Bodies on Display
On the Doctor-Patient Relationships Portrayed in Thomas Eakins’s
The Agnew Clinic (1889) and Stanley Kubrick’s A Clockwork Orange (1971)
On the Doctor-Patient Relationships Portrayed in Thomas Eakins’s
The Agnew Clinic (1889) and Stanley Kubrick’s A Clockwork Orange (1971)
By Haoran Xia
June 15, 2024
It is an extremely painful thing to be ruled by laws that one does not know.
–-Franz Kafka, The Trial
Introduction
Being a patient is something unavoidable in life.
This is not to promote a rather pessimistic way of looking at life and how to navigate it but to acknowledge the fact that, as human beings, being ill and therefore, being a patient is something we cannot avoid, something we must learn how to manage while we continue our life with illness, with the terrifying idea that we may be treated differently by our friends, family, and the society. Being a patient means our perception of our relationship with other people changes—we worry that our illness or its symptoms will render us abnormal, a spectacle, a thing to be looked at—reducing the size of space and the amount of time we originally had, freely, for building a relationship with other people as healthy, ‘normal’ human beings. Being a patient means things in life will change its orbit in its old way: you need to be taken care of, you cannot work out, your diet must change, you must adjust your lifestyle, and of course, you must go see a doctor. Therefore, patients reorient their ways of thinking, behaving, and perceiving, adapting to situations they previously managed differently and—in short term or long term—establish new relationships with other people who will be closely and intimately involved in their state of being a patient. One of the most necessary, perhaps the most vital relationships that patients need to establish is the one with their doctors.
Throughout the history of western cultures, doctors are predominantly portrayed as the ones who save, cure diseases, and represent hope, life, and future. Asclepius in Greek mythology serves as a primary representation of what doctors are or what doctors ought to do for themselves, for their patients, and for the public: to save and to cure, without causing any harm, willingly and unconditionally. However, as time goes by, history evolves, folklore fades, although doctors continue to fulfill their duties and save lives, the identity of doctors becomes more politically complicated than that in the ancient times. Within modern western discourse, doctors have become a symbol of class: to be a doctor signifies that one belongs to at least in the upper-middle class of the society; doctors also symbolize knowledge: to be a doctor means one comprehends fully and anatomically about the construction, logic, structure, and organization of the human body; furthermore, doctors represent power and science: one holds the sovereign power and the discretion to decide to save or not to save not only within hospitals, but within government, prisons, schools, and offices. They exert their power by looking at the body parts of their patients, by touching skins and/or bodies of their patients, and by cutting open, penetrating their patients in the form of surgery with their sharp, hygiene scalpel. The knowledge they have consolidates their absolute power, laying the scientific foundation for their power within the medical discourse. Therefore, indeed, doctors save, but doctors are also in an absolute position beyond patients’ understanding, knowing, seeing, and perceiving. Metaphorically speaking, if doctors are far beyond reach, how can patients establish a relational foundation and develop an actual relationship with them? After all, the construction of any relationship requires a geographical—geographical in a tangible and intangible sense—reduction between the individuals to foster a form of trust, care, and intimacy. Even if patients do establish a relationship with their doctors after confronting their multiple identities, does this relationship contain a quality of reciprocity and assure a patient’s autonomy to act?
By posing such questions, I argue that the relationship between doctors and patients is non-reciprocal. This quality of non-reciprocity stems from the power in the formation of the identity of doctors, which implicates itself with institutional, governmental, societal, and infrastructural politics and affects, and therefore, situates itself in a position whose primary goal is not to secure and/or protect the autonomous rights of patients but to sustain the circulation and (re)production within the medical discourse, with doctors as irreplaceable tools. Drawing on the theories of Foucault, Barthes, Haraway, and Berlant, I divide my thesis into two chapters. Each chapter focuses on one object and on aspects of the myriad factors contributing to the construction of non-reciprocal nature of the relationship between doctors and patients.
In chapter one, I primarily engage with critical theories from Foucault and semiotics from Barthes to examine the relationship between doctors and patients from the perspective of power and ethics in Thomas Eakins’s realist painting The Agnew Clinic. Eakins painted the The Agnew Clinic in the late-nineteenth century, primarily as a tribute to the esteemed Dr. Agnew upon his retirement. My reading in chapter one will focus on the signs, texts, and the narratives within and beyond this painting and how they, implicitly, reflect the quality of non- reciprocity of the relationship between doctors and patients. This painting, nearly 140 years old, is still culturally, politically, ethically, and philosophically relevant in our times and in our reflective thinking on the relationship between doctors and patients.
Chapter two’s emphasis shifts to the context before patients becomes patients, specifically focusing on the moments, spaces, intimate relations, and projections of potential outcomes when they decide to undergo surgery—the form of informed consent. My analysis on informed consent will revolve around a reading and a critical analysis on Stanley Kubrick’s film A Clockwork Orange. Engaging with Foucault, feminist and science studies from Haraway, infrastructure studies from Star, and affect from Berlant, my analysis in chapter two will scrutinize three scenes in the film whose dialogues, spatial setting, and camera angles/movements form the textual foundation for my analysis of the politics, power, ethical promises, and optimism within the concept of informed consent. Additionally, affects associated with informed consent and about post-consent life will be further analyzed within the frame of this film.
Through my examination of these two objects, I argue that the relationship between doctors and patients is fundamentally non-reciprocal. This is partly because, within Western medical discourse, doctors' knowledge transforms into a form of power production, central to their identity formation. Additionally, without their awareness, doctors become an apparatus of power within the medical infrastructure, which is intimately intertwined with governmental, juridical, and other societal infrastructures. This dynamic positions doctors as saviors and patients as those to be saved. Consequently, patients' illnesses become signs and codes for doctors to study and decipher, reducing patients to tools, instruments, or pure objects, deprived of their human agency within the Western medical infrastructure. If reading The Agnew Clinic invites us to see the formation and (re)production of doctors' power in the context of surgery, reading A Clockwork Orange offers a broader perspective—before, during, and after medical procedures—providing a more holistic scrutiny of the doctor-patient relationship within Western medical infrastructure.
June 15, 2024
It is an extremely painful thing to be ruled by laws that one does not know.
–-Franz Kafka, The Trial
Introduction
Being a patient is something unavoidable in life.
This is not to promote a rather pessimistic way of looking at life and how to navigate it but to acknowledge the fact that, as human beings, being ill and therefore, being a patient is something we cannot avoid, something we must learn how to manage while we continue our life with illness, with the terrifying idea that we may be treated differently by our friends, family, and the society. Being a patient means our perception of our relationship with other people changes—we worry that our illness or its symptoms will render us abnormal, a spectacle, a thing to be looked at—reducing the size of space and the amount of time we originally had, freely, for building a relationship with other people as healthy, ‘normal’ human beings. Being a patient means things in life will change its orbit in its old way: you need to be taken care of, you cannot work out, your diet must change, you must adjust your lifestyle, and of course, you must go see a doctor. Therefore, patients reorient their ways of thinking, behaving, and perceiving, adapting to situations they previously managed differently and—in short term or long term—establish new relationships with other people who will be closely and intimately involved in their state of being a patient. One of the most necessary, perhaps the most vital relationships that patients need to establish is the one with their doctors.
Throughout the history of western cultures, doctors are predominantly portrayed as the ones who save, cure diseases, and represent hope, life, and future. Asclepius in Greek mythology serves as a primary representation of what doctors are or what doctors ought to do for themselves, for their patients, and for the public: to save and to cure, without causing any harm, willingly and unconditionally. However, as time goes by, history evolves, folklore fades, although doctors continue to fulfill their duties and save lives, the identity of doctors becomes more politically complicated than that in the ancient times. Within modern western discourse, doctors have become a symbol of class: to be a doctor signifies that one belongs to at least in the upper-middle class of the society; doctors also symbolize knowledge: to be a doctor means one comprehends fully and anatomically about the construction, logic, structure, and organization of the human body; furthermore, doctors represent power and science: one holds the sovereign power and the discretion to decide to save or not to save not only within hospitals, but within government, prisons, schools, and offices. They exert their power by looking at the body parts of their patients, by touching skins and/or bodies of their patients, and by cutting open, penetrating their patients in the form of surgery with their sharp, hygiene scalpel. The knowledge they have consolidates their absolute power, laying the scientific foundation for their power within the medical discourse. Therefore, indeed, doctors save, but doctors are also in an absolute position beyond patients’ understanding, knowing, seeing, and perceiving. Metaphorically speaking, if doctors are far beyond reach, how can patients establish a relational foundation and develop an actual relationship with them? After all, the construction of any relationship requires a geographical—geographical in a tangible and intangible sense—reduction between the individuals to foster a form of trust, care, and intimacy. Even if patients do establish a relationship with their doctors after confronting their multiple identities, does this relationship contain a quality of reciprocity and assure a patient’s autonomy to act?
By posing such questions, I argue that the relationship between doctors and patients is non-reciprocal. This quality of non-reciprocity stems from the power in the formation of the identity of doctors, which implicates itself with institutional, governmental, societal, and infrastructural politics and affects, and therefore, situates itself in a position whose primary goal is not to secure and/or protect the autonomous rights of patients but to sustain the circulation and (re)production within the medical discourse, with doctors as irreplaceable tools. Drawing on the theories of Foucault, Barthes, Haraway, and Berlant, I divide my thesis into two chapters. Each chapter focuses on one object and on aspects of the myriad factors contributing to the construction of non-reciprocal nature of the relationship between doctors and patients.
In chapter one, I primarily engage with critical theories from Foucault and semiotics from Barthes to examine the relationship between doctors and patients from the perspective of power and ethics in Thomas Eakins’s realist painting The Agnew Clinic. Eakins painted the The Agnew Clinic in the late-nineteenth century, primarily as a tribute to the esteemed Dr. Agnew upon his retirement. My reading in chapter one will focus on the signs, texts, and the narratives within and beyond this painting and how they, implicitly, reflect the quality of non- reciprocity of the relationship between doctors and patients. This painting, nearly 140 years old, is still culturally, politically, ethically, and philosophically relevant in our times and in our reflective thinking on the relationship between doctors and patients.
Chapter two’s emphasis shifts to the context before patients becomes patients, specifically focusing on the moments, spaces, intimate relations, and projections of potential outcomes when they decide to undergo surgery—the form of informed consent. My analysis on informed consent will revolve around a reading and a critical analysis on Stanley Kubrick’s film A Clockwork Orange. Engaging with Foucault, feminist and science studies from Haraway, infrastructure studies from Star, and affect from Berlant, my analysis in chapter two will scrutinize three scenes in the film whose dialogues, spatial setting, and camera angles/movements form the textual foundation for my analysis of the politics, power, ethical promises, and optimism within the concept of informed consent. Additionally, affects associated with informed consent and about post-consent life will be further analyzed within the frame of this film.
Through my examination of these two objects, I argue that the relationship between doctors and patients is fundamentally non-reciprocal. This is partly because, within Western medical discourse, doctors' knowledge transforms into a form of power production, central to their identity formation. Additionally, without their awareness, doctors become an apparatus of power within the medical infrastructure, which is intimately intertwined with governmental, juridical, and other societal infrastructures. This dynamic positions doctors as saviors and patients as those to be saved. Consequently, patients' illnesses become signs and codes for doctors to study and decipher, reducing patients to tools, instruments, or pure objects, deprived of their human agency within the Western medical infrastructure. If reading The Agnew Clinic invites us to see the formation and (re)production of doctors' power in the context of surgery, reading A Clockwork Orange offers a broader perspective—before, during, and after medical procedures—providing a more holistic scrutiny of the doctor-patient relationship within Western medical infrastructure.
For a full version of the thesis, feel free to send a request via email.