001 The making of a modern death

I’ve just started my M.Litt dissertation.  My supervisor suggested the practice of writing something every day, something akin to a journal entry rather than a formal academic piece.

I have neither the time nor energy to write every day, but I will when I get the chance and I suppose why not put it out here for the 7 people who read this to see it, critique and hopefully give me some feedback to make it better. 

The basic idea for the thesis goes something like this:

How does modern medicine’s domination of how we die form problems for the Christian tradition of Ars Moriendi

Here’s what I wrote today:

It is impossible to understand what a modern death looks like, or perhaps more accurately, how we have come to understand our own deaths, without first investigating how we got to where we are.

For thousands of years, a death without input from the physician was all anyone would expect. Even for those who paid for a doctor to attend the ill would not expect any intervention once it became clear that the patient was gravely ill. Medicine simply had very little to offer in terms of effective interventions. Leeches, blood letting and enemas were sometimes taken under duress but no one expected leeches to deal with a gangrenous foot the way a modern surgeon might.

There was usually more snake oil and quackery than there were life saving interventions.

Even socially, the doctor was not the highly respected pillar of society that he is today. While the doctor may have made an income, the doctor rarely ascended the classes or commanded the respect of the nobility. Too much time covered in the blood excrement of the poor and the dying tended to keep one excluded from the more exclusive social circles.

But the late 19th and early 20th century saw a remarkable change in the societal position and role of the physician. Foucault in the Birth of the Clinic charts the story of medicine and its attachment to the new science. Perhaps this is best exemplified by the white coat. The white coat was worn first by the laboratory scientist, not the physician. The scientist was trained in empiricism and hypotheses and experimental design. The physician was trained in the somewhat nebulous art of clinical examination and heuristics passed down from former generations.

By donning the white coat, physicians allied themselves to the new science. They committed themselves to hypothesising and testing. The great discoveries of the new science would soon be intimately linked to the physician. As the mythic function of the scientist grew (along with some actual world changing real world discoveries) so did the mythic function of the physician.

Alexander Flemming was one of the physician/scientists. His lab work, and almost accidental discovery of what became penicillin undoubtedly saved millions of lives from overwhelming bacterial infection. He wore the white coat and his tireless lab work was translated into a huge public health improvement. This sealed the deal for the physician – here we  had tangible and incontrovertible proof that science is progressing human existent with the physician at the centre.

Christopher Barnaard was a South African surgeon, famous for performing the first heart transplant. He shot to instant fame and the lifestyle of movie stars and models that go with it. His face graced the cover of Time magazine long after the recipient of the first heart transplant had died. Just 18 days after the operation. The almost immediate (in terms of functional life) death of Louis Washkansky is seldom remembered in a decade where science and medicine seemed capable of anything. It was of course the same decade that the united states landed a man on the moon. Optimism was running high.


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