Abstract
An emerging body of literature in sociology has demonstrated that diagnosis is a useful focal point for understanding the social dimensions of health and illness. This article contributes to this work by drawing attention to the relationship between diagnostic spaces and the way in which clinicians use their own bodies during the diagnostic process. As a case study, we draw upon fieldwork conducted with a multidisciplinary clinical team providing deep brain stimulation (DBS) to treat children with a movement disorder called dystonia. Interviews were conducted with team members and diagnostic examinations were observed. We illustrate that clinicians use communicative body work and verbal communication to transform a material terrain into diagnostic space, and we illustrate how this diagnostic space configures forms of embodied ‘sensing‐and‐acting’ within. We argue that a ‘diagnosis’ can be conceptualised as emerging from an interaction in which space, the clinician‐body, and the patient‐body (or body‐part) mutually configure one another. By conceptualising diagnosis in this way, this article draws attention to the corporal bases of diagnostic power and counters Cartesian‐like accounts of clinical work in which the patient‐body is objectified by a disembodied medical discourse.
Highlights
In 2003 deep brain stimulation (DBS) was approved as a means of managing dystonia, a neurological disorder that in severe cases is characterised by painful, crippling body postures
Using the notions of communicative body work and sensorial reflexivity, we argue that diagnosis is a process whereby diagnostic knowledge – usually inscribed in a durable form such as a text – emerges from an interaction in which space, the clinician-body, and the patient-body mutually configure one another
The diagnostic corporal skills of the physiotherapists are an important component of the Paediatric Motor Disorder Service
Summary
In 2003 deep brain stimulation (DBS) was approved as a means of managing dystonia, a neurological disorder that in severe cases is characterised by painful, crippling body postures. By 2010 approximately 1000 people worldwide had received DBS for dystonia, most of whom were adults with ‘primary’ dystonia, in which dystonia is the only neurological pathology These patients respond well to DBS: as DBS reduces their dystonic movements, they experience a marked functional gain. Dystonia is a consequence of (or is ‘secondary’ to) brain damage; damage that may result from natal trauma, for example, and which will often cause other motor system abnormalities such as spasticity. The response of these patients to DBS is more variable. Because only dystonic movements are reduced by DBS, the presence of spasticity and other motor system abnormalities will limit any functional gain (Marks et al 2009): the
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