Patients’ images and doctors’ images; Film a s a new way of portraying patients
A central aspect of the films we are discussing in this project is that they show patients, or part of patients. Sometimes when performing a test, helping, so to speak, a doctor to make a point. One aspect that is worth discussing is the new portrayals of psychiatric and neurologic patients film made possible.
Yet, the word “portrayal” might be misleading, as it focusses on the author of the film, who wants to convey a certain image. As will hopefully become clear throughout these posts, I do not view the “portrayal” of patients in early neurological films as static. One of the unique qualities of film is that is also shows or “captures” the patient’s reaction to this portrayal. In this, even if films are also edited and cut and no “mere representations”, they differ significantly from the classical written case history.
Yet, a crucial difference is that the camera allows the patient to look back. Not less technological or artificial (where and how you place the camera undoubtedly changes how we see what is shown) than a photograph of written account, film might possess a quality other ways of documenting miss. First, it shows the patient “in motion”: they are not showed in a fixed moment anymore. Second, what is shown cannot be entirely controlled. Yes – the camera can be placed in a certain angle, and work for a set number of minutes, but how you exactly look when you are being filmed – is that something that can be entirely controlled?
In a compilation of short medical films from 1925, titled “Tests of vestibular function”, for example, we see various tests patients are asked to perform. Both the patient and doctor are dressed neatly in a suit – the doctor’s one is a clear grey. (Interestingly, in some clips when a nurse enters, she wears the distinct “white coat”.) Other features are distinguishing the patient from the doctor are the fact that the patient is sitting in a chair, whilst the doctor is preparing them for the experiment, such as putting the patient’s arms in a certain position, closing their eyes, etc. The doctor moves around; the patient has to sit still or perform in a particular way.
In one of the clips, titled “Falling test” (from [15.03] in the clip)., a patient is being turn around and round by the doctor. At the end of this – no doubt very dizzying – exercise, when the chair is put to stillness and the patient opens his eyes, he almost imperceptibly frowns and seems to sigh from relief. Now, whereas this might seem a straightforward and “normal” reaction (“Of course you’re relieved if someone is not turning your chair around with your eyes closed!”), these few seconds underline an important aspect of early twentieth-century patient films I would like to explore further. They show how patient and doctor interact and react to each other, including those reactions that both the patient and practitioner might initially not want to show. However, some differences between both are crucial (the patient is carefully set up and prepared, the doctor can walk around, etc.).
Another example is a footage wherein German neurologist Kurt Goldstein (1878-1965) makes one of his patients perform a range of tasks. The patient, whom I will refer to as “the man with the moustache”, as I have no other identification of him, is, just as the patient of the first clip, sitting in a chair. Goldstein (white coat, bald scalp), makes him carry out various tasks. The patient is put “to the forefront”, Goldstein appears with utensils, but is careful to not walk in front of the patient.
During the last experiment of the footage, the man with the moustache needs to put his hand up, next to a kind of wooden stick several times. Here, no doctor can be seen, at least not visibly: the medical authority remains present through the set-up and carrying out of the experiment. This raises interesting questions with regard how the authorship and authority of medical expertise are “made visible”. In the Goldstein clip, it is through the set-up. In the “Falling test” discussed earlier, we can actually see the doctor – since he needs to be part of the experiment. How does this influence and possibly reframe the doctor-patient interaction? How can we still “see” the doctor’s presence on the film even without him physically being present in the image? And what can be said about the different ways in which the patient is portrayed, and acts in front of the camera?
In their thoughtful and thorough analysis of the Danish film Häxan (1921), anthropologists Richard Baxstrom and Todd Meyers write how film might be seen as a unique way to combine several elements and then brings them to life. They take the film they analyse as both an anthropological and cinematic object (2016:7). Filming and depicting witches – as the movie Häxan does – leads to a paradox, according to Baxstrom and Meyers: “Any claim to knowing the witch implies being caught by her; any claim to objectivity in the face of the witch requires her disavowal as a “real” entity” (ibid.).
Can a similar claim be made about how neurological and psychiatric patients are shown and portrayed in early twentieth century films? This will be a question I aim to explore by discussing various of these movies. How can we view film as a new way of documenting the patient-doctor relationship, and how does film reframe the patient allows a reframing of the patient’s image, including what the patient can “do” with film?
In Le pouvoir psychiatrique (Psychiatric power), French philosopher Michel Foucault writes how the birth of the neurological body means a changing diagnostic practice; instead of being the only one in charge, the medical practitioner now also depends on the patient’s willingness to participate in the experiment (Foucault 2003). Foucault does not address film as a technique in these lectures, but this question is indeed important to explore; what role can the patient play in early neurological films?
Readings
Baxstrom, Richard & Todd Meyers
2016 Realizing the Witch: Science, Cinema, and the Mastery of the Invisible. New York: Fordham University Press (Forms of Living Series).
Foucault, Michel
2003 Le pouvoir psychiatrique. Cours au collège de France. 1973-1974. Paris : Gallimard/Seuil (Hautes Etudes).
Films :
Wellcome collection. Test of vestibular function. https://wellcomelibrary.org/item/b1669157x#?c=0&m=0&s=0&cv=0
Goldstein footage (not sure how to cite this)