The Birth of the Clinic

Upon Further Consideration: This work stresses the political economy less than 'Birth of the Prison'. One chapter does mention post-Revoultionary France's justification for caring for the impoverished as experimental work to prevent the diseases of the elite but the implications are not stressed and are not part of the primary conclusion of the book. This work is smart in its hint at the occult/spiritual and secretive aspects of medicine (and the French Revolution?): doctors as 'body priests' and 'genii' working with societal 'chains', and the revelation that modern medicine (and modern society) changed when the taboo of mutilating corpses was finally lifted. (Fast-forward 200 years to today's for-profit 'organ farms'.) Enter the 21st century Culture of Death and the land of the Lynchian living-dead where we are all forever exposed to the new Sacrament of the Ghoulish Gaze (taught in every medical school, hyped by National Geographic and now automated by HIPAA with threat of penalty). We are all subjects of the clinician-priests and the clinical society, that in its rather promethean and insipid lust for tabulation, information and the secrets of death (vs. the Hellenistic lust for perfected life) has created a giant, cultural sarcophagus: a perverse microscopial entombment that further and further distracts from the work of life. Foucault's brilliance is in opening doors and leaving them open.

Foucault has been interpreted in the US as a pretentious standard-bearer of postmodernism - as an almost "evil" figure who threatens to undermine the foundations of Western knowledge with his problematisation of conceptual categories. It doesn't help that his work has been taken up to justify just about any subversive perspective, whether well-conceived or not. This is only a pitifully small perspective on the man and his work. Foucault should be seen first as a historian, not a philosopher; second, his work should be lauded for the contribution it makes to Western knowledge rather than the superficial "threats" it makes to perspectives whose time has come in any event. Every revolution of perception has been accompanied by vociferous resistance, yet a great many of those sounding their disapproval loudly probably don't really understand what the late Michel was really on to.The Birth of the Clinic, MF's most accessible work, is a well-researched, brilliantly interpreted account of the development of the clinical "gaze" in the wake of modern medical knowledge and practice. Foucault problematises the institution of the clinic, showing how clinical perception is the result of a historically specific constellation of knowledge and power. His ultimately emancipatory analysis is substantiated every step of the way with textual and historical examples. No metaphysics here, just a radical questioning of the nature of knowledge within institutional practice.So, sorry (Objectivists!) if this is too much to handle. It's good research, plain and simple. Don't dismiss Foucault as a lightweight postmodernist - try to see him where he would situate himself, in the tradition of reflexive historical sociology.

" The birth of the Clinic " is an attempt by the philosopher and the learned historian to decipher the secret of medical perception. Only when the chaotic and subjective clinical experience is transcended to the objective language, we have the medicine as a scientific subject as today. As a physician myself , I think understanding " clinical gaze " helps me to define the place of modern medicine, of doctors and patients and of medical organisation in this fast changing world.

In this short book that forms a worthy companion to his classic "Madness and Civilisation," Michel Foucault first traces the history of medical care from the days when people were usually treated at home by their families, to the early nineteenth century, when public health became a political issue. The outcome of this process was the "clinic," which Foucault defines a field of confinement where those labelled ill, the Other, were monitored and treated to further the reciprocally-linked goals of the health of society and the furtherance of medical knowledge. Foucault's well-documented narrative concerning the evolving socio-political perception of health and medicine, however, pales in erudition and philosophical significance when compared to the primary thrust of the book ; namely, in detailing how the medical profession ordered and analyzed not only disease, but later the human experience itself. Both seeming to have pushed back the finality ! of death through conjoining to it to the experience of life, and isolating disease not as a phenomenon in itself, but like life and death, simply as a discursive manifestation of visible and invisible symptoms, the medical profession acquired for itself the mantle of positivism that is still basically unquestioned by the public even today.

This book examines our cultural tendency to elevate the authority of the physician. It introduces the concept of the clinical gaze and describes the way the myth of this gaze was developed in the early Enlightenment atmosphere and fostered the birth of the clinic. A detailed online summary by Lois Shawver, with excerpts and page numbers, can be found through some of the standard search engines.