The two-way mirror in Bedside Manner is a rich metaphor for what really goes on in empathy. Putting a patient in a perfectly mirrored room is cruel; they are cut off from any real interaction and see only endlessly repeated images of themselves, getting smaller and smaller. With a two-way mirror everything depends on how much light the patient’s room and the doctor’s room gives out. If the doctor is dark and the patient brilliantly lit, all the doctor sees is the patient. But if the patient is in shadow and the doctor radiates too much energy, then all the doctor sees is a reflection of herself. If the therapy is going well, the glass gets thinner and thinner, and in the end the patient and doctor are in the same room, together, just two people who care about each other.
- Alice W. Flaherty, MD PhD, Author of The Midnight Disease
Bedside Manner is a series of photographs and an 18-minute video that explores the little-known world of standardized patient simulations. Standardized patients (SPs) are professional medical actors who are trained to present particular sets of symptoms in order to help medical students improve their diagnostic skills and bedside manner. Routinely, SP encounters are filmed and evaluated by medical professors who observe the interaction of student and medical actor through a one-way mirror.
The history of Western medicine is connected to issues of spectatorship, display, and pathology. I’m interested in how visual imagery has been used historically to represent the body and construct medical interactions. For instance, the famous nineteenth-century neurologist Jean-Martin Charcot presented hysterical female patients in an amphitheater and routinely photographed them acting according to enforced expectations, negatively linking women and pathology. My work examines the burden of medical history and the clinical gaze.
Empathic experience can connect, or it can replace the other’s pain with the projection of the observer. To be a “patient” is to be observed, reliant on a doctor’s interpretation and understanding of one’s body. My photographs document SPs and highlight the craft of the staged tableaux: the work gains its power by straddling the line between fact and fiction. Even though the standardized patient may be performing, this doesn’t mean the encounter isn’t “real”; acting and staged representations inform the interaction between patients and doctors in important ways. In order to express their suffering, real patients must learn how to act in doctors’ offices. Through simulated pain, we start to become aware of our empathic processes and the ethics of seeing. Bedside Manner prompts larger questions about authenticity, representation and perception.