Book Review: The Courtiers’ Anatomists

BookReviewLogoReview by Elisabeth Brander

In the history of anatomy, certain people and places have proved to be a popular topic. Andrea Carlino, Sachiko Kusukawa, and many others have considered the significance of 16th century anatomists, often emphasizing the work of Andreas Vesalius, while Andrew Cunningham has taken a broad look at Enlightenment-era anatomy with a particular focus on Italy and England. In The Courtiers’ Anatomists: Animals and Humans in Louis XIV’s Paris (University of Chicago Press, 2015), Anita Guerrini, professor of history at Oregon State University, examines a place and time that has not been the focus of as much academic interest. Her latest monograph describes the activities of a group of anatomists working at the Paris Academy of Sciences during the 17th and 18th centuries.

23130498Guerrini’s narrative is rich and complex. By using a broad framework that discusses the importance of animal dissection for the development of early modern experimental science, she deftly touches on several key components of anatomical practice during the French Enlightenment. The stage is set with an overview of the Parisian anatomical scene during the 17th century: the rivalry between the physicians of the Paris Faculty of Medicine and the surgeons at Saint-Côme for access to dissection material, the question of whether reading texts or performing dissections was more beneficial for the study of anatomy, and the impact of William Harvey’s discovery of the circulation of the blood. The physiological discussions precipitated by Harvey, and the mechanistic theories of René Descartes, became central to the work of a number of French anatomists including Jean Pecquet and Louis Gayant, who embraced animal dissection as a means of investigating structure and function. These men carried out much of their work at the Paris Academy of Sciences, an intellectual organization founded in 1666 whose members had a broad interest in scientific inquiry and were active in fields including mathematics, astronomy and, of course, anatomy. Continue reading “Book Review: The Courtiers’ Anatomists”

Book Review: The Straight Line

BookReviewLogoWhat makes a person heterosexual? Can heterosexuality be measured in the body? In the brain? Is it discerned and practiced through sexual acts? Emotional attachments? Self-reported desires? Can it be chosen or is it innate? In modern Western culture most individuals are presumed to be heterosexual until they convince us otherwise through acts or affiliations; once the world understands an individual to be homosexual (in the hetero/homosexual landscape bisexuality is routinely elided) — once that individual has crossed “the straight line” into gay or lesbian identity — can that individual return? In The Straight Line: How the Fringe Science of Ex-Gay Therapy Reoriented Sexuality (University of Minnesota Press, 2015) sociologist Tom Waidzunas (Temple University) explores these questions through the lens of ex-gay reorientation therapy status and practices in the United States.

thestraightlineToday, reorientation therapies — a collection of practices that seek to shift a person’s sexual orientation from homosexual toward heterosexual — exist on the fringes of established scientific communities, broadly understood to be both ineffective and often also harmful to patients. Yet seventy years ago, in the postwar period, reorientation therapies were considered to be a cornerstone of treatment for those experiencing homosexual desires or engaging in homosexual acts. How, then, did a collection of practices once considered standard practice get pushed to the edges (if not off the edge) of legitimate scientific understanding? And, perhaps more importantly, how did the journey of reorientation therapy from the center to the margins of psychiatric care in the United States change how Americans understand the nature of human sexuality?

Waidzunas sets out to answer this question using a blend of sociological, historical, and queer theoretical methods. Drawing on archival research and interviews with key figures, he traces how the political agitation of gay-affirmative and anti-gay social movements struggled within and around the mental health professions succeeded over the course of half a century in redrawing the boundaries of accepted scientific knowledge. In response to the reorientation community’s belief that sexual orientation can be changed, gay-affirmative therapists and activists have increasingly relied on notions of fixity: the notion that one’s body carries an innate true orientation that can be measured and remains stable throughout one’s life even as personal identity and community affiliation may change. While effective in marginalizing reorientation practices hostile to homosexual desires, the notion of a fixed sexual orientation is scientifically fraught (how to measure it?) and problematically cis male-centered (most assertions of sexual fixity are rooted in studies involving penises and porn). Ultimately — without discounting the harms done to individuals in ex-gay therapy —  The Straight Line challenges gay-affirming readers to re-examine their assumptions that the demise of reorientation science is an untempered win for LGBT rights.  Continue reading “Book Review: The Straight Line”

Is the Pen as Mighty as the Scalpel? Literature and the Saving of Lives

dailydose_darkstrokeLois Leveen, PhD is a Kienle Scholar in Medical Humanities at Penn State College of Medicine and the author of the novels Juliet’s Nurse and The Secrets of Mary Bowser.  Her public humanities work focuses on how content and approaches from literary studies, history, the visual arts, and related fields can foster greater reflection for individuals and deeper bonds of community among practitioners, patients, and families.  Contact her through humanitiesforhealth.org.

Lucy Kalanithi, widowed in her thirties by lung cancer, describes her neurosurgeon husband’s final year not as a period of dying but as a period of living:  

By the time he had become too sick to continue working in the operating room, he was writing furiously about his struggles — as a physician, a lover of literature and a terminally ill patient — to continuously seek and live his values. Returning to writing kept him serving others and helped him to live well.

The result of this furious writing is Paul Kalanithi’s memoir, When Breath Becomes Air, a deeply moving literary work.  As a record of how to cope with terminal illness and a document of how to accept suffering as part of what makes us human, the memoir does indeed serve its readers.  In the coming years, it will likely become a favorite text for medical humanities courses and scholarship.  But the greatest power of the book lies in what it tells us not only about Kalanithi’s slow demise from cancer, but about how his own dying contrasts with that of his close friend and fellow resident “Jeff” (like many memoirists, Kalanithi uses pseudonyms for nearly all of those he writes about), whose life ends suddenly, by suicide.  

For all the emotional impact of Kalanithi’s memoir, what strikes me most about it is how little attention Jeff’s death gets from critics and readers.  Both Paul Kalanithi and Jeff are highly skilled surgeons and caring human beings, yet as captivated as we are with the dramatic and rare death of a young physician from cancer, we seem unable to confront the equally awful reality of physicians dying from suicide.  It may strike us as incomprehensible that a thirty-something non-smoker could suffer from advanced lung cancer, but when it comes to physician suicide, we are more willfully refusing to comprehend how wide spread the problem is.

To put it more bluntly, how can we expect physicians to care for and save us, unless we acknowledge how difficult it has become for them to care for and save themselves?  

Answering that question can have important consequences for physicians, patients, and public health.  Approximately 400 physicians die by suicide every year in the US.  Thousands of others experience such intense burnout they leave the profession.  Still more continue to practice, despite untreated depression or burnout.  In The Hidden Dying of Doctors: What the Humanities Can Teach Medicine, and Why We All Need Medicine to Learn It, I argue that Kalanithi’s memoir—and medical humanities more broadly—can provide an important model for addressing these problems.

I have many friends who are healthcare practitioners, from ER doctors to infectious disease specialists, from hospital nurses to physicians serving indigent patients.  Sometimes I feel a little ridiculous (or self-important) to suggest to them, or to anyone who deals with sickness and dying in their workplace that there can be something lifesaving about bringing literature, art, philosophy, and other humanities into their already busy professional training and careers.  But the response I’ve gotten from physicians to The Hidden Dying of Doctors underscores how imperative this work is.