Laurie Toby Edison


At the Will of the Body, Part 3b: Doctors as Patients

Lisa Freitag says:

Dr. Lisa Freitag is a former pediatrician in Minneapolis, Minnesota.  She wrote some guest posts for us in 2013, and we are delighted to have more of her insightful presence here. This is the second half of the third (and last) part: Part 3a is here; Part 2 is here; and Part 1 is here. Part 3b has been reposted from its original posting due to technical problems.

According to Arthur Frank, whose academic theories on the doctor-patient relationship began to crystallize in his book about his own illnesses, At the Will of the Body, doctors are not really caregivers. This seems counter-intuitive, since medicine is supposed to be the most caring of professions. However, doctors do not know how to act towards their patients as persons. Frank states “I reserve the name “caregivers” for the people who are willing to listen to ill persons and respond to their individual experience.” (48) His own doctors, he says, rarely did this, instead dealing with him merely as a malfunctioning body in need of repairs. If doctors relate only superficially with others in illness, they seem unlikely to have a template for dealing with themselves as patients either.

These misconceptions are perhaps ultimately destructive to the formation of a human relationship between doctor and patient, no matter which side of the relationship he finds himself on. This is demonstrated well in the opening chapter of Sherwin Nuland’s famous book, How We Die, where he reports his first encounter with death. The patient was a middle-aged man who died of a massive heart attack while the young Dr Nuland was examining him. Nuland goes to great lengths to convince the reader and himself that it wasn’t his fault. He does this, not by grieving at human mortality, but by transferring the blame to the patient. Nuland’s description of the dead man and the destructive life style that brought him to his early death, borders on hatred. Nuland describes the man’s “flabbiness,” his “gluttony,” his laziness at taking a sedentary desk job, and compares this “high pressure boss of large, tough men” to his own 22 year old “boyishness.” Though he admits that these were not known risk factors at the time, these are disdainful words that imply a sinful life. The man was ultimately responsible for his own demise, not because he is mortal, just as Dr Nuland is, but because he lived in wrongness.

Arthur Frank sees illness as a chance to witness the mortality which we all share. Instead of  recognizing, and perhaps mourning, their common humanity, Dr Nuland distances himself by describing the man’s shameful life-style. One can assume that Nuland himself does not do all those naughty things, and can therefor believe he himself is safe from such a death. He spends the rest of the chapter, and indeed the book, describing in detail the ways in which the body can betray its owner, always with the idea that this knowledge, applied scientifically, will prevent death. I suspect that Dr Nuland’s own death will come (came?) as quite a surprise to him.

It is far easier to blame the wrongheaded patient rather than mourn the fact of death. Indeed, we were taught in medical school that mourning is out of place. We were supposed to create an emotional distance between ourselves and our patients. This was called maintaining objectivity, and is, we understood, a necessity, if one is to be a rational scientist. As Frank has recognized in At The Will of the Body, this distancing leads to thinking of patients as merely broken engines in need of repair. The person inside is largely ignored, except as the means which medical instructions will be carried out. The person, submitting to the will of the medical system, becomes a compliant body.

So what is a doctor to do when his own body escapes control and betrays him to illness? He must resent not only the sudden possession of a now-defective body, but also struggle to find a place to shift the blame for its failure. He must either accept that, like his patients, he might be mortal, or work to forget that medicine is not infallible. At the same time, he must willingly subject himself to becoming a body in the eyes of his peers.

All of these things are in operation when I become a patient, though I have, so far, not had a fatal one. I am surprised to find myself unprotected from sickness, and feel angry because I can’t think what I might have done to deserve it. Having at times seen illness as Dr Nuland does, as a sign of weakness in others, I find it nearly impossible to forgive it in myself. At the very least, I have failed to exert proper control over my body. It doesn’t help that I know precisely what has gone wrong, what that failure might lead to, and how painful it is likely to be to attempt to correct it.

Which is why, at the six week follow-up visit after surgery to fix my broken arm–which I honestly considered skipping altogether–I was completely inappropriate. I was annoyed that I was there, reluctantly complying with an unnecessary recommendation. My fractures were healing quite well, due to hard exercise and the help of some very good physical therapists. The orthopedic surgeon seemed inordinately pleased at his success with my operation, as though he still considered my arm partly his possession.

At one point, he told me, as though imparting a special confidence to a fellow doctor, that he liked the outcome so much that he was going to use the same “surgical approach” more often. It seems that he had put the incision on my shoulder in a different spot than usual. This was because he didn’t want to bother moving my unresponsive body between the surgery on my elbow and shoulder. I managed, just barely, to avoid saying what I was thinking, which was that this seemed terribly lazy to me. He looked, briefly, a bit confused by my horrified silence. Then he relaxed. He didn’t say anything, but he might have been thinking, Oh, right! Doctors are terrible patients. There was a small, indulgent chuckle.

I guess I was supposed to display more gratefulness. Or less implied skepticism at his talents. I feel kinda bad about this, but not bad enough to come back, as he wants me to, in another six weeks, so he can further admire his handiwork.

My Photos in LGBT Art: Our Common Wealth Exhibition

Laurie says:

I’m delighted to have four of my portraits at the Commonwealth Club in San Francisco.  I’ll be there for the artist’s walk-through at the opening with other artists and the curator Pam Penniston to talk about them.

The exhibition is at the gallery of the Commonwealth Club in downtown San Francisco and runs through September 21st. The Commonwealth Club and its Arts Member-Led Forum hosts many notable artists in the gallery of its headquarters in downtown San Francisco.




Photos include this photo of writer and father of marvelous twins Marlo Gayle from Familiar Men: A Book of Nudes. He wrote a superb essay on masculinity for the book and has published a number of erotica stories.

The Queer Cultural Center looks at the art that comes from LGBT artists as a foundation on which to build our community – our common wealth and direction. It is often ahead of the political or social movements in sensing what things are significant – and sometimes it’s just fun. This exhibit looks at diversity in our queer community, from the artists themselves to their chosen disciplines; we are showcasing woven and embroidered fabric, photography, painting, drawing and even a small installation.


Hagiwara Hiroko

This photo is of Hiroko Hagiwara, a dean and professor at Osaka Prefecture University. She is a feminist scholar and activist who was one of my primary collaborators on my Women of Japan project.

The other two photographs are of Samuel R Delany and Tee Corinne.

The photograph of my friend Tee was taken shortly before her death in 2006. Tee was a groundbreaking Lesbian erotic artist whose works included The Cunt Coloring Book, her solarized erotic photographs of lesbians, and her remarkable final project Scars, Stoma, Ostomy Bag, Portacath: Picturing Cancer In Our Lives.

Samuel R Delany’s photograph is from Familiar Men: A Book of Nudes. From his earliest books as a science fiction writer, his work included issues of sexuality, ethnicity, race and gender, including polyamorous love. He brought queerness into the future.


Tickets (click here) are free.  (I’d told that even if just the waiting list is left you should be able to register there and be able to come to the event without problem.).

I was in the The National Queer Arts Festival exhibition in May at the SomARTS gallery, which was also curated by the Queer Cultural Center. It was was thoughtful and exciting work and the curatorial walk-through was great.  I’m anticipating that it will be equally fine for this exhibit.

Artists include Rudy Lemcke, Lenore Chinn, Bren Ahearn, Indira Allegra, Preston Gannaway, and curator Pamela Peniston in an examination of their work and a discussion of LBGT art.

The opening is Tuesday, July 29th at the Commonwealth Club Gallery (595 Market Street San Francisco).  The reception is from 5 to 6PM and the walk-through starts about 6PM. The exhibition runs til the 18th of September.

I’m excited about being there.

Aerial Photography Re-imagined

Laurie says:

I’m back from Detroit and the Sojourner Truth archive in Battle Creek.  I’ll have a lot to say about this next week.  But I want to think about it for a while.

This post is about drones used for a new kind of aerial photography.  They have a far closer range and different perspectives then a small plane.  Like any vision opportunity the importance is the quality the work.  The tech only provides the tools.


Rancho Seco, California

Rancho Seco, California


BBC:   The arrival of cheap drone technology – and small, light high-quality cameras – has given rise to a new genre of beautiful aerial photography and film-making.

A new competition, sponsored by National Geographic (and Dronestagram), has highlighted some stunning examples of drone photographs taken in the past year.


The Tamul waterfall in Mexico

The Tamul waterfall in Mexico


The winner of the competition was a stunning view of an eagle soaring high above a national park in Indonesia.


Eagle in Bali Barat National Park, Indonesia

Eagle in Bali Barat National Park, Indonesia


I really like the three photos above, but I’m not knocked out by that many of the photographs I saw.  But the potential is fabulous.

The Unexpected Body

Debbie says:

When two different regular readers refer us to the same link (and a third to the source material), they’re probably on to something. It’s exciting enough that Prince Fielder (is that the best name ever for a baseball player?) was the cover model for ESPN Magazine’s “The Body” issue.

Fielder posed naked, in his tattooed glory, in a pose designed to showcase, rather than downplay, his pot belly. The issue features many other interesting (including some nonstandard) sports bodies.

Better still is Leigh Cowart’s analysis at The Concourse. First of all, she gave me the term “The Unexpected Body,” which I feel like I should have heard before, but is new to me. Cowart says,

The unexpected body is one that looks out of place in a sport, the grown-up version of the kid who always heard they had ‘a good heart, but the body’s just not there.’ They defy society’s narrow expectations; they make everyone eat their words. …

People expect certain kinds of bodies from certain kinds of athletes, with each little pocket of competition tending toward a preferred morphotype. Opposite Balanchine’s ideal ballerinas, with their small heads and sloped shoulders and long feet tacked onto their whisper-light frames, football likes men who are broad and tall and thickly draped in muscle, the largeness of the frame superseded only by the voracious nature of the appetite required to maintain—never mind bulk-up—such a massive organism. Basketball, on the other hand, has a known affinity for an ultra-tall, ultra-lean body. …

But baseball is somewhat more relaxed in the body department, thanks in part to the diversity of positions. There are durable, muscular catchers; shortstops with those fast-twitch, spring-loaded legs; third baseman who are sturdily built yet lean enough to snap and twist at the waist. Who would look at Babe Ruth, Ichiro Suzuki, Greg Maddux, Barry Bonds, Yu Darvish, and Yasiel Puig, and assume they were all professional athletes at the highest level of the same sport?

As a small-time, not especially knowledgeable, baseball fan, I find this fascinating. I have seen vast differences in height, leg length, stockiness, etc. on the baseball field, in a very different way than one sees it in soccer or basketball, and never given it a second thought.

Cowart goes on to talk about Fielder:

There’s an audacity to Fielder’s athleticism. That he could be so unusually large for the game and yet still play it well, combined with the fact that he appears to give not a single fuck about the former, make him an easy favorite. He’s an 162-day-a-year reminder that cultural body norms are almost always short-sighted and lacking, at the very least. With his exceptional mass, his sloppy but enthusiastic running, his swing that spans wide and arching, and his frantic mid-run dives, Prince Fielder embodies so much of what’s great about the game. He’s our ultimate fat baseball player.

I’ll stop quoting now, but the third part of Cowart’s article talks about the social media reaction to the picture. Unsurprisingly (if you’re a body-image activist), at least some people in social media lost their shit when they saw Fielder’s belly. Despite the man’s remarkable track record, many people can’t see him as an athlete and see his pot belly at the same time. One of my “favorite” tweets is:

How am I going to explain Prince Fielder’s Body Issue cover to my children

— Matt Collins (@RedSox_Thoughts) July 8, 2014

Well, Mr. Collins, I would suggest, “Doesn’t he look wonderful?” Someone at the link suggested, “Children this is what confidence and normalcy look like. May you always feel comfortable in the skin you’re in,” which works for me too.

The unexpected body, it seems, is not just unexpected but incomprehensible. As a nation, we are so convinced that fat is antithetical to athleticism and good shape that we don’t even know what to do with the combination when it is shown in unmistakable glory.

Kudos to ESPN for using Fielder’s photo. I just hope every fat kid who wants to be a baseball player sees this picture (and doesn’t have a father who can’t figure out what to tell their kid about an athlete’s pot belly).

Also thanks to Lizzie Fox and Lynn Kendall for the pointer to Cowart, and Steven Schwartz for the pointer to the ESPN issue.

At the Will of the Body, Part 3a: Doctors as Patients

Lisa Freitag says:

Dr. Lisa Freitag is a former pediatrician in Minneapolis, Minnesota. She wrote some guest posts for us in 2013, and we are delighted to have more of her insightful presence here. This is the first half of the third (and last) part; Part 2 and a link to Part 1 are here. We’ll finish Part 3 in the next couple of weeks, between posts from Laurie and Debbie.

People have said, “Doctors make terrible patients,” to me, usually with a little indulgent laugh, as a sort of joke meant to partly excuse a demonstration of un-patiently behavior on my part. Maybe doctors as a group are bad at receiving care; I certainly am. I am a terrible patient.

I curse, I scowl, I second-guess science, and I resolutely refuse to be cheerful in the face of adversity. I resent the whole package of being ill; the discomfort, the weakness, the interruption of better plans, and especially the reduction in status from person to patient. Waiting in a room full of other supplicants for access to the purveyor of all that is holy, creates in me a gnawing and impotent anger. The knowledge that, at a different time, I held this power over others, and believed it to be benign does not improve this anger. While I was working as a doctor, I felt rather put upon, because there was only one of me, and all those people were out there in my waiting room, waiting for beneficence.

Although I suspect that I am not the only doctor who harbors a creeping uncertainty about the truths of the religion that is medicine, very few have ever admitted it to me. I have witnessed very few of my fellows during illness, so I cannot vouch for their terribleness as patients. I cannot assume that my reasons for being a doctor who is a bad patient are typical, nor can I support the hypothesis that doctors universally suck at patienthood. But some of the things I was taught over the years, do seem to indicate that doctors would, in fact, be unlikely to adapt well to the role.

One of the first things we learned in medical school is that doctors do not get sick. Of course, doctors get the flu, or feel crappy, but there are no offers of sympathy, no postponements of work to be done, no allowance for time off. Any display of weakness, or need for allowances is considered inappropriate. Your personal life must not interfere with the important work of medicine.

When I was in my third year of medical school, one of the interns, two or three years ahead of me in training, got stomach flu while on call. After a few hours of vomiting and diarrhea, he thought he might be getting dehydrated. So he started an IV on himself and continued working. Somewhat later, a mother, not recognizing him as a doctor with his scrubs and IV pole, complained that a “patient” was examining her child. The intern was reprimanded for his error, but he was not sent home to recover in peace. He merely heparin-locked the IV while seeing patients, so that it would not be visible.

This was not an isolated incident. Doctors never call in sick. If you get two hours of sleep the night before, or have a low-grade fever, or feel like you might be coming down with something, you go to work. One of my partners worked until noon the day he had surgery on his back, because his procedure wasn’t scheduled until 1:30 PM. The same guy never forgave me for my son’s premature birth, not because I had stupidly failed to recognize signs of early labor and continued working, but because my sudden absence really messed up the schedule.

Thus doctors spend all day examining the bodies of sick people, while not tolerating any sickness in themselves or their peers. The combination of ignoring one’s own body while spending every waking hour attending to the needs of others’ broken bodies, cannot be healthy. This dissonance between realities breeds, I think, a general disrespect for the body and its functions, and a specific suspicion of the person who is ill. Being sick becomes an inability to control the body, a sort of failure of character.

The main thing one learns in medical school is medicine. Tons upon tons of science, all directed at the battle against disease. To keep being a doctor, one must be convinced of having a chance of actually winning. So we forget what that we know all bodies must eventually break down, and concentrate on bolstering the body’s defenses. Many patients these days are offered only optimism, encouraged to hope for a cure, even if one is unlikely. At the same time, doctors often know from experience what the worst looks like. In a serious illness, a doctor must walk a tightrope between hope and despair, remembering past triumphs and failures in similar situations. Suppression of this knowledge can become a necessary component of maintaining the proper optimism.

The refusal to display or acknowledge illness reinforces the popular image that being a doctor confers an immunity to the things that plague the rest of the world. There is some implication that doctors deserve this reward. Doctors themselves seem to accept, if not expect, the benefits of their superiority, from waived parking tickets to large incomes. Apparent immunity to illness is another perk, explained away scientifically by the assumption that doctors supposedly enjoy the very best insurance and preventive medical care. Thus, we can bury quite deeply both the knowledge that we might become seriously ill and the fact that death is inevitable. When another doctor needs medical care, everyone involved is reminded that it is a fiction, and the illusion fails. Neither doctor nor doctor-turned-patient appreciate the reminder.


Julian Dimock: Photographs Of African-Americans – South Carolina 1905

Laurie says:

This extraordinary collection of Dimock’s work has recently been put on line by The Museum of Natural History. Given the obvious quality of the work on line, I’m hoping sometime to have a chance to see the originals. I am initially struck by the brilliant and respectful photographs he took of African Americans in South Carolina at the turn of the century. I am going to take the time to explore all his work in the collection. In this post I am more focused on the portraits, but I expect that if I could see the originals I would be just as focused on the images of people at work or in their surroundings.

I see work with the eye of, among other things, a portrait photographer whose photography involved working collaboratively and respectfully with the people I photograph, to give some sense of who they are. When I see work that honors the humanity of the people in the photographs I respond.

Dimock SC Woman

Woman with arm akimbo, Beaufort, South Carolina, 1904

From the Museum website:

The images in the Julian Dimock Collection consist of approximately 3400 photographs on glass taken by Julian A. Dimock (1873-1945) in the United States in the early part of the 20th century from about 1904 to 1911. Dimock, who donated the negatives to the Museum in 1920, traveled the Southern states over many years, both alone and with his father, and scientists and guides, such as anthropologist Alanson Skinner, and during Museum funded trips to Southern locations like The Everglades. Carrying heavy and cumbersome photographic equipment over challenging terrain, Dimock trained his lens on the people and landscape of the South. He widely published images and articles in travel journals and guides such as Outing Magazine, and in books he published with his father, Anthony Weston Dimock, such as Florida Enchantments (1908).

Dimock’s work in the South documents African American communities, both former slaves and descendants of slaves, including many moving portraits of individuals and groups working and living in South Carolina and Alabama.

Dimock SC House Servant

House servant, South Carolina, 1905

He also took hundreds of photographs of the Seminole Indians of Florida and preserved their glorious traditional dress and customs on film. Dimock is likewise well known for his images of Ellis Island and the poignant circumstances of immigrants of Manhattan’s Lower East Side at the turn of the last century. All of the photographs capture cultures and customs with an exceptional compassion and with the beauty and sensitivity Julian Dimock is known for.

Dimock SC fishermen

Fisherman and boy shoveling oysters, Hilton Head, South Carolina, 1904

The quotes below are from ChickenBones: A Journal for Literary & Artistic African-American Themes as part of a review of Dimock’s book of these images.

A poignant collection of 155 photographs, Camera Man’s Journey takes us to a place at once familiar and foreign. Set in the South early in the twentieth century, these photographs bridge a distance not only of time but also of contrasting attitudes and customs.

The images show African Americans in or around Columbia, Beaufort, and Hilton Head, South Carolina. Some photographs were taken in surroundings where blacks might associate with whites–out of necessity and according to strict custom.

Most of the images, however, are set in “colored sections” or other remote areas of town or country where blacks were obliged to fashion lives apart. Under segregation and disenfranchisement, men, women, and children are portrayed in ordinary occupations and pursuits: a peddler selling his wares, a woman tying a toddler’s shoes, a barber and his young apprentice taking a break outside their shop.

Julian Dimock, whose works appeared often in major travel and nature magazines, took the photographs in 1904-5. So many photographers of the era tended to romanticize or politicize their African-American subjects; Dimock was different. Signs of want and inequity are plain to see in these images, but Dimock portrays his subjects as they really were in all of their dignity, strength, and beauty. — Georgia Book News

Dimock SC Matt Jones

Matt Jones, Hilton Head, South Carolina, 1904

When you have time, take the time to explore his archive. You will be well rewarded.

What Is Walking Good For?

Debbie says:

As the World Cup moves through its paces, I keep thinking about this post from Lisa Wade at Sociological Images:

Juliano Pinto, who has paraplegia, kicked off the World Cup wearing an exoskeleton. The media story is, of course, “Look at this amazing technology that lets people out of wheelchairs and let them walk!”

Lisa Wade refers us to Red Nicholson at AttitudeLive, who has a different view:

The implicit message from the media seems to be, ‘Wheelchairs suck! Walk in this robot instead!’.

In many ways, it’s as if mainstream news organisations have taken it upon themselves to fulfil the “dream” of wheelchair users, without actually stopping to ask two really important questions.

  1. Is this really your dream?
  2. How will this relentless pursuit of pseudo-walking (because let’s be clear here, we’re strapping you to a robot) make people feel who don’t share this dream?

So for the record: this is not my dream. I have no more desire to be strapped to a robot than I do to go swimming with great white sharks. In truth, my life as a wheelchair-user is a very good one. I do a lot of great things and know a lot of great people.

So hey, able-bodied media: quit making me feel like wheelchairs are a shitty, sub-par option. Stop beating your exoskeleton drum. And most of all, let go of your obsession with walking, because it’s totally overrated.

It should go without saying that Nicholson is making enormously good sense, and voices like his need to be heard — a lot!

But, speaking as a person who can walk, I think he is leaving out two important things.

First, our buildings and structures and systems need to be welcoming to people in wheelchairs. Walking is not over-rated if it’s the only way to get somewhere you need or want to be. Almost no single-family homes are built for wheelchairs, and many apartments are also inaccessible (though some dwellings are ramped after the fact, generally when a wheelchair user moves in). So life in a wheelchair means life not visiting a lot of other people’s homes, not seeing your friends in their own spaces. Even when public space is reasonably accessible, it is often not thought out: the building might be accessible but the bathroom door too narrow, or the elevators might take you to some floors and not others.

That’s a frustration that can be addressed by high-tech walking exoskeletons … or by responsible building practices and a commitment to universal design.

Second, temporarily able-bodied people like me (some disabled people call us “TABs”) are often patronizing, disparaging, or dismissive of people we can’t look in the eye. People in wheelchairs are often treated like children, or become invisible. It’s common for a wheelchair user with a service dog to have people talk to the dog and not the human … repeatedly. It’s not just common but standard for restaurant, store, and public employees to ask the walking companion of a wheelchair user “Does he want …?” “Would she like …?” as if the person in the chair was deaf, or incapable of talking, or incapable of thinking.

That’s a discrimination that can be addressed by high-tech walking exoskeletons … or by changing social expectations to recognize the lived human experience of the person in the chair.

I’m genuinely glad that Red Nicholson thinks walking is overrated. I think so too. But some of the perks that come with walking could be far more widely extended. And then maybe the high-tech exoskeletons would be more of a toy and less socially important.

When Junk Science Meets Junk Food

Laurie and Debbie say:

eating in a settlement house kitchen

Scientists at the University of Toronto have released a report claiming that the very existence and availability of fast food somehow makes us be in a hurry. “Fast food represents a culture of time efficiency and instant gratification,” says Chen-Bo Zhong, who co-wrote the paper with colleague Sanford DeVoe to be published in a forthcoming issue of Psychological Science. “The problem is that the goal of saving time gets activated upon exposure to fast food regardless of whether time is a relevant factor in the context. For example, walking faster is time efficient when one is trying to make a meeting, but it’s a sign of impatience when one is going for a stroll in the park. We’re finding that the mere exposure to fast food is promoting a general sense of haste and impatience regardless of the context.” They did three experiments, each with less than sixty participants (less than thirty outside of the control groups), all of them University of Toronto students. So we already know we aren’t looking at real science. Their theory, which they “confirmed,” was that fast food logos, such as the ubiquitous Macdonalds’ golden arches, make people more impatient, and make them do tasks in more of a hurry. The experiments consisted of subliminal or peripheral vision flashes of fast food logos during other tasks. (We wonder if the control group got subliminal flashes of Alice Waters and the food at her restaurants.) While they don’t actually say in their paper that they are talking about why poor people make bad decisions, they do talk about “density” of fast-food restaurants, which we all know tends to happen in lower-income neighborhoods. (Fast food isn’t exclusively, or even perhaps mostly, the food of poor people. Know any white men in the tech industry? Any gamers?) Nonetheless, Kathryn Hughes, writing in the Guardian, has an excellent class-based critique: The panic around the moral and psychological damage of fast food … was always [fueled by] a much deeper suspicion of what it represented: ignorance, indifference, a wilful inability to imagine a better way of feeding the future. It’s for that reason that, back in the early 19th-century, moralists including William Cobbett churned out a whole array of “cottage economies” and “penny cookbooks” aimed at stopping the working classes from squandering money in the pie shop. These prim moral primers were full of bright suggestions for turning the scrag end of lamb and on-the-turn turnips into something that not only nourished body and soul but also saved pennies for a rainy day. … What all those Victorian moralists missed – just as the Toronto report ignores – is that fast food is the emblematic product of maturing and late capitalism. Urban workers, forced to work longer and longer hours, do not have the time to invest in cooking from scratch. Those who are obliged to live in shared accommodation and rented digs may not have the right equipment for making real food slowly (Agas don’t fit into bedsits; microwaves do). When you are exhausted after a 10-hour shift, then soup is fiddly to consume on the way home. Burgers and kebabs, by contrast, are easy to eat with one hand and require neither plates nor knives. Far from being the refuseniks of capitalism, unable to master its first principle of delayed gratification, the people who rely on fast food outlets are its honourable foot soldiers. We should salute them. Hughes is right on target for most of her essay, and is invoking a long and fascinating history of missionaries, settlement houses, and other do-gooder efforts aimed to make “the poor” eat “right,”  but we disagree with her that delayed gratification is a capitalist virtue, especially in 21st century capitalism. While she excoriates the study for ignoring how workers are pushed into fast food, she also ignores how consciously and carefully fast-food corporations engineer the attraction and desirability of fast food. Just to be clear, neither we nor Hughes are saying that fast food is a good thing, or good for us. Working through purchasable state legislatures, the corporations work hard to ensure ridiculous amounts of salt and sugar in every school cafeteria. Working with urban planners, they carefully calculate which street corners, neighborhoods, and strip malls will be most profitable for new locations. And working with food scientists, they carefully study exactly how much fat, salt, and sugar will make you reach for the next Dorito. So who exactly is into instant gratification? Who is trying to move fast, make immediate moves that might not be so sensible in the long term? Who is impatient? Well, fast food customers perhaps–but fast food owners, demonstrably. And no one is going to fund tiny, silly studies of what the owners do when their own logos flash subliminally onto a screen. Thanks to Annalee Newitz at i09 for the pointer.

At the Will of the Body, Part 2: (Becoming a Body)

Lisa Freitag says:

Dr. Lisa Freitag is a former pediatrician in Minneapolis, Minnesota. She wrote some guest posts for us in 2013, and we are delighted to have more of her insightful presence here. This is the second of three or four parts; the first is here. Watch for the others over the next month or so, between posts from Laurie and Debbie.

It was a fortunate coincidence that I found a copy of Arthur Frank’s 1991 book, At the Will of the Body, just a week or so before I fell and broke my arm at the shoulder and elbow. During the incoherent time that followed, I wasn’t able to read much, but I found Frank’s book surprisingly easy to read for an academic text. I had to reread it (several times, actually); its observations on what it means to be ill were close enough to my experience that much of it instantly resonated.

Frank has become, since writing At the Will of the Body, an acknowledged expert on the modern doctor-patient relationship and how it is failing both doctor and patient. This book has his very first observations on the subject, not yet fully developed, but all too clear to a reader of his later books and papers. I read the first chapter, ‘Becoming Ill,’ the night before going in for surgery. In it Frank describes the interaction between himself and his physician after he had a heart attack, He is surprised and dismayed at the clinical coolness with which his doctor relayed the diagnosis. The doctor speaks as though the body was nothing other than a thing, and its ills a mechanical breakdown which can be managed with no concern to the inhabitant of that body. Frank says, “Thus in disease talk my body, my ongoing experience of being alive, became the body, an object to be measured and thus objectified.”

This is perhaps not the wisest thing to read the night before surgery, particularly if one is already aware of, and resentful about, the distance which modern medicine has placed between itself and the people it purports to want to help. The next day I would have a first-hand experience of the objectifying process. Following the ways in which I lost my self to the practice of medicine at least gave me something to do while I was waiting. It was certainly better than giving way to the gnawing uncertainty and fear that comes before surgery.

The giving up of my self began, actually, in the parking lot. The hospital was under construction, and there were very strict signs conveying rules regarding who was allowed to drive where. When my husband dropped me off at the front door, an actual armed guard appeared, his duty clearly to make sure we were allowed to use the entrance. Only after assuring him that I was a patient were we allowed to stop there. Just to be allowed in the entrance, I had to change from person to patient.

Just inside that door, a brash woman demanded paperwork and answers to a bunch of questions that in other circumstances would have been grounds for invasion of privacy. She did not question her total right to answers, or her ability to keep them private, despite there being only a small padded partition between her and the coworker sharing the same desktop. At that stop, I gave up both privacy and identity. I was given a wristband proclaiming my new identity; Lisa,  open reduction of humerus and olecranon fractures, 01/05/56, no allergies.

I was a physician on staff at that hospital for almost ten years, yet the hallway down to the surgical waiting room was totally unfamiliar. Fifteen years ago, I used to walk these halls as though I owned the place, a fiction to which everyone else also ascribed. I was quite aware that as a lowly pediatrician, I did not own anything, but was still comfortable in belonging there. I saw no one I knew, and was relieved that no one who knew me had to see me in my new guise.

The surgical waiting room is like one of Dante’s levels of Hell. I am not entirely sure what I gave up there, but it was a loss worth grieving. Perhaps it was something like freedom. After turning over the evidence of my new identity to another woman at another desk, I was told to sit. And wait. My husband was with me, but neither of us knew how to act. Other family groups shared the room, but each group isolated ourselves in our own private knot of pain and worry. It seemed to be expected, and was surprisingly hard. We were all waiting to be admitted to the inner sanctum where, amid wonder and terror, we would be saved. Or cured. Or something. It was like waiting for Godot. The only appropriate response would have been to run away, but that was impossible. So we sat. Patiently. Patient. Waiting.

In a later chapter, that I had not read at the time, Frank talks about the body as territory, which medicine claims as its own by the combination of clinical distance and clinical expertise. Frank was given a new identity, as I was, as the cancer patient in a certain room. His doctors spoke to him about his disease in the passive voice, as though no actual person was involved. His body became the recipient of a treatment called chemotherapy. He says,

When a person becomes a patient, physicians take over her body, and their understanding of the body separates it from the rest of her life. . . Medicine cannot enter into the experience; it seeks only cure or management. It does offer relief to a body that is suffering, but in doing so it colonizes the body. This is the trade-off we make in seeking medical help.

He admits that, if the treatment works, as it did in his case, the colonization might be worth it.

By waiting in that room, I was allowing the colonization of my body. I had been identified. My elbow and shoulder had been mapped out for attention. Waiting was a form of consent, permission to be converted fully into a body.

In the next room, a small exam room, I lost my clothes. In a pretend effort to help me preserve something of myself, I was offered replacement clothes, an enormous blue thing with ties at the back and, amazingly, a pocket containing a small heater. That they had really no concern about my essential nakedness was demonstrated by leaving the door to the room open. My body sat in a huge recliner chair, in full view of everyone in the hall outside. No one passing by seemed to notice. I found that I really didn’t care much either.

The next room was a sort of surgical staging area. We bodies were lined up on gurneys, separated from each other by thin curtains. Here, I finally met a doctor. So did everyone else. At this point we were supposed to be sedated into incoherence. I was not, because I did not want narcotics. My punishment for this was a nerve block, a trivial procedure, at least for the anesthesiologist. Holding still for this, and not screaming, was like being complicit in my own torture. I do not recommend this route.

I was beginning to resent becoming a body, but then I had a pain-inspired revelation. Early in my training, I had seen operations similar to what was about to happen to me. I had two fractures, one in my elbow and one in my shoulder. A person I had met only once, an orthopedic surgeon, was about to cut ten-inch incisions over both joints in order to directly manipulate my bones into their proper position with his gloved hands. He was then going to keep the bits of bone where he put them by inserting metal strips held in place by screws. I had a vivid image of this, but could not apply it to myself. This is, after all, not something you do to a person. It can be done only to a body. And so, I submitted willingly to colonization. I became a body for them. And for me. It was much better that way. In the operating room, as the anesthesia hit my veins, I felt a surge of relief close to joy.

One week later, at my post-op appointment, I was still a body. The surgeon told me that most people want the metal removed from their elbow after it heals. I told him that it would take a massive amount of discomfort before I wanted anything like that operation to happen to me again. He seemed offended that I hadn’t appreciated the experience more. Maybe he was just disappointed that he would not get to cut me open again. Most surgeons are known to be massively disinterested in anything that doesn’t involve scalpels. He glanced at my two scars, assigned a nurse to remove the staples he’d put in a week ago, and left without a word.

Links Return Again

It would be great if this image of Karlesha Thurman had gone viral for better reasons (like because it’s beautiful) …

Karlesha Danae breastfeeding

Thurman posted this photo on the Black Women Do Breastfeed Facebook page. Although she never posted it on Instagram or Twitter, NewsOne reports that Instagram, Twitter, and Facebook went ablaze with men and women, mostly Black, calling her a wide-range of unprintable profanities. (I would need to see some data before I was convinced about “mostly Black.”)

However, Thurman also has some amazing supporters, including Ashley Wright, also quoted in the NewsOne article:

Every time I get a chance, I try to cheer everyone on in that post to get them to see that this is OK, that this is awesome, and we need to support this Mother,” she said. “We just don’t see it often. A lot of people believe that African-American women don’t breastfeed their children because, during slavery, we were wet nurses to the quote unquote White man; therefore, we do not breastfeed. I think that can’t be further from the truth as of right now. I do believe that may have played a part way back then; however, now, I do not see that as a barrier.

I imagine Thurman appreciating this excellent article by Tamara Winfrey Harris:

Strong. Black. Woman.

The words fit together like blue oil, sizzling hot combs, and Sunday afternoon. They embody the idea of African American women as perpetually tough and uniquely indestructible. …

But in a society that finds little to praise in black women, other groups’ appreciation for perceived black female strength can feel like a reductive appreciation. Strength becomes one of few positive adjectives black women can own.


If you ever wondered why the Catholic Church is so opposed to birth control (I know I have), here’s some history which will make you wonder even more.  In 1968, Pope Paul VI convened a commission to examine the Church’s position:

The commission voted overwhelmingly to recommend that the ban against artificial means of birth control be lifted. …

Unhappy with the direction of the commission, the Vatican packed the last commission meetings with fifteen bishops to formulate the final recommendation to the pope. But even the bishops voted nine to three (three abstained from voting) to change the teaching, concluding that the popes’ previous teaching on birth control were not infallible and that the traditional theological basis for the prohibition of contraception was invalid. They declared that responsible parenthood was an essential part of modern marriage .

Despite the commission’s years of work and theologically unassailable conclusion that the church’s teaching on birth control was neither infallible nor irreversible, Pope Paul VI stunned the world on July 29, 1968, when he reaffirmed the church’s ban on modern contraceptives in Humanae Vitae (Of Human Life).

His reason? He based it on a dissenting opinion which said, in part, The Church could not have erred through so many centuries, even though one century, by imposing under serious obligation very grave burdens in the name of Jesus Christ, if Jesus Christ did not actually impose those burdens.”

So, we can’t be wrong because that would mean we had always been wrong. Way to reason!


Surprise! Certain opera reviewers have not outgrown fat-shaming. [NOTE: I should not have said "opera" has not outgrown fat-shaming. That was hyperbole.]

… a pile of weekend reviews arrived from London, courtesy of five older male critics writing about an emerging Irish mezzo-soprano named Tara Erraught. Erraught is singing Octavian in the Strauss opera Der Rosenkavalier at the , which opened Saturday night. What is stunningly apparent is just how much a woman’s body matters onstage — way more, if these five critics are to be believed, than her voice, her technique, her musicality or any other quality. …

I find it astounding that across five widely read publications, not a single editor saw fit to go back to the writer and challenge what he had written. Yes, visuals matter — even more now, in the age of live broadcasts — but these critics have seized this as license to forget why anybody shows up at an opera house to begin with.

Neither have the streets of Seattle, as Courtney Meaker relates in an excellent long essay, much of it about why she doesn’t (most of us don’t) respond to street harassment …

Last night, I was walking across a crosswalk while fat and female. Two guys in a white SUV rolled down their window to say. “Hey, cunt. Cunt. Hey. You’re fat. Fat, fat cunt. Fat. Fat. Cunt. ” I didn’t even realize they were talking to me at first. By the time I’d made it past their car, the guy in the passenger seat had rolled down his window to continue yelling at me. Changing it slightly to make it very clear, yes they were talking to me, and yes, they wanted a reaction. I didn’t have one. I was in my time. My time to walk, to think, to decompress after a long day. I just kept walking.

Juliana at Feministing has at least somewhat of an antidote (with lots of great links) …

In the year since [my dad] and I last talked about health and weight, I’ve begun actively seeking out social media that reminds me that I am not alone. Relatively speaking, my body does conform to many normative standards of beauty, but like many of us, I — and people I love — have been trained to believe that it will always fall short. This reaction makes sense when all we have to work with are the narrow standards for an “attractive” or “fit” or “healthy” body that society provides us. We talk a lot about how we need to call out mainstream media for celebrating only thin, white, cis, traditionally feminine women as beautiful and making us hate ourselves. What we don’t hear enough about is where we can find alternatives. If we are going to do the difficult and never-ending work of unlearning normative beauty standards, we have to be as persistent and consistent as mainstream media is with us. Luckily, there are people out there creating media that showcases different bodies wearing different clothing and doing different things than we get to see in mainstream media.


The World Health Organization and the American Medical Association are moving into the 21st century.

Both groups issued similar statements this month: here’s a quote from WHO:

Requiring surgery as a prerequisite for obtaining legal documents is often a coerced sterilization: “Some groups, such as transgender and intersex persons, [have] a long history of discrimination and abuse related to sterilization, which continues to this day. Such violations are reflected, for example, in the various legal and medical requirements, including for sterilization, to which transgender and intersex persons have been subjected in order to obtain birth certificates and other legal documents that match their preferred gender.”

This has no legal standing, but both groups are prestigious, and it should be at least a step in the right direction.


Fashion isn’t exactly body image, but it’s close.

Clothing of the past has a rep for being toxic and/or deadly, but clothing of the present is less examined.

The green of the shimmering silk, now slightly faded, was one of the Victorian era’s most fashionable hues; people, mostly women, wore it even after it was widely known that the arsenic-based dye responsible for the colour could lead to horrible physical suffering and early death.

The article is especially rich because the exhibit curator Elizabeth Semmelhack is both very smart and very informed:

Semmelhack refuses to see fashion extremes and the risks people took to remain in vogue as ridiculous. Not following fashion was equally perilous, she says: “If idealized femininity is about women’s participation in fashion, and if femininity or beauty is the major thing you are judged and valued by, then, if you reject it, trust me, all hell breaks loose.”

It’s impossible to look at the exhibit and not draw contemporary analogies—narrow footwear replaced by vertiginous heels, corsets by sausage-casing Spanx, Dickensian factories by offshore sweatshops. Our forebears were willing to burn for fashion. We’re too evolved for that: We let others burn for us.

The future of clothing is here, and one of the forms it’s taking is this NYU student project where how much of your life you reveal online is reflected in how your dress changes.

​​​​This 3D-Printed Dress Reveals More Skin As You Reveal More Data

Co-creator Xuedi Chen says:

In the physical realm we can deliberately control which portions our bodies are exposed to the world by covering it with clothing. In the digital realm, we have much less control of what personal aspects we share with the services that connect us. In the digital realm we are naked and vulnerable.

By participating in this hyper-connected society while having little to no control of my digital data production, how much of myself do I unknowingly reveal? To what degree does the aggregated metadata collected from me paint an accurate portrait of who I am as a person? What aspects of my individuality are reflected in this portrait?

I love the project and I would like to see a less gendered version, which perhaps Chen and co-creator Pedro Oliviera are working on now.

Most usual sources: Feministe, Feministing, io9, and Shakesville, plus assorted other blogs I read. Thanks to Deena for the opera link, Lizzy for the walking in Seattle link, and Lisa for the historical clothing article.

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