Knowledge Production and the Making of Medical Meaning

Swedish scholarship has shown that place matters for scientific knowledge production, but it has largely focused on natural science laboratories. This presentation argues that the place of biomedicine, formed through negotiations between actors, structures how competing visions of medical research and education are evaluated, prioritized, and materialized.

The presentation examines how visions for Sweden’s biomedical development were negotiated and re negotiated through the planning and early use of the Biomedical Center (BMC) in Uppsala. Envisioned as a flagship investment in biomedical expansion, today one of northern Europe’s largest biomedical facilities, BMC became an influential part of the negotiation process by offering spatial possibilities, constraints, and promises, affecting how actors debated needs, justified priorities, assessed feasibility, and translated visions into material form. Yet these negotiations remain largely unexplored.

Combining Thomas Gieryn’s concepts of place and boundary work, the presentation approaches BMC as both a stabilizing structure and a boundary drawing resource. Drawing on the archival study undertaken in my dissertation, which traces actors and visions across university and national archives, the presentation will show how different actors mobilized the building depending on their aims: as a symbol of modern biomedicine, a prerequisite for expanding medical education, a constraint in budget negotiations, and a justification for national investment. These negotiations materialized certain futures while foreclosing others, making visible whose arguments gained traction and which visions of medicine were judged actionable. Once established, the building continued to shape what was politically and epistemically possible while enabling reinterpretations not envisioned at the outset.

Foregrounding place contributes to medical humanities by revealing how biomedical governance operates through spatial arrangements. Understanding Sweden’s biomedical development therefore requires attention to how futures become durable through place.

Swedish public libraries developed in the early twentieth century, with a clearly articulated educational and moral mission, as well as a connection to social medicine, including eugenics. Until 1965, so-called morality clauses stipulated that libraries would not receive state funding if they acquired inappropriate literature, or made medical works on sexuality available to minors. Hygiene and discipline are clearly reflected in the vision for, and the operation of, public libraries.

In a Swedish context, the journals Folkbiblioteksbladet and Biblioteksbladet played a guiding role in library collection development during the first half of the twentieth century, by publishing reviews specifically aimed at librarians and intended to support the selection process. In opinion pieces in these journals, various writers also articulated their views on the harmful effects that reading might have.

Reviews of, and debates about, children’s and young adult literature are of particular interest, since young readers were regarded as especially vulnerable and thus in need of protection. Discourses about (un)suitable literature for children and young people reveal underlying conceptions of childhood, as well as class and gender.

In this presentation, I look at how health metaphors are used in relation to literature and reading in the journals, for example descriptions of literature as poisonous or nourishing, dirty or intoxicating; of reading as mental and spiritual gymnastics; of libraries as a prophylactic measure; and of good books as an antidote or a vaccine against the constant threat of the bad books.

Menstruation remains one of the most ubiquitous yet theoretically underexamined phenomena in medical humanities, exposing the limits of how the field understands embodiment, knowledge, and care. Drawing on my ongoing doctoral research, this research examines representations of menstruation in global Anglophone literature by women authors (1978–2020), asking how menstrual experience is narrativized across genres and what these narratives reveal about the cultural production of medical knowledge.

While medical humanities has increasingly foregrounded embodiment, it has yet to fully engage with menstruation as a sustained epistemic and political concern. This project addresses that gap through a comparative, intersectional analysis of texts from the Global North and South, spanning realist fiction, speculative narratives, and feminist horror. Across these forms, menstruation emerges not as a stable biological fact but as a culturally mediated and politically contested experience shaped by caste, race, colonial histories, stigma, and reproductive governance.

Rather than treating literature as reflective of medical discourse, this research positions it as a constitutive space where menstrual meanings are produced, negotiated, and resisted. Drawing on postcolonial feminist theory, affect studies, and critical menstruation studies, it traces how narratives move from silence and abjection toward articulation and resistance, echoing Hélène Cixous’s call to “write the body,” while interrogating the limits of contemporary “period-positive” discourse.

By foregrounding menstruation as a point of tension between biology, culture, and power, this research proposes it as a methodological entry point for critical medical humanities, demonstrating how literary texts participate in the making and unmaking of medical knowledge.

Biomedical systems privilege forms of knowledge that are standardised, measurable, and institutionally validated, systematically marginalising the situated, experiential knowledge through which chronic illness is managed. Within Medical Humanities, scholars such as Angela Woods and Arthur Frank have established the epistemic significance of patient experience, yet its authority remains structurally constrained within clinical hierarchies shaped by broader social and political inequalities.

This paper analyses community-based knowledge production in the context of Thalassemia major, a transfusion-dependent haemoglobinopathy, situating it within the uneven healthcare landscape of India. It argues that in conditions requiring sustained, lifelong care, patients and caregivers actively produce and circulate operational knowledge essential to survival, forming intergenerational epistemic networks. Drawing on Miranda Fricker’s concept of Epistemic Injustice, Donna Haraway’s notion of situated knowledge, and Jean Lave and Etienne Wenger’s theory of communities of practice, the paper conceptualises these practices as forms of knowledge production that both emerge from and contest dominant epistemic orders.

In shared clinical spaces such as transfusion centres, experienced patients and caregivers translate complex biomedical protocols into actionable practices, manage treatment cycles, navigate institutional constraints, and sustain long-term care. This circulation of community-based expertise not only improves health outcomes and psychosocial resilience but also exposes how clinical authority depends on, yet fails to recognise, distributed forms of knowledge.

Methodologically, the paper employs a participatory qualitative design based on in-situ interviews and sustained observation during transfusion processes. It argues that the politics of knowledge production in healthcare is not only a question of recognition but of participation. Despite generating critical knowledge, patients and caregivers are rarely included in decision-making processes. This exclusion reveals a structural disjuncture between those who produce knowledge in practice and those authorised to formalise it, and calls for a redistribution of epistemic authority that recognises community as central to medical knowledge-making.