Skull Base Knowledge. Cultural Implications of Cranial Plastic Surgery

Sigrid Weigel, Ernst-Johannes Haberl, Volker Hess, Uta Kornmeier, Stefan Reinsch, Simon Strick, Li Anna Töppe
Sponsorship Volkswagen Foundation »Schlüsselthemen der Geisteswissenschaften«/»Key Issues for Research and Society« 2011–2014

Research collaboration of Center for Literary and Cultural Research Berlin and Pediatric Neurosurgery and Institute for the History of Medicine of the Charité – University of Medicine Berlin

The project’s point of departure is the discrepancy between the technologically advanced operation procedures in plastic surgery and the vague terminology of the evaluative description of its »object«. The project investigates the cultural and scientific historical origins of the norms and ideals of physical appearance and of its function as an index of personality. The often unacknowledged presence of these concepts in medical discourse, as well as in visual representations and medical practice and therapy, will be examined. Serving as the focal point of the project is the human skull and its crucial role in the perception of self and others.
The project answers to the demands of highly specialized surgical practitioners, who are correcting skull deformations in children at the Charité University Hospital Berlin. The project aims to investigate the unacknowledged cultural meanings and historical contexts of head shapes, and to provide the practitioners with ways to negotiate these in their medical practices. The goal is to uncover and comprehend the underlying cultural conceptions by means of an informed, reflective and patient-oriented research methodology.
The historical component of the project will investigate the genesis of the concept of a »well-formed« skull that arises from the interrelation of medical science, arts and cultural semantics. The contemporary portion of the project investigates the interactions between medical experts and patients.

Sub-projects:
Texts: Rhetoric and Cultural Semantics of Cranial Knowledge in Medicine (Simon Strick)

Focusing on the genealogy of and current discourse on Craniosynostosis, this project analyzes the discursive field of the »malformed skull«. Since the discovery of prematurely fused cranial sutures by Virchow around 1860, and the routinization of its surgical treatment about 40 years ago, the vocabulary to describe the pathological skull shape has changed considerably. With the help of qualitative content-analysis of medical articles and textbooks, the project will establish the semantic field that characterizes cranial knowledge. With special attention to cultural and historic connotations of medical rhetorics (»malformation«, »deformity«), the underlying cultural assumptions of distinctions between »deviant« and »normal« head shapes will be investigated.

Visualizations: Cranial Images in Art, Medicine and Statistics (Uta Kornmeier)

All medical professional publications work with visualizations (whether they are drawings, photographs, diagrams, or pictures and models produced by imaging technologies). As art history, visual studies and media sciences have demonstrated, images are no mere illustrations of pre-existing knowledge, but play an instrumental part in the actual generation of that knowledge.
This project part analyses the specific rhetoric of images in contemporary and historical cases involving craniosynostosis, and examines the interaction between text and image.

Medical Practices: Doctor-Affiliated Interaction (Birgit Griesecke)

Although the surgical treatment of craniosynostosis leads to dramatic alterations of exterior appearance, there is no long-term study that documents the longevity of the morphological change. Equally absent are studies inquiring into the satisfaction of the parties involved regarding the operations and their effects upon self- and external perception. This patients’ perspective (or that of those acting on their behalf) can however provide insight into what is expected of contemporary high-performance medicine during an intervention into a body part that is public and intimate at the same time. With the help of narrative interviews (as a method of medicine-ethnology inspired by qualitative social research), the subjective assessments of the patients (and their families) in regards to the treatment will be reconstructed.

Cultural Historical Investigations into Correlations between the Figure of the Doctor and the Artist (Dissertation Project, Li Anna Töppe)

The dissertation project examines interrelations between art and plastic surgery. Focus of the analysis is the search for shape and the way it is constituted in both disciplines.
The project aims at characterizing this by looking at the specific ways material is used and techniques are established at the end of the 19th and in the course of the 20th century in both contexts. Concepts of movement and immobility as well as of the body are also considered in order to understand the processes and outcomes of the »productions« of forms.