{"id":608,"date":"2021-09-17T12:00:00","date_gmt":"2021-09-17T15:00:00","guid":{"rendered":"https:\/\/levedura.blog\/?p=608"},"modified":"2022-09-05T19:00:35","modified_gmt":"2022-09-05T22:00:35","slug":"rosto-ciencia-e-bisturi","status":"publish","type":"post","link":"https:\/\/levedura.blog\/en\/rosto-ciencia-e-bisturi\/","title":{"rendered":"Face, Science, and Lancet"},"content":{"rendered":"
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The delivery went well, but the doctors didn\u2019t take the baby back to the mother as\nexpected. The father was frightened. He went to find out what had happened, but no one would\ntell him anything. After much insistence, which resulted in a heated argument with one of the\nhospital security guards, he was finally allowed access to his newborn child. Before, however, the\nobstetrician announced: \u201cWe\u2019re not sure what to do\u2014the boy was born with no face.\u201d<\/p>

The parents discovered, a few days later, that there was an opening extending from the\nbaby\u2019s upper lip to the nose through the roof of the mouth\u2014in medical terms, cleft lip and palate,\na congenital anomaly <\/em>that occurs in the embryonic period, up to the 12th week of pregnancy.\nThyago, now a lawyer and interlocutor of the research I am developing, had a face. A face that,\nafter more than 10 surgeries performed over two decades of treatment, has a small scar. This true\nstory, which took place in the mid-1980s in a hospital in S\u00e3o Paulo, is still re-enacted in present\ndays. There are many medical professionals who, like most lay people, do not know how to act\nwhen faced with faces that cross the border of what we consider normal<\/em>.<\/p>

As in the case of the doctor who was unable to name the baby\u2019s condition, the vast field\nof textual and image information available to us does not seem to be enough to talk about the\nface. It escapes us at the same time it constrains us. Disability studies theorist Garland-Thomson\nsays the face is an epistemological problem that can only be resolved through analogies. Daniel\nBlack, a thinker in the field of communication, describes the face as an anatomical and perceptive\nphenomenon, the most unstable and illusory part of the human body. The human face is that\nwhich forever surpasses efforts to capture it or establish a generalized vision of its reality.\nRecognizing the face of someone we love or cherish, for Black, is not just about the combination\nof shapes, but also about the feelings their faces communicate to us. This ability to read faces, of\ncourse, is informed by our assumptions and prejudices.<\/p>

But what makes the face one of the body\u2019s main points of reference? Why does it largely\nconcentrate one\u2019s identity markers and means of communication with their surroundings? These\nare questions that still elude me, and for which there are no exact answers. However, there\u2019s an\napproach that helps me to think about these issues in a more \u201corganized\u201d way: the idea that the\nface spreads. An example of this is that we often take the face for the individual, and the individual\nfor the face. The face seems to emanate to the rest of the body and beyond. Whether through the\nsenses\u2014sight, hearing, touch, and smell\u2014or through speech and expressions, the face does not\nend in itself.<\/p>

We could also ask ourselves: what is a face? Well, there are fourteen individual bones\nthat together form parts of the digestive, respiratory, visual, and olfactory systems. A set from\nwhich we infer someone\u2019s gender, age, ethnicity, and social class. However, whereas a person\u2019s\nface is one of the greatest expressions of our humanity, as the anthropologist David Le Breton\nsays, it can also be altered. Like a canvas, it allows the viewer to capture what the body insists on\nlaying bare\u2014feelings and emotions which we cannot suppress or mask\u2014thus, it is also the target\nof massive interventions whose objective is, above all, to adjust its shape, such as plastic surgery.<\/span><\/p>

It is currently accepted among biologists that the human face is a combination of\nbiomechanical, physiological, and social influences. The face begins to develop around the\ntwenty-fourth day in the embryonic stage. Specialized pluripotent cells, called cranial neural crest\ncells, are primarily responsible for the facial skeleton whose development occurs concomitantly\nand interdependently with the skull. In fact, that\u2019s when a fetus can develop cleft palate and lip.<\/p>

\u00a0While studying a little about facial embryology, in order to better understand Thyago\u2019s\ncase and those of other research interlocutors, I came across the following term: facial process. As\na layperson, I was dazzled by the images of what I understood to be the nose, mouth, eyes. For\nembryology, however, the correct terminology was \u201cfrontonasal prominence process,\u201d \u201cmaxillary\nprominence process,\u201d etc. Certainly, at a certain point in pregnancy and especially after birth, these\n\u201cprocesses\u201d are no longer seen as such and are named as the parts we usually know. However,\nwhat caught my attention was that the face itself, even in biological terms, is not \u201cready.\u201d Either\nbecause it is still at an embryonic stage, or because we\u2019re not born with a fully grown set of teeth,\nor because our eyes, ears and nose are still developing. Additionally, if we turn a careful look at the\nface\u2014and this applies to the rest of the body\u2014we will see that even after adulthood it is not\n\u201cfinished.\u201d Throughout life these \u201cfacial processes\u201d are quite evident, especially as we grow older.\nStill, we assume one\u2019s face as something solid and finished, and we\u2019re stunned when we realize\nhow little agency we have with regard to these changes. For Gilman, historian of science,\nintervening in the body through surgery and other technologies would be connected to this fear.\nA way for us to take control not just of the physical body, but everything it represents. In the case\nof the face, this means what we are as individuals, our character and personality.<\/p>

Whether through beautifying and repair\ntechnologies or to accompany physiological processes\nconceived as more natural, our faces are constantly in the\nprocess of being made. Even though these are phenomena\nthat have always accompanied us, the face and the ways in\nwhich we modify it\u2014or how we try to interrupt its\ntransformations\u2014are still understudied. It is important to say\nthat technologies such as plastic surgery, despite being seen\nas new, have existed since ancient times. It was only in the 16th\ncentury and as a result of the syphilis epidemic, however, that\nthese surgeries began to be performed more frequently. At\nthat time called decorative surgery<\/em>, these procedures were\nmeant to rebuild the noses of people affected by an advanced\nstage of the disease.<\/p>

In the 19th and 20th centuries, with the Crimean War\n(1853-1856) and the First (1914-1918) and the Second World\nWar (1939-1945), there was a great increase in surgical\ntechniques. Due to the huge number of victims with mutilated\nand burnt faces and bodies, methods of reconstruction\nbecame increasingly specialized. Plastic surgery then began\nto move away from the stigma that associated it only with the\nillnesses resulting from syphilis and began to represent an\narea of medicine dealing with those who serve the nation,\ngradually becoming respectable in terms of profession.<\/p>

In Brazil, the second country in number of plastic\nsurgery procedures in the world, Renato Kehl was a prominent\nfigure. The doctor and eugenicist (1889-1974), long before\ninternationally renowned Ivo Pitanguy, stood out for attributing\na role to plastic surgery that went beyond mere aesthetics. For\nKehl, diets, genetics, and plastic surgery were crucial\ningredients for the \u201ccure of the ugliness\u201d of Brazilian people.\nYes, exactly that\u2014according to the doctor, the Brazilian\npopulation was too degenerate, and corrective procedures for\n\u201cmalformations\u201d were essencial not only for individuals, but for\nthe whole nation. He believed that cosmetic surgeries should\nbe not only carried out in rare cases but as a continuous and\ncomprehensive policy.<\/p>

The relationship between the sciences that study and intervene in the face with\neugenics and racism is even broader still. There have been many different approaches taking\nfacial features as indicators of one\u2019s personality and character. These all assumed the outside as a\nrevelation of inside: criminology allied to craniometry\u2014whose main representative is Italian\nsurgeon Cesare Lombroso (1835-1909)\u2014and physiognomy, an enterprise originated in India and\nalluded to certain biblical passages. Indeed, since Pythagoras (570 BC \u2013 490 BC) and even much\nearlier\u2014still to this day\u2014there has been this enduring idea that one\u2019s face spreads. This\nperspective helps us to understand a little about how science has often conceived the face as a\nclear, and often irrefutable, mirror of the individual\u2014a profoundly dangerous notion, with tense\nimplications. It was once believed that operating on the faces of people considered too ugly could\nhelp reduce crime. Different oppressive political projects relied on claiming that the \u201cJewish nose\u201d\nor the \u201cBlack nose\u201d needed repairing. Conversely, these are the same surgeries\u2014it\u2019s worth pointing\nout\u2014that have long enabled people born with cleft lip and palate to speak, eat and breathe with\nquality of life, and feel comfortable with the aesthetics of their own face.<\/p>

In a conversation we had in May 2020, Andr\u00e9, a research interlocutor who, like Thyago,\nwas born with cleft lip and palate, told me this: \u201cPeople see this scar<\/em> \", pointing to the region\nbetween the upper lip and the base of the nose, \u201c and transport it across your entire body<\/em>.\u201d He was\nreferring to the discrimination he\u2019s faced, such as how he often got treated in job interviews, the\nworkplace, and in school for having a mark on his face and speaking slightly through the nose.\nAgain we see how someone\u2019s face and its markers can be taken as the whole individual.<\/p>

Racist, ableist, and even eugenicist assumptions of what a face should look like to be\nconsidered beautiful or even normal and acceptable have long shaped our understanding of what\na face is or what it should be like. This does not mean, however, that we should discredit the\nsciences and doctors or treat all facial intervention procedures as perverse technologies. That\u2019s\nnot the point I\u2019m trying to make. However, just as the face is ever a work in progress, ongoing even\nmuch after the fixed maturation we assume to take place in adulthood, so are the disciplines that\ndeal with the face\u2014in fact, science in general. As many anthropologists and philosophers of\nscience have insisted, scientists in all different fields must periodically question ourselves about\nthe questions that move them, and the ideas that inform them. It\u2019s imperative to make this\nunfinished nature more and more evident. Lest we run the risk of generating dead knowledge in\na society that does not value the diversity of life.<\/p>

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