Review: The Birth of the Clinic: An Archaeology of Medical Perception

The Birth of the Clinic: An Archaeology of Medical Perception by Michel Foucault
My rating: 4 of 5 stars

I see The Birth of the Clinic by Michel Foucault, here ably and even passionately translated by A.M. Sheridan Smith, is part of the World of Man: A Library of Theory and Research in the Human Sciences, series edited by R. D. Laing. I’d like to find a complete list of this Library, somewhere.

The 18th century development medicine as a practice in French and European history is the declared content here, with noted French personages and the disruptions of The French Revolution. However, what is striking and moving is the subtext, a reverential, mystical, even fetishistic exploration of the doctor’s inspection and interview, here translated as the medical ‘gaze’. From the Preface, “This book is about space, about language, and about death; it is about the act of seeing, the gaze.” And later, “The observing gaze refrains from intervening: it is silent and gestureless. Observation leaves things as they are; there is nothing hidden to it in what is given.” Then at length, “The clinical gaze is a gaze that burns things to their furthest truth. The attention with which it observes and the movement by which it states are in the last resort taken up again in this paradoxical act of consuming. The reality, whose language it spontaneously reads in order to restore it as it is, is not as adequate to itself as might be supposed: its truth is given in a decomposition that is much more than a reading since it involves the freeing of an implicit structure. … The clinical gaze is not that of an intellectual eye that is able to perceive the unalterable purity of essences beneath phenomena. It is a gaze of the concrete sensibility, a gaze that travels from body to body, and whose trajectory is situated in the space of sensible manifestation. For the clinic, all truth is sensible truth; `theory falls silent or almost always vanishes at the patient's bed-side to be replaced by observation and experience; for on what are observation and experience based if not on the relation of our senses? And where would they be without these faithful guides?”

There are several other phrases that are striking and evocative, conjured by Smith from Foucault’s French. I would love to hear a Nick Cave album inspired by these thoughts:

• “The artisanal skill of the brain-breaker”
• “the didactic totality of an ideal experience”
• “sympathy preserves the fundamental form by ranging over time and space; causality dissociates the simultaneities and intersections in order to maintain the essential purities.”
• “…the perception of death in life does not have the same function in the nineteenth century as at the Renaissance. Then it carried with it reductive significations: differences of fate, for tune, conditions were effaced by its universal gesture; it drew each irrevocably to all; the dances of skeletons depicted, on the underside of life, a sort of egalitarian saturnalia; death unfailingly compensated for fortune. Now, on the contrary, it is constitutive of singularity; it is in that perception of death that the individual finds himself, escaping from a monotonous, average life; in the slow, half subterranean, but already visible approach of death, the dull, common life becomes an individuality at last; a black border isolates it and gives it the style of its own truth. Hence the importance of the Morbid. The macabre implied a homogeneous perception of death, once its threshold had been crossed. The morbid authorizes a subtle perception of the way in which life finds in death its most differentiated figure.”
• Etc.

This makes poetic and reverential the import of “The doctor will ‘see’ you now.”

View all my reviews