Title: "Chronic(ling) Illness and the Work of Historicizing Johanna Hedva's 'Sick Woman Theory'"
In their 2016 essay “Sick Woman Theory,” genderqueer artist and social theorist Johanna Hedva described the category of “Sick Woman” as encompassing those individuals “who have been historically pathologized, hospitalized, institutionalized, brutalized, rendered ‘unmanageable,’ and therefore made culturally illegitimate and politically invisible,” and according to Hedva, “to stay alive, capitalism cannot be responsible for our care—its logic of exploitation requires that some of us die” (Hedva, n.p.). Hedva’s theory is important to my own work, which explores how nineteenth-century physicians conscripted the bodies of sick, dying, and dead patients during epidemics of yellow fever, cholera, and typhus, to produce new knowledge toward nosological ends. My dissertation, like the institutions it examines, is populated by a diverse assortment of Sick Women, all of whom shared a status as, at one point or another, institutionalized political outsiders. But a too-close focus on the condition of patienthood—even if it cuts across categories such as race, gender, and ability, not to mention time and space—flattens how those categories have intersected with experiences of being a patient. This does not mean that historians and other scholars should discard Hedva’s theory, but it does mean that we should carefully contextualize our applications of it.
In this paper, I ask: how do we do that? Defining intimacy as a value-neutral condition of physical and sensory proximity that can acquire a positive or negative valence based on context, I explore the relationship of Hedva’s theory to my own examination of historical forms of intimate care provided to institutionalized patients. Care can be—has been—violent and coercive, for all its intimate potential. I argue that the deeply intimate treatment regimens characteristic of the nineteenth century’s anatomical-clinical synthesis could not always save the patient. But if they failed the patient, they did not fail the physician, who drew upon pre- and postmortem observations of patients in constructing “fuller” accounts of diseases and the body. In nineteenth-century Philadelphia, the logic of clinical intimacy required some patients to die.