The Semiotics of Western Hospitals: From a Stone Boat in Rome to Reconstructing the Self in Montreal

In this article I analyze the symbolic role of the hospital in its social context, from its creation in Rome in the 2nd century BCE to contemporary Montreal hospitals. I trace the change from its original role as a site to isolate the sick to limit the symbolic pollution of the allegedly perfect social body of the Roman state, a trope that became an important vector of unity as Rome expanded and incorporated greater numbers of foreigners and slaves. Today, however, western hospitals have become a semiotic engine where patients construct a new biography to counter the depersonalisation of contemporary medical practices. I propose that today patients use the hospital as raw material to construct a temporal framework that substitutes the rhythms of everyday life that illness and the institutional culture of the hospital have interrupted. These narratives adhere to the same basic structure: the entrance scenario is always admission to the hospital; the plot structure is built with the non-medical details of the daily hospital routine. Surrounded by a neoliberal ethos that insists on the autonomy of the self but silenced by the mechanisation of illness, contemporary patients transform hospitals into semiotic engines where patients use their immediate environment to re-engineer new voices of the self.