| As it did in so many other arenas, the French Revolution of 1789 razed the medical landscape in France. Revolutionaries, pushing for open access to all professions, successfully eradicated the corporate privilege that characterized medical practice in the ancien regime; where they failed, however, was in replacing it with any coherent set of professional guidelines. Professional medicine in the early nineteenth century foundered, without a clear course between the statist and laissez-faire models that had so clearly failed by 1803. A new clinical-associative model emerged in the 1820s that placed doctors in a position of establishing social value both through service to the state and through service to individual patients. Case narratives, as the primary link between the individual and the collective, became a discursive category of proof---and an integral component of medical identity---in the early nineteenth century. Doctors consciously sought to establish their place in the social hierarchy through a "scientific" validation of the bourgeois worldview, particularly with regard to questions of gender and class. They further cemented their authority by using literary narratives---sentimental, gothic, and realist---to give their arguments currency by establishing both the social value and the expertise of medical professionals. This dissertation thus argues for a re-conceptualization of the process of medical professionalization as a process of identity construction, based on a performative model of negotiation between creator and audience. |
