Samuel Beckett, in his partly-autobiographical novel, Murphy (1957), uses his narrator to describe a series of hospital encounters intended to uncover the medical condition underlying a cardiac complaint. Without success, he tells the reader, his "irrational heart" was "inspected, palpated, auscultated, percussed, radiographed and cardiographed" (3). Although Beckett would not have described Murphy as an illness narrative, he captures very accurately the dominant perspective on the history of the modern medical encounter. Murphy is subject to the objectifying gaze of medical professionals and their visual technologies while at the same time he is characterised as the "irrational" patient solely defined by his specific pathology. This positioning of medical authority and patient submission is precisely the totalizing relationship of the clinical gaze as determined by Foucault in The Birth of the Clinic. Foucault's conceptualization of a paradigm shift in Western medicine has been endorsed by studies of nineteenth- and twentieth-century clinical medicine, which describe a significant reorientation in the balance of power between patient and doctor around 1800 (Ackerknetcht; Fissell; Jewson) and the growing dominance of an 'object- oriented' medical cosmology. It is this construction of the medical encounter and the growing dominance of biomedicine that Foucault seeks to chronicle that scholars of illness narratives have long sought to overturn. In this scholarship patient narratives are neither irrational nor passive but instead actively and subjectively valuable stories of illness that give both meaning and context to the conditions of illness from the patient's perspective. While the methods by which such narratives might be analysed and interpreted have led to scholarly disagreement, Arthur Frank captured a consensus when he argued that "narratability means that events and lives are affirmed as being worth telling and thus worth living. Being narratable implies value and attributes reality" ("Why Study" 111). Despite its efforts to reassess, and indeed to respect and value the patient story, illness narrative scholarship has rarely sought to do so by rejecting the orthodoxy of Foucault's vision of the emergence of the clinical gaze that led originally to the dismissal of the patient perspective that it seeks to re-inscribe. Critics have, of course, followed Habermas in his judgement that Foucault's reading of the historical evolution of the modern hospital was overbearingly structural and lacking in specific example (Kennedy, Revising 9-10; Rylance, 256; Jones and Porter). However, there has been little attempt to consider whether those aspects of the clinical medical encounter that Foucault claimed had been rejected by the beginning of the nineteenth century did, in fact, disappear or whether they were maintained, and continue to be so, in illness narratives of varying type and form. The Birth of the Clinic argues that key to the emergence of the clinical gaze was the loss of a "visionary space" (Foucault x) which is evoked through a language both fantastical and myth-making, a language that both gave room for the imagination and privileges the imaginative, historicised metaphor as providing access to truths about medical encounters and illness. These are the "imaginary investments"
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