CT Suite: The Work of Diagnosis in the Age of Noninvasive Cutting

410 Pages·2008·4.691 MB·English

by  Barry F. Saunders

CT SuiTe
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Studies of Objectifying Practice Arjun Appadurai,
Jean Comaroff, and
Judith Farquhar
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The Work of Diagnosis in the Age
of Noninvasive Cutting
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Durham and London
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© 2008 Duke University Press
All rights reserved
Printed in the United States
of America on acid-free paper ¥
Designed by Amy Ruth Buchanan
Typeset in Minion and Gotham
by Achorn International
Library of Congress Cataloging-
in-Publication Data appear on the
last printed page of this book.
Duke University Press gratefully
acknowledges the support of the
University Research Council at
the University of North Carolina,
Chapel Hill, which provided funds
toward the production of this book.
ConTenTS
Acknowledgments vii
Introduction 1
1 Reading and Writing 13
2 Cutting 93
3 Diagnosing 130
4 Curating 159
5 Testifying and Teaching 199
6 Exposition 275
Impression 300
Notes 307
Clinical Terms and Jargon 345
Bibliography 349
Illustrations 375
Index 379

ACknowledgmenTS
This book would not exist without the generous attentions and critical tractions
of professors, colleagues, students, and friends over fifteen years or so.
Special thanks are due Judith Farquhar—for her marvelous examples of
discernment and clarity of explanation, and much more, over many years—
and for her initial welcome of this book as part of the Duke University Press
series Body, Commodity, Text. I also thank Ruel Tyson for contributions to my
scholarly vocation and formation at so many crucial junctures, including many
parts of this book. And I thank Larry Churchill for welcoming me to the in-
terdisciplinary conversations at unc Social Medicine, which has become such
a fine intellectual home.
Among colleagues at the University of North Carolina, Chapel Hill, who
shaped the book most directly—by commenting over the years on writing, of-
fering bibliographic recommendations, thinking with me about biomedicine-
as-culture, and more—are Keith Wailoo, Tomoko Masuzawa, Carol Mavor (all of
whom critiqued the dissertation that preceded the book), Kevin Parker, Richard
Clark, Victor Braitberg, Fletcher Linder, Della Pollock, Mark Olson, Keith
Cochran, Stephen Pemberton, Joel Elliott, Roper Marks, and Larry Russell.
I am indebted to my hosts at the University Hospital Department of Radiol-
ogy where I conducted my fieldwork in the late 1990s. The chair and vice-chairs
and the directors of ct services were welcoming and cooperative. Members of
resident and attending staff, many technologists, several nurses and adminis-
trators, and various clerks, schedulers, and couriers were helpful in answering
questions, allowing themselves to be recorded and photographed, and gener-
ally tolerating my intrusions into busy routines. This book is thin tribute to
many performances of skill and care that I witnessed. Any misrepresentations
of radiological views and activities in this book are my own. I am also grateful
to Dr. Melissa Rosado de Christenson and colleagues for my welcome in a fall
2000 visit to the afip Department of Radiologic Pathology.
The book has benefited from feedback on various presentations in schol-
arly colloquia and meetings: Duke Sawyer Seminar on Cultures and Medicine;
University of Chicago Department of Anthropology; European Association for
Social Anthropologists (Vienna); Association for Social Anthropology (Man-
chester); Society for the Social History of Medicine (Manchester); Society for
Literature and Science (Los Angeles); Tanner Humanities Institute (Salt Lake
City). I am particularly grateful for the perspicuity and help of several host col-
leagues in these settings: Priscilla Wald, Cristina Grasseni, Simon Cohn, Jim
Bono. Helpful commentaries included those of Joe Dumit, Jean Comaroff,
Barbara Stafford, Brian Rotman, Timothy Lenoir, and Andreas Roepstorff—
among many others.
Two anonymous readers of the book manuscript at Duke University Press
were meticulous and generous in their interventions. Ken Wissoker and Court-
ney Berger deserve thanks for securing their help—and also for their own pa-
tience and prudence throughout manuscript revisions.
Over a longer durée, Kathryn Montgomery’s insights into literary meth-
ods in medicine—and friendship—have been very important. Another friend,
Liza Wieland, lent her poet’s ear to this project when my own editorial judg-
ment was at low ebb.
At the University of North Carolina, I am fortunate to have recurring teach-
ing roles, and fine colleagues, in both Anthropology and Religious Studies. Stu-
dents in several graduate seminars have offered helpful critical commentaries
on chapter drafts. In Social Medicine, I remain deeply grateful for my teaching
appointment (and for one leave!) while this book project was in the works,
and I am particularly appreciative of warm collegial support I enjoyed from
Sue Estroff, Nancy King, Gail Henderson, Bill Lachicotte, Jon Oberlander, Don
Madison, Kendrick Prewitt, Bill Kerwin, W. D. White, Terry Holt, Des Runyan,
Alan Cross, Rebecca Walker, Judy Benoit, Lisa Perry, and others. In Medicine
and Family Medicine, I thank Fred Sparling, Tim Carey, Byron Hoffman, Todd
Granger, Mark Gwynne, and Warren Newton for recognition of my scholarly
work. At Chatham Hospital, erstwhile home away from home, I thank Jim
viii  •  Acknowledgments
Adams, Annette Willett, Cam Austin, Bea Morehead, deb Garner, and John
Dykers for the same, and for their friendship.
Two able assistants supported specific phases of this project: Rachel Winters
helped with bibliographic work; and Lisa Smith transcribed tapes of radiologi-
cal shoptalk. Several archivists provided special help beyond reproduction of
images: Michael Rhode (National Museum of Health and Medicine, afip)
and Eileen Mathias (Academy of Natural Sciences). A grant from the Univer-
sity of North Carolina’s University Research Council helped defray publication
costs.
Finally: I express my heartfelt thanks to my family and friends—especially
my wife, Susan—who gave me the support and freedom to think and write and
kept their impatience for the book’s finish mostly under wraps.
Acknowledgments  •  ix