The city
has from ancient times been seen as a nexus of confluences. In
its glory, the polis, Athens for instance, represented the center
of balance and enlightenment, where a man like Orestes could find
justice and be released from mental and physical torment. In its
decadence, the city becomes the site of pollution and infection:
the pestilence in Thebes stands for crimes against king and nature.
Medieval cities, ravaged by the plague, lost two thirds of their
citizens through death; other, more fortunate inhabitants could
take refuge in the country, away from the hot points of contamination;
The Decameron is an entertainment for just such refugees. Revolutions
were fomented in cities. Spectacles such as ritual processions,
marches through arches of triumph, public executions, all required
the collective gaze of multitudes to achieve their greatest effects.
During the Industrial Revolution and in its aftermath, as cities
increased their populations more than five times, these pullulating
centers fostered both the most horrific sites of congestion, filth,
and diseases, as well as the greatest advances in sanitation known
in human history. Competing and overlapping discourses about eugenics
and degeneration in general took their data from urban populations.
Psycho-analysis began as an investigation of Viennese bourgeois
malaise. In the United States as well, cities have been the object
of pronounced ambivalence. Jefferson described cities as a canker
on the body politic and urged parents to forbid their sons to
visit European capitols. Progressives regarded cities as a source
of liberation once they were cleansed of corruption. The anomaly
of New York City as the cultural center of the U.S. and Washington,
D.C., as the capital points to the American ambivalence about
cities. The Humanities Center invites proposals for talks that
address the ways in which health and disease have been represented
as located in the city. What is the significance of the urban
setting in the pursuit of health and/or disease? How our attitudes
about cities formed by the discourses of health practitioners,
innovative medical geniuses, social reformers, novelists, artists,
and composers in depicting the vectors of health and disease among
citizens of the polis? How, in turn, are our views of disease
and health colored by cultural notions of the city as both a center
of medical expertise and an environment where pollution, noise,
germ transference, and adulterated food supplies promote the spread
of disease?
SPEAKER ABSTRACTS
Kristine M. Gebbie, Joan Hansen Grabe Dean, School of Nursing, Hunter College, CUNY
Healthy Cities or Health in Cities?
In the world of public health, there is much enthusiasm for the phrase ‘healthy cities’ and several projects that are designed to engage a wide range of citizens in activities to make their city a healthy city. A dominant paradigm displaying the determinants of whether or not an individual will be healthy includes both the physical and social environments as critical components. There are also multiple perspectives on city life that suggest it is inherently unhealthy or at least far less healthy than an idealized, bucolic rural or suburban life. Which paradigm works for what purpose? Is it possible to concentrate on a healthy city without considering the individual health of each inhabitant? Is it possible to attend to the health of a series of individual city dwellers without considering the overall level of functioning of the city? Taking the perspective of a long-time public health official and nurse, this session explores how various ways of considering health from a corporate or individual level might influence decisions about health investments and planning.
Ellen
Barton, Professor
of English and
Richard Marback, Associate Professor of
English,
The Bodies of the Urban Public
The bodies of the urban public have always been of special importance to medical research, from the new Renaissance practice of grave-robbing from urban cemeteries for the emerging art and science of dissection (Park), to the injection of cancer cells in terminal patients in an urban hospital in 1963, during a period David Rothman calls “the gilded age of [medical] research,” a time when researchers “ran their laboratories free of external constraints”.
In this presentation, we look at minority inclusion in medical research from a combined micro- and macro-perspective. Barton, a linguist, first presents the findings of a micro-level linguistic analysis of offers to participate in cancer clinical trials, with data analyzed by race. The study analyzed the presentation of key elements of informed consent during trial offers, finding that there were significant differences in trial offers to African-American vs. Caucasian-American patients. Marback, a rhetorician, then theorizes the results of this study, beginning with consideration of the urban teaching hospital as a racialized site and the idea of inclusion as the preferred response to patterns of racial exclusion —in this case the singular appeal to African-American patients to want to participate. By situating the appeals in these cancer clinical trials in a more general description of the successes and failures of appeal to inclusion that shape current rhetoric, this analysis argues that mandated minority inclusion in medical research fails to adequately respond to the systemic racism that continues to debilitate the bodies of the urban poor.
Kristin Ross, Professor of English, NYU
Bad Blood
In this talk I focus less on the sick of the city than on those fictional figures who investigate them: doctors and detectives. I begin with the theory of the novelist as doctor or physiologist, engaged on equal footing with the scientist in the “universal investigation” that was the dream of the 19th century: Zola, heredity, and the naturalist experiment. I trace the way in which the doctor/diagnostician of social ills is replaced in the 20th century by the figure of the private investigator. Both doctor and detective share, by way of their profession, an exceptional access to the urban totality and the raw material it offers. Yet both suffer from a hierarchical distribution of places and functions that isolates them from “the people” they investigate or treat—they are different from their patients or clients, exterior to their situation. For crime writers in France writing after 1968, this epistemological and narratological problem was viewed as a political dilemma—one they attempted to solve by a transformation of the figure of the detective.
Sherylyn
Briller, Assistant Professor of Anthropology, and
Stephanie Myers Schim, Associate Professor
of Family, Community and Mental Health,
Contemplating Death in a Dying City
With the growth of cities came new ways of contemplating the meanings
of life, health, and individual and collective ways of living.
The creation of urban environments also changed how people die,
where they die, and how death is represented. We will discuss
selected social and public health aspects of urban death over
time and across locations. Building on this historical and cross-cultural
discussion, we will highlight the importance of understanding
death within particular urban contexts. Metropolitan Detroit provides
a rich exemplar of an urban area in which death and dying and
related social meanings need to be considered. We discuss ways
in which recent interdisciplinary scholarship enriches understanding
of the relationships between health, personhood, life, and death
in this unique urban context. As historical, social, and economic
forces converge on Metro Detroit and profoundly impact current
health care resources, access to care, and quality of life overall,
the discussion of what death and dying mean, how they are experienced,
and the representations they have are all the more relevant. We
will discuss some collaborative research exploring individual,
family and community stories of dying in Detroit. Through these
end-of-life stories, we will highlight some of the cultural, physical,
spiritual, ethical, legal, political and economic issues that
arise when thinking about death in this 21st century post-industrial
urban context.
Heather
Dillaway
Associate Professor of Sociology
Women, Disability, and Reproductive Health in Detroit: A Report on Research and Advocacy in a Local, Urban Context
Traumatic spinal cord injury (SCI) refers to a sudden injury that causes paralysis and loss of sensation, the effects of which occur below the trauma site. For this reason, some persons lose the ability to use their legs and lower body (paraplegia) while others lose this ability from the neck down (tetraplegia). Approximately 253,000 Americans currently live with SCI, and an estimated 11,000 new injuries occur each year (National Spinal Cord Injury Statistics Center, NSCISC 2008). Since complete or partial motor paralysis necessitates lifelong wheelchair use and lifelong coping with a range of serious medical complications (Jensen, Kuehn, Amtmann, & Cardenas 2007), a survivor of SCI must contend with their appearance as a permanently broken body as they strive for desired participation in society replete with social and physical barriers. Thus, it is difficult at first to conceptualize individuals who have a disability like SCI as physically “healthy.” And what about women with disabilities? Again, we assume that women with disabilities might not experience reproductive "health” at all, only "illness.”
We attempt to expand the literature on and understanding of disabled women’s “health” experiences by reporting on data from 20 in-depth, individual interviews with Detroit women who have existing spinal cord injuries. Our findings suggest that women in our sample were not always stereotyped as non-reproductive by their physicians; in fact most reported being told by SCI doctors that “they could still get pregnant.” Our findings also suggest, however, that disabled women in our sample do not have adequate access to comprehensive reproductive health care. The idea that reproductive “health” is something that only able-bodied women can achieve is an important theme in our interviews. In this paper we also discuss how the local, urban context impacted these women.
References
Freeman, E., Grisso, J., Berlin, J., Sammel, M., Garcia-Espagna, B., & Hollander, L. 2001). Symptom reports from a cohort of African American and white women in the late reproductive years. Menopause, 8(1), 33-42.
Jensen, M., Kuehn, D., Amtmann, D., & Cardenas, D. (2007). Symptom burden in persons with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 88, 638-645.
NSCISC (2008). National spinal cord injury statistics center. http://www.spinalcord.uab.edu
Spradley, J. (1979). The ethnographic interview. New York: Holt.
Anne
Duggan
Associate Professor of CMLLC
Jacque Demy’s The Pied Piper,
or Dis-ease in the Provincial City
The explication for the Humanities Center Fall Symposium includes
“bourgeois malaise” as one venue for exploring the
Representation of Health and Disease in the City. Films by the
French New Wave director Jacques Demy constantly move between
nostalgia for the provincial city one left to “make it”
in Paris, and criticism of the dis-ease of bourgeois life within
the closed environment of such cities as Nantes (Lola, 1960),
Cherbourg (The Umbrellas of Cherbourg, 1964), and Rochefort (The
Young Girls of Rochefort, 1967). Whereas The Young Girls of Rochefort
celebrates the comforts and joys of the provincial city, only
marginally treating the constraints of provincial life, The Umbrellas
of Cherbourg depicts a more tragic version of the rigid social
structures and bourgeois mentality that prevail in the closed
environment of Cherbourg.
In my paper, I will explore the dis-ease
of the provincial city in another film by Demy, The Pied Piper
(1971), which takes an allegorical look at the prejudices and
constraints of bourgeois society depicted more “realistically”
in his other films. Following the German legend of the Pied Piper,
Demy situates his story in the quite literally closed city of
Hamelin, which has cut itself off from the rest of Germany to
protect itself from the Black Death. Although the plague poses
a potential threat to the city, the true menaces to Hamelin include
the burgermaster, a social climber who sells his daughter off
to improve his own social standing; the baron, so obsessed with
his own personal salvation that he spends all the town’s
money and resources on building a cathedral instead of fighting
the plague; and an unscrupulous and superstitious clergy, who
condemn the Jewish alchemist Melius for believing the plague has
natural causes and is not a punishment sent from God. The tale
tragically ends when the people of Hamelin, out of self-interest
and social prejudice, refuse to pay the man who rid the city of
rats and burn at the stake the Jewish doctor who nearly found
a cure for the plague. In Demy’s Pied Piper, the plague
becomes a metaphor for the ills of Hamelin society. In the end,
it is not the rats or the plague that destroy the town, but the
people themselves.
Annie
Higgins
Assistant Professor of CMLLC
Touching the City: Ease and Dis-ease
of Oasis, Prison, and Village
The city plays a potent role in a number of modern Arabic
novels and short stories, in some cases taking on a persona of
its own which interacts with its denizens. The city is the locus
for plays of power amongst local, national, and global forces
reshaping the individual's role in the microcosm of his daily
life as well as the macrocosm of changing regional relations.
These changes affect the ease and dis-ease of human relationships,
societal structure, and the effectual exercise of power on political
and personal bases.
In Abdelrahman Munif's novel, Cities of
Salt, we see the transformation of an industrially unsophisticated
society when an oasis is erased while its inhabitants are displaced
in a city where their values, goals, and relationships take on
new dimensions. The urban locus brings social breakdown, with
tragic dis-eases caused by sudden shifts from rural to urban,
local to global, independent to colonial, and a bartering to a
monetized economy. While the images are not all negative, this
work was close enough to the discomfort of political reality to
cause the novelist's exile from his native Saudi Arabia.
Salwa Bakr's novel, The Golden Chariot,
demonstrates how an Egyptian women's prison introduces the protagonist
to fellow inmates from a wider range of social strata than her
cloistered life of freedom gave her. Here, she evaluates which
women will accompany her in the golden chariot of her fantasy,
thus becoming the judge of inclusion and exclusion, but using
different criteria than those by which the court judged her. Prison
is an urban locus for containing society's dis-eases, by confining
the dis-eased. Paradoxically, these socially excluded women find
inclusion and spiritual ease through communication, compassion,
and individual expression which they lacked when free.
The Dawm Tree of Wad Hamid is Sudanese
author, Tayeb Salih's, powerful short story where nature and ancient
village traditions subvert successive government authorities in
their attempted public works program, designed to ease the village
into the chain of modern life. The city-authorized program of
modernization and ease is refuted by notions of the relationship
between local residents, prophecy, and nature. The impotence of
the capital city's influence-wielders in contrast to the lasting
power of the tree and villagers' perceptions etch indelible questions
of who dominates and what endures.
While the city is at times a source of
dis-ease, disturbing the flow of life of simpler times, it can
also ease social dysfunctions in unexpected ways, inverting inclusion
and exclusion, and engendering new lines of communication. In
another scenario, nature and villagers' connection to the land
can vanquish political and industrial intrusions sent from the
city. These three writers show how oasis, prison, and village
touch the city and are touched by it, easing and dis-easing the
individual's relationship to their spiritual selves, their society,
and their environment.
Thomas
Kohn
Assistant Professor of CMLLC
The Source of the Plague at Thebes
in Seneca’s Oedipus
It is well known that disease plays an important role in the myth
of Oedipus. In Sophocles’ Oedipus Tyrannus, it
is the impetus which drives the king to investigate the murder
of his predecessor. Seneca picks up this motif in his Oedipus.
But whereas Sophocles merely mentions the Plague, Seneca goes
into much greater detail, as both Oedipus and the Chorus describe
the symptoms and the devastating effect the disease is having
on both the physical and moral health of Thebes. And although
the audience knows that the Plague has come from the gods, the
king suggests that the Sphinx has brought this destruction on
the city, perhaps meaning that the rotting corpse is the source
of the pestilence. But it is more interesting to consider the
literary source of the disease. Again, Seneca is most directly
copying Sophocles. But his descriptions also seem indebted to
Thucydides and his account of the Plague of Athens. In this, Seneca
follows a long tradition of plague-narrative from the historian
through Lucretius to Vergil and Ovid. But the playwright is the
first to link the Thucydidean Plague to a city other than Athens,
thus combining the traditions of Sophocles and Thucydides in an
attempt to show disease in an urban setting.
Chris
Leland
Professor of English
Reading from Letting Loose 'Thanateros,'
Chapter 2
This novel (1996) explores the years from the 1950s through
the 1990s through the lives of its three major characters who
all hail from the same small town--a Vietnam Veteran, a woman
entrepreneur, and a gay photographer in now living in New York
City, Barry Caraway. In this chapter, set in February of 1984
but with action interspersed from 1982, Barry visits his wealthy
friend, Bowen, whose apartment on the Upper West Side has become
something a hospice for victims of AIDS, the disease which killed
Barry’s lover, Jacy, early in the epidemic.
What is notable is that, at this point,
while most of New York (and most of the United States) remained
relatively ignorant of and/or complacent about HIV, the virus
had devastated the gay communities in the larger metropolitan
areas. There was a peculiar and ugly smugness in Reagan’s
America at the horror being visited upon a group who many, at
least, felt had brought plague upon themselves. It was only later
that the full extent of the pandemic, now in its thirtieth year,
received the attention it deserved.
Herein, then, is the story of those who,
in the midst of an apparently healthy city, confront the ravages
of epidemic disease. For brevity’s sake, I’ll be reading
the passages from 1984. Those from 1982 relate Jacy’s diagnosis,
illness, and death.
Daphne
Ntiri, Associate
Professor of Africana Studies and
Merry Stewart from University of Detroit
College of Nursing,
Transformative Learning Intervention:
Effect on Functional Health Literacy and Diabetes Knowledge in
Older African Americans
This study evaluated the effect of a transformative
learning (TL) intervention on functional health literacy and diabetes
knowledge in older African Americans in Detroit. Twenty participants
from senior community centers completed a six session intervention.
Research pertaining to adult learning theories has been centered
in traditional educational environments (e.g. classrooms). However,
adult learning theories are reaching beyond traditional contexts.
These extended contexts include health care environments. The
exploration of educational pedagogies for adults in health care
has been driven by longer life spans and the increasing incidence
of chronic illnesses (Chronic Illness - The Rise of Chronic Illness,
2007).
Educators have explored the process of change in adults over the
years. Adult educators have been shifting from a complete reliance
on traditional pedagogical approaches to alternative learning
approaches (Knowles, 1984). Knowles stated that the goal of these
alternative approaches should be to motivate adults to become
more active in the learning process. Active learning affords adults
the opportunities to develop new frames of reference and see the
world differently from where they were before. Green (1981) advocated
that active learning principles emphasize learner choice more
than expert control.
Mezirow (1996) has expanded the theoretical
debate further with his focus on transformative learning (TL).
Mezirow declared that TL is a social process by which one can
construct and apply new meaning to one’s experience as a
guide to action. In other words, TL is viewed as an effective
method to expand one’s consciousness and bring about the
required social change as is advocated in this study. Additionally,
TL is a self-directed process whereby learners use their initiatives
with or without the help of others to determine the information
they need and seek ways to acquire it (Cranton, 2006). This acquisition
process involves self-reflection by the learners in which they
question why it is important to learn and the validity of the
learning itself (Pilling-Cormick, 1997). This process is also
in support of Freire’s (1970; 1973) theory of critical consciousness
that promoted the application of transformative learning principles
as an instrument for personal transformation and social change.
Freire asserted that education is liberating for both the change
agent and the individual learner in the search for knowledge.
Mary
C. Sengstock
Professor of Sociology
Family Violence: Is It a City Problem?
Nearly four decades of conducting research and presenting training
sessions on family violence at several levels (spouse abuse, child
abuse, and elder abuse) provide extensive evidence of the manner
in which family violence tends to be viewed. Is it a health problem
or a deviance problem? Is it a problem at all? Or is it simply
the way in which some people choose to conduct their family lives,
and is, therefore, none of anyone else’s business? Is it
a problem which should be of concern for all of society? Or is
it only a problem to be found in the “evil urban centers”?
In this presentation, I will discuss the prevalent tendency to
view family violence as primarily a health problem, and likewise,
as a problem indigenous to the urban environment, one not likely
to occur in the idyllic settings outside of urban centers.
