Levine Medicine 2

This week’s articles focused on the mediation of medicine, and two themes that recur in these readings are seeking reassurance of normality and the effect of what we learn on how we perceive.




In Joseph Dumit’s article “Is it me or my brain? Depression and neuroscientific facts”, the author begins by stressing how neuroimaging techniques such as the PET scan allow unprecedented visualization of different “types” of brains, which presumably entail different “types” of people. Dumit is interested in the cultural and visual logics by which these images can persuade viewers “to equate person with brain, brain with scan, and scan with diagnosis. He suggests that when we read causality when we look at these types of different brain scan for different conditions, it in fact stems from out local culture (the example with the big toe). Dumit proposes an objective-self, which is the set of acts that concerns our brains and our bodies deriving from received-facts of science and medicine. He draws a distinction between these received-facts rather than just facts from the activity of translation, or mediation, which transforms the fact from one media to another. The proliferation of these brain scans used in the context of differences derived from other conditions (such as manic and depressive versus normal states) gives us the cultural common sense that two different behavioral states would have different brain states. He brings up the notion of identity politics with the example of Tracy Thompson, who conceptualizes her depression by seeing herself as a new type of person, a depressed person, with a different type of brain, a depressed brain. He concludes his article by proposing a particular kind of self he calls the “pharmaceutical self”, where as one takes psychoactive drugs to help oneself recover from one’s condition, one finds himself in a state of not normal, but better. In this way, mental illness is seen as sort of a pharmaceutical side effect.



Shigehisa Kuriyama’s article “Between Mind and Eye: Japanese Anatomy in the Eighteenth Century” introduces Sugita Gempacku, a Japanese physician, and his translation of a Dutch medical text into the Kaitai Shinsho. Gempacku uses the expression memboku o aratameru, “changing one’s outlook”, in which he calls for a fundamental rethinking of the nature and method of medical knowledge. This change is primarily perceptual, and it refers to a new way of seeing just as much as a new way of thinking. Gempacku asserts that previous failures of traditional medicine ultimately were a failure of vision, and although Japanese doctors had preformed dissections in the past, he saw the human body differently than they had seen it. In other words, we see what we are taught to look for. For example, the doctor Toyo postulated that the small intestine was a myth perpetuated by medieval physicians, even after performing dissections. Kuriyama holds that this difference in perception between Gempacku and Toyo were due to the texts that guided their seeing. Gempacku found that the Western anatomical pictures perfectly matched the cadaver, and Kulmus’s illustrations guided not just what Gempacku saw but how he saw, he acquired a new visual style. The Western anatomical illustrations were more faithful to actual human anatomy, and Shiba Kokan explains: “if..a picture does not faithfully copy an object as it really is, it loses this marvelous usefulness.” Interestingly, Kokan refers to the camera obscura as the epitome of the Western style of illustration, as a practically useful form of art. Have you had any experience that made you aware of how mediated vision actually is? Have you visually perceived something differently after learning to look for things you have not previously been looking for?



“Sonography and Sociality: Obstetrical Ultrasound Imaging in Urban Vietnam” by Tine Gammeltoft addresses the ways in which new reproductive technologies, such as the ultrasound, are introduced and consumed in developing countries, such as Vietnam. Previous studies have characterized ultrasound technologies as a male, medical, and technocratic takeover of pregnancy and birth, however Gammeltoft notes that this literature often ignores how the technology is actually consumed by its users. In Vietnam, ultrasound sound scans are very common, and Gammeltoft found that the average number of ultrasounds per pregnancy was about 6.6 for the over 400 women interviewed. One of the major differences in the consumption of ultrasound technology in Vietnam is the concern for safety: Vietnamese woman tended to not trust the safety of the technology, and often worried that the ultrasound was harming her fetus. Even through this fear and suspicion, the women reported that they still “had to go see”. Gammeltoft hypothesizes that this perception that ultrasound “must” be harmful may be due to Sino-Vietnamese medical theories, which stress the importance of bodily balances and sketches disease and illness in terms of disturbance. Despite their lack of trust in the technology, the Vietnamese women had many of these ultrasounds done in order to get reassurance that their fetus was developing normally. The women that were interviewed wanted to see how the fetus is developing manifesting in several scans, even though they thought these scans might be harmful. Gammeltoft attributes this to the concept in Chinese medicine of a body that is vulnerable to disorganization and in need of continued reinvention. The mistrust may stem from the proliferation of stories of pregnancies gone awry, and the sense that a healthy mother and baby is not guaranteed.



I found that one of the most interesting aspects of this reading is how unaware I was of the mediation of vision, of our actual visual perception of things and how it is changed by how we are taught to look at it. For example, I am a neuroscience major who has done many dissections in my required course load, and thinking about the human body in the non-Western aspects discussed in the readings (for example as a “liquid” body or envisioning our internal body structure as the traditional anatomical depictions in figures 1.1. and 1.3. of Kuriyama’s article illustrate), is almost alien to me. I find myself trying to convince me that I would never have seen the body in such ways, but my perception of the anatomy of the human body is probably due to the way that I have been taught. Is this change in perception ‘relearnable’? If I spent enough time with traditional Chinese and Japanese medical texts, do you think that this perception would replace my current one, or can these two modes of vision coexist simultaneously?



Both the Dumit and Gammeltoft articles dealt with the need to be assured of normality. There are patients that see the graphical contrast of normal and depressed brain scans and worry that there is something wrong with their brain and therefore themselves, and there are also Vietnamese mothers who repeatedly get ultrasounds that they feel may be dangerous in order to reassure themselves that their child is developing normally. The contrast between the normal and the abnormal has been discussed in class before (such as in relation to the episode of wife swap), but what is it about the need for normality that is so powerful that a mother would expose her fetus to what she suspects to be harmful technologies in order to find out if her child is normal?

-Matthew Levine