Medical rooms and hospitals are safe, infantalising, dangerous, creepy, life-saving, traumatising places, and I offer them here as examples of what Foucault called ‘heterotopia‘.
The hospital’s ambiguous relationship to everyday social space has long been a central theme of hospital ethnography. Often, hospitals are presented either as isolated “islands’ defined by biomedical regulation of space (and time) or as continuations and reflections of everyday social space that are very much a part of the “mainland.’ This polarization of the debate overlooks hospitals’ paradoxical capacity to be simultaneously bounded and permeable, both sites of social control and spaces where alternative and transgressive social orders emerge and are contested. We suggest that Foucault’s concept of heterotopia usefully captures the complex relationships between order and disorder, stability and instability that define the hospital as a modernist institution of knowledge, governance, and improvement.
Hospitals (like airports) elicit the full range of human emotion and are symbolically useful arenas for storytellers. Who better than writers to describe what it feels like to be inside a hospital?
I followed [the psychiatrist] down a depressing hallway into a tiny windowless office that might have housed an accountant. In fact it reminded me a bit of Myron Axel’s closet, filled with piles of paper waiting to be filed, week-old cups of coffee turned into science experiments, and a litter of broken umbrellas nesting beneath the desk.
I must have looked as surprised as I felt when I entered her office, for Rowena Adler looked at the utilitarian clutter about her and said, “I’m sorry about this mess. I’m so used to it. I forget how it looks.”
– Someday This Pain Will Be Useful To You by Peter Cameron
The author may have enjoyed writing that description because at James Sveck’s next appointment they are in a different room.
Dr Adler’s downtown office was a pleasanter place than her space at the Medical Center, but it wasn’t the sun-filled haven I had imagined. It was a rather small dark office in a suite of what I assumed were several small dark offices on the ground floor of an old apartment building on Tenth Street. In addition to her desk and chair there was a divan, another chair, a ficus tree, and some folkloric-looking weavings on the wall. And a bookcase of dreary books. I could tell they were all nonfiction because they all had titles divided by colons: Blah Blah Blah: The Blah Blah Blah of Blah Blah Blah. There was one window that probably faced an airshaft because the rattan shade was lowered in a way that suggested it was never raised. The walls were painted a pale yellow, in an obvious (but unsuccessful) attempt to “brighten up” the room.
The description of James’ psychiatrist’s rooms is broken up, judiciously, and fits around the action. James’ reaction to the rooms reflects how he feels about life at this juncture: He expected better. He expected different; instead he gets this underwhelming life.
I looked around her office. I know it sounds terrible, but I was discouraged by the ordinariness, the expectedness, of it. It was as if there was a catalog for therapists to order a complete office from: furniture, carpet, wall hangings, even the ficus tree seemed depressingly generic. Like one of those little paper pellets you put in water that puffs up and turns into a lotus blossom. This was like a puffed-up shrink’s office.
In a book of essays, Tim Kreider’s description of hospitals is one of the best I’ve encountered:
Hospitals are like the landscapes in recurring dreams: forgotten as though they’d never existed in the interims between visits, but instantly familiar once you return. As if they’ve been there all along, waiting for you while you’ve been away. The endlessly branching corridors sand circular nurses’ stations all look identical, like some infinite labyrinth in a Borges story. It takes a day or two to memorize the route from the lobby to your room. The innocuous landscape paintings that seem to have been specifically commissioned to leave no impression on the human brain are perversely seared into your long-term memory. You pass doorways through which you can occasionally see a bunch of Mylar balloons or a pair of pale, withered legs. Hospital beds are now just as science fiction predicted, with the patient’s vital signs digitally displayed overhead. Nurses no longer wear the white hose and red-cross caps of cartoons and pornography, but scrubs printed with patterns so relentlessly cheerful–hearts, teddy bears, suns and flowers and peace signs–they seem symptomatic of some Pollyannish denial. The smell of hospitals is like small talk at a funeral–you know its function is to cover up something else. There’s a grim camaraderie in the hall and elevators. You don’t have to ask anybody how they’re doing. The fact that they’re there at all means the answer is: Could be better. I notice that no one who works in a hospital, whose responsibilities are matters of life and death, ever seems hurried or frantic, in contrast to all the freelance cartoonists and podcasters I know.
Time moves differently in hospitals–both slower and faster. The minutes stand still, but the hours evaporate. The day is long and structureless, measured only by the taking of vital signs, the changing of IV bags, medication schedules, occasional tests, mealtimes, trips to the bathroom, walks in the corridor. Once a day an actual doctor appears for about four minutes, and what she says during this time can either leave you and your family in terrified confusion or so reassured and grateful that you want to write her a thank-you note she’ll have framed. You cadge six-ounce cans of ginger ale from the nurses’ station. You no longer need to look at the menu in the diner across the street. You substitute meat loaf for bacon with your eggs. Why not? Breakfast and lunch are diurnal conventions that no longer apply to you. Sometimes you run errands back home for a cell phone or extra clothes. Eventually you look at your watch and realize visiting hours are almost over, and feel relieved, and then guilty.
— Tim Kreider, “An Insult To The Brain”, We Learn Nothing
What’s It Like To Work In A Psych Hospital? is a podcast from Psych Central with someone who explains how psychiatric hospitals are traumatising for everyone in and around them, not just for the patients.
Header painting: William Simpson – One of the wards of the hospital at Scutari 1856