Joanna Sheldon wrote:
>
>Yoshie,
>
>>On general principles, I agree with Kelley, in that we don't have
>>time to keep up with every innovation in every science & technology.
>>There are some exceptions, though.
<snip>
>>Parsons' study of "the sick role" does
>>not fit chronic illnesses (such as clinical depression) very well.
>>Those who have chronic illnesses and permanent disabilities tend to
>>become more knowledgeable about their own illnesses & disabilities
>>and often about the practice of medicine in general also,
<snip>
>
>You remind me of the fact that Freud wrote that it it is characteristic of
>the "melancholic" to be extremely knowledgeable about all aspects of
>his/her dis-ease: its catalysts, symptoms and results. There wasn't a
>whole lot to know about medical treatment at the time, I suppose.
as i see it, pharmacological intervention underwent a small 'revolution' with the development of chemotherapies, i.e., ehrlich's salvarsan, "magic bullets" and all that. i've no idea of how this went down in psychoanalysis, whether a magic bullet did in the unconscious or what.
pharmacological intervention, as regards agency, is at least a two-way affair -- in the context of what one as patient/patients is/are willing to do, and what the doctor/s is/are willing to do to patient/s. then moving in/out/up a level from individual or group relations the legal, moral, cultural, political, economic normic constraints/licenses come into play.
consider as well the approach and breadth of knowledge of medical practitioners vs. that of patients yoshie pointed out. how it all fit's? i dunno. but i think medical sociology/ethnography might be helpful for understanding it, social construction of illness too, maybe biopolitics, though i have problems with the latter concept.
look at the tuberculin mania in 1890/1 - thousands of consumptives rushed to berlin to get some of robert koch's "lymphe" - which, it turned out, was a false cure. (tuberculin is a glycerine extract of mycobacterium tuberculosis culture, and causes a delayed-type allergic reaction (which no one knew much of anything abt. at the time, and is what is used in the tine tests).
despite the mania and its fallout, tuberculin injections were used in some sanatoria in Germany as part of the therapeutic regime before ww1 and i don't know how long thereafter, or how widespread but i've come across refs pre ww1. I've seen some before/after photos of patients from around the turn of the century of people w/tuberculosis of the skin ("lupus vulgaris") - a disfiguring conditon - and it really looked like the tuberculin injections - in effect a local treatment - helped. visible, literally in-your-face improvement - (that's a historical judgement). not a cure, and really bad scarring. but koch, it seems, thought it was. koch, who (not only) due to immense skill, innovations in culturing techniques, microscopy, staining, was able to "see" the bacilli, the aetiological agent of tb.
compare "seeing" microbes with seeing the lesions and pathological changes. seeing shadows on an xray image. are they, as bernike pasveer puts it, "shadows of knowledge"? what doctors see vs. what bacteriologists, or radiologists see, or what anyone who might know what to look for can see. what thomas mann had hans castorp see, what madame chauchat saw. (what you are seeing with is another question, which ian hacking among others has handled.)
what what should one make of these visibilties? it's not self-evident, any of this kind of seeing.
>Come to
>think of it, though, the depressive that I am in closest contact with can
>reel off a list an arm long of all the medications he's taken, and their
>effects.
and some folks talk incessantly abt. their diets or sport activities.
reciting the long list of meds is also part of the 'ritual' of anamnesis.
if you take medication indefinitely or long-term on a daily basis you might want to know just what it is that you are ingesting and for what reason(s), to what ends, what risks you are taking. regardless of whether it's aspirin, prozac, pred, or the pill... then again you might not want to, or can not know.
but, you may!
sapere aude and a nice weekend,
Anita