1.1.2: Medicine's Visual Cultures

I am framing my argument in a discourse known as visual culture. An interdisciplinary field that was popularized in film studies and art history at the end of the last century, visual culture is interested in the socially constructed ways by which cultures see. By understanding the socially, temporally, and regionally bound ways subjects are instructed to see, visual culture scholars work to understand how ideologies are tied into representative objects and practices. This field sees the processes of looking, the “visual event”, as an act which is the result of a co-constitutive process of ideology, history, place, and temporality. As Nicholas Mirzoeff defines this process, it is “an interaction of the visual sign, the technology that enables and sustains that sign, and the viewer.”¹ So the meaning which is generated from a visual form is not an A to B transmission of idea from representational object to viewing subject, but instead the result of a constellation of influences ranging from the ideological training of a student to see in an art seminar, to the technologies which afford and demand particular modes of viewing: for Mirzoeff, “seeing is not believing but interpreting.”²

Ways of seeing have been tied to ways of knowing, and they help make sense of the various ideologies which are taken for granted in a given culture. The modern viewing subject was constructed by and through scientific experimentation. As Jonathan Crary argues, “[v]ision and its effects are always inseparable from the possibilities of an observing subject who is both the historical product and the site of certain practices, techniques, institutions, and procedures of subjectification.”³

This framework, while deeply convincing, has a methodological issue: it generally uses case studies to represent broader cultural attitudes regarding vision. Jonathan Crary used changing scientific understandings of vision to contextualize and understand impressionist and post-impressionist painting;⁴ Anne Friedberg discussed the breakdown of the single point perception of depth to understand how graphic user interfaces (GUI) became so commonplace in computing;⁵ and Michel Foucault uses the development of the anatomical-clinical method to understand the ways patients are objectified and othered in the process of medical diagnosis (2.2.2).⁶ In many ways these arguments are compelling because of how they take a medium-range research program, focused on some cultural phenomenon as it interacts with all sorts of other cultural processes, and extrapolates it into a generalizable understanding, which can, in turn, be projected outward to other related phenomena.⁷

The clinical gaze is something that is general enough to evoke, expand upon, and nuance into relation with discourses around medicine (2.2.2). It is a popular, compelling, and deeply helpful framework, because it provides a shorthand for different biomedical practices, from microscopic vision, to medical cinematography, to clinical photographs, to technologies of transparency, to the utopian construction of a perfect anatomical subject.⁸ I will go into more detail as to the function and practices associated with clinical vision in the next chapter (2.2.2). For this chapter, however, it is important to know that, unlike Foucault’s later post-structural post-1968 scholarship, clinical vision was the result of a singular case study into a specific historical moment:⁹ Foucault was looking at medicine in post-revolutionary France, and his observations came out of that cultural, scientific, and political moment.

How would medicine’s visual culture be understood if clinical visuality was not the dominant mode to understand medical culture? How would medicine’s visual culture be understood if the discourse’s understandings about representation were developed in relation to another disease—like tuberculosis, or cholera, or AIDS, or cancer—or another political shift—like the post-civil rights era changes in the US, or the necropolitical terrain of post-9/11 America (2.1.3; 2.1.4)?

One of the through-lines for this chapter is an interest in point of view: doctors were looking at their patients in a clinical mode, but they also followed other modes of aesthetic and visual practice.¹⁰ They built sanatoria and advised on the hospital wards (1.2.4; 1.2.5); they imaged patients, and at times were caught on the other side of the camera lens (1.4.1; 1.4.2). Importantly, they were not the only actors making visual material, as charity organizations also began springing up in this same period, sometimes run by medical professionals and sometimes not. Medicine’s visual culture is not a singular object, but a weave of contested discourses and visualities, and this chapter is as an invitation to spend time with these many different practices.