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Review – The Bloomsbury Handbook to the Medical-Environmental Humanities

In Cancer Vixen, the graphic memoir by Marisa Marchetto, the artist draws a splash page where she depicts herself sitting  on the surface of the earth, looking up at a host of victims on a cloud in space. The victims are explaining to her how their cancers might have been caused by “toxic garbage,” “jet fuel” containing benzene dumped into drinking water, “pesticides,” and “radioactive dust” forming cancer clusters. The depiction of Marchetto  on her artist’s table—facing the cluster of victims with her back to the reader and her pen poised over a sheet of paper—serves an interesting function: namely, it aligns the reader’s vantage point with Marchetto’s, making us witnesses to the testimonies of the dead as they recount their shared state of precarity, touching on themes of health, the environment, and social justice all in one frame. The narrative here talks simultaneously of two different illnesses: that of the body and that of the earth. More importantly, however, is how this narrative shows that these illnesses are porous and reciprocally affect each other.

Considering the growing importance accorded to studies of planetary health and precarity, the Anthropocene, and human-nonhuman relationships and their shared vulnerabilities (especially in the light of the Covid pandemic), The Bloomsbury Handbook to the Medical-Environmental Humanities is a timely contribution to understanding two disciplines that converge in both obvious and nuanced ways. The diversity of texts is exciting not just in terms of the ‘subjects’ of the essays—which include Camus’s work, citizen science blogs, mushrooms, and microbiota vaults—but also for the range of methodological approaches it offers to the study of the Medical and Environmental Humanities. It is clear that all sides of this intersection hope to both learn from and instruct the other disciplines, as is evident in  theoretical paradigms as vast as affect studies, disability studies, ecofeminism, ethnobotany, metabolic poetics, and new materialisms, to name a few. The book is divided into four broad clusters: Econarratology and Narrative Medicine, Environmental Toxicity and Public Health, Entanglement, and Cultural Approaches. This last section in particular is a laudable attempt at including specific cultural traditions that influence perceptions of medicine and the environment, though the specificity of these essays makes them less about conceptualizing common methodologies for approaching the field—which the rest of the volume appreciably carries out—and more about including diverse perspectives.

Some of these essays dwell on clear convergences, such as Sofia Varino’s essay on ecopolitics in autobiographical narratives about Multiple Chemical Imbalance, also called “Environmental Illness,” while others,  such as Eric Morel’s essay on Narrative Knowing and Narrative Practice,  situate themselves in one field and draw from the methods of the other. The handbook begins with a rudimentary understanding of the Medical Humanities as a study of storytelling in medical contexts, exemplified by Charon’s use of the parallel chart in Eric Morel’s essay. The use of such a definition to identify affective categories in Environmental Humanities work and therefore to produce “alternative humanist work” (14) begins the handbook on the right note—that is, by offering a pragmatic method to approach the field. A sole chapter on graphic medicine, already a substantial part of handbooks and readers in the Medical/Health Humanities, is Murali and Venkatesan’s study of Paula Knight’s infertility memoir, The Facts of Life, which appears to suggest a supplementary function to the nurturing of nature, though the authors carefully term it “an alternative to biological motherhood” (48). While the article is prefaced with a comprehensive survey of the representation of disorders in graphic medicine, the article wagers for the established argument that nature is cathartic.

A more nuanced and historically contextualised conceptualization of this argument occurs later in Samantha Walton’s essay on the eco-recovery memoir, which “describes nature as a potent agent capable of influencing mental health outcomes: in effect, changing us, and influencing how we feel, and interact with and within the world” (97). Walton draws out the presence of the ecological self across texts, one that is fully realized when it is completely embedded within a natural space. 

These hints of an emerging posthuman consciousness are also noticeable in “Fungi Umwelt,” a contribution by the experimental performative artist Maria Whiteman. Whiteman draws ontologies and temporalities of being from her experiences going “fungal” (51): exploring the world of mushrooms and how their relationship with other, non-human animals intersects with human health. This is one of few articles in the handbook that calls for better categorization within the volume—it could easily also have found a home in “Entanglements” instead of in “Narrative Medicine,” where it is presently housed.

Several of the essays in the volume feature autoethnography, including the pieces by the editors which conclude the volume in its epilogue, “Our Bodies, Our Minds, Our Planet” . Both Rangarajan and Sarveswaran meditate on prana, broadly construed as breath, exploring “how environmental damage is mapped on the porous human body” (Rangarajan 395). They also draw inspiration from their own journeys: for Rangarajan, from the experience of being the caregiver of her Parkinson’s-afflicted father and from her observations regarding the politics of oxygen during the pandemic;  for Sarveswaran, from what she witnessed about Silicosis in the Thar. Slovic’s own piece traces the book’s origins to the manner in which the pandemic pushed to the forefront the multiple and “mirroring vulnerabilities” (392) of humans and the environment.

It is no surprise then that the pandemic runs through the volume as a major theme. It appears, amongst other places, in Gizem Yilmaz Karahan’s essay, which considers relational ontologies through a study of historical narratives and Mary Shelley’s The Last Man, as well as in Kathryn Yalan Chang’s study of two physician farms through ideas of food security and communities of care, ultimately foregrounding how the pandemic was really a coming together of several catastrophes—a global syndemic.

The major difference between the Bloomsbury Handbook and others that have appeared in recent years—such as the Stephen Herbrechter-edited Palgrave Handbook of Critical Posthumanism (2022), or the 2020 Routledge Handbook to the Medical Humanities edited by Alan Bleakley—is the absence of a section historicizing the emergence of such a confluence, a task which is instead performed within some of the individual essays and, to some extent, in an excellent overview to more recent work.  This makes the “handbook” function better as a topically organized reader, which is to say it seeks to interpret varied texts using different sets of theoretical approaches, than as a handbook, which lays forth the history, methodologies, debates and futures for the reader, defining the field’s parameters. In sum, the volume provides an interesting assortment of essays that shift seamlessly between studying different genres and modes, giving us various ways to consider how the studies of health and the environment are linked.

Works Cited:

Bleakley, Alan, editor. Routledge Handbook of the Medical Humanities, Routledge, 2020.

Marchetto, Marisa Acocella. Cancer Vixen: A True Story. Knopf, 2014.

Slovic, Scott et al. eds, The Bloomsbury Handbook to the Medical-Environmental Humanities, Bloomsbury Academic, 2022.

Image Source: Wellcome Images, “Fairy ring mushroom” by R. Baker, 1896.

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