occult power of its brutality, and perhaps even some hidden meaning, secrets spurring from the end of time:
My body, under the effect of either pleasure or pain, is put in a state of theatricality, of paroxysm, that I would like to reproduce in some way: photography, film, tape recording. As soon as a deformation occurs, as soon as my body is hysterical, I would put in place a transcription mechanism: […] My body is a laboratory that I exhibit, the only actor, the only instrument of my organic delirium. Partitions on a fabric of flesh, of insanity, of pain. Observe how it works, collect its performances.
Through the shift from creative writing to embodied experience, what is at stake is opening up literature’s body to its scientific self, but also to its dissemination in time, as Guibert feels his death approach:
A rotation took place, an accelerated gyrating movement, which pressed me like a centrifuge ride at the fair, and grinded my limbs in a blender. It brings me closer to Suzanne, who is herself ninety-five years old, it would be like a spell she cast on me so that we could still love each other despite the sixty years that separate us, and the stall point of friendship caused by impotency and mental failure. Now we can again understand each other and communicate. We are also the same in our bodies and our thoughts, in the experience of old age. We have finally become husband and wife.
For Guibert, illness is not only the suffering of the body, it is the suffering of linear history. “AIDS made me take a journey through time,” he wrote, as if as death approaches, only literature had the power to make sense of the untimely pain, which a chronological apprehension of history is incapable of grasping (Le protocole, p. 130). As Guibert’s case illustrates, sciences and history should always serve human nature and not the other way around: therefore, he creates while “[a]rmed with an ophthalmologist’s lens, a play of microscopic mirrors, science at the service of erotism, stroboscoping distended flesh.” Beyond any pretention to historical and scientific objectivity, Guibert’s embodied experience of disease teaches us that a desire for knowledge and creation is, first and foremost, a Desire: a human pulsion, in every senses and directions a pulsion can move, towards the Other as a body, a word, a mind, a piece of time or knowledge. A desire that indeed can never be fully satiated.
Decontextualizing medico-literary history to better potentialize the anachronical (re)creation of knowledge
If the ethical and epistemological goals of medicine, history and literature may differ, as far that their relation to truth and objectivity is concerned, their investigation objects and subjects, for their part, are rigorously the same: the human body and mind. A century before Guibert’s first AIDS writings, Zola drew to our attention:
We must note that everything hangs together, that if the field of the experimental physician is the body of [human] in its organ’s phenomena, at the normal and pathological states, our field, for our part, is also the body of [human] in its cerebral and sensual phenomena, in the sane and morbid states. […] We fatally continue, I repeat, the work of the physiologist and that of the physician, who continue that of the physicist and the chemist. From that moment, we enter into science (Zola)
As I move forward my literature research and my clinical practice, I start to feel that my interest is not the stabilization of historical facts—which I recognize are important in other types of investigations—but the anachronical echoes that resonate between them. I don’t believe in an essentialist conception of historical truth and progress, and even less so in the assumption that everyone is de facto living, talking, reading and creating from their so-called present. The present time is an illusion to be creatively deconstructed by literature, thanks to an anachronical approach to History, anchored into the creative deployment of meanings and knowledge between time periods. In that sense, literature is a powerful engine that may help shake up the apparent stability of historical facts, not by judging whether they are true or false—a vain purpose for literary critics in my opinion—but rather by apprehending the epistemological potential that creative writing can deploy in our relation to the past, present and future.
Literature is not a fixed time-space, happening at a precise calendar date. There is no privilege to be granted to the present in which a book gets published. Historical approaches to the humanities should be aware of that: Literature is not History, and Literature does not bow to the authority of chronology. As soon as it is born, it lives in its own anachronical relations with time, space, bodies, languages and History. One thing needs to be clarified before I end this post: the idea that literature is free from the constraints of chronology is not to be read as a plea against historical methodologies. Rather, it is an invitation to reflect, perhaps along the lines of the questions my talk raised in Paris, on the dialogue—or the mutual ventriloquism—that needs to sparkle between historical facts and literary/artistic creation. Such a dialogue would involve constantly moving meanings, never to be fixated in their “own” time period. Literature, then, is not merely a reconstruction of History, but a creative engine to destabilize and invent from and beyond its linear and chronological ineluctability.
 Roughly translated from French expression “Siècle des Savants” [savants = knowledgeable people] which shows how language embeds the usual adequation of “science” and “knowledge”.
 Claude Bernard. (1865). Introduction à l’étude de la médecine expérimentale. Paris: Baillière. Available at http://archive.org/details/introductionalt00berngoog, p. 6.
 In which the reader can find such masterpieces as Germinal (1894) and The Human Beast (1890).
 Émile Zola. (1880/2006). Le Roman expérimental. Paris: Éditions Flammarion. p. 95.
 Hervé Guibert. (1977/ 2009). La mort propagande. Paris : Gallimard. p. 7-9.
 Ibid. p. 16.