Following the latest New Generations workshop in Durham University’s Institute of Advanced Studies (IAS) on September 25th 2014, New Generations Programme member Claude writes:

Building bridges over the river Wear
by Claude Jousselin

Bridge over the river WearA week after the CMH New Generation workshop took place in Durham (where the river Wear flows), I am still revisiting the conversations that took place in the great surroundings of the Institute of Advanced Studies. Revisiting or am I revisited? In conversation in my department, keywords keep popping up, triggered from different contexts: space, humility, trust, inclusivity and of course interdisciplinary, the topic of the workshop. My experience of remembering/recollecting during this last week takes me back to one of the strong moment of the workshop.

On the morning of the second day, the New Generation cohort attempted to visualise and map what Medical Humanities and its knowledge production may look like, by using felt pens and cards. Inspired by the plan of St Gall, a 9th century parchment depicting “the ideal” monastery that was most likely used as meditation tool, Mary Robson encouraged us to draw and see our thinking unfold. The outcome was as diverse as the discipline represented in the workshop, some more artistic than others, yet amongst the various metaphors, there seem to be a common representation of a Medical Humanities as a dynamic and evolving system. What an optimistic vision worth pursuing!

But I run ahead of myself. The first day of the workshop was full of discussions and debates, exploring the role of interdisciplinary engagement in the making of Medical Humanities. More than multi-disciplinary, interdisciplinary research requires an open engagement with the knowledge of others, willingness to learn and see the world differently. I have to confess that the practicalities of such endeavour seem daunting to me, as the obstacles were enumerated; funding frameworks, disciplinary traditions and stereotypes, hierarchical structures etc. As a PhD student, I found at times that it was easier to reflect on the notions of interdisciplinary being discussed through my own experience of collaboration, albeit limited. Conducting a PhD research project we are often told is on one hand a solitary and lonely endeavour and on the other a rare opportunity to choose a research topic and follow the process to conclusion. In other words autonomy, independence and singularity seem to feature prominently in this representation of a PhD as a training exercise. My own attempt at bridging across disciplines, from Social Anthropology towards Psychiatry was made more complicated as I also opened another bridge towards a patient organisation.

In a little book called “L’art des ponts; Homo pontifex” , Michel Serres pays homage to bridges for the way they connect humans with one another, materially and metaphorically. Within his poetic and often passionate depiction of bridges made of stones, steel or words, he gives us also a strong advocacy for reaching out towards knowledge on the other side, out of the comfort zone.

“Have the courage to build bridges across the widest cultural gaps. No words, in any dictionary, can translate exactly words of your own language, their semantic domains do not match. You will need to stutter in another language…To eat, sleep, walk, communicate, these elementary acts require the effort of throwing yourself on the other side. Keep your bank behind you; it can support you, you can rest on it; but turn your front, sex, belly and face towards the other bank, throw your arch in the exchange. Otherwise you will learn nothing. Amaze yourself, not of the difference, as we did in the past, but of your own affiliation and belonging. “(Serres, 2006:123 my tentative translation)

Michel Serres’s academic career has been located between disciplines, of philosophy, of science, and of literature, not quite settling in any of those solely, but moving across (Serres, 2014). He tells us that just as there are tolls to all bridges, a price to pay for crossing over, there are costs and risks in reaching out to others too.

In my recent fieldwork, moving between psychiatric institution and patient organisation, I found myself sometimes in difficult situation. On one hand I risked being recruited in by a discipline, psychiatry, that historically as links with anthropology ((Kleinman, 1995; Skultans, 2007) and whose research’s practices are based on collaboration. On the other, it was particularly challenging to define how collaboration may be done with a patient organisation. What kind of knowledge exchange could take place, when experiential knowledge of a disorder , something I could not claim to have, was at the core of their concerns (For further details see Jousselin, 2013).

Martyn Evans’s provocation on our first day at Durham spoke to this concern directly. If a discipline consists of the following elements, knowledge, skills, attitude, expertise, experience and community, can patienthood be a discipline? Provocation indeed, as what came to my mind was the use of the term “professional patient” in past decades, which took a pejorative turn in psychiatry, describing someone feigning illnesses for dishonest purposes, i.e. malingerers. But beyond this provocation was an important question, how can patients’ knowledge help shape medicine? Does this knowledge need to be translated into disciplinary terms in order for learning to take place?

My regular contact with support groups during fieldwork in the UK tells me that there is already some translations taking place; the people I met often had to translate medical concepts into their everyday lives. The members of the groups were interested (amongst other things) in the practical aspect of drug treatments, how to best take the medicine, how to spread the dosage throughout the day, if you are working or when you are at home, in order to maximise the positive effect and minimise side effects. Neither the conversation with their doctor, nor the written pharmaceutical information could tell them that. Indeed some of the support groups build databases, archives of their experience for their own use and reference, which they used alongside the knowledge from medical textbooks. That this patient’s knowledge is heterogeneous, tangled, local and never complete, is also what makes it practical and applicable for the people concerned.

Paying attention to the pragmatic knowledge of patient can be helpful to clinical practices (see Mol, 2003; Pols, 2011 amongst others). But is it applicable to academic research? How can this patient knowledge engage in a dialogue with academia, how does it cross the bridges without paying too much of a cost, without being disciplined, as it were? If its complexity is its strength, then it also poses challenges of translation. This, I hope to explore further during my participation in the New Generation training program and I look forward to be inspired by the varied disciplines involved and their world views.

References

Jousselin. (2013). Shifting collaboration: diplomatic skills in the field. Goldsmiths Anthropological Research Papers, 18(1), 38–53.

Kleinman, A. (1995). Writing at the margin : discourse between anthropology and medicine. Berkeley ; London: University of California Press.

Mol, A. (2003). The body multiple : ontology in medical practice. Durham, N.C. ; London: Duke University Press.

Pols, J. (2011). Breathtaking practicalities: a politics of embodied patient positions. Scandinavian Journal of Disability Research, 13(3), 189–206.

Serres, M. (2006). L’art des ponts: homo pontifex. Pommier.

Serres, M. (2014). Pantopie: de Hermès à Petite Poucette. Paris: Éditions Le pommier.

Skultans, V. (2007). Empathy and healing : essays in medical and narrative anthropology. New York: Berghahn Books.


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