Katja Herges

Health concerns by migrants have been neglected in the German healthcare system, and they are impacted by discriminating discourses of othering. By analysing two autobiographical illness narratives by immigrants in contemporary Germany, this article exposes limitations in existing discourses of migration health and argues for more relational and affirmative theories of illness and care. Evelyn Leandro’s diary The Living Death: The Struggle with a Long-Forgotten Illness (2017) describes her own drawn-out therapy against leprosy as a Brazilian in Berlin. In Mr Kiyak Thought That the Best Part of His Life Will Start Now (2013), the Turkish-German journalist Mely Kiyak narrates her father’s experience with advanced lung cancer in a German hospital. Drawing on medical anthropology, postcolonial theory and material (eco)feminism, I argue that these narratives establish migrant health and agency in transnational assemblages that include chemotherapy, lungs and skin, family networks, healthcare providers, food cultures and health policies. These assemblages of illness are connected with the narratives’ hybrid and relational aesthetics and politics: similar to Gloria Anzaldúa’s practice of autohistoria-teoría, I show how Kiyak’s and Leandro’s life writing combines personal and communal storytelling with critical theorising to include diverse voices, languages, histories and identities. By transgressing identities of self and other, German and foreign, patient and physician, human and non-human, the narratives inspire a greater sense of the extent to which (all) bodies, histories, cultures, technology and medicine are entangled in a dense network of relations. This article envisions a relational and hybrid ontology and aesthetics of migration health and thereby intervenes into the growing field of transcultural medicine and medical humanities.

Health concerns by migrants have been neglected in the German healthcare system, and they are impacted by discriminating discourses of othering. By analysing two autobiographical illness narratives by immigrants in contemporary Germany, this article exposes limitations in existing discourses of migration health and argues for more relational and affirmative theories of illness and care. Evelyn Leandro’s diary The Living Death: The Struggle with a Long-Forgotten Illness (2017) describes her own drawn-out therapy against leprosy as a Brazilian in Berlin. In Mr Kiyak Thought That the Best Part of His Life Will Start Now (2013), the Turkish-German journalist Mely Kiyak narrates her father’s experience with advanced lung cancer in a German hospital. Drawing on medical anthropology, postcolonial theory and material (eco)feminism, I argue that these narratives establish migrant health and agency in transnational assemblages that include chemotherapy, lungs and skin, family networks, healthcare providers, food cultures and health policies. These assemblages of illness are connected with the narratives’ hybrid and relational aesthetics and politics: similar to Gloria Anzaldúa’s practice of autohistoria-teoría, I show how Kiyak’s and Leandro’s life writing combines personal and communal storytelling with critical theorising to include diverse voices, languages, histories and identities. By transgressing identities of self and other, German and foreign, patient and physician, human and non-human, the narratives inspire a greater sense of the extent to which (all) bodies, histories, cultures, technology and medicine are entangled in a dense network of relations. This article
envisions a relational and hybrid ontology and aesthetics of migration health and thereby intervenes into the growing field of transcultural medicine and medical humanities.

Contemporary textual and visual representations of cancer engage self-reflectively with death and dying, yet they often rely on normative notion of death as the end of an individual life. This article focuses on stylised cancer portraits of the young German Nana Stäcker which she took in collaboration with her mother and professional photographers during her chemotherapy and until her death. Intervening in the field of Queer Death Studies this article explores if and how these images allow us to rethink normative Western notions of death. Drawing on Rosi Brai-dotti's posthuman theory of death and of female subjectivity, I argue that the photo shoots recast Nana's illness and dying as a gendered and creative process of subject formation beyond individual death. Through creating aestheticised and eroticised camp images, Nana playfully performs und subverts a range of iconic Western femininities and styles both life and death as a constant becoming. Portraits of Nana as virtual female corpse further highlight this continuity of life and death by reinserting death into life. While these images resist a necropolitical engagement with cancer and dying, they suggest an impersonal and affirmative understanding of death that opens up bioethical questions about contemporary cultures of longevity and health.

Illness narratives, often based on autobiographical experiences of female patients or their caregivers, have increased in recent decades in the West (Lorde 1980; Mairs 1996; Stefan 2007; Schmidt 2009; Hustvedt 2010). Such narratives often describe explicitly the material and affective aspects of intimate bodily experiences. I analyze two German quest illness narratives: Charlotte Roche’s pop novel Feuchtgebiete (2008) and Detlev Buck’s German-Cambodian film Same Same But Different (2010) that is based on the memoir Wohin Du auch gehst by German journalist Benjamin Prüfer (2007). In both narratives, the protagonists and their partners struggle in their search for love and identity with illness or injury in relation to body fluids, including hemorrhoids and HIV. I argue that Feuchtgebiete and Same Same But Different not only critique medical and cultural discourses on body (fluids) and sexuality but also foreground a feminist trans-corporeal concept of the body and of body fluids that is open to fluid identities and material connections with the (global) environment. At the same time, the conventional and sentimental ending of these quest narratives undermines the possibilities of the trans-corporeal body and its fluid exchanges.

Background—The pathology of neuromyelitis optica (NMO), in contrast to multiple sclerosis, comprises granulocyte infiltrates along extensive lengths of spinal cord, as well as optic nerve. Furthermore, IFN-β treatment worsens NMO. We recently found that experimental autoimmune encephalomyelitis (EAE) induced with Th17 cells is exacerbated by IFN-β, in contrast to disease induced with Th1 where treatment attenuated symptoms.

Optical coherence tomography (OCT) has gained increasing attention in multiple sclerosis (MS) research and has been suggested as outcome measure for neuroprotective therapies. However, to date it is not clear whether patterns of retinal nerve fiber layer thickness (RNFLT) loss are different in MS compared to other diseases such as glaucoma and data on RNFLT loss in MS patients with or without optic neuritis (ON/NON) have remained inconsistent or even contradictory. In this large cross-sectional study we analyzed the patterns of axonal loss of retinal ganglion cells in MS eyes (n=262) with and without history of ON (MS/ON: 73 eyes; MS/NON: 189 eyes) and patients eyes with glaucomatous optic disc atrophy (GA: n=22; 39 eyes) in comparison to healthy control eyes (HC: n=406 eyes). We found that significant average and quadrant RNFLT loss is detectable by OCT in both MS and GA patients compared to healthy controls (p<0.01). The age- and gender adjusted average and quadrant RNFLT did not differ significantly between MS and GA patients (p>0.05). Average (p<0.0001) and quadrant (p<0.05) RNFL thinning is significantly more severe in MS/ON versus MS/NON eyes, and the extent of RNFL thinning varies across quadrants in MS/ON eyes with the highest degree of RNFLT loss in the temporal quadrant (p<0.001). RNFLT reduction across all four quadrants in MS patients as a whole as well as in MS/NON eyes argues for a diffuse neurodegenerative process. Superimposed inflammatory attacks to the optic nerve may cause additional axonal damage with a temporal preponderance. Future studies are necessary to further evaluate the capacity of OCT to depict disease specific damage patterns.

Holocaust memoirs and diaries such as Ruth Klüger's weiter leben have been published in large numbers in the last decades, but more recently, another genre of life writing about memory has emerged and received much attention: memoirs, novels, and documentaries about life with and care for patients with dementia, including Arno Geiger’s Der alte König in seinem Exil [The Old King in his Exile]. The interrelations between Holocaust and dementia memoir, between contemporary bodily trauma and past traumas, and remembering and forgetting the past, have been neglected so far. This might reinforce the dichotomy between concepts of social remembering and individual pathological forgetting, “collective memory” in the social sciences and “cognitive memory” in neuroscience.
In line with recent neuroscience research of memory as oscillatory neuronal activity, feminist philosopher Karen Barad suggests, that remembering isn’t a recording or even a reconstruction of the past through the lens of the present. Drawing on Barad, I analyze in this paper how these intersections between Holocaust and bodily trauma allow us to conceptualize memory/loss beyond a recovery or a loss of the past, but as continuous and dynamic reconfiguration of time, space and matter. Both Klüger and Geiger use spatial metaphors of disorientation, exile and deterritorialization to emphasize both the painful and transformative aspect of this process. In theorizing re-membering as material entanglement beyond the individual brain, life writing about memory/loss might contribute to bridge social and bodily understandings of memory.

In Western culture, movement is mostly considered a mechanical displacement of bodies from A to B in a pre-existing temporal-spatial setting. Movements allow for functional activities that permit people to live independently. Like memory, movement and mobility are considered essential components of a modern, independent life and of personhood. In consequence, dependency on caretakers and tools is perceived as loss or limitation of control, independence and privacy, and people with moving disabilities are marginalized and infantilized, as not fully alive or mature. Western medical care takes it for granted that we must strive to restore normalized, autonomously moving bodies or adapt bodies as closely as possible to the ableist norm. So far, scholarship on German life writing about illness has focused on the aesthetic value of illness narratives and the individual and subjective voices they add to medical discourse. In contrast, I attempt to show in this presentation how life writing about " abnormal " embodiment and movement can be generative and creative in rethinking bodily movement beyond events of independent displacement. I analyze Reto Gloor's The Karma Problem: MS – an incurable Disease takes Control, [in German: Das Karma-Problem: MS – eine unheilbare Krankheit übernimmt die Kontrolle] a graphic memoir that describes the first years of Gloor's life following his diagnosis with Multiple Sclerosis, an autoimmune disease of the nervous system.

The two migration illness narratives Herznovelle [heart novella] by Jewish Russian-Austrian and Schuppenhaut: Ein Liebesroman [Scaly Skin: A Love Story] by the Slovak-Swiss author Irena Brežná portray imagined or real love affairs between a health care provider and a patient. I argue that in both novels the love affairs disrupt the traditional Western model of hierarchical and separate bodily identities of physician and patient and their gendered dichotomy: these sexual transgressions open ambivalent, fluid and hybrid identities in between and across bodily borders. However, the fragility of these identities is highlighted through the female protagonists’ final return to their husbands.

In recent media coverage of migrants and refugees, especially in the aftermath of the refugee crisis in Europe, discourses of embodiment, pathology and nationality continue to intersect. The human body and the body of the nation are conceived as closed entities. Consequently, both bodily borders and national borders are established and reinforced through surveillance and processes of elimination. In medical models, illness and in particular infectious agents are often imagined as foreign elements that pose an internal or external threat to the body, much like migrants are perceived to threaten the body politic. Furthermore, medical theory frequently implies a linear chain with a simple cause-effect-elimination logic, starting with a specific source of infection, the appearance of the first symptoms, the medical detection of the causative agent, and the treatment that eliminates the causative agent and leads to the restoration of a healthy body. Thus, the body is not only a victim of foreign pathological elements, but also, once the treatment starts, a passive target of active, almost omnipotent drugs even though long-term care of patients with chronic illnesses often precludes cure and restoration and frequently requires multiple therapeutic approaches. This dichotomy of passive body and active drug is reflected in the notion of the passive migrant, who, unlike the active citizen, depends on the public health care system that pays for her or his needs. In the following I want to focus on the often-neglected experiences of chronically ill migrants in the German context and, more importantly, on the ontological potential of migrant narratives concerning questions of embodiment and long-term care. In other words, the purpose of this presentation is not to deny that migrants deal with very specific health problems nor to imply that all writing by migrants is primarily concerned with migration, foreignness, and exile.

This course will explore contemporary ethical issues confronting the practices of medicine and biosciences through the lens of narratives. We will examine memoirs, ethnographies, plays, films on topics such as euthanasia/assisted suicide, research ethics, abortion and reproductive control, genetic control and IVF and government intervention and child neglect. Through these narratives we will explore and discuss the biomedical, legal and ethical concepts and practices that are raised by these complex bioethical issues. We will develop our ability to critically evaluate arguments and to write clearly about our own position on ethical issues in biomedicine.

Course Description The field of medicine and the humanities has been studied historically through fictional accounts of illness, often written from the perspective of a physician-author. However, this course analyzes 19 th , 20 th and 21 st century artistic and medical texts about pathology across multiple media and perspectives, including (graphic) memoir, case history, drama, short story, poetry, film, documentary, photography, blog, exhibition and illustrations. These works will allow us to think about 1) how Western medicine and culture conceptualizes bodies, pathology and health in different time periods, 2) how social categories of gender, race, class are implicit in these concepts and 3) how these concepts shape our understanding of Western healthcare. Humanities inquiry is especially useful here, as we examine how the documents of human experience and culture represent the intimacies, complexities, and contradictions of such concepts over time. Specifically, we will focus on four themes and trace historical changes: anatomical representations of bodies (from Vesalius to Gunter von Hagens), definitions of mental illness (from hysteria to environmental illness), response to old and new plagues (from syphilis to cancer, and approaches to pain and dying. Our task in this course is to use a view from the humanities to better understand concepts of bodies, pathology and health and their relations, both historically and presently. Finally, we will attempt to use such knowledge to think about the complexity of healthcare in the US, and how health care and policy might look like in the future.

In recent decades, life writing has exploded in popularity: memoirs that focus on traumatic experiences now constitute the largest growth sector in book publishing worldwide. But life writing is not only highly marketable; it also does important emotional, cultural, and political work. It is more available to amateurs and those without the cultural capital or the self-confidence to embrace more traditional literary forms, and thus gives voice to marginalized populations. Contested Selves investigates various forms of German-language life writing, including memoirs, interviews, letters, diaries, and graphic novels, shedding light on its democratic potential, on its ability to personalize history and historicize the personal. The contributors ask how the various authors construct and negotiate notions of the self relative to sociopolitical contexts, cultural traditions, genre expectations, and narrative norms. They also investigate the nexus of writing, memory, and experience, including the genre's truth claims vis-a-vis the pliability and unreliability of human memories. Finally, they explore ethical questions that arise from intimate life writing and from the representation of "vulnerable subjects"; as well as from the interrelation of material body, embodied self, and narrative. All forms of life writing discussed in this volume are invested in a process of making meaning and in an exchange of experience that allows us to relate our lives to the lives of others.