My university students are very good at behaving. They say “thank you, Heather,” after every class, write emails with streamlined professionalism, and (almost) always follow instructions. This quarter in my “Medicine in British Popular Culture” seminar course, we’ve committed to loosening that grip on affective constraint. We start class with silly ice-breakers, we welcome deep personal sharing, we let ourselves get what I call “thoughtfully, compassionately, pissed off” about things that matter to us. Still, as a young(ish) female-presenting instructor, it’s hard to shake the impulse to justify my authority with traditional, scripted professional affects: distance, control, restraint. But for the most part, ever since our perforative veneers started to crack, it’s yielded discussions that are surprising, sincere, vibrant, and at least from what I can tell, personally meaningful. This is only possible, of course, after a lot of scaffolding and trust building—and it helps that they’re a small group of 13 students on a Study Abroad in London (they’ve more or less had to form close bonds and intellectual intimacy). With intentional expansion of our own affective horizons, I wanted to think with them about affect in medicine. In Western medical discourse, which affective modes are sanctioned, which are monitored, which are erased? For whom? By whom? And how does affect influence how we perceive medical authority?
Tracing a well-worn path back to the Enlightenment, the idea that medical discourse requires emotional detachment has maintained a persistent, if mythical, status in Western cultural life. Most physicians I know hate this clichéd stereotype but concede that it—or at least the outward performance of it—contours their image of professionalism in the field. A physician has to keep their cool. It makes sense. Starting in dissection lab, medical students are trained to express outward emotion only in specific, designated spaces—the donor honoring ceremony, in-lab respect rituals, outside hobbies, a humanities class (if they’re lucky enough to be offered one)—but not in the clinic, hospital, or classroom; not when they need to convey authority and expertise. Of course, this doesn’t mean that those medical spaces are void of visible affect. Rather, it’s affective modes like active detachment and distanced, calculated empathy that contribute to what we might see as a reassuring authority, a clear-eyed knowledge. And as for the patient, the environment demands they seal off their individual affective biomes to enter into this predetermined ecosystem.
These tamed affects spatialize the medical environment, creating an infrastructure of feeling—what’s appropriate and what’s not appropriate for anyone inside it to express. In a regime of expert disinterest, affect recasts medical tools and instruments as aesthetically sterile metrics extracting unbiased truths; demands a choreography of patient silence that transforms rooms into “waiting” rooms; and shapes the doctor-patient relationship by widening its gap and molding the language patients use like the details they share and the tone they share it with. This isn’t to say that other affects don’t spill and erupt into medical discourse, but those are aberrations, disruptions meant to be quickly erased, concealed, saved for home. If they’re embraced, they’re marked as exceptions—the unexpected investment of a doctor crying with you, an unprecedented display of empathy, disappointment, fear. They’re covered over and diminished by medicine’s highly-monitored even keel. This type of authority-through-affect spatializes its environment with monotone rationalism.
But what would it look like for a vibrant and careening affect like rage to spatialize medical discourse? Or rather, where can rage spatialize and overtake the rationalizing cadence of Western medical science? To think about this question I wanted my students to discuss Susan Stryker’s foundational and controversial 1994 transcribed performance piece, “My Words to Victor Frankenstein Above the Village of Chamounix: Performing Transgender Rage” alongside selected chapters from Mary Shelley’s 1818 Frankenstein (covering Victor’s education, animation of the creature, and his dumping of the female creature’s anatomical tatters into the ocean). In the piece, Stryker allegorizes her own transness with the medicalization and enraged monstrosity of Frankenstein’s creature, drawing a parallel in shared physical constructedness, societal rejection, and ensuing rage against oppression. She embraces this entanglement, reclaiming rage and “monstrosity” as trans values. Her piece has received significant attention and criticism that is outside the scope of this post to discuss; it’s a very historically specific text (my students were quick to pick up on that) and we spent time discussing the piece on its own before thinking about its implications for medical discourse and on our reading of Shelley’s novel. The focus in this post is on the second line of the monologue, that her body “is the product of medical science” (245). What does it mean for this to be her opening move, for her to establish that her body is both emphatically medical and full of rage?
But first, I had a basic question about Frankenstein; is it about medicine? Is the creature the product of medical science? There are ways to easily research a question like this—looking up the status and definition of “medicine” as a discipline in the early nineteenth century, returning to the text to find Victor Frankenstein has no strictly “medical” training or degree (in anything). But my students (and I should have anticipated this), before they could even get to the medical part of the question, delighted in gnawing on what it means for a text to be “about” something. I loved this, but redirected to return to something we asked on day 1 of class; what they themselves consider to be beneath the umbrella of the “medical.” Students drew from that discussion now to answering “is Frankenstein about medicine?”, filling up three columns on the whiteboard: “yes,” “sorta,” and “no.” One of the more compelling ideas to come from this was that the novel is a warning to medical science and so, is about medicine. This is a common take on the text but what was different here was putting it in conversation with our discussion on the expectations of affect in medicine. To what extent, I asked them, could Frankenstein read as a warning against affective attachment and excess in medical discourse? Are zeal (Victor’s) and rage (the creature’s) irreconcilable with medical sciences, with medical bodies?
Now back to Stryker. For her, rage does not negate the status of her body as a medical body. Rage, like language itself, becomes a raw material that trans communities and individuals can “mobiliz[e] into effective political actions” that (re)spatialize the trans body as medical body (244). Stryker begins by emphasizing that her body is a medical “product”: “the transsexual body is an unnatural body. It is the product of medical science” (245). Medical science “produc[ed]” her body and medical discourse actively reproduces violence against it. Medical discourse streams through and defines her body with a composed, ‘rational,’ script: “I live daily,” she writes, “with the consequences of medicine’s definition of my identity” (249). “The [medical] men who made [her] body” also defined it with the performative proclamation, “it’s a boy!” at birth and catalog transness “as an emotional disorder” (249). Because medicine conventionally forecloses or erases the full affective spectrum of human life—only permitting affects that are tamed—it’s no surprise that under the discourse of medicine, Stryker also gets confined to a narrow personhood, “perceived as less than fully human due to the means of my embodiment,” i.e. due, in part, to medicine (245, my emphasis). Might full affective expression be part of what medicine withholds from her? Is there a relationship between medical discourse having limited affective range and the limitations imposed on trans life?
How does having an embodiment created by medical science but also devalued by medical science give her a different purchase on medical discourse? In other words, how might it be different from feeling rage because of medical systems / infrastructure / procedures / inequities, etc.? Why does it matter that she doesn’t entirely ‘other’ or externalize medicine as a force completely outside of herself? Does her identification with the creature rhyme with her identification with medicine, and why does that matter for the affective horizons of medical discourse?
Rather than turning away from medicine entirely in order to assert her claim to personhood, Stryker opens up medical discourse to richer affective possibilities. Her performance could have challenged and diffused the definition of her body as a medical body. She could have focused solely on the constructed nature of all bodies, identities, and discourses—and she does prompt the viewer/listener to consider their own “seams and sutures”—but she holds on to the special medical status of her body, refuses to deny it, and brings rage vibrating into it (247). Stryker validates rage as a force in a different kind of medical body: “rage colors me as it presses in through the pores of my skin, soaking in until it becomes the blood that courses through my beating heart” (249). Rage, alongside and as medicine, (re)anatomizes. Her body is a site for fusing medicine with extreme affect, holding both together at once. Filtering through her pores, rage shapes a medical discourse that exceeds her body, filling the space as a new possibility in the medical environment. Her performance not only reclaims language (“monster”), but also the limitations on the affective discourses of medicine, medical bodies, and the authority to catalog oneself within medical—human—anatomies of rage. What’s possible in and what’s occluded from the medical discourse of a rage anatomy?
In considering rage as a viable affect in medical discourse, it’s necessary to consider whiteness as an enabling privilege. Fueled by tropes assigning violent anger to people of color, and people who are Black in particular, there’s an unequal degree of safety socially sanctioned by whiteness that allows for rage to disrupt medicine’s affective ecologies. Stryker’s whiteness inevitably provides certain affective allowances, certain buffers from violent and institutional retaliation. How do multiple striations of power pull on or give slack to what affective modes are available—or safe?
In a sort of micro-coda to close this post, I’m reminded of an extremely tangential example of rage—highly diluted, commodified, and enabled by privilege—overpowering the authority of “detached” medical data. I’m thinking about all the times Mark Cuban gets mad at entrepreneurs selling a medical product on the reality tv show “Shark Tank.” I know that turning now to a show like “Shark Tank” seems out of place, if not completely inappropriate. Stryker’s rage builds from and against violent systems that devalue, endanger, and destroy trans lives. “Shark Tank” is a group of millionaires sitting around throwing their cash at money-hungry capitalism-doting entrepreneurs. But it’s exactly that discomfort that makes Mark Cuban’s outbursts so representative of the social contracts restricting access to certain types of affect in medical discourse. For him in particular, having highly stylized public displays of authority in medical and health sectors is an important business strategy. In January 2022 he co-founded a pharmacy distribution company, Cost Plus Drugs, categorized as a public benefit corporation with the aim of lowering costs for generic drugs. There’s no doubt his onscreen fighting-for-the-little-guy shade of masculinity and his image as a deeply attached, impassioned, angry defender of the people play a part in promoting the brand’s rhetoric of socially-conscious business.
Without going into too much detail on the show (and its myriad issues like constant profit-mongering, exploitation of euphemistic labor “overseas,” glorification of late capitalism, gilding of the mythic “American Dream,” racialized and gendered discrimination, predatory deals, and humiliation showered on naive entrepreneurs that often borders on bullying), I’m interested in the many times that Mark Cuban uses anger to declare a product is a scam, often before hearing about any research that has gone into it. Here (and only here), it matters less whether or not the science entrepreneurs bring is bogus or whether their advertising is misleading. What’s relevant here is the way that Mark Cuban’s affective cloud overpowers all claims to scientific authority in its path. In examples like the infamous pitch for “Minus Cal” on Episode 1 of Season 11, he laughs at and derides the entrepreneurs, interrupts almost every other shark at least once, raises his voice at everyone, and breaks the fourth wall/aquarium glass to bluntly tell viewers not to buy the product. How do his absurd wealth, whiteness, maleness, vocal veganism, and repeated references to being the “outspoken” owner of the NBA’s Dallas Mavericks (a mascot too on-the-nose here) entangle with—and allow—the power of anger to disrupt and reshape medical and health discourse? And, alternatively, what does Mark Cuban’s rage witnessed by millions each night make possible for the horizons of affect in medical discourse, the opportunities for engaging and attaching in medicine differently?
Works Cited
Susan Stryker. My Words to Victor Frankenstein Above the Village of Chamounix: Performing Transgender Rage. Dec. 2021. EBSCOhost, https://search-ebscohost-com.proxy.uchicago.edu/login.aspx?direct=true&db=edsair&AN=edsair.doi………..265a81106310da0d71967afc810806f9&site=eds-live&scope=site.
“Shark Tank US: Sharks Get Into Heated Argument Over Minus Cal Product.” Season 11, episode 1, Sony Pictures Television, 29 September, 2019. Youtube. https://www.youtube.com/watch?v=pwf1UmbjQho.