OUR little French friend, Madame Didier, was not a woman to do things by halves. She was one of those rare exceptions among Parisian ladies – she was a perfectly happy wife; nay, more, she was in love with her own husband, a fact which, considering the present state of society both in France and England, rendered her almost contemptible in the eyes of all advanced thinkers. She was plump and jolly in appearance; round-eyed and brisk as a lively robin. Her husband, a large, mild-faced placid man – “mon petit mari,” as she called him – permitted her to have her own way in everything, and considered all she did as perfectly well done. Therefore, when she had proposed this informal dance at the Hôtel de L – , he made no objection, but entered into her plans with spirit; and, what was far more important, opened his purse readily to her demands for the necessary expenses. So nothing was stinted; the beautiful ballroom attached to the hotel was thrown open, and lavishly decorated with flowers, fountains, and twinkling lights; an awning extended from its windows right down the avenue of dark ilex-trees, which were ornamented with Chinese lanterns; an elegant supper was laid out in the large dining-room, and the whole establishment was en fête. The delicious strains of a Viennese band floated to our ears as Colonel Everard, his wife, and myself, descended the staircase on our way to the scene of revelry; and suggestions of fairyland were presented to us in the graceful girlish forms, clad in light diaphanous attire, that flitted here and there, or occasionally passed us.

The Reading Guide aims to lead the reader through In Memoriam and should be read alongside the text of the poem, which is printed, in full, below. Initially, it is important to read In Memoriam from beginning to end in order to gain an appreciation of the poem's shape and the narrative that it outlines. To help with this, I provide a summary of the poem and a brief accompanying glossary indicating sections addressed in the commentary. However, because In Memoriam is a poem of fragments that both construct and threaten to disassemble the whole, the Guide, which follows the full text of the poem, does not perform a straightforwardly chronological reading of the poem. Instead, it selects four different pathways through the text, each focusing on a particular theme: language, touch, economies of loss, and cycles and rituals. Taking the poem apart and piecing it back together in different ways will give a sense of the wide variety of images, metaphors, ideas and arguments that In Memoriam strains to hold together within its length and of the different ways that they work with and against one another. The themes I have chosen provide just a sample of the different ways through In Memoriam, and in the ‘Teaching the Text’ section that concludes this book I suggest others that readers might want to trace for themselves. At the beginning of each reading, I list those sections of the poem on which the reading focuses and it is a good idea to reread those sections before coming to the commentary text. In each case, the commentary will explain some of the key ideas that underpin the reading and then explore how these ideas fi nd expression in In Memoriam, and how they inform and structure the elegy.

2.1 Introduction

The DTC industry is centred around the online sale of genetic tests. The industry has emerged and has been able to develop because of rapid advances made in two technological areas: genetic and genomic science; and computing. The rate of technological advances in genetics and genomics is continuing on an almost unprecedented scale. This chapter provides a brief introduction to the scientific advances that have enabled the DTC industry to develop and an overview of the types of service currently available.

2.2 The Nature of Genetic Information and Genetic Exceptionalism

(a) What is Genetic Information?

Genetic information can be defined as ‘the information carried in a sequence of nucleotides in a molecule of DNA or RNA’. For present purposes, genomic sequence data can be understood as the data generated by sequencing technology. It has recently been suggested by Raymond McAuley that the cost of sequencing a genome will be less than the cost of flushing a toilet by 2020. ‘As of January 2014, sequencing a human genome cost just under $1,000 – less than the cost of a chest X-ray’ and ‘genome scanning is dropping in cost faster than computers can keep up. Moore's Law observes that computing power doubles every two years, but the cost of sequencing a genome drops by 5 or 10 times per year.’

DTC services normally only sequence a portion of an individual's genome, rather than the entire genome sequence. However, this may change, as more companies begin to offer whole genome sequencing.

In this chapter, I shall re-evaluate the diachronic, evolutionist model that establishes World War II as a watershed between classical and modern cinemas, and ‘modernity’ as the political project of ‘slow cinema’. I will start by historicising the connection between cinematic speed and modernity, going on to survey the veritable obsession with the modern that continues to beset film studies despite the vagueness and contradictions inherent in the term. I will then attempt to clarify what is really at stake within the modern-classical debate by analysing two canonical examples of Japanese cinema, drawn from the geidomono genre (films on the lives of theatre actors), Yasujiro Ozu's Floating Weeds (Ukigusa, 1959) and Kenji Mizoguchi's Story of the Last Chrysanthemums (Zangiku monogatari, 1939), with a view to investigating the role of the long take or, conversely, classical editing, in the production or otherwise of a supposed ‘slow modernity’. Mizoguchi is notable for his lavish use of the long take and the long shot, and was accordingly hailed for his realism by Bazin's disciples in the pages of the Cahiers du Cinema in the 1950s (see Rivette, 1958; Rohmer, 1957; Godard, 1968). This, however, did not suffice to secure him a place within the modern canon, as proved by Deleuze's classification of his films as ‘movement image’, that is, alongside the classical cinema of montage. Conversely, Deleuze placed the production of Ozu, an inveterate adept in montage throughout his oeuvre, under the time-image category, making it akin to modernity.

About an hour and twenty minutes into Apichatpong Weerasethakul's Palme d’Or-winning Uncle Boonmee Who Can Recall His Past Lives (Loong Boonmee raleuk chat, 2010, hereafter Uncle Boonmee), the titular character lies in a cave, close to death, being looked after by members of his family. Boonmee (Thanapat Saisaymar) describes a dream that he had the previous night, of having arrived in the future by a time machine:

The future city was ruled by an authority able to make anybody disappear. When they found ‘past people’, they shone a light on them. That light projected images of them onto the screen. From the past, until their arrival in the future. One of those images appeared, these ‘past people’ disappeared.

As Boonmee recalls his dream, the audience of Apichatpong's film is presented with a series of ten still images, each held on screen for contemplation. These static images include: seven of soldiers, three of which also include someone dressed in a gorilla costume; two of young men in T-shirts and jeans, throwing objects and taking photos by the side of a river; and a final image of circular marks on a dirt road.

This sequence is preceded by shots in which little movement occurs (clouds drifting across the moon, a pair of red glowing eyes shifting in the cave's darkness), and is followed by a return to moving images of Boonmee dying, his body approaching the stillness of death.

THE FUTURE OF ‘TOTAL PAIN’

I want to end by considering where my exploration of ‘total pain’ leaves the term regarding both its usefulness within the increasingly divergent fields of hospice, end-of-life and palliative care and its wider potential as an evocative shorthand for conceptualising care more generally.

‘Total pain’, it seems, can mean everything and nothing. As I showed in Chapters 1 and 2, although the term is often taken to be a static concept, Saunders's own pragmatic approach to its definition is reflected in its myriad uses in the various contemporary healthcare settings which have inherited it. Yet, rather than the ‘definitional confusion’ observed by Krawczyk and Richards (2018, p. 129), I suggest ‘total pain’ is better understood, like Anne Harrington's framing of other forms of medical holism, as a ‘culturally suggestive metaphor’ (1996, p. 209). It is not a static concept but a flexible term that appeals to scientific fact. It foreshadows more recent developments in pain research that highlight the interaction between physical processes of pain with emotional and social factors while also constituting a rhetorical rallying point for emergent forms of care which require a situated responsiveness resistant to epistemological frameworks. The ambiguity of the component words of ‘total pain’ means it therefore risks signifying a hollow cultural holism which conceals – and, in print, appears to perpetuate – the same old procedural biomedical approach of checklists and performance measures. Yet, as I outlined in Chapter 3, this same vagueness performs the inherent uncertainty of pain or care for which description is often itself a form of explanation.

In this chapter, I explore possibilities for a narrative interpretation of ‘total pain’ that avoids the criticisms set out in the previous chapter. Using Saunders's interest in nostalgia, I suggest dying might represent a special case for thinking in narrative terms. Moreover, Saunders ignores issues of truth or long-term coherence in favour of the therapeutic benefit of the meaningful relational time facilitated by narrating. Rather than simply asserting control over the meaning of a terminal illness through the reconstructive process of narration, perhaps understanding ‘total pain’ in narrative terms should be seen in relation to the provisional processual act of narrating, which is phatic in the way it affirms the relation between the speaker and those around them in the moment of telling.

PROMINENCE OF VERBAL NARRATIVES

Saunders's use of idealised patient narratives might be understood to be reassuring rather than prescriptive: their aim is to diffuse the cultural terror that Saunders believed surrounds the process of dying. Saunders defended accusations that she idealised patient narratives with the suggestion that such examples are educative precisely because they demonstrate the possibility of a peaceful death (1974f, p. 25). The prominence of articulate narratives in her publications, and the subsequent emphasis on narrative in relation to ‘total pain’, is a symptom of the means of communication. Spoken lectures and written contributions most easily employ verbal narratives, and these are more readily reproduced in the work of others. Saunders often used photographic slides in her lectures, but these are infrequently reproduced in print, presumably due to cost.

THE following morning at the appointed hour, I went to Cellini's studio, and was received by him with a sort of gentle courtesy and kindliness that became him very well. I was already beginning to experience an increasing languor and weariness, the sure forerunner of what the artist had prophesied – namely, a return of all my old sufferings. Amy, tired out by the dancing of the previous night, was still in bed, as were many of those who had enjoyed Madame Didier's fête; and the hotel was unusually quiet, almost seeming as though half the visitors had departed during the night. It was a lovely morning, sunny and calm; and Cellini, observing that I looked listless and fatigued, placed a comfortable easy-chair for me near the window, from whence I could see one of the prettiest parterres of the garden, gay with flowers of every colour and perfume. He himself remained standing, one hand resting lightly on his writing-table, which was strewn with a confusion of letters and newspapers.

“Where is Leo?” I asked, as I glanced round the room in search of that noble animal.

“Leo left for Paris last night,” replied Cellini; “he carried an important despatch for me, which I feared to trust to the post-office.”

“Is it safer in Leo's charge?” I inquired, smiling, for the sagacity of the dog amused as well as interested me.

“Much safer! Leo carries on his collar a small tin case, just large enough to contain several folded sheets of paper. When he knows he has that box to guard during his journeys, he is simply unapproachable.

All of this can be summed up in the phrase: we are not conscious of the con¬scious activities of our brain, which the technologies of brain exploration allow us to disclose and identify.

As we have seen, the cerebral activities that accompany access to consciousness emerge against the backdrop of unconscious activities that precede them and are even their indispensable conditions. Yet the expressions of our conscious subjective states, whether for ourselves or for others, including for the experimenter in the cognitive neurosciences, necessarily draw on our everyday language and its meanings. Put differently, they describe states of affairs that signify something about ourselves and the external world. Yet what they express in this way often has a fictional character relative to an objective reality, which an external observer can appreciate in the form of the conditions that allow the subject to express what she is conscious of. These expressions thus appear as more or less illusory interpretations of what the subject perceives within and around herself; interpretations that sometimes express deeply held beliefs. As we shall see, certain pathological and experimental situations make this phenomenon particularly evident.

Yet the interpretative activity of our consciousness also appears in normal conditions insofar as it always involves the projection of meaning – a function of what I earlier called ‘machines for producing meaning’. These machines are operative even when what we say or believe is not merely illusory or delusional but, on the contrary, claims the privilege of rationality.

Polysemy

On various occasions in this book, we have encountered the notion of the conatus, this peculiar and central notion in Spinoza's philosophy, which in various forms traverses all parts of the Ethics. It appears at the beginning of the third part, on the origin and nature of the affects. Insofar as it takes the form of desire, the conatus plays the role of a primitive affect, together with joy and sadness, from which all other affects arise; and we have seen that affects are a privileged place for the observation of the mind–body union, following the definition of the affect as ‘the affections of the Body by which the Body's power of acting is increased or diminished, aided or restrained, and at the same time, the ideas of these affections’ (Ethics III, Def. 3). Joy and sadness are defined precisely as passages from a lesser perfection to a greater perfection and vice versa, as well as, respectively, the increase and diminution of the power of acting.

Yet the conatus first appears without any explicit reference to affective life, as a dynamic property of ‘each thing’, whether human or nonhuman, living or nonliving.

Its basic ‘canonical’ form, so to speak, is formulated in the third part of the Ethics:

The striving (conatus) by which each thing strives to persevere in its being is nothing but the actual essence of the thing. (Ethics III, 7)

The original work upon which this book is based began almost a decade ago and as with many other new technologies, the personal genomics industry is still developing at a rapid pace. This is also a period of change for the law and so this book captures the industry and the state of the law at a particular moment. I intend to be able to update this volume in the future, but as this manuscript was submitted in late 2018 and will be published in mid-2019, some things may change in the interim and I will only be able account for these changes in the future. I ask readers to bear this in mind and to please note that this book is intended to provide an introduction to a complex area and provide some suggestions for reform, which it is hoped will contribute to stimulating a wider discussion of regulation of personal genomics and of technology more generally and the ways in which we all interact with contracts and privacy policies online.

The Table of Abbreviations for DTC Contracts provides links to the Wayback Machine wherever possible. Efforts have also been made to provide archived links throughout.

The first scene of Casa de Lava (1994) shows the eruption of Cape Verde's Fogo Island volcano, recorded in 1951 by Portuguese geographer Orlando Ribeiro (Figures 2.1 and 2.2). The inclusion of such colour-infused images signals a clear stylistic departure from the monochromatic stylised ambience of Pedro Costa's directorial debut, Blood. These images, taken from what was once a scientific documentary, transmit approximation to a filmic style which privileged location – both as a thematic element and a film set. The third feature film directed by Costa, Ossos (Bones, 1997), transmits similar textual and stylistic preoccupations. Partly filmed at the former Lisbon shantytown of Fontainhas, the film develops further the rapport between fiction and documentary. Bones depicts the lives of characters cast out of the city's mainstream social fabric. These roles are mostly played by non-professional actors recruited on location.

Though stylistically distinct from each other, Casa de Lava and Bones nevertheless express authorship processes reflecting aesthetic inheritances. Casa de Lava was planned around a possible adaptation of the low-budget horror film I Walked with a Zombie, directed by Jacques Tourneur in 1943. As for Bones, its non-linear narrative and decelerated aesthetic minimalism transmit a clear influence of the cinema of Robert Bresson. It is clear, however, that Cape Verde and Fontainhas were the settings which propelled Costa's attention to the creative potential of working within the multifaceted contexts of these two locations – geographical, spatial, historical and social. The locations offer what Martin Lefebvre designates as ‘a doubly temporalized landscape’ (2006: 29).

To further clarify why dualism poses a particular problem for any present-day philosophical attempt to renew the legacy of Paul, it is imperative to discuss Nietzsche, for whom the problem of dualism is, ultimately, a problem of nihilism. Given the German philosopher's influ¬ence on European thought, it is hardly surprising that his reflections on the apostle are often referred to and are object of separate study. In the turn to Paul, Nietzsche's remarks on the founder of Christianity tend to serve as a counterpoint to clarify which version of Paul philosophers would like to bring to the fore. In the introduction, I already referred to Blanton writing that Nietzsche ‘failed radically to transform […] the ongoing cultural and political functions of the Pauline legacy’. This remark basically captures the mood of the present-day philosophical assessment of Nietzsche's Paul. Let me begin this chapter by admitting that my own approach also uses – or abuses? – Nietzsche in this way. Yet, I do think that, at particular points, Nietzsche did portray the apostle quite accurately. Let us therefore consider what he captured and what he distorted in his portrayal of Paul. This chapter is devoted to this consideration by addressing, first, Nietzsche's judgement on the onto¬logical dualism he perceives in the apostle; second, the peculiar polemic in which he is engaged with the founder of Christianity; and, third, the particular implications of these two issues for his interpretation of pistis or faith. The last section of this chapter is devoted to Foucault's reappraisal of ancient philosophy in contemporary European thought, in order to show how this facilitated a reappreciation of Paul after Nietzsche's devastating critique. The details of this reappreciation are explored in the following chapters.

In 1904, caricaturist Max Beerbohm produced a cartoon entitled ‘Mr Tennyson, reading “In Memoriam” to his Sovereign’. The cartoon pictures a large, almost empty room decorated with heavy curtains, four small chairs and a fi replace with an empty grate, above which sits an ornamental clock. The walls are decorated with fl oral wallpaper and hung with a single portrait of Prince Albert. In the room sit Alfred Tennyson and Queen Victoria. Tennyson, hair and beard fl apping, arms gesturing widely and legs lifted straight out in front of him, reads from sheets of paper that he holds in his hand. Victoria, dressed in black, seated with her hands demurely in her lap and her feet resting on a foot stool, looks straight ahead, past Tennyson, towards the door.

Tennyson, who became Poet Laureate (the poet of the nation, an honour bestowed by the monarch) in 1850, met Queen Victoria on a number of occasions. He also enjoyed reading his poetry aloud. However, Tennyson never read In Memoriam to Queen Victoria. By imagining this encounter, Beerbohm, who was famous for satirising the culture and celebrities of his day, pokes fun at poet, queen and poem. He also tells us something about the cultural identity of In Memoriam at the end of the nineteenth century. Beerbohm identifi es In Memoriam with the Victorian establishment and with the Victorian culture of mourning that found its best example in Victoria's own extended period of mourning for Prince Albert, who died in 1862. His cartoon is probably based on reports that In Memoriam and the Bible were the two texts in which the Queen found comfort after her husband's death, a widely reported fact which bestows the poem with a near-religious authority. Beerbohm recognises that authority, but he also calls it into question by inviting us to laugh at it.