Speaking with Frankenstein

This collaborative essay experimentally applies the insights of Mary Shelley's 1818 gothic fantasy Frankenstein to clinical interactions between present-day physicians and the patients they, akin to Shelley's human protagonist, so often seem to bring (back) to life. Because that process is frequently fraught with unspoken elements of ambivalence, disappointment, frustration, and failure, we find in Shelley's speculative fiction less a cautionary tale of overreach than a dynamic parable of the role that the unspoken, the invisible, and the unknown might play in contemporary physician/patient relationships. Playing with that parable, we consider its relevance to four often unacknowledged dynamics that shape physician/patient interaction: commitment to a false binary of life and death; the tyranny of normative aesthetics; shared negative affect; and the ethics of care and care-denial. To "speak with Frankenstein" is, we show, to make space for the otherwise unspeakable. The result is a more complete model of narrative medicine that accommodates to its ideal of open communication and full attention the persistence of what cannot be said, seen, or known--only imagined and approximated.

     

Intertrial effects of same-different judgements

Specific intertrial effects (repetition effects) and general intertrial effects (refractoriness or persisting attention to the preceding trial) were studied with the same-different judgment task, which dissociates the effects of response repetition and stimulus repetition. Response repetition alone did not facilitate performance. Stimulus repetition did aid performance, but mainly when accompanied by response repetition. Subjects tended to avoid the normal comparison process by using the (invalid!) “bypass rule” (Fletcher and Rabbitt, 1978): repeat the response if the stimulus or some aspect thereof (letter contents, size, position) is repeated from the preceding trial, otherwise change the response. As to general effects, partial refractoriness was evident at response execution, but not at earlier processing stages. Mean RT increased, but errors decreased, as the response-stimulus interval (RSI) between trials decreased. Presenting a new letter pair immediately after the preceding response produced a delay, but subjects used the waiting time, while the response system recovered or was redirected to the present trial, to improve the accuracy of their decision.     

Contribution of somesthetic information to the perception of body orientation in the pitch dimension

This study investigated the contribution of otolithic and somesthetic inputs in the perception of body orientation when pitching at very slow velocities. In Experiment 1, the subjects' task was to indicate their subjective postural vertical, in two different conditions of body restriction, starting from different angles of body tilt. In the "strapped" condition, subjects were attached onto a platform by means of large straps. In the "body cast" condition, subjects were completely immobilized in a depressurized system, which attenuates gravity-based somesthetic cues. Results showed that the condition of body restriction and the initial tilt largely influenced the subjective postural vertical. In Experiment 2, subjects were displaced from a vertical position and had to detect the direction of body tilts. Results showed that the threshold for the perception of body tilt was higher when subjects were immobilized in the body cast and when they were tilted backward. Experiment 3 replicated the same protocol from a supine starting position. Compared to results of Experiment 2, the threshold for the perception of body tilt decreased significantly. Overall, these data suggested that gravity-based somesthetic cues are more informative than otolithic cues for the perception of a quasi-static body orientation.