Seeing, Knowing, Doubting: The “Expert” Gaze

Man and things. – Why does man not see things? He is himself                                                                                                   standing in the way: he conceals things. (Nietzsche, Daybreak, §438)

When exploring how the brain was “made” visible, what techniques were used and how these were justified, one quickly finds oneself wondering about another question: For whom where those images made?

The blog post on Marey and Comandon shows that film was by no means an uncontested method; in fact, it was highly controversial from the very beginning. Whereas one might start thinking that film made the process of data collection easier, by making recordable images that could be stored, reproduced, and distributed, for many scientists the issue was far more complex. The narrative and aesthetic aspects of film triggered a lot of discussion about the use of film, in particular about the validity of its use and the data it produced.

For example, medical doctor and historian with a specialisation in the neurosciences Geneviève Aubert (Université de Louvain, Belgium) locates the “birth” of cinema and cinematography in 1985, when the Lumière brothers held a first public viewing in Paris (Aubert 2002). Yet, this does not solve our question with regard to film as scientific method. Would Marey and Comandon accept 1895 as “birth” of cinema? Would Goldstein? How does film as “public” cinema relate to film as scientific practice?

When one wishes to analyse the birth of a certain “gaze”, one theorist is unavoidable. I am referring to French historian of ideas Michel Foucault (1926-1984), whose influential works have focussed on the history of ideas and the human sciences. Foucault’s work addresses a large variety of issues; a few famous books have focussed on the “birth” of madness, the medical sciences and sexuality.

In The Birth of the Clinic (La Naissance de la Clinique), which was published in French in 1963 and translated into English a decade later, Foucault focusses on the birth of the medical “gaze”. (The translation is complicated and contested, as the French “regard” could be both translated as “perception” as well as “gaze”. The 1973 translation works with “gaze”. Now, whereas a case could be made to dispute this translation, this blog does not seem to be the most appropriate context to do so, therefore I will refer to “gaze” too.)

In chapter seven, titled “Seeing and Knowing” (Voir, savoir), Foucault describes how perception became the most important assessment tool in medicine. This “perception” which is simultaneous to the birth of the medical “gaze”, which comprises both the act of seeing as well as the body of knowledge this practice consists of are traced back to the Hippocrates, the father of modern medicine. Yet, how medical perception was exercised in the early days of modern medicine (the 18th century), differed very much from how Hippocrates had conceptualised it. Whereas Hippocrates had indeed named observation as the most important technique, how it was reframed in the early eighteenth century clinic attached even more importance. Perception in modern medicine has far more advantages of a different nature:

They [the advantages] were at the same time the privileges of a pure gaze, prior to all intervention and faithful to the immediate, which it took up without modifying it, and those of a gaze equipped with a whole logical armature, which exorcised from the outset the naïvety of an unprepared empiricism. We must now describe the concrete exercise of such a perception. 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. (107)

Ce sont à la fois les privilèges d’un regard pur, antérieur à toute intervention, fidèle à l’immédiat qu’il reprend sans le modifier, qui exorcise d’entrée de jeu la naïveté d’un empirisme non préparé. […] Le regard qui observe se garde d’intervenir : il est muet et sans geste. L’observation laisse en place ; il n’y a rien pour elle de caché dans ce qui se donne. (153)

Medical perception and its exercise require an expert gaze, a trained eye; in fact, the clinician’s perception is so skilled it does not have to intervene or rely on questioning (“there is nothing hidden to it in what is given”). Foucault’s emphasis on the fact that this perception is silent and without gesture are important aspects of expert perception and its practice. The clinician’s expertise is expressed through a particular practice. This expertise is reinforced by the absence of discourse.

How the silent observer has marked our ideas of – reliable – expertise, both in a laboratorian setting as well as in the consultation room, is an interesting notion. How does the practice of expertise relate to other ways of behaving, talking, moving around? What does an expert have to do in order to establish the patient’s confidence? Conversely, this analysis opens up an interesting line of inquiry with regard to the practice of expertise and turning it into a highly respected and imported practice of medicine, neurology, and the contemporary neurosciences.


Aubert, Geneviève

2002 Arthur van Gehuchten takes neurology to the movies. Neurology, Volume 59 (10) 1612-1618

Foucault, Michel

1963 La naissance de la Clinique. Paris : PUF (Quadrige).

1976 The Birth of the Clinic. Trans. A. M. Sheridan. London: Tavistock.

Nietzsche, Friedrich

1997 [1881] Daybreak. Thoughts on the Prejudices of Morality. Trans. R. J. Hollingdale. Cambridge/New York/Melbourne/Cape Town: Cambridge University Press.