An example of msamsam handwriting on an unfolded sheet of paper, previously inside a cabsulih. From Esmail Nashif, “Building the Community: The Body, the Material Conditions, and the Communication Networks,” in Palestinian Political Prisoners: Identity and Community (London: Routledge, 2010).
An example of msamsam handwriting on an unfolded sheet of paper, previously inside a cabsulih. From Esmail Nashif, “Building the Community: The Body, the Material Conditions, and the Communication Networks,” in Palestinian Political Prisoners: Identity and Community (London: Routledge, 2010).

I begin this text on viscerality and its evisceration where I do most reflections on the violence of settler-colonialism—in the shadow of Frantz Fanon.

“The colonized intellectual who wants to put his struggle on a legitimate footing, who is intent on providing proof and accepts to bare himself in order to better display the history of his body, is fated to journey deep into the very bowels of his people.”1

Throwing caution to the wind, we embark on this voyage that many believe Fanon to be firmly opposed to. To be sure, Fanon does warn about the dangers of journeying into the bowels, but to read his words as a deterrent of its undertaking would be a grave mistake. Fanon does not dismiss the importance of the viscera as a site of affective and somatic resistance to colonization; rather, he warns against its exploration through modes of self-autopsying—those forensic operations bent on seeking national culture in the nostalgic entrails of colonial cadavers. As a revolutionary psychiatrist who treated patients during (and in the lead up to) the Algerian revolution, Fanon’s appreciation of the visceral is evident in his extensive—and prescient—psychiatric writings on the inextricable link between colonization and psychosomatic afflictions which were at the time just beginning to be understood under the umbrella of ‘cortico-viscerality.’2 Perhaps what is at stake for Fanon is not the exploration of the visceral landscape but how it is undertaken—which roads are traveled, and in whose vehicle. Land is gutted into scenery when we are made passengers in our own bodies, travelers relegated to peering out the window where there used to be but the thin film of separation between immediacy and feeling. The visceral knows no borders: it is the radical interpenetration of the outside within, the sketched contours of a fullness we call hunger whose stomaching becomes the work of living. Besides, a camera can’t record what it’s hell bent on destroying.

And yet, there will always be those who film to heal.3

Rouzbeh Shadpey, A Tale of Two Pills: Two Figures (“Evisceration and revisceralization with PillCam (formerly M2A) and cabsulih: double bind, non-randomized controlled trial of safety and gut feeling” and “Pathophysiology and clinical presentation of the Cotard colonizer”), 2022.

The Prisoner

Within Occupied Palestine, a prisoner writes a letter (or a poem, or a book). On a piece of paper half the size of an A4 sheet, he writes microscopically between perpendicular columns that have been penciled in. His words, barely legible to the naked eye, take on an elliptical shape as they populate the page, descending its length rather than crossing its width. The prisoner tightly folds the paper and bundles it with a dozen similar ones. He begins to wrap this sheaf of letters in scraps of plastic amassed from bags that litter the prison, rolling it into a cylindrical shape no larger than a centimeter in width, and three to four in length. He burns the edges of this plastic—fusing it together, encapsulating within its skin his precious words. He swallows the pill.

The Patient

A patient visits a gastroenterologist to rule out occult gastrointestinal bleeding. His iron reserves are low and the doctor suspects his gut of betraying him via slow exsanguination. Physical examination draws the portrait of a person whose inner eyelids are bone white, stool pitch black, and breath shallow with fatigue. Traditional endoscopy can’t reach the small bowel, the patient is told, where the lesion most likely lies. As an efficient and more comfortable alternative, the doctor proposes video-capsule endoscopy. It’s easy, the doctor reassures him, as he pulls out something resembling a slightly oversized pill from his medical cabinet. It contains a camera lens on one end, and across its body reads the word “PillCam.”

The Cotard Colonizer: A Case Study

1880: Describing the case of Mademoiselle X—the 43 year old woman whose symptoms would become the substrate of her attending psychiatrist’s eponymous syndrome—Dr. Jules Cotard details the following:

“We have been observing since a few years… a patient who presents a quite singular hypochondriac delusion. She affirms that she has no brain, nerves, chest, stomach or entrails; she has only left, in her own words,the skin and bones of the disorganized body. This delusion of negation extends even to the realm of metaphysical ideas which were once the object of her strongest convictions: She has no soul, God no longer exists, the devil either. [Mademoiselle X] no longer being but a disorganized body, does not need to eat to live, she could not die of a natural death, she will exist eternally unless she is burnt, fire being the only end for her.”4

Cotard Syndrome, also referred to as ‘Walking Corpse Syndrome,’ describes a psychic constellation of symptoms defined by delusions of nihilism that vary in scope and intensity. These may range from the absence of specific organs to the absence of existence entirely—of the self or the world around it. The Cotard patient’s nihilism gives rise to a paradoxical belief: that they are immortal. The fault lines of the fracturing Cotard psyche reveal a secret intimacy between two metaphysical views which appear, at first glance, irreconcilable. Nihilism and immortality share close footing in the Cotard patient, whose delusional self-eviscerating often spills into the realm of indestructibility.

In their irreducible conviction that they are already dead, the Cotard patient successfully transcends mortality. And, in doing so, sublimates their suicidal drive into one that is rational. The act of suicide becomes a mere empirical demonstration, a receipt that proves their non-existence. This is the psychotic garb of a body without organs, one that delusionally empties itself of viscerality in order to feel nothing and destroy everything. This is the psychosis of settler colonialism.

I want to consider the schema of settler colonialism as being symptomatic of Cotard’s syndrome. That the colonizer’s desire for genocide and conquest is the symptom of a self-annihilating drive that is propelled by delusions of immortality, fed and nourished by delusions of nihilism. Like the Cotard patient, the colonizer’s suicidality may take the shape of a durational assault: that slow death by starvation that became the tragic misfortune of Mademoiselle X. Indeed, nihilistic delusions—whether preoccupied with missing viscera or the lack of a bodily self entirely—lead to starvation because one feels they do not need to eat. Why would they, after all, with no stomach to fill, or gut to lubricate? And yet, some still do. Such is the case of the German jurist Daniel Paul Schreber, who writes in his Memoirs:

“I existed frequently without a stomach; I expressly told the attendant… that I could not eat because I had no stomach… Food and drink taken simply poured into the abdominal cavity and into the thighs, a process which, however unbelievable it may sound, was beyond all doubt for me as I distinctly remember the sensation. In the case of any other human being this would have resulted in natural pus formation with an inevitably fatal outcome; but the food pulp could not damage my body because all impure matter in it was soaked up again by the rays. Later, I therefore repeatedly went ahead with eating unperturbed, without having a stomach…”5

Schreber, avowing to the attendant that he has no appetite because he is missing a stomach nevertheless continues to eat. How?

Because of hunger.

“For this too exists
to be hungry without appetite.”6

+ + +

Settler colonialism is fueled by hunger. All-consuming, it is a faim sans fin—an unending hunger—which has grown autonomous of the appetite which birthed it. This hunger cannot be housed by the modest shelter of the stomach wall, whose elasticity can only extend so far. Once its threshold is reached, the stomach wall alerts hunger to its limits, imposing the law of its diet. The stomach—as an organ of moderation—becomes a physiological obstacle to the Cotard Colonizer’s unfettered appetite, leaving him to hallucinate its amputation. Bifurcating the appetite from the body—in an act of psychic self-mutilation—the Cotard Colonizer becomes hyperphagic, unable to be sated by the violence he sows. In his study of phantom internal organs, T.L. Dorpat distinguishes phantom limb sensations in patients who have lost internal organs with those who have lost external ones, noticing that those whose amputations lie in the viscera do not report sensations of “‘having an internal organ’, but rather of having sensations normally associated with the functioning of the organ in question.”7 This is phantom hunger, the weapon of the Cotard colonizer—that of which echoes Antonin Artaud when he says, in his radiophonic voice:

“there are those who say that consciousness
is an appetite,
the appetite for living;

and immediately
alongside the appetite for living, it is the appetite for food
that comes immediately to mind;

as if there were not people who eat without any sort of appetite;
and who are hungry.

For this too exists
to be hungry without appetite;


+ + +


If the colonizer has deluded himself into thinking his organs are missing, where does he believe them to have disappeared? According to Jasbir Puar, he hallucinates them as the Other.

Addressing the Israeli Defense Forces’ practice of tallying the number of shot knees during the Great March of Return in Gaza, Puar notes:

“This art exceeds the process of tabulation, as it involves a scrambling of fleshly registers, of limbs, of organs, of blood. To explain and redress the violence of dividualization, there is often a recourse to the presumed relay of humanism: the perpetrators have to dehumanize the protestors, or have never humanized them, in order to maim and kill them… Dividualization does not rehearse the primacy of human forms and in fact exploits humanist attachments to these forms… it is that the dividual, not the individual, is the instrumentalized unit of such a biopolitics.”9

The philosophy and practice of maiming has become a primary vector through which biopolitical control is maintained in the Israeli occupation of Palestine. Addressing the asymmetry between the liberal (white) subject of disability rights and the Palestinian protester—whose “permanent disability” results from “a state of perpetual injuring”—Puar brings to our attention a unit of maiming that escapes the ethical framework of the individual: the organ.10

Looking through the gun scope of the Israeli sniper, we see a gaze that is fixed at the level of the dividual: on knees, tendons, capillaries, limbs, and spilled organs. The gun sight of the sniper, operating like the chemical process of preparing a microscopic slide, brings its specimen into sight through fixing it. This is what Puar calls an “unseeing and reseeing of corporeality”: a total and totalizing Gestalt shift between ground and figure whose ultimate goal is the cutting of their binding tie altogether.11 As Puar remarks, “one learns not to see the limb as missing a/the body.”12

We begin to understand, here, that an amputation has been hallucinated into existence well before the act of maiming. Once the bullet is fired and lodged into the knee, an injury is produced whose palliative care will most likely involve the amputation of the afflicted limb. What ensues is a positive feedback cycle which reinforces the cognitive distortion of both the sniper and the state. This perceptual reshaping should be understood as the symptom of a larger settler-colonial desire to separate organ from organism, part from body, visceral from viscera, and figure from ground.

According to Henri Bergson, the difference between machines and organisms lies in the realm of time: machines are spatial entities whereas organisms contain time and can only be comprehended in relation to a past. In light of this, dividualization becomes the logic of ontological separation pushed to its extreme: a dispersion into geometric space that disavows the colonized as organs of a national body, as a people with a past.13 To counter eviscerations, both real and hallucinated, revisceralization becomes a tool and philosophy of resistance for Palestinians.

Revisceralization: Counter-technologies of Palestinian Liberation

The cabsulih emerged as a makeshift form of communication for Palestinian revolutionaries. Their large-scale incarceration, intensifying in 1967, was an attempt by the forces of occupation to fraction, atomize, and isolate the revolutionary spirit and resistance of Palestinians. Using what was available to them—material scraps and their bodies—prisoners hid their words, and those of their comrades, in the depths of their bowels.14

Upon ingestion, the cabsulih inscribed the social into the individual’s flesh, making them the body of its message. The prisoners’ viscera became constitutive of a complex subdermal network of written communication that defied the colonizer’s attempts at carceral containment. During the travel of cabsulih from M2M through kisses with loved ones and across the netting that divided families from inmates, or A2(M2A…), a community of political captives came to be formed. Spanning across and beyond prisons, the creation of a visceral commons effectively rehabilitated the political prisoner into a once again active participant of the Palestinian national movement.

We are reminded here of Mikhail Bakhtin’s analysis of the potentiality of the grotesque viscera as a space within which “the confines between bodies and between the body and the world are overcome.”15 The cabsulih—in conjunction with the prisoners that carry it—can be understood as a cosmotechnics of Bakhtinian viscerality, situating the bowels as a site of radical interchange and interorientation where the individual body ends and the collective body begins.

+ + +

Sumud is not a philosophy as much as it is an organic practice, a commitment, and a collectively shared system of beliefs that sinews the psychic and social body in the face of occupation. In the words of Muhammad Funun, a Palestinian politial prisoner in the 1970s, “its roots grow, bloom, and deepen like a living entity, and it is nourished by every preceding experience.”16

Against the everyday violence of living under occupation, Palestinian psychotherapeutic practice becomes a source—and manifestation—of sumud. In Psychoanalysis Under Occupation: Practicing Resistance in Palestine (2021), Lara and Stephen Sheehi explicate a theory of psychoanalysis rooted in the indigenous practices of Palestinian clinicians and their patients who create spaces of psychic liberation, which is to say, spaces of social and political resistance. What crystallizes in their accounts is a Palestinian clinical practice that actively seeks to break “the circuit of disavowal and splitting that is at the heart of disenfranchising Palestinians not only of their land but of their very being and selfhood.”17 At the heart of this resistance is a refusal of depoliticized psychoanalytical practice that abstracts psychic suffering from the violence of occupation, and the struggle for national liberation.

Acknowledging the psychic lifeworlds of their patients as a material, empirical, reality, the Palestinian clinician rejects depoliticized frameworks of mental health as vehicled by the Israeli state and the international community through the UN and NGO complex. These are the trauma-centered and resilience-based models of therapy which further atomize Palestinian subjectivity into the perfect victim, or, in the words of David Eng, the “good liberal objet worthy of repair.”18

Instead, what Lara and Stephen Sheehi highlight are practices congruent with Fanon’s theory of sociogeny, existing at the intersection of the personal (individual), the social (collective), and the poetic (imaginative). Recognizing that the violence of living under occupation “always enters the room,” the Palestinian clinician refuses to pathologize dissent through diagnostics which reduce symptoms to the realm of disorder. Instead, symptoms may be recognized as the result of “functioning within the reality principle that stops up the flow of the unconscious, the social, and the intersubjective.”19 At times, they may be understood as the very sign of sumud itself. Such is the case of the anger, frustration, and violence which protects the Palestinian from entering into the dissociative terrain of dialogue with the oppressor. It is also the nature of the delusions of a Palestinian Jerusalemite living in the Old City who is afraid that leaving the gates of his house would bring him to be “lifted up” and swept away. By situating patient experiences within Palestinian intersubjectivity, the Palestinian clinician resists the dismemberment of the psyche under the guise of psychoanalytic innocence.20 Instead, as the Sheehis remark, they cultivate a networked practice that “reproduces the social and psychological processes and practices of sumud by shoring up Palestinian psychological defenses…through connecting them to shared experience.” Such is the work of revisceralization, that which, in the words of Karim Kattan, imagines how the archipelago can become a continent. 21

Missile Pill

M2A was invented by Gavriel Iddan, an Israeli military scientist whose work on missile technology as the head of the electro-optical design section of the RAFAEL (Armament Development Authority) would equip missiles with the gift of sight.22 In the 1980s, Iddan engineered the camera that would become the missile’s seeker—a video-technological prosthetic which allowed it to capture and guide itself to its victim. Three decades after its conception, the organ come to be known as ‘the eye of the missile’ would turn its gaze towards new visceral horizons. In order to facilitate the biotechnological surveillance of those areas of the intestines which lay beyond traditional endoscopy’s reach, Iddan miniaturized the seeker and encapsulated it within a pill. A missile pill.

Thus, M2A was born.

The abbreviation—short for “mouth-to-anus”—is a decidedly gay expression commonly used within medicine to describe afflictions of the entire digestive tract.

In 2000, M2A—now rebranded as Pillcam— became the first commercialized instance of video-capsule endoscopy (VCE), receiving its FDA approval just a year later. Marketed as a minimally invasive alternative to traditional endoscopy, Pillcam’s smooth plastic pill journeys effortlessly through the digestive tract propelled by natural peristalsis. It takes two pictures per second across approximately eight hours. 57,000 color images are uploaded in real-time to a computer worn by the patient, reconstructed into a diagnostic video-voyage. “It’s like swallowing a missile that doesn’t explode,” says the C.E.O of Given Imaging: the company Iddan created to transform the seeker into Pillcam, from a missile that does explode into one that doesn’t.23 Given Imaging is now being developed under the Minimally Invasive Therapies Division of US biomedical giant Medtronic.

What is being sketched here is not the shameful past of an otherwise ingenious medical invention. Pillcam is inscribed within the longue durée of a cosmotechnics that transforms Palestinian death into Israeli-European-American gut health. Its technology—conceived and perfected in a process Ali Abunimah describes as Israel’s “field testing” of weapons in “real time”—continues to be refined with each and every devastating cycle of destruction wrought upon Gaza.24 To abstract Pillcam from its genesis is to mislead patients about the risk they incur during its ingestion. Adhering to the philosophy of technic, Pillcam constitutes an extension of the body’s organs and memory.25 However, unlike most technology, its extension is directed inwards. As the eye of the missile enters the patient’s body, so too does its memory: of the violence it has witnessed, the violence made possible by its witnessing. Within the bowels, Pillcam spreads like a mnemonic vector of disease, contaminating its host’s tissues. Such adverse effects are unacknowledged by the medical sciences under the pretext of the M2A digestive tract—a pipeline between eating and shitting where the labor of digestion is nullified and made apolitical. It is the digestive equivalent of a colonial myth that espouses there can be contact without contamination. 26 As patients with leaking guts, we are wary of narratives pertaining to digestive sovereignty. Within colonial relations, Ewa Macura-Nnamdi reminds us, “eating always subjects… because it rests on an assumption that to ingest is to accept what one eats… and the world it brings in its wake.”27 It is this very world that we, as patients, refuse to swallow.

The Patient

As patients in the face of Pillcam, we enact our power through refusal. In this process, we turn our illness into a weapon directed against the necropolitics of the Israeli state.28 Refusal becomes an act that protects the gut and its capacity to feel—a blockade against bearing in one’s body the mnemonic traces of colonial violence waged against Palestinians for over seven decades. We are aware that Pillcam remembers its dismemberments, that its lens is imprinted with a negative consciousness that leaks as it travels inside us—the absorption, ingestion, and digestion of which is deeply harmful for our bodies, minds, and spirits. In our pursuit of health in illness, and the fight against the illness that is occupation, we refuse to be complicit in colonial evisceration. Turning our viscera into a weapon which operates in solidarity with the fight for Palestinian freedom, we honor that eternal gnawing of the gut we sometimes call our gut feeling.

A Tale of Two Pills
00:00 - 00:00
29 July 2022
Essay by Rouzbeh Shadpey

Rouzbeh Shadpey is an adisciplinary artist, musician, and writer with a doctorate in medicine and indefatigable fatigue. His work explores (de)colonial pathophysiologies of illness and weariness, with a focus on the aesthetics and poetics of neuroimaging, diagnostics, and fatigue. Shadpey’s musical practice under the name GOLPESAR / گلپسر  combines avant-garde electronics, scraped guitar, spoken word, and echoes of Iranian sonics. He currently lives in Tiohtiá:ke / Mooniyang, colonially known as Montreal.

...people.” [1]
Frantz Fanon, The Wretched of the Earth, trans. Richard Phillcox (1961; repr., New York: Grove Press, 2004), 149.
...‘cortico-viscerality.’ [2]
See ‘V. Colonial War and Mental Disorders’ in The Wretched of the Earth. Fanon, The Wretched of the Earth, 181-235.
...heal. [3]
5 Broken Cameras, Film (Kino Lorber, 2011).
The Prisoner
The Patient
The Cotard Colonizer: A Case Study
...her.” [4]
Jules Cotard, “Du Délire Hypochondriaque Dans Une Forme Grave de La Mélancolie Anxieuse,” Annales Médico-Psychologiques 6, no. 4 (1880): 168–74, The translation is my own.
...stomach…” [5]
I first encountered this passage in Jalal Toufic’s negative answer to his self-answered question “[do we not have] Organs? [No].” Jalal Toufic, “If You Prick Us, Do We Not Bleed? No,” in Forthcoming, 2nd ed. (Berlin: Sternberg Press, 2014), 40. For original citation, see Daniel Paul Schreber, Memoirs of My Nervous Illness (New York: New York Review ; London, 2001), 145.
...appetite.” [6]
Antonin Artaud, “To Have Done with the Judgment of God, a radio play (1947),” in Antonin Artaud, Selected Writings (Berkeley: University Of California Press, 1988), 564.
...question.” [7]
Laurent Gautron, “The Phantom Satiation Hypothesis of Bariatric Surgery,” Frontiers in Neuroscience 15 (February 1, 2021): 5,
...well?” [8]
Artaud, “To Have Done with the Judgment of God, a radio play (1947),” 564.
...biopolitics.” [9]
Ezekiel Dixon-Román and Jasbir Puar, “Mass Debilitation and Algorithmic Governance,” E-Flux, no. 123 (December 2021): 7,
...organ. [10]
Jasbir K. Puar, “Spatial Debilities: Slow Life and Carceral Capitalism in Palestine,” South Atlantic Quarterly 120, no. 2 (April 1, 2021): 396-399
...altogether. [11]
Dixon-Román and Puar, “Mass Debilitation and Algorithmic Governance,” 7.
...body.” [12]
Dixon-Román and Puar, “Mass Debilitation and Algorithmic Governance,” 8.
...past. [13]
I am putting forward, here, a tentative reading of Puar’s concept of ‘dividualization’ in relation to Yuk Hui’s extensive genealogy of the concept of organicism in Western philosophical thought. See Yuk Hui, Recursivity and Contingency (London, United Kingdom ; Lanham, Maryland: Rowman & Littlefield International, Ltd, 2019).
Revisceralization: Counter-technologies of Palestinian Liberation
...bowels. [14]
Esmail Nashif, “Building the Community: The Body, the Material Conditions, and the Communication Networks,” in Palestinian Political Prisoners : Identity and Community (London: Routledge, 2010), 38-72.
...overcome.” [15]
Mikhail Bakhtin, Rabelais and His World, trans. Helene Iswolski (Bloomington: Indiana University Press, 1984), 317.
...experience.” [16]
Lara Sheehi and Stephen Sheehi, Psychoanalysis under Occupation : Practicing Resistance in Palestine (New York: Routledge, Taylor & Francis Group, 2022), 76.
...selfhood.” [17]
Ibid, 22.” [18]
Ibid, 61.
...intersubjective.” [19]
Ibid, 52.
...innocence. [20]
Ibid, 78.
... [21]
Karim Kattan, “The Funambulist Correspondents 30 /// as If It Were True,” THE FUNAMBULIST MAGAZINE, March 31, 2022,
Missile Pill
...sight. [22]
“Camera-In-a-Pill Gives a Closer Look,” ISRAEL21c, November 1, 2001,
...doesn’t. [23]
“Camera-In-a-Pill Gives a Closer Look.”
...Gaza. [24]
Joseph Pugliese, Biopolitics of the More-Than-Human : Forensic Ecologies of Violence (Durham: Duke University Press, 2020), 70.
...memory. [25]
See Yuk Hui’s discussion on André Leroi-Gourhan’s philosophy of technic for more on this. Yuk Hui, The Question Concerning Technology in China an Essay in Cosmotechnics. (Falmouth Urbanomic, 2018).
... [26]
See Max Liboiron’s brilliant analysis of the colonial implications of threshold theories of environmental pollution and contamination. Max Liboiron, Pollution Is Colonialism (Durham: Duke University Press, 2021).
...wake.” [27]
Ewa Macura-Nnamdi, “The Alimentary Life of Power,” GLQ: A Journal of Lesbian and Gay Studies 21, no. 1 (January 1, 2015): 96,
The Patient
...state. [28]
Wolfgang Huber, Jean-Paul Sartre, and Sozialistisches Patientenkollektiv, Turn Illness into a Weapon for Agitation by the Socialist Patients’ Collective at the University of Heidelberg (Heidelberg Krrim, Self-Publ. For Illness,1993).