CT Suite: The Work of Diagnosis in the Age of Noninvasive by Barry F. Saunders

By Barry F. Saunders

In CT Suite the health care provider and anthropologist Barry F. Saunders presents an ethnographic account of the way a specific diagnostic know-how, the computed tomographic (CT) scanner, shapes social family and highbrow actions in and past the CT suite, the unit in the diagnostic radiology division of a big educating clinic the place CT photos are made and interpreted. concentrating on how services is played and the way CT photographs are made into diagnostic proof, he concentrates no longer at the functionality of CT pictures for sufferers yet at the functionality of the pictures for doctors going approximately their exercises. but Saunders deals greater than insider ethnography. He hyperlinks diagnostic paintings to practices and conventions from open air drugs and from prior ancient moments. In discussion with technological know-how and know-how stories, he makes an important contribution to scholarship at the visible cultures of medicine.

Saunders’s analyses are trained via strands of cultural heritage and conception together with artwork old opinions of realist illustration, Walter Benjamin’s matters approximately violence in “mechanical reproduction,” and tropes of detective fiction corresponding to intrigue, the case, and the offender. Saunders analyzes the diagnostic “gaze” of scientific group of workers analyzing pictures on the viewbox, the two-dimensional photos or slices of the human physique rendered by way of the scanner, equipment of archiving photographs, and using scans as pedagogical instruments in scientific meetings. Bringing cloistered diagnostic practices into public view, he unearths the customs and the social hierarchies which are formulated and negotiated round the weighty presence of the CT scanner. while, through returning all through to the nineteenth-century rules of detection and clinical authority that tell modern clinical prognosis, Saunders highlights the specters of the previous in what seems to be a preeminently sleek computing device.

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Here it seems enhanced by collegial comfort, by histories of prior consultations. But soon the colleagues revert to conventional roles— radiologist speaking to image-appearance, pulmonologist to clinical issues: 84 Pulmonary attending: Describe just what you’re seeing? ct attending: [authoritative tone:] . . ill-defined patchy groundglass opacity,85 primarily in mid lung fields . . ” Pulmonary attending: If I was to bronchoscope her, would middle lobe be a good place to go? . superior segment of left lower lobe .

I mean like—um, am I looking at—seeing the same thing? Attending: Yeah, this thing here? Body ct fellow: I didn’t—just to play devil’s advocate, could that be the bottom of . . Resident: . . it’s volume averaging— Attending: It’s volume averaging of that first rib costochondral junction. To avoid being tricked by volume averaging, one can discount findings that do not extend across contiguous slices—and one can make thinner slices. Then there is “motion artifact” (from breathing, peristalsis, shifting on the table).

All right. Lungs, no nodules. Liver, kidney, spleen, adrenals, panc, normal . . abdominal, pelvic, retroperitoneal, adenopathy and fluid . . No . . change. Good for this man. The litany of the checklist offers comfort—proper reconnaissance, summation of friends well-met. It recurs in viewbox conversations and in some dictated reports. 52 “Security” is further testimony to affective, expectant components of radiographic attention, dependent on the comforting familiarity of the normal. 53 Naming findings can be a courtesy extended to friends, or a way of controlling enemies.

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