The Westernized Hospital's Research Arm

The hospital is a relic, a product of a certain moment in the past, which is why it had to be replaced by the research hospital, which is relatively less weak. The hospital is no longer an institution where power circulates, but rather is a powerless institution due to its passivity in the field of knowledge. Even as a research hospital, the hospital is not necessarily anything other than an outdated institution; for this "hospital research" is not as we imagine scientific research to be. Medical-science research is governed by a certain structure which makes it treat a certain body of text (“body of text” includes the rules and regulations, medical procedures, the documentation of what takes place etc) as essential and original. We say so because, even with the forward movement of research, the hospital relies on a static body of texts as its foundation; it relies on individuals who have already finished their formal education, and this formal education itself has not been significantly updated. As soon as one enters a hospital, one is in rigid territory fully controlled by a body of texts. Even the research such a hospital carries out is nothing more than a way to legitimize the unchanging body of texts that prefigures the hospital's activities; we may speculate, for instance, that much of the research is done by an aloof group of hospital staff reliant on medical-scientific methodology hundreds of years old. The hospital as an institution exists only in order to justify bodies of texts upon which it stands. In short, the hospital is a point of failure in research and science.

We are interested in the hospital because it represents, as "medical-science," an institution between science and reality. It seems to us that the hospital performs well in its administration of established science on the populations, but it seems weak in engaging the population in the scientific endeavors that it espouses; it remains secretive about its research arm, to say the least. Without the support of the population, a certain obsolete body of texts within science dominates the hospital. Moreover, the hospital does not espouse the research endeavors within science, rather, it places itself in that safe space away from research, utilizing only those “trusted” methods circulating in society and the other hospitals at large. It cannot implement and critically evaluate radically new techniques and new modes of treatment, but must rely on what society considers to be effective and appropriate. Without the support of science, the hospital becomes a dangerous place that gives rise to what can be characterized as a legitimate culture. This legitimate culture is the hospital as subscribing to a certain image, an ideal image of the doctor or the nurse. It is this ideal image of doctors and nurses, and not the scientific endeavor, which gives the hospital its legitimacy in the eyes of laypersons today.

This criticism of the hospital has to be considered because of the changing nature of the human subject today. The human subject has, in most of his/her endeavors, given up the tag of “patient” and has become more out of control. The hospital was a firm establishment when the activities of the human subject usually relied on his/her becoming safe from harm, and when there was a willingness on the part of the patient to be under the complete control of a hospital for the duration of the treatment. Today, harm is often actively sought and the hospital visit has become a regular activity in a subject's life. The demarcations between society and hospital have been made so rigid that the hospital cannot influence behaviors in wider society at all. And in one sense, the hospital is too reliable, it is almost a paradise when compared to the rest of society. The subject is not to be taken as a patient, but has become more and more, in Lacanian terms, the “subject supposed to know,” the subject who wishes to participate within research under development rather than remain under control by a rigid body of rules and regulations that govern treatment. The subject wishes to offer to his/her treatment rather than passively spending time on a hospital bed. he/she has often actively sought western medical-science from a range of choices. Additionally, the patient "calls out" to the doctor to participate in the treatment, to encourage in the doctor a willingness to treat, especially in Nepal, where neglect during treatment has caused deaths; and isn't it a proper research component which would encourage doctors not to neglect? In order to rebel against the hospital, the subject uses the cultural sphere, in the form of medical advertisements and TV shows on alternative, non-western treatments, to demonstrate how it wants to participate in its own treatment. 

These observations do not prove that the hospital has to be given up entirely. But, in order to adapt, the hospital does need to change some things: first, it must give the tag of research hospital more weight in order to more actively participate in research (this does not mean that patients are to be converted to lab mice, but the ways in which the patient information is recorded and elicited may have to change; the machines used in a hospital may have to updated, given that these machines do represent scientific progress), second, the hospital must remove itself from the influences of the culture industry: it cannot ride on the image of the serious, concerned and thoughtful doctor as created in popular TV shows. By projecting its ideal image onto the screen, the doctor will soon look even more untrustworthy to patients. In short, the movement of the hospital should be towards 'research-oriented' rather than 'service-oriented.'