Anyone remember the psychology experiment where you are told to look at a group of students passing the ball to each other in a room and to count the number of times they pass the ball? Towards the middle of the experiment, a gorilla walks through the center of the circle, stays there for nine seconds and then walks away. When the researchers took a poll, many of the viewers did not notice the gorilla and were shocked at their inability to catch something so salient. The Kuriyama article explores this notion of seeing only what we are taught to look for. Kuriyama suggests that unlike Gempaku, whose work was a turning point in Japanese history, others failed because they looked without seeing. Have you had this experience before? He believed that there was a different realm, and in order for one to tap into it, one must first undergo “a fundamental rethinking of the nature and method of medical knowledge, a radical transformation of the habits of mind” (pg 22). How does one change his outlook? Have you had any experiences where you had to undergo a radical transformation of your thought process? This relationship between the eye and the mind, looking and seeing is extremely fascinating.
Later in the Kuriyama article, he suggests that one of the reasons for Gempaku’s success was the use of a different guide. Instead of using the old Japanese texts, whose pictures emphasized the artist’s experience, he translated the Dutch texts, which placed emphasis on how closely they represented actual object. In essence, by using a different text as a guide, he was able to change his outlook. The sonography article explores this issue of guides in Vietnam. We see that women obtained many ultrasound scans (one woman had 30!), despite the dangers of having so many and the questions about its credibility. The major reason was to confirm that the child was developing normally. Unlike in Western cultures, where the fetus is seen as a stable and fixed representation of the “baby”, the Vietnamese women see the image as “fleeting and transitory pictures of human beings in the process of becoming” (pg 145). Since the baby is constantly changing, they have to monitor its development, ensuring that there are no abnormalities. Do we agree with this characterization of Western cultures? It seems as if he puts all western cultures in the same umbrella. Here we see the role of society as guides. As the women are engrossed in a society that spreads stories questioning the credibility of these ultrasound images, they cannot help but look at it with disbelief. A Vietnamese woman can therefore “change her outlook” by either becoming part of a western society, i.e. using this new culture as a guide by default, or reading scientific papers about ultrasound, thereby actively shunning the societal guides. Finally, the Dumit article explores how we have come to see images as representations of our brain. These images are so persuasive that alter our perceptions of our own bodies, which he refers to as the objective self. Do we agree with this notion?
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I found the notion of having guides to help change a person’s view of something in the Kuriyama article very interesting. As seen in the other two readings for this week, whether it is a doctor or a society, people’s views of the body as well as other things are affected by how others say they should look at things. The notion of people getting sick has dramatically changed over time. Doctors long ago thought weather and a person’s location made them sick. The church use to tell people they got sick because they were sinners, and now doctors use technologies like PET scans and sonographs to “prove” their diagnosis. But even now there are differences in doctors and the way they view the body. Holistic medicine and western medicine are very different and depending who people trust or are influenced by depends on how they see the body. Based on the findings of the two articles it seems like there is a tendency for humans to believe what they can see. Being able to see inside one’s body as an “objective self” as Dumit states allows people to see what is happening to them. With the influence of a guide, the people can interpret what they see without feeling like it is actually happening to them. This distance may be able to give people comfort from their fears related to a diagnosis or abnormality.
Along with the previous posts, I found all of the articles to be very interesting in the way that medicine can mediate our perceptions. Having taken Anatomy and Physiology, I was in agreement with Kuriyama's notion of visual guides and how we see what we are taught to see, for I would not have learned anything in that class if I had not been taught what each anatomical structure and its function were first. This made it hard for me to think that someone could change the outlook of an entire country and their perception of medicine and the body- how difficult this must have been to alter your own view. I also really enjoyed the way social interaction, consumer economy, revenue, cultural traditions, etc can influence the actions of women and reproductive technology in the Gammeltoft article. At first I thought it was absurd that a woman would get over 30 sonograms, and that such women were also unsure and afraid of the uncertainty of these scans, but I found myself identifying with the sociocultural norms of such medical technologies. If I were to hear such horror stories of birth defects and mishaps on a daily basis, I would be more inclined to take advice to go for routine ultrasound scans. It was also really eye opening to see the experiences people share with brain images and they way they perceive themselves with such images. Again I found myself going along with such notions of having a brain type being parallel to one's own identity. Overall, these articles showed me that medicine has more of a way than I thought of influencing people and their actions and thoughts as a mediator.
Reading the articles, listening to what Victor said yesterday and following this discussion, I feel it is a bit more complex to anthropologically look at medicine and the body in the same way as we look at photography or television - even though maybe we should. I say this because our body is the first mediation, and one might even say that, given that we are our body, that our self is mediated. These are all ideas that are very hard to digest.
The first thing I thought was brilliant of the Kuriyama piece was the idea of seeing only what we are taught to look for. The experiment the lead post cited is fascinating because it shows us there is a true distinction between "looking" and "seeing". It is like "hearing" and "listening", and tells us a lot about what we are given to "look" without actually "seeing".
However, there is something that I did not really grasp from the articles: I understand the fact that our representations of the body are mediated by cultural references, and that one might consider auras or meridians in the same way as we consider muscles. Yet this is something that I never contested, I don't think anyone can say that his representation is "better". Representations are the foundation of any relations in the world, starting from the distinction between signified and signifier in language. The question I ask myself is essentially about the ethical implications of the differences in conceiving the body and medicine, and I have not understood that fully.
The last thing I would like to talk about and I think is important to discuss is the relationship between the body, perception and our mediated relation to the world. When Brian O'Blivions claims in "Videodrome" that "the television screen is the retina of the mind's eye. Therefore, the television screen is part of the physical structure of the brain. Therefore, television is reality and reality is less than television", I feel as though there is more truth in this than Cronenberg's gory images from the 80's, and that we sometimes "see" things without knowing we are seeing them - and yet they have a great impact on our unconscious and our psyche in general.
- Ayan Meer
I agree with the prior blog posts that different views on medicine can have an impact on how we perceive ourselves and our own health. I found it fascinating in the Dumit article when journalist Tracy Thompson changed her outlook of her depression and distinguished between her brain being sick and her self being sick. Once she was able to identify that she is depressed because she has a depressed brain, she was able to reshape the way she viewed her illness and was more able to combat that illness. It was as if she was able to face her illness in a new way with this change in her perception of it. Also, through the images of the brain via different scanning methods, or guides, people can identify their illnesses and interpret them in new ways. This was also evident in the sonography and sociality article where women were able to connect with their unborn children through ultrasound machines to make sure that their children were developing correctly. Through this medium, these mothers were able to look at the sonogram and essentially “see” the development of their children. There is definitely a difference between looking and seeing, as raised in the Kuriyama article, but I agree that the use of media in the medical field allows humans to connect with their own bodies in a different way that they now understand what is happening to their bodies in both the physical and spiritual sense.
I found the description of ultrasound machines in the Gammeltoft article to be extremely pertinent to our discussion of mediated medicine, considering that through this medium, mothers are able to see their developing unborn children (to a certain degree). This reminded me of the new technology of Da Vinci surgery through machines being built and used all over the country, including on the Hopkins campus itself. Basically, these machines provide a way for surgeons to operate from distant locations; a doctor can watch a live screen and use triggers and controls in real time in Baltimore to operate on a patient in Los Angeles. Not only does this mediate surgery in the sense that it creates a technologically distant way to operate, but it evens turns medicine into a media activity, in some sense. In other words, these triggers and controls make me think of video game controls, and therefore surgery is somehow being put on a similar level as something as casual and media-related as that. On one hand, this technology is amazing; it makes it possible for patients to have a specific doctor operate, for example. On the other hand, I think it has some pretty obvious risks involved with it. Not only that, but it kind of takes away the personal aspect of medicine. Some people see it more as a get-in-get-out type of field, holding doctors only to the responsibility of fixing medical problems, but others truly care about the personal factor. Doctors are even taught in medical school how to deal with patients on a personal level! What becomes of this in Da Vinci surgery? What becomes of this in any sort of mediated medical practice?
I agree with Ayan in the statement above that it is a bit complex to look at medicine and the body in the same way as we look at photography or television in class. It was difficult to grasp all that information in that sort period of time in the classroom.
I was in agreement with Kuriyama's notion of visual guides and we see what we are taught to look for. This reminds me of a story my Dad told me. The story goes, there is a guy who has been blind all his life and in his late twenties; The doctors came to him with saying they can give him an operation to make him see. When he was blind, he always loved eggs. They were his favorite food and he would always mix everything he ate with eggs. The smell, shape and feel of the egg were really cool to him. The first time he gazed at the egg, he saw an ugly yellow eye looking at him. The yellow yolk and the white around it made him want him to throw up. His expectations of an egg were supposed to look great and beautiful but he instead he is disgusted by it. We are desensitized because we grow up to what an egg looks like. We are taught to see what an egg looks like and the uses an egg can do with other foods.
Gammeltoft shows how reproduction engages with “politics, culture, and economy,” paying particular attention to how new reproductive and genetic technologies are changing women’s experiences of “pregnancy and birth and challenging conventional notions of kinship, family, and gender” (133). She then goes into detail with ultrasounds becoming popular in the world today. Gammeltoft mentions that in Vietnam, scans seem to have become “culturally mandatory” (137). This rapid expansion of the use of “obstetrical imaging technology” in Vietnam must be seen in the context of a variety of factors related to the social changes in the area (137). Since the baby is changing constantly, the Vietnamese have to monitor its development, ensuring that there are no problems or any complications.
Dumit writes about how we have come to see images as representations of our brain. He mentions the “objective self” which refers to the images that are so convincing; we alter our own gaze of our own bodies. Anorexics and bulimics alter their own gazes to the point where they see themselves as being overweight so they resort to starving and/or purging themselves. Reading a magazine and seeing the reality of what celebrities look like today is one of the many reasons why people do harm to their bodies.
-Chase Winter
Ayan brings up a really good point about the way we should look at medicine as compared to photography or television. The Dumit article was particularly interesting to me in this regard because it discusses the idea of the PET scans as a type of photograph of the ‘self’ in some way. In this sense our image of self is mediated both by the physical image as well as by the way in which we are describing what is the ‘self.’ The discussion of depressed people trying to come to terms with depression as an issue with the depressed person verses an issue with the brain of the person also speaks to this. The scan mediates our concept of self in such a way that those the person and the persons brain are two distinct things. It is not that the person behaves in a way that is problematic, it is that there is an objective thing happening in their brain that can be captured in an image that causes depressed feelings. The way we can distinguish between the two explanations is so counter-intuitive, because we feel like there shouldn’t be a difference between a person and his or her brain but the fact that the brain seemingly acts in an independent manner counters that logic. This works very well with the idea of looking at anatomy in different ways as talked about in Kuriyama. When we look at the PET scans of a depressed person and instead of saying “I see a brain with activation in x and y areas” but instead say “this is a depressed persons brain” we are very clearly doing what Kuriyama talks about when he says we see what we are taught to look for. In this case doctors are taught to look for the signs of depression or schizophrenia, rather than to look at the person or the brain as an independent entity that does not wholly encompass what it is to have a certain illness.
I found one of the more interesting ideas from the Dumit article to be that the depressed brain-type “substitutes itself for the real self and speaks instead” (Dumit, 45). As the other blogs have pointed out, this notion of the brain and the self being two distinct beings is a direct byproduct of the advances in medical imaging technology. Before advanced imaging techniques were available, diagnoses of psychological disorders were based almost entirely on personality flaws and one’s social context. The disorder and an individual’s real self were one and the same. Today, however, people like Thompson can construct realities in which they are depressed persons because they have depressed brains. Essentially, advances in imaging technologies have allowed individuals to pit the abstract notion of the brain against that which is tangible, able to be seen in the mirror, etc. Dumit states it best, “Even in the face of specific received facts about ourselves such as brain images, there is room for negotiation and redefinition” (44).
Kuriyama argues that pictures can provide a new way of looking at the world only if an individual conditions themselves to look at pictures differently. As other blogs have noted, there are vast differences between the ways that the sonograms are viewed in Vietnam and the West. These differences are grounded in historical and local stories of abnormal births and deaths. Essentially, while these Vietnamese women are having their bodies mediated by medical imaging, they are mediating the images themselves with their own cultural and social backgrounds. This emphasizes that the effect of different forms of mediation is based to some extent on the individual’s frame of reference.
-Daniel Gergen
I agree that Western medicine has changed dramatically, from the 2D to the virtual ultrasound, and the influence that it has had on developing countries does seem to be characterized as an all-encompassing group. Although I wasn’t fully aware of the average number of ultrasounds that a woman is expected to get during her pregnancy, I was extremely shocked to know that the largest number reported by one of the Vietnamese women was greater than 30. Despite the known risks of excessive ultrasounds, the comfort of knowing the progress of the developing fetus was far more important. You could even sense the hesitancy of the women when describing their worries before knowing the condition of their child. It also seemed that the market and policies of the country encouraged the ease at which ultrasounds could be obtained.
In regards to the Dumit article, one of the most interesting quotes I can pull from this article when speaking of the objective self is, “Mediators translate received-facts into new media where they are re-presented as facts to be received in turn” (Dumit 39). This emphasizes the idea of how information is mediated from sender to receiver, and how this information is translated. This description also loosely reminds me of the “Telephone Game,” where one person creates a phrase, which is passed through a chain of people. The last person to receive the message has to say what he heard, whether it is correct or incorrect. The last person’s interpretation is based on the understanding of the person adjacent to him, not on that of the original sender. In the case of Kuriyama, he clearly used his own personal experience to shape the transition between the Dutch and Japanese descriptions. I feel that by doing this, one automatically accepts the notion that these objects are represented within one’s own body. This relies on perception and vision.
Like many of my section-mates, the articles led me to ponder how frequently “we see what we are taught to look for,” as stated by Kuriyama. In regard to this idea, I found a quote from the beginning of the Gammeltoft article to be particularly fascinating: “I went for the (ultrasound) scan thinking that if the fetus was not normal, I would be forced to have an abortion. So I went very often, I felt nervous and wanted to see if my fetus had all its limbs or not.” Presumably, this mother was going in for an ultrasound relatively early in her pregnancy (as abortion was still an option and she mentioned that her fears were tied to an early-pregnancy cold…); at the fetus’s early stage of development, the mother would most likely be unable to discern that her baby was developing correctly without a doctor’s interpretation of the ultrasound. So while the mother verbalizes that she desires to “see if her fetus had all of its limbs,” in reality, her doctor would need to be the one to indicate that all the limbs were present, etc. In this situation, the doctor is seeing what the mother cannot and interpreting the image for her. In this way, medical imagery becomes almost like a language, one that is universal amongst those who are trained to comprehend it; this sentiment harkens back to Kuriyama’s description of Gempaku’s ability to translate a Western anatomical text to Japanese although he spoke no Dutch.
While the three articles had me pondering how we “see what we are taught to look for,” the Dumit article in particular made me reflect on how perhaps sometimes seeing may not be the only sense of value when constructing an understanding of one’s health, physical state, and objective self. Dumit states “we should try to become as aware as possible of the people who interpret, rephrase, and reframe the facts for us (the mediators), and around them, the structural constraints of each form of representation- peer review, newsworthiness, doctor-patient relationships (the media).” For me, this quote emphasizes that so called “facts” may only take you so far, and that there is frequently room for personal feelings and “gut instincts” to factor into one’s understanding of medical conditions.
The articles and Victor’s presentation made me ponder the necessity of taking medical imagery and the associated explanations with a grain of salt- if one feels that something is wrong, and nothing is showing up on the ultrasounds or PET scans, this does not necessarily mean that everything must be ok. I would like to discuss further the dominance of “fact-based” medical practice and technology in our society over that of natural/eastern medicine that seem to involve a more personal touch and less emphasis on clear-cut rights and wrongs. Is there still room for personal feelings, hunches, and vagueness within the ever advancing world of medical technology and imagery?
I agree with the Kuriyama concept of "guides",and think that it would be successful in changing mindsets about concepts in medicine. I also realize, and have seen instances where even guidance has failed.
I was a part of a program which brought together students that were trained in Western medicine and students that were trained in traditional Eastern medicine. The students that were trained to diagnose problems with a series of Western examinations could not adjust thier thinking to embrace a type of medicine. They struggled to fathom that re-labeled organs of the body, used accupuuncture and qi pathways to diagnose sickness and used herbal medicine in the place of synthetic pills.
This is all just to say that while there might be instances where a "guide" can change personal views, but we must also be cognicent of times it does not.
One of the recurring themes that I noticed in the readings for this week was fear. In the Gammeltoft piece, ultrasounds were the means to cope with the fear of fetal abnormalities, while the Dumit piece addressed the fear of mental abnormalities through the visualization of PET scans. My question, though, is whether this fear is always present, or if it is the ability to visualize abnormalities that perpetuates this fear. I think that it is the later, especially when looking at the case of the depressed journalist, Tracy Thompson. Tracy struggles with the notion of illness and whether “there is something wrong with [her] brain” or if “there is something wrong with [her]” (42). Dumit goes on explaining how it is possible that with the negative notion of sick “she forges a positive identification with her own brain-illness. She is a depressed person because she has a depressed brain” (42). Tracy thus sees her illness in a different manner because there is a visual representation and a scientific explanation for her illness. To a bio-molecular neuroscientist depression is nothing more than a chemical imbalance. I find this to be a correct but incomplete scientific explanation because the mind and sense of self is far more complicated and far too abstract to categorize as simply a chemical imbalance.
Dumit’s article was in particular interest to me because I am a neuroscience major and work with MRI scans on a daily basis at research. When I look at a brain scan I immediately spot the abnormalities. The image that Professor Pandian projected in class of two PET scans of a cocaine-addicted brain and a normal brain, for example, might have just looked like two colorful pictures of brains to anyone not familiar with brain function and anatomy. But instead I saw enlarged lateral ventricles and a decrease in glucose levels in the cocaine-addicted brain. This relates back to the Kuriyama piece where he stated, “we are only able to distinguish what we distinguish only because we are guided by teachers and texts. In other words, we see what we are taught to look for” (28). To me, Kuriyama’s whole argument makes me a bit uneasy because I began to question what I have been taught to believe in science. What if our visualization of microscopic structures is influenced by our perception of what life should look like. If the “failure of traditional medicine ultimately lay in a peculiar failure of vision” (23), what is to say that our Western view of the body and physiology isn’t also flawed, especially since much of science is viewed through a lens rather than with the naked eye.
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