In this post I'll be talking about the technology involved in force feeding, and describing force feeding as a technologically mediated reality.
I'm using the term mediated reality with explicit reference to the Silicon Valley led idea of mediated reality as reducible to digitally augmented reality.
Digitally augmented reality is the dominant commercial form of mediated reality, in which digital objects are overlaid onto a user's experience of the real world. Think Pokemon Go or Google Glass. But while these high profile products are worth thinking about, the attention they are given diverts us from other important forms of technologically mediated reality that exist outside of the world of tech start ups and Wired magazine.
Contemporary technology is not just digital, and mediated reality is not just augmented.
Through an examination of the technology used in force feeding, I'll lay out the possibility of negative form of mediated reality - subtractive reality. If augmented reality is a domain in which a subject’s perception of the real is overlaid with virtual sensory data, then subtractive reality is a domain in which a subject undergoes the imposition of a single technological reality onto their virtual realm of possibilities.
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There are two kinds of technology used in force feeding: mechanical technology and nutritional technology.
Mechanical Technology
(Nasogastric) Feeding Tube
In the Suffragette Sylvia Pankhurst's account of her force feeding from 1913, she describes the doctors 'trying to force the india-rubber tube down my throat'. These days, with modern plastics allowing the creation of thinner tubes, the nose is the preferred cavity through which to administer food. In a medical setting this is for comfort, and in a prison setting such as Guantanamo Bay it reduces the ability of a hunger striker to force the tube out through coughing or gagging.
At first, Guantanamo doctors were using thick 4.8mm tubes 'to allow quicker feeding, so permitting guards to keep prisoners in their cells for more hours each day'.
Moath al-Alwi, in US custody since 2002 and one of Guantanamo’s first prisoners wrote, 'they push a thick tube down my nose until I bleed, after which I vomit'. In 2005, there were reports that 'wardens would strap detainees to a feeding chair and violently insert feeding tubes as a form of punishment.'
Perhaps in response to the international outcry caused by these reports, the US military eventually swapped the 4.8mm tubes for 'soft and flexible' 3mm tubes. That's almost a 40% reduction in size, so presumably the 4.8mm tubes were neither soft nor flexible.
As I wrote previously, when someone is force fed by the gavage technique in which the feeding tube goes right down to the stomach, food is administered without engaging the sense of taste. The feeding tube - and particularly the nasogastric tube used in Guantanamo Bay - creates a unique, mediated way of administering nutrition.
The reality of the force fed subject is a mediated reality, but it is a subtractive reality, where experience is diminished by the use of technology.
The sensual experience of eating food is complex. We taste and smell what we eat, and we sense its texture - taken together these constitute the 'mouthfeel' of the food.
This mouthfeel is removed in force feeding and is replaced by a different sensation: a plastic tube (lubricated with a numbing agent called Lidocaine, or, until doctors pointed out that it could cause pneumonia, olive oil) moving down their nasal passage and oesophagus. You can imagine that the liquid meal replacement drink can be felt moving down the tube - a change in temperature maybe, a pulsing motion as the liquid glugs down. And as described by various prisoners, if the tube is inserted roughly, the prisoner may feel the heat of blood from their nose, and perhaps the taste of blood in their mouth. And, if they vomit while the tube is being inserted, then they will taste and smell the vomit.
Five Point Restraint Chair
The five point restraint chair, as its name suggests, holds a prisoner securely at five points across their body. The restraint chair was introduced at Guantanamo in 20015. Until then, hunger strikers had been sedated before they were force fed.
From what I can work out, it seems that the chair was introduced to allow for the prisoner to be conscious during feeding, but importantly, it also restrains hunger strikers after the feeding to ensure that they can't vomit up the food by sticking their fingers down their throat.
This image of the chair shows it fitted with a foam head brace. This removes the need for any human restraint whilst the hunger striker is being fed - though I think the head would still have to be held by a warden or doctor while the tube was inserted in the nose.
The five point restraint chair is used in prisons across America, though it seems it's only in Guantanamo Bay where it used for force feeding. To prison guards it's known as the 'be nice chair' or the 'we care chair'. For prisoners it has been called 'the devil's chair' and 'the slave's chair'. In Guantanamo, its Arabic name translates as 'the torture chair'.
Nutritional Technology
Meal Replacement Liquids
Nutritionally balanced replacements for food were a 20th century fascination. Before then, most cultures used preserved foods - cured meat or dried fruit for example - as 'replacements' for foods that could not be eaten fresh because of the changes in seasons.
After the 20th discovery of vitamins, the possibility of replacing food with its constituent chemical parts became imaginable, if not possible. The techno-futurist vision of meal replacement pills was a popular sci-fi trope in the 1920s and 30s. With the space race in the 1960s, meal replacement became a real problem to be solved - and what we know now as energy bars are the direct descendants of 'space food sticks'. Liquid nutritional supplements were developed for hospital patients who couldn't eat solid food, but in the 80s and 90s they also began to be marketed at people looking to lose weight, or build muscle. Think Slim Fast or protein shakes.
(It's interesting to note that the meal replacement industry has had a shot in the arm from its 'techification' by start up companies like Soylent and Huel, both companies described as 'food tech start ups'. Clearly, the idea to replace meals with a nutritionally balanced substitute is not new, but looking at the history of meal replacement, it seems to me that even the idea to market them for non-medical use is an old one. At best, you could say Soylent and Huel are branding and distribution companies targeting a youth market brought up on the idea that everything is somehow related to digital technology.)
Guantanamo Bay uses a variety of meal replacement products made by the company Abbott Laboratories, a 'worldwide American healthcare company'. Of Abbott's meal replacement products, Guantanamo feeds its hunger striking prisoners Ensure 'Meal Replacement Shakes', Jevity 'Complete, Balanced Nutrition® With Fiber', and Pulmocare 'Therapeutic Nutrition for people with chronic obstructive pulmonary disease'.
The particular qualities of these different products are important, and in future research I'll go into that, but they are similar enough so that I can use Ensure as the example.
Ensure Milk Chocolate Flavour is described as including:
'9 grams of protein
26 essential vitamins and minerals, including antioxidants
220 nutritious calories'
The bulk of the ingredients in the drinks are:
'Water, Corn Maltodextrin, Sugar, Milk Protein Concentrate, Canola Oil, Soy Protein Isolate, Cocoa Powder (Processed with Alkali), Corn Oil concentrate'
Below 0.5% you have a large number of other flavourings and the vitamins. I'm not necessarily interested in the nutritional value of the Ensure drinks, although it does bring to mind Sidney Mintz's writing on sugar and how it went from a luxury product to a main source of calories for Europe and America. For this piece of writing, the ingredients list serves to show that the drinks are not food and they are not meant to be understood as food. Rather, they are meant to be understood as a technology, a scientific fact you can drink. The experience of consuming a bottle of Ensure, even willingly, is very different from the experience of eating food.
The entire point of the technology is nutrition without food. When the Suffragettes were on hunger strike, they were force fed a cooled, blended mixture of boiled cabbage and water. Alongside the fact that the Suffragettes were fed through rubber tubes pushed down their throats, while being held down by nurses and doctors, you begin to get an idea of the very particular experiences of force feeding created by the technologies available at the time.
Meal replacement drinks are presented by their makers as a 'neutral' form of nutrition (particularly the Jevity brand which is flavourless, or more correctly, it has no added flavour). With their medicinal packaging, they play an illustrative role for the US government when it describes its force feeding as lifesaving medical care or treating malnutrition in prisoners.
But nothing is really flavourless, and even though the flavoured or unflavoured liquid travels down to the stomach in a tube, bypassing the organs of taste and removing the mouthfeel normally associated with food. I still wonder about the flavour of the materials in the prisoner's stomach. Already nauseous from the Ludocaine and from the tube pushed down their nose, I imagine them back in their cell, burping up the flavours of the liquid - the synthetic vanilla of the Ensure, or the textural oilyness of the unflavoured Jevity. This is a form of trauma - the repetition of an original experience that bypassed the body's normal processing.
By replacing solid food with a limited range of meal replacement liquids, the force feeding procedure bypasses the metaphorical idea of taste as an expression of preference. Like the five point restraint chair, using certain food replacement products limits the possible decisions that the prisoner can make for themselves. The range of possible experience (the virtual realm) is limited to a singular reality decided by the prison. Perhaps the prisoner can express a preference for Jevity over Ensure, or maybe even a particular flavour of Ensure - but the decision will not be based on the taste of that particular flavour as it is consumed, but on what it feels like to taste the burps they do when they're sitting red eyed and nauseous in their cell a few hours later.
In a future post I'll describe the ideological infrastructures that, alongside these technologies, shape force feeding as a contemporary practice, and how they impact on the procedure as a form of subtractive mediated reality.