If there is one thing that frustrates me about my medical encounters, it is the medical professional’s narrow focus on the body’s workings. While I can appreciate the insistence on tissues, blood, muscles, nerves, I also find there is something essential missing from this equation: the self. As Micheline Louis-Courvoisier (2003) has observed, those of us who work with patient letters do not ‘work on bodies’; rather, we work with individuals, ‘selves’ who suffer, selves who bleed, selves who swell up, selves who experience pain, love, passion, fear, anger, selves who weep, laugh and sigh.
For these selves, the body is simultaneously a canvas that reflects a performed identity and a stage that performs identity for them. Bodies do not always comply with norms, as Judith Butler has argued. Nor do they always comply with individual understandings of self. Bodies, in this sense, have agency all of their own and as a result, selves and identities are produced by bodily experiences. Our understandings of the body may be socially constructed, but the fact remains, as Simone de Beauvoir has argued that our bodies remain the “instrument of our grasp upon the world” (Second Sex, trans. Parshley, 34). Thus while we may be fully aware that our bodies are racialized by social constructs, for example, we are corporeal entities who must navigate the embodied reality of racialized skin, racialized hair, racialized bodies…
The suffering body performs its troubles, its malady, its malaise on a public, political, historical stage that is already overdetermined. While its meanings shift depending on the historical, political, social, cultural moment, it remains an abject space that continually troubles the illusion of health. In today’s cultural climate, the obese body acts as a marker for negative moral qualities: slovenliness, laziness, lack of self control. The obese body produces a similarly obese self. The maternal body, meanwhile, is an intensely public space upon which are imprinted socially and culturally sanctioned ideals of motherhood: self-effacement, sacrifice, beneficence and generosity. In the eighteenth century, we might look to the bodily outcomes of sexually transmitted disease. The fluid nature of these bodies that did not conform to normative bodily ideals revealed moral qualities such as: lack of control, immoderate behaviour, and intriguingly, effeminacy… and we might consider, too, the emergence of maternal breastfeeding as the key performative achievement of good motherhood. The lactating breast, in this sense, produced maternal identity and profoundly shaped maternal selves.
Where, in a suffering body, might subjectivity be located? How does suffering, in itself, shape notions of identity and self? How does the suffering body produce the subject? And in each particular historical, social or political moment, what might that mean for the sufferer?