Sarah Yousri Ali is a Visiting PhD student in the Department of English at King’s College London. She works on affect theory and graphic medicine.
Ziad Elmarsafy teaches Comparative Literature in the Department of Languages, Literatures, and Cultures at King’s College London. A neophyte in Health Humanities, he is currently involved in a project unfolding at the intersection of psychoanalysis, racism, migration, and literature.
Patrick ffrench is Professor of French in the Department of Languages, Literatures and Cultures and is co-Director of the Centre of Humanities and Health.
Alice Hazard is a Teaching Fellow in Medieval French Studies in the Department of Languages, Literatures and Cultures. Her research in Medieval French literature features an exploration of the face as a mediating surface. Her book The Face and Faciality in Medieval French Literature was published by Boydell & Brewer in May 2021.
Tareq Layka is a dentist with a deep interest in Global Health and Peacebuilding. He is passionate about the intersectionality of health with other fields, such as politics and humanities, especially through clinical lenses. He is studying MSc in Global Health, Social Justice and Public Policy at King's College London.
Flora Smyth-Zahra is a restorative dentist, graduate in English Literature, founder and lead of Clinical Humanities at King's Faculty of Dentistry, Oral and Craniofacial Sciences.
Neil Vickers is Professor of English Literature and the Health Humanities and co-director of the Centre for the Humanities and Health. He joined the department in 2005 as Lecturer in Literature and Medicine, having previously had a career in epidemiology and public health.
James Wishart is a Teaching Fellow in French in the Department of Languages, Literatures and Cultures at King’s College London where he specialises in post-war French poetry and intellectual history.
A number of texts had been selected as a basis for the discussion. These included a short piece titled ‘Mouth’ by the heterodox French writer (philosopher, novelist) Georges Bataille, an essay by the post-war French psychoanalyst Pierre Fédida ‘Where does the human body begin?’ which itself drew on Bataille’s piece, a section from Sigmund Freud’s The Interpretation of Dreams (the analysis of the specimen dream, otherwise known as the dream of Irma’s injection), and an excerpt from French philosopher Jean Baudrillard’s Consumer Society titled ‘The Pathos of the Smile’.
The discussion ranged widely, and brought a number of themes or tensions into focus, which I have tried to summarise broadly below under different ‘topic’ headings.
The Dynamics of Care
Bataille’s provocative text starts with a contrast between the mouth as the ‘prow’ of animals and the ‘recession’ of the mouth in the course of human evolution. He emphasises how, despite the evolution of the human head such that the protuberance of the jaw recedes to make the eyes (and forehead?) the most prominent part and the focus of cogitation, the mouth can still be the location of screams and of extreme pain. We noted Bataille’s Baconesque image of the mouth as a kind of extension of the spinal cord in these experiences. Bataille superimposes on the contemporary image of human physiology a ‘primitive’ and animal image, which Fédida describes with the term ‘regression’. In the light of this emphasis on the mouth as the organ of potential pain and screams we discussed the dynamics of care between the carer and the afflicted person, Neil Vickers’ introduction in which he mentioned his interest in the ‘weirdness’ of the responses of able bodied and healthy others to afflicted persons. On the one hand the carer is engaged in empathy with the suffering other; on the other hand the fact that our sympathetic nervous system which controls the fight-flight reflex is on permanent standby means there is an impulse to flee from it, to distance it. So caring, and empathetic response to the pain and suffering of the other appear ‘strange’ in this light. We discussed the role of the vagus nerve in ‘smoothing out’ and amplifying the potential for conflict and antagonism between persons by delivering signals of safety. We discussed abjectness within the context of clinical education and professional identity formation of future dentists and doctors. The ethos of care appears in this light as the capacity to bear or withstand the pain of the other.
Intimacy and the Person
While Bataille mentions the ‘formlessness’ of the mouth, and Fédida argues that the mouth is where the ‘person’ disappears, we discussed how in the practice of dentistry the mouths and teeth of individual patients can be recognisable (and the teeth are often the last resort for identification in forensic dentistry). So we noted a tension between the theoretical, aesthetic and psychoanalytic perspectives, which moved away from ‘the person’ and those of the carer, which move towards it. Moreover, unlike a surgeon or doctor dealing with a foot injury, for example, a dentist is ‘inside the head’ of the patient, in a very intimate way (we also discussed the differences between the face and the head, and the mouth and the head). The patient is usually conscious during treatment under local anaesthesia. So, the relational dynamics between dentist and patient are particularly acute and important.
The Consumerization of Dentistry
Baudrillard’s account of the way the managerial classes develop an affectivity of ‘warmth’ in order to further the purposes of business, and his focus on the smile as the currency of this consumerism led to a discussion of the transformation of dentistry from an essentially Hippocratic practice to one dominated by the consumerist ethos of buying a good smile and conforming to a societal ideal of dental aesthetic. This had the nefarious effect of increasing the unequal distribution of care at a global scale, especially in a context in which oral health is increasingly linked to systemic health. Additionally, reference was made to The Managed Heart by Arlie Hochschild, which traced the meaning of the smiles flight attendants were encouraged to display to customers in the late 1970s. The smile was an earnest that customers would receive more than they gave and they often checked if this was the case by behaving abominably towards the flight attendants.
‘Hating the Dentist’
We discussed how patients often arrive for dental care by saying that they ‘hate (the) dentist(s)’, and want to spend as little time there as possible, to get it over and done with. This could potentially lead to a divergence on the part of the dentist between expedient ‘technical’ treatment, on the one hand, and the more relational practice of dentists who are eager to develop a more intersubjective dynamic with their patient, especially given the intimacy of their engagement with the patient. Again what comes to the fore here is the asymmetry of the relationality of care.
Georges Bataille, ‘Mouth’ in Visions of Excess: Selected Writings 1927-1939, trans. by Allan Stoekl with Carl R. Lovitt and Dinald M. Leslie (Minneapolis: University of Minnesota Press, 1985), p. 59.
Jean Baudrillard, ‘The Pathos of the Smile’ from The Consumer Society: Myths and Structures, trans. by George Ritzer (Sage, London, England, 1998), pp. 160-61.
Alan Bleakley, (2020). Educating Doctors' Senses Through The Medical Humanities: "How Do I Look?" (1st ed.). Routledge. https://doi.org/10.4324/9780429260438 Ch 2
Georges Didi-Huberman, La Ressemblance informe ou le gai savoir visuel selon Georges Bataille (Paris: Macula, 2019)
Documents: doctrines, archéologie, beaux-arts, ethnographie, 1929-1931 (Reprinted in 2 vols. by Jean-Michel Place, 1991)
Family Guy : ‘Brian the Closer’ https://youtu.be/Rg0QWQT-tHo
Pierre Fédida, ‘Where does the Human Body Begin?’, trans. by Patrick ffrench from Par où commence le corps humain? (Paris: PUF, 2000), pp. 29-43.
Pierre Fédida, ‘Anxiety in the Eyes’, trans. by Patrick ffrench and Nigel Saint, Psychoanalysis and History, forthcoming.
The Francis Report
Sigmund Freud, ‘Analysis of a Specimen Dream’ from The Interpretation of Dreams, trans. by James Strachey (Harmondsworth: Penguin, 1991), pp. 130-45.
Arlie Hochschild, The Managed Heart (San Franscisco: University of California Press, 2012)
Paul Ricoeur, Oneself as Another, trans. by by Kathleen Blarney (Chicago and London: The University of Chicago Press, 1992)