Foucault was a French philosopher known for his interrogation of knowledge and structures of power. In Birth of the Clinic (1973) he described how the medical gaze arose from 18th-century dissection, which exposed ‘what for centuries had remained below the threshold of the visible and expressible’ developing further through 19th-century pathological anatomy, which reduced the body to assorted organs and tissues.
it therefore goes beyond what it sees; it is not misled by the immediate forms of the sensible, for it knows how to traverse them; it is essentially demystifying.
Foucault demonstrates how the medical gaze shapes the clinical encounter by assuming the patient as the object of the gaze while knowledge rests with the doctor, a hierarchy of power which continues to the present day.
In medical education, visual artefacts, including anatomy drawings, medical photographs and artworks depicting illness or disability, are often used in a way that reinforces the medical gaze.
Fiona Johnstone’s definition of a visual medical humanities emphasises vision as an embodied sense with an affective quality. In her Manifesto for a Visual Medical Humanities Johnstone states:
A visual medical humanities embraces ambiguity. A visual artefact – be that image, object, or an entirely different category of item – can facilitate the suspension of certainty and function as a site for productive doubt. This ambiguity is often particularly evident in the case of the art object.
Through art objects that represent the artist’s own disability or illness – visual autopathographies – we begin to explore art in a way that ‘embraces ambiguity’ (Johnstone) and allows for deflection or interrogation of the medical gaze. Couser has hailed the rise in written autopathographies as ‘a sign of cultural health – an acknowledgement and an exploration of our condition as embodied selves.’ In the work of three artists: Alina Szapocnikow (1926-1973), Anjum Singh (1967-2020) and Dolly Sen (1970–), who explore their embodied experience of illness through art, we find reversals, disruptions and challenges to the prevailing medical gaze.
Alina Szapocznikow’s work uses industrial materials, such as polyester resin and glass wool. Tumors Personified is an autobiographical work, created after she was diagnosed with breast cancer in 1969. It consists of amorphous resin shapes, crushed and compressed, upon which the cast of her own face is visible. The tumors lie on a bed of gravel as if extracted from the earth.
Szapocznikow reverses the medical gaze; her own sculpted face stares back at us from these scattered and abject fragments or ‘objets maladroit’ as she described them in her own words. We see her image stamped on each one; they are her creation. Attempts to ‘medicalise’ our gaze, to reduce these disorderly objects to tissue or clumps of cells, are deflected by their personification as the artist and maker.
Anjum Singh’s sculptures and paintings reflect the entanglement of bodies with urban cities and environmental pollution, often related to Delhi, where she made her home. After her cancer diagnosis, her work, always brightly coloured and organic in form, began to reflect her illness. Her backdrops of saturated reds and pinks contain nucleated cellular forms, reminiscent of microscopic views of a tissue biopsy, overlaid with images of the anatomical heart, scalpels, suture lines and machine parts.
Singh appropriates these symbols for her own purposes, playfully juxtaposing text from her own medical records. If the medical gaze ‘demystifies’ Singh’s artist’s gaze re-enchants and reimagines her illness.
Dolly Sen is a writer, artist, performer and activist whose work employs humour and subversion to undercut the power dynamics inherent in the psychiatric gaze. Arising from their own experiences of poor mental health, Sen’s work has included a spoof ‘Trip Advisor’ review of psychiatric inpatient facilities and their own ‘DSM 69’ or Dolly Sen’s Manual of Psychiatric Disorder as a creative response to the standard classification of mental disorders used by professionals, The Diagnostic and Statistical Manual of Mental Disorders. As Sen states:
I called it ‘DSM 69’ as a send-up of the DSM (Diagnostic and Statistical Manual) but also showing by subverting or parodying the form you can then change the position of power to show how disturbing and fundamentally flawed psychiatric authority can be.
Within its pages, Sen interrogates the standard risk assessment performed on admission to point out that psychiatric inpatients are routinely ‘at risk’ of a loss of freedom, violent physical restraint and the unwanted side effects of medication. Sen goes on to say:
When I present this to some professionals, a light switch goes on. They comprehend where I – and so many others – are coming from.
Sen’s work satirises the apparently benevolent practice of psychiatry by questioning the boundaries drawn between madness and sanity and the resulting legal and political ramifications, thus subverting the psychiatric gaze.
Since Foucault wrote The Birth of the Clinic, the medical gaze has embraced new imaging and pathology techniques as well as machine learning. The authority granted by pathological anatomy, which Foucault described as a ‘recasting at the level of epistemic knowledge itself’, has extended the medical gaze further.
In viewing these artists’ visual autopathographies we are given the opportunity to employ a different gaze from the medical. Through their works, we can attempt a deeper understanding of the destabilising, phenomenological experience of illness.
Fiona Johnstone, Manifesto for a Visual Medical Humanities (2018),
G. Thomas Couser (1991) Autopathography: Women, Illness, and Lifewriting, a/b: Auto/Biography Studies, 6:1, 65-75
Michel Foucault. The Birth Of The Clinic (1973) (London, Routledge, eBook, 2003)