Brandy Schillace's Blog

I am autistic. I’m also hyperlexic, have a memory with photographic acuity… and the social graces of an orangutan. (Note: they are socially intelligent animals, but are the only primates to live almost entirely solitary lives, so you know, it can be hard to remember the secret handshakes). I absolutely love a puzzle, but it was the behavior of Sherlock himself—in the stories and later adaptations—that kept me coming back. Whip-smart, but seemingly bad at close relationships; possessed of every special interest but oblivious to things others take for granted; has an infuriating way of inferring and finishing other people’s sentences, and is prone to the wildest impulses. For all of these reasons, my first—and still favorite—books are those varied collections of short stories and novellas, Study in Scarlet and Hound of the Baskervilles in particular. But as it happens, cozy-style mysteries of all sorts have been a safe haven for neurodiverse characters (and readers), from the fastidious and habitual perfectionist Hercule Poirot created by Agatha Christie—to Rex Stout’s Nero Wolfe with his special interests, avoidance of social situations, and low emotional affect. Is there something about neurodivergence and detection? I wrote about it recently for CRIME READS and spoke about it on BBC radio.

Or--read about my own neurodivergent character, Jo Jones in The Framed Women of Ardemore House

Review by Matt Kowal [image error]

Modern depictions of the American South often consist of a confined set of characteristics – hospitable family values, religious purity, and racial tensions. While this perception of the South certainly stems from the observable reality, it fails to address seldom mentioned yet detectable attributes of the region: gay tourist destinations in Panama City, syphilis outbreaks in Orlando, and the social manifestation of repressed sexual desires.

Trent Brown’s Sex and Sexuality in Modern Southern Culture examines the sexual history of the American South from the early 20th century to the present through a series of essays on topics ranging from the underground sex trade in Alabama to the allure of sexual depravity baked into the Florida Panhandle’s tourism industry.  While the anthology’s contributing historians focus on disparate topics, Brown incorporates their work into a coherent volume that explores the diverse characteristics that define Southern sexuality. In his introduction, Brown notes a dichotomy of sexual expression in Southern culture, describing the region as both “sexually open and sexually closed, as sometimes outwardly chaste and inwardly sultry, and as simply sexually demonstrative and open” (13).

Indeed, Brown observes a fluid perception of Southern sexuality permeating each essay. According to Richard Hourigan (“Creating the Perfect Mancation”), a stroll through Myrtle Beach almost certainly entails “seeing a strip club or listening to one of their tacky, sexually charged promotions” (113). Meanwhile, Krystal Humphreys (“A Bonfire of Chastity”) details the ideal southern Christian woman as openly chaste and sexually pure; an indelible standard representative of the South. Similarly, Jerry Watkins (“A Queer Destination”) notes that the LGBTQ community in Florida “quietly flourished in the 1950s” despite government pressures and homophobic rhetoric (136). Sex and Sexuality in Modern Southern Culture contrasts public disdain for openly-lewd individuals with a private lust for pleasure; it draws attention to the way a perception of ostensibly-Southern chastity serves to accentuate illicit sexual acts. Yet the anthology goes beyond a simple survey of Southern sexuality. It challenges the existing narrative of a romanticized South that prides itself in chastity and monogamy by calling attention to histories of homosexuality, a sexually charged tourism industry, and the glorification of obscenity. It questions the narrative of Southern purity and public censorship, seeking to historicize how and why Southerners have come to maintain these seemingly contradictory beliefs and practices. Sex and Sexuality also incorporates an analysis of the interplay between sexuality and race, exploring the compounding impact of the South’s history of slavery and segregation.

Southern historians, activists, and those well-versed in the South’s relation to the history of chattel slavery in the United States may find similarities in the white Southern violence and vulgarity intended to demonstrate authority and that used to repress social movements during the Civil Rights era. Francesca Gamber (“We Raised Them Up Never Even to Look at One”) considers the sexual and racial climate of the South in the 1960s asserting that “black women were particularly vulnerable to physical remonstrance…the sexual subtext of many of these attacks was seldom subtle” (73). Gamber notes the use of sexual threats and appalling shows of violence as a way to enforce submission with one extreme instance involving a police officer beating a pregnant woman, thereby causing a miscarriage. Furthermore, Katherine Henniger (“The Mandingo Effect”) recognizes the 1975 film, Mandingo as a candid expression of Southern sexually charged racial tension. Henniger credits Mandingo with acknowledging “white sexual and moral depravity in race relations, but firmly defines and confines it as southern” – perhaps to demonstrate the evolution of these prejudices into the entertainment sphere since their supposed Civil Rights-era suppression (180).

Ultimately, Sex and Sexuality in Modern Southern Culture considers what appears on the surface to be a simple question: how is sexuality manifested in the American South? However, as the anthology’s contributors demonstrate, the heterogeneous and often contradictory nature of Southern sexualities challenges us to ask a multitude of subsequent questions regarding the interaction of public and private spheres, the state of Southern homosexuality, and the role of race. Despite the challenge of containing such multitudes, Trent Brown provides a concise yet comprehensive overview of sexual history in an enigmatic region that leaves the reader satisfied. This anthology supplies an invaluable resource to cultural historians thirsting for knowledge on one of the most beguiling regions of the United States (and perhaps even the world).

 

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Brandy Schillace, Editor-in-Chief

Hanna Clutterbuck-Cook, Managing Editor

Anna J. Clutterbuck-Cook, Review Editor

Download PDF of 1:3b [link to come]

Reviews

Bellies, Bowels and Entrails in the Eighteenth Century

Review by Burcu Alkan

The History of Reason in the Age of Madness: Foucault’s Enlightenment and a Radical Critique of Psychiatry

Review by Burcu Alkan

Blood Matters: Studies in European Literature and Thought, 1400-1700

Review by Sarah E. Parker

[image error] Review by Burcu Alkan

Although not quite the “grand seat of consciousness” like its counterpart the brain, the stomach, with a massive nervous system of its own, is long deemed a kind of a second brain. This “gut” of the gut-feeling and the neighbouring viscera is the focal point of Bellies, Bowels and Entrails in the Eighteenth Century (Manchester University Press, 2018), edited by Rebecca Anne Barr, Sylvie Kleiman-Lafon, and Sophie Vasset. As this collection of essays show, the eighteenth century intellectual world was very much preoccupied with the bowels, the stomach, and other internal organs within the abdominal cavity in pursuit of a form of self-knowledge expressed in the materiality of the body. The texts discuss grotesque, non-heroic, ailing, and deformed bodies against the celebrated “ideal,” through literary representations, political encounters, critical caricatures, and anatomic drawings in order to underscore “the darker side of the Enlightenment” (5).

The book comprises of four parts, each of which have thematically linked essays. There are fifteen chapters in total that explore the relationship between the organs and functions of the digestive system and their cultural connotations in the long eighteenth century, a period that roughly begins in the last decade of the seventeenth century and ends in the first decade of the nineteenth.

The first part, “Urban congestion and human digestion” revolves around both literal bodily functions and symbolic representations of the stomach. For instance, in their respective chapters, Gilles Thomas and Sabine Barles & André Guillerme examine the functions and the transformation of the residential, commercial, and underground structures of Paris and liken the deleterious world of dirt, dead, saltpetre and excrement that sustains the city’s socio-economy to the bowels of an organism. Ian Miller moves up the digestive tract and details out what the changing understanding of the stomach means for both medicine and the perception of the self. Miller notes that it was in the eighteenth century that the stomach was dethroned from its position as the “seat of the soul” (63). Instead, it began to be portrayed as a potent organ that dissolves, ferments, and putrefies. It is a beastly organism but one that has a complicated system of its own, ensuring the dissolution of only food matter and not itself, and thus, maintaining the survival of the whole body.

The essays in the second part, amusingly titled, “Excremental operations,” focus on the attention paid to faeces in the eighteenth century. The artists and intellectuals of the era seem to have had rather interesting engagements with the matter. Amélie Junqua explores the relationship between the state of the paper industry and the literary worth of poetry, united in the common denominator of bowel movements and their outcomes. Her examples from Jonathan Swift, John Dryden, and others are both informative and entertaining at the expense of bad poets. Jennifer Ruimi’s work on French comedy is an equally informative and entertaining look at the use of faecal matter as a form of parodic social critique and burlesque erotica. In their own gleeful ways, both the English and the French of the century facilitated the mundane world of bowel movements as a revolt against decorum. Essentially, that the world has evolved towards a definitive privacy in that department renders the practices of and concerns regarding excremental affairs quite alien but fascinating to the modern reader.

The third part, “Burlesque Bellies” is particularly interesting as the preoccupation with the innards of the human body and its processes, which is itself a result of the Enlightenment, turns against the Enlightenment. Guilhem Armand looks at the parodies of “pompous knowledge” and the pedantic scientific productions of the era. Once again, the French satire proves highly comic in terms of the relationship between “farting” and certain types of scholarship. Sometimes literature does prove timeless and discourses of flatulence could probably speak to today just as well. Similarly, Clémence Aznavour examines Pierre de Marivaux’s works along the lines of the deflation of representative values in epic narratives. The contrast “between the image of the hero and his physiology” (219) is highlighted through the uncontrollable functions of the body and its ailments, such as constipation, diarrhoea, flatulence, and the like. While the parodic nature of the texts is amusing in their own right, they also underscore the prevalent push towards the recognition of the materiality of the body.  

The final part focuses on the visual representations of the viscera. Barbara Stenz begins with the interconnection between the ideal, healthy body and the deformed, ailing body. She notes, “During the Enlightenment authors of all persuasions – doctors, men of letters, philosophers, theoreticians of art – based many of their observations and assumptions on a model of the body whose balance and fine proportions served as a foil to a growing obsession with degeneracy” (274). Irrespective of political inclinations, the adversary was caricaturised as big bellied, underlining -often wrongfully acquired- excess. Moreover, another key element of the Enlightenment attitude towards science, reason, and knowledge became manifest in the emergence of anatomic drawings. The artists were introduced to a new way of seeing and understanding the self through the matter of the body. Dorothy Johnson explores how the Enlightenment instigated “a reconceptualisation of the body itself” through “a literal and metaphorical carving out, a disembowelment and dismemberment that was no longer proscribed or confined to medical practice but instead was on public view” (295). However, as befits the Enlightenment spirit, these liberations in science and arts regarding the “knowledge of the body” were paralleled by contrasting religious discourses. Jacques Gélis discusses how this type of knowledge of the body was appropriated accordingly to the spiritual needs of the rural people in the form of representative saints.

There are many other essays in Bellies, Bowels and Entrails that are equally interesting and fascinating, such as laymen’s epistolary correspondences with expert physicians and the connections between appetite, health, and desire in the notorious pornographic texts of John Cleland, marked by an understanding that the  body is “an eloquent object” (229). In fact some of the chapters are so interesting that their shortness does not do them justice. For instance, Micheline Louis-Courvoisier, in her chapter “The Soul in the Entrails” examines the tradition of epistolary-diagnosis in relation to how the people of the eighteenth century related to their ailing bodies. However, their relation to the concept of the soul as such is not explored adequately. Likewise, the handling of anatomic paintings in Johnson’s piece is highly engaging but it is not treated quite enough.

The editors state that the book was born out of a conference held in Université Paris-Diderot in 2014. That some of the essays feel brief for the expectations they raise might be an outcome of such conversion. Another consequence as such is probably the limited focus of the essays to German, French, and English examples. Accordingly, the collection, like many similar others, is firmly situated within the boundaries of nuclear western academia. Still, as the editors note in the introduction, Bellies, Bowels and Entrails might not be “for delicate stomachs” (17) but it is a rather interesting read nonetheless, revealing another Enlightenment.

[image error]Review by Burcu Alkan

From his seminal Madness and Civilization (1964) to his later studies on various structures of power, Michel Foucault’s works have instigated a diverse and often contentious set of reactions in many fields. However, John Iliopoulos’s book is not yet another work that argues for or against Foucauldian thought or just another history of psychiatry. The History of Reason in the Age of Madness: Foucault’s Enlightenment and a Radical Critique of Psychiatry (Bloomsbury, 2018) scrutinises the concept of reason as defined by the Enlightenment thinkers and the corresponding changes in psychiatry over the past centuries through Foucault’s meticulous analysis of both. It is an in-depth and highly-informed engagement with Foucault’s oeuvre. Iliopoulos goes beyond the all-too-familiar uses and misuses of the Foucauldian approach and clarifies many misreadings and misinterpretations.

He first positions Foucault’s critique of Enlightenment by underlining that Michel Foucault is “neither [an] anti-Enlightenment thinker who rejects reason and truth” nor does he prescribe to a simplistic “notion of the triumph of rationality” as a resolved, finished product (p. 2). Instead, he is concerned about the relationship between reason and rationality, the limits of that relationship, and what that relationship and its limitations say about the ways in which people relate to reality. Forms of rationality, Iliopoulos explains, “are forms of conduct and a structuring of reality based on reason as a principle of knowledge and action. Forms of rationality constitute the implementation of reason in everyday affairs” (p. 4). Disregarding their distinction as such turns the Enlightenment ideas into self-righteous purveyors of truth.

Given the necessity of such a distinction and the complications that arise from its lack, Iliopoulos spends the first couple of chapters in setting the foundation straight. In the first chapter, he asks the Kantian question of “What is Enlightenment?” and proposes it as being essentially, “the age of critique” (p. 7). About the intrinsic dangers of self-righteousness that underlie the “blackmail of the Enlightenment,” Iliopoulos explains: “Rationality is reason as principle of knowledge, necessary for grasping and manipulating reality, which does not cover the entire field of human experience and when it attempts to extend its powers to domains beyond its limits, undermines itself by falling into arbitrariness and irrationality. The courage to recognize these limits and the rigour to demarcate them belong to the reflective properties of reason” (p. 5). In this context, Iliopoulos examines the impact of Kant’s “Anthropology” on the conception of madness and the limits of psychiatry in the eighteenth century. The acknowledgement of the boundaries in the comprehension of madness enabled the “alienists” to see beyond the normative pressures of rationality. Yet, when the proto-psychiatrists prescribed to the necessity of defining issues incomprehensible to rationality through the lenses of rationality and “incorporate[d] tenets of positivism” into their work, they lost their “scientific rigour” (p. 17).

In the second chapter, Iliopoulos extends his analytical evaluation of Foucault’s work to both philosophical and psychiatric applications of phenomenology. He notes: “Phenomenology is the offspring of a primordial confrontation between reason and madness, the direct derivative of this fundamental tension, which created the rational phenomenological subject capable of contemplating the sick consciousness” (p. 28). Foucault’s analysis of madness and psychiatry through phenomenology maintains a distanciation from external theories, perceptions, and presumptions and focuses on what the manifest reality of “madness” reveals. Such a consideration of madness transcends and transgresses the established truth regimes that limit understanding, as madness itself poses its own truth regime against normative rationalities. The mad consciousness does not have a distorted perception of truth but a unique relationship with it, that is, its own truth regime. An example of this is shown through how the hallucinating person never confuses the voices of the “real” world with the voices that only they hear. Accordingly, madness becomes a category of truth in itself, “an epistemological problem” as it clashes with “the exoteric forms of knowledge,” “the diagnostic truth” that determine and categorise madness (pp. 44-45).

In the third chapter, Iliopoulos moves to the basics of discourse analysis as an examination of how “forms of rationality, infiltrate, make up and organize power relations and their effect in the way reality is perceived” (p. 30). The historicity of Foucault’s approach distinguishes his work from a simplistic relativisation of the experiencing subject, and thus, from direct phenomenological interpretations. The “subjects and objects emerge simultaneously as a result of truth procedures specific to a given historical period” (p. 47) and the said truth procedures are always in a complex relationship with ethics, politics, and jurisprudence. Consequently, for Foucault, the perception of madness and the development of psychiatry from the eighteenth century onwards have been contingent upon the “three modalities of truth”: politics, science, and ethics, and their tension-laden encounters. Whether it is the public hygiene requiring those who do not fit the normative regulations of society to be kept away or the jurisprudential necessities of differentiating between the “real criminals” and those who are “mentally ill,” psychiatric medicine bears immense power and intense pressure.

Accordingly, the fourth chapter brings the debates to Foucault’s critique of the politics of power, discipline, and abuses of psychiatry. It discusses his engagement with anti-psychiatry and his analysis of ethico-politics concerning psychiatric medicine. Although Foucault appreciates the contributions of anti-psychiatric debates, he is not necessarily an advocate. He argues that certain forms of rationality created correlated structures of power through logical truth-regimes that were needed, produced, and disseminated within societies. Yet, he rejects monolithic interpretations of power that identify it only with sovereignty, oppression, and prohibition. He establishes a critical distance with anti-psychiatric movements that maintain only a negative and domineering power model. Hence, he proposes “an anonymous, multiple, pale, colorless power” (p. 83), that of discipline. Psychiatric discourse has been in flux due to a drive to become a reliable scientific enterprise and a dependable forensic field. As much as it was prone to abuses of power, it was also geared towards preventing such abuses by malingerers and aimed at safeguarding the vulnerable. Such complexity and complications mark Foucault’s meticulous historical critique of psychiatry not only as an institution but also as an evolving field and discourse.

The fifth and sixth chapters look at the nineteenth century as a critical threshold in the history of psychiatry before it was medicalised in the contemporary sense with the inclusion of biology, pharmacology, and neurosciences. They focus on two distinct but interrelated subjects: an ailment, hysteria and a model of treatment, psychoanalysis. Under the pressure of external truth-regimes, psychiatry was strained to establish reliable epistemological foundations in order to prove its medical status. The body became “both the foundation of perceived reality and the object of this reality as a set of biological processes, […] the unequivocal source of a knowledge […] not only diagnostic but also prognostic” (p. 109). As madness was not demonstrable anatomically and psychiatry was up against the “somatocracy” of positivism, neurology provided the needed material for a medical identity, engendering neuropsychiatry. However, certain types of “madness,” particularly hysteria resisted such classifications and continued to challenge the position of psychiatry as a branch of medicine. The hysterics demonstrated symptoms of neurological disorders but these symptoms lacked references in the nervous system. Charcot’s application of hypnosis further problematised the situation, as neurological symptoms without anatomical correspondence could also be instigated exogenously through suggestion. Still, Charcot’s technique proved to be a name-making method by enabling the differentiation of “real” neurological symptoms from “simulated” ones.

The nineteenth century became a stage for the clashes between two separate truth regimes within psychiatry: the “dominant scientific truth regime […] that is guided by rationality” and “that has become increasingly positivist” in handling mental illness and the “marginalized truth regime that tests madness” guided by reason and “establishe[d] a relationship with otherness” (p. 125). Psychoanalysis brought their conflict-ridden antagonism into an undeniable focus by weaving back and forth between them and creating its own unique space in the process. Freud proposed psychoanalysis as a medical and psychological practice, expanding the realm of psychiatry but challenged its established structures by means of inverting its diagnostic model. Psychoanalysis employed a traditional medical conception of truth, i.e. the notion of crisis. However, instead of looking for the kernel of truth in the patient’s mind, it focused on the presence of falsity and illusion to simulate crisis and thus render it accessible to a possibility of comprehension. Iliopoulos maintains that Foucault’s analysis was not an attempt at invalidating psychoanalysis as a scientific method but a genealogical study to locate it “in Western rationality and to assess the type of truth that it articulates in relation to psychiatry” (p. 126). What Foucault sees is not an epistemological weakness but “a unique type of discourse that can critique psychology itself as well as historical analysis” (p. 133).

The History of Reason ends with a brief chapter discussing the psychiatrists as intellectuals, showing “how their epistemological status can question current security-oriented rationality” (p. 153). It is an intense and informative book that traces the history of psychiatry through its philosophical veins. Moreover, it is a reconsideration of the threshold between modernity and postmodernity, a fluid space that bears the potential to bring together the critical enterprise of the Enlightenment and the radical edge of the postmodern. It is a reminder of the alertness necessary in critical thinking, a warning regarding the pitfalls of Enlightenment rationality that ignores its dialogue with reason. Yet, it also encourages a renewed faith in critique a la Enlightenment, as John Iliopoulos revisits the potential in Foucault’s work in navigating that fluid, liminal space.

[image error]Review by Sarah E. Parker (Associate Professor, Jacksonville University).

This collection of essays, Blood Matters: Studies in European Literature and Thought, 1400-1700 (University of Pennsylvania Press, 2018),  explores the material understanding and figurative use of blood in the late medieval and early modern world. Bringing together the work of scholars in history and literature, this interdisciplinary collection introduces a conversation about the important and multiple roles that blood played in the early modern worldview. That said, the book’s editors, Bonnie Lander Johnson and Eleanor Decamp, are both scholars who focus on early modern theater, and that area of specialization informs much of the collection. The chapters explore in particular the liminal quality of blood; because blood typically hides within the workings of the body, the moments when it appears are laden with meaning.

The chapters are relatively short and grouped thematically. The first group of chapters deals with the blood’s literal and metaphorical circulation. The opening essay, by Margaret Healy, addresses the work of William Harvey, who discovered the circulation of the blood. Healy takes issue with Christopher Hill and John Rogers’ argument that Harvey’s late work on circulation signals a revolutionary and “vitalist” turn in his philosophy and politics. Instead, she argues, Harvey’s vitalism remains consistently Aristotelian throughout his lifetime. The next chapter, by Heather Webb, predates the discovery of circulation as we think of it, but she argues that medieval authors Dante Alighieri and Catherine of Siena nevertheless view blood as a dynamic entity in a constant state of circulation that connects the individual physical body to the body of the church more broadly. One of Catherine’s letters uses her own blood as a metaphor for the warmth and life that she believes her spiritual vigor could bring to a sickly church. Katharine A. Craik’s essay on Shakespeare’s Henriad is one of many essays that deal with Shakespeare and early modern drama in this collection. By examining the character Pistol, Craik draws attention to the class tensions in Henry’s famous lines in the St. Crispin’s Day speech that “he today that sheds his blood with me / Shall be my brother; be he ne’er so vile, / This day shall gentle his condition” (4.3.60-63). While Henry’s speech suggests that war can overcome class divides, Craik shows that Pistol and other characters belie that claim.

The second section groups essays that discuss wounds and wounding. Continuing the volume’s focus on Shakespeare, Hester Lees-Jeffries’ chapter considers the representation of wounds on the Shakespearean stage. Coriolanus is described as “mantled” in his wounds, a metaphor that Lees-Jeffries explores in terms of the material world of the theater where a blood soaked garment would have played the role of both costume and prop to communicate the various wounds in Shakespeare (Macbeth, Julius Caesar, etc.). Gabriella Zuccolin and Helen King shift the focus to the history of medicine and consider the ways that nosebleeds were specifically gendered in the early modern period. In contrast with Laqueur’s theory of the one-sex body, they focus on cases where women were believed to get nosebleeds because of the suppression of their menses, and explore this topic in relation to contemporary beliefs about the humoral system and the benefits of regular bleeding. Joe Moshenska’s final chapter for this section investigates the boundary between animal and vegetable by considering an odd trope in the epic tradition: the hero’s encounter with a bleeding tree. Medieval and Renaissance authors, including Dante, Ariosto, and Spenser, take up the story of a man trapped in a tree from Virgil’s Aeneid, and Moshenska connects the moment of violence in these stories (when the hero breaks the tree’s branch and prompts it to speak) to the violence of poetry more broadly.

The third group of chapters deals with the theme of corruption in the blood. Tara Nummedal offers a fascinating analysis of the relationship between blood and alchemy’s concern with the role that menstrual blood played in generation and corruption. This chapter considers the work of Anna Zieglerin, a German alchemist who claimed that her own body had been purified by alchemy, causing her not to menstruate. Ben Parsons discuses another corrupted demographic, adolescent boys. According to medieval pedagogical treatises, he argues, boys had an excess of blood, a fact that made them both receptive to learning, but also unruly and in need of discipline. In one of the best contributions to this volume, Bonnie Lander Johnson focuses on a specific kind of corruption in Shakespeare’s Romeo and Juliet, namely greensickness, which was believed to affect young people as they reached sexual maturity. She argues that the Nurse’s parallel references to Juliet’s weaning and her maturation “functions as a greensickness narrative” in the play (144).

The fourth section of the book takes up the important role that blood played as a source of proof in legal contexts. Lesel Dawson discusses the bizarre medieval and early modern belief known as “cruentation,” according to which the body of a murder victim would bleed when its murderer approached. Dawson discusses myriad references to this belief in early modern drama. Eleanor Decamp’s important research into the distinctions between barbers, surgeons, and barber-surgeons in the early modern period informs her chapter on the appearance of a basin in the final bloody scene of Titus Andronicus. By showing the association between blood basins and barbery, Decamp unpacks the puns on, references to, and associations with barbery in the climax to Shakespeare’s most gruesome play. Elizabeth Dutton also wonders about blood on the medieval and early modern stage, considering in particular the material fact that it would have been difficult for the actors to get blood off of their hands. Her reflections on this problem cover the anti-Semitic miracle play known as the Croxton Play of the Sacrament, which features a dramatic bleeding host scene, alongside scenes from Macbeth. Patricia Parker’s essay comes back to the importance of blood as proof in an overview of the meanings of the bloody cloth in Cymbeline, which she connects to Sujata Iyengar’s scholarship on the influence of the Passion in Shakespeare’s plays.

The book’s final section, called “Signs and Substance,” is the most loosely connected group of chapters. Frances E. Dolan writes about the association between blood and wine in early modern arguments that England should embrace a domestic viniculture to avoid taking in foreign “blood.” Dolly Jørgensen’s chapter looks at changes in the medieval calendars, specifically the December representation of pig slaughter, which became more graphic in the late medieval period. Helen Barr’s final chapter offers a surprising reading of The Canterbury Interlude (a contemporary response to Chaucer’s Canterbury Tales) where she imagines a Pardoner who is beaten by a phallic pilgrim’s staff as a precursor to the appalling scapegoating that accompanied the AIDS epidemic.

Since many of these chapters focus on drama, the collection will be most useful to Shakespeare enthusiasts and students of early modern drama. The fact that the chapters are fairly short (between 10-15 pages) also makes them good candidates for anyone teaching early modern literature or history with an eye to the history of medicine and the important role of blood as metaphor and substance in the early modern world.

The book is part of a larger “Blood Project,” based at Oxford University. Though it is a bit dated, the website for the project has useful resources for anyone interested in learning more about the role of blood in the history of late medieval and early modern medicine. Readers of this journal might be especially interested in the recorded performance of the Croxton Play of the Sacrament, which is available on that website.

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Brandy Schillace, Editor-in-Chief

Hanna Clutterbuck-Cook, Managing Editor

Anna J. Clutterbuck-Cook, Review Editor

Download PDF of 1:3 [link to come]

Editorial

Health, Gender, and Embodiment, Part Two

Brandy Schillace, Editor-in-Chief

Features

Pain, Prestige and Embodiment

by Rosemary Behmer Hanson

#MeToo, Mental health, Revenge Porn, and the Nineteenth Century

by Katherine Gilbert

Sharing Pain: Zines and Mental Illness

by Shelley Lloyd

Maternity Stories as Social Change

by Sarah MacDonald

The ART of Infertility: A Community Project Reimagining Reproduction Advocacy

by Maria Novotny

Embodying Trauma: Acute and Accumulated

by Heather Stewart

Reviews

A Kairotic Moment for Women’s Pain and Illness: A Review of Three Books

Review essay by Caitlin Ray

How to Survive a Plague by David France

Review by Katelyn Smith

Invisible No More by Andrea Ritchie

Review by Ayoola White

The Future of Dósis

Fall 2018 (1:3) is the final issue of Dósis. There will be a Review Supplement (1:3b) issued in November or December of this year, and then the publication will go dormant. For the foreseeable future, this website (medhumdosis.com) will remain online for readers to access the archives going back to March 2011. If you have questions please contact Brandy Schillace at bls10@case.edu.

Download PDF of 1:1 (Winter/Fall 2018).

Download PDF of 1:2 (Summer 2018).

Download PDF of 1:3 (Fall 2018). [link to come]

Download PDF of 1:3b (Fall 2018 Review Supplement). [link to come]

by Brandy Schillace, Editor-in-Chief

In this, our third and final issue of 2018, we present a series of thoughtful essays to carry us through the electoral season. Since our inception, which pre-dated the Dosis name, we’ve undertaken to present issues of health and social justice. Never has the call to action and advocacy seemed more necessary than now, as we watch women’s voices silenced or disbelieved by party politics, and the rights of LGBT, women, and minorities facing further restriction. Your words, your voices, matter. These essays, which follow on as part two of Gender, Health, and Embodiment (for part one, see Summer 1:2) speak to access, to history, and to our need of mutual support networks. From mental health history (Gilbert) and embodied pain and trauma (Stewart and Hansen), to issues of maternity and infertility (MacDonald and Novotny) and the rhetoric of depression narratives (Lloyd), our Fall/Winter issue brings the ongoing struggles for acceptance and voice to the fore.

This issue will also mark our last for the Dosis blogzine. But while we will not be posting additional CFPs in the foreseeable future, we are not closing our doors. The blog will continue to operate as archive for reading these works, and there may occasionally be additional editorial posts. Our work here has been an honor, but we’ve turned energies into other channels, still fighting the good fight for inclusivity and social justice. I would like, here, to particularly thank the Managing editor, Hanna Clutterbuck-Cook, and the Book Review editor, Anna Clutterbuck-Cook. Their titles do not do justice to the amount of behind the scenes work they have undertaken in the last 3+ years. I would like also to thank our engaged authors for sharing their time and words with us. And finally, hats off to you, our readers. We know that you are out doing your part. We encourage you not to lose hope, and to come together for support and self-care. And of course, as our cover image to the downloadable and sharable PDF makes clear, we thank you for voting for change!

by Rosemary Talbot Behmer Hansen, MA, MPH

It’s estimated that tens of millions of women in the U.S. are dealing with unnecessary pain because doctors assume that, even if there is something wrong with them, they’re probably exaggerating their symptoms. Simply put, medicine doesn’t trust women to be familiar with their own bodies. [1]

There is “no shortage” of data that confirms that men receive superior management for chronic pain. [2] This essay will use fibromyalgia as a case study for assessing how gender identity unjustly exacerbates physical and psychosocial suffering for chronic pain patients.

Fibromyalgia Background

Fibromyalgia Syndrome is a condition characterized by chronic widespread pain and somatic symptoms. While the disease mechanisms are yet to be entirely understood, fibromyalgia has been shown to be due to an abnormal interaction of neurological, neuro-hormonal, and immunological systems. Symptoms include pain, fatigue, sleep disturbance, anxiety, depression, memory and mood deficiencies. As well as having genetic components, fibromyalgia can be triggered by psychological trauma, infection, and physical pain experiences. Newer diagnostic criteria reveal a fibromyalgia female to male ratio of 2:1, which is similar to those of other chronic pain disorders. There is no cure for fibromyalgia. Patients can sometimes find relief with pharmacological, psychological, educational or holistic therapies. [3]

History of Women’s Pain

“…the outlook for patients is rosier than you might expect given the condition’s perplexing reputation.” [3]

Long before chronic pain conditions such as fibromyalgia were coined, women who reported pain, distress and fatigue were given the diagnosis of hysteria. Latin for “womb,” hysteria in the 18th century was thought to originate in women’s reproductive systems. In the 20th century, Freud proposed that hysteria was a conversion of psychological distress, brought on by repressed memories that manifested in female bodies. Men diagnosed with hysteria were described as “weak, effeminate creatures” without the qualities that are seen as “appropriately masculine.” [5]

The term “fibrositis” was coined by a 1968 physician in Illinois to describe “a constellation of generalized stiffness, headaches, malaise, and tender points… [in women] who tended to be “worry warts.” The trigger for the exclusively-female fibrositis was believed to be “reckless emotion.” [3] In the late 1980s, fibrositis evolved into the diagnosis called fibromyalgia. The diagnosis allowed people living with chronic pain to find support from rheumatologists who finally saw their pain as a disease of the body, and not the mind. [5]

Criticism of fibromyalgia patient credibility was swift. A physician stated that people with fibromyalgia syndrome had real pain, but suffered from an inability to cope with both the intensity of their symptoms as well as, in general, the various stressors in their lives. [6] He, like many other doctors, believed fibromyalgia enabled patients to abuse the medical system. Indeed, Indiana University Neurology Professor John Kincaid estimates that about half of all physicians today do not believe that fibromyalgia exists—a notion that is contrary to the findings of countless researchers, the World Health Organization and the American College of Rheumatology. [3]

Disease Prestige

…diseases and specialties associated with technologically sophisticated, immediate and invasive procedures in vital organs located in the upper parts of the body are given high prestige scores… At the other end, low prestige scores are given to diseases and specialties associated with chronic conditions located in the lower parts of the body or having no specific bodily location, with less visible treatment procedures, and with elderly patients. [7]

This is the conclusion from a 2008 Norwegian study, which asked senior physicians, general practitioners and senior medical students to all rank 38 diseases, including cancer and diabetes, in terms of prestige. Fibromyalgia was ranked last by all three participant groups. [7]

Disease prestige can impact the quality of treatment a patient receives. Access to care, hospital funding, medical research and funding, and physician support, have all been associated with disease hierarchy. [8, 9] In a blog written by a physician who was diagnosed with fibromyalgia, she asserted that the primary reason why fibromyalgia research has inadequate support is sexism. [10] Her sentiment is supported by a National Fibromyalgia Association medical advisor, Dr. Patrick Wood, who argues that the complaints of fibromyalgia patients are dismissed because they are women. [4]

Physician Heroics

“…physicians value narratives in which they are portrayed as ‘masculine and extraordinary lifesavers’, reflecting deep-rooted heroic tales of Western culture.” [9]

When treating a patient in an acute, urgent circumstance such as during a heart attack, physicians are required to perform systematic medical evaluations and use highly technological interventions when time is of the essence. Studies have confirmed that many physicians find these dramatic moments to be of high interest. [9]

Fibromyalgia patients may inadvertently challenge traditional physician roles of being “extraordinary lifesavers.” Diagnosing fibromyalgia, in many ways, requires physicians to admit that they “just don’t know what’s wrong.” [11] This is a tough thing to do when Western culture associates medical certainty with physician prestige. Furthermore, treating fibromyalgia patients involves a longitudinal process of therapeutic trial and error. [4] These patients are not damsels in distress to be quickly rescued from the jaws of death; they may instead be viewed as challenging women who oftentimes fail to immediately respond to medical treatments. In short, saving the “weaker sex” from chronic pain is trying. [10] Accordingly, some physicians find treating patients with fibromyalgia “tremendously frustrating” and a “thankless task.” [4, 12, 13]

Embodied Suffering

“Sometimes [doctors] take out their frustrations on the patients and blame the patients for the illnesses… There’s a long history of this in medicine.” [4]

Women do not just suffer from fibromyalgia itself; they suffer from the sexism related to attempting to find and receive appropriate medical care. One physician argued that chronic pain becomes “involved in a lifestyle mix,” and that all associated symptoms become prominent “when the individual focuses on herself and her discomfort.” [6] The author follows this statement with a more overtly sexist remark: “it is mostly women who fall into this category.” [6] Similarly, some physicians who treat chronic pain patients report not trusting their patients or their experiences of pain. [13, 14] It takes on average about five years for chronic pain patients like those with fibromyalgia to receive a proper diagnosis. [16]

The term “fibromyalgia personality” is sometimes used to stigmatize fibromyalgia patients as inherently irrational and hysterical. One physician said, “You immediately know they have [Fibromyalgia], often even before they say anything, just from the way they’re behaving and their personality.” [5] It is of no surprise, then, that women with medically unexplained disorders have reported being met with “skepticism,” “feeling rejected, ignored,” and being “blamed for their condition” by their physicians. Women experience illness in “delegitimizing and stigmatizing” ways because both their moral character and their mental health are frequently questioned by others, “doctors in particular.” [15]

The doctor-patient relationship in adversarial instances like these may devolve into one of scrutiny, distrust and disgust. This unique dismissal of women’s pain as irrational, emotional, psychological, immoral, and potentially deserved, is not surprising from a feminist perspective. [3, 4, 16, 17, 18] In the fibromyalgia community, it is referred to as the “credibility issue,” and its consequences to the afflicted may include: psychosocial problems, refusal to seek medical care, self-blame and loathing, worsening of condition, and suicide. [4, 11, 19] Fibromyalgia patients may become subject to physical and moral scrutiny from friends, family members, coworkers, and total strangers. [4, 17]

In short, women with fibromyalgia risk being cast as bad women. They may be perceived as any combination of ungrateful, lazy, hysterical, after disability benefits, and manipulative. [6] Because they inadvertently challenge common societal narratives about physician roles, they risk causing their healthcare providers to feel frustrated, delegitimized, and even emasculated. We should therefore not be surprised that living with fibromyalgia can be “re-[traumatizing].” [19] Disease, gender and society interact, forcing those with fibromyalgia to embody the role of deviant womanhood.

Person Prestige

“According to a National Pain Report survey conducted last year, a staggering 90 percent of women with chronic pain feel that the health care system discriminates against them.” [11]

A quick, informal survey of my Facebook friends revealed a startling quantity of stories about pain dismissal and credibility challenges in biomedical settings. Regardless of illness type, many of my friends had been made to feel like they had become problems, rather than merely had problems: their cases were viewed as atypical, uninteresting, or altogether fake; their very beings were criticized. Thankfully, after relentlessly advocating for themselves, most of them eventually found affirmative, compassionate and appropriate healthcare services elsewhere. But what happens to those who cannot advocate for themselves? How do our collective societal values increase suffering for the sick and injured?

Stigma is unjust because it uniquely punishes already-marginalized people by treating them as social deviants. It enables xenophobia in society and ultimately jeopardizes population health. We see the effects of stigma in the Norwegian researchers’ disease prestige hierarchy list, too, when reviewing diseases with the lowest prestige: anxiety neurosis, hepatocirrhosis (cirrhosis of the liver), depressive neurosis, schizophrenia, anorexia, and AIDS. [7] When we consider the patient populations at risk for these diseases, it appears that the prestige of the patient matters when determining disease hierarchy: disease prestige impacts patient prestige, and patient prestige impacts disease prestige. We have seen this most disturbingly play out in the ongoing HIV/AIDS crisis, where patient nationality, race and ethnicity, sexual orientation, gender identity, age, profession, religion, economic status and other identities intersect to determine public sympathy for the afflicted and public support for global health interventions.

Whether we are discussing syphilis, myocardial infarction, breast cancer, substance abuse disorders, or any other condition, patient identity need not exacerbate patient suffering. There is room for improvement. We can start by challenging harmful notions of physician prestige, fighting problematic ideas of disease prestige, and believing that neither pain nor person is invisible.

Rosemary Talbot Behmer Hansen is an M.D. candidate at Rutgers New Jersey Medical School in Newark, New Jersey. She has both an M.A. in Bioethics and an M.P.H. with a major in Health Policy & Management from Case Western Reserve University (May, 2018) and her academic interests include issues of patient autonomy and medical decision-making. She lives in the Greater New York City area with her husband Ryan Behmer Hansen and dog, Franklin.

References

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Stetka B. Fibromyalgia: Maligned, misunderstood and (finally) treatable. Scientific American. Published 2014. Accessed May 31, 2018.
Williams I. Why fibromyalgia has a credibility problem. Health.com. Published 2016. Accessed May 31, 2018.
Oldfield M. “It’s not all in my head. The pain I feel is real”: How moral judgement marginalizes women with fibromyalgia in Canadian health care. Womens Heal Urban Life. 2013;12(1):39-60.
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  Stone L. When you’re sick, the support you’ll get may depend on the “worth” of your disease. The Conversation. Published 2018. Accessed May 31, 2018.
  Ng BK. Disease prestige: A case of hierarchy in medical conditions and specialties. MIMS Today. https://today.mims.com/a-case-of-hierarchy-in-medical-conditions-and-specialities. Published 2017. Accessed May 31, 2018.
  O’Connor MI. The woman patient: Is her voice heard? Sharing Mayo Clinic. Published 2013. Accessed May 31, 2018.
  Culp-Ressler T. When gender stereotypes become a serious hazard to women’s health. ThinkProgress.
  Gordon DA. Fibromyalgia–Real or imagined? J Rheumatol. 2003;30(8):1665-1666.
  Matthias, M. S., Parpart, A. L., Nyland, K. A., Huffman, M. A., Stubbs, D. L., Sargent, C. & Blair MJ. The patient-provider relationship in chronic pain care: Providers’ perspectives. Pain Med. 2010;11(11):1688-1697.
  Associates PDHR. Americans Talk about Pain; A Survey among Adults Nationwide .; 2003.
  Werner, A. & Malterud K. It is hard work behaving as a credible patient: Encounters between women with chronic pain and their doctors. Soc Sci Med. 2003;57(8):1409-1419.
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  Tasca, C., Rapetti, M., Carta, M. G. & Fadda B. Women and hysteria in the history of mental health. Clin Pr Epidemiol Ment Heal. 2012;(8):110-119. doi:10.2174/1745017901208010110.
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by Katherine Anne Gilbert

In the wake of Tarana Burke’s #MeToo, movement, studies showing the connection between sexual harassment, assault and psychological suffering have received increasing attention. The collective weight carried by women who experience these violations is heavy. As women continue to come forward and share their narratives via journalism and social media, mental health scholars and practitioners have established the deep toll placed on women by continued sexual violence and harassment. The psychological effects may manifest as anxiety, depression, and “data suggests that anywhere from 30 to 80 percent of sexual assault survivors develop PTSD.” Through what is called “somatizing,” the trauma can manifest in physical symptoms: “muscle aches, headaches . . . chronic physical health problems such as high blood pressure” and even “heart issues.” Considering recent data collections, including one that found 81% of women have experienced sexual harassment, we can say with confidence that a large number of women are forced to manage the mental and physical health effects created by a society that perpetuates gender inequality.

What might contemporary conversations about #metoo have to do with my own area of study, Victorian literature? Recently, some Victorianists have argued that in many ways we are still Victorians; by this they mean that many of the issues we are grappling with right now have points of germination in the nineteenth century: climate change begins with industrialization and the rise of capitalism; residual effects of British colonialism and empire reach like tentacles across time; debates about liberalism and conservatism find their roots in polemics as far back as those by Edmund Burke, Mary Wollstonecraft, and mid-nineteenth century writings by J.S. Mill; and in the U.S., our grappling with racism and policing is contextualized by our inability to come to terms with the legacy of slavery.

Undoubtedly, contemporary sexual harassment and assault are about the exercise of power over others, but part and parcel of that dynamic are attention to the arrangement of bodies in space, and claims about whose bodies are allowed to exist in what spaces at what times. Here too, a turn to the nineteenth century helps us to see how current sexual violence and harassment can be more completely understood through the enshrinement of the public/private divide during industrialization in the nineteenth century. While men and women were associated with different spaces before then, the rise in industrialization, cities, and commutes to and from work ushered in a new spatial organization of bodies in the Victorian period. Previously, the predominance of agricultural work meant that families frequently labored in one space; while different members of a family might have a variety of roles in a rural economy, the family, as a whole, lived and worked in one location.

During the rise in industrialization and capitalism, men left homes in the morning and returned at night after having executed their professional duties in urban spaces. Women, then, became cast as idealized “angels” at home who set and maintained morality in a system largely used to raise children but also conceptualized women as needing to be shielded from the more brutal, fast-paced economic forces of the city. Middle-class white women in particular were cast as fonts of purity that created moral sanctuaries to which men, after a long day at work, could return home for moral repair. Coventry Patmore famously enshrined a married woman’s role as “The Angel in the House” in an 1854 narrative poem of the same name and John Ruskin wrote of a woman’s domain as a sort of domestic royalty in his popular 1865 Sesame and Lilies.

One can draw a line between such texts and recent discussions of how women should be viewed in the political world and in the office: In 2008, then-senator Hilary Clinton struggled to be heard during a 2008 speech due to the presence of a male attendee who held a sign that said “Iron my shirt,” as he shouted the same, repeatedly, over her attempts to articulate policy ideas to her audience. The “Pence rule,” or the idea that a married man cannot have a dinner with a woman other than his wife, even to discuss business, as well as John Kelly’s statement that when he was growing up, “women were sacred,” (or, Patmore-eque “Angels”) operate along similar lines. Pence and Kelly’s ideas about morality insist on supposed protections for women that in fact disempower women, box them in, shut them out, and shut them down.

Many of the reforms that were passed in the nineteenth century focused on married women. This is undoubtedly due to the especially dangerous effects of the law of coverture, which subsumed the legal identity of women under that of her husband. When women married, they and their husband became one, and that “one” was the husband. As a “femme covert” a married woman could not control her own earnings or enter into contracts, for example. She was not an independent legal person, but in many ways, a legal child.

The public/private divide continues to operate in the lives of women from a range of racial and national backgrounds. Women’s bodies, as do all bodies, take up space; legal and social control of women entails forms of control of those bodies. We might think of school dress codes that insist girls’ bodies are distractions that hinder boys’ learning in public schools. Notably, today, those who continue to behave as if women’s bodies do not belong in public spaces, through, for example, street harassment, also are part of a larger ideology that insists that women’s bodies be asserted into public spaces, against their will, with techniques such as revenge porn and online body shaming through trolling.

One recent and most dystopic example of this is the proposal that women’s bodies be part of a forced “redistribution” of sex to keep “incels” (involuntarily celibate men) from exploding into murderous rages. In this schema, women’s bodies become property of the state and of lonely men whose sadness must be repaired through rape of women. What might more often be considered private and intimate acts become robotic distributions of female bodies through public and state power.

Revenge porn is an especially disturbing, though conceptually useful way of thinking about the tenacity of the public/private organizing principle as it threads its way from the Victorian period to 2018. One recent study on the mental health effects of revenge porn found that “women are much more likely to be pressured to send nude photographs, and they are also much more likely to be victims of revenge pornography. According to the Cyber Civil Rights Initiative, as many as 90 percent of victims are women.” Women victims whose photographs have been uploaded to revenge porn websites are then often stalked and harassed by viewers, as their contact information is sometimes included by the perpetrators. Recent studies show that, like women who experience harassment and assault, women who are victims of revenge porn also suffer long-term mental health effects: “The humiliation, powerlessness, and permanence . . . leave victims engaged in a lifelong battle to preserve their integrity. Consequently, victims of revenge pornography suffer from similar enduring mental health effects as described by victims of child pornography, such as depression, withdrawal, low self-esteem, and feelings of worthlessness.” Another study noted the frequency of PTSD in victims of revenge porn, too.

The tenacity of the public/private divide now means that women’s bodies are either restricted from access to the public sphere, when women insist on such access through their own will, but then also forced into the public sphere, when they lack control over whether or not their images, and discussion of their bodies, should appear there. The insistence that women belong in the private sphere is one side of the same coin that forces them into the public sphere without their consent.

In each case, women are reminded that they still do not have the right to exist in public spaces free from harassment and terror. Women’s attempts to cross over into the public sphere, in politics, business, Hollywood, and more, are met with the suggestion that they lack morality, and as such, their bodies must be exposed as immoral corpora. While online versions of such tactics are new due to the emergence of new technologies, the underlying principle reveals that we continue to have much in common with Victorian understandings of whose bodies are allowed to exist in public spaces and what possible punishments lie in wait for women who dare to make their own choices about where, why, and how their bodies will exist in space.