Towards the Medical
In Freudian psychoanalytical terms the mechanisms of fetishism are described as a disavowal of infantile castration anxiety, a replacement of the moment of sight of the female genitals, the proof of castration, with the pleasure of the last moment in which the female could be viewed as phallic. Thus, for Freudians, fetishism replaces the shock of discovery of the lost female phallus. Fetishism is seen as a denial of sexual difference. This, according to Freud, would explain the fetishes for fur (a signifier for pubic hair) or shoes (the object of the gaze before the curious eye, looking ever higher, sees the gaping maw of the vagina).

Freud's theory of sexuality is laced with holes: most obviously the fixing of a temporally frozen sexuality onto a single arche moment, itself dictated by the unholy claustrophobia of the mother/ father/ child triadic structure. This in addition to the over-riding importance he gives to the phallus present / absent dichotomy, which negates the potentialities of a psychoanalytical signifying practice for the vagina except as a ragged, scarred wound. Further of course the goal oriented sexuality of psychoanalytic theory is itself redundant, as if desire depended on the libidinal cathexis, on the objective driven need to ejaculate a wad of cum in a misguided attempt to position procreation as a primary objective of the mechanisms of sex.

Fetishism has, however, become the terminology with which self-defined socio-sexual ghettos have chosen to define themselves. Yet this fetishism, like Freud's construction of fetishism as a single interest, fixed by a single moment, is an act of restriction. Defining a multiplicity of sexualities under the collective banner of fetishism is to force them into the imagined comfort of a single discursive moment rather than attempting to understand the need for `perversities' as a fluid flow of de-centred non-essential desire/s: a flux of forces.

The usage of the word fetishism has simply become a method by which a construction of sexual exploration has become semiotically defined: everybody, from the latex wearing demi mode to leather-boys, all have been pigeonholed as fetishists.

To be defined is to be controlled, consequently what follows is an attempt to suggest a proliferation of desiring memes loosely based on the multiple thematics of the medical, yet to do so without suggesting any overall meaning or manifestation or collective experience, rather to act as an heterogeneous text, as a fragmented dissemination recognizing that "desire is not something that deforms but that disconnects, changes, modifies, organizes other forms, and then abandons them"(1).

A culturally specific euphemism for the initial mutual sexual explorations of children: "playing at doctor and nurse" returning, unwittingly, to Freud, and the moment of the discovery of difference. Yet the specific nature of the phrase suggests a cultural investment within the ritualized modes of the examination. Like the mother, the nurse has a specific working knowledge of the body, whilst it is the mother who teaches the child about hygiene, and the borders which demarcate the zones constructed as the clean and the dirty, it is the nurse who is able to reiterate, and expand upon, the lesson. The nurse is the beneficiary to a knowledge - that appears as arcane - concerning which areas of the body are taboo / infected / infested. If it is the mother who starts the mapping of the flesh in infancy, it is through interaction with medicine that this cartography is able to continue. Whilst the figure of the matron or nanny clearly represents the libidinal focus for those with clichéd Oedipal fantasies, the nurse stands separate, not only is her knowledge more thorough and more extensive, she also lacks the visible difference in age that separates the Oedipal fantasist and the older women. Indeed the nurses-of-collective- fantasy are invariably young, and often barely out of their teens (see, for example, the nubile nurses in hardcore pornography, or the heavily sexualized nurses of mainstream entertainment).

Popular constructions of fetishism have frequently been manifested via uniforms and the specific accouterments associated with the cultural understanding of the history of clothing. The interest in, for example, Japanese and German military uniforms from the Second World War, serves in part as a theatricization of sadomasochistic desire, manifested as supreme fantasy of dominance and submission via the iconographic reservoir of fascism . The nurse's uniform and doctor's lab coat are similarly invested with meanings, in part they imply a submission, a giving-up-of-will to the potential of discomfort or pain (physical and physiological) of the examination. However, the starched whiteness also implies a blank canvas, waiting to be marked with the tracings of blood, urine, and faeces, as the body is compelled to open itself and divulge its secrets.

While vincilagnia may possibly function as an initial drive-to-fascination with medical devices, the use of such tools suggests a wider interest than pure bondage and restriction. Medical tools have an intrinsic fascination in part as a result of their function as devices by which the human body is both revealed and constructed. Devices which, by their very nature, suggest an invasive exploration of the fleshy interior of our bodies: gynecological stirrups, lights, examination tables, clamps, and speculum. These tools render the body as transparent, revealing its inner workings. For some, the fascination of such technologies is a move towards potential forms of post-human hardbodies, or new-reconfigurations of soft-bodies augmented by leg-braces or artificial limbs, such an iconographic reservoir emerges in the mise-en-scene of contemporary cinema, in films such as Crash (David Cronenburg, 1996) in which Gabrielle's (Rosanna Arquette) leg-braces become intrinsic to the representation of her sexuality.

Medicine and medical examinations serve as reminders to the fragile nature of the body. An apparently unified zone which, upon inspection, reveals itself to be a collective of organs which are designed to function together but are under continual assault from viruses, microbes, bacteria, parasites, and the physical dangers which occur in the material world in which they exist. Whilst some diseases have long been considered a form of eroticism (see, for example, the Romantics construction of suffering from the exegesis of tuberculosis, a fascination carried through the literature of vampirism, etcetra) this interest has less to do with medicine and more to do with an exaggerated sense of existential melancholy. The fascination with the medical emerges within traumaphilia. Traumaphilia suggests an interest in the weakness of the body, always able to be damaged, torn, and mutilated. An erotic fascination which is manifested by various aspects of contemporary society (such as car-crashes) and which finds its zenith in the accident and emergency rooms of the modern hospital. This zone is delineated in the works of Romain Slocombe and Trevor Brown, both of whom focus on the relationship between images of sexuality and medicine within their art .

Through the wards, and the long tiled corridors, the traumaphile finds the corporal body everywhere under attack, wounds describing a world defined, and often savagely wrecked, by speed and sudden violence. The soft-bodies in the hospital speak of a violence that has already happened, the wounds are witnesses to a trauma that is already flesh-memory past, once in the hospital the tender damaged body is sterilized, sutured, and bandaged. These procedures signify a world that - for all of its modernity - is ultimately thanatopic. But the removal of death from the daily existence of the majority of people has once again rendered it as unknown, thus it returns to contaminate desire, but this return is mutated and constructed via contemporary discourses of death: the medical.

The contemporary discourses around the human body demarcate an increasingly dangerous zone of potential contamination from HIV, numerous manifestations of Hepatitis, and - no doubt - a proliferation of other viruses and symptoms still waiting to be discovered, catalogued, and named. Safe sex information emphasizes the boundaries of the body and suggests that these borders be rigorously patrolled via ultra-sensitive sheets of rubber, latex and plastic. Sex has become implicitly medicalized.

Notes:
(1) A version of this was published in Body Prope, ed David woods, Creation, 1999.

©Jack Sargeant