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Andrea Mancuso – The self-surgeons

“ The possibility for the individual of being both the subject and object of his own knowledge implies an inversion in the structure of finitude.”
– Foucault “Birth of the Clinic”


Amanda Fielding presses the record button on her video camera and using an electric drill, a scalpel, and a hypodermic needle (to administer a local anesthetic) begins to drill a hole in her head. Ms. Fielding is the surgeon and patient. She is also an enthusiastic supporter of one of the oldest surgical practices trepanation—a process of cutting a hole in the skull to relieve pressure on the brain caused by a perceived disease or trauma.


In the North Western state of Wyoming an intelligent and skilled craftsman is polishing his custom made prosthetics. He had been having problems with his teeth and is missing several, the expense and procedure of having a licensed dentist surgically implant artificial teeth was prohibitive. He fabricated his new teeth out of a resin. Using Ambesol as an anesthetic he proceeded to install his custom made dental prosthetics.


An adult male has circumcised himself to save the expense of a conventional operation. The procedure took six separate operations over the period of 15 days. Ice applied to the penis was used as anesthesia.


Artic explorer Kate Jordan trapped in Antarctica until winter breaks performed her own fine needle breast biopsy after discovering a lump on her breast.


Victor Yazykov’s life was in danger he was 900 miles at sea and suffering from a life-threatening abscess on his elbow. On land in New England Dr. Daniel Carlin of the New England Medical Center was contracted to give medical advice to the AroundAlone Racers. Dr. Carlin sent Mr. Yazykov via email a 13-step protocol on how to lance and drain the abscess. Mr. Yazykov managed to complete the procedure successfully.


After years of others casting doubts upon their hypotheses about the etiology of peptic ulcer disease, one Australian researcher chose to drink a broth of Helicobacter pylori which he felt certain would induce ulcerous lesions in his duodenum. When his predictions came true the researcher demonstrated the cure with antibiotics.


In 1921 in the city of Kane, Pennsylvania a doctor desperate to prove something to the medical establishment takes a knife and under local anesthetic cuts open his own abdomen. Dr. Evan O’Neill Kane a 60-year old Chief Surgeon “believed that ether was being used far too often when less dangerous local anesthetics could be used”. Dr. Kane propped up on the operating room table with a mirror over his abdomen successfully preformed a surgical procedure to remove his own appendix.


These are stories of self-preservation, of physical exploration. These are stories of self-surgery. These are the purposeful actions of non-psychiatric individuals venturing into the carefully reasoned domain of surgery, not quite as far afield as the wasteful-land of self-mutilation. They are evidence of internal dissent within and beyond the sanction of standardized medicine. As such, these activities are hyper-localized uprisings set on a political platform that denies the pacification of the corporeal body. The self-surgeons disavow the boundaries between patient and practitioner. If we use a broad definition of surgery as: any procedure that purposefully alters tissue, then the space between the white, sterile, guarded/exclusive surgical stage and Mr. Yazykov’s boat begins to close down. Procedures on the flesh abound; from the surgical floor in a hospital, the Botox injections at parties, dentist chair drillings, the Rabbi performing a circumcision in a Temple or home, the boy getting his ear pierced in the local Mall, the young girl getting her first tattoo, the middle aged man applying whitening solutions to his teeth, the preteen at the tanning booth, the removal of an imbedded splinter, and various bathroom lancings – surgery is all around us.


This expansive surgical domain indicates a shifting in the foundation on which medical knowledge is encrypted. Medical knowledge is partially controlled by the artifice of complexity. The body has been described so thoroughly in sickness and in health that the layperson is often bewildered in the description of their “condition.” Despite the individual’s intimate physiological understanding of themselves as a “patient” he or she becomes dependent on the system of medicine structured around the premise of a “code” of signs and symptoms, and a “decoder” in the form of a diagnostic clinician.


The self-surgeons question the codification of medical knowledge and their therapeutic options. Their actions are political and reasonable to the extent that they act to de-mystify medical procedure and to reclaim control over self. The concealment and control of medical knowledge is called into question. The elegance of physiologic principles is a resource of both beauty and paradigms. As our culture becomes more imbued with technology, and medical knowledge disseminates, some individuals are beginning to embrace their bodies’ plasticity. Despite a seemingly daunting tome of information and technology involved in the process of surgery many individuals have managed to tackle their own surgeries. Perhaps it is the very availability of all this information that buoyed the confidence of these self-surgeons. This seems an ever more reasonable outlook given that we are living in a time where even our inorganic creations are built with the capacity to self-heal, and self-transform. Nanotechnology labs presently are developing machines that have self-regulating and self-restorative qualities, which closely resemble our immune system. What were once solely biological processes are now being bestowed upon inorganic systems in some bio-electro-mechanical transference of our genetic database. Such an insatiable desire to disseminate our biological message seems to follow that most basic need of life, from the bacteria to the human, the drive to reproduce. This tendency is inherent in our instinctual drive for self-preservation.




“The body continuously self-repairs. Every five days you get a new stomach lining. You get a new liver every two months. Your skin replaces itself every six weeks. Every year, ninety-eight percent of the atoms of you body are replaced.”[1]



Humberto Maturana and Francisco Varela, Chilean biologists see in each organism a fundamental principal of life, they refer to it as “autopoiesis”—life’s continuous production of itself. Lynn Margulis and Dorion Sagan use the model of an autopoietic entity to define life—a cell is alive but a virus is not, a virus is too small to self-maintain.




“Pattern recognition was such a useful trait for our ancestors that, even if occasionally wrong, the Aha! Feeling of discovery would have been reinforced. Aesthetic judgments of elegance and beauty, often cited in the preference for certain equations over others in physics, show that scientific correctness can also be intuitive. What we know, what we are capable of knowing and seeing, has been shaped by our evolution as surviving creatures.”[2]




“Changing to stay the same is the essence of autopoiesis. It applies to the biosphere as well as the cell. Applied to species, it leads to evolution.”[3]



The idea of self-repair is not foreign to our cells. It is an idea that is apparent at the surface of our skin and within the images that manifest the construct of our culture. Self-repair is evident in our creations. From “disk first aid” programs to the construction the concept of the Posthuman or Transhuman, autopoiesis is extended to include technology as part of the evolutionary equation.


Foucault argues that the modern body is pacified through the ritual of clinical examination. There is a level of abdication of authority or dominion over one’s destiny that is implicit in the trust the patient bestows upon the clinician. Ignorance in the state of the art in patient care tends to render the patient at a power disadvantage in the health care relationship. This knowledge deficit is bridged in large measure out of necessity by the small but desperate population of self-surgeons who feel they have only themselves to rely on, only themselves to trust. As Foucault points out “The possibility for the individual of being both the subject and object of his own knowledge implies an inversion in the structure of finitude.”[4] This is the proactive inversion that the self-surgeons typify.


In the creative arts the evolutionary instinct of the artist turn self- assigned transhuman has drawn artist to explore self-surgery. The need to address the body from a standpoint of a biomechanical mechanism or an interface with the inanimate world has become an interest of the arts at least since the late 19th century. Many authors and artists have chosen to explore the similarities and even union of life and non-life technologies. To express these ideologies some artists have resorted to invasive body modifications or “improvements” either abstractly, or distinctly recognizable as forms of plastic surgery. Beginning in the 20th century, several artists have come to appreciate the mutability of the human body as a new “canvas” upon which to self-express, and as such to self-fulfill. In this way, the capacity to remake oneself renders many of these unusual, pseudo-surgical procedures equivocal with the more pragmatic endeavors pursued by self surgeons. Among these body art performances are Annie Sprinkle’s public exhibition of pelvic and breast exams, Ulay Abramovic sewing his lips shut, Chris Burden’s self inflicted gun shot wounds and Carolee Shleeman removing a scroll of paper like surgical packing from her vagina.


On the stage performing to a sold out crowd of university students the Australian performance artist Stelarc Attaches a third arm to his body. He is interested in enhancing the body, extending it and seeing what it can actually do. Stelac in an interview about his artwork says, “For me the body is an impersonal evolutionary, objective structure. Having spent two thousand years prodding and poking the human psyche without any real discernible changes in our historical and human outlook, we perhaps need to take a more fundamental physiological and structural approach, and consider the fact that it’s only through radically redesigning the body that we will end up having significantly different thoughts and philosophies.”


At the “Fierce” art festival in London the artist “Franco B” lightly sliced up his abdomen and left the wounds open for six hours to exhibit the slow process of bleeding, coagulation, and to “re-examine the notions of what is beautiful.”


In another example, the artist known as Orlan has been transforming herself through extensively documented plastic surgeries over a period of several years. Her reconfiguration involves facial tucks, pulls, lifts, and implants, as well as abdominal, and chest reconstruction.


Western culture is racked with illness. Curious syndromes ooze out of the wounds left open by the inattentive or uninterested clinical institutions and their practitioner, a consort we will call Medicine. Names of new maladies grown in the petri dish this vacuum has created: ADHD, ADD, chronic fatigue syndrome, recovered memory syndrome, multiple chemical sensitivity, AIDS… Even medically established pathologies are becoming suspect by clinicians who are driven to disbelieve patient’s symptoms such as chronic pain or depression in the wake of their own inability to produce concrete diagnostic evidence via MRI, CT X –RAY, Ultrasound, or laboratory data and labeling these patients as malingerers, Munchhausens, or frequent fliers.


These syndromes are the disorders of life in the absence of medical explanations. The climate of high volume, economically driven medicine has brewed even more impatience in an already impatient field- to the dismay of the patient. The mandates of the HMO or the scarcity of resources in the socialized medical systems of Europe and Canada has widened the distance between client and caregiver to a distance which figuratively and literally makes effective examination an improbable task.


The reaction to the mismatch between a patient’s wants and needs and Medicine’s interest or ability to meet those needs has grown. These above mentioned syndromes and the more verifiable afflictions of hypertension, diabetes, heart disease, cancer, obesity and the like are rampant. Whether real, imagined, or both these entities are to some extent, sought after by individuals in our culture. The clinicians of Medicine are no longer the unquestioned, revered sages of healthcare they once were known as. Many of today’s patients bring their own research and treatment recommendations for their clinician to follow or they will “find a doc who will.” The lay people now recognize the business of Medicine, why drugs are made for some ailments and not others, why physicians recommend some medications and not others, and why researchers study some potential treatments and not others. The “Patient’s Bill of Rights” exists not only to protect the patient but also to enable them.


Beneath this stormy climate of Western Medicine are the limpid pools of pure knowledge, where the pearls of research data drip down and collect for the world to gaze upon. These sometimes clear, sometimes murky waters are no longer hidden from the public at large in the hegemonic cave spaces Medicine once kept them. Anatomy from the gross to the cellular, cells from the membranes to the molecular, molecules from base sequence of DNA to the quark, physiology, pathology, microbiology, biochemistry, immunology all these kens are compiled in neat texts for anyone to read. Therapeutics and pharmaceutics (though controlled by Medicine) are also readily available to those who are interested to know of them. These facts were once the somewhat secret, alchemical dogma known only to the initiated, to Medicine.


The consequence of having such disclosure is only beginning to emerge. Business (men) become biotechnologists, “shamans” become spokes (men), patients become researchers and therapists, activists become “pharmaceutical” reps, artists become steering committees… In essence, the individual gains both the knowledge and the responsibility of what to do with that knowledge.


To meet their unmet needs… to relieve their suffering…to satisfy their curiosity…to maintain control over their body…to find their cure… Perhaps these are among the reasons why someone would study, prepare, rehearse, and ultimately remove their own tonsils with a mirror, an Exacto blade, and some gauze.


Notes

[1] Lynn Margulis and Dorion Sagan, What is Life? (Berkeley, CA: University of California Press, 2000), p. 23.

[2] Ibid., p. 32

[3] Ibid., 33.

[4] Michel Foucault, Birth of the Clinic: An Archaeology of Medical Perception (London: Routledge, 2003), p. 196

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Special issue: transhumanism
Tags: Andrea Mancuso, biotechnology, transhumanism

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