"Horror in Medicine" – a Response

Last night I had the pleasure of attending a lecture by Dr. Catherine Belling (associate professor at Northwestern University’s Feinberg School of Medicine), an event launching the “Imagining Health Project” series by the IHR Medical Humanities Initiative at ASU. This series is meant to integrate art and the humanities with medicine driven by the philosophy “health is a basic human need” that encapsulates a variety of physical and mental components.
Belling’s talk, entitled “Imagining Disease–Horror and Health in Medicine,” was hosted by the Mayo Clinic in Scottsdale. While I have personally been to lectures taking place in art museums, cafes, and libraries, attending a humanities-driven event at a working medical treatment and research facility was definitely a novelty.  Tackling the themes of uncertainty and fear at the center of medical care, Belling’s lecture focused on what she termed “a poetics of medicine” in which the humanities offers ways to approach healthcare in all of its facets. She named three terms implicit in this discussion: imagining (or imagination), disease, and horror. I found her definitions and conclusions regarding imagining and horror to be the most compelling, and I will briefly summarize her key points below while also noting my own reactions to the material, posing questions I still need answered (perhaps you dear reader, can help!).
That which is “imaginary” as defined by Belling exists only in the imagination. It has no real existence, no concrete reality or actuality. However, she does allude to tiny pieces of evidence, which can be visual (as with a facial expression or physical tick), that alert others of the presence of what is conceptualized or imagined internally. These representations shape stories, both our own personally as well as how others shape our stories and us in a larger sense. As a literature scholar, this idea of visual representation seems particularly important. Not only do I read written words and try to find layers of meaning within them (the story within the story), but I at least like to think that I view the world with a similar curiosity. Constantly I find myself “reading” the visual presentations of others from clothing to body language. Not only does this hypothetically give me some insight into their character, and allows me to categorize them (much in the same way as assigning a genre to a book), but it allows me to catalog myself. The way I in turn decide to represent my visual expression in relation to others drives both of our “stories.”
I believe this also has implications in the medical world as well, especially in considering how patients and medical professionals interact. When you enter a doctor’s office for an assessment the first thing they are going to do is note your physical appearance—what symptoms you are or are not showing on the surface (or the covering of your skeleton as I believe Belling would conceptualize it). In turn, as the patient you are aware of how they are dressed (the ubiquitous white coat, which I can say from personal experience, seems to be diminishing in popularity at least at the Mayo Clinic), how they are often standing while you sit in the chair or on the examination table. Both of these things play a part in the power dynamic such a relationship dictates. But can this change? Are there ways for patients and medical practitioners to present themselves visually that would change the doctor-patient relationship for the better? Or for the worse? And how could all of this, or rather, how does all of this, effect the imagination of medicine in general?
As an avid consumer and scholar of the horror and Gothic genres, I found myself understandably fascinated by Belling’s discussion of horror. She pointed out how our definition of “horror” as a society is unclear, citing both the crowd of definitions in the Oxford English Dictionary, suggesting how unstable the term is, as well as how popular culture and media coverage aid in the construction of horror as an emotion and a label. Belling’s own definition of horror is thus: “how we imagine what lurks inside of us, and what it might do.” I found this perfectly succinct. Looking at the horror literary genre, I personally believe that what scares us, particularly what monsters we create, are representations of internal paranoia we are afraid our own bodies will eventually express. In this way, Belling’s point that “horror is about our bodies” seems incredibly accurate. We are either afraid of something harming us, or of us harming ourselves. Even our reactions to horror are corporeal. The screams, the shiver, the cautious glance, even the jump from the chair are all physical (and visual). What I would add to Belling’s theory however, is the role other bodies play. Horror is not just about how we conceptualize our own form, but how we imagine out body relates to another in appearance and function. Werewolves and ghosts are both good examples of this. Both are “othered” and therefore feared or made horrific because they look differently from the “regular” human. The danger, the fear, comes from our capacity to visualize ourselves as Them. After all, it only takes one bite and a full moon to become part wolf, and as for becoming a ghost…well, death is the only barrier there.
Returning to medicine, the inexperienced medical student is first and foremost taught to see the horrific as normal—to see the insides of the body, the skeleton (the other/Other body within us), and physical abnormalities as natural or even routine. My father, a physician himself, once described to me how his first autopsy in medical school involved dissection of the back. The face of the cadaver was turned down, made invisible (although arguably more pronounced in the imagination). Not until much later in his training, one of the last autopsies he performed in school, did he saw through the face, separating the skull into two neat halves. He also told me that facing the inside of a skull on the first day would have been impossible: “I couldn’t even imagine it.”