Medical Humanities, COVID-19, and States of Confinement

Neni Panourgiá //

5 June 2020, peonies.

Medical humanities, an area of inquiry that seeks to bridge the practice of medicine with the conceptual and ethical questions that arise from the contact between medicine and its object, the human being, is inherently interdisciplinary and open to diverse and often disparate approaches to science. Moving across disciplines, lexicons, protocols, and methodologies, medical humanities has carved a space that seeks to provide a safe discursive place for both practitioners and patients.

Before we start considering, however, the methodological and epistemological challenges posed to this new field, it is imperative that we consider the field itself on two of its main parameters: first, on its fundamental epistemic basis; and second, on its stated object.

Medical humanities, as a field of study, is concerned with the challenges and difficulties inherent in the contact among human beings who occupy a number of different subject positions that all appear to be fixed and stable but which, upon closer consideration, reveal their instabilities. These different positions are as much ontological and sociological as they are historico-political, and they all encase a power differential—these positions are, of course, the ones occupied by the different actors who find themselves entangled in such a contact, namely the physicians, other health providers (from nurses to nutritionists), intimates and family members, and, obviously, the patients themselves. Although the encounter is hierarchically scripted (physicians at the very top and intimates at the very bottom) the relationality of these positions is always potentially precarious as it can be upset at any moment, as when physicians find themselves in the position of the patient, with an entirely new horizon of socio-political and historical potentialities. In other words, from the moment that a physician will become a patient s/he engages in a relationship with the attending physicians and healthcare providers on a new plane of interaction. What will not change, however, is what always remains constant, which is of course the ontological position of all actors involved—they are all human beings.

As we all know, however, the definition of the human being is also notoriously slippery, a condition that renders the relationship among all these actors inherently dangerous. What we know as the “human being,” the organic being that exists as a social, political, emotional, and affective logical and dialogical entity conceptualized as apposite to the rest of nature, is being attacked constantly, as much from theory that seeks to stretch and expand its definition to include the mechanical and the millennial, as from ideology that seeks to exclude an ever-growing number of populations, an exclusion that is race-, gender- and class-inflected. Therefore, even when the conceptualization of the “human being” gets elasticized to the point of inclusion of the techno-being (often to the detriment of the human) it still cancels the inclusion of the poor, the migrant, the refugee, the HIV+ sex worker, the black, the indigenous, following a history that has already excluded other “superfluous” and “undesirable” populations—Indians, women, Jews, Africans, slaves, Black and brown bodies, the mentally impaired, the leftists, the deviants.

It is precisely at this point where medical humanities can and should intervene and interrupt. Interrupt both the epistemic and the political monologues that are erected around the notion of the human being by demanding that the interaction and contact between doctors and patients be done not on the level of the “patient” but on the level of the human being, and by challenging the monologues of sovereign power that seek to constantly define and redefine the “human being” according to the political expedience of the time. Put totally bluntly: medical humanities should not be a field unless and until it expands its borders to include not only the medical but, as Franz Fanon told us, also the politico-economic: include the politico-economic subjects that occupy the spaces of refugees and migrants (and the distinction that separates them), of overworked and underpaid workers, of teen pregnancies and eclipsed grandparents, of the new professorial precariat, the tortured and the maimed, the abjected and stripped of their humanity non-normatives, the racialized and gendered subjectivities.

Therefore, the epistemological and methodological questions that arise from the above statements relocate as much as destabilize the expectations regarding what constitutes the field. The primary question is, certainly, the epistemological one—what sorts of knowledges are expected and possible from this field, if we take into account the questions above. What is it that medical humanities is expecting to know, and what is it that it expects to transmit as epistemic knowledge?

The other question is methodological—how is it possible for medical humanities to produce a knowledge that will be useful and usable, unless it engenders an epistemic dialogue between medicine, on one hand, and the humanities and social sciences on the other? Engaging in close readings of literature and history can certainly produce a way of reading and listening, a way of thinking on the possibility of multiple or alternative engagement with notions, concepts, and definitions. But what is direly needed is in-depth, sustained, long-term, and systematic involvement with the populations present in this exchange of medicine with the socio-humanities. An involvement that will include and translate the disparate languages and lexicons to each other and will create the space for the cultural translation of the different positionalities. This is what this exercise during the COVID-19 pandemic is trying to address as it attempts to excavate the social epidemiology of this pandemic within the very specific context of incarceration and post-incarceration in New York.

NOTE: I first presented a portion of this piece at the CHCI conference at King’s College, UCL, in London in 2016. A different version was presented at the inaugural conference on Medical Humanities at Chancellor’s College, University of Malawi, Ζomba, Malawi, 24-27 August 2017. I wish to thank ICLS for the support at both conferences. I want to thank Geraldine Downey, who had the original idea to organize a workshop. I also want to thank Nora Kushner Salita, Tiangchen Lyu, Zachary Owen Miller, and Julia Lesh, the Columbia undergraduate volunteers, and my student Ariana Orozco, who volunteered to do the last round of edits with the participants. I could not have run the workshop without Jeremiah Aviles. M.Lisa Hollingworth’s contribution was invaluable. I want to thank Allen James, currently the Violence Prevention Co-Chief at the Attorney General’s Office in Washington, DC, who came as a guest speaker to the workshop. I also want to thank the Prison Education Program at the JIE Initiative for all the support of the workshop. Lindsey Schram took care of all practical matters. Mia Ruyter, the Education and Outreach Manager for the Heyman Center for Humanities and the Society of Fellows, made much-needed iPad tablets available to the students. It would not have been possible without the steadfast support and encouragement of Eileen Gillooly. Finally, I want to thank Arden Hegele and Rishi Goyal for enthusiastically supporting the idea of a special issue and Danielle Drees for editing.

Image note: Several essays are accompanied by photographs that I took of flowers at Riverside Park in spring 2020. They are meant as temporal transitional points during the time that the workshop took place, from the last day on campus in the fall semester of 2019 to the last day of class in June 2020.

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