PGR/ECR Medical Humanities training events

In 2019-20 the EBI ‘Medical Humanities’ Research Strand, Centre for Health, Humanities & Science, and South, West & Wales Doctoral Training Partnership collaborated to run a training scheme for PGRs working in the field of ‘medical humanities’. This training ran as a cohort scheme with 11 participants from across the region, from a range of disciplinary backgrounds. The cohort attended three full-day workshops over 18 months, at which University of Bristol staff from a range of disciplines and professional services provided training on the themes of ‘Connecting’, ‘Funding’ and ‘Planning’.

CHHS research seminar (online) – Dr John Troyer

We were joined by Dr John Troyer on the 6th of May who gave a talk entitled ‘When Everything Dead is New Again: Rethinking the Current Death and Dying Movement’.

Troyer asserted that the future of death is almost always somehow about a present moment forgetting the past. In the post-WWII English-speaking First World, social movement debates about the future practice of dying as well as the concept of death itself began crystallizing in the 1970s. An enormous body of death research and discourse emerged over forty years ago that addressed class, gender, disease, and end-of-life acceptance issues. 

Indeed, but for the emergence of twenty-first century digital communication technology and social media networks, 2020’s discussions around death and dying more or less mirror the same 1970s issues. 

His question for the CHHS seminar was not why this has happened (discourses are forgotten and overlap all the time), rather he wanted to ask how a decade’s long production of death debate and research that specifically addressed the future of death (amongst other topics) seemingly vanished. Or, more than vanished, is almost entirely excised from contemporary discussions around the death taboo hypothesis, critiques of state intervention on the dying, and concepts of ‘natural death.’

Some key discursive points did emerge in this analysis. The 1970’s never seem to fit twenty-first century future-nostalgia for a ‘better time to die’ when compared to the Victorian era. The social and political movements from forty-years ago are also rarely identified as having made death a consciousness raising issue for future generations.  Finally, the emergence of HIV/AIDS during the 1980’s heavily shaped future understandings of 1970s death discourse.

If thinking about death’s futures can teach scholars anything it is this: all things dead will eventually become new again, including the 1970s.

CHHS research seminar (online): Dr Theo Savvas

Dr Theo Savvas gave our second online CHHS research seminar on the 6th May.

Title: ‘Hitherto we’ve had a certain lack of meat here’1: Representations of Vegetarianism in Utopian Literature

Savvas argued that abstaining from the consumption of animal flesh—‘Pythagoreanism’ before 1838, ‘Vegetarianism’ thereafter—has a long and varied literary history. One aspect of this history that has remained fairly consistent is the frequent representation of such abstention in imaginings of ideal worlds: Pythagoras looked back to the vegetable-eating of the Golden Age; the Utopian novel looks forward to a time when the slaughter-house is no more. In this talk, Savvas provided an overview of these representations, before focusing on some of the ‘scientific romances’ of H.G. Wells, who had an ambivalent response to the burgeoning vegetarianism of fin-de-siècle London. In these works, he suggested, vegetarianism figures as a useful way of thinking about the demarcation between the human and the animal

CHHS research seminar (online): Dr Jeremy Simon

Title: Is it true that the valiant never taste of death but once?: A pluralistic approach to time of death

On March 25th the CHHS held its first online research seminar with guest speaker Dr Jeremy Simon. Simon argued that our current concept of death is not essentially different from that of the preceding millennia. This concept is of an abrupt transition from one state (life) to another (death). This transition in the body then causes many secondary changes. Among others, the person’s property must be transferred to new owners, their spouse may remarry, their body may be buried or otherwise disposed of, the family should mourn, medical treatment is no longer considered necessary, appropriate or possible, and, recently, the patient’s organs can be transplanted. What is essential, though, is that there is a single physiological event, which marks a single transition, and this single transition yields multiple consequences.

The sharp transition from life to death, however, was only apparent, or perhaps better, temporary, a feature of the pre-modern condition. The absence of effective interventions meant that peoples’ brain-stems, hearts and lungs all stopped working essentially simultaneously, and patients with severe brain injury or pathology (i.e., those whose cortices were not functioning) reached that point promptly, due to dehydration if nothing else. Modern medicine, however, has allowed us to separate these events, and thus unsharpen the transition from life to death. For those whose hearts have stopped, we have defibrillators and bypass, so that the brain, and in some cases, the heart, can survive cardiac arrest. For those whose brainstems are not functioning, we can support the cortex and heart with intubation. And for those whose cortices are not functioning we have intravenous and gastrostomy nutrition and hydration.

The ability of modern medicine to separate these events that formerly occurred as a bundle has not gone unnoticed by philosophers. The response has been to try to determine which of these events (roughly, cortical death, brainstem death and cardiorespiratory death) results in the transition from life to death, that is, is really death. This attempt has not resulted in consensus, however, but in dissatisfaction and paradox. Simon suggested that the reason for this failure is that there is no unified concept of death, but rather, several. Loss of personality is one transition that can be thought of as death, loss of the brain’s control of the body another, loss of a heartbeat a third. Each of these, however, represents a somewhat different change, a somewhat different conception of what it is to die. Without modern medicine, there was no need to consider the differences between these transitions, because they all occurred essentially simultaneously. Now, however, we must consider the meaning and implications of each transition for itself. We are conflicted as to when death occurs because we are conflicted as to what it is to die.

Furthermore, as we peel apart these transitions, we will likely find that just as there are multiple transitions, which, at least potentially, occur at different times, the various social and legal implications of death are most reasonable connected with one or another of these physiological transitions. Thus, in order to answer the question “Is he dead?” we must first ask “Why do you care?”

CHHS Research Seminar: Exploring the Franko B Archives

Following a ‘Research Resources’ award from Wellcome, the Theatre Collection has been working on a project for the past 18 months to catalogue, conserve and make publicly accessible the archive of artist, curator and teacher, Franko B.  Franko B’s practice explores the limits of the body, touching on pain, suffering and sexuality in contemporary culture.  He rose to prominence in the 1990s due to his extraordinary body-based performances at the ICA in London that often involved blood-letting.  Creating work across performance, video, photography, painting, sculpture and mixed media for the last 30 years, Franko’s experiences of suffering, neglect, homelessness and marginalisation as an adolescent, and then as a young gay man and punk living in London during the AIDS epidemic, deeply influenced and intertwined with his practice.  Archivists Jo Elsworth, Julian Warren, Sian Williams, who are working on the project, introduced the Franko B archive and there was an opportunity to handle items from the collection.

Attendees were made aware that Franko’s archive contains material which some people may consider challenging, including images depicting blood-letting and sexually explicit images.

Public Lecture

The Centre for Science and Philosophy and the Centre for Health, Humanities and Science co-hosted a Public Lecture entitled ‘Why Precision Medicine is not Very Precise (and why this should not surprise us)’. There was a talk by Professor Anya Plutynski, followed by a panel discussion with Dr Karoline Wiesner , Dr James Brennan and Heidi LoughlinDr Julian Baggini acted as Chair.

 

ABSTRACT OF TALK

Precision medicine has created a lot of hope, especially for cancer patients. In the ideal case, there is one comprehensive test provided to patients, a clear-cut prognosis, one clearly preferred targeted therapy, and outcomes will be ideal. Plutynski argued that in the vast majority of cases, what we actually find, and indeed ought to expect, are rather different outcomes. Decisions about treatment are complex, there are moderate improvements in survival in the vast majority of cases, and indeed, very few cancer patients are likely to benefit. This talk explained why this is true, and why this should (by now) not surprise us. Plutynski then offered advice for patients and families, and for researchers and policy makers, to ensure better communication about this difficult process.

 

CHHS Research Seminar: Dr Alexandra Pârvan

Disease, health, and the person. How ontology works as a (mis)treatment tool in clinical contexts
Dr Alexandra Pârvan argued that ontology is at work in clinical contexts, and just as virtually anything else, it can either help or hinder. Both clinicians and patients answer for themselves, whether reflectively or not, the basic ontological question “what is this?” applied to disease, health, patient, person/self, treatment, medical care, the clinician’s role, the object of treatment, etc. For instance: What it is to be a person with disease – is the person something else with the disease? is the person-with-disease something less? is the person to be equated with the disease in treatment? What is the entity that needs treatment? Are person and disease to be treated and acknowledged separately, as two different entities? What is health-within-illness, and what it is to be healthy? etc. Answers to these questions are inevitably produced, and they constitute metaphysical assumptions which are often unrecognised, and which permeate the treatment settings and affect the way care is provided, received or self-administered. For this reason I argue for the need to provide “metaphysical care”. Pârvan’s focus was to show that the ontology instinctively at work in both clinicians and patients has ancient roots, conflicts with what can count as person-centred care today, and does not work well in long-term treatment. Parvân then sketched an alternative ontology, which she called “transgressive”, and which, when adopted, may be regarded as one way of providing metaphysical care and self-care.

CHHS + CHLS Research Seminar: Dr Richard Lyus

The Centre for Health, Humanities and Science and the Centre for Health, Law and Society jointly hosted Dr Richard Lyus on 02.10.19. Lyus is a specialty doctor in Sexual & Reproductive Health at Homerton University Hospital in London, and a doctoral student in the School of Humanities at the University Brighton. He presented on ‘The Fetus That Therefore I Am: A Doctor Reads Derrida in the Abortion Clinic’.

Lyus argued that the gestated human is, from almost its very beginning, a gesturing one. These gestures evoke varying responses in those who bear witness to them, especially in the case of fetal gestures made in response to harm, which may be evident in abortion. Medical discourse and much bioethics has responded to this particular type of fetal gesture by debating whether or not it indicates a correlated pain experience in a putative fetal consciousness. In 1997, Parliament asked the Royal College of Obstetricians and Gynaecologists to respond to these fetal gestures, and the report produced by the RCOG is a good example of how this consciousness-based response requires recourse to neuroanatomical determinations concerning the spatial and chronological boundaries of the human subject. These determinations are in fact problematised by pregnancy itself, and they depend on an an implicit distinction between two types of gesture, or two types of sign: those which are meaningful because associated with a consciousness, and those which are meaningless because not associated with a consciousness. Lyus used Derrida’s reading of a parallel distinction in Husserl (expression vs. indication) and Descartes (response vs. reaction) to argue that commitment to such a scheme is metaphysically dualist, and that more importantly this dualism is anthropocentric and vivisectory in its Cartesian provenance. Such a Cartesian sensibility is unsuited to discussions of fetal life, the animals to which the RCOG report compares the fetus, and procedures in which those fetuses and animals are harmed. Lyus concluded that the political and scientific inevitability of this Cartesian response in the RCOG report renders it precisely the kind of gesture which the Cartesian response itself divests of meaning. Those who support access to abortion should distance themselves from such politically expedient but flawed accounts, and develop new accounts of fetal life which do not recapitulate the gestures of a philosophical tradition that is characterised partly by an inability to respond meaningfully to pregnancy, birth, and abortion.

CHHS Research Seminar: Dr Ian James Kidd

On the 18th of June Dr Ian James Kidd presented a talk entitled ‘Pathophobia, Illness and Vices’.

Kidd noted that narrative accounts of the lived experience of somatic illness consistently describe a whole range of morally objectionable forms of treatment – coldness, rudeness, insensitive comments, intrusive questions, and acts of cruelty, neglect, and coldheartedness. All of these are instances of what he calls ‘pathophobia’, the oppressive mistreatment of somatically ill persons. After distinguishing this concept from sanism and ableism, he argued that the moral wrongs of pathophobia are best analysed using a framework of vice ethics. To that end he described five clusters of pathophobic vices and failing and ended with some ameliorative proposals.

Contact: Dr Ian James Kidd – 

‘Graphic Medicine’ – Ian Williams

Ian Williams is a comics artist, doctor and writer, now living in Brighton.

The website he began in 2007, GraphicMedicine.org, gave a name to what would become a transatlantic, and perhaps global movement, Graphic Medicine. It remains the best place from which to start exploring that world.

His own contributions — creative, academic, and organisational — to the movement have been great. Some of his graphic novels, strips, academic chapters, edited books, and conferences are listed below.

His most recent publication — Jan 2019 — is The Lady Doctor. (New York Times: ‘offers the engrossing perspective of a hard-working and fallible physician. The Lady Doctor… illuminates something profound.’ The Lancet: ‘It’s very funny and also often very sad.’ Herald Scotland: ‘It’s snorting-tea-out-your-nose-while-you’re-reading-it funny.’)

In this talk he introduced Graphic Medicine in the round, and talked about the roles it could play in the lives of doctors, nursing staff, carers and patients (or patients, carers, nursing staff and doctors). Plenty of time was left for a Q&A session at the end, and attendees were encouraged to submit questions by email before the event.

Ian is also responsible for creating a new Bristol mural in the Stokes Croft area of the city, which is providing an accessible and inclusive way of representing and communicating issues surrounding healthcare. The wall art was commissioned by the Centre for Health, Humanities and Science at the University of Bristol, with the support of the Elizabeth Blackwell Institute. For full details of this fantastic initiative click here.

Ian Williams can be found on twitter as @TheBadDr and @GraphicMedicine.