ASA Decennial Conference - Anthropology and Science
The science of functioning bodies
Contact convenor: Gooberman-Hill
MRC Health Services Research Collaboration
Department of Social Medicine, University of Bristol
Bristol, BS8 2PR, UK.
Tel: 0117 928 7293.
What happens when science replaces parts of, or otherwise assists, our bodies? This panel will explore anthropological approaches to scientific and technological interventions that assist physical functioning and mobility in everyday life. While this may be interpreted in its broadest sense, work that examines this may be rooted in specific medical interventions or technology. For instance, interventions such as artificial hip or knee replacements involve the replacement of body parts with manufactured entities. Alternatively, the body’s functioning may be replaced or supplemented by external, engineered aids and appliances. How are these interventions negotiated and understood? How do we theorise such altered bodies? How can we develop that theorising in the light of pertinent work such as that on ageing and disability?
The panel will maintain a broad remit, and hopes to encourage debate and contributions from those working in spheres such as medical anthropology, disability and ageing. Discussion will have relevance for pragmatic and theoretical understandings of the body and of scientific or medical interventions.
Pump technology: modern insulin infusion and the body
Since the 1980s, over 150,000 insulin dependent diabetics have adopted insulin pump technology as their standard of care. This device, no large than a beeper, offers diabetics “an artificial pancreas” that delivers insulin continuously. The largest pump manufacturer today, Medtronics, introduced its first product line in 1983 and has expanded and improved its pump technology since then. Although contemporary pumps cannot respond to changes in blood sugar, manual programming allows the user to respond to high and low blood sugars and better manage their healthcare.
Many diabetics are resistant to adopt pumps for many practical reasons, such as its expensive price. Yet, many also refuse to permanently alter their bodies and resist the encroachment of technology on the body. This paper will examine how pump users imagine their body when they wear an insulin pump. Through interviews with pump users, I will analyze impressions of its potential technological advances and threats; notions of the permanency of pump management; and individual choices regarding the display of this part. This study will engage on recent work on normalcy and disability, technology and the body, and medical advances that demand alternate conceptions of the body.
Old joints versus new joints for ‘old’ me: time, (dis)comfort and risk, and views about hip and knee surgery
Caroline Sanders, University of Bristol
This paper is based on results of interviews with people who are potential candidates for (or recipients of) hip and knee replacement surgery as a consequence of severe osteoarthritis (OA). The conceptual elements of time, (dis)comfort and risk, proved analytically helpful in making sense of interview narratives and seem inextricably linked. Views and decisions about whether or not to have such surgery were intertwined with thoughts of subjective selves, especially their views about ‘self’ in the context of the life course, and hence the passage of time. More specifically, their talk articulated their experience of symptoms as an expression of the ageing body, and was reflective of the cultural context of ageing in late modern society. Their comfort/discomfort (body and mind) with such experience impacted on perceptions of joint replacement as being either inappropriate or restorative. Notions of risk were also central to views and decisions about surgery, and were often expressed through stories about people known to respondents who had previously undergone surgery. Such stories seemed to be used as a means to shore up decisions and action (or inaction) regarding the seeking and receiving of treatment. The findings have resonance for policy concerns about unmet needs for total joint replacement surgery.
Semiotics of altered body parts
Contemporary “body parts surgery” rely not only on medical and technical basis nor it evokes only ethical and legislative discourse. It is deeply rooted in “mytho-logical” thinking and dualistic metaphysics, which are negotiated within the context of contemporary culture. As ethnographic data indicates the most elaborated discourse on body parts surgery accompany the crossing between this two different metaphysics: when thinking by analogy (body parts as analogies of emotions, character, identity, society) is trying to be replaced by thinking within dualistic sign structure (body as “flesh” and machine). For example, first transplantations of heart were accompanied by objections caused by the fact, that it was perceived as a hotbed of emotions, feelings and soul, that it is inseparably connected with personal identity (i.e. sexual) – so, the question arouse, what will happen with a man (recipient) who will get a woman’s (donor) heart, what about his personality, would he become a homosexual? “Breaking the spell” of the body, treating it as a flesh, deprive it of so far meanings, moves it toward area of completely different semiotic system – from “body as sign (text)” to the “body as thing” in the process of accelerated semiosis. In connection with it, a new hierarchy of body parts appears. The place of precious (“nobel”) and unprecious body parts is taken by useful and useless ones, the expensive and cheap (market is regulating their value). The body functions within consumer culture, and its parts functions as products that are consumed in many different ways. For those who do not agree with such a “narcissistic” vision of the body, transplantations are contemporary versions of cannibalism.
Tracing this discourse is the best way to understand contemporary body as social construct. It also enables to recognize awaken by surgery fears of a “new Frankenstein” or “neo-cannibalism” as the consumer culture products.
Technokids? Insulin pumps incorporated in young people’s bodies and lives
Griet Scheldeman, University of St. Andrews
Over the last few years in the UK insulin pumps have become an option to treat (people with) insulin dependent diabetes. Multiple daily insulin injections, by syringes or pens, are replaced by a pump, which is attached with a canula to the belly and pumps a programmed dose of insulin into the body every three minutes. It is said that this continuous insulin flow imitates more closely the workings of a pancreas, compared to the huge doses of insulin injected in the body 2 – 4 times a day. Therefore the pump can have significant physical benefits (better adjusted insulin dose and thus having a better controlled blood sugar level, feeling and being more ‘healthy’) and, even more important to the users, huge life-style benefits. Pump wearers report they have regained their freedom and live a normal life again, being able to do what they want when they want.
In recent fieldwork in Scotland I followed closely 5 young people (age 11-17) who are wearing an insulin pump. In several interviews with them over the period of a year I explored how they experienced life with the pump. This paper examines how and whether they ‘incorporated’ this external technological device (the pump) in their lives, touching upon such issues as perceived freedom, control and commodification of the body, and exploring broadly how these young people relate to the pump. Does it remain an external device or does it become part of them? Do they have to renegotiate control over their body? Do they hand over the intense routine of diabetes management to a technical device? Are all these topics even issues to them?
The paper offers an account of scientific intervention experienced as the visible and tangible ‘replacement’ of an invisible and intangible organ.
Beyond functioning: simple technology, complex lives
Rachael Gooberman-Hill, University of Bristol
In this paper I discuss my ongoing fieldwork with older people in the UK. As part of this work I explore informants’ use of and attitudes to mobility aids (walking sticks, frames, wheelchairs etc.). Such aids are crucial for functioning and often stand in metonymical relationships with older age itself. Interestingly though, these aids also have their own complex existences that are embedded in people’s life-stories and experiences. Aids such as sticks and chairs have specific, remembered origins, emotionally charged histories, and hoped-for futures. These trajectories are bound-up with elements of their users’ lives that include family circumstances, significant life events and self-image. For instance, sticks are inherited from relatives, wheelchairs are obtained at times of crisis, and walking frames are left to one side for the sake of appearances (or vice versa). Thus, while aids certainly do provide physical assistance, we also need to see them as intertwined with people’s everyday lives, pasts and futures. As such, mobility aids are intrinsic to the embodied person. While many such mobility aids may seem relatively simple, the nature of the engagement between person and aids is highly complex and may mirror people’s engagement with more technologically complex medical interventions.