Translationality

Essays in the Translational-Medical Humanities

Douglas Robinson

• Publisher: Routledge
• Year: 2017
• Print ISBN:
  9781138727045
• eBook ISBN:
  9781351750882
• Topic: Languages & Linguistics
• Subtopic: Linguistics
• Index: Languages & Linguistics

This book defines "translationality" by weaving a number of sub- and interdisciplinary interests through the medical humanities: medicine in literature, the translational history of medical literature, a medical (neuroscience) approach to literary translation and translational hermeneutics, and a humanities (phenomenological/performative) approach to translational medicine. It consists of three long essays: the first on the traditional medicine-in-literature side of the medical humanities, with a close look at a recent novel built around the Capgras delusion and other neurological misidentification disorders; the second beginning with the traditional history-of-medicine side of the medical humanities, but segueing into literary history, translation history, and translation theory; the third on the social neuroscience of translational hermeneutics. The conclusion links the discussion up with a humanistic (performative/phenomenological) take on translational medicine.

Essay 1 The medical humanities

The creation of the (un)real as fiction

The overarching question I want to ask in this essay is: where does the “reality” of the world come from? What makes other people and our own selves seem real? And, if the deterioration or outright collapse of the neurocultural support system for that seeming would appear to suggest that what we call “reality” is actually a lot more like “fiction” than we thought, is there a difference between fiction and reality, and if so, how is it created and maintained?

To support that overarching question I will be asking a series of subquestions, marked Q1, Q2, Q3, etc.; the direction in which I plan to move over the course of the essay is that “reality” is a production of the limbic system, especially of the emotions – our feeling of reality. My trigger observation for the series of explorations that follow is that some thinkers have been arguing over the last few decades that our feeling or sense of reality, our ability to “realize” the world and our selves, has just recently been depleted (over the last century or so); Jean Baudrillard (1981/1994) in particular, in his controversial notion of simulacra, has even argued that it has been lost entirely, that “reality” has been completely subsumed into virtuality. David Shields (2010) argues somewhat more moderately that we have developed a “reality hunger” – a craving for “authenticity,” things and personalities that feel (more) real because they represent a nostalgic past sense of reality; but of course the Baudrillardians would insist that the “reality” of a vinyl record, a treadle sewing machine, a plank floor, or an exposed-brick wall is just a simulacrum of a different vintage (a “counterfeit”), not qualitatively different from a streaming video or an ePub whose pages rustle when you turn them. The runaway popularity of Baudrillard’s “topos of simulacra” (Smith 2001, 2) among the culturati speaks to a pervasive sense that “reality” is nowadays somehow at risk, under assault, or perhaps just crumbling away into nothing. Something like this concern about the ascendancy of “fiction” – pretense, fakery, fraudulence, imposture – over “reality,” authenticity, and so on, is also a key theme and structural organizer in Richard Powers’s (2006/2007) novel The Echo Maker. How should we understand this?

What I argue in this essay is that neurological deficits and disorders – especially the famous Capgras delusion, which provides the major plot point in The Echo Maker – can shed some light on the question of the depletion or disappearance of “reality.” I also show that two applications of the most obvious, literal, popular interpretation of Baudrillard to humanistic texts – Kevin Casper’s 2015 application of simulacra to the 2010 Jackass 3D movie and Álvaro Ramírez’s 2005 application to Don Quixote – reveal that interpretation as completely inadequate, and a confederation of the Capgras delusion and other neurological “misidentification” disorders in the Powers novel and subtler interpreters of Baudrillard begins to compensate for that inadequacy en route to that broader theory of human social interaction that I call “icosis.”

1.1 Capgras fictions 1: The Echo Maker

The basic plot of the novel is that Mark Schluter, a fairly ordinary 27-year-old working-class man from Kearney, Nebraska, skids off an icy country road and flips his truck, and then hangs there unconscious for an untold period of time, slowly freezing, until someone spots the wreck and makes an anonymous call to the police. Once Mark has been found and cut out of his truck with an acetylene torch and rushed to Good Samaritan Hospital in Kearney, someone (else?), whom he comes to think of as his mysterious “guardian,” leaves a mysterious note on his table:

I am No One

but Tonight on North Line Road

GOD led me to you

so You could Live

and bring back someone else. (12)

Those five lines also become the titles of the novel’s five parts:

The first part, “I AM NO ONE,” tells the story of Mark’s initial recovery (and diagnosis as suffering from the Capgras delusion) through the eyes mostly of his older sister Karin, who Mark thinks is a double (possibly a government spy); then Karin’s boyfriend Daniel finds two books by Dr. Gerald Weber, a famous cognitive neurologist, and Karin contacts him, in the hope that he might come and cure Mark.

The second part, “BUT TONIGHT ON NORTH LINE ROAD,” tells of Dr. Weber’s first visit to Kearney, his interactions with Mark and Karin, Mark’s two wild guy friends Duane Cain and Tom Rupp, Mark’s sometime girlfriend Bonnie Travis, Mark’s empathic attendant Barbara Gillespie, and the attending neurologist at Good Samaritan, Dr. Hayes.

The third part, “GOD LED ME TO YOU,” tells the story of Mark’s move back home, where he is initially convinced that his dog and his house are doubles, and then, gradually, that the entire neighborhood is a Truman Show–like production, where everyone and everything is a phony stand-in for some person or thing or place he remembers. His paranoia grows, and he begins obsessively documenting the imposture that he finds all around him. Meanwhile, Dr. Weber’s reputation is unraveling, as he is accused of professional ethics violations and even, hintingly, outright fraud.

Part 4, “SO YOU MIGHT LIVE,” continues the plot developments in part three – Mark’s paranoia, Dr. Weber’s professional meltdown, Karin’s panicky attempts to remain cognitively solvent in the turbulence of Mark’s paranoia – but also brings the mysteries of Mark’s accident and Barbara’s sinister vibe to closure. And the very brief concluding part five, “AND BRING BACK SOMEONE ELSE” – only a dozen pages long, out of nearly 600 – ties together the loose ends, drug and mild shock therapy curing Mark of his Capgras, so that he recognizes Karin as his sister again and comes out of the paranoid concoction of wild conspiracy theories.

The neurological disorder that Powers “translates” from cognitive neuroscience into the plot engine of his novel, the Capgras delusion (also called Capgras syndrome), was first diagnosed and named by Joseph Capgras (1873–1950) in 1923. The disorder typically presents as the patient’s conviction that loved ones have been killed or kidnapped and replaced by doubles (see Hirstein and Ramachandran 1997; Ramachandran 1998, ch. 8; Breen et al. 2000; Ellis and Lewis 2001). Capgras sufferers are certain that their spouses, their children, their close friends, even their pets are not the “real” people or other creatures they pretend to be: Mark first believes that his sister Karin is not really his sister but an impostor – a government spy, or possibly a cleverly programmed robot – then that his house and his dog are doubles, and eventually that everything, his entire town of Farview, perhaps his entire universe, is a fake, a sham, a charade, an imposture. As they get used to the “impostors,” too, Capgras sufferers typically begin to “realize” that the first-order doubles have been killed or kidnapped and replaced by doubles-of-doubles, who in turn are eventually replaced by doubles-of-doubles-of-doubles. Worse, some look in the mirror and become convinced that they themselves have been replaced by doubles. This seems to happen to Mark as well: late in the novel, he begins to suspect that he ran over himself on the highway that night, and it occurs to Dr. Weber that “he’d begun to double himself” (384).

This all sounds strikingly like (one common interpretation of) Jean Baudrillard’s theory of simulacra: the loss of a sense of reality; the increasing impossibility of establishing the reality of another person, a pet, or even the self. In Baudrillard’s terms, the “doubles” are simulacra who look exactly like the “real” people, but are manifestly not them. And doubles-as-simulacra proliferate, until it seems to the Capgras sufferer as if reality has been subsumed into diabolical simulation, is drowning in simulation.

Of course there is also a significant difference, in that Baudrillard never ventures a guess as to how this happens. His theory of simulacra is not a cognitive neuroscience model – and everything in The Echo Maker, including the powerful ecological subplot, is about cognitive neuroscientific explanations. Baudrillard’s theory of simulacra is what Charles Levin (1996) calls a “cultural metaphysics” – either a trendy apocalyptic metaphysics of the postmodern End Times or a trenchant theory of culture disguised as a trendy apocalyptic metaphysics of the End Times, but in either case utterly lacking in etiological detail. How exactly do simulacra come to colonize our sense of reality? What intellectual, experiential, behavioral, neural processes enable that colonization? Baudrillard and his many followers have no idea, and don’t really care. The theory is cool. That’s the main thing.

What Capgras can offer us, if we’re interested – and Powers is a persuasive and knowledgeable guide, if we set off on that journey – is an exploration of one possible neural etiology of the depletion of “reality,” based on the interaction of two neural pathways for the recognition of faces: the analysis of visual features and emotional response. Normals use both: their brain’s fusiform face area (FFA) analyzes appearances based on lines, contours, and so on, and their emotions sort the results into greater and lesser degrees of familiarity, based on the presence or absence and relative intensity of an emotional “glow” signaling the face of someone they care about. Damage to the FFA causes “face-blindness”: the subject (like “Joseph N.,” as reported by Dr. Weber in The Echo Maker (188–90)) claims not to recognize the faces of friends and loved ones, but skin-conductance tests indicate a somatic response to them. (See also the Damasio team’s early work on this: Tranel and Damasio 1985; Tranel et al. 1988, 1995; Damasio et al. 1990b, 1993.) S/he recognizes them emotionally, but because s/he doesn’t recognize them analytically, consciously, s/he isn’t aware of recognizing them, and so claims not to.

As Powers’s narrator points out (190), the Capgras delusion is the opposite of face-blindness: it is caused by damage to the emotional circuits contributing to face-recognition. Capgras sufferers have fully functional FFA capabilities. They can analyze visual features perfectly, and recognize that that man sitting across from them at the dinner table “is” their husband, or that that face in the mirror “is” the self, but they feel no emotional “glow” signaling familiarity, and so confabulate otherness – or what Baudrillard calls simulation. To them it is uncanny that that person can look exactly like a loved one but not be the loved one – which is to say, not be the real loved one. The somatic response, measurable by a skin-conductance test (basically a polygraph machine), generates the feeling of reality; damage to that neural circuit creates a sense that reality has been sucked out of the “recognized” face. As a result, the face is recognized but not real. The “simulation” theory – that the loved one (or the self) has been kidnapped and replaced with a double – is the desperate confabulatory attempt made by what Michael S. Gazzaniga (1989) calls the left brain’s “interpreter” to explain the discrepancy.

Now one might want to protest that according to Baudrillard the subsumption of reality into virtuality is ubiquitous, at least in the postmodern West, while the Capgras delusion is a neurological disorder that is quite rare. The simulacra that plague Capgras sufferers are also considerably more localized than Baudrillard’s: they tend to be limited to the sufferer’s nearest and dearest, including pets and the self. They do not include whole cities, like Los Angeles (Baudrillard 1981/1994, 12–14), or, ultimately, everything. Mark is one Capgras sufferer who gradually comes to believe that everything is simulated; if applied to Baudrillard’s explicit theory, this model would say that everyone is a Capgras sufferer for whom everything is simulated – though in Baudrillard most people aren’t aware of that.

But Powers seems determined to build something like Baudrillard’s universalizing claim into the very fabric of his novel. For one thing, the more tendentious Baudrillardian imagery of simulation runs like a scarlet thread through the novel: Karin thinking of the streets of Kearney that they were “a simulation more predictable than one of Mark’s online games” (37); Karin saying to Daniel, “Don’t you see, yet? I’m not her. I’m just a simulation. Something you invented in our head” (368); the Weber-focalized narrator describing the mirror-neuron system as “simulations simulating simulations” (485). I haven’t seen Powers admitting in print that he was influenced by (or was even thinking of) Baudrillard on simulacra here, or elsewhere in his writing, but the circumstantial evidence for such influence seems quite compelling. Even more compellingly, late in the novel Karin muses that “the whole race suffered from Capgras. Those birds [the cranes that migrate every March through the Platte River area just south of Kearney, Nebraska] danced like our next of kin, looked like our next of kin, called and willed and parented and taught and navigated all just like our blood relations. Half their parts were still ours. Yet humans waved them off: impostors” (439).¹

Of course the problem with that equation is that the cranes weren’t yesterday our loved ones, our nearest and dearest, and do not therefore, as a result of our brain-related illness or accident, come to be experienced only today as impostors or doubles. If they ever were our nearest and dearest, they were that tens of thousands of years ago, and what our collective Capgras has “destroyed” is an emotional glow of familiarity that – if it ever existed at all – is buried deep in our race memory. The “collective Capgras delusion” that Powers puts in Karin’s late revelation is either a metaphor, an analogue – our denial of kinship with the rest of nature is like Capgras – or, if it is “real” (whatever that means), it has plagued “us” for all of human history, and indeed may be identical to human history. The “reality” of our “collective Capgras delusion,” to put that more cynically, is a tendentious interpretation, an activist construct that Arne Naess and other deep ecologists, and perhaps Powers as well,² are trying to inculcate in a transformed human consciousness – trying to make real. Trying to infuse with the feeling of reality, through powerful storytelling. That cynical reading makes the whole thing sound like a fantasy, if we proceed from the platonizing/objectivizing assumption that a thing is either “real” or “fake,” simulated; but Powers emphatically rejects that Platonism/objectivism, and I want to expand on his post-Kantian model as we go along, moving in the direction of a socioecological model of reality-construction or reality-periperformance that I call “icosis.”

Another way of putting that, to which I want to return in section 1.4: if we accept a post-Kantian/social-constructivist (or what I will call a “periperformativist”) model of reality-creation, the difference between one person creating a reality (say, Mark believing that he is not related to the woman calling herself Karin) and an entire population creating a reality (say, humans believing that they are not related to cranes) is that group-plausibilization makes the latter sense of reality “sane” and the former sense of reality “crazy.” There is no question but that, as the novel sees it – and we participate in that group seeing as well – Mark’s Capgras delusion is crazy. As things stand today, it is equally crazy to see humans as related to cranes. The deep-ecological hope, in which the novel participates, is that that will change, in the sense that people everywhere will come to experience cranes and other living and natural things as related to them, and the group-plausibilization of species interrelatedness will make what now seems crazy seem sane. (What’s interesting there is that Mark’s denial of his sibling relationship with the woman he calls Kopy Karin or Karbon Karin begins to drive Karin krazy too. As her only surviving family member, Mark is for her the most powerful group-plausibilizer of her status as his sister, and thus of a hugely important part of her identity. As a result, his denials begin to wear away at that group-plausibilized identity – begin to deplausibilize one part of it, and thus to drive a wedge into the very core of her identity, destabilizing the whole thing.)

One might be tempted to argue, given Baudrillard’s utter disregard for the neurological how of his topos of simulacra, and the w...

Table of contents

• Cover
• Title
• Copyright
• Contents
• List of Figures and Table
• Preface
• Essay 1 The medical humanities: the creation of the (un)real as fiction
• Essay 2 The translational humanities of medicine: literary history as performed translationality
• Essay 3 The medical humanities of translation: the social neuroscience of hermeneutics
• Conclusion: the humanities of translational medicine: the performative phenomenology of (self-)care
• References
• Index