something about "The Birth of the Clinic" by Michel Foucault

In The Birth of the Clinic, Michel Foucault mines late 18th and early 19th century changes in medical practice (this, significantly, is around the time of the American and French Revolutions, following on the heels of the Enlightenment). These changes shaped modern medicine.

The discourse on human rights inspired by these revolutions led to an overall concern with society and health; and the move toward egalitarianism pushed physicians (and teaching physicians) out of the the aristocracy and reassigned them to general society.

The new imaginings of hard science dictated that we let truths reveal themselves to us. In The Birth of the Clinic, Foucault feels out what he calls the medical gaze--a way of seeing in which the physician allows the disease to reveal its own truth. The human body gives off signs, and the physician uses his knowledge and observations of the body to translate the reality of the disease.

The physician talks to the patient, observes him, examines him, orders tests and whatnot. Mysticism is abandoned for a discussion of the body; the physician relies less on bookish medical wisdom and instead reads the body. The physician's eye sees in space symptoms and physical signs.

The physician’s observations affect the gaze; the gaze affects the physician. Doctors systematically describe diseases using medical jargon. The physician's power is now his experience rather than his status. The gaze has scientific credibility. And we've successfully achieved truth in spite of the doctor's status, not because of it. (So we think.)

about selections from "Critical Essays on Michel Foucault"

This collection of essays opens with philosopher Gilles Deleuze rephrasing and re-articulating Foucault's concept of power. There is little new ground here, but the essay is a good opener. The first real bright spot in this collection is "Foucault's Oriental Subtext", in which Uta Liebman Schaub identifies Eastern influences in Foucault's work. Primarily she sees the obliteration of the self in the remedy to Western systems' ceaseless quest to isolate and peg the self, and to tie this knowable self to an identity, as described by Foucault.

The essay "Foucault's Art of Seeing" by John Rajchman opens with Foucault's startling idea that seeing--vision--"structures thought in advance". The visual representation of thought, of how people have seen their world and then accordingly made sense of it, is tied to their age, their time. So seeing yields different concepts and ways of thinking about a given subject. For example, in the classical age, people grouped plants by their character. Now scientists group them primarily by their surface traits.

Foucault took an interest in how concepts of visualization become embedded in institutional practices, and how ethical and moral judgements of things and people changed with those concepts. It is hard to imagine now that people asked different questions in the past; we tend to think we've always been "logical", that being logical is part of our nature. But being "logical" used to be a moral exercise.

Finally, Rajchman explains how, for Foucault and his philosophical-critical descendents, thinking is a dangerous act. I found this section of Rajchman's essay confusing; is it dangerous because it's always situated and political? because it's tied to moral and ethical consequences? because we, merely by thinking of things, may unknowingly reinforce or change ways of conceiving? Whatever the answer, the aim on the other side of that danger, what Foucault pursued, is a world that is not yet visible.

In "Beyond Life and Death: On Foucault's Post-Auschwitz Ethic", James W. Bernauer addresses Foucault's critics who charge the intellectual giant with advocating an amoral aestheticism. Bernauer begins his defense by recognizing Foucault's resistance to the scientifically-minded life style that presupposes we are knowable and, therefore, decipherable (and, as a consequence, subject to be judged against norms). He seemed to champion humans as sexual, primarily, and so he probed how sexuality came to be thought of as a moral experience. The modern age and its States conceive of citizens as life to be kept alive; Foucault conceived of man as desire.

That power that conceives of us as human souls in a life or death struggle categorizes us, marks our individuality, attaches us to an identity, subjectifies us, and imposes its truth on us. The sciences--the currently dominant producers and venue of true knowledge--"direct both the cognitive enterprise and the technologies for human self-relation". Foucault examined how people "became anxious about this or that," and urges us not to look so hard at what we hope to achieve, but rather what struggles we face.

Again, Foucault's ultimate goal was freedom. He knew there was no escaping knowledge-power-self relations for good, but he also thought that no "configuration" (of thought and power?) should be thought unchangeable.

Alienation to alienated

When reading Madness & Civilization, know that a lot of people considered normal today would have been diagnosed mad in previous centuries. For example, Foucault spends a great deal of time discussing melancholics, known today as people suffering from depression.

Anyway, finished reading Madness & Civilization. The closing of chapter IX, "The Birth of the Asylum", includes this wonderful sentence--the parentheticals are mine:

He (Freud) did deliver the patient from the existence of the asylum within which his "liberators" had alienated him; but he did not deliver him from what was essential in this existence; he regrouped its (the asylum's) powers, extended them to the maximum by uniting them in the doctor's hands; he created the psychoanalytical situation where, by an inspired short-circuit, alienation becomes disalienating because, in the doctor, it becomes a subject.1

Here, I think Foucault is saying something like this: The structures and practices of the asylum gave doctors moral authority over the mad; doctors objectified the mad in those asylums, thereby alienating them, making them outsiders in the real world of reason. But once patient care fell to psychiatry--most notably with Sigmund Freud--doctors' authority transferred from those structures to the personage of the doctor. The doctor then exercised his authority in the psychiatrist's office. There, the alienation that was, in the asylum, only a side effect of being the anomaly became itself a neurosis to be studied and speculated on.

Pure rad.

His arguments probably don't play well when taken in pieces like this, but one can see how rich the content of his writing is. I could spend three days unpacking this one sentence and still not feel the thing fully fleshed out.

I think the prevailing opinion is that Foucault was not much of a writer. I disagree, although I have only translations to judge by.

1"Madness & Civilization" by Michel Foucault