Health and Healing in America

This week, continue reading in Rutkow’s book, Chapters 2 and 3, and the printed essay from The Birth of the Clinic by Michel Foucault.

Click here to download my “Cliff Notes” (Ok, “Hangen Notes”) to the Foucault reading, to help you read your way through it. Also, this movie clip from the 1993 Harrison Ford film The Fugitive applies – I’ll be talking about it in my notes.

For Wednesday, we are not meeting in person. Please write a journal entry on Blackboard reflecting on Rutkow’s chapters and Foucault’s ideas by considering the discussion questions below (in about 500 words total, you don’t have to answer every question). I already know this is hard to read, so don’t use the journal to complain about its difficulty; rather, look on the positive side and see and celebrate what you CAN gain and learn from it.

How does your own hospital/clinical settings differ from the late 18th century “clinics” Foucault studied and the 19th century medical care that Rutkow describes?

At what point in your own medical/nursing training did you learn “the gaze” as Foucault describes it? This was probably an entirely unconscious process, and perhaps you have never had a chance to reflect on it. But think back: somewhere along the way, you learned to separate a patient from his/her disease and to establish, through trained observation (what Foucault calls “the medical gaze”), your authority over that disease by learning to recognize and name it.

In your own clinical settings, it’s your job to generate an explanation (verbal, or written in a chart using the SOAP formula) to communicate your findings 1) to other medical professionals and 2) also to the patient. How do those explanations and descriptions (what Foucault calls “discourses”) differ? How easy do you find it to “switch” between discourses?

I’m curious: do you think electronic medical records (which of course Foucalt had no experience with) are an entirely new system of medical explanation, or are they just a digital version of the modern explanatory systems we already have?

On that same note, do you find that today’s technological interface that comes between you and the patient (electronic monitors, thermometers, even gloves) helps or hinders your trained ability to “discover” the disease? What are some ways that 21st century clinical technologies are an advantage and/or a disadvantage in diagnosing and treating patients? In other words, how has technology altered “the gaze” (and therefore, medical thought/discourse itself)?