A 2: Thinking about theoretical sources to use

I mentioned many theoretical sources at A2, but it was not clear which were driving the essay.  My tutor encouraged me to do an annotated bibliography about my sources which is in this post. This clarified my thinking a lot so that Foucault, Hall and Barthes rose to the ‘top of the pile’ and Bakhtin, who I thought might be one of my main sources, went to the bottom of the pile.  This was also helped by focussing my reading and study on my most important sources Foucault and Hall. 

Learning Objective

LO1: undertaken research and study demonstrating comprehensive knowledge of your area of specialisation and built a theoretical framework for your creative practice

A 2: Thinking about theoretical sources to use

19th February 2020

Introduction

It is not clear which theoretical sources are driving the essay.  My tutor encouraged me to do an annotated bibliography about my sources and suggested a framework for doing so, which I am using.

What are the essential theoretical sources that inform my work?

1. Foucault’s writings on power and institutions

1.1 Summary

Foucault’s writing asserts that human behaviour is invented rather than being intrinsic (Rose, 2016). His key works examine the emergence of modern clinical medicine, the nature of mental and other illnesses, prisons, sexuality, and the formation and exercise of power and control of institutions (Foucault, 1996, 1969, 1994, 1984, 2008). 

How doctors are represented depends on understanding medical culture. Foucault argues that there is not an ‘objective’ single view about medical culture, rather that it is embedded in social, cultural, and historical attitudes towards health and medicine (Foucault, 1996). 

1.2 Value and relevance to my work

Medical discourse is ‘refers to the special language of medicine, the form of knowledge it produces and the professional institutions and social spaces which it occupies” (Nead, 1988).

My literature review shows that there is a dominant medical ideology and that medical, media and other organisations affect the distribution of doctor images, as portraits, press TV media (Deborah Lupton, 1998;957).

The three pivotal points of change in doctor representations that I have identified appear linked to social, political and cultural changes of that time (Weisberg, 1995). 

For example in medical portraiture of this time conventions change so that the patient and carers are, for the first time, appear together with the doctor in the patient’s home on canvas (Weisberg, 1995; Michelena, 1887; Fildes, 1891). This reflects changing ideologies about the role of doctors and the French (and British) state’s commissioning and “moralising” influence, a desire to advertise new technologies, such as vaccination, and the certification of doctors and formation of their institutions. (Weisberg, 1995; Riedel, 2005; Morrison, 2016). We also see the rise of the image of celebrity doctors and institutional curation of medical curation of doctor images that demonstrate their power and influence (Jordanova, 2003, 1999, 2018, 2013). 

TV doctors are represented positively; they educate viewers about health care; and the trope of the ‘Jekyll and Hyde’ and troubled hero doctor persists (Turow, 2010; Hoggart, 2000). We also see changing public perceptions of doctors and the role of medical and media institutions (Chory-Assad and Tamborini, 2001; Solange, 2005) (Turow, 2010; Quick, 2009; Hoggart, 2000; Feasey, 2008). They also recognise variables, such as the role of institutions, control of production and audience readings; the latter research shows that viewers make sophisticated contextual reading of what they view (Turow, 2010)

1.3 Sources

Key sources are theoretical treatises and commentary, images of engraving and medical paintings (Rowland’s ‘A visit to the doctor,’ Fildes, ‘The Doctor,’ Currie’s, ‘The Three Oncologists’), and other literature.

1.4 Key references

Foucault, M. (1969) Archaeology of Knowledge. London and New York: Routledge.

Foucault, M. (1984) ‘Of other spaces: Utopias and Heterotopias. https://web.mit.edu/allanmc/www/foucault1.pdf’ In: Architecture/Mouvement/Continué; (“Des Espace Autres,” March 1967 Translated from the French by Jay Miskowiec) 

Foucault, M. (1994) Power: Essential Works 1954-84: Volume Three. (s.l.): Penguin Books.

Foucault, M. (1996) The Birth of the Clinic: An Archaeology of Medical Perception. Oxford: Vintage; Reprint edition (1 May 1996).

Foucault, M. (2008) ‘“Panopticism” excerpt from Discipline and Punish. (English translation, 1977 by Alan Sheridan, New York, Pantheon).’ In: Discipline and Punish. Multidisciplinary Global Contexts. https://muse.jhu.edu/article/252435/pdf: Indiana University Press. pp.1–12.

2. Hall and colleagues ‘Circuit of culture’ model  

2.1 Summary

Stuart Hall’s and his colleagues developed the ‘circuit of culture model to help understand mass communication; they identify “distinctive moments” of a “complex structure of dominance” – production, representation, consumption, identification and regulation (Hall, 1980, 1975; du Gay, 1997). 

2.2 Value and relevance to my work

There are at least three pivotal points in the visual representation of doctors; in paintings of the mid-19th-century, in magazine and book culture of the mid 20th-century, and the democratisation of doctor images of the ‘Internet age’. 

In the 19th-century we see a change in doctor representation, where the patient is represented in medical portraiture as exemplified in Fildes painting ‘The Doctor’ (Fildes, 1891). Like the French salon paintings of the 1880’s these sold to a ‘mass’ audience (Birchall, 2003; Fildes, 1891). These images are produced by institutions and as propaganda, consumed and welcomed by patients and doctors and help create the identity of the caring doctor.  

Over a hundred years later in the magazine Life’s, ‘The Country Doctor,’ and in the UK’s ‘A Fortunate Man,’ we witness a ‘new’ representation of the ‘hero’ doctor with a multiple images and anchoring texts, and an audience of millions (Cosgrove, 1948; Charlotte7178, 2018; Quinn, 2012; John Berger, 2016). 

An analysis of the role of institutions, control of production and audience readings, as in the work of Turow which showed that viewers make sophisticated contextual reading of what they view, is essential to a complete understanding how and why doctors are represented as they are (Turow, 2010). Lewis does this well in analysing medical representation, in a single of episode of Newsweek, using the framework of Hall’s ‘Circuit of culture’ model (Lewis, 2007)

2.3 Sources

Fildes’ ‘The Doctor’ portrait (Fildes, 1891), ‘The Country Doctor’ image (Cosgrove, 1948), and my own new research about internet doctor representations.

2.4 References 

du Gay, P. (1997) Doing cultural studies: The story of the Sony Walkman. London: Sage.

Hall, S. (1975) ‘Encoding and Decoding in the Television Discourse’ Paper for the Council of Europe Colloquy on Training in the Critical Reading of Televisual Language. Centre for Mass Communication, University of Leicester: Centre for Cultural studies, University of Birmingham, UK. At: https://core.ac.uk/download/pdf/81670115.pdf (Accessed  31/10/2020).

Hall, S. (1980) ‘Encoding/decoding’ In: Culture, Media. Language. London: Routledge.

3.  Panofsky’s and Barthes’ theories of image understanding and analysis

3.1 Summary

Panofsky divides iconography into three deepening levels of image understanding, that depend, in this context, on an understanding of medical and visual culture (Panofsky, 1955).

A related theory for exploring the meaning of images is from Roland Barthes with ideas about iconicity, mythology and coding (Barthes, 1957, 1977)

3.2  Value and relevance to my work

This has already provided a framework for examining particular images and their meaning. 

3.3 Sources

Key images that I have selected

3.4 Key references

Panofsky, E. (1955) ‘Iconography and Iconology: An introduction to the study of Renaissance Art’ In: Meaning in the visual arts. London: Penguin Books. pp.51–81

Barthes, R. (1957) Mythologies. (2012th ed.) New York: Hill and Wang (Originally published Editions du Seuil).

Barthes, R. (1977) ‘The rhetoric of the image.’ In: Image-Music-Text. New York: Hill and Wang. At: https://faculty.georgetown.edu/irvinem/theory/Barthes-Rhetoric-of-the-image-ex.pdf (Accessed  06/11/2020).

4. Bourdieu’s Cultural Capital and Habitus

4.1 Summary

Cultural Capital according to Bourdieu, is gained mainly through an individual’s initial learning, and is unconsciously influenced by the surroundings In the case of habitus, it relates to the resource of knowledge (Bourdieu, 1977; Huang, 2019). Knowledge is about the way how people view and understand the world, which is gained via a specific culture that an individual lives in. While also showing how Bourdieu’s work on economic capital, social capital and cultural capital can help us to understand the contemporary world and its practices.

4.2 Value and relevance to my work

We see this in the use and display of medical icons, doctor performance or habitus, certification, and presentation in paintings, photographs, and on film (Inferno, 2016; Lau, 2004; Rice, 2010; Barcelos Neto, 2003). There is a worked example in my text about the way in which a stethoscope is used to display knowledge and develop doctor identity (Lau, 2004). 

4.3 Sources

Key images that I have selected.

4.3 Key references

Bourdieu, P. (1977) Outline of a Theory of Practice. Cambridge: Cambridge University Press.

APPENDIX

LESS SURE ABOUT THE RELEVANCE OF THESE NEXT THEORIES 

I have included these to show what else I have been looking at.

Tajfel and Social Identity Theory

1.1 Summary

Tajfel’s Social Identity Theory provides a comprehensive analysis how professional and other groups form their identities and differentiate themselves from other people and groups (Tadfel, 1882; Tajfel, 1981).

1.2 Value and relevance to my work

The identity of doctors is created in the work and minds of doctors and non-doctors and their social relationships. An important feature of this is intergroup differentiation and how doctor identify themselves, particularly visually (Tadfel, 1882; Tajfel, 1981). We see this is the use and display of medical icons, doctor performance or habitus, certification, and presentation in photographs and on film (Inferno, 2016; Lau, 2004; Rice, 2010; Barcelos Neto, 2003).

1.3 Sources

There is an extensive literature on medical education about the formation of doctor which I have already researched. Pertinent research will appear in the work.

1.4 References

Tajfel, H. (1882) Social identity and intergroup relations. Edited Henri Tajfel. Cambridge: Cambridge University Press.

Tajfel, H. (1981) Human groups and social categories: studies in social psychology. Cambridge: Cambridge University Press.

Barcelos Neto, A. (2003) ‘Art and Agency: an Anthropological Theory’ In: Cadernos de Campo (São Paulo, 1991) 11 p.147.

Barthes, R. (1957) Mythologies. (2012th ed.) New York: Hill and Wang (Originally published Editions du Seuill).

Bakhtin’s theory of ideology and dialogue

1.1 Summary

Bakhtin’s theory and critique of ideology answers one of the weaknesses of the descriptive Fucoidan approach to looking at systems by including reflexive human understandings and interactions (Gardiner, 1992; 191). It is that human communication that we also see a central to his thought on dialogue which is about engagement with people and not simply structures (Shires, 2016; 31).

1.2 Value and relevance to my work

Our three pivotal phases of doctor representation are related to political, cultural and social changes. In health care we see the transitions from the formalisation (certification) of health care to protect patients from quack doctors, to medicalisation of illness, the inclusion of patient experiences and most recently the promotion of patient autonomy and self-care (Morrison, 2016; Lupton, 2003). Patients make sophisticated readings about medical culture as in those relating to media doctors (Solange, 2005). Understanding the relationship between doctors,  patients and the public is an essential dimension in my discourse.

1.3 Sources

Here I will bring my own experiences of being a doctor to bear, particularly in acting out relationships with patients. 

1.4 References

Gardiner, M. (1992) The Dialogics of Critique: M. M. Bakhtin and the theory of ideology. London and New York: Routledge.

Shires, J. (2016) ‘Mikhail Bakhtin’ In: Dialogue Theories, Volume II. Great Britain: Dialogue Society.

Reflections ahead of exam submission

11th December 2021

  • This was a critical paper that I produced at the suggestion of my tutor to develop my theoretical framework. I can’t remember her ever giving feedback about it or a revised A2 that I wrote, but I realised that she was pointing me in the right direction and allowing me to find my own way.
  • The result of this paper was that I realised that I could focus on a small number of sources but did not have an in-depth knowledge of my theoretical sources. I spent 4-6 weeks studying Foucault’s writings and trying to make my own interpretations of what he was saying. That paid dividends as it suggested areas to explore in my writing such as a framework for challenging power which appears as a main chapter.
  • I can see now that theory can drive a dissertation or at least underpin it and perhaps that is the case with my theoretical framework.
  • At the time, a year ago, the process of deciding on a theoretical framework was full on angst and uncertainty, but as I become more confident in applying Foulcaudian insights to my dissertation it became easier and more natural. I started to enjoy what I was doing rather than it being a slog.