This conference happens in February 2010 and will "...explore the relationship between physical practice and historical narrative."
Well. Gosh darn it. If physical and narrative aren't my two favourite words...
Life Lines: Rupture and Healing in the Personal and Social Body
Abstract:
As the boundary between the inside (body) and the outside (world), the skin plays an important role in the creation of identity [1]. Paint, burns, inscriptions and areas of exposure all convey information about oneself and one’s body. As zones of both rupture and healing, scars are multivalent markers of this social information. Life Lines, an interdisciplinary and multimedia project that collects and exhibits photographic portraits and autobiographical narratives of the scarred body, uncovers personal stories of skin rupture and healing. In doing so, it exposes the socio-cultural contexts from which bodily stories derive, and the social implications of sharing a personal medical history.
Since 2006, over 50 participants have either been photographed or submitted photographs to this project, which can be found online at http://www.onlinelifelines.blogspot.com. Participants are also requested to write or discuss their experiences of having acquired their scars, and the meanings they believe to be attached (both by themselves and society at large) to their scars. The project is exhibited online, at academic conferences, and in gallery settings.
Contrary to popular belief, there is no clear correlation between the size or appearance of a scar and the psychological distress that it causes [2]; generational divides have also been shown to indicate oppositional perceptions of scars’ appearances, meaning and importance [3]. As with other facets of bodily identity, the scar’s representation is fluid, determined by one’s location in place, time and larger socio-historical narratives. Life Lines participants demonstrate their efforts to navigate the ever-shifting personal and social complexities engendered by bodily experience.
REFERENCES
1. Bakhtin, M. M. Toward a Philosophy of the Act. Vadim Liapunov, Michael Holquist, Eds. Austin: University of Texas Press, 1993.
2. Tebble, Nicola J., Robert Adams, David W. Thomas, Patricia Price. Anxiety and self-consciousness in patients with facial lacerations one week and six months later. British Journal of Oral and Maxillofacial Surgery 44 (2006) 520-525.
3. Yanik, M., Gurel, Simsek, Kati. Psychological Impact of Cutaneous Leishmaniasis. Clinical and Experimental Dermatology 29 (2004) 464-467.
Saturday, November 28, 2009
Wednesday, November 18, 2009
Study in Action 2010 -- Life Lines as an Anti-Oppression, Anti-Ableism Activist Project
Study in Action is an undergraduate conference at Concordia University that focuses on relating students and academics to the activist community in Montreal. I proposed Life Lines because it's the kind of activism (intense, personal, creative, one-on-one) that I prefer to engage in. Don't get me wrong -- I like the big stuff (protests, petitions, marching down Ste. Catherine's Street -- like we did the other night: www.missingjustice.ca) but I think my psychotherapy training has given me better tools in working through some of the big issues on a micro, more personal scale.
Proposal:
I am a Montréal-based visual artist working with issues of bodily self-determination and body image. The project that I would like to present at Study in Action 2010 is called Life Lines and can be found at http://www.onlinelifelines.blogspot.com . In it, I photograph people's scars and document their narratives of having acquired these scars, as well as what personal meaning their scars carry, and what meanings the participant believes the outside world gives to them. Since I began to exhibit the project online in 2006, I have also received submissions from around the world -- people who have photographed themselves and who wish to share their own stories/images. While my work explicitly focuses on a 'taboo' or 'unsightly' subject area, it is a body-positive, anti-ableist project. In essence, this presentation would have three aims: a) to address the oppression felt by people whose physical appearance marks them as 'other'. b) to encourage a safe (anonymous) exchange of stories and images about personal struggles to overcome illness, disease, accident, violent attack, surgerical procedures, etc. and finally, c) to encourage viewers to reconsider their ideas about their own bodies, as well as the bodies of others.
Proposal:
I am a Montréal-based visual artist working with issues of bodily self-determination and body image. The project that I would like to present at Study in Action 2010 is called Life Lines and can be found at http://www.onlinelifelines.blogspot.com . In it, I photograph people's scars and document their narratives of having acquired these scars, as well as what personal meaning their scars carry, and what meanings the participant believes the outside world gives to them. Since I began to exhibit the project online in 2006, I have also received submissions from around the world -- people who have photographed themselves and who wish to share their own stories/images. While my work explicitly focuses on a 'taboo' or 'unsightly' subject area, it is a body-positive, anti-ableist project. In essence, this presentation would have three aims: a) to address the oppression felt by people whose physical appearance marks them as 'other'. b) to encourage a safe (anonymous) exchange of stories and images about personal struggles to overcome illness, disease, accident, violent attack, surgerical procedures, etc. and finally, c) to encourage viewers to reconsider their ideas about their own bodies, as well as the bodies of others.
Tuesday, November 17, 2009
Sociology of the Body -- Paper on Sociological Perspectives on/Cultural Criticism of Wounds and Surgery
I wrote this for a Master's class I audited at Concordia University last winter (2009). Called 'Sociology of the Body', it was taught by one of the first and most innovative body theorists, Dr. Anthony Synnott. There were five students in the class. All women. We talked about our personal, embodied experiences. A lot. And it was great.
The Paper:
The Oxford English Dictionary defines scar primarily as a noun of the human body: “…a mark left on the skin or within body tissue after the healing of a wound or burn.” (scar) It is only secondarily defined as “…a mark left at the point of separation of a leaf, frond, or other part from a plant.” Our language shows that the essence of a scar is its relationship to the body from which it grows. A sociological study of scars must also be grounded in and mediated by bodily experience. And the relationship is reciprocal – through studying our scars we can gain insight into our bodies and their placement in society.
Every culture responds uniquely to the fact that every person has a scar. Some, such as the Booli, Chopi, Luba and Kakwa tribes of the Former Congo and Sudan, use purposeful scarring as a traditional decorative practice. (Junod, 1970) In western cultures we are fascinated by decorative scars on ‘other’ (foreign or stranger) bodies, but repulsed by those on our own. For many westerners, the stigma of the visible scar is compounded by the hidden story of the traumatic and painful experience that caused it. This discomfort perhaps gives rise to the final meaning of the noun scar: “…a lasting effect left following an unpleasant experience.”
While specific experiences can vary, scars always result from an incision into the skin. According to Medscape, within just 48 hours of such an incision the process of epithelialization (the growth of skin over a skinned area) begins. Collagen synthesis follows, building flesh; the wound gradually begins to close. Collagen synthesis can continue indefinitely and determines the thickness of the scar. Overgrowth of scar tissue will cause ‘proud flesh’ (raised skin) and hypertrophic and keloid scars result from an excess proliferation of collagen.
The above description demonstrates the first biomedical approach to scarring. In most discussions of scars, the medical emphasis is decidedly non-social and non-cosmetic: focusing on the healing of the actual incision, doctors and surgeons are concerned about factors such as infection and rupture. But the medical profession also offers another perspective – it provides the only reliable method of scar removal, which is done through moving the scar into a pre-existing crease or creating many smaller scars to mask the original. Medical practitioners are responsible both for giving scars and taking them away, and this is only one way in which they are uniquely positioned in their privileged access to the patient’s body.
In this paper, I will examine the ways that the biomedical model treats patients, their bodies and the marks made upon them. I will explore these issues in light of the medical narratives contributed by participants of Life Lines, a photo-essay cum social intervention that I produce. Finally, I will address the relationship between medical practices and the structure of the project itself.
Life Lines combines my experience in the visual arts and practice as an intern psychotherapist. I photograph people’s scars and collect their stories of scar acquisition. The data thus generated is published online, in gallery exhibitions and at academic conferences. Contact with participants is usually initiated by email, either through a community bulletin board system (such as Craigslist, www.craigslist.com), or through a mutual friend. I describe the project and tell the participant that, should they choose to participate, I would photograph them and ask for ‘a story about how you got your scar, what it means to you and what it means to other people.’ If the participant is still interested, they are then invited to visit my studio, where I photograph them with a digital-SLR camera in natural or available light. After the photo session, the participant is asked to email me their story. I email them the photos I intend to publish. With their permission I publish and perhaps exhibit their artefacts; I also offer complimentary prints of their photographs.
While surgeons do practice techniques to minimize scarring – for example, TransUmbilical Breast Augmentation (the insertion of breast implants through the bellybutton) – emergency services are often conducted without concern for the aesthetic or social factors of the prominent scarring they may cause. Even in emergency cases, however, it is assumed that the patient is not primarily concerned with survival, but rather with a minimization of scarring. In her autobiographical novel The Year of Magical Thinking, Joan Didion describes her resistance to a tracheotomy proposed for her comatose daughter. (NB: I have no idea why the formatting is like this, here. I tried to fix it -- suggestions?)
Similar conflicts, reflecting ambivalent attitudes toward surgical scarring, are evident in several Life Lines stories.
Kevin (Appendix A) has a six-inch vertical scar across the centre of his stomach – the result of an emergency surgery due to a burst spleen after a serious car accident. The scar is noticeable, with some raised skin; it is not entirely straight, as it deviates to curve around the bellybutton. We do not know whether the curve – which he told me “looks a bit like a garden path around a tree or a pond” – is the result of ‘aesthetic’ considerations (not wanting to eliminate the belly-button because it is a part of most human bodies) or the relative difficulty of cutting through previous scar tissue (also the belly-button). In any case, Kevin does not appreciate the curve; it brings attention to the scar, and he believes it exaggerates the seriousness of the injury. At the same time, it looks slightly whimsical, not an attribute that most young men would wish their bodies to exemplify.
Kevin’s story highlights the role of power in medicine, particularly in surgical contexts. Feminist, post-colonial and post-modern thinkers have criticised the biomedical model and its claims to healing. They state that it creates a locus of power outside of the patient whom it supposedly services. Michel Foucault was one of the first such critics, with the publication of Birth of the Clinic (1975), in which he philosophized the body as the site of intersection between society and power.
In 1951, Talcott Parsons formed a more sociologically informed theory of medicine. He identified the surgeon as the classic American ‘hero,’ due to his active and pragmatic approach to the world. In contrast to this ‘hero,’ the patient is seen as a passive observer, exempt from social obligation while performing the ‘sick role’.
Feminist thinkers, such as Margrit Shildrick, have expressed concern that such an enforced or accepted power imbalance is not only counter-productive to healing, it is also a matter of unethical conduct. To her,
The imbalance of power can leave people feeling left out of their own bodies. In the context of Life Lines, this sometimes appears as unhappiness with a scar or criticism of its prominence. We should, however, conduct a more nuanced analysis of power within medical interaction.
It is easier to see the double-edged sword of medical authority in times of upheaval. In World War II, the Third Reich used medical terminology and concepts (such as disease and quarantine), to orchestrate and justify the torture of millions of Jews. (Proctor in Malacrida & Low) Medical power carries an immense responsibility. In Anil’s Ghost, his novel about the long-standing and bloody civil war in Sri Lanka, Michael Ondaatje describes a doctor who, in adherence to this responsibility, has allowed his own agency to be subsumed by the Hero role. His responsibility to respond to crisis has pushed to the limits of his physical, mental and emotional abilities.
It is hard to imagine this doctor wielding authoritarian power over a patient, yet it is just at this point of extreme responsibility that a doctor is liable to make the worst, most dangerously powerful mistakes. The boundaries between powerful and powerless are not always clear-cut.
Roughly half of Life Lines participants have scars resulting from surgeries for accident injuries, cosmetic reasons or internal illnesses. While their descriptions of medical practices are sometimes horrifying (such as descriptions of absent or ineffective anaesthetic), many follow Andrea’s (Appendix B) statement: “Hurrah for living and for surgeons.” Generally, perceptions of the medical profession are neutral to positive.
When participants describe practices that they dislike(d), they often frame them in an explanatory and/or emergency context. For example, Agi (Appendix C) describes how
She writes how the guilt of hearing their daughter’s screams (due not to the injury but to the medical treatment they had requested) affected the life of her family and subsequently herself. While she does not condone or criticise the paramedics’ behaviour, she does look for rationale from the behaviour of her family:
We can see a similar movement of responsibility – from blaming medical professionals to blaming (or exonerating) family – in Fred’s (Appendix D) story. He writes about the surgery he received for pyloric stenosis, a rare illness that prevents infants from digesting food. The scar on his abdomen is starkly noticeable, with stitches over an inch long. Fred emailed me from Australia because he had seen the photograph of another participant, Tamara. Her scar is from the same surgery, performed forty years after his. Fred had always been uncomfortable with his scar, feeling that it marked his body with evidence of poverty and war. In his email he commented that it is several times the size of Tamara’s, but in his narrative he does not state that his surgeon could or should have produced a smaller, less noticeable scar. Instead he attributes its size to the state and availability of medical supplies in post-war Holland. He also attributes his discomfort and feeling of stigmatization to his own shyness and his family’s “reticent” nature.
Susanna (Appendix E) happily underwent breast-reduction surgery as a teenager. Because she was still pubescent, her breasts continued to grow and are no longer the size she wants. An outsider could interpret this surgery as unsuccessful, perhaps the result of questionable medical practices, as
But Susanna does not offer a negative interpretation, instead emphasising the elation she experienced directly post-surgery:
While the previous three narratives describe somewhat questionable medical practices, even evident malpractice does not seem to elicit participants’ condemnation. Peter (Appendix F), whose wrist scar “…looks a lot like the scar Frankenstein has on his forehead,” seems to bear no anger toward the surgeon who botched his surgery three times:
In fact, Peter seems amused that this surgeon has been sued for malpractice, saying,
Conventional unconventional models (such as feminist and post-modern) would predict a negative reaction to most surgery, given that it is part of the medical model that denies patient subjectivity and “…requires the patient to completely surrender control in order to regain the parts of themselves affected by illness.” (Moreira, 2001 in Moreira 2006) In this ideation, a botched surgery would be experienced as the ultimate betrayal (‘a rape of sorts’ as Agi describes) and much resentment would be voiced. Most botched or questionable surgery narratives from Life Lines, however, tend toward appreciation instead.
The vast majority of participant narratives that deal with successful surgery (that is, not questionable or botched) follow this vein. In fact, some non-surgical narratives, such as the one contributed by Scott, whose parents “probably should have taken me to the hospital,” refer to a desire for medical intervention. It seems that some of us enjoy being objectified and pacified by medicine at some times and in some contexts.
I believe this trend could be due to any combination of three factors: first, the people who elect to participate in Life Lines may have a particularly positive view of themselves and their bodies and subsequently a more generous approach to bodily ‘invasions’ such as surgery; the inclusive and pro-scar nature of the project itself may also influence their stories.
Second, the participants’ lack of animosity may reflect a post-operative psychological strategy of re-framing. That is, telling themselves and others that the experience proceeded as they wanted it to, thereby allowing them to reclaim a significant amount of agency.
Lastly, it may be that the biomedical model does not, in fact, cause detriment to the patient in de-privileging his or her perspective.
With regard to the first possible factor, I should note that not all Life Lines participants are shame-free and happy with their bodies. Shara (Appendix G), for example, describes the result of her scoliosis surgery,
Shazi (Appendix H) describes the debilitation he feels about having extreme acne:
Despite the pro-scar attitudes of myself and pro-medical attitudes of many other participants in the project, these narratives show a genuine personal shame about scarring. It does not seem likely that my pro-scar perspective is all-pervasive, and would not be pervasive enough to cause recipients of major surgery to feel positively about their experience.
Because many of the surgeries that appear in Life Lines were deemed urgent – that is, necessary for survival or functioning – the patient’s experience in these situations is one of complete passivity in light of necessity. This is a power differential above and beyond that which is normally present in the medical dynamic. In most emergency situations, the patient is not able to decline treatment and this is particularly true for those whose surgeries occurred during childhood. It is a healthier psychological attitude to re-narrate unavoidable events not as impositions but as personal choices. The participants may be regaining their own subjective power (agency) by refusing to acknowledge or claim victim status for their medical mistreatment.
The final interpretation for this data is that the biomedical model does not deny patients’ subjectivity and agency as it once did, or, that this denial is in some way beneficial. It may be possible for medical treatment to be both passivity-inducing and a positive subjective experience. There are arguments that the medical system – based on the biomedical model but mediated by real people including doctors, nurses, aids, caregivers, medical suppliers and other patients – is an important source of patient support, and in fact reinforces patient agency before and after surgery.
In his study Self, Agency and the Surgical Collective, Tiago E. Moreira describes the disruption that surgery and illness cause, and how the patient feels this rupture in almost every area of his or her life. (Moreira, 2004) To re-enter society, the patient must repair these breaks or adapt to life with them. It is through the post-surgical environment that this occurs, as the patient begins to identify him or herself as a survivor.
This process is mediated (to follow the terminology above, the self is ‘re-framed’) by the “socio-technical ensemble on which the patient depends immediately after surgery.” (34) Surgery may exclude patient subjectivity, but the socio-technical ensemble helps to create a new patient identity. This new identity may very well take the form of victimhood, although many post-operative techniques aim to help patients achieve ‘normalcy’ in their appearance and movements. To Parsons, it would appear that the medical system is helping to transform the very ‘sick role’ it initiated. Again, it seems that the specific roles we once attributed to actors in the medical process are in fact fluid and multi-dimensional.
Callon and Rabeharisoa (1998, in Moreira 2004) see this process in terms of ‘patient collectives,’ which are the “unfolding compositions of bodies, competences, artefacts, procedures and emotions gathered together by particular activities around/with a patient.” (35) These collectives coalesce in the moment of surgery. Their destruction is the major task of social reintegration – and the medical system (by virtue of completing the surgery) necessarily assists in this destruction.
The scar that results from surgery is permanent, however, and cannot simply be dismantled. The biomedical model may not foster a pathological dependence on the ‘sick role,’ the ‘socio-technical ensemble,’ or the ‘patient collective,’ but it does leave the patient with a marker of these structures. In the end, the patient bears the responsibility of integrating the scar into the outside world. The pro-surgery aspects of Life Lines narratives may reflect an ability (possibly supported by the medical system) to dismantle the (possibly benevolent) apparatuses of medical treatment. It is not surprising that people successful in this task would look positively on their brief experience as a passive, sick person.
There is also the possibility for patient agency before surgery. One participant, Patricia, has a fine white scar from surgery on wrist-joint ganglia. Because it was a minor surgery, she was given only local anaesthetic and was awake when the surgeon drew his guiding line on her wrist. This was the line upon which he would cut and which would eventually become her scar. She timidly asked him to re-draw the line in an “S” because she "preferred that shape." Her scar indeed reflects this shape and is accompanied by a sense of satisfaction at having been able to modify the impact of a medical process on her body.
Never having been excluded from the surgical process, Patricia’s subjectivity has remained intact through its entirety. An experience such as this would most likely make the task of dismantling the role/collective/ensemble much easier, if not irrelevant.
Patricia is a visual artist, and her ability to re-draw the mark on her body is reflective of the work of contemporary performance artists. They have used and reoriented the unique and dramatic aspects of medical treatment, including white lab coats, machines that examine and monitor the body and flesh-obscuring bandaging. In The Scar of Visibility, Petra Kuppers examines this sub-genre, and she points to the work of Kiki Smith, Mona Hatoum, Damient Hirst, Pepe Espaliu, Hamad Butt, Donald Rodney, Stelarc, Mac Quinn, Gina Pane and Orlan, among others. (Kuppers, 15)
As an artistic pursuit, Life Lines also draws from the aesthetic, the emotional and the medical. While the medical depiction of scarring is based on the severity of the wound and the rate of collagen production, in a creative context the scar is,
Kuppers sees these ideas at work in performances by Pam Patterson, an artist who lives with cancer. Patterson makes use of various objects, from breast prostheses to river stones. She also uses small slides that Kuppers believes intentionally mimic X-ray images. After the performance Bodysight: A Reclamation Project, Patterson spoke to the audience and,
As a scientific discipline, medicine depends on vision and techniques for mapping and seeing. Although the preference for visual evidence reflects a physical tendency toward vision (it is estimated that up to 80% of our sensory information is received through sight), theorists have described medical practices of body imaging as excessively reductive. Marita Sturken and Lisa Cartwright echo the sentiment that these images de-privilege subjective experience. They describe how an ultrasound image,
To Don Ihde, medicine performs this reductionism because it provides an image valuable to the physician in its ‘reiterability:’
The idea of reiterability coincides neatly with Kuppers’ description of the scar as ‘a repetition that holds on to its history.’ (19) Through physical healing, the scar itself becomes the image most relevant to the patient/subject, although the medical image of the wound may be more valuable to the medical professional. The biomedical model creates and prioritizes its visual evidence of the patient’s body; it would be valuable for patients to create their own visual representation of their felt evidence.
I did not set out to create medical images for Life Lines. It was my intention that the photographs, like the narratives, could be used as a means of re-framing an injury and the possible stigmatization resulting from it. I have introduced my own aesthetic to the photographs, for example using grey-scale so that they appear in soft tones of black and white. When I show the participant their photo, it is my hope that, in addition to my tastes, it in some way represents their own experience of bodily difference. This image is not medical, but it also is not antagonistic to medical representations. It simply operates on a different, possibly more patient-centred, level.
I am cognisant of the interrogating factor of the camera, both within and without medical contexts, and the vulnerability inherent in being photographed. The history of medical photography of illness and deformity is one of objectifying and demeaning images, often obtained through duress. As the project director and photographer, I perform a role with authority not unlike that of the doctor: I collect personal information about the participant’s life and body, then document and display it. I have sometimes worried that I am merely recreating the medical dynamic, tipping the balance of power away from the subject and towards myself.
I use various methods to broach this topic. The first is allowing the participants to contact me and arrange their sessions; I do not pursue notably scarred individuals and I try to be as accommodating as possible with participant requests. These have included being able to bring a friend, to remove their clothes in private, or to discuss the project at length beforehand. Many of my methods have grown out of experiences within the project. For example, I now allow the participant to sort through and crop or delete any of their photos directly after the session.
The visual aspect of the project has been important for most participants. The majority of people are somewhat shy about having their bodies photographed. For many, it is the first time that their scar has been explicitly examined outside of a hospital. They express nervousness before the photo-shoot and sometimes relief afterward. To some, the semi-objective nature of my photography – although I worry it does not do enough to represent their subjectivity – shows their scar in a new, more positive light. For example, Jonathon (Appendix I) writes,
Jonathon is referring to the disjuncture between his personal sense of his body (what could be called ‘felt evidence’) and the seemingly more objective (to him, more valid) depiction made by myself and the camera. Perhaps the difference between this photo and one taken by a medical practitioner is in the latitude Jonathon has with its interpretation. He places the image in a social context, which he would not necessarily be able to do with a medical image. He refers back to his perception of other people’s experience of his body, which is a major factor in his narrative, as he describes feeling “weak and undesirable.” Because he finds the Life Lines image less stigmatizing, Jonathon appreciates the difference, and perhaps incorporates the ‘objective’ image into his own subjective body-image.
The same belief in the objectivity of the camera elicited an opposite reaction from Carmen (Appendix J). She is the only participant whose ‘scar’ is not literally a scar: she asked me to photograph the stretch marks on her breasts, stating that although she has,
While she was one of the calmer and seemingly more comfortable participants, Carmen emailed me after I had published her photos (which she refers to as “the post” in the following excerpt) in a state of agitation. She wrote:
Taken aback, I responded,
We proceeded to negotiate which pictures could be published; Carmen’s indecision revolved around conflicting desires to remain anonymous, to not to be represented as ‘deformed’ and also to pursue the aesthetic component of the project:
Eventually, we decided to remove the picture through which she could potentially be identified – the one that showed her face – and to replace it with one that showed her stretch marks more visibly. This process is analogous to the traditional medical approach of photographing disease and illness: obscuring the patient’s identity (and thus their subjectivity) in favour of a more explicit, ‘objective’ look at the disease. The difference here is that the anonymity and objectification were performed at the firm request of a willing participant. As some surgery patients may prefer to be de-subjectified, Carmen preferred a less personal representation.
Not all surgeons are heroes, but the biomedical model cannot simply be depicted as an evil, authoritarian regime. The roles played by both the doctor and the patient are consistently complicated, and the stories in Life Lines reflect the grey areas that arise around surgery and scarring. The project itself enters these liminal spaces, following other artists’ adoption and re-working of medical methods. It walks a fine line between artistic/social documentation and medical mimicry. Every scar represented is somewhere in the process of continual modification and reintegration. Just as collagen fibres knit together to close a wound, so too can stories of personal agency.
Epilogue:
Life Lines continues to grow, and so do I. Over the past three years over 50 people have participated in this project, and I still receive submissions and requests for photo-shoots. The methodology has changed in response to participant requests, and I have begun to transcribe and audio-record participant narratives. In the interest of developing this participant-centred approach, I should conduct a follow-up questionnaire asking about participant experiences before, during and after this project.
While it is a non-medical study of medicalized phenomena, Life Lines also documents self-inflicted scars and other injuries not necessarily requiring medical intervention. Future study could explore these scars, perhaps through narrative analysis: researchers in psychology have developed methods of quantifying narrative data. Such a study could include quantitative analysis of differences reflected by the impact of gender, age of injury and location of injury on the participant’s body.
Finally, there is a strong relationship between scars and tattoos. Not only are they both permanent marks on the subject’s body, I suspect that their relationship is inverse, that is, as socio-biological artefacts and processes, they mirror one another. To get the tattoo-mark, the participant chooses a concept (often a self-defining narrative) and design (image) and then the mark is made. The scar-mark is made first, followed by the image (the healed wound) and the creation of the story (also a self-defining narrative). As one commentator wrote, “Scars are tattoos with better stories.” If this relationship is further examined, it might allow us to adopt well-established ethnographic tattoo-research methodologies into the relatively unexplored area of scar study.
Works Cited:
Callon, Michel & Rabeharisoa, Vololona. The participation of patients in the process of
production of knowledge: the case of the french muscular distrophies association.
Sciences Sociales et Santé. Volume 16, Number 3, 41, September 1998. (cited in
Moreira, 2006)
Didion, Joan. The Year of Magical Thinking. Alfred A. Knopf: New York, 2005.
Foucault, Michel. (A. M. Sheridan Smith, trans.) The Birth of the Clinic. New York:
Vintage Books, 1975.
Ihde, Don. Bodies in Technology. Minneapolis: University of Minnesota Press, 2001.
Junod, Henri Philippe. Bantu Heritage. Johannesburg: Negro Universities Press, 1970
Kuppers, Petra. The Scar of Visibility: Medical Performances and Contemporary Art
Minneapolis: University of Minnesota, 2007
Malacrida, Claudia & Low, Jaqueline, Eds. Sociology of the Body: a Reader. Toronto:
Oxford University Press, 2008.
Moreira, Tiago E. Incisions: A study of surgical trajectories. PhD, thesis. University o
Lancaster University, 2001.
-- Self, Agency and the Surgical Collective: detachment. Journal of
Sociology of Health Illness. Volume 26 Issue 1, Pages 32 – 49, February 2004.
Ondaatje, Michael. Anil’s Ghost. New York: Alfred A. Knnopf, 2000.
Parsons, Talcott. The Social System. New York: Free Press of Glencoe, 1951.
Romo III, Thomas. Wound Healing, Skin. New York: Medscape Feb. 18 2008. Retrieved
April 15th 2009. (http://emedicine.medscape.com/article/884594-overview)
Scar, Compact Oxford English Dictionary. Retrieved April 15th 2009.
(http://www.askoxford.com/concise_oed/scar_1?view=uk).
Shildrick, Margrit. Leaky Bodies and Boundaires: Postmodernism and (Bio)ethics. New
York: Routledge, 1997.
Sturken, Marita & Cartwright, Lisa. Practices of Looking: An Introduction to Visual Culture. New York: Oxford University Press, 2001.
The Paper:
The Oxford English Dictionary defines scar primarily as a noun of the human body: “…a mark left on the skin or within body tissue after the healing of a wound or burn.” (scar) It is only secondarily defined as “…a mark left at the point of separation of a leaf, frond, or other part from a plant.” Our language shows that the essence of a scar is its relationship to the body from which it grows. A sociological study of scars must also be grounded in and mediated by bodily experience. And the relationship is reciprocal – through studying our scars we can gain insight into our bodies and their placement in society.
Every culture responds uniquely to the fact that every person has a scar. Some, such as the Booli, Chopi, Luba and Kakwa tribes of the Former Congo and Sudan, use purposeful scarring as a traditional decorative practice. (Junod, 1970) In western cultures we are fascinated by decorative scars on ‘other’ (foreign or stranger) bodies, but repulsed by those on our own. For many westerners, the stigma of the visible scar is compounded by the hidden story of the traumatic and painful experience that caused it. This discomfort perhaps gives rise to the final meaning of the noun scar: “…a lasting effect left following an unpleasant experience.”
While specific experiences can vary, scars always result from an incision into the skin. According to Medscape, within just 48 hours of such an incision the process of epithelialization (the growth of skin over a skinned area) begins. Collagen synthesis follows, building flesh; the wound gradually begins to close. Collagen synthesis can continue indefinitely and determines the thickness of the scar. Overgrowth of scar tissue will cause ‘proud flesh’ (raised skin) and hypertrophic and keloid scars result from an excess proliferation of collagen.
The above description demonstrates the first biomedical approach to scarring. In most discussions of scars, the medical emphasis is decidedly non-social and non-cosmetic: focusing on the healing of the actual incision, doctors and surgeons are concerned about factors such as infection and rupture. But the medical profession also offers another perspective – it provides the only reliable method of scar removal, which is done through moving the scar into a pre-existing crease or creating many smaller scars to mask the original. Medical practitioners are responsible both for giving scars and taking them away, and this is only one way in which they are uniquely positioned in their privileged access to the patient’s body.
In this paper, I will examine the ways that the biomedical model treats patients, their bodies and the marks made upon them. I will explore these issues in light of the medical narratives contributed by participants of Life Lines, a photo-essay cum social intervention that I produce. Finally, I will address the relationship between medical practices and the structure of the project itself.
Life Lines combines my experience in the visual arts and practice as an intern psychotherapist. I photograph people’s scars and collect their stories of scar acquisition. The data thus generated is published online, in gallery exhibitions and at academic conferences. Contact with participants is usually initiated by email, either through a community bulletin board system (such as Craigslist, www.craigslist.com), or through a mutual friend. I describe the project and tell the participant that, should they choose to participate, I would photograph them and ask for ‘a story about how you got your scar, what it means to you and what it means to other people.’ If the participant is still interested, they are then invited to visit my studio, where I photograph them with a digital-SLR camera in natural or available light. After the photo session, the participant is asked to email me their story. I email them the photos I intend to publish. With their permission I publish and perhaps exhibit their artefacts; I also offer complimentary prints of their photographs.
While surgeons do practice techniques to minimize scarring – for example, TransUmbilical Breast Augmentation (the insertion of breast implants through the bellybutton) – emergency services are often conducted without concern for the aesthetic or social factors of the prominent scarring they may cause. Even in emergency cases, however, it is assumed that the patient is not primarily concerned with survival, but rather with a minimization of scarring. In her autobiographical novel The Year of Magical Thinking, Joan Didion describes her resistance to a tracheotomy proposed for her comatose daughter. (NB: I have no idea why the formatting is like this, here. I tried to fix it -- suggestions?)
E v e r y o n e i n t h e n e u r o u n i t s g o t a t r a c h , t h e y h a d k e p t s a y i n g t o m e t h a t d a y . A t r a c h c o u l d b e d o n e w i t h f e n t a n y l a n d a m u s c l e r e l a x a n t , s h e w o u l d b e u n d e r a n e s t h e s i a n o m o r e t h a n a n h o u r . A t r a c h w o u l d l e a v e n o c o s m e t i c e f f e c t t o s p e a k o f , o n l y a l i t t l e d i m p l e s c a r , a s t i m e g o e s b y m a y b e n o s c a r a t a l l . T h e y k e p t m e n t i o n i n g t h i s l a s t p o i n t , a s i f t h e b a s i s f o r m y r e s i s t a n c e t o t h e t r a c h w a s t h e s c a r . T h e y w e r e d o c t o r s , h o w e v e r f r e s h l y m i n t e d . I w a s n o t . E r g o , a n y c o n c e r n s I h a d m u s t b e c o s m e t i c , f r i v o l o u s . I n f a c t I h a d n o i d e a w h y I s o r e s i s t e d t h e t r a c h . ( 1 2 5 )
Similar conflicts, reflecting ambivalent attitudes toward surgical scarring, are evident in several Life Lines stories.
Kevin (Appendix A) has a six-inch vertical scar across the centre of his stomach – the result of an emergency surgery due to a burst spleen after a serious car accident. The scar is noticeable, with some raised skin; it is not entirely straight, as it deviates to curve around the bellybutton. We do not know whether the curve – which he told me “looks a bit like a garden path around a tree or a pond” – is the result of ‘aesthetic’ considerations (not wanting to eliminate the belly-button because it is a part of most human bodies) or the relative difficulty of cutting through previous scar tissue (also the belly-button). In any case, Kevin does not appreciate the curve; it brings attention to the scar, and he believes it exaggerates the seriousness of the injury. At the same time, it looks slightly whimsical, not an attribute that most young men would wish their bodies to exemplify.
Kevin’s story highlights the role of power in medicine, particularly in surgical contexts. Feminist, post-colonial and post-modern thinkers have criticised the biomedical model and its claims to healing. They state that it creates a locus of power outside of the patient whom it supposedly services. Michel Foucault was one of the first such critics, with the publication of Birth of the Clinic (1975), in which he philosophized the body as the site of intersection between society and power.
In 1951, Talcott Parsons formed a more sociologically informed theory of medicine. He identified the surgeon as the classic American ‘hero,’ due to his active and pragmatic approach to the world. In contrast to this ‘hero,’ the patient is seen as a passive observer, exempt from social obligation while performing the ‘sick role’.
Feminist thinkers, such as Margrit Shildrick, have expressed concern that such an enforced or accepted power imbalance is not only counter-productive to healing, it is also a matter of unethical conduct. To her,
The essence of…[medical] health work is dispassionate intervention on the part of the professional into an essentially passive body. …there is, too, little sense in formal medical ethics that health care may involve mutual participation in a joint endeavour, or that, despite new constructions of the late modern body which privilege a unified systems approach, the integrity of the patient as a person may be at stake. (Shildrick, 18)
The imbalance of power can leave people feeling left out of their own bodies. In the context of Life Lines, this sometimes appears as unhappiness with a scar or criticism of its prominence. We should, however, conduct a more nuanced analysis of power within medical interaction.
It is easier to see the double-edged sword of medical authority in times of upheaval. In World War II, the Third Reich used medical terminology and concepts (such as disease and quarantine), to orchestrate and justify the torture of millions of Jews. (Proctor in Malacrida & Low) Medical power carries an immense responsibility. In Anil’s Ghost, his novel about the long-standing and bloody civil war in Sri Lanka, Michael Ondaatje describes a doctor who, in adherence to this responsibility, has allowed his own agency to be subsumed by the Hero role. His responsibility to respond to crisis has pushed to the limits of his physical, mental and emotional abilities.
H i s d u t i e s m a d e h i m c o m e u p o n s t r a n g e r s a n d c u t t h e m o p e n w i t h o u t e v e r k n o w i n g t h e i r n a m e s . H e r a r e l y s p o k e . I t s e e m e d h e d i d n o t a p p r o a c h p e o p l e u n l e s s t h e y h a d a w o u n d , e v e n i f h e c o u l d n ' t s e e i t . ( 2 1 1 )
It is hard to imagine this doctor wielding authoritarian power over a patient, yet it is just at this point of extreme responsibility that a doctor is liable to make the worst, most dangerously powerful mistakes. The boundaries between powerful and powerless are not always clear-cut.
Roughly half of Life Lines participants have scars resulting from surgeries for accident injuries, cosmetic reasons or internal illnesses. While their descriptions of medical practices are sometimes horrifying (such as descriptions of absent or ineffective anaesthetic), many follow Andrea’s (Appendix B) statement: “Hurrah for living and for surgeons.” Generally, perceptions of the medical profession are neutral to positive.
When participants describe practices that they dislike(d), they often frame them in an explanatory and/or emergency context. For example, Agi (Appendix C) describes how
Two of them [paramedics] finally arrive in an ambulance, they tell everyone to clear the room, she’s [herself as a young girl] left alone with them, one of them holds her, the other one sews her up, no anesthetics ... the pain is only a blur. She’ll never forget what one of them said close to the end – “we’re almost done, we’ll just sew this up quickly [referring to the wound above the left eye] it’ll feel like a mosquito bite” – my ass! That was the most painful mosquito bite I’ve ever had in my life! It felt awful to say the least. I was being saved yet at the same time I felt constrained, violated, and thrown into an abyss without protection of anyone I counted on. It felt like a rape of sorts.
She writes how the guilt of hearing their daughter’s screams (due not to the injury but to the medical treatment they had requested) affected the life of her family and subsequently herself. While she does not condone or criticise the paramedics’ behaviour, she does look for rationale from the behaviour of her family:
All they could do was stand on the other side of the door waiting for it to be over. I know it was an accident, no one’s fault really, it happened in spite of them – I believe they couldn’t have done much to prevent it - either way.
We can see a similar movement of responsibility – from blaming medical professionals to blaming (or exonerating) family – in Fred’s (Appendix D) story. He writes about the surgery he received for pyloric stenosis, a rare illness that prevents infants from digesting food. The scar on his abdomen is starkly noticeable, with stitches over an inch long. Fred emailed me from Australia because he had seen the photograph of another participant, Tamara. Her scar is from the same surgery, performed forty years after his. Fred had always been uncomfortable with his scar, feeling that it marked his body with evidence of poverty and war. In his email he commented that it is several times the size of Tamara’s, but in his narrative he does not state that his surgeon could or should have produced a smaller, less noticeable scar. Instead he attributes its size to the state and availability of medical supplies in post-war Holland. He also attributes his discomfort and feeling of stigmatization to his own shyness and his family’s “reticent” nature.
Susanna (Appendix E) happily underwent breast-reduction surgery as a teenager. Because she was still pubescent, her breasts continued to grow and are no longer the size she wants. An outsider could interpret this surgery as unsuccessful, perhaps the result of questionable medical practices, as
My breasts are now too big to fit into normal North American bras so I order them online from the UK…I am jealous of friends who can go without bras. It seems so freeing, so comfortable and sexy.
But Susanna does not offer a negative interpretation, instead emphasising the elation she experienced directly post-surgery:
I felt terrific. I can’t resist saying that I felt as though a huge weight had been lifted off my shoulders – emotionally and physically, I really did. I remember the first normal bra I wore. It was black with grey flowers on it. I was thrilled. I kept flashing everyone my new breasts – I finally felt like they were sexy.It does not faze her that she may need to undergo major surgery a second time.
While the previous three narratives describe somewhat questionable medical practices, even evident malpractice does not seem to elicit participants’ condemnation. Peter (Appendix F), whose wrist scar “…looks a lot like the scar Frankenstein has on his forehead,” seems to bear no anger toward the surgeon who botched his surgery three times:
The really weird thing is that the scar shouldn't be as bad (good) [sic] as it is. The surgeon I had really screwed up. In addition to putting tendons and muscles in the wrong place he couldn't follow the initial incision he made so with each surgery the scar grew. I didn't realize that is was a shit job until a shocked doctor took a look at it a few years ago.
In fact, Peter seems amused that this surgeon has been sued for malpractice, saying,
The best part is that my dad recently sent me an article about the doctor that worked on my arm. He has been suspended from practicing, and the article cited specifically: ‘He is no longer allowed to operate on patients 16 and younger and can not perform hand and wrist surgeries.’
Conventional unconventional models (such as feminist and post-modern) would predict a negative reaction to most surgery, given that it is part of the medical model that denies patient subjectivity and “…requires the patient to completely surrender control in order to regain the parts of themselves affected by illness.” (Moreira, 2001 in Moreira 2006) In this ideation, a botched surgery would be experienced as the ultimate betrayal (‘a rape of sorts’ as Agi describes) and much resentment would be voiced. Most botched or questionable surgery narratives from Life Lines, however, tend toward appreciation instead.
The vast majority of participant narratives that deal with successful surgery (that is, not questionable or botched) follow this vein. In fact, some non-surgical narratives, such as the one contributed by Scott, whose parents “probably should have taken me to the hospital,” refer to a desire for medical intervention. It seems that some of us enjoy being objectified and pacified by medicine at some times and in some contexts.
I believe this trend could be due to any combination of three factors: first, the people who elect to participate in Life Lines may have a particularly positive view of themselves and their bodies and subsequently a more generous approach to bodily ‘invasions’ such as surgery; the inclusive and pro-scar nature of the project itself may also influence their stories.
Second, the participants’ lack of animosity may reflect a post-operative psychological strategy of re-framing. That is, telling themselves and others that the experience proceeded as they wanted it to, thereby allowing them to reclaim a significant amount of agency.
Lastly, it may be that the biomedical model does not, in fact, cause detriment to the patient in de-privileging his or her perspective.
With regard to the first possible factor, I should note that not all Life Lines participants are shame-free and happy with their bodies. Shara (Appendix G), for example, describes the result of her scoliosis surgery,
… I think of my entire back/spine as a disaster area... I am disfigured by both the disease and the cure.
Shazi (Appendix H) describes the debilitation he feels about having extreme acne:
Horribly scarring the skin on my torso and arms, not to mention my already disfigured face. This time I really feel like showering with acid to melt my skin away.
Despite the pro-scar attitudes of myself and pro-medical attitudes of many other participants in the project, these narratives show a genuine personal shame about scarring. It does not seem likely that my pro-scar perspective is all-pervasive, and would not be pervasive enough to cause recipients of major surgery to feel positively about their experience.
Because many of the surgeries that appear in Life Lines were deemed urgent – that is, necessary for survival or functioning – the patient’s experience in these situations is one of complete passivity in light of necessity. This is a power differential above and beyond that which is normally present in the medical dynamic. In most emergency situations, the patient is not able to decline treatment and this is particularly true for those whose surgeries occurred during childhood. It is a healthier psychological attitude to re-narrate unavoidable events not as impositions but as personal choices. The participants may be regaining their own subjective power (agency) by refusing to acknowledge or claim victim status for their medical mistreatment.
The final interpretation for this data is that the biomedical model does not deny patients’ subjectivity and agency as it once did, or, that this denial is in some way beneficial. It may be possible for medical treatment to be both passivity-inducing and a positive subjective experience. There are arguments that the medical system – based on the biomedical model but mediated by real people including doctors, nurses, aids, caregivers, medical suppliers and other patients – is an important source of patient support, and in fact reinforces patient agency before and after surgery.
In his study Self, Agency and the Surgical Collective, Tiago E. Moreira describes the disruption that surgery and illness cause, and how the patient feels this rupture in almost every area of his or her life. (Moreira, 2004) To re-enter society, the patient must repair these breaks or adapt to life with them. It is through the post-surgical environment that this occurs, as the patient begins to identify him or herself as a survivor.
This process is mediated (to follow the terminology above, the self is ‘re-framed’) by the “socio-technical ensemble on which the patient depends immediately after surgery.” (34) Surgery may exclude patient subjectivity, but the socio-technical ensemble helps to create a new patient identity. This new identity may very well take the form of victimhood, although many post-operative techniques aim to help patients achieve ‘normalcy’ in their appearance and movements. To Parsons, it would appear that the medical system is helping to transform the very ‘sick role’ it initiated. Again, it seems that the specific roles we once attributed to actors in the medical process are in fact fluid and multi-dimensional.
Callon and Rabeharisoa (1998, in Moreira 2004) see this process in terms of ‘patient collectives,’ which are the “unfolding compositions of bodies, competences, artefacts, procedures and emotions gathered together by particular activities around/with a patient.” (35) These collectives coalesce in the moment of surgery. Their destruction is the major task of social reintegration – and the medical system (by virtue of completing the surgery) necessarily assists in this destruction.
The scar that results from surgery is permanent, however, and cannot simply be dismantled. The biomedical model may not foster a pathological dependence on the ‘sick role,’ the ‘socio-technical ensemble,’ or the ‘patient collective,’ but it does leave the patient with a marker of these structures. In the end, the patient bears the responsibility of integrating the scar into the outside world. The pro-surgery aspects of Life Lines narratives may reflect an ability (possibly supported by the medical system) to dismantle the (possibly benevolent) apparatuses of medical treatment. It is not surprising that people successful in this task would look positively on their brief experience as a passive, sick person.
There is also the possibility for patient agency before surgery. One participant, Patricia, has a fine white scar from surgery on wrist-joint ganglia. Because it was a minor surgery, she was given only local anaesthetic and was awake when the surgeon drew his guiding line on her wrist. This was the line upon which he would cut and which would eventually become her scar. She timidly asked him to re-draw the line in an “S” because she "preferred that shape." Her scar indeed reflects this shape and is accompanied by a sense of satisfaction at having been able to modify the impact of a medical process on her body.
Never having been excluded from the surgical process, Patricia’s subjectivity has remained intact through its entirety. An experience such as this would most likely make the task of dismantling the role/collective/ensemble much easier, if not irrelevant.
Patricia is a visual artist, and her ability to re-draw the mark on her body is reflective of the work of contemporary performance artists. They have used and reoriented the unique and dramatic aspects of medical treatment, including white lab coats, machines that examine and monitor the body and flesh-obscuring bandaging. In The Scar of Visibility, Petra Kuppers examines this sub-genre, and she points to the work of Kiki Smith, Mona Hatoum, Damient Hirst, Pepe Espaliu, Hamad Butt, Donald Rodney, Stelarc, Mac Quinn, Gina Pane and Orlan, among others. (Kuppers, 15)
As an artistic pursuit, Life Lines also draws from the aesthetic, the emotional and the medical. While the medical depiction of scarring is based on the severity of the wound and the rate of collagen production, in a creative context the scar is,
…self and nonself: it implicates and questions the subject's agency and yet asserts the viability of the body/mind as a creative, adaptive, and plastic entity. The scar moves matter into a future of a new flesh: a different subject emerges, a re-creation of the old into the new, into a repetition that holds on to its history even as it projects itself into an unpredictable future. (Kuppers, 19)
Kuppers sees these ideas at work in performances by Pam Patterson, an artist who lives with cancer. Patterson makes use of various objects, from breast prostheses to river stones. She also uses small slides that Kuppers believes intentionally mimic X-ray images. After the performance Bodysight: A Reclamation Project, Patterson spoke to the audience and,
…explained her reasons for the little visualization machines [showing small slides] circling her performance: during her recent experience, she had received an MRI, X-rays, two ultrasound biopsies, three mammograms, and other interventions, and the display was her way of reclaiming her body’s experience from these visualization machines . (14)
As a scientific discipline, medicine depends on vision and techniques for mapping and seeing. Although the preference for visual evidence reflects a physical tendency toward vision (it is estimated that up to 80% of our sensory information is received through sight), theorists have described medical practices of body imaging as excessively reductive. Marita Sturken and Lisa Cartwright echo the sentiment that these images de-privilege subjective experience. They describe how an ultrasound image,
…will be perceived as more reliable than a woman’s descriptions of her bodily sensations of pregnancy – or what has been termed “felt evidence.” (Chapter 8: Vision and Truth)
To Don Ihde, medicine performs this reductionism because it provides an image valuable to the physician in its ‘reiterability:’
One can return, again and again, to the image to detect features previously overlooked or previously unnoted. It is the instant and reiterable feature of the visualization that makes it valuable for science. (45)
The idea of reiterability coincides neatly with Kuppers’ description of the scar as ‘a repetition that holds on to its history.’ (19) Through physical healing, the scar itself becomes the image most relevant to the patient/subject, although the medical image of the wound may be more valuable to the medical professional. The biomedical model creates and prioritizes its visual evidence of the patient’s body; it would be valuable for patients to create their own visual representation of their felt evidence.
I did not set out to create medical images for Life Lines. It was my intention that the photographs, like the narratives, could be used as a means of re-framing an injury and the possible stigmatization resulting from it. I have introduced my own aesthetic to the photographs, for example using grey-scale so that they appear in soft tones of black and white. When I show the participant their photo, it is my hope that, in addition to my tastes, it in some way represents their own experience of bodily difference. This image is not medical, but it also is not antagonistic to medical representations. It simply operates on a different, possibly more patient-centred, level.
I am cognisant of the interrogating factor of the camera, both within and without medical contexts, and the vulnerability inherent in being photographed. The history of medical photography of illness and deformity is one of objectifying and demeaning images, often obtained through duress. As the project director and photographer, I perform a role with authority not unlike that of the doctor: I collect personal information about the participant’s life and body, then document and display it. I have sometimes worried that I am merely recreating the medical dynamic, tipping the balance of power away from the subject and towards myself.
I use various methods to broach this topic. The first is allowing the participants to contact me and arrange their sessions; I do not pursue notably scarred individuals and I try to be as accommodating as possible with participant requests. These have included being able to bring a friend, to remove their clothes in private, or to discuss the project at length beforehand. Many of my methods have grown out of experiences within the project. For example, I now allow the participant to sort through and crop or delete any of their photos directly after the session.
The visual aspect of the project has been important for most participants. The majority of people are somewhat shy about having their bodies photographed. For many, it is the first time that their scar has been explicitly examined outside of a hospital. They express nervousness before the photo-shoot and sometimes relief afterward. To some, the semi-objective nature of my photography – although I worry it does not do enough to represent their subjectivity – shows their scar in a new, more positive light. For example, Jonathon (Appendix I) writes,
Those images are pretty fantastic. I wish the scar was more prominent, but I guess that's a benefit of doing this project for me - it helps me see how I perceive it much stronger than it actually is. That's a very wonderful thing about the camera - though it distorts and highlights based on the lens and settings, ultimately it does tell the truth, or some vision of it. And it reminds us how our own vision is just one, that doesn't necessarily have anything to do with the way others will see us.
Jonathon is referring to the disjuncture between his personal sense of his body (what could be called ‘felt evidence’) and the seemingly more objective (to him, more valid) depiction made by myself and the camera. Perhaps the difference between this photo and one taken by a medical practitioner is in the latitude Jonathon has with its interpretation. He places the image in a social context, which he would not necessarily be able to do with a medical image. He refers back to his perception of other people’s experience of his body, which is a major factor in his narrative, as he describes feeling “weak and undesirable.” Because he finds the Life Lines image less stigmatizing, Jonathon appreciates the difference, and perhaps incorporates the ‘objective’ image into his own subjective body-image.
The same belief in the objectivity of the camera elicited an opposite reaction from Carmen (Appendix J). She is the only participant whose ‘scar’ is not literally a scar: she asked me to photograph the stretch marks on her breasts, stating that although she has,
…various scars from various things on…[her] body…[She] would never, ever feel as horrible and self conscious about them as…[She does] about…[her] stretch marks.
While she was one of the calmer and seemingly more comfortable participants, Carmen emailed me after I had published her photos (which she refers to as “the post” in the following excerpt) in a state of agitation. She wrote:
Just saw the post........... OK, sorry to be super annoying BUT I didn;t realize you were going to put that horriffic and absoluteley repulsive las pic of my deformed breast. Oh God I want to die. Ok, you can keep it IF you please, please, please delete the pic that shows my actual face so people don;t know that it's me and that I'm that totally repulsive. I know you won;t agree and I don;t need reassurance I just do NOT want people seeing my face any more. I am never getting naked again ever.
Taken aback, I responded,
Well hey, I want you to feel good about it. It matters less to me than it does to you... So I've taken the post down (it's saved, but as a draft). Think about what you want (which pictures, etc.), and just let me know in a few hours or at the end of the day or when you're ready... I just really love that portrait, but then maybe I could take other portrait photos of you that aren't 'scar' related…. Let me know what you want. It's not empowering if you hate it! Well, that is, if you hate it and don't want it up!
We proceeded to negotiate which pictures could be published; Carmen’s indecision revolved around conflicting desires to remain anonymous, to not to be represented as ‘deformed’ and also to pursue the aesthetic component of the project:
Hmmm...okay, much thinking. I've decided that you can keep the first two pieces, i.e. the one of my face/cleavage and the one where you just see my earings, cleavage, and the side of my face. Not the one I hate. If you like, you could also put the one where my hair just kind of dangles down?
I'm torn because if I were you, the artist, I would want to keep the one that shows the scars best. It works directly towards your theme, but isn;t as pleasant/pretty as the portrait. But the truth of the matter is that the portrait, though beautiful and...in a way showinbg some inner sadness...doesn't even show enough scars to make it...you know, matter?
"Like, why is this girl so obsessed with these half-invisible scars?? Get over yourself, lady." says the viewer that thinks like Carmen. It's a tough call because I'm more prone to think as the artist, and I think that the work would be more successful with that last photo. But as the subject, I really can't handle disclosing so much of myself to the public. Even if no one I know sees it, I'll still know.
So, in closing (haha...oh I'm such a caffeine fiend at night and write these convoluted emails) you can put the first two photos and the one with my hair hanging down, but no close-up scars one.
Eventually, we decided to remove the picture through which she could potentially be identified – the one that showed her face – and to replace it with one that showed her stretch marks more visibly. This process is analogous to the traditional medical approach of photographing disease and illness: obscuring the patient’s identity (and thus their subjectivity) in favour of a more explicit, ‘objective’ look at the disease. The difference here is that the anonymity and objectification were performed at the firm request of a willing participant. As some surgery patients may prefer to be de-subjectified, Carmen preferred a less personal representation.
Not all surgeons are heroes, but the biomedical model cannot simply be depicted as an evil, authoritarian regime. The roles played by both the doctor and the patient are consistently complicated, and the stories in Life Lines reflect the grey areas that arise around surgery and scarring. The project itself enters these liminal spaces, following other artists’ adoption and re-working of medical methods. It walks a fine line between artistic/social documentation and medical mimicry. Every scar represented is somewhere in the process of continual modification and reintegration. Just as collagen fibres knit together to close a wound, so too can stories of personal agency.
Epilogue:
Life Lines continues to grow, and so do I. Over the past three years over 50 people have participated in this project, and I still receive submissions and requests for photo-shoots. The methodology has changed in response to participant requests, and I have begun to transcribe and audio-record participant narratives. In the interest of developing this participant-centred approach, I should conduct a follow-up questionnaire asking about participant experiences before, during and after this project.
While it is a non-medical study of medicalized phenomena, Life Lines also documents self-inflicted scars and other injuries not necessarily requiring medical intervention. Future study could explore these scars, perhaps through narrative analysis: researchers in psychology have developed methods of quantifying narrative data. Such a study could include quantitative analysis of differences reflected by the impact of gender, age of injury and location of injury on the participant’s body.
Finally, there is a strong relationship between scars and tattoos. Not only are they both permanent marks on the subject’s body, I suspect that their relationship is inverse, that is, as socio-biological artefacts and processes, they mirror one another. To get the tattoo-mark, the participant chooses a concept (often a self-defining narrative) and design (image) and then the mark is made. The scar-mark is made first, followed by the image (the healed wound) and the creation of the story (also a self-defining narrative). As one commentator wrote, “Scars are tattoos with better stories.” If this relationship is further examined, it might allow us to adopt well-established ethnographic tattoo-research methodologies into the relatively unexplored area of scar study.
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-- Self, Agency and the Surgical Collective: detachment. Journal of
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Ondaatje, Michael. Anil’s Ghost. New York: Alfred A. Knnopf, 2000.
Parsons, Talcott. The Social System. New York: Free Press of Glencoe, 1951.
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April 15th 2009. (http://emedicine.medscape.com/article/884594-overview)
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(http://www.askoxford.com/concise_oed/scar_1?view=uk).
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Maps of Meaning at University of Toronto -- My First Scar Paper
2006. I had written about skin already, about a year before. In that paper (which I will post, somewhere on here, and link to it when I do) I studied Western women's skin-care habits and the pain that they (we?) endure in the quest for flawless and 'pure' (white -- though tanned) skin. And I wrote a personal health narrative that described my relationship to my skin and also my relationship to my scar...
It was the beginning of a wonderful friendship.
These are some of my first thoughts about scars, and difference. I'm not sure I stand behind the ideas about stats/summation of difference, but it was something I was interested in at the time. The paper was for a course taught by the ever-popular Jordan Peterson at the University of Toronto, where I was finishing my degree in psychology.
Abstract:
Whether through surgery or accident, incisions and abrasions on our bodies leave their mark. These scars seem random, unsightly and personal. The study of these scars is necessarily the study of anomaly. Because scars are distributed across the body, the averaged human body would have no scars on it. Every body, however, has a scar on it.
Many biomedical practices focus on gaining structural knowledge of the body’s interior. The surgeon delves within the body and removes, inserts or otherwise changes it. Surgeons create maps to make scars; they follow these maps with their hands to explore the unknown territory of another’s body. When the patient is not in an empowered position, this mapping results in a colonialist perspective of the body. The scars that result from surgery can also be envisioned as personal maps. We must work towards an approach to the body which comes more from within than from without.
Introduction:
Whether through surgery or accident, incisions and abrasions on our bodies leave their mark. These scars seem random, unsightly and personal. To ask someone about a scar is to invite the telling of his or her life story. What is it about scars that we find so disturbing and so compelling? Why are we so disgusted by them? How can we otherwise conceive of scars – and thus, our bodies – to feel stronger and more embodied because of them? To explore these issues, we must incorporate terms and approaches from psychology, philosophy, cultural studies and medicine; we must also examine our subjective physicality.
Writing about bodily experience is necessarily limited in that it enforces linearity on non-linear sensations and emotions. In an effort to encompass non-linear modes of thought and experience, I have completed two art pieces which explore these questions (see appendices A and B). The first is an art installation, through which one can examine the spatial dimensions of this issue; the second is an edited photo, which explores metaphorical and iconic symbolic representations.
Background:
The study of scars is necessarily the study of anomaly. The study of anomaly is in turn the study of the norm. One can only conceive of anomaly when one can conceive of a norm to deviate from; being abnormal is discouraged in our society. In Constructing Normalcy, Lennard Davis posits the origin of our desire to represent normalcy in our person in the rise of statistical measures:
With the concept of the norm – as represented by the ‘average man’ or those who fall under the bell curve in its densest places – comes the concept of deviation. As Davis writes, “…the average then becomes paradoxically a kind of ideal, a position devoutly to be wished” (27) . If one were to make a composite photograph of all the people in the world, one could present an image of the ‘average’ human. Similarly, because scars are distributed across the body, the averaged human body would have no scars on it. Every body, however, has a scar on it.
To escape from the distortion of the norm, we must change our ideas of the ideal. The pragmatic advantage of the statistical norm is that it allows us compare people to it. It is useful in education, for example, when one wants to identify and segregate children whose abilities lie at the extremities of the bell curve. We must keep this advantage in our new conceptualization.
The Installation (Appendix A):
In my art installation, I propose a spatial summation of difference. Where physical realities are ignored or distorted in statistical norming, this process acknowledges and includes them (see Appendix A). Where in an ‘average’ the scar disappears (and thus becomes deviant), here the scar is highlighted, becoming a shared phenomenon. The idea of the ‘norm’ is turned on its head: what was abnormal is now normal.
Theorizing the Installation:
The idea of the ‘untouched’ or pure body goes beyond the aspect of the norm as ideal; it is the basis of all that we perceive of as young and attractive. We spend much of our time pursuing the ideal of the unscarred and unblemished. There are uncountable techniques for minimizing or disguising variable marks upon our skin. In my research for this paper, I constantly came across websites promoting scar ‘removal.’ One stated,
Our obsession with scar minimization is part of our culture’s general approach to bodies as strange and compelling. It seems that the body is paradoxically both known and unknown to us; both a source of pleasure and disgust. Because we inhabit our bodies – we move in, with and by our bodies – we alone are privy to our physical sensations, and our bodies’ interior functions. At the same time, we are not aware of and cannot control the structure of our bodies’ interiors.
Even if one has studied anatomy and ‘knows’ all of the organs and tendons of the body, one never knows the exact state and composition of one’s physical interior. We feel much of what happens behind our skin, but we are not always aware of it; we do not know what it looks like and we cannot explain it. Thus, it is like a land unknown. Many traditions and thinkers have focused on this aspect of the interior.
Erich Neumann was one such thinker. As a Jungian psychologist, he believed the ‘vessel’ was the primary symbol of the feminine aspect of both male and female psyches. This aspect is always represented by,
While the unknown can also be represented in the outside world, the physical interior is always unknown structurally and only sometimes known experientially.
Many wellness practices based in Eastern philosophies focus on gaining knowledge of the experiences of the body. These include mindfulness mediation, yogic practices and body psychotherapy. Many biomedical practices focus on gaining structural knowledge of the body’s interior. David Michael Levin posits that the dominant intellectual conflict is no longer between “mind” and “body,” but between the body of medicine and the body of experience (Johnson). Dissection, the X-ray and laparoscopy are all ways of interrogating the body for this knowledge. So is surgery, which requires the creation of x-rays and consequent cutting open of the skin to explore and to make right the organs within. The surgeon delves within the body – Neumann’s numinous unknown – and removes, inserts or otherwise changes it. Once the work is done, he/she stitches or staples the cut skin together, with the intention of making the incision close.
The practice of stitching two materials together is an old one. The word stitch comes to us from Old English stice, a puncture or stab, akin to the Old English word for stick; sew is even older, having been derived from the Proto-Indo European base *siw-, to sew. Although we have innovated aspects of stitching – such as the threads that decompose once the wound has healed, or the use of staples – the basic pattern of sewing has not changed. Sewing is traditional ‘woman’s work’ and its use in modern surgery has an element of obscenity and pragmatism.
We would like surgery to be literally clean-cut, simple and high-tech. Hospitals convey this need with their beige walls and white lab coats; surgery is not supposed to be about cutting open and stitching up real bodies – that is for the realm of the horror movie. Because surgery accesses the unknown and the personal, while also confronting death, we would like to distance ourselves from it as much as possible. This is, in the end, an impossible narrative if our bodie live to tell it.
Surgery comes from a Latin word which evolved from the Greek kheirourgia “hand-work” based on kheir “hand” + erg- “work.” The same root underlying erg-/org- became "work" in English.
Peterson also discusses hand-work in relation to the unknown, albeit not in the sense of literal surgery:
Taking this general statement, and applying it to the specific situation of surgery, illuminates issues of subjectivity and objectification. Many patients never meet their surgeon; to the surgeon, the patient’s body is literally, “the undifferentiated mass of unobserved and un-encountered ‘existence.’” If one is being operated on, one is being constructed (‘carved out’) by the hands of another.
The patient is usually prone and almost always under anesthetic when surgery takes place. The most prominent part of both our personal known (experienced) and unknown (unexplored internal structures) are explored by another, in our absence.
The second objectifying aspect of surgery is the creation of an impersonal map upon one’s body. Excepting cases of emergency, the surgeon will draw upon the patient’s body a few lines where he/she plans to make the incision. Surgeons create maps to make scars; they follow these maps with their hands to explore the unknown territory of another’s body.
***NB (this was a footnote): In her play, The Good Body, Eve Ensler explores the issue of surgical mapping in her monologue of ‘A Thirty-Five-Year-Old Model’:
In this mapping, the patient is not in control; in the process described above the (female) patient is nothing more than passive territory to be explored. This mapping results in a colonialist perspective of the body. The challenge that arises is to take the tracks that have been made by the other’s mapping and to make them into one’s own. A personal map includes one’s own set of directions and feeling of location. This is what I aim to do with my installation piece, and with the attached photo.
The Edited Photograph (Appendix B):
***NB: These were the early days of photoshop.
In the attached piece (Appendix B), I have reclaimed my scar. Instead of the straight line that it usually is, my scar becomes an escher-esque pattern, with no end or beginning. I think it looks more organic but also more purposeful – more in line with practices of body modification or mutilation than the passivity that usually accompanies surgery. The design also encompasses the symbol of the oroborus, a metaphor for the “precosmogenic chaos…the self-consuming serpent…represents the union of matter and spirit, and the possibility of transformation”(Peterson, 89). As the serpent eats its tail, so my scar squares itself.
When the great unknown is represented by the serpent, it is almost always female. In the same way, our disgust with scars relates to our disgust with the female body. The conceptualisation of the interior body as ‘unknown’ carries with it the element of femininity. Neumann’s woman = body = vessel equation exemplifies this, reflecting the Jungian characterization of the unconscious as feminine. If the interiors of our bodies are the feminine unknown, incisions that allow us contact with the interior are analogous to other openings on women’s bodies. To be specific, cuts are vaginal; thus, scars have a womanly connotation. This image is frequently denigrated. The existentialist philosopher Jean-Paul Sartre described, “the obscenity of the feminine sex…of everything which “gapes open.”…the hole, before all sexual specification, is an obscene expectation, an appeal to the flesh” (85-86).
Conclusion:
Scars indicate our abnormality and thus our deviance. Scars remind us of a rupturing between the realms of the known and the unknown. Scars are often created as a result of processes in which we are passively mapped. Scars are feminine. All of these elements have relevance to the social structuring of incision, wounding and healing; in conclusion, it may be beneficial to turn to a more depth-analytical psychological perspective.
The process of splitting in two (of which the scar is evidence) can be seen metaphorically as a process of differentiation. Like the process of mapping or exploring the body’s interior through surgery,
The killing of an all-embracing monster and the construction of the universe from its body parts is symbolic (metaphorical) representation of the central, adaptive process of heroic encounter with the undifferentiated unknown, and the construction or generation of differentiated order as a consequence (Peterson, 124).
In Jungian fairytale interpretation, the act of cutting in two does not signify death so much as life and new growth (Yeoman). If we could see our scars as evidence of our ability to define, heal and grow from our own bodily experiences, perhaps we would not find them so frightening.
Works Cited:
American Society of Plastic Surgeons, Online. Retrieved March 26th 2006.
http://www.plasticsurgery.org/public_education/procedures/ScarRevision.cfm
Cronenberg, David. Lecture. Kodak Lecture Series. Ryerson University. November 7th
2004.
Davis, Lennard. Constructing Normalcy. In Enforcing Normalcy: Disability, Deafness
and the Body (23-29). New York: Verso.
Differentiation. Jung, C.G. Trans. R.F.C. Hull, Eds. H. Read, M. Fordham, G. Adler, and
Wm. McGuire. The Collected Works of C.G. Jung. Bollingen Series XX.
Princeton: Princeton University,1953-1979.
Ensler, Eve. The Good Body. New York: Random House, 2004.
Johnson, D.H. Who Walks? In The Body in Psychotherapy: Inquiries into Somatic
Psychology (pp. 1-17). Berkely: North Atlantic Books, 1998.
Langer, Susanne K. Philosophy in a New Key: a Study in the Symbolism of Reason, Rite,
and Art. Cambridge, Mass.: Harvard Press, 1942.
Lao Tzu, The Tao Te Ching. New York: Penguin Putnam, 1963.
Neufeldt, Victoria. Ed. Webster’s New World Dictionary. New York: Simon and
Schuster, 1989.
Neumann, Erich. Trans. Ralph Manheim. The Great Mother. Princeton: Princeton
University, 1963.
Peterson, Jordan. Maps of Meaning: the Architecture of Belief. New York: Routledge,
1999.
Plato. Trans. Tom Griffith, Ed. G.R.F. Ferrari. Republic. Cambridge: Cambridge
University, 2000.
Sartre, Jean-Paul. Existentialism and Human Emotions. New York: Citadel, 1957.
Sturken, M. & Cartwright, L. (2002). Scientific looking, looking at science. In Practices
of Looking (pp. 279-313). Toronto: Oxford University Press.
Tolle, Eckhart. The Power of Now. Vancouver: Namaste, 1997.
Surgery. Yourdictionary.com. Retrieved March 26th, 2006.
http://www.yourdictionary.com
Wendell, Susan. Feminism, Disability and Transcendence of the Body. Canadian
Women’s Studies 13(4), (116-122). (1993).
Yeoman, Ann. Rumplestiltskin. NEW404: Psyche’s Stories. New College, University of
Toronto, February 18th 2006.
It was the beginning of a wonderful friendship.
These are some of my first thoughts about scars, and difference. I'm not sure I stand behind the ideas about stats/summation of difference, but it was something I was interested in at the time. The paper was for a course taught by the ever-popular Jordan Peterson at the University of Toronto, where I was finishing my degree in psychology.
Abstract:
Whether through surgery or accident, incisions and abrasions on our bodies leave their mark. These scars seem random, unsightly and personal. The study of these scars is necessarily the study of anomaly. Because scars are distributed across the body, the averaged human body would have no scars on it. Every body, however, has a scar on it.
Many biomedical practices focus on gaining structural knowledge of the body’s interior. The surgeon delves within the body and removes, inserts or otherwise changes it. Surgeons create maps to make scars; they follow these maps with their hands to explore the unknown territory of another’s body. When the patient is not in an empowered position, this mapping results in a colonialist perspective of the body. The scars that result from surgery can also be envisioned as personal maps. We must work towards an approach to the body which comes more from within than from without.
Introduction:
Whether through surgery or accident, incisions and abrasions on our bodies leave their mark. These scars seem random, unsightly and personal. To ask someone about a scar is to invite the telling of his or her life story. What is it about scars that we find so disturbing and so compelling? Why are we so disgusted by them? How can we otherwise conceive of scars – and thus, our bodies – to feel stronger and more embodied because of them? To explore these issues, we must incorporate terms and approaches from psychology, philosophy, cultural studies and medicine; we must also examine our subjective physicality.
Writing about bodily experience is necessarily limited in that it enforces linearity on non-linear sensations and emotions. In an effort to encompass non-linear modes of thought and experience, I have completed two art pieces which explore these questions (see appendices A and B). The first is an art installation, through which one can examine the spatial dimensions of this issue; the second is an edited photo, which explores metaphorical and iconic symbolic representations.
Background:
The study of scars is necessarily the study of anomaly. The study of anomaly is in turn the study of the norm. One can only conceive of anomaly when one can conceive of a norm to deviate from; being abnormal is discouraged in our society. In Constructing Normalcy, Lennard Davis posits the origin of our desire to represent normalcy in our person in the rise of statistical measures:
It was the French statistician Adolphe Quetelet (1796-1847) who contributed the most to a generalized notion of the normal as an imperative. He noticed that the ‘law of error,’ used by astronomers to locate a star by plotting all the sightings and then averaging the errors, could be equally applied to the distribution of human features such as height and weight. He then took a further step of formulating the concept of ‘l’homme moyen’ or the average man (26).
With the concept of the norm – as represented by the ‘average man’ or those who fall under the bell curve in its densest places – comes the concept of deviation. As Davis writes, “…the average then becomes paradoxically a kind of ideal, a position devoutly to be wished” (27) . If one were to make a composite photograph of all the people in the world, one could present an image of the ‘average’ human. Similarly, because scars are distributed across the body, the averaged human body would have no scars on it. Every body, however, has a scar on it.
To escape from the distortion of the norm, we must change our ideas of the ideal. The pragmatic advantage of the statistical norm is that it allows us compare people to it. It is useful in education, for example, when one wants to identify and segregate children whose abilities lie at the extremities of the bell curve. We must keep this advantage in our new conceptualization.
The Installation (Appendix A):
In my art installation, I propose a spatial summation of difference. Where physical realities are ignored or distorted in statistical norming, this process acknowledges and includes them (see Appendix A). Where in an ‘average’ the scar disappears (and thus becomes deviant), here the scar is highlighted, becoming a shared phenomenon. The idea of the ‘norm’ is turned on its head: what was abnormal is now normal.
Theorizing the Installation:
The idea of the ‘untouched’ or pure body goes beyond the aspect of the norm as ideal; it is the basis of all that we perceive of as young and attractive. We spend much of our time pursuing the ideal of the unscarred and unblemished. There are uncountable techniques for minimizing or disguising variable marks upon our skin. In my research for this paper, I constantly came across websites promoting scar ‘removal.’ One stated,
Scars -whether they're caused by accidents or by surgery- are unpredictable. The way a scar develops depends as much on how your body heals as it does on the original injury or on the surgeon's skills…no scar can be removed completely, plastic surgeons can often improve the appearance of a scar, making it less obvious through the injection or application of certain steroid medications or through surgical procedures known as scar revisions (American Association of Plastic Surgeons, italics added).
Our obsession with scar minimization is part of our culture’s general approach to bodies as strange and compelling. It seems that the body is paradoxically both known and unknown to us; both a source of pleasure and disgust. Because we inhabit our bodies – we move in, with and by our bodies – we alone are privy to our physical sensations, and our bodies’ interior functions. At the same time, we are not aware of and cannot control the structure of our bodies’ interiors.
Even if one has studied anatomy and ‘knows’ all of the organs and tendons of the body, one never knows the exact state and composition of one’s physical interior. We feel much of what happens behind our skin, but we are not always aware of it; we do not know what it looks like and we cannot explain it. Thus, it is like a land unknown. Many traditions and thinkers have focused on this aspect of the interior.
Erich Neumann was one such thinker. As a Jungian psychologist, he believed the ‘vessel’ was the primary symbol of the feminine aspect of both male and female psyches. This aspect is always represented by,
The basic symbolic equation woman = body = vessel…All the basic vital functions occur in this vessel-body schema, whose ‘inside’ is unknown. Its entrance and exit zones are of special significance…All body openings – eyes, ears, nose, mouth (navel), rectum, genital zone – as well as the skin, have, as places of exchange between inside and outside, a numinous accent for early man…The concrete corporeity of the body-vessel whose inside always remains dark and unknown is the reality in which the individual experiences the whole unconscious world of instinct (39-40).
While the unknown can also be represented in the outside world, the physical interior is always unknown structurally and only sometimes known experientially.
Many wellness practices based in Eastern philosophies focus on gaining knowledge of the experiences of the body. These include mindfulness mediation, yogic practices and body psychotherapy. Many biomedical practices focus on gaining structural knowledge of the body’s interior. David Michael Levin posits that the dominant intellectual conflict is no longer between “mind” and “body,” but between the body of medicine and the body of experience (Johnson). Dissection, the X-ray and laparoscopy are all ways of interrogating the body for this knowledge. So is surgery, which requires the creation of x-rays and consequent cutting open of the skin to explore and to make right the organs within. The surgeon delves within the body – Neumann’s numinous unknown – and removes, inserts or otherwise changes it. Once the work is done, he/she stitches or staples the cut skin together, with the intention of making the incision close.
The practice of stitching two materials together is an old one. The word stitch comes to us from Old English stice, a puncture or stab, akin to the Old English word for stick; sew is even older, having been derived from the Proto-Indo European base *siw-, to sew. Although we have innovated aspects of stitching – such as the threads that decompose once the wound has healed, or the use of staples – the basic pattern of sewing has not changed. Sewing is traditional ‘woman’s work’ and its use in modern surgery has an element of obscenity and pragmatism.
We would like surgery to be literally clean-cut, simple and high-tech. Hospitals convey this need with their beige walls and white lab coats; surgery is not supposed to be about cutting open and stitching up real bodies – that is for the realm of the horror movie. Because surgery accesses the unknown and the personal, while also confronting death, we would like to distance ourselves from it as much as possible. This is, in the end, an impossible narrative if our bodie live to tell it.
Surgery comes from a Latin word which evolved from the Greek kheirourgia “hand-work” based on kheir “hand” + erg- “work.” The same root underlying erg-/org- became "work" in English.
Peterson also discusses hand-work in relation to the unknown, albeit not in the sense of literal surgery:
The capacity to create novel behaviours…in response to the emergence of the unknown might be regarded as the primary hallmark of human consciousness…this process literally allows us to carve the world out of the undifferentiated mass of unobserved and unencountered “existence”…We carve out the world as a consequence of our direct interactions with the unknown – most notably, with our hands (66-67).
Taking this general statement, and applying it to the specific situation of surgery, illuminates issues of subjectivity and objectification. Many patients never meet their surgeon; to the surgeon, the patient’s body is literally, “the undifferentiated mass of unobserved and un-encountered ‘existence.’” If one is being operated on, one is being constructed (‘carved out’) by the hands of another.
The patient is usually prone and almost always under anesthetic when surgery takes place. The most prominent part of both our personal known (experienced) and unknown (unexplored internal structures) are explored by another, in our absence.
The second objectifying aspect of surgery is the creation of an impersonal map upon one’s body. Excepting cases of emergency, the surgeon will draw upon the patient’s body a few lines where he/she plans to make the incision. Surgeons create maps to make scars; they follow these maps with their hands to explore the unknown territory of another’s body.
***NB (this was a footnote): In her play, The Good Body, Eve Ensler explores the issue of surgical mapping in her monologue of ‘A Thirty-Five-Year-Old Model’:
My surgeon literally changed me with his hands, with his instruments, with his vision. He removed some things and added others. I’m not anything like the person I was six years ago…After I woke up from my first surgery, he was there standing over me. He was very excited. He had taken a life-sized photograph of my entire body naked. It felt a bit invasive. I mean, I am shy and I didn’t really know him. There were corrective red marks all over my body like the kind you got on your spelling mistakes in seventh grade… “Your body is a map,” he said. “These red marks are designated beauty capitals that need renovation and work.” That was six years ago and today I am …[my surgeon’s] creation.
In this mapping, the patient is not in control; in the process described above the (female) patient is nothing more than passive territory to be explored. This mapping results in a colonialist perspective of the body. The challenge that arises is to take the tracks that have been made by the other’s mapping and to make them into one’s own. A personal map includes one’s own set of directions and feeling of location. This is what I aim to do with my installation piece, and with the attached photo.
The Edited Photograph (Appendix B):
***NB: These were the early days of photoshop.
In the attached piece (Appendix B), I have reclaimed my scar. Instead of the straight line that it usually is, my scar becomes an escher-esque pattern, with no end or beginning. I think it looks more organic but also more purposeful – more in line with practices of body modification or mutilation than the passivity that usually accompanies surgery. The design also encompasses the symbol of the oroborus, a metaphor for the “precosmogenic chaos…the self-consuming serpent…represents the union of matter and spirit, and the possibility of transformation”(Peterson, 89). As the serpent eats its tail, so my scar squares itself.
When the great unknown is represented by the serpent, it is almost always female. In the same way, our disgust with scars relates to our disgust with the female body. The conceptualisation of the interior body as ‘unknown’ carries with it the element of femininity. Neumann’s woman = body = vessel equation exemplifies this, reflecting the Jungian characterization of the unconscious as feminine. If the interiors of our bodies are the feminine unknown, incisions that allow us contact with the interior are analogous to other openings on women’s bodies. To be specific, cuts are vaginal; thus, scars have a womanly connotation. This image is frequently denigrated. The existentialist philosopher Jean-Paul Sartre described, “the obscenity of the feminine sex…of everything which “gapes open.”…the hole, before all sexual specification, is an obscene expectation, an appeal to the flesh” (85-86).
Conclusion:
Scars indicate our abnormality and thus our deviance. Scars remind us of a rupturing between the realms of the known and the unknown. Scars are often created as a result of processes in which we are passively mapped. Scars are feminine. All of these elements have relevance to the social structuring of incision, wounding and healing; in conclusion, it may be beneficial to turn to a more depth-analytical psychological perspective.
The process of splitting in two (of which the scar is evidence) can be seen metaphorically as a process of differentiation. Like the process of mapping or exploring the body’s interior through surgery,
The killing of an all-embracing monster and the construction of the universe from its body parts is symbolic (metaphorical) representation of the central, adaptive process of heroic encounter with the undifferentiated unknown, and the construction or generation of differentiated order as a consequence (Peterson, 124).
In Jungian fairytale interpretation, the act of cutting in two does not signify death so much as life and new growth (Yeoman). If we could see our scars as evidence of our ability to define, heal and grow from our own bodily experiences, perhaps we would not find them so frightening.
Works Cited:
American Society of Plastic Surgeons, Online. Retrieved March 26th 2006.
http://www.plasticsurgery.org/public_education/procedures/ScarRevision.cfm
Cronenberg, David. Lecture. Kodak Lecture Series. Ryerson University. November 7th
2004.
Davis, Lennard. Constructing Normalcy. In Enforcing Normalcy: Disability, Deafness
and the Body (23-29). New York: Verso.
Differentiation. Jung, C.G. Trans. R.F.C. Hull, Eds. H. Read, M. Fordham, G. Adler, and
Wm. McGuire. The Collected Works of C.G. Jung. Bollingen Series XX.
Princeton: Princeton University,1953-1979.
Ensler, Eve. The Good Body. New York: Random House, 2004.
Johnson, D.H. Who Walks? In The Body in Psychotherapy: Inquiries into Somatic
Psychology (pp. 1-17). Berkely: North Atlantic Books, 1998.
Langer, Susanne K. Philosophy in a New Key: a Study in the Symbolism of Reason, Rite,
and Art. Cambridge, Mass.: Harvard Press, 1942.
Lao Tzu, The Tao Te Ching. New York: Penguin Putnam, 1963.
Neufeldt, Victoria. Ed. Webster’s New World Dictionary. New York: Simon and
Schuster, 1989.
Neumann, Erich. Trans. Ralph Manheim. The Great Mother. Princeton: Princeton
University, 1963.
Peterson, Jordan. Maps of Meaning: the Architecture of Belief. New York: Routledge,
1999.
Plato. Trans. Tom Griffith, Ed. G.R.F. Ferrari. Republic. Cambridge: Cambridge
University, 2000.
Sartre, Jean-Paul. Existentialism and Human Emotions. New York: Citadel, 1957.
Sturken, M. & Cartwright, L. (2002). Scientific looking, looking at science. In Practices
of Looking (pp. 279-313). Toronto: Oxford University Press.
Tolle, Eckhart. The Power of Now. Vancouver: Namaste, 1997.
Surgery. Yourdictionary.com. Retrieved March 26th, 2006.
http://www.yourdictionary.com
Wendell, Susan. Feminism, Disability and Transcendence of the Body. Canadian
Women’s Studies 13(4), (116-122). (1993).
Yeoman, Ann. Rumplestiltskin. NEW404: Psyche’s Stories. New College, University of
Toronto, February 18th 2006.
DispatX -- Proposal to Work Collectively on Bodies/Scars/Maps
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click here to view the post.
Bodies of Knowledge -- Installation Proposal: Scars and Cities (an abandoned idea)
I proposed this (below) in 2006 -- working with ideas of the city as body, which takes its basis from the long history of analogies between land and body (e.g. the King as Head of State).
It was accepted. I tried it, and it didn't work. Thanks for comin' out.
Installation Proposal:
A large mirror stands against the wall. As people mill about, entering the presentation space, they catch sight of their own reflection. Intrigued, a few walk over. They are instructed to consider the scars on their bodies: where are they? How did they get there? How do they feel about them? What stories are associated with them?
There are pens available. Different colours are assigned to different height ranges (for example, those who are between four and five feet tall will use a blue pen; between 5 and 6 will use a green pen, etc.). The participants are asked to draw their scars on the mirror in front of them. One at a time, they approach the mirror. They draw their scars in the way they experience them – perhaps larger or more jagged than would appear to an observer.
At the end of the evening, the pattern of scars will be recorded. I plan to have at least hundred people draw their scars in this way. Their marks will overlap and undercut one another. This is a spatial summation of difference. I hope to find areas of the body that are more likely to be scarred than others – areas where this particular sample reported more scarring.
The pattern that results will eventually be scaled to match the size of a map of Toronto. Toronto is the city in which the participants meet; the city is a macrocosm of the body we inhabit. Following the lead of artists who have explored the translation of data from one discipline/realm/space/encoding to another, the pattern of marks accumulated from the scar mapping will be mapped onto the city.
Conceptually, the downtown core will be situated where the ‘average’ head of the participants is approximately situated. They are parallel their mutual connotation of intellect and productivity. Descending through the conceptual body, the heart will map onto approximately Rosedale; there are parallels here as well, in the sense that Rosedale is a neighbourhood of large, comfortable homes -- the heart the city would like to present to the world. The extremities (hands and feet) overlay the extremities of the city: suburban areas.
I hope to eventually conduct installation/interactive pieces in the areas that are demarked by a high density of scars.
It was accepted. I tried it, and it didn't work. Thanks for comin' out.
Installation Proposal:
A large mirror stands against the wall. As people mill about, entering the presentation space, they catch sight of their own reflection. Intrigued, a few walk over. They are instructed to consider the scars on their bodies: where are they? How did they get there? How do they feel about them? What stories are associated with them?
There are pens available. Different colours are assigned to different height ranges (for example, those who are between four and five feet tall will use a blue pen; between 5 and 6 will use a green pen, etc.). The participants are asked to draw their scars on the mirror in front of them. One at a time, they approach the mirror. They draw their scars in the way they experience them – perhaps larger or more jagged than would appear to an observer.
At the end of the evening, the pattern of scars will be recorded. I plan to have at least hundred people draw their scars in this way. Their marks will overlap and undercut one another. This is a spatial summation of difference. I hope to find areas of the body that are more likely to be scarred than others – areas where this particular sample reported more scarring.
The pattern that results will eventually be scaled to match the size of a map of Toronto. Toronto is the city in which the participants meet; the city is a macrocosm of the body we inhabit. Following the lead of artists who have explored the translation of data from one discipline/realm/space/encoding to another, the pattern of marks accumulated from the scar mapping will be mapped onto the city.
Conceptually, the downtown core will be situated where the ‘average’ head of the participants is approximately situated. They are parallel their mutual connotation of intellect and productivity. Descending through the conceptual body, the heart will map onto approximately Rosedale; there are parallels here as well, in the sense that Rosedale is a neighbourhood of large, comfortable homes -- the heart the city would like to present to the world. The extremities (hands and feet) overlay the extremities of the city: suburban areas.
I hope to eventually conduct installation/interactive pieces in the areas that are demarked by a high density of scars.
Canada Council for the Arts -- Grant Application for Development of Life Lines as an Online Project
I wrote this application in 2007. I think it would have stood a good chance of getting some funding BUT they decided I wasn't really an artist. I'm not really sure why -- if it walks like an artist, if it talks like an artist... But in any case, I was in some other country when the decision came through, and I didn't appeal it.
Significance of Activity Statement:
I am applying for a Canada Council for the Arts grant in order to expand Life Lines, a photography project in which I document and explore physical scars and their effect on identity. I photograph people’s scars and publish the in-depth stories of their origins. After this process I often receive personal letters detailing the transformative nature of this experience. I currently have no structure in which to represent or foster this reflection. A CCA grant would allow me to host a website with discussion features so that members of the public could participate in an ongoing dialogue. It would also allow me to print and exhibit several new photographs and possibly pay the participants an honorarium for their work.
I began my artistic practice as a freelance photographer, focusing on decay in architecture. Influenced by recent work in front of the camera, I have now moved into portraiture, particularly of those who consider their bodies ‘different’. I am interested in the emotional and social components of photography and have been working on Life Lines since early 2006.
I have exhibited at The Little Art Show (Fall 2007 and 2006), Resistor Gallery's Akin Bazaar (Summer 2007) Good For Her (Fall 2006) and the Riverdale Art Walk (Summer 2006). Life Lines has been published online since early 2006 and has received comments and submissions from around the world; in September 2006 I was interviewed by The Medium paper and CKUT radio about the project. I have also presented my findings at an academic conference (Bodies of Knowledge, 2006) and conducted an interactive workshop on scar narratives (Java Knights, 2006).
This grant would allow me to breathe new life into a valuable project that has been pushed aside due to a lack of financial resources. People have fascinating things to say about their bodies, their scars and their experience of being photographed and displayed. I find this aspect of the project particularly interesting and would like to see it grow into a thriving area for online interaction. I would also be excited to further exhibit my work in a more accessible public context and to provide compensation to the people whose bodies I study.
Images Attached (screen shots from the project):
Significance of Activity Statement:
I am applying for a Canada Council for the Arts grant in order to expand Life Lines, a photography project in which I document and explore physical scars and their effect on identity. I photograph people’s scars and publish the in-depth stories of their origins. After this process I often receive personal letters detailing the transformative nature of this experience. I currently have no structure in which to represent or foster this reflection. A CCA grant would allow me to host a website with discussion features so that members of the public could participate in an ongoing dialogue. It would also allow me to print and exhibit several new photographs and possibly pay the participants an honorarium for their work.
I began my artistic practice as a freelance photographer, focusing on decay in architecture. Influenced by recent work in front of the camera, I have now moved into portraiture, particularly of those who consider their bodies ‘different’. I am interested in the emotional and social components of photography and have been working on Life Lines since early 2006.
I have exhibited at The Little Art Show (Fall 2007 and 2006), Resistor Gallery's Akin Bazaar (Summer 2007) Good For Her (Fall 2006) and the Riverdale Art Walk (Summer 2006). Life Lines has been published online since early 2006 and has received comments and submissions from around the world; in September 2006 I was interviewed by The Medium paper and CKUT radio about the project. I have also presented my findings at an academic conference (Bodies of Knowledge, 2006) and conducted an interactive workshop on scar narratives (Java Knights, 2006).
This grant would allow me to breathe new life into a valuable project that has been pushed aside due to a lack of financial resources. People have fascinating things to say about their bodies, their scars and their experience of being photographed and displayed. I find this aspect of the project particularly interesting and would like to see it grow into a thriving area for online interaction. I would also be excited to further exhibit my work in a more accessible public context and to provide compensation to the people whose bodies I study.
Images Attached (screen shots from the project):
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