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Prescriptions: The Semiotics of Medicine and Literature

Article excerpt

Both medicine and literature are signifying systems that include fundamental ambiguity, a semiotic strategy of interpreting symptoms, a narrative and mythologizing urge, and the creation of categories through performative speech acts. When literature portrays medicine, it therefore has the opportunity to comment upon signification itself

Just as ancient Greek religion united the principles of medicine and literature in Apollo, who was the god of both the healing arts and poetry (Jones 11), ancient Greek philosophy linked medicine and the verbal arts. Plato, in the "Phaedrus," has Socrates suggest that "rhetoric is like medicine" (306). Socrates argues that medicine treats the body and rhetoric the soul, but this particular text, emerging from Socrates's desire for Phaedrus, deconstructs the distinction between the physical and the rhetorical. Thomas Mann, in Death in Venice, and Jacques Derrida, in "Plato's Pharmacy" (in Dissemination), both make clear that it is impossible to determine whether Socrates desires Phaedrus's body only as a way to gain access to his soul or whether he merely feigns interest in the soul in order to get Phaedrus's body. The blurring of the boundaries between body and soul in the "Phaedrus" breaks down the separate identities of rhetoric and medicine.

The ambiguity of the Socratic desire that blurs the boundaries between body and soul is, as Derrida's reading emphasizes, one of the crucial factors unifying medicine and literature, since medicine is itself fundamentally ambiguous. To take just one example, "drugs" are both the miraculous and much desired remedy to imperfect health and a societal scourge against which total war must be waged (Ronell, Crack Wars). The surgeon operates with a double-edged scalpel: operations are the mirror images of Sade's dissections (Morris). Despite its benevolence, medicine has, as Laurence Rickels observes, a "primal proximity to murder and torture" (211).

In this ambiguity, medical practice betrays its status as a discursive practice akin to writing. The latter, as Socrates explains using a medical metaphor, is supposed to be a cure, a remedy for forgetfulness, but the drug also causes forgetfulness, because people won't bother to remember things once they can write them down (Derrida 323). Derrida for this reason describes the written text as a pharmakon, which he defines as "this medicine, this philter, which acts as both remedy and poison," Because of its "pharmaceutical" nature, writing "can be--alternately or simultaneously--beneficent or maleficent" (70). It is more than a coincidence that Derrida uses a medical analogy to describe rhetoric, for what unites medicine and rhetoric as pharmakons is their basic ambiguity, their fundamental resistance to absolute values.

While language's fundamental ambivalence is like a pharmakon, or "pharmaceutical," medicine as an institution can also be seen as an ambiguous text with multiple meanings. Max Horkheimer and Theodor Adorno regard the post-Enlightenment institution of medicine as fundamentally ambivalent because, although it undeniably lengthens lives and betters the quality of many of those lives, it also empowers certain elites and institutions in a way that inevitably produces injustices (xiv). In a fragment of the Dialectic of Enlightenment entitled "Contradictions," Horkheimer and Adorno acknowledge the merits of modern medicine while stressing the complicity of the individual physician in the hardening institutionalization and commodification of health (328). Michel Foucault's more thorough and specific investigations of the ambivalent medical discourse of the eighteenth century have found, alongside an increasing medical efficiency, both a growing concentration of power in the clinics and insane asylums and an increasi ngly vital medical discourse that began to produce and police a wide range of human experience. While Foucault's study of medical power and Derrida's analysis of the pharmakon are part of different discussions, the institutions of medicine that Foucault and others have studied can in turn be analyzed from the perspective of the pharmakon. …