0.3.1: The Structure of this Dissertation

This dissertation is composed of four chapters, broken into couplets based on subject matter. The first two chapters interrogate the history of tuberculosis, the visual cultures around the disease after Robert Koch’s microbial arguments, and the use of specimens in normal science research into tuberculosis.¹ The second two chapters reflect on the methods I employed to make those claims. This dissertation is primarily a methods project: I am most interested in thinking through the problems of existing media studies approaches and trying to provide different methods and frameworks for future scholarship. This said, I wanted to include some more concrete case studies to help work through the concept of the specimen and how it is employed in medical knowledge work.

I have constructed the dissertation as a pair of couplets: the first couplet—chapters one and two—show the results of the methodologies for which I argue. They also, importantly, are presented in such a way as to show their limitations. This project is interested in the ethical problems that arise when working in the history of medicine, and rather than shying away or hiding my own messy, unethical work I have chosen to instead show it directly. I often write in this dissertation that I am a hypocrite, and that my arguments are fraught, imperfect, and messy (2.4.3; 3.4.1; 3.4.2). This is a tactical decision, because I want to show how even conscientious work is often at odds because of how it has to address problems at different scales (4.3.5).² I also wanted to have some evidence in the form of case studies for readers to be able to reflect on when reading the second couplet—chapters three and four—so that they may be able to see the ethical limitations of the first chapter couplet’s case studies. I have ordered these chapters as such, so as to emphasize that there could be no ethical interventions without having first gotten my hands dirty in the history of tuberculosis.

Chapters one and two address tuberculosis’ visual culture. A study in the various technologies, practices and ideologies which guide visual understanding in biomedical practices,³ these chapters look to how patients and their bodies are framed in the primary literature (1.1.2; 2.1.2). Chapter one looks to the non-scientific ways tuberculosis, patients with tuberculosis, and sanatoria were seen at the turn of the twentieth century. This chapter serves to set the table for the historical and ideological frameworks in which tuberculosis was enmeshed. Looking at three case studies—of the sanatoria movement, hygienic approaches to the disease, and the framing of medical professionals—it teases out the capitalistic, eugenicist, ableist and classist ideas which were discussed around tuberculosis. I think about the wider visual cultures around tuberculosis which are not addressed by Michel Foucault’s {#D-507}clinical gaze</b></span> (1.1.2; 2.2.2).⁴ The concepts around tuberculosis and those who suffered from the disease were defined by a broader network of volunteers, public health officials, and, of course, doctors. These were also developing alongside a growing biomedical community in the United States, the influx of public and private funds, and American medicine’s burgeoning international acclaim. I show how biomedical epistemics are interlinked with these broader programs’ ideological assumptions.

Chapter two builds upon this work to examine the specimen in detail. Built around two case studies, I look at Robert Koch’s bacteriological research to concretize my thinking around the specimen, before addressing human wet tissue specimens used in tuberculosis research. Koch’s work presents a helpful framework to reconsider how media studies can examine scientific representations, as well as framing the broader scientific discourses around tuberculosis in the period of interest. Following this examination, I turn to wet specimens, as they appear in the tuberculosis corpus. This case study thinks through a patient’s clinical history. This examination lets me ask about how specimens become anonymous and in what ways a patient’s medical history is significant for medical knowledge work. I think through how the object of the specimen requires a certain ahistoricity, while also demanding a specific detailed past for it to be leveraged for scientific claims. By examining this fraught linkage, with the help of Indigenous, new materialist, and death studies frameworks, I argue for the continuity between the patient and the wet tissue specimen which was taken from their body.

This second case study works to bridge my main intervention: specimens were always people once, and as scholars we are obligated to care, respect, and tend to them. The next two chapters trace my thinking to get to these conclusions, by looking at two different analytical and practical methods.

Chapter three frames arts-based research as an exploratory and speculative method to think through the practical, ethical, and conceptual problems which can emerge early in a research project. Looking at two video installations and a photo essay, this chapter traces my thinking in each phase of the dissertation’s research, showing both a narrowing of subject matter and a slowly developing approach to the opaque (5.1.4). In showing my work—taken from grant proposals, written documents accompanying the installations, and the installations themselves—I describe how the ethical problems in the history of medicine became so central in this dissertation, showing different, evolving approaches to how to display, describe, and engage with medicine’s often horrific primary materials. In working through these cases, I describe how creative approaches can be especially useful in early stages of scholarly research. Moreover, I think about the affordances of creative methods in ways that do not think of them as being essentially better than other analytical or scholarly approaches.

Chapter four follows chapter’s three’s interest in arts-based research to think more broadly about practice-based research employed by the digital humanities. Where the third chapter presents research en media res—or as it happened in the process of doing research—the fourth chapter shows the final results of these methodological and ethical concerns, presenting a framework which thinks through the slippery, violent problems of working in the history of medicine. This chapter shows how the critical digital humanities—a field that uses digital methods as an avenue to critiqueideological presumptions encoded into digital platforms and tools—can benefit from modes of refusal argued for by Indigenous and postcolonial scholars (4.1.2). This chapter engages with the ways refusal can be used as a method to address the broader ethical problem of continued extraction and exploitation by medical scientists, historians of medicine, and myself (0.2.2; 4.2.3; 4.2.4). More than theorizing on this problem, the chapter presents how an opaque ethics can be applied to future scholarship (4.3.5).

The last two chapters in this dissertation reveal how an iterative research method can function in humanistic research. These two chapters reflect on the various methods and approaches I took during my research. Where the first two chapters show what kind of research I was able to enact over the course of the dissertation, the latter two show how much my thinking shifted the longer I worked with materials in the history of medicine. The various methods I applied, from the creation of corpus and visual data set (X.1.1; X.1.3), to exploration through arts-based research, to the literal application of the opaque, changed my understanding of tuberculosis, the doctors who worked on the disease, and the systems that produced scientific research. Each chapter should be seen as a permutation, which evolves over the course of the dissertation. As everyone who has written a long document such as this is already aware of, every chapter and every section touches on and is influenced by every other. While there is an intentional structure at play, I encourage readers to follow the interlinking hyperlinks as they wish. Sometimes, as with the chapters on visual culture, I will have touched on a concept multiple times (1.1.2; 2.2.2). Other times, I will mention a concept off-hand, providing the section in which I described this concept in more detail. In providing the links, my hope is to guide readers to different places in the dissertation that may help make the concept clearer, or give additional context as to my argument. This dissertation can be read in sequence or explored non-linearly. A linear approach shows a succession of logic which is built for readers who are more comfortable with book-style projects; the non-linear, by contrast, affords for readers a means to follow the arguments that speak most to them.