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Chaotic bodies, safe space and the enigma of environmental illness <ul><li>Dr Fiona Coyle </li></ul>
<ul><li>Doctor:   I’ll do a physical exam today, repeat the blood tests as well as get more information about the timing o...
Schema <ul><li>Introduction to Environmental Illness (EI) </li></ul><ul><li>The complexity theory model of illness </li></...
What is environmental illness? <ul><li>Symptoms include: chronic fatigue, muscle spasms, severe headache, brain fog, anxie...
What is complexity theory about?  <ul><li>The “study of the behaviour of macroscopic collections of simple units (atoms, m...
Sensitivity to Initial Conditions <ul><li>That’s the trick with environmental sensitivities, everybody’s unique.  There’s ...
Critical thresholds   <ul><li>It’s all of it, because I was exposed to all of it.  The pre-employment injections, the nerv...
Bodies in Chaos <ul><li>You see, what I envisage actually happens to people is that, it doesn’t matter what the stimulus i...
<ul><li>And apparently that wasn’t the last straw, because I already was full of chemicals or whatever, which I didn’t kno...
Bodies in chaos need safe spaces <ul><li>Corporeal chaos = war metaphor in patient discourse </li></ul><ul><li>Characteris...
The EHCNS
Representations of Space:  a decentralised planning operation <ul><li>A “conceived space” as denoted by “scientists, plann...
<ul><li>The architects of Nova Scotia’s Environmental Health Centre in Fall River are taking great precautions to protect ...
Spatial practices:  the construction of healing spaces <ul><li>A materialised, socially-produced, perceived space, which i...
 
Offices, technologies, medical records, the photocopier room and a small kitchen/staff room . Zone 1
A complexity theory perspective <ul><li>Acceptance of sensitivity and difference. </li></ul><ul><li>Crystallise chaos, usi...
Zone 2 <ul><li>The reception, waiting room, sauna room and gym . </li></ul>
<ul><li>Patients and their accompanying relatives will not only be screened for scents, they may even be asked to hit the ...
Zone 3 <ul><li>Sealed by a coded door, houses doctor’s offices and treatment/testing lab. </li></ul>
Spaces of Representation:  resisting predictability <ul><li>“ lived spaces” are linked to the “clandestine or underground ...
Organic Garden You teach a patient grounding, so that they put something into the ground like plant a tree, they see that ...
Sauna smells <ul><li>Detoxification triggers emission of odours </li></ul><ul><li>E.g. one patient emitted noxzem a, a for...
Conclusion <ul><li>Health professionals turned to paradigm of complexity theory for their answers to such unpredictable, d...
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Environmental illness, complexity and healthcare

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Environmental illness, complexity and healthcare

  1. 1. Chaotic bodies, safe space and the enigma of environmental illness <ul><li>Dr Fiona Coyle </li></ul>
  2. 2. <ul><li>Doctor: I’ll do a physical exam today, repeat the blood tests as well as get more information about the timing of the symptoms. </li></ul><ul><li>[Hmmm. I wish this patient would just get better! I’ve tried everything I know to pin down the diagnosis but nothing has come up. I suppose she could have environmental sensitivity disorder - I haven’t been able to come up with any other diagnosis. But there’s so little evidence about its cause and treatment. That leaves me between a rock and a hard place. What can I offer a patient like this?] (Weston et al, 1991:42). </li></ul>
  3. 3. Schema <ul><li>Introduction to Environmental Illness (EI) </li></ul><ul><li>The complexity theory model of illness </li></ul><ul><li>Bodies in chaos need safe spaces </li></ul><ul><li>Case study on The Production of Space : The Environmental Health Centre, Nova Scotia (EHCNS) </li></ul><ul><li>Conclusion </li></ul>
  4. 4. What is environmental illness? <ul><li>Symptoms include: chronic fatigue, muscle spasms, severe headache, brain fog, anxiety and depression. </li></ul><ul><ul><li>Appear after exposure to ‘safe’ levels of chemicals </li></ul></ul><ul><ul><li>Can change over time </li></ul></ul><ul><ul><li>Switch between different organ systems </li></ul></ul><ul><ul><li>Effects disproportionate to their cause </li></ul></ul><ul><ul><li>Often labelled as ‘psychiatric’ </li></ul></ul><ul><ul><li>Multifactorial </li></ul></ul>
  5. 5. What is complexity theory about? <ul><li>The “study of the behaviour of macroscopic collections of simple units (atoms, molecules, bits, neurons) that are endowed with the potential to evolve in time (Coveney and Highfield, 1995:425). </li></ul><ul><li>Basic assumptions: sensitivity to initial conditions, non-linearity, emergence, self-similarity at different scale levels (fractals), feedback, critical thresholds, self-organisation and unpredictability. </li></ul><ul><li>Body and environment separate but interconnected systems – chemical reactions trigger structural changes and threaten adaptability. </li></ul>
  6. 6. Sensitivity to Initial Conditions <ul><li>That’s the trick with environmental sensitivities, everybody’s unique. There’s no universal principles or laws because we’re all individual bodies. I cannot be like you or anybody else. </li></ul><ul><li>Aurora, Halifax </li></ul><ul><li>I think there is a pattern…I mean, when we talk to people, we can understand perfectly what people are talking about and their reactivity and everything. But their circumstances may be very unique to them. </li></ul><ul><li>Healthcare Professional, EHC </li></ul>
  7. 7. Critical thresholds <ul><li>It’s all of it, because I was exposed to all of it. The pre-employment injections, the nerve agent that we were ordered to take, the anthrax inoculations…then all the toxic exposures through the war and hands on with prisoners of war that had shrapnel wounds, radioactive shrapnel wounds, now that I know. So you know, this piles up and up and up. </li></ul><ul><li>Leadora, Ottawa </li></ul><ul><li>I know all my life, I have really bad allergies. And they got a little bit worse each year I was in the city. So what I think is that it was the straw that broke the camel’s back. I was just in a situation which was too much for my immune system and it coped as long as it could and then it just crashed. Not for any particularly good reason on that day. It was gonna happen sometime. </li></ul><ul><li>Rohan, Ottawa </li></ul>
  8. 8. Bodies in Chaos <ul><li>You see, what I envisage actually happens to people is that, it doesn’t matter what the stimulus is, is that the person goes from an orderly balanced state into chaos…when the autonomic nervous system goes out of balance and is dis-regulated, you can get all kinds of bizarre reactions and that person is just totally out of balance. </li></ul><ul><li>Healthcare Professional, EHCNS </li></ul>
  9. 9. <ul><li>And apparently that wasn’t the last straw, because I already was full of chemicals or whatever, which I didn’t know. That sort of made the glass overflow and from that moment on, everything went really fast, the symptoms, one after another. </li></ul><ul><li>Siobhan, Ottawa </li></ul><ul><li>If wheat plus cheese plus that exhaust equals a reaction, you know, the complexity of it just explode, like you can’t think of these. So what, so those 15 foosd together, that will equal a reaction, you know? Its very frustrating thinking about it. </li></ul><ul><li>Rohan, Ottawa </li></ul>
  10. 10. Bodies in chaos need safe spaces <ul><li>Corporeal chaos = war metaphor in patient discourse </li></ul><ul><li>Characterised by turbulence, unpredictability, uncertainty, the fog of communication blackouts and in this case, a loss of personal control (Paul Virilio and Manuel De Landa) . </li></ul><ul><li>Safe space associated with control, stability and predictability, communication and the presence of uncontaminated, clean air. </li></ul><ul><li>Examples: home, car, ‘natural’ spaces, EHCNS </li></ul>
  11. 11. The EHCNS
  12. 12. Representations of Space: a decentralised planning operation <ul><li>A “conceived space” as denoted by “scientists, planners, urbanists, technocratic subdividers (decoupiers et agenceurs), as of a certain type of artist with a scientific bent” (Lefebvre, 1991, p.38). </li></ul><ul><li>Construction of an experimental utopia </li></ul><ul><li>Collusion between various stakeholders </li></ul>
  13. 13. <ul><li>The architects of Nova Scotia’s Environmental Health Centre in Fall River are taking great precautions to protect the air inside the building, even if it means creating a NASA-like research lab. No smoking by the construction crews, no garbage on site, no idling engines in the parking lot, no heavy deodorant, no mail delivery and definitely no visitors. Even the upcoming grand opening won’t include guided tours – not even for the politicians who approved the funding. </li></ul><ul><li>The Halifax Daily News, February 16, 1997, Daily Edition, p.25. </li></ul>
  14. 14. Spatial practices: the construction of healing spaces <ul><li>A materialised, socially-produced, perceived space, which incorporates the repetitive tasks and “status quo practices” of everyday life (Soja, 1996, p.66; Shields, 1999). </li></ul>
  15. 16. Offices, technologies, medical records, the photocopier room and a small kitchen/staff room . Zone 1
  16. 17. A complexity theory perspective <ul><li>Acceptance of sensitivity and difference. </li></ul><ul><li>Crystallise chaos, using the Butterfly Effect </li></ul><ul><li>Hyperactive CNS calmed via biofeedback and meditation to lower reactivity levels </li></ul><ul><li>Rehabilitation counsellor: ‘we share the air’ and search behaviour. </li></ul>
  17. 18. Zone 2 <ul><li>The reception, waiting room, sauna room and gym . </li></ul>
  18. 19. <ul><li>Patients and their accompanying relatives will not only be screened for scents, they may even be asked to hit the showers…When they come in, they will be sniffed, very politely’ he said...We want people to feel safe and secure’. </li></ul><ul><li>Dr Fox, quoted in The Halifax Daily News, February 16, 1997, Daily Edition, p.25. </li></ul>
  19. 20. Zone 3 <ul><li>Sealed by a coded door, houses doctor’s offices and treatment/testing lab. </li></ul>
  20. 21. Spaces of Representation: resisting predictability <ul><li>“ lived spaces” are linked to the “clandestine or underground side of social life” (Soja, 1996, p.67). </li></ul>
  21. 22. Organic Garden You teach a patient grounding, so that they put something into the ground like plant a tree, they see that the roots are growing, and you know, watering and healthy, so they can reflect on their own life. I think, like this patient goes out there, she used to have a mask and now she’s just, you know, she walks out in the garden and she’s learnt by coping skills to tolerate things out there. Healthcare Professional, EHCNS
  22. 23. Sauna smells <ul><li>Detoxification triggers emission of odours </li></ul><ul><li>E.g. one patient emitted noxzem a, a former ‘Avon lady’ began to smell of perfume </li></ul><ul><li>This ‘wasn’t a consistent model of change” (Healthcare Professional, EHCNS) </li></ul>
  23. 24. Conclusion <ul><li>Health professionals turned to paradigm of complexity theory for their answers to such unpredictable, dynamic corporeal behaviour. </li></ul><ul><li>“ This is a little more ‘playing with puzzle pieces’, ‘listening to the whole story’ and ‘trying to find new alternatives’” (Aurora, early thirties). </li></ul><ul><li>Lived bodies as “subjects of study”, serve to critique, educate and potentially change ideologically dominant medical frameworks. </li></ul>

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