Journal of Moral Theology, Vol. 2, No. 1 (2013): 113-131
Body Work and the Work of the Body
Jeffrey P. Bishop
e cult of the body beautiful, symbolizing the sacrament of life, is celebrated everywhere with the earnest vigour that characterized rit- ual in the major religions; beauty is the last remaining manifestation of the sacred in societies that have abolished all the others. Hervé Juvin
HE WORLD OF MEDICINE has always been focused on bod- ies—typically ailing bodies. Yet recently, say over the last century or so, medicine has gradually shied its emphasis away from the ailing body, turning its attention to the body inT health. us, it seems that the meaning of the body has shied for contemporary medicine and that it has done so precisely because our approach to the body has changed. Put in more philosophical terms, our metaphysical assumptions about the body, that is to say our on- tologies (and even the implied theologies) of the body, come to shape the way that a culture and its medicine come to treat the body. In other words, the ethics of the body is tied to the assumed metaphys- ics of the body.1 is attitude toward the body is clear in the rise of certain con- temporary cultural practices. In one sense, the body gets more atten- tion than it ever has, as evident in the rise of the cosmetics industry, massage studios, exercise gyms, not to mention the attention given to the body by the medical community with the rise in cosmetic derma- tology, cosmetic dentistry, Botox injections, and cosmetic surgery. e body’s dry skin, its smelliness, its hairiness, its shape, and its health are an almost constant obsession of contemporary Western cultures. e clothing with which we decorate the body, the perfumes we create to mask its smells, and the dyes we use to hide gray hair all
1 I have elsewhere suggested that medical science and the drive of transhumanist medicine is the contemporary carrier of the kind of metaphysics that Heidegger critiques as onto-theo-logy. See J. P Bishop, “Transhumanism, Metaphysics, and the Posthuman God,” Journal of Medicine and Philosophy 35, no. 6 (2010).
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demonstrate just how obsessed we are with the body, how it occupies our attention. On the extreme technological side, we find the transhumanist hope that we will exceed many of our bodily limitations, through body modification. e hope is:
to reach intellectual heights as far above any current human genius as humans are above other primates; to be resistant to disease and impervious to aging; to have unlimited youth and vigor; to exercise control over their own desires, moods, and mental states; to be able to avoid feeling tired, hateful, or irritated about petty things; to have an increased capacity for pleasure, love, artistic appreciation, and se- renity; to experience novel states of consciousness that current hu- man brains cannot access.2
e body is mere matter to be manipulated for pleasure and desire. Such statements illustrate a dualism between will and matter, a dual- ism more extreme than the mind-body dualism in that will is unfet- tered by the limitations of the body and the body is mere matter submitted to that will. In this world-view, the body is means to achieve our hedonic desires, and all bodies are ailing in the sense that they are limited by their materiality. According to this view, all treatment is a form of enhancement insofar as it overcomes material limitations. e dermatologist not only treats skin cancers and infec- tions, but also has techniques and creams to prevent wrinkling. e dentist not only treats tooth decay, but also whitens and straightens the teeth. Yet, with all this attention to the body, we hardly even think of— think on—the body. at is to say, the body seems to receive little attention as to the kind of thing that it is. We seem to think of the body in much the same way that we think of the bronze of the statue, the mere stuff that is molded. In this sense, we do not think the body is much of anything in itself, except insofar as it carries our mean- ings, meanings that are dualistically separated from the body itself. e body seems at best to be thought of as an instrument to achieve one’s psychological desires. At worst, it is mere canvas upon which one paints or parchment upon which one writes oneself into exist- ence. In health care ethics, that means that most ethical analysis and commentary focuses on things like informed consent, which is cen- tered upon the will—and not on the body—and on what one is will- ing to have done to one’s body. We find church program aer church
2 Nick Bostrom, e Transhumanist FAQ Version 2.1 (Oxford: World Transhumanist Association, 2003), 5.
Body Work and the Work of the Body 115 program—many of which I have led—where the emphasis is placed on making sure that one has one’s wishes written into legal docu- ments like Living Wills or Advance Directives to Physicians or doc- uments where one names who will make decisions about one’s body in the case that one is no longer able to exert authority over that body. No one really thinks of the body per se at such times, but how it will be treated or disposed; no one is actually thinking of the body when getting one’s affairs in order. e body is just there, almost un- thought, almost without meaning; the focus is on the will and deci- sion. e body is just one of those affairs that one must get into or- der, like the other property that one has to dispose of in one’s will. e sort of thing that we think the human body is comes to in- form what it is that we think we can do, morally speaking, with that thing. Yet, there is little thought given to the body in contemporary bioethics and our ethical treatment of the body is thus affected. In modern bioethics, the focus is not on any integrity and meaning that the body carries as a body. Instead, we focus on the meaning that we—willful and intellectual beings that we are—have invested into the body post hoc. e body, in our contemporary understanding is just a neutral carrier of meaning, an instrument of my will or a can- vas upon which I paint or create myself. ere is, then, an ontology implied in this contemporary mindset in which the body is an object of great importance both in health care and in contemporary society, and at the same time the forgotten stuff that we manipulate through various practices. I have elsewhere described what the body is for modern medi- cine.3 In e Anticipatory Corpse, I claim that the dead body is epis- temologically normative for contemporary medicine. at means that the body for medicine is a corpse, animated by metaphysics of efficient causation, a mechanism where dead matter is in motion by virtue of the force of its prior efficient causes. Not only is our first patient dead—literally patient to the medical student’s probing—but it was because of the rise of anatomical investigation that contempo- rary medicine was born. Even though we have been dissecting dead human bodies for more than 500 years without qualms, it was not until about 200 years ago that modern medicine began. At that time, there was a fundamental shi in our relationship to the body. It came to be seen as inanimate, dead material. As medicine evolved through the 19th Century, we find a shi in emphasis from anatomy to physi- ology—the so-called science of life. Still, death is the normative posi-
3 See Jeffrey P. Bishop, e Anticipatory Corpse: Medicine, Power and the Care of the Dying (Notre Dame: University of Notre Dame, 2011).
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tion of the body. Physiologists like Marie Francois Xavier Bichat could claim that, “[l]ife consists in the sum of functions by which death is resisted.”4 Or as the greatest physiologist of the 19th Century, Claude Bernard could claim, the term “life” has “no objective reality” in physiological science.5 Even the renowned Guyton’s Textbook of Medical Physiology states that “the human being is actually an au- tomaton, and the fact that we are sensing, feeling, and knowledgeable beings is part of this automatic sequence of life.”6 e dead material of the body in automatic, machine-like sequence takes precedence. In this paper—all too brief as it is to properly address the ques- tions—I shall begin to sketch the way that contemporary medical understandings of the body move into contemporary culture, rein- forcing, for those of us who live in the West, the bizarre position of the body as both the focus of our attention and yet at the same time that which is hardly even thought of. I shall do so by engaging popu- lar culture. First, I shall engage the travelling bodies exhibitions that have become so popular in recent years. Second, I shall describe how cosmetic surgery perpetuates our cultural understandings of the body.7 If the body is just dead material, it is not different than marble that can be sculpted into whatever we desire. I shall conclude by claiming that, for the Christian, the body is not a static thing; nor is it easily a thing that can be separated in its nature from culture, as sug- gested by scientific reductivists, where we can derive the ought from knowing the naturalistic is. Instead, the body is something that is shaped by its practices, and it is only in the practices of liturgy and charity—in sacrament—that the Christian body comes into being. Moreover, I shall further claim that it is precisely in our sacramental theologies shaped by our theology of the Incarnation that we find normativity, that is to say that we find the locus of our non- relativistic understanding of ethics of the body, in the Body.
4 Marie Francois Xavier Bichat, Physiological Researches on Life and Death, trans. F. Gold (Boston: Richardson and Lord, 1827), 9-10, in Significant Contributions to the History of Psychology: Series E Physiological Psychology (Washington DC: University Publications of America, 1978). 5 Claude Bernard, An Introduction to the Study of Experimental Medicine, trans. Henry Copley Greene (New York: Dover Publications, 1957), 67. 6 Arthur C. Guyton and John E. Hall, Textbook of Medical Physiology, 11th ed. (New York: W. B. Saunders 2006), 3. 7 It is equally possible to tell a similar story in reverse order: modern Western culture gave birth to modern medicine. Aer all, medicine is both produced by and produc- es the culture within which it finds itself. However, for the moment I want to focus on the ways in which medicine shapes the culture and thereby shapes our thinking and doing as it relates to the body.
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THE EMPTY WORLD OF BODIES8 e public display of the dead body has once again come into vogue over the last 20 or so years. Anatomic dissections were a public spectacle for the intelligentsia during the Renaissance. As better preservation techniques were developed, installations of dissected bodies were placed in museums for viewing in the 19th and early 20th Centuries.9 With the even newer plastination technologies of the last few years, bodies have been put on display for purportedly educa- tional purposes. No longer bodies in rigor mortis preserved in for- maldehyde, like those bodies from my medical training in the late 1980s, these new techniques allow for the body to become more mal- leable without all the noxious chemicals. ese bodies are meticu- lously preserved, dissected, and displayed. I attended two traveling exhibits of plastinated bodies that have recently come through St. Louis. Premier Exhibitions, a company that produces various traveling educational exhibits, placed its exhib- it, “Bodies, e Exhibition,” in the Galleria Shopping Mall, occupy- ing a large retail space le empty by the economic downturn. View- ers were encouraged to obey the command of the Oracle at Delphi, to “know thyself;” a sign over the exhibit entrance encouraged attendees to “learn about yourself” as they travelled through the exhibition. A series of posters lined the long corridor through which the at- tendees passed as they moved from ticket purchase to exhibit hall. Posters of eight or ten major figures in the history of medicine, from Hippocrates to Galen, to Vesalius, to Louis Pasteur, to Watson and Crick looked out onto the crowds. e triumphalist tone of the ex- hibit told us a familiar story; we were lost and living in the dark ages when a few men—they were all men—of science drove us forward in knowledge against the etiquette of a squeamish and superstitious so- ciety. As Claude Bernard said, “A physiologist is not a man of fash- ion, he is a man of science, absorbed by the scientific idea which he pursues; he no longer hears the cry of animals, he no longer sees the blood that flows, he sees only his idea and perceives only the organ-
8 Portions of this section have appeared in a substantially different form. See Jeffrey P. Bishop, “Searching for ourselves in this colony of corpses,” Australian Broadcasting Corporation, http://www.abc.net.au/religion/articles/2011/11/07/3357- 988.htm. 9 Geoffrey Rees, “More Wondrous and More Worthy to Behold: e Future of Public Anatomy,” 36-47, in Controversial Bodies: oughts on the Public Display of Plastinated Corpses, ed. John Lantos (Baltimore: Johns Hopkins University, 2011); Callum F. Ross, “e History and Potential of Public Anatomy,” in Controversial Bodies, 63-72.
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ism concealing problems which he intends to solve.”10 Opening the living bodies of animals and the dead bodies of humans in the face of a squeamish opposition was the first step toward our salvation of the body from death and decay; or so went the story-line of the exhibit, and so goes the modern medical science story. Once inside the exhibit hall, numerous bodies were displayed in various positions. It is difficult to orient oneself in the dissected and skinless body, so each body had skin in few strategic places to help orient the viewers. Sometimes the bodies were dissected and dis- played in order to highlight the organs. At other times, it was the musculature, at other times the nerves or blood vessels. e precision of the anatomic dissections was remarkable, and indeed elegant. e dissections were so good that what stood out most was just how much space there is in the human body, or rather just how empty the body really is. Another exhibition company, this one created by the now world- famous Gunther von Hagens, also stopped in St. Louis. Von Hagens’s exhibits have travelled the world over, and his advertising claims to be the “original exhibition of real human bodies.” An im- age used in the promotional materials showed the upper torso and head of a body with the skin pealed back and the various muscles of the face exposed.11 e Pa- rotid and sub-mandibular salivary glands, the mandi- ble, as well as the muscles of mastication were exposed, showing just how much empty space there is even in the face. e Frontal bone and skull-cap were also re- moved, and the brain was visible along with the meninges—the thin, clear, vascular membrane that lines the outer surface of the brain. In the promotional photograph, a sparkle of light reflects from the top of the cerebrum in the image, as if to remind us that at one point this body had a spark of life in it, that it was animated, or perhaps that a self once resided somewhere deep in the brain. e photo suggests that the seat of the soul is here, where light emanates from the brain. In both exhibits, the bodies were placed into everyday poses, which were most striking. A body “kicked” a soccer ball, a leg ex-
10 Bernard, An Introduction to the Study of Experimental Medicine, 103. 11 Gunther von Hagens, “Body Worlds and the Brain,” http://media.ticketmas- ter.com/tm/en-us/dbimages/80965a.jpg.
Body Work and the Work of the Body 119 tended such that the foot hit the ball perfectly. e muscle groups involved in kicking had been meticulously dissected and exposed, demonstrating the elegance of the body, surely, but also the elegance of the technique of plastination and dissection. Another body leans over in a Heisman-trophy pose, football cradled in the le hand, right arm extended to resist an approaching tackle. e Heisman- trophy body was dissected such that its back muscles were exposed as it leaned forward against the would-be tackler. e origin of each rib and posterior portion of each vertebra—the back bone—was re- moved, exposing the spinal cord with the nerve roots extending out along different muscle planes. e stark tension between the lifeless and motionless bodies in positions that suggested motion and life was only exceeded by the faces of these bodies. e Asian facial features of each body in Premi- ere Exhibition’s “Bodies, the Exhibition,” contrasted sharply with the fact that the body was playing American football. Much of the re- proach leveled by critics of body-exhibition has been directed at the origin of the bodies.12 In fact, von Hagens himself—the founder of Body Worlds—directed criticism at his competitors such as Premier Exhibitions because many of the bodies that Premier acquired and displayed came from the Chinese government.13 e implied criti- cism was that the people, whose bodies these were, had not consent- ed to plastination or to exhibition. Von Hagens insists that all of his bodies have been donated; and he routinely advertises this fact to call the morals of his competitor into question. In other words, his dis- play of bodies is ethically acceptable because the persons willed it so. ere are several stories that can be told about the bodies in these exhibitions. First, there are stories that the exhibitors would like to tell us. ere is the story, already noted, of the triumph of medical science over darkness and ignorance, which had for centuries al- lowed the secrets of the body decay with it.14 e long corridor of posters told us the story of the body veiled from view and saved from
12 Ruth Levy Guyer, “Anatomy Without Integrity,” in e Anatomy of Body Worlds: Critical Essays on the Plastinated Cadavers of Gunther von Hagens, ed. Alicita Rodriguez, T. Christine Jespersen, and Joseph Starr (Jefferson, NC: McFarland and Company, 2008), 202-10; Peter M. McIsaac, “Worrying About Democratic Values: Body Worlds in German Context, 1996-2004,” in e Anatomy of Body Worlds, 121- 35; Linda Schulte-Sasse, “Vive la differénce: Gunther von Hagens and His Maligned Copycats,” in Controversial Bodies, 79-89. 13 Schulte-Sasse, “Vive la differénce: Gunther von Hagens and His Maligned Copycats.” 14 See especially chapter 8 of Michel Foucault, e Birth of the Clinic: An Archaeology of Medical Perception, trans. A. M. Sheridan Smith (New York: Vintage Books, 1991), 124-48.
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ignorance and death by men whose pursuit for knowledge out- weighed the mores of their simple-minded culture. ere is the close- ly allied story of progress, where one can make his or her body healthy or diseased. At one installation in “Bodies, the Exhibition,” there were two sets of lungs—one set healthy and one set from a former smoker. Beside the display was another case in which viewers were encouraged to deposit their cigarettes. e story here seems to be that you can shape your own body: you are the sculptor of your own health. ere is a second story told by the cosmopolitan and politically correct critics of the exhibition of bodies. ey tell the story of poor Chinese people—or worse of Chinese prisoners, who cannot them- selves consent—whose families could not afford to follow their own cultural customs of body disposal. What right does the Chinese gov- ernment have to take possession of the bodies and hand them over for plastination and to sell them for display?15 is story is about ownership, authority, and sovereignty over the body. Aer all, the worst insult to Western sensibilities is that one cannot do with one’s body what one desires. Life and liberty are referred to under the gen- eral name of property in John Locke’s An Essay Concerning Human Understanding.16 Aer all, “man being born… hath by Nature a Pow- er… to preserve his Property, that is, his Life, Liberty and Estate…,” as Locke notes in the Second Treatise.17 ere is a third story meant to cover over difference. is story goes something like this. “Know thyself.” ese bodies are just like ours. Just like us, they ran and played games. ey played soccer and football, and cards. Implied in this story is another story: Bodies are malleable; they can take the shape of whatever we want to do with them. Bodies are empty things, awaiting a self to write itself into ex- istence. As we learned from Locke—the physician—the self is a tabu- la rasa, an empty and blank slate. We either narrate ourselves into existence or are narrated into existence by others. We either shape ourselves, or are shaped by the state. ere is yet another story im- plied in this one: just as these bodies are dead, so is yours, or it cer- tainly will be dead in due course. One needs the spark, the will to shape and mold your body into what you will, for your time is short.
15 Guyer, “Anatomy Without Integrity;” McIsaac, “Worrying About Democratic Values: Body Worlds in German Context, 1996-2004;” Schulte-Sasse, “Vive la differénce: Gunther von Hagens and His Maligned Copycats.” 16 John Locke, An Essay Concerning Human Understanding, ed. Kenneth P. Winkler (Indianapolis: Hackett, 1996). 17 John Locke, Two Treatises of Government, ed. Peter Laslett (Cambridge: Cambridge University, 1988), VII:87, 323.
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It seems that it is precisely this emptiness that we hope to fill up as we try to animate our bodies with the games and meaningless activi- ties that divert us from our dead and empty bodies, our dead and empty selves. As I will attempt to show, this idea of empty selves or of malleable bodies moves effortlessly and without opposition in popu- lar culture of celebrity and beauty and of cosmetic surgery.
CULTURAL ICONS AND MANUFACTURED IDOLS18 A 2011 survey found that more than half of Americans approve of cosmetic surgery.19 Many celebrities, both men and women, have been rumored to have had cosmetic surgery. One website (celebri- typlasticsurgery.tv) not only outs celebrities that have had cosmetic surgery, but also suggests which stars are in need of it. In addition, the acceptability of plastic surgery is on the rise in every economic tier in American society.20 In fact, another survey done by the Amer- ican Society for Aesthetic Plastic Surgery in 2011 showed that 48% of respondents making less than $25K per year approve of cosmetic surgery. As incomes rise, so do the approval ratings, with 62% of those making over $75K per year approving of cosmetic surgery. e same survey noted that about one-third of Americans were consider- ing cosmetic surgery for themselves.21 Television programs like Extreme Makeover and Bridal Plasty— where women compete for the perfect wedding including cosmetic surgery—reflect the popularity of cosmetic surgery and also help to popularize it. While most celebrities would like to keep their “body work” under wraps, there is far less shame in it today than even just a
18 Portions of this section have appeared in substantially different form. See Jeffrey P. Bishop, “e Cultured Body and the Cult of Medicine,” Australian Broadcasting Corporation, http://www.abc.net.au/religion/articles/2011/08/23/3299808.htm. 19 American Society for Aesthetic Plastic Surgery, “Survey Shows at More an Half of American Approve of Cosmetic Plastic Surgery,” http://www.surgery.org/ media/news-releases/survey-shows-that-more-than-half-of-americans-approve-of- cosmetic-plastic-surgery. 20 American Society of Plastic Surgeons, “Moms Would Opt for a Body ‘Makeover’; Baby Boomers Want to Fight Age with Fillers and Facelis if Money Wasn’t an Issue,”http://www.plasticsurgery.org/news-and-resources/press-releasearchives/- 2010-press-release-archives/new-survey-shows-interest-in-cosmetic-surgery-is- up.html; American Society for Aesthetic and Plastic Surgery, “Despite Recession, Overall Plastic Surgery Demand Drops Only 2 Percent From Last Year,” http://www.surgery.org/media/news-releases/despite-recession-overall-plastic- surgery-demand-drops-only-2-percent-from-last-year; American Society for Aesthetic Plastic Surgery, “Survey Shows at More an Half of American Approve of Cosmetic Plastic Surgery.” 21 American Society for Aesthetic Plastic Surgery, “Survey Shows at More an Half of American Approve of Cosmetic Plastic Surgery.”
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decade ago.22 Our cultural understanding of the body has shied and the aesthetic enhancement of the body has become so commonplace that we do not think of it as enhancement, as for example in the use of orthodontic braces or teeth whitening. Modern plastic and reconstructive surgery developed as the result of war. Surgical techniques were perfected on those badly maimed soldiers, sailors, and pilots suffering from serious bodily trauma, but who had survived their wounds. In addition, surgical techniques were created for women who had lost a breast to breast cancer. Plas- tic and reconstructive surgery for those disfigured by accident or dis- ease attempts to restore people to cultural notions of normal and ac- ceptable appearance, even if they are not able to return victims to a cultural standard of beauty. us, plastic and reconstructive surgery began as a response to suffering. And by virtue of the knowledge and skill gained in the treatment of trauma or disease, medicine and sur- gery began to address other things that made us uneasy; that is to say, other things that dis-eased us, like our perceived bodily imperfec- tions—a large nose, small breasts, or droopy eyes—became some- thing in need of treatment. us, we see the rise of blepharoplasty or jaw contouring. Breast reconstruction and implants came to be used to enhance breast size, reinforcing a certain cultural aesthetic. Implants are now used to highlight the buttocks, the thighs, the calves, the biceps and triceps. Today, there is even labiaplasty and vaginoplasty. Vaginal “rejuvena- tion” procedures are increasingly advertised as a procedure to “reju- venate” the vagina “by reducing labial tissue and decreasing the opening of the vagina,” as one on-line advert put it, in order to in- crease sexual pleasure, if not for oneself, then for one’s male partner. Cosmetic surgery responds well to the suffering of the worried or to the suffering of those that are ill-at-ease with their bodies, bodies that do not measure up to some cultural ideal, or even just those who want to get the most pleasure out of their bodies. Medicine partici- pates in the manufacturing of the cultural ideals of the body, as can be seen in our cultural icons, namely celebrities. ese desires for perfect bodies are taken on by regular plebs. For example take a non-celebrity, who would become a celebrity—Nadya Suleman, the Octomom. She seems to be mirroring the life of a celeb- rity—Angelina Jolie, e Tomb Raider. Rumors persist that, before Nadya Suleman became famous for conceiving and delivering octu- plets, she had plastic surgery. Suleman, who already had six children, delivered octuplets with the assistance of medical technology.
22 Jennifer Garcia, “Heidi Montag: Addicted to Plastic Surgery,” People (January 13, 2010).
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Popular culture both glamor- ized and attacked Suleman. On the one hand, the cover of Star Magazine proclaimed “Nadya’s secrets” for losing all of her “baby fat” in only one year aer deliver- ing her babies. She had done so with “no nips, no tucks, no lipo.” e cover boasted that, inside its covers, Nadya would reveal her “secrets to flat abs & erasing stretch marks,” and it heralded, “her marriage plans.” Aer all, there was no clear father in the picture and for Star Magazine to appeal to all those mothers who wanted to lose the “baby fat” there would need to be some semblance of respectability for a strikingly beautiful mother of 14 children.23 On the other hand, the me- dia also attacked her. e Feb- ruary 11, 2009 cover of Life and Style Weekly sported a photo- graph of Suleman next to one of Angelina Jolie, highlighting the similarities between the two women. e cover accused Suleman of bad mothering.24 e evidence of her poor char- acter was bulleted: “An ever- increasing giant family,” “Plastic surgery to copy her (Angelina’s) looks?” “Has the Angelina fan gone too far?” e lower le hand corner of the cover had a photograph of a pre-mature ba-
23 Amy Judd, “Octomom, Nadya Suleman, New Bikini Body in Star Magazine” (Jan- uary 20, 2010), http://www.nowpublic.com/culture/octomom-nadya-suleman-new- bikini-body-star-magazine-photo-2560305.html. 24 Courtney Hazlett, “Octuplet Mom Patterning Herself of Angelina Jolie” (February 11, 2009), http://today.msnbc.msn.com/id/29125355/ns/today-entertainment/t/ octuplet-mom-patterning-self-angelina-jolie/.
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by surrounded by and connected to medical equipment. Presumably this child was one of Nadya’s octuplets, or at least it is meant to re- mind the viewer of them. e tagline for the photo asks, “Who will care for her 14 children?” However, Suleman is no mere opposite of Jolie; rather, she is Angelina’s mirror image. Jolie is the “natural” beauty; Suleman is an image of Jolie’s beauty, not “natural” in any sense. Jolie is wealthy because she sells her beauty and idealized womanhood; Suleman is poor because she had to purchase her beauty and idealized woman- hood. Suleman is the irresponsible mother. Jolie is a humanitarian mother, not only giving birth to her natural children, but also adopt- ing children that might have been destitute otherwise. Suleman pro- duces children through the manufacture of medicine and leaves them destitute, if we accept the implied critique of Life and Style Weekly. Jolie, because she has the means, can save children from destitution. Try as we might to convict Suleman, a nagging question remains. Is Nadya guiltier than the rest of us in the mindless pursuit of aes- thetic perfection? Surely, she crossed some line, but that line does not appear to be delimited by the body. When we do think of the limits of the body, it is merely a mechanical limit, the limit to which we can push the material of the body. In fact, we marveled at just how far her body could be pushed by medical science and how resilient Suleman’s body has been. Aer all, each of us pursues some cultural aesthetic daily. We shave and wash; we color our hair and we adorn our bodies, all in conformity to cultural norms of beauty, hygiene, and proper com- portment. In this sense, we are perhaps on a spectrum with Nadya. She had a desire to be the “perfect” woman. Yet we are a bit repulsed by her; her body had to be instrumented by medical technology both in order to look like and to be like Angelina. She violated the West- ern secular norm of responsible parenthood—three children and no more. She had distorted our image of “natural” beauty and woman- hood in her pursuit to be like Angelina. On the one hand, the image of womanhood that Jolie represents is an object desired by many in Western culture, both men and wom- en, and as we export Western cultural ideals, it is becoming an ideal of beauty for the rest of the World. On the other hand, no woman could possibly live up to the iconic image of Angelina. Suleman could not meet the standard of Angelina’s beauty, try as she might. She could not be satisfied with herself, having failed to reach perfection on her own; nor could she be satisfied in manufacturing for herself that ideal.
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Yet, there is nothing “natural” about Angelina’s beauty, even if she has never had cosmetic surgery.25 It is clear that, if one compares a series of photographs of Jolie from an early age until now, her beauty seems to have existed all along. Still, that does not mean that her image has not been carefully craed. e photos are themselves posed and composed.26 Even in the early photos, Jolie poses for the camera: she is placed into provocative sexualized positions; her facial expressions are sensual, suggesting desire. In short, her image is molded to an already extant notion of beauty, a notion of woman- hood and sexuality that already has been shaped by decades of im- agery since the invention photography. us, the beauty of Angelina Jolie is already refracted through a Western lens. Locke’s tabula rasa—that self, which is a blank and empty slate— not only refers to the soul upon which one writes oneself into being. In fact, the blank slate is increasingly the body, the empty slate upon which we write our story, upon which our culture writes the story of an empty culture. If Suleman is the distorted and highly manufac- tured image of Jolie, then Angelina is also the simulacrum of a West- ern ideal of “natural” womanhood and beauty. We attack Suleman for distorting the image of Jolie; yet Angelina is already a refracted image of Western notions of the body that in itself is mere matter for manipulation. us Jolie is not an icon of perfect Western woman- hood so much as she is an idol, to which we bow down, an idol of our own construction, a god made in our image and likeness. ere is no doubt that medicine assists in manufacturing these bodies, like that of Nadya Suleman. To that degree medicine is cul- pable for producing distorted bodies; it sacrifices those, like Suleman, to its gods. Medicine’s error is not merely that it exploited Suleman, or that it did not exercise good judgment in implanting too many zygotes into Suleman’s uterus. e body is instrumented for self- gratification, for self-aggrandizement, leading to evermore dissatis- faction with the body. It is merely lifeless clay animated by our own deepest desires, desires that are not merely our own, but those of the culture that helped to produce them. Medicine’s error is that it un- critically participates in a cultural construction of an ideal woman- hood, all the while turning the body into mere matter to be shaped according to our desires, to our wills.
25 “Angelina Jolie on Plastic Surgery: ‘I Haven’t Had Anything Done’,” US Weekly (December 6, 2010), http://www.usmagazine.com/celebrity-style/news/angelina- jolie-on-plastic-surgery-i-havent-had-anything-done-2010612. 26 “Angelina Jolie on Plastic Surgery.”
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Cosmetic surgery and cosmetic dermatology only possess the lat- est tools that we use to treat our dis-ease with the body, our uneasi- ness with bodies. Yet, at the same time, it also constructs the dis-ease that we have with our bodies. It is thus because medicine thinks the body in this way. For us, the un-sculpted body is lifeless, just like an unsculpted slab of marble or molten bronze of the Greek or Renais- sance sculptors. ese artists brought to life for their cultures their gods and goddesses. e modern sculptor’s knife, carving the fragile clay of the body, brings to life our gods and goddesses at which to marvel, leaving us lifeless bodies. So it seems clear that medicine helps to produce the cultural body. As I argued in e Anticipatory Corpse, that body is lifeless, and this lifeless body is epistemologically normative. at normative and dead body makes its way into the cultural phenomena of anatomic exhibitionism. e lifeless bodies of von Hagens and Premiere Exhi- bitions, among others, educate us, but not about anatomy or physiol- ogy or health. ey educate us culturally; there is a certain kind of scintillation they promote; naked bodies playing games, and most recently, bodies having sex.27 e whole point seems to be to create desire. Moreover, these attitudes of desire come to be directed at one’s own body. Jolie’s body exists to sell things; but more than that, she sells desire. She creates unsatisfied and insatiable desire with her body; that desire feeds on the hapless bodies of so many men and women in our culture.28 So, when this insatiable desire is directed at the body, the body is consumed by our gods. e body is not only lifeless, it has been killed, sacrificed to sate our desire for our idols.
THE WORK OF BODIES I am a student both of phenomenology and of structuralism. at is to say, I hold, with Hannah Arendt, that the human being both produces culture out of its nature, and its nature is produced by that culture.29 e work of the great phenomenologist, Maurice Merleau- Ponty, suggests that it is the body in action, not only in mere passive perception, that grounds reflective interaction with the world. Put differently, the body, not the mind, is the locus of subjectivity.30 Fem-
27 Peter Kiefer and Claudia Weingärtener, “Dr. Tod zeigt Leichensex in Berlin,” Bild (May 5, 2009), http://www.bild.de/regional/berlin/weit/er-zeigt-leichen-beim-sex- 8239816.bild.html. 28 See especially Herve ́ Juvin, e Coming of the Body (New York: Verso, 2010), 27-8. 29 H. Arendt, e Human Condition, 2nd ed. (Chicago: University of Chicago, 1958), 11-13. 30 Maurice Merleau-Ponty, e Phenomenology of Perception, trans. Colin Smith (New York: Humanities, 1962).
Body Work and the Work of the Body 127 inist scholars like Iris Marion Young31 and Gail Weis32 have brought Merleau-Ponty’s fundamental insight into conversation with femi- nism, which had tended to focus on the structural aspects of culture that informed sexism. eir work has thus fundamentally trans- formed the work of Merleau-Ponty, in my view, because it takes seri- ously the points of embodiment made by Merleau-Ponty, but their work also shows the way in which the body is in conversation with and is changed by its social, political, cultural, and historical envi- ronments.33 ese thinkers understand the human being to be in dy- namic relation with the cultural space and historical time within which any particular body exists and finds its orientation. Such a view is not incompatible with Aristotelian or omistic understandings of bodies and ethics. Of course, Aristotle and om- as tell us that we are habituated into the virtues. e body is formed in habit—a second nature.34 ere are signs emerging from the con- temporary neurosciences that an Aristotelian/omistic account of virtue is confirmed. For instance, the idea of habituation seems to be compatible with the extreme neuroplasticity of the brain and with the dynamism of the body and the body image, as suggested by both Young and Weiss. In other words, bodies both produce and are pro- duced by their cultures; that is their nature. In e Anticipatory Corpse, I described Kantian space and time as empty abstract forms of the intuition. I also showed how in post- modernity, time became historical time and how space became polit- ical space.35 So instead of the a priori forms of the intuition—space and time—structuring our experience, with post-modernity political space and historical time came to structure our lives for us. But, we must now, instead of understanding being grounded in time or his- torical time, look to traditions that continue to be practiced. We must no longer look to space, or political space, but it must be under- stood to be grounded in the communal space. Not space and time, but traditions and communal practices created by liturgical practices
31 Iris Marion Young, On Female Body Experience: “rowing like a girl” and Other Essays (New York: Oxford University, 2005). 32 Gail Weiss, Body Images: Embodiment as Intercorporeality (New York: Routledge, 1999). 33 Jackie Scully has carried out a similar project with regard to disabled bodies. Jackie Leach Scully, Disability Bioethics: Moral Bodies, Moral Difference (Lanham: Rowman & Littlefield, 2008). 34 omas Aquinas, Summa eologica, trans. the Fathers of the English Dominican Province (Westminster, MD: Christian Classics, 1949), I-II q. 55; Aristotle, “Nicomachean Ethics,” in e Complete Works of Aristotle, ed. J. Barnes (Princeton: Princeton University, 1986). 35 Bishop, e Anticipatory Corpse: Medicine, Power and the Care of the Dying, 28-60.
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and practices of charity are what structures and creates the Christian body. e Anticipatory Corpse concludes with a question. Medicine is caught up in a set of practices that think about and do things to the body as if it were mere lifeless matter. In other words, medicine’s an- imating and dominant philosophy creates all the ethical conundrums presented to us from ICU care to palliative care. With this fact in mind, I conclude that given that the dead body is epistemologically normative in modern medicine and given its emphasis on a meta- physics of efficient causation, “might it be that only theology can save medicine?” I suspected that there might be many different theologies of medicine. I expected theological responses to be highly and partic- ularly theological accounts that are dependent upon robust meta- physical and moral commitments. But by theology, I do not neces- sarily mean the writings of theologians. I mean the true theologians in the more Orthodox Christian sense, namely those holy men and women who offer themselves in the care of bodies; these theologians are proposing a true theology. In other words, I meant that robust sacramental practices might save medicine. Sacramental practices, that is so say, liturgies are meant to re- orient us. Let us examine the word “reorient.” e word “orient” means east. To re-orient is to get your bearings, eastward. e idea of orientation, comes directly out of the Latin rite Liturgy, because the people and the priest face east. e altar always faces liturgical east. Yet, in order to re-orient us, liturgy must dis-orientate us away from those things of the world that had captured our desires. I have essen- tially argued thus far in this paper that our bodily orientation is off, precisely because our orientation is directed toward the body as tabu- la rasa, as mere matter molded to the will. ere are multiple ways that this story can be told: One could point to certain consumerist attitudes in culture that bleed over into medicine, a slightly different version of the case I have made above. Or, there is a certain profit motive that has captured the heart of medicine. Or, the desires of the body are directed at the body, consuming the body. It is pretty much the case that whatever ails a culture will ail its medicine, and whatev- er ails medicine will ail the culture. us, liturgy, before it can orient us, it must first disorient us. Catherine Pickstock, in her work, Aer Writing: On the Liturgical Consummation of Philosophy, has robustly made this point about reorientation in liturgy. Pickstock notes that many of the more- recent translations of the liturgy carry with them too much Renais- sance and Enlightenment logic. In response, she turns to the old Lat- in rite mass. She points to several of the disorienting features that decentralize the subject. For example, the ancient liturgies of the
Body Work and the Work of the Body 129 church have all sorts of starts and stops; just when you think you are off and moving through the Liturgy, its flow is interrupted. It stops, offers prayers again, and starts over. “Again, and again, let us pray to the Lord.” In the modern translations of liturgies, we do not see these starts and stops as much, because they have for the most part been edited out. Another example might be found in the Divine Liturgy of St. John Chrysostom or the Divine Liturgy of St. Basil. ere are several points where the agency of the priest and the people is confused; you are not sure who is acting, the people, the priest, the deacon, the bishop, Christ, the Holy Spirit, or the Father. us you are never cer- tain if one is acting, or if one is actually being acted upon. e lan- guage of liturgy is performative, that is it enacts what it says. And in being said, what is enacted acts upon the actor. In other words, simi- lar to the points made by Merleau-Ponty, Young, and Weiss, bodies are the locus of subjectivity, but that subjectivity is one constructed in a dynamism of action and being acted upon. Yet, perhaps different from the phenomenological-structural interaction described by these recent thinkers, the embodied subjectivity of the worshiper does not take center stage. e embodied subject is decentered by a different body and a different agency than its own. e body is worked upon. In addition, in liturgy, space and time are distorted. As brought to our attention recently by the work of John Milbank, the term “secu- lar” just means “age.”36 Many of the prayers in divine liturgy end with the phrase in saeculum saeculorum… unto the ages of ages. is phrase, “unto the ages of ages,” is a superlative phrase, the time of times, or rather eternity. It is not unlike another superlative, namely the “holy of holies,” the place where the altar sits. All liturgies take place within the Holy of Holies, that is to say, the space of liturgy. us, we pray unto the ages of ages, entering into God’s “time” (eter- nity), and it takes place in the holy of holies, in God’s “space,” or ra- ther in the most holy place. us, liturgical practice is disorienting to us, and as long as it is disorienting, that means that something else has been orienting us. e point of liturgy is to reorient us, to redi- rect us to the East, to get us to let go of ourselves and to face East, to face God, to get our bearings from God. e point is to face East, to the rising Sun, to the Resurrection. Finally, the body is in motion in liturgy. e body acts. It sits, it stands, it bows, it prostrates itself. e body acts and is acted upon. e body, along with its desires and its will, is being reoriented; it is
36 John Milbank, eology and Social eory: Beyond Secular Reason, 2nd ed. (Oxford: Blackwell, 2006), 9-18.
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being shaped by practices. It is not self-absorbed. e head is bowed; the will is retrained through the activity of the body in liturgy. Yet, these practices are different from the practices of contemporary cul- ture, such as body massages, cosmetic dermatological practices, or surgical practices. ese are ersatz liturgies, where desire is directed at the body. Liturgical practices are not just a different set of practices from those of contemporary culture. Instead, in liturgy the body of the true God is made present in the saying and doing that is liturgy. Put differently, all bodies are transformed during the activity of litur- gy in that the immanent and transcendent touch in the space and time of Liturgy, in the traditions of and in the communities at prayer. Out of this fundamental founding activity of the body—that is to say, out of the work of the body that is worship—all other activity, all other work, all charity and ethics is possible. e act of bowing the head, and reorienting the body reorients desire and the will for action in the world. Shortly before I asked the question, “Might it be that only theology can save medicine?” I had just two or three sentences earlier wrote another thing; perhaps we can learn from those who are marginalized, those who are theologians in the more ancient sense of the word. Perhaps it is they who can direct us. e true theologians are not those like me who think and write. By the true theologians, I mean those who pray and who do. I do not mean those who do what I do, namely scholarship. I mean by theologians those, like Blessed Teresa of Calcutta, who pray and serve and not necessarily theologi- ans who give us rationales for our activity. ere is a photograph of Teresa that I love. It was taken in the last years of her life; she is old and frail. She is in a wheel chair. Sitting at her feet is a young woman, whose face is lit with love and admiration for Teresa. Teresa’s face is likewise lit with love. She is slouching over a bit in the chair, her back stooped with years of service and hard work. She reaches out an ancient, weathered hand in blessing. Her body has literally been shaped by her practices of prayer and service. Her practices of prayer and service have been insinuated into her sinews. It is here, then that we see bodies shaped by practices of care, literally bent over in the work of caring for the body of the other. Te- resa’s activities in caring for the other, but the practices shaped her own body and shaped her will. She gives us new insight into the im- portance of habits in creating the habitus of the living body. Her body is stooped and as stooped, she can more easily care for those lowest to the ground. us, the body literally conforms to and is transformed by its practices. It exists in the middle voice, so to speak. e middle voice has been lost in most modern languages, but in ancient Greek and to a lesser extent in Latin, it was prominent. e middle voice is be-
Body Work and the Work of the Body 131 tween the active and the passive voice. e body, when it acts, is also and at the same time acted upon. In the activity of prayer one acts, but one is also acted upon. Just in the activity of praying, even in the absence of supplication prayer, one’s body is changed by its own ac- tivity. In praying, one is changed. In serving the poor, one is reaching out beyond oneself, certainly, but at the same time and in a different way, one is changed in serving the poor. Just look at Teresa of Cal- cutta’s body, changed by her actions. ere is much more that could be said about Divine Liturgy, about how the body of Christ—that is to say, the church—makes pre- sent the body of Christ in bread and wine, in the flesh. One could reflect upon the way in which in consuming the body and blood of Christ, one is consumed by Christ. We could reflect upon how, in the Word being made flesh, my flesh is made into the Word, made alive truly. We could reflect on how the divine became human so that hu- mans may become divinized. But as far as I am concerned, each of these reflections must begin in liturgical practices. Christ, our true God, has said that he comes into our midst at two points: one is in Divine Liturgy, in the Sacraments, where the body of Christ is made present in the breaking of bread. e other is when we reach out to the least of these. In both instances, as we act, we are acted upon. Our wills are thus formed, and transformed; our bodies are formed and transformed. Might it be that only liturgy can save the body?37
37 I would like to thank my graduate students, Rachelle Barina, Devan Stahl, and Emily Trancik for reading and commenting on earlier versions of this paper.