Medical Screening: Medical Imag[in]ing, the Body, and the Self A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL OF THE UNIVERSITY OF MINNESOTA BY Sara Jo Cohen IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY Paula Rabinowitz, Siobhan Craig May 2011 © Sara Jo Cohen 2011 i Table of Contents Figure List…………………………………………………………………………….…ii Introduction: Medical Screening ………………………………………………………………………1 Chapter 1: Invisible Visibility: The Cadaver, the X-ray, and Medical Imag[in]ing ………………………………………………………………37 Chapter 2: Our Bodies, Our Cells: Visible Invisibility, Recumbent Women, and the Microscopic……………………………………………...89 Chapter 3: Invisible Audibility: The Telephone and the Abject in Medical Screening……………………………………………………...142 Conclusion: Medicine 2.0?................................................................................................................198 Bibliography……………………………………………………………………..……212 ii List of Figures Chapter 1 Figure 1: John Banister, member of the British Company of Barbers and Surgeons delivering an anatomical lecture, ca. 1580. Artist unknown……………………................................38 Figure 2: Dr. Richard H. Whitehead (in apron) with anatomy class, 1890. North Carolina Collection Photographic Archives……………………………………………………...38 Figure 3: Chest X-ray with time stamp, dated 11 Dec 06……………………………………...…52 Figure 4: Blondie’s decaying face. Screen capture from The Good, the Bad, and the Ugly (MGM, 1967)……………………………………………………………………………………85 Figure 5: Bill Morrison’s decaying film. Screen capture from Decasia: The State of Decay (2003)………………….................……………………………………………..85 Chapter 2 Figure 1: Cell in late prophase, an early stage of mitosis……………………………………... 117 Figure 2: Frida Kahlo, Without Hope, 1945……………………………………………….…….117 Figure 3: Diego Rivera, Vaccination Scene and Healthy Human Embryo Surrounded by Diseased Cells, 1933. Fresco, from Detroit Industry Murals, North Wall……………………...120 Figure 4: Frida Kahlo, Frida and the Miscarriage, 1932……………………………………….122 Figures 5: Images of green sea urchin zygote cells undergoing mitosis…………………………122 Figure 6: Image cytokinesis in green sea urchin zygote cells…………………………………...122 iii Figure 7: Frida Kahlo, My Grandparents, My Parents, and I, 1936……………………………125 Figure 8: Frida Kahlo, Henry Ford Hospital, 1932……………………………………………..125 Chapter 3 Figure 1: Washington, D.C—The attempted assassination of the president - the discovery of the location of the bullet by means of Professor Bell's induction-balance / from a sketch by William A. Skinkle…………………………………………………154 Figure 2: Diane Arbus, “Norman Mailer,” 1963…………………………………………….….165 Figure 3: The Prince combing his hair. Screen capture from Wild 90………………………….168 Figure 4: The Prince sneering (and drinking). Screen capture from Wild 90….……………….168 Figure 5: Norman Mailer being escorted to jail by U.S. Marshalls. Screen capture from Dick Fontaine’s documentary, from Will the Real Norman Mailer Please Stand Up?.........174 Figure 6: Lieutenant Francis Xavier Pope tells Lee Ray Rogers about his avenger. Screen capture from Beyond the Law…………………………………………………177 1 Introduction: Medical Screening “They’re infected,” my mother would say peering into my chronically inflamed ears. “Don’t tell the doctor we know—and definitely don’t tell him we have this,” she would continue, indicating the otoscope she had just removed from my ear. A stay-at- home mom, she had always wanted to be a doctor, but was told by her parents that college was no place for “nice Jewish girls.” Instead, she took a two-year accounting degree and married (and soon divorced) a doctor. Years later, she would marry into a family of hypochondriacs, generations of whom would work together to provide her with opportunities to exercise (and exorcise) her medical aspirations. My sister and I provided her with a host of chronic ear infections, brutal colds, and imagined maladies ranging from encephalitis to tapeworms; three of my four grandparents required my mother’s services as de facto hospice nurse, waiting on them in their last months and waiting with them until their deaths. As a child in the mid-1980s, I had no idea why my mother’s otoscope was a secret. When I asked her about it recently, she replied, “It wasn’t a secret—it’s just that nobody had them in those days and regardless of my diagnosis, you still needed to go to the doctor.” I imagine now that my mother thought she had knowledge that she wasn’t supposed to have as a nice-Jewish-stay-at-home mom: she knew what the insides of my sister’s and my ears looked like, and this knowledge was reserved for our pediatrician. The idea that this rarefied knowledge was off limits for my mother, and presumably for my sister and I, seems absurd now. I’ve seen plastic surgery performed on television and I’ve seen Dr. Oz show diseased organs to Oprah’s studio audience. I’ve watched 2 footage of colonoscopies on YouTube and performed virtual knee surgery on a cartoon patient.1 Pretty much anytime I’ve turned on a television after nine pm, I’ve seen television-drama corpses, always shot in blue tones, zipped into body bags on crime scenes or unzipped from body bags in morgues. Images of the body’s insides and afterlife proliferate in contemporary popular culture, and the act of looking at them has become commonplace. For my mother, seeing the inside of the body was once forbidden; now it’s part of our everyday lives. Long before it became a staple on afternoon and primetime television, medicine was part of film’s unconscious. The three men most often cited as the medium’s pioneers, Thomas Edison, Auguste Lumière and Louis Lumière, were steeped in the study of science and medicine. Before they invented the cinematograph, the Lumière Brothers worked as medical photographers, and after a five-year interlude as popular filmmakers (1895-1900), Auguste and Louis Lumière both returned to medicine.2 Neither of the Lumières were doctors—Louis’s training was in physics, and Auguste was an amateur medical researcher—although both brothers dramatically impacted the technologies of medical imaging.3 Louis pioneered tomography, a technique of imaging the body in sections now used in CT (computed tomography) scans. Together the Lumières patented autochrome plates, soon to be known as Lumière plates, which 1 See http://edheads.org/activities/knee/knee1/index.htm if this sounds appealing to you. 2 Bruno Salazard, Christophe Desouches, and Guy Magalon, “Auguste and Louis Lumière: Inventors at the service of the suffering,” European Journal of Plastic Surgery 28 (2008), 441-447,446, 447. 3 The Lumières were also active in the development of hospitals. Auguste was an active member of the Board of Directors of the Hospitals of Lyons and, during World War I, worked at the Hôtel Dieu Hospital in Lyon as a surgical assistant for operations and lecture courses. During the war, Louis opened a 100-bed hospital (Salazard, Desouches, Magalon, “Auguste and Louis Lumière,” 444, 446). 3 were used in 1914 in the first commercial photographic cystoscope, an early endophotographic tool for examining the bladder (446, 443, 442). Auguste brought his work in medicine and film together when he shot the first medical film, which depicted a military doctor examining patients in front of a barracks. This film then inspired surgeon Eugène-Louis Doyen to contact and contract Clément Maurice, who once worked with the Lumières in the projection room of the Grand Café, to work as cameraman in his operating room. The two used the Lumière Cinematograph to make films on subjects including a craniotomy, a hysterectomy, the separation of conjoined twins Doodica and Radika Neik, and even an armpit operation. These films, screened legally and illegally all over Europe and the United States, were some of the earliest medical films intended for popular audiences (443). In November of 1895, while the Lumière Brothers were preparing for their first public film screening, Wilhelm Röntgen’s discovered X-rays.4 Cinema and X-rays crossed paths almost immediately;5 upon hearing of Röntgen’s discovery, Thomas Edison demanded that his lab workers build him a darkroom so that he could experiment with the rays himself. He named the X-ray process he developed in this darkroom, which produced real-time images of the body’s insides, “fluoroscopy” and travelled around the United States promoting fluoroscopy alongside his cinematic 4 Joel D. Howell notes that Frederick Winslow Turner published his first work on scientific management, which would go on to dramatically shape the hospital business, in 1895 as well. [Joel D. Howell, Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century (Baltimore and London: The Johns Hopkins University Press, 1995), 30]. 5 Lisa Cartwright brilliantly maps out the stakes of this historical coincidence in her chapter “Decomposing the Body: X Rays and the Cinema,” Screening the Body: Tracing Medicine’s Visual Culture (Minneapolis: University of Minnesota Press, 1995), 107-142. 4 works. He attempted to unite the two technologies in X-ray moving pictures, but the genre never gained the status of popular entertainment because Edison (and through him the press) quickly discovered the risks to which that the X-ray cinematographer exposed himself. Prolonged exposure to radiation left Edison with a left eye that was out of focus, upset digestion, and lumps throughout his stomach; it caused his lab assistant, Clarence Dally, to lose his arm to radiation damage.6 Cinema had left Edison and Dally’s bodies decayed and broken. Before his radiation sickness, Edison wasn’t a stranger to illness. Nor were his transoceanic colleagues the Lumières. Perhaps early cinema was deaf (as Michel Chion insists we call it rather than silent)7 because Edison, due to childhood Scarlet Fever and untreated middle ear infections, was also deaf. Perhaps Edison saw his sickly reflection in the fragility of the highly flammable film stock with which he worked, a medium that required constant care in order to prevent its destruction, and that demanded Edison be both its nurse and its undertaker.