Professional medicine has had an antagonistic relationship with women throughout its history. Since the 1800s, physicians have wrested control over abortion away from women1 ; medical intervention has become the Western norm for pregnancies2; and, doctors routinely fail to recognize women's illnesses, often outright dismissing them as psychosomatic.3 Indeed, as Kathryn Pauly Morgan charges, medical authorities believe they are solely entitled to manage women's health, bodies and minds, as well as determine women's health needs.4 It is a difficult relationship: while modern medicine has benefited women through certain of its advances, it has also contributed greatly women's embodied subordination.
An examination of Michel Foucault's text The Birth of the Clinic: An Archaeology of Medical Perception lays bare the discursive underpinnings of this fractious relationship.5 This analysis of modern medicine's historical development illustrates the transition from a medieval medicine of visionary beliefs to the rational 'seeing' medicine of contemporary society. A close, but critical, reading of this text reveals the unspoken gender hierarchies embedded in the medical knowledge structure, which Foucault analyzes. Specifically, modern medical perception is exposed (again) as a masculinist apparatus of biopower/knowledge, stemming from its historical connections with Enlightenment thought and the tenets of the French Revolution. As many feminist theorists have now charged, Cartesian dualism entrenched patriarchal sexual binaries; its rational male subject is associated with the mind; its female counterpart is associated with the unruly body and, therefore, in need of control.6
In its strictest sense, the binary construction of medical knowledge is derived from this sexual hierarchy. 'Man' is the 'normal,' living medical model of health and 'woman' is the pathologized deficient object in need of medical intervention. This dualism, however, is laced with paradoxes and instabilities which are produced by the exact workings of this medical discourse. Man, for instance, must also become a medical object to enter the medical paradigm for treatment, while woman is central to medical authority as the discursive pathologized foil to the male medical norm. As will be demonstrated, such paradoxes ultimately lead to 'woman' being equated with death through the dysfunctional logic of medicine's bipolar knowledge structure. Taking up Elizabeth Grosz's suggestion that women's corporeality is used as a discursive substitute for the disembodied man in masculinist knowledges, this woman-as-death paradox both challenges and reinforces the structure of medical knowledge. This contradiction, in turn, suggests a frailty in the hegemonic force of contemporary medicine which may signal space for resistant alternatives.
Problematizing the objective face of medical authority in this way, the hierarchical binary logic of medical biopower/knowledge can be deconstructed, thereby exposing its collusion with other epistemologies. This analysis is, then, both an archaeology of Foucault's analysis of the historical development of medical knowledge and an archaeology of medical knowledge itself.
Uncovering the Male Subject of Medical Perception: Revealing the Paradox of Woman-As-Death
An initial reading of The Birth of the Clinic may not seem to reveal a gendered discourse. Foucault details the historical events which shaped medical knowledge into a rationalized system in post-Revolution France. Developing a totalizing system for clinical observation, this period marks the ascendance of medicine's separation of the normal from the pathological. Yet, it is precisely the productive biopower of this oppositional logic that inextricably connects medical knowledge to the gender binary hierarchy. As Foucault demonstrates, this transition of medical knowledge did not arise in isolation from the social, cultural, and political events of its time. It was, instead, intimately entwined with them. In Foucault's particular reading, the events surrounding the French Revolution tied medicine to Enlightenment notions of civil society, rationality, and the agental-yet abstract-individual. Numerous feminist scholars have now exposed this individual as a discursive male construct derived from an Enlightenment hierarchy of the active male agent over his passive female foil.7 And, as Thomas Laqueur asserts, this transition to a 'two-sex/flesh model' of sexual difference is explicitly entwined with the biopower of the rising science of medicine.8 It is not that sexual difference was 'proven' per se, but rather that the politics and power relations of the time converged with the production of a new social order through which the body was being remade; and, it was a new kind of 'sexed body' that was central to the sociopolitical changes of the eighteenth and nineteenth centuries, over which medicine was given primary authority.9