Reviewed by:

• Metagnosis: Revelatory Narratives of Health and Identity by Danielle Spencer
• Bradley Lewis (bio)

Danielle Spencer’s Metagnosis: Revelatory Narratives of Health and Identity is a landmark and deeply imaginative contribution to work at the interfaces of biomedicine, psychiatry, humanities, literature, popular culture, cultural studies, disability studies, memoir, and personal narrative. It fills an important niche in the interdisciplinary domains of health humanities, medical humanities, and narrative medicine and is a welcome contribution to these fields. Indeed, I think we can see it as a “next generation” diffraction of those fields as they move from exploring interdisciplinary connections toward making confident discoveries and assertions of their own. Spencer writes much of the book in the first person as she explores her own experiences with extraordinary vision, medical diagnostic categories, surgical procedures, critical theory, and narrative medicine. She brings extensive scholarship to the process informed by her role as academic director of the Columbia University narrative medicine master’s program and as co-author of The Principles and Practice of Narrative Medicine. Metagnosis is thus not only a lively and enjoyable read; it is an education and masterclass in the uses of literature and humanities for understanding and navigating health, health care, and embodied identity more broadly.

At its heart, Metagnosis is a form of “autotheory” that deftly weaves together personal narrative of embodied experience with analysis and criticism of experience and the multiple discourses and institutions that surround and shape such embodied and enculturated experiences (35). This means there is no science/humanities divide in the text; the two have become so deeply cross-connected and intertwined that they work together like obvious collaborators—think of Uhura, Spock, and Bones—even when they are also at times antagonists and in conflict with each other. This welcome biocultural complexity effortlessly troubles and holds in tension binaries between medical/health humanities (focusing on the individual and the clinical encounter) and critical medical humanities (focusing on the social/political/cultural power dynamics [End Page 399] that surround that encounter). By weaving both the personal and the critical together, we can see how critical humanities can be part of an affirmative skill set (a “treatment” method, as Spencer puts it) useful for both individuals and biosocial/biopolitical communities who are navigating the world of bodily and mental difference and the many paradoxes, dilemmas, and conflicts that inhabit that world.

Part 1 of the book begins with Spencer’s coinage of a new term, metagnosis.

Met•ag•no•sis, n. [/,mɛtəˈnəʊsɪs/]. Etymology: from μετα-across, changed, different, after + γιγνώσκειν to learn to know, perceive. 1. The revelation of a longstanding undetected condition effecting a change in the terms of knowledge. a. Medicine. Diagnosis of a previously unobserved pathology, such as becoming aware that one is colorblind. May also occur when the diagnostic classification has shifted, as with the emergent and changeable category of autism spectrum disorders. b. Identity etc. Revelation of knowledge bearing upon selfhood, such as genetic testing indicating genealogy differing from one’s prior awareness.

(3)

Spencer argues that metagnosis, as a phenomenon, is becoming increasingly common as biomedical and genomic knowledge continues to develop. With increasing diagnostic categories and screenings (not to mention global pandemics and global medical surveillance and intervention), metagnosis serves as a bellwether for how we all must navigate biomedical and genomic research that is rapidly bleeding out of the laboratories and the clinics and moving further and further inside everyday lived experience and cultural formations. This means, for Spencer, we all need new and evolving languages to navigate emerging biomedical formations. And, it means, at least for me, that scientistic researchers and their journalistic and marketing promoters are not the only ones who can, or should, be empowered to make meaning and coin terms. All of us, or as Spencer puts it, all “fellow persons with bodies,” can and must be included in new languages and narrative creations for new times (299). Spencer’s complexity certainly shows the way for collaborative work at the interface of science and humanities. But it also makes clear...

审核人：

• 代谢：丹妮尔·斯宾塞（Danielle Spencer）关于健康与身份的启示性叙述
• 布拉德利·刘易斯（生物）

丹妮尔·斯宾塞（Danielle Spencer）的诊断学：关于健康与身份的启示性叙述是在生物医学，精神病学，人文科学，文学，大众文化，文化研究，残疾研究，回忆录和个人叙事的界面上工作的具有里程碑意义和深远想象力的贡献。它在健康人文，医学人文和叙事医学的跨学科领域中占据了重要的位置，并且在这些领域中可喜可贺。确实，我认为我们可以将其视为这些领域的“下一代”衍射，因为它们从探索跨学科的联系转向对自己的领域做出自信的发现和主张。斯宾塞（Spencer）在以第一人称视角撰写本书时，就以非凡的视野，医学诊断类别，手术程序，批判理论和叙事医学探索了自己的经历。叙事医学原理与实践。因此，诊断学不仅是生动有趣的阅读，而且是一种有趣的阅读方法。它是一门有关使用文学和人文学科来理解和导航健康，保健和更广泛地体现身份的教育和大师班。

从本质上讲，诊断是一种“自动理论”的形式，它巧妙地将个人化的体验式叙述与对体验的分析和批评以及围绕并塑造这种体现和文化化体验的多种话语和制度编织在一起（35）。这意味着文本中没有科学/人文学科的分歧；两者之间已经变得如此紧密的联系和交织在一起，以至于它们像明显的合作者一样共同工作-想想Uhura，Spock和Bones-即使他们有时有时是对立的并且彼此冲突。这种受欢迎的生物文化复杂性毫不费力地困扰着医学人文科学（关注个人和临床）与关键医学人文（关注社会/政治/文化力量的动态）之间的紧张二元关系[End Page 399]围绕着那个相遇）。通过将个人和批判者编织在一起，我们可以看到批判性人文科学如何成为平权技能集的一部分（如Spencer所说的“治疗”方法），对于在世界中航行的个人和生物社会/生物政治社区都是有用的身心差异以及居住在这个世界上的许多悖论，困境和冲突。

本书的第1部分从Spencer的新名词“ metagnosis”开始。

遇见否，n。[/，mɛtəˈnəʊsɪs /]。词源学：从μετα-穿越，变化，不同，在+ γιγνώσκειν之后学会了解，感知。1.揭示了一个长期未发现的情况，这种情况影响了知识方面的变化。一种。医学。诊断先前无法观察到的病理，例如意识到自己是色盲的。当诊断分类发生变化时，也可能会发生，例如自闭症谱系障碍的新出现和多变的类别。b。同一性等有关自我的知识的揭示，例如基因测试表明家谱与一个人先前的意识不同。

（3）

斯宾塞认为，随着生物医学和基因组知识的不断发展，诊断学作为一种现象正变得越来越普遍。随着诊断类别和筛查的增加（更不用说全球流行病以及全球医学监测和干预），诊断学已成为我们所有人如何进行生物医学和基因组研究的领头羊，而生物医学和基因组研究正迅速从实验室和诊所中流失，并朝着更远的方向发展。深入了解日常生活经验和文化形态。这意味着，对于Spencer来说，我们所有人都需要新的和不断发展的语言来导航新兴的生物医学形式。而且，这至少对我而言意味着，科学家研究人员及其新闻和市场推广人员不是唯一能够或应该做到的人，有权做出含义和硬币术语。我们所有人，或者正如Spencer所说的那样，所有“有身体的家伙”都可以而且必须包含在新语言和新时代的叙事作品中（299）。斯宾塞（Spencer）的复杂性无疑显示了在科学与人文科学界进行合作的方式。但这也很清楚...