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(Re)Examining the Clinical Gaze Through the Prism

of Literature

JOHANNA SHAPIRO, PH.D.


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The fact that physicians have the


authority to direct a probing, dissecting, and
analytic gaze toward their patients is one of
M any professionals, including
psychotherapists, teachers, pastors,
and artists "gaze" upon others in both literal
the most unique, yet by and large and metaphorical ways. But the practice of
unremarked upon, aspects of the doctor- medicine ideally employs a clinical gaze
patient relationship. Using the work of simultaneously organized along analytic,
Michel Foucault as a foundation, as well as diagnostic, empathic, and healing pathways
examples from fictional literature, this article not fully replicated by any other profession.
raises the question of how we as clinicians Patients expect, permit, and even invite the
look at our patients, how our patients gaze physician's actual gaze to explore the
back, and what can be accomplished or exteriors and interiors of their bodies in
destroyed by these exchanges. The article exchange for explanation and relief of
first revisits characteristics and suffering (Klass, 1987). Physicians, in turn,
consequences of various types of clinical use this literal gaze to inspect, analyze,
gaze. It then suggests the importance of assess, diagnose, as well as convey a range
training the gaze to include "transformative" of emotional attitudes. But the clinical gaze
modes of seeing, such as empathically as metaphor also symbolizes broader, more
witnessing the suffering of patients and intangible dimensions of interaction and
recognizing the common bonds we share relationship in ways of great importance to
with them, in order to restore a humanizing both patient and doctor. When we ponder
dimension to professional perception. the clinical gaze in all its multi-
dimensionality, we discover we are only in
the beginning stages of comprehending what
Fam Syst & Health 20:161-170, 2002 it is, what it might be, and how it should be
trained.
Defining the clinical gaze. Medical
education has treated the gaze either as an
observational, data-gathering tool or as a
nonverbal communication technique. On a
content level, of course, all medical
students are trained to become careful
observers of patient signs and symptoms.
Johanna Shapiro, Ph.D., UC Irvine Department
of Family Medicine, 101 City Dr. South, Rte. 8 1 , Bldg. This usually means honing one's analytic
200, Orange, CA 92868-3298; (949)824-3748; visual assessment of specific aspects of the
jshapir@uci.edu. patient's physical presentation. In

161
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162/ FAMILIES, SYSTEMS & HEALTH

combination with other sources of data- essential for the application of proper
gathering, the gaze-as-observation is a key science to the patient (Landau, 1993). On
component of the medical system of the other hand, it has been pointed out that
diagnosis, prognosis, and prescription. "if the physician's gaze loses sight of the
On a behavioral level, we classify the patient's immanent humanity, it is the
clinical gaze under the category of "eye patient who suffers..." (Henderson, 2000).
contact," a nonverbal behavior that is itself We must therefore wonder in what manner
nested within the larger grouping of doctor- the gaze should be conducted. Should we
patient communication skills. Medical look at the patient with steadiness or
interviewing techniques emphasize the tenderness, or some admixture thereof
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importance of making eye contact with (Coulehan, 1995)? What is our intent when
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patients (Coulehan & Block, 1997), while we cast our gaze in the direction of a
recognizing that this behavior should also patient? And what is the meaning of the
be influenced by factors of duration, gaze we receive in return?
frequency, gender, and circumstance
(Randall-David, 1989; Kleinke, 1986). FOUCAULT HELPS US SEETHE
However, the clinical gaze is inevitably CLINICAL GAZE
more than simple observation or eye
contact. The essence of the clinical gaze has Becoming aware of the gaze. Michel
as much to do with the psychological and Foucault, the French post-structuralist
spiritual meanings it creates for both patient philosopher who viewed himself as an
and physician as with the empirical evidence "archeologist" of social patterns, was among
it adduces or its more quantifiable the first to call attention to the physician's
behavioral properties. The gaze is not gaze as instigating and creating a new kind
simply a unilateral action directed by an of relationship between doctor and patient.
actor (physician) toward a passive object In The Birth of the Clinic (Foucault, 1973),
(patient). Rather, it is a metaphor for an Foucault documented the rise during the
evolving relationship emerging conjointly eighteenth century of "le regard," the
from the personhood of the doctor and that detached, scientific, objectifying profes-
of his or her patient. Indeed, the exchange sional gaze. This gaze was in large part the
of gazes helps to create, reflect, destabilize, result of the newly emerging science of
and reconstitute this relationship. Of course, pathological anatomy, which for the first
literally speaking, it is not "the gaze" that time enabled doctors to penetrate the
communicates, but the persons doing the surface of the (dead) body (Scott, 1987), in
gazing. Nevertheless, reflecting on the gaze the process transforming the (living)
rather than on the people gazing can be patient's bed into a field of scientific
useful. By thinking about how we look at investigation. Foucault contrasted the
the Other, and how the Other looks back at scientific gaze with the subjective, surface
us, we can learn something about who we gaze of earlier generations of physicians,
are in relation to each other. which was necessarily less expert but more
Training the clinical gaze. While few humane.
medical lectures are provided on training Properties of the clinical gaze
the clinical gaze as the term is used in this according to Foucault. Foucault's
paper, much subtext about the gaze exists. analysis highlighted the inherent power of
William Osier (1987) implied that physicians the clinical gaze, which he described as "the
should gaze on their patients with depositary and source of clarity... [with] the
"aequanimitas." Many physicians continue power to bring truth to light." This new gaze
to believe that the detached clinical gaze is presumed to penetrate below the surface
SHAPIRO /163
of things-and people-until it became "the were sometimes defined more by the
master and determiner of truth," able to medical community than by patients
distinguish between the appearance of truth themselves (Pryce, 2000). The gaze
and truth itself (Riska, 2000). By implication, dissected, segmented, and disassembled
whatever this gaze could not detect or people without containing a process for
understand necessarily fell outside the restoring their wholeness. Thus, the gaze
domain of important knowledge. Because tended to jeopardize the patient's claim to
of this property, the gaze became the authenticity. What the patient "really" felt,
primary vehicle by which not only even who the patient "really" was, became
physicians, but also the patients themselves, dependent not on his or her own subjective
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discovered what was "real" and objective experience, but on what the gaze discovered
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about their symptoms and what was and concluded. In this model, the individual
subjective and therefore invalid. Doctors increasingly became an object to be broken
alone, through their gaze, had the down and explored, a disembodied collection
competence to make proper judgments of organs or pathologies. The effect of the
about health and illness (Malterud, 1999). gaze was to turn the patient into the Other,
The gaze was dominating and governing, someone (or something) completely
with both decisional and interventional different and separate from the examiner.
authority, the power to determine "how At its worst, the gaze evolved into a form of
things really are." symbolic violence against patients, a
Above all, the gaze identified by Foucault powering-over that reduced and demeaned
was a modernist one in which an expert their humanity (Bourdieu, 1991).
imbued with professional knowledge used
a visualizing modality to gather specialized GAZING ATTHE GAZETHROUGH
information about the patient beyond that LITERATURE
which the patient him or herself could
provide. One of the attractions of the clinical Invaluable though Foucault's
gaze (later to be complemented by contributions were in first making us aware
"technological" means of gazing, such as x- of the existence of the gaze, and then helping
rays, MRIs, CAT scans, and laboratory us to question its purposes and effects, his
testing) was that it enabled the physician writing focused only on one permutation of
to pass more quickly through the the phenomenon. Of course, other forms of
discursive, subjective, and often unreliable the gaze exist, some more dangerous and
patient narrative. By giving the physician some more humanizing than the one
an expert way of gathering data inaccessible Foucault uncovered. Further, Foucault did
to the patient, the physician gained a new not emphasize the patient's gaze because
sense of control and invulnerability. he was more interested in the effects of the
Effects of the Foucauldian gaze on power wielded through the physician's gaze
patients. While the clinical gaze Foucault on patterns of social discourse. Indeed,
specified had the power to diagnose Foucault claimed that "medicine is all about
pathology more accurately and efficiently the confrontation of a gaze and a face... in
than previous approaches, it could also which people are trapped in a common, but
become a form of social control, urging its non-reciprocal situation (italics mine)."
targets (patients) into a posture of self- However, the patient is more than a "docile,
surveillance (monitoring for disease and compliant body" (Pryce, 2000), the passive
pathology) and confession (willingness to recipient of the medical gaze. Patients can
relinquish personal privacy). Yet the ends also turn their gaze on doctors (Szykiersky
and purposes of these behavioral controls & Raviv, 1995), and powerflowsfrom as well

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164/ FAMILIES, SYSTEMS & HEALTH

as toward patients (Williams & Calnan, framework of the clinical encounter, several
2000). literary examples of problematic "ordinary"
To further our understanding of the and "scientific" gazes are discussed below.
clinical gaze, we must do some archeological The voyeuristic gaze. The voyeuristic
digging of our own. One "artifact" that can gaze has as its aim not the assistance of
be helpful in this excavation is fictional the patient or the amelioration of the
literature about doctors and patients. The patient's suffering, but rather gratification
evocative, imaginative qualities of of the physician's curiosity and cravings,
literature allow us to easily comprehend, and perhaps reassurance of his or her own
be moved by, and reflect on different aspects anxiety (Kendrick & Costello, 2000). It is
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of the gaze. Literature is effective in this an overly intimate, self-indulgent gaze,


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pursuit because its assumptions and springing from a desire to move too close
interests focus on issues of meaning and to the patient in fulfillment of physician
relationship, thereby providing useful, desires. At first glance, the gaze of
immediate access to the multiple voyeurism seems remote from the practice
dimensions and possibilities of the gaze. of medicine. Yet it is a gaze that sometimes
While generally the medical literature has infiltrates the attitudes of medical students
not paid much attention to the clinical gaze,1 in a gross anatomy lab, or at the bedside of
infictionalliterature, references to the gaze a patient with an obscure, but intriguing
linking doctors and patients are common. medical condition. And how many
We will examine several aspects of the gaze- physicians can claim never to have gazed
in-literature, including non-Foucauldian, at a patient with voyeuristic fascination?
Foucauldian, and post-Foucauldian Bernard Pomerance's play The Elephant
interpretations. Man (Pomerance, 1973) tells the story of
the 19th century historical personage John
THE ORDINARY GAZE VS. THE Merrick, severely deformed by Proteus
SCIENTIFIC GAZE syndrome. Merrick supported himself
through young adulthood as a freak show
The ordinary gaze. Philosophers of exhibit but was later taken under the
medicine have sometimes distinguished protection of the physician Dr. Treves and
between the scientific and the ordinary lived out the remainder of his life in London
gaze. While the scientific way of perceiving Hospital. In the play, Dr. Treves displays a
reality has been criticized for its voyeuristic obsession with Merrick, whom
dehumanizing tendencies, ordinary he sees as furthering his academic career.
patterns of perception have been praised as In support of this end, Treves facilitates a
full of possibility and promise if steady stream of upper-class visitors to
reincorporated into the doctor-patient Merrick's chambers. Their gaze, while
relationship (Hick, 1999). Yet most of us who ostensibly benevolent and charitable, in
have directed an ordinary gaze toward reality indulges both their and Dr. Treves'
patients, or received such a gaze in return, attraction to deformity and monstrosity.
are aware that it too can sometimes cause Another illustration of voyeurism occurs
harm because of its lack of reflexive in the short story "The Secret" by
awareness and intentionality. Within the emergency room physician Frank Huyler
(Huyler, 1999). This story recounts a
situation in which the mouth of a severely
1
Much of the professional analysis of the gaze is injured man on a ventilator is overrun with
instead found in the nursing literature (Gastaldo & maggots, which provokes a spree of
Holmes, 1999). fascinated ogling among the medical staff.
SHAPIRO /165
Since their stares occur while the patient are no longer personal or emotional but
is unconscious, there is no attempt to look scientific and rational. In effect, it provides
beyond the medical curiosity to the person a weapon and a shield against the Scylla of
of the patient or even to obtain his submitting to one's own baser impulses and
permission for their gaping. When the the Charybdis of being emotionally
patient awakes, he is surrounded by overpowered by the patient's suffering.
knowing smiles but never learns their The Foucauldian gaze is perfectly
cause. Both of these examples raise captured in the poem "Technology and
troubling questions about the presence of Medicine" (Campo, 1994). The author, an
the voyeuristic gaze in the medical internist, Harvard professor, and respected
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encounter. poet, laments that his medical education


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The avoidant gaze. The avoidant gaze transformed him into a kind of
may characterize well-intentioned but Frankensteinian man-machine - "My eyes/
insecure doctors who are fearful of Are microscopes and cathode X-ray tubes/
becoming overwhelmed by their patients' In one" - who sees only bacteria, bones, and
suffering and do not want to engage blood chemistry. In the process of developing
interpersonally with patients. This gaze is this newly trained vision, he fears he has
rooted in the need to move away from the lost his ability to understand that his patient
patient, thereby minimizing contact to is someone "just like me." This gaze is
escape intimate and feeling connection. The also well represented in the poem, "The
student-physician with few skills for Doctor Who Sits at the Bedside of a Rat."
emotionally addressing patients' distress (Miles, 1967). In this poem, the physician
and uncomfortable with intimacy may approaches the patient as a lab animal, and
simply choose to avoid looking at his or her observes only "...a paw twitch, an ear
patient as much as possible. So may the tremor, a gain or loss of weight." The
cynical, burned-out physician who has no author acquiesces (ironically) that these
emotional resources left to expend through must be the only sources of data worthy of
gazing. physician attention. Both poems
Anatole Broyard, the former editor of disconcertingly portray the gaze of objective
the New York Times Book Review who died scientific curiosity that sees the patient as
of prostate cancer in 1992, described this Other, a specimen for examination and
sort of gaze well (Broyard, 1992): "I think treatment.
doctors have...a systematic avoidance of The patient gazes back. Unskillful
that click of contact...a generic unfocused forms of physician gazing, whether ordinary
gaze. They look at you panoramically. They or scientific, are often met with equally
don't see you in focus." In the short story questionable patient gazes. Rather than
"Outpatient" (Warren, 1990), Dr. Heller expose their vulnerability to the critical eye
mostly looks at the chart or the wall, of the physician, patients may respond with
anywhere but at his patient, Luisa. "He despair, cynicism, rage, or withdrawal. The
looks into the distance, concentrating. He Elephant Man portrays John Merrick
doesn't look at her." These writings remind rebelling against the voyeuristic gaze aimed
us that we can pretend to look at someone in his direction by becoming a voyeur
without really seeing them. himself. He stares at that most forbidden
The scientific gaze. The Foucauldian object in Victorian society, the exposed body
gaze of analysis and detachment implicitly of a respectable woman, using his anger to
solved the problems of both voyeurism and challenge conventions regarding who is
avoidance. This mode of looking eliminates empowered to stare at whom. In
exploitation and evasion because its aims "Outpatient" we find what is likely a

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widespread, but also cynical and aggressive, Fiction helps us recognize how the gaze
patient fantasy. The patient Luisa, who can shift subtly but crucially from
happens to be a skilled hypnotist, turns the detachment to witnessing. Often it is the
tables on her competent but unfeeling engagement of the patient in the encounter,
physician byfirstputting him into a trance, something the patient does or reveals, that
then forcing him to undress and sit naked moves the physician's gaze to this new level.
on the exam table. By contrast, the patients For example, in William Carlos Williams'
in the two poems cited above have lost their classic story "A Face of Stone" (Williams,
capacity to gaze at their doctors at all. In 1962), the doctor gazes coldly and
effect, their personhood has vanished from reductively at the poor, uneducated,
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these poems. Finally, as a patient Anatole immigrant parents inexplicably worried


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Broyard attempts to protect himself from about their normal healthy baby. The doctor
the emotional vacancy he encounters in his literally sees them as stupid, ignorant
physicians' eyes by adopting a consistently animals. Later, however, he discovers that
ironic, precious lens through which he then the infant's mother is a survivor of the
must perceive not only his doctors, but also pogroms. By being willing to understand the
his own dying. effects of this horrific experience on the
woman's life and attitudes, the doctor
GAZING BEYOND FOUCAULTTO begins to bear witness to the suffering she
POSSIBILITIES OF TRANSFORMATION has endured. When next he looks at his
patient, he sees her in a new, more
The above literary examples imply that compassionate way; the gaze she returns
it is difficult for both physicians and patients to him is similarly rehumanized.
to shift the nature of the gaze in a more In "Imelda," a short story by the Yale
humanizing direction. Yet such professor and surgeon Richard Selzer
transformation can occur. What kinds of (Selzer, 1998), Dr. Franciscus, a renowned
gaze enable us to authentically acknowledge plastic surgeon, conducts a charity
the subjective, particular experience of the reconstructive surgery clinic in a remote
suffering patient, or even to see the patient Honduran village. In the title case, he
not as Other, but as Self? In literature, we examines a girl with a hideous cleft palate
find many instances of what might be deformity. At first, his gaze sees only the
termed witnessing or recognizing gazes. anatomical error and the path to its
In these examples, we see the patient not correction, not the child's humiliation.
as a passive, acted-upon object but rather Later, when his patient unexpectedly dies
as fully participatory in a relational process during the surgical procedure, Dr.
of mutuality and reciprocity. Franciscus takes it upon himself to inform
The witnessing gaze. Witnessing is a her mother. Yet he cannot find the words,
term that grew out of the post World War and it is she who must tell him of her
II Holocaust literature and implies a daughter's death. Confronted with this
willingness to be empathically present with, articulated reality, "He closed his eyes. Nor
rather than turning away from, the did he open them until he felt the touch of
suffering of others. Witnessing in medicine the woman's hand.. .Then he looked and saw
has been described as the ability to accept the grief." At this moment, the physician is
and honor, rather than diminish, patients' able to be fully present to the mother's
anguish (Frank, 1995). It incorporates an suffering. As Selzer concludes, "There are
engagement between physician and patient events in a doctor's life that seem to mark
that the Foucauldian gaze lacks (Davenport, the boundary between...seeing and
2000). perceiving."
SHAPIRO /167
The gaze of recognition. Another recognition (both are suffering men, trapped
transformational way of looking is the gaze in impossible circumstances), and a glimmer
of recognition. Recognition represents an of understanding and human connection
even deeper level of connection than occurs.
witnessing in that it implies not only a In another Selzer story "Fetishes"
respectful acceptance of the Other, but an (Selzer, 1998), a middle-aged woman,
understanding that, at some basic human Audrey, facing surgery for a possibly
level, the Self is the Other. Such a gaze malignant ovarian cyst, is terrified only that
apprehends the oneness and connection of her husband will discover her secret-that
all living things and thus reduces the she wears false teeth! Most of her doctors
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distance between doctor and patient dismiss her concern as misplaced pride and
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(Martin, 1976). Berger, in A Fortunate Man: remove their glance to that "vast, safe
The Story of a Country Doctor (Berger, distance." But with one, a lowly, lame
1967) discusses this phenomenon of "deep Indian intern, Audrey throws herself on his
recognition." He implies that it is the mercy and begs for help. Dr. Bhimjee
patient's willingness to be vulnerable to the understands Audrey's distress. "For a long
physician that allows the latter to moment they looked at each other, during
accurately mirror the former, and in the which something, a covenant perhaps,
process find him/herself reflected as well. Audrey did not know, was exchanged... deep
"The Appointment," by internist, called unto deep." Deep calls unto deep, soul
professor, and ethicist Lawrence touches soul, and doctor and patient
Schneiderman (Schneiderman, 1995), recognize the suffering Self in the Other.
portrays a Mexican mother whose child has
died seeking help at a community clinic. TRAINING THE CLINICAL GAZE:
The usual gaze she encounters from the IMPLICATIONS FOR MEDICAL
clinic physicians is a "cold" one. At the EDUCATION
turning point of the story, a compassionate
bilingual psychiatrist approaches the The clinical gaze can be a valuable
mother and speaks to her in her own instrument of healing, an agent not simply
language. "He does not look me over like of dividing, segmenting, and dehumanizing,
the other doctors. Instead, he looks only but also of repairing and rehumanizing. It
into my eyes." Whereas the expression can be used either to emphasize the space
"looking over" conjures up images of that exists between patient and physician
inspection and evaluation, the psychiatrist's or to bridge that space. It would be naive
gaze acknowledges their shared humanity. and misplaced to condemn the prevailing
This recognition of Self in Other facilitates professional gaze out of hand, since its
the patient's struggle to confront her loss reductive, categorical, analytic approach is
and begin the slow process of healing. responsible for much of the successes of
Doc in a Box (Burton, 1991) describes an modern medicine. As Stoller (1996) points
encounter with a difficult patient out, power has negative and positive
complaining of a headache. When the aspects, energy as well as hostility, so it is
protagonist Dr. Smith examines the man's both necessary and appropriate that the
eyes, he tries to remind himself that "he clinical gaze be informed by specialized
was looking at the man's retina, not his expert knowledge. But it must also
soul," but he cannot prevent himself from incorporate the human dimensions of
seeing "the red blur of sadness that covered relationship to function in a healing, as well
all that the man saw." At this moment, as a diagnostic, manner.
patient and doctor exchange a gaze of For this reason, as Hick suggests, we

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need to cultivate an art and science of reintroduction of forms of looking that


perception, to help students recognize promote patient (and physician) well-being.
multiple gazes in both themselves and in A second approach involves a willingness
their patients, learn when various types of to pay close attention to the gaze of the
gaze are appropriate, and know how to patient. What is this gaze revealing? What
move comfortably among them in tandem does it hide? What is it asking of us? What
with their patients' gazes (Hick, 1999; does it want to share? The clinical gaze of
Davenport, 2000). Precisely because the the physician cannot be trained in a vacuum.
gaze Foucault describes has become so Acknowledging the gaze of the patient as
widely disseminated, medical education an equally influential element in the
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must take special care to retain and refine interaction is a crucial way of empowering
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other more humane forms of gazing in its patients. By developing sensitivity to the
learners. Physicians of necessity peer into desires and fears conveyed in the patient's
vulnerability, hurt, and suffering, so they gaze (Campo, 1997), we will begin to learn
must have the ability to convey concerned, what is required from our own reciprocating
as well as analytic, observation (Norvedt, gaze.
1998), especially when the gaze of the Reclaiming a more humanizing gaze will
patient is seeking such a response. As the probably be a futile task if approached on a
French philosopher Levinas expressed the purely scientific or procedural level
problem, to achieve a moral stance in (Toombs, 1992). But complementary
medicine, it is important to regain access approaches that combine emotional and
to "the primary, ethical vision of the intellectual engagement are available to us.
patient's face," which is often lost under the As suggested by the above discussion, one
scrutinizing scientific gaze (Levinas, 1982). way to accomplish physician simultaneous
To rehumanize and transform our clinical self-reflexivity and awareness of patients is
gaze, we first must be willing to look into to expose physicians-in-training to
our patients' eyes. imaginative literature and first-person
As clinicians and teachers, we must narratives by patients and physicians that
think seriously about how we want to examine the gaze. The reflective process
exercise our gaze and how we want to train- can also be encouraged through journaling
or untrain-the gaze of others. Practically and other forms of reflective writing. A
speaking, we know very little about how to further way to stimulate reflection on and
do this, and systematic pedagogical generate ideas about working with the
suggestions must await further empirical clinical gaze is to examine it through Balint
and qualitative research into this important groups, which provide an ideal forum for
but neglected area. An important first step examining the interpersonal and
is making our gaze self-reflexive (Manias intrapersonal qualities that either push
& Street, 2000), turning the gaze inward physicians away or move them toward their
on ourselves as well as outward toward the patients (Balint, 1957). Finally, to explore
patient. Indeed, several authors have the myriad potentialities of the clinical gaze,
pointed out that the controlling power of we can turn to the role-modeling of wise
the gaze depends in part on its being a one- and compassionate clinical teachers. These
way phenomenon (Szykiersky & Rivas, individuals, by highlighting and explicating
1995; Parker, 1995), so that while the patient their own shifts among various types of
must reveal all, the physician may remain gaze, can help students recognize the
hidden. Reflecting on and questioning the importance of how to look as well as help
nature of our gaze will help us challenge them discriminate proper and respectful
its unconscious application and allow for the uses of the gaze.
SHAPIRO /169
Perhaps as clinicians we can never Gastaldo, D., & Holmes, D. (1999). Foucault and
completely eliminate elements of the nursing: A history of the present. Nursing
Inquiry, 6, 231-240.
voyeuristic gaze. At times, it may be that Henderson, W.S. (2000). Life on the Mississippi.
we m u s t confess our emotional Medicine and the arts. Academic Medicine,
inadequacies and seek refuge in an avoidant 75, 1000.
gaze. Sometimes the detached clinical gaze Hick, C. (1999). The art of perception: From the
is both necessary and appropriate. Of life world to the medical gaze and back again.
greatest importance is that we learn to pay Medicine, Health Care and Philosophy, 2,129-
140.
attention to and cultivate the ability to Huyler, Frank. (1999). The blood of strangers:
"shift" our gaze in dynamic interaction with Stories from emergency medicine. Berkeley:
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

our p a t i e n t s to other, more h u m a n e University of California Press.


This document is copyrighted by the American Psychological Association or one of its allied publishers.

dimensions. When we are successful in this Kendrick, K.D., & Costello, J. (2000). "Healthy
task, our routine looking at patients viewing?": Experiencing life and death
through the voyeuristic gaze. Nursing Ethics,
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transformation. entirely benign procedure (pp.111-116). New
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The virtual gaze of health care in the next

International Exchange of Experienced Family Therapists


between North America and New Zealand
The Hutt Valley District Health Board's Child, Adolescent & Family Service, located
at Lower Hutt Hospital, Wellington, New Zealand, seeks expressions of interest from a
similar service within the United States or Canada interested in exploring the mutual
exchange of experienced family therapists for a period of 12 months.
We are a multi-disciplinary out-patient mental health service with a staff of 30 - 35
practitioners. The prominent modality of our work is Family Therapy.
The purpose of the exchange would be for the visiting clinicians to gain experience of
other clinical practice within the field of Family Therapy, personal professional
development including unique training opportunities, information and cultural exchange,
and international networking.
The concurrent exchange of a family therapist from each service means a temporary
staff position, and possibly accommodation, could be available for each visitor.
If your clinic or service is interested in pursuing this idea further please email us at
either child, and, family @ hvh. co. nz or avoca @ ihug. co. nz to further develop the concept.