116th Annual Conference - Bellingham, Washington
Friday, November 9 - Sunday, November 11, 2018

The Uncanny Patient: Reconciling the Psychological Trauma of Abject Horror in Medicine

Johan Clarke, Georgetown University

Julia Kristeva’s theories on abjection provide a framework to understand physicians’  fascination with the body going wrong. This paper uses Kristeva’s Powers of Horror to deconstruct various works of literature and the author’s personal experiences in medicine to understand the physician and the patient's uncanny relationship to the body and discomfort with death.


A teratoma is an easily resected ovarian tumor, evocative of disgust and fascination to the physician removing it, but often benign. Most patients, though, do not know it is possible to grow cavities full of teeth and hair inside one’s abdomen. The diseases that disgust most people, like teratomas growing body parts in unnatural places, fascinate most physicians, and many describe their patient’s condition with both horror and glee. The literary critic Julia Kristeva’s theories on abjection and the uncanny discuss how the breakdown between what is us and what we consider the things we cast off, like corpses and feces, instill a fear of our mortality. These theories provide a framework to understand physicians’  relationships to their patients - mediated by fascination, horror, the desire to intervene, and the contradictory desire to detach. A physician’s simultaneous repulsion and fascination of the diseased state causes psychological trauma as they have to confront the cognitive dissonance of violating a body, like cutting open an abdomen to remove a teratoma. The character Akhmed from A Constellation of Vital Phenomena portrays this cognitive dissonance as he reconciles the violating act in performing an amputation. Elaine Scarry's theories on torture from The Body in Painhelp to unpack Akhmed's disconnect between empathisizing with the patient while also harming the patient. Physicians overcome this by “casting off” the patient and treating them as a body rather than a person, ignoring the patient’s needs and autonomy. Many of the perspectives in Voices from Chernobyl highlight the patient and their loved ones attempting to advocate for bodily autonomy and recognition. This paper argues that the patient can conversely use the physician’s uncanny fascination as a way to obtain treatment and be recognized by their physician, even if it is as an object. The patient can also use art to reconcile the abject fears they have of their own bodies, producing beautiful interpretations of their deformities in the process of accepting  these bodily changes and, ultimately, their own mortality. The paper uses theories set forth by Tim O'Brien in The Things They Carried and his interest in the beauty with truthful representations. The film Annihilation uses science fiction to portray changes of the body found in cancer and how patients can understand and accept these changes and consider them beautiful. The personal narrative in Audre Lorde's Cancer Journals provides a response to cancer that accepts new forms of aesthetic beauty that reject classic heteropatriarchal understandings of the breast and body. This paper uses Kristeva’s Powers of Horror essay to deconstruct works of fiction, narrative nonfiction, film, and the author’s personal experiences in medicine to navigate how both the physician and the patient use their uncanny relationship to the body to feel closer to and more comfortable with death.

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