Cells and the (imaginary) patient: the multistable practitioner–technology–cell interface in the cytology laboratory

Abstract

Modern health care is inextricably bound up with technologically mediated knowledge and practice. It is vital to investigate its use and role in different clinical contexts characterized, on one hand, by face to face practitioner and patient encounters (where technology may be conceptualised as hindering therapeutic relations) and, on the other hand, by practitioners' encounter with bodily parts in laboratories (where conceiving of patients may be thought of as confounding objectivity). To contribute to the latter, I offer an ethnographic analysis of cytology laboratory practitioners' work and microscopic assessment of normal and abnormal cells. First, I discuss the biomedical literature on cytology and the quest for a non-variational bodiless vision. Second, I discuss the concept of multistability, first developed by philosopher of technology Don Ihde, here used to analyse technologically mediated perception and how practitioners interact with technology. Combined with long term ethnographic fieldwork it enables access to, and analysis and articulation of the implicit multifaceted practitioner-technology-cell interface embedded in clinical practice and diagnostic processes. I will also address some implications of my analysis for clinical cytology.