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Been thinking a lot lately about the construction of disability along lines of in/visibility to the medical gaze and I figure I may as well compile these fragmentary thoughts into a meta-thread for now since I know there are a few folks who are also pondering this stuff:
Whether a person's disability is visible or invisible has to do with whether the clinic has localized it to a particular site of pathology (i.e., whether it is visible to the medical gaze or not). https://twitter.com/alexhaagaard/status/1282072548553953280
This is important to recognize not as a validation of the medical gaze but to acknowledge the different ways in which medically visible and medically invisible disabilities are constructed within society, and the very distinct histories that they have.
The histories of disability that we tell as *the* history are bound up in hypervisibility - freak shows, clinical photography, grand rounds - and tend to disregard the distinct histories and experiences of those whose embodied reality goes unseen by the medical gaze...
...and becomes recast as psychological/psychosomatic - histories of medically invisible illnesses are histories of hypochondria, hysteria and madness.
This is something that needs unpacking but while disability can be understood as the "constitutive outside" of the normative body constructed by the clinic I think we also need to consider medically invisible disability as the constitutive outside of medically visible disability.
Medically visible disability is positioned as something to be "corrected" - cured.
Medically invisible disability is positioned as a moral failure. The responsibility is on the sick person to make "lifestyle changes." https://twitter.com/alexhaagaard/status/1288191747953168384
Medically invisible disability is positioned as a moral failure. The responsibility is on the sick person to make "lifestyle changes." https://twitter.com/alexhaagaard/status/1288191747953168384
And if they don't or can't, that's positioned as a failure of willpower, and/or noncompliance.
If they do, and it doesn't work, they're told to accept their illness.
If they do, and it doesn't work, they're told to accept their illness.
(The histories of hypochondria and homeopathy are interesting here because of the ways in which they co-evolved with the clinic, and positioned medically invisible illnesses as consequences of lifestyle and morality.) https://twitter.com/alexhaagaard/status/1288472889013010433
I think another benefit of conceptualizing in/visible disability in relation to the medical gaze is that medical visibility it's not inherent to any particular embodied state.
It's contingent on whether clinicians are inclined to see the materiality of your disability, which is in turn contingent (in very complex ways) upon medical racism, misogyny, etc.
And it also has to do with preserving medical power.
Because I found the exact physiological site of my narcolepsy.
But because I was the one who found it, the effectiveness of my self-treatment is taken as evidence that it was never real to begin with.
Because I found the exact physiological site of my narcolepsy.
But because I was the one who found it, the effectiveness of my self-treatment is taken as evidence that it was never real to begin with.
("Real" being somatic, under the medical gaze.)
And what this reveals is that medicine doesn't actually treat illness. It corrects bodyminds that it deems abnormal.
What about infectious disease, though?
That's the trump card of modern clinical medicine, right?
Modern clinical medicine gave us antibiotics and vaccines.
That's the trump card of modern clinical medicine, right?
Modern clinical medicine gave us antibiotics and vaccines.
But this is the exception that proves the rule. (I've always had a hard time wrapping my mind around this idiom but, well, I get it now.)
Because think about how doctors respond to patients who show up at urgent care with a nasty sore throat asking for antibiotics.
Because think about how doctors respond to patients who show up at urgent care with a nasty sore throat asking for antibiotics.
Under the clinical gaze, the relevant problem isn't the sore throat, it's the bacteria that have taken up residence in the sore throat.
And if there's no bacteria, what's the prescription? A cup of tea, rest, and acceptance. Lifestyle and willpower/morality.
And if there's no bacteria, what's the prescription? A cup of tea, rest, and acceptance. Lifestyle and willpower/morality.
Anyway, that's where my thinking is at on this right now.
Tl;dr it's essential to recognize how medical in/visibility has given rise to distinct histories and constructions of disability and illness, in order to understand the particular experiences and oppressions associated with each.
Some good reading - will add more as I find more:
"Incurable and Intolerable" by Jason Szabo
"The Birth of the Clinic" by Michel Foucault
"A Condition of Doubt" by Catherine Belling
"Medicine In Society" edited by Andrew Wear
"Patients and Practitioners" edited by Roy Porter
"Incurable and Intolerable" by Jason Szabo
"The Birth of the Clinic" by Michel Foucault
"A Condition of Doubt" by Catherine Belling
"Medicine In Society" edited by Andrew Wear
"Patients and Practitioners" edited by Roy Porter
Addendum: The reason I feel it's ineffective to define in/visibility in terms of what the general public "sees" is because you end up with arguments like, "it's not that they can't see my disability, they choose not to."
Which is true.
Which is true.
But also erases the profound sense of invisibility that many folks experience - the sense that your own body and your perceptions of it are unreal.
And I think it's helpful to trace these experiences to the way that we learn to define our embodied experiences...
And I think it's helpful to trace these experiences to the way that we learn to define our embodied experiences...
...as "real" or "unreal" based on how and what is accounted by the medical gaze.
Medical in/visibility won't resonate for everyone as part of their identity, and that's okay.
Medical in/visibility won't resonate for everyone as part of their identity, and that's okay.
It's one way of putting language to an historical and experiential distinction that often gets erased within disability spaces, by connecting it to the ways in which the clinic operates as a site of oppression and regulation.
Medical vs. literal invisibility: https://twitter.com/alexhaagaard/status/1289967893199781889
Framing of medically invisible ("essential") symptomatologies as psychosomatic: https://twitter.com/alexhaagaard/status/1290374405026131969
