1.4.2: Hands in Frame

Doctor’s hands are important for their work: they are used to hold patients in place, to percussively tap on their chest to hear for tuberculous infection in the lungs (fig. 2), they are used in surgery, in autopsy. The tuberculosis corpus has plenty examples of images showing doctors how to use their hands (figs. 1 & 2).

Figure 1. A figure showing the process of auscultation---the percussive tapping on the chest to hear for symptoms associated with the lung. Tuberculosis: A Treatise by American Authors on its Etiology, Pathology, Frequency Semeiology, Diagnosis, Prognosis, Prevention, and Treatment. Edited by Arnold C. Klebs. New York & London: D. Appleton and Company, 1909.

Figure 2. While not associated with tuberculosis, this image is in a larger text on differential diagnosis. It offers a kind of anonymity to the patient; although, that may be part of a treatment regimen. Carmody, T. E.. The Differential Diagnosis of Lesions of the Mouth Due to Carcinoma, Sarcoma, Syphilis and Tuberculosis. 1909.

Doctors’ hands appear more often in specimen photographs, than doctors do in the professionally framed photographs discussed in the previous section (1.4.1). Doctors reach out to display a diagnostic procedure (fig. 1); their hands work with experimental instruments (fig. 3). In some photographs the doctor’s hands may be necessary to display the proper way to go about a complicated procedure (fig. 4 - 6). The thing that unifies these later images is that the doctors’ hands emerge in the context of a different kind of biomedical visual practice: when there is a specific research object that needs to be seen on another human’s body.

So far in this chapter, I have avoided images that depict specimens. What I have shown is that the contexts and discourses around medical visual culture is much messier and broader than Michel Foucault could articulate. For this dissertation, these doctors’ hands serve as a bridge: to link these other visual cultures to the visualities of the specimen, which will appear in the next chapter (2.1.4; 2.2.2). They reveal a kind of construction and specificity in framing—to hold a patient still, to bring the camera to the patient or the patient to the camera, to have another pair of hands operate the machine—as well as an intention, to grasp both in an intellectual sense but also in a domineering one.¹

What is important, and what I see when I see doctors holding their patients in this way, is a striking contrast: while these images share an inkling of intent as the ones discussed in the previous subsection (1.4.1), their composition is decidedly different. Where doctors and their patients are gazed at a distance in examples of doctors at work, the point of view in these accidental hands in frame is always much closer to the humans with the shot sizes ranging from a medium-close to a close-up. This is partly because of the image’s intended object: the photographer is trying to capture something smaller than a whole human body. The reduction in scope—from whole room to a part of the body—is matched by the amount of space that can be taken up by the doctor: it is a scale of hands, not of bodies. And the hands in frame are not always the intended object of interest; they are an unintentional side effect of a discipling practice (2.1.2). They hold patients in place. They make the phenomena visible. They turn the patient, the body, the organ, the subject, the object, whatever the intended imaging target, docile.² I will address these ideas in more detail in the next chapter (2.1.3; 2.1.4; 2.3.1).

Figure 3. This image depicts a process of animal testing, with the doctors hands using an apparatus to assist in the required protocols. Edward R., Leroy S. "Reinfection in Tuberculosis: Experimental Arrested Tuberculosis and Subsequent Infections" The American Review of Tuberculosis 5. Baltimore: National Tuberculosis Association, 1921-1922.

Figure 4. Depicting an vaccine injection, the doctor is more prominent in frame than in others. With his back to the camera and the patient also partially concealed, the image focuses on the procedure itself. Francine, A. P.. Pulmonary Tuberculosis: Its Modern and Specialized Treatment. Philadelphia & London: J. B. Lippincott Company, 1906. Image courtesy of the New York Academy of Medicine.

Figure 5. The doctor's body depicts how they can help a patient who has difficulty swallowing as a result of the disease. Lockard, Lorenzo B.. Tuberculosis of the Nose and Throat. St. Louis: C. V. Mosby Medical Book & Publishing Co., 1909.

Figure 7. Often wet specimens, when left in jars of spirit or formalin, will be held in place by glass pins or glass plates. This image is unique because, for most of the photographs of wet specimens, there are fewer overt tools that help reveal parts of the organ. Bushnell, George. “Manifest Pulmonary Tuberculosis," The American Review of Tuberculosis 2. (1918-1919), 140-178.

Figure 8. A microscopic illustration showing Mycobacterium tuberculosis after a dying process. Image courtesy of the New York Academy of Medicine.

There is power expressed in this imaging practice—who is imaged and who is left out of the frame; who controls the image and who is imaged. Some spaces are deemed clean and others dirty, some bodies are allowed rest and care and others are placed within a disciplining framework, where they are always st fault (1.3.4; 1.3.5).³ These contrasts remain ever present in the discourse, born on tide of supposed superiority: by who cures and who is cured, by who researches and who is researched, by who has scientific/social/cultural authority and who does not (0.1.4; 2.1.4; 2.4.2).⁴

In the next chapter, I am going to look at the human body as it has been pieced apart—through magnification, through the dissection of organs. All of these images were been taken from the bodies of research subjects for the purpose of scientific research. The doctors’ hands will be absent, but their intention will not be. Sometimes doctors’ intervention will be more apparent, like the use of a pin that pulls a flap of flesh to reveal what is underneath (fig. 7), and sometimes this will be less obvious, as the doctors dye cells of patients (fig. 8) (2.1.3). These processes follow a different kind of vision, one which is trained in doctors, but which rhymes⁵ with and engages in concert with the kinds of visual practices described in this chapter. While not dependent, the two are entangled in such a way so as it would do harm to pull them apart fully.⁶