After you have read "Spaces and Classes," the first chapter from Michel Foucault's book The Birth of the Clinic, comment here. As always, you can comment with an idea you had while reading, an explanation that helps us better understand the text, or a continuation of the conversation started by another student.
If you can't think of what to comment, return to the details from the reading that stood out for you, then do some writing about them to find your ideas. (Then do some re-writing to craft a comment.)
A detail that caught my attention was the author's comment on page 15 about hospitals: "This is not medicine; the same is true of hospital practice, which kills the capacity for observation" (Foucault). This statement was actually somewhat humorous for me because it made me remember the current medical system and changes to it due to the health reform. More recently doctors are required to see a certain number of patients a day, and in order to do so many of them have to shorten the time they spend with each patient. This is especially seen in hospital settings, but it can vary based on doctor specialties and hospital organization. It can be intuitive to think that the less time spent with each patient causes doctor appointments to be less effective, but again this can vary.
ReplyDeleteI also thought it was interesting that Foucault believed the sick should stay at home around family where they originally fell ill, as opposed to being isolated away in a hospital. He also describes the hospital setting as an "unkempt garden" and "temples of death" which "alter the nature of the disease and makes it more difficult to decipher" (Foucault 17). It created a visual in my mind of tiny microbes following doctors from room to room, infecting and complicating the diseases of the patients. As much as hospitals try to prevent the spread of infection and disease, it is not uncommon for this to happen.
Foucault, Michel. "The Birth of the Clinic: An Archaeology of Medical Perception." New York: Vintage, 1994. Print.
Similar to what Nessa mentioned, I also found it interesting that Foccault believed the sick should stay at home and around the family. Foccault argues that a hospital is a breeding ground for diseases yet fails to acknowledge that a sick man confined to his home will likely infect his family in just the same way (18). If a man does not receive treatment for his ailment then he will likely pass it on to those that surround him. A hospital on the other hand, can cure the sick and stop the spread of the disease when the individual returns to his/her everyday life. Foccault’s idea that a sick man “in a hospital is double burden for society” is also flawed (18). The sooner a sick man gets better, the sooner he can work again and provide for his family, thus avoiding the “poverty and disease” that Foccault argues a family is subject to with a hospitalized man (18). Foccault’s alternative seems to be the implementation of private doctors that visit the home, however, I believe that this idea is rather idealistic. I was generally unconvinced by Foccault’s arguments but nevertheless found his perspectives interesting to entertain.
ReplyDeleteFoucault argues that there are three ways in which we spatialize disease. The first is through the ‘medical glance’. Disease is removed from the body and looked at separately without attachments. The second way in which we spatialize disease is by looking at the patient and the disease together. The disease develops through the patient and can move from organ to organ depending on the physiology of the patient. I personally found the third way of spatialization to be more interesting. This spatialization of disease is the way disease is bound into, and distributed from centers designed for the benefit of the sick, or hospitals. Before civilization developed into a tightly knit web, life was simpler and disease mirrored that. But since, society has come together and folded into itself as disease has, becoming more complex and difficult to map. Foucault argues that the hospital is the artificial distribution and origin of disease. It is the place where diseases entwine running the risk of losing its identity. “Contact with other diseases, in this unkempt garden where the species cross-breed, alters the proper nature of disease and makes it more difficult to decipher.” Foucault argues that rather than the institution of the hospital, that home care should be the norm for society. Disease becomes more difficult to record when artificial disease are embodied into the patient, and a “free spatialization for disease, with no privileged region,” would allow the disease to exist as itself.
ReplyDeleteOne of the details that I found interesting in Foucalt's argument was his opinion on the relationship between life and the nature of disease. He states that the rationality of life is identical with the rationality of disease (that which threatens life), and that they do not counteract each other but rather fit into one another. An other hand, he believes that it is the internal structure of a patient and the level of knowledge of a doctor regarding a specific disease that is considered counter-nature. Factors such as temperature and age of the patient, as well as lack of precise understanding of the nature of the disease create disturbances in identifying a disease and attempting to cure it.
ReplyDeleteI also thought that Foucalt's logic in "spacing" diseases was interesting. "The distance that separates one disease from another can be measured only by the degree of their resemblance, without reference to the logical temporal divergence of genealogy" (6). This view almost completely apposes today's understanding of the origin of diseases which is mostly based on evolution and divergence of viruses, bacteria, etc. Foucalt's opinion concerning the similarities of diseases leads to his steps for prognosis of a disease. He believes that a doctor should wait until a disease has developed until he can identify it. However, today's doctors try to make a prognosis as soon as possible and start treatment, unless it is proven to be necessary to wait for the disease to enter its more serious stages.
I agree with Foucault when he gives the example of an Asclepius dividing his patients into groups and dealing out the prescriptions because there are just too many of them to interact with personally. This reminded me of how I came to the doctor's office one time to get a prescription for a stronger cold medicine and the doctor told me I had allergies and prescribed Zyrtec. The truth is that doctors are so overwhelmed with patients that they just don't have the time to sit down to consult with a patient for an extended period of time. Maybe in the future, a new model of healthcare can be proposed, for example, personalized medicine. But as for now, the reality is that patients can often get the wrong diagnosis because the doctor does not have sufficient time to review everything about the patient's background/environment to make the right diagnosis.
ReplyDeleteI was interested in knowing what you meant by "personalized medicine", unless you meant it to mean a type of care in which the doctor spends more time with the patient in the exam room. If so, I do not think spending more time with patients would necessarily improve the care they are receiving. What makes medicine difficult to practice can sometimes be that patients are not giving all the information a doctor needs to know, either because they forget aspects of their medical history or are hesitant to mention personal information. It is difficult for doctors to get patient information when there still is not an efficient system for passing information from hospital to hospital, from clinic to clinic, etc. Without this information at the time of the appointment, I can see how it is more efficient to cut the current appointment short and ask the patient to come back at another time.
DeleteWhy did Foucault titled this first chapter "Spaces and Classes"? As I read though the chapter, I found it interesting how Foucault first talked about the space of configuration of diseases and localization of the illness and the space in your body and diseas. As I continue reading, I like how I could have a image in my head about how a disease could be mapped out in your body and also picturing how it develop and begin to think about my family tree and trying to figure out the roots of the disease. I agree with Foucault knowledge about diseases and his logical though about the society in the 18tth century. The connections he makes though out this chapter fascinates me, I do agree that the hospitals are not always the best place to go because of all of the ill people you are surrounded by making you question was is the purpose of going to the hospital. Also the questioning about what is a good medicine that actually works for you?
ReplyDeleteMegan hit the nail on the head, I wish Foucault would have stated it as simply, perhaps something was lost in the translation from French.
ReplyDeleteIn reading "spaces and classes" I find the text difficult to absorb. The analogies used by Foucault in the first few pages seem to deal with analogies based on other disciplines but the purpose of these analogies isn't to enlighten non-medical experts by using a familiar analogy. It seems the more i read of this text the more i have to go back and reread previous sections of the passage. Some arguments seem nearly verbatim to those made a page or two before, and it is obvious the goal of this writing is not to inform or provide a history.. Foucault's writing is definitely thought-provoking, though it mainly made me think about how much I wanted to eat a sandwich or go ride a bike instead of reading through cluttered quotes which open arguments and frustrate the reader (at least me) into losing interest in Foucault's message.
In reading "Spaces and Classes", I thought that one of the ideas brought up towards the end of the article was most interesting. The author mentions that "Assistance should be related neither to productive wealth (capital), nor to the wealth principle that produced (profits, which are always capitalizable), but to the very principle that produces wealth: work." I thought this idea was very straightforward and is much more direct than most takes on health care. Usually when talking about healthcare this is caution in try and make everyone happy and not offend anyone. I felt that not only the author's idea but the sentence structure in which he presented it made his opinion clear and direct to the audience.
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