Differences in Medicine: Unraveling Practices, Techniques, and Bodies (review)

Abstract

Reviewed by: Differences in Medicine: Unraveling Practices, Techniques, and Bodies * Gerard J. Fitzgerald (bio) Differences in Medicine: Unraveling Practices, Techniques, and Bodies. Edited by Marc Berg and Annemarie Mol. Durham, N.C.: Duke University Press, 1998. Pp. vii+272; illustrations, figures, tables, notes/references, index. $17.95. In the last ten years historians of technology and medicine have paid increasing attention to the complexities of biomedicine. The rise of scientific medicine and the corresponding changes in medical technologies since the nineteenth century have resulted in dramatic scientific and technological developments. These have influenced social and cultural discontinuities to varying degrees in different geographic settings. The ten essays in Differences in Medicine: Unraveling Practices, Techniques, and Bodies reflect the increasing sophistication of scholars within science studies and medical anthropology who seek to untangle the multilayered web of practice within late-twentieth-century Western biomedicine. As a volume in a new series called “Body, Commodity, Text: Studies of Objectifying Practice,” this book provides a number of interdisciplinary case studies from France, Germany, the Netherlands, the United Kingdom, and the United States. The various authors investigate the intercultural processes by which medical practitioners and patients negotiate and construct patient bodies and identities. It is the identification of perceived “unities” within Western medicine and of the process by which “these unities dissolved” (p. 4) that drives these essays and raises intriguing questions about the nature of biomedical practice. Because of the prevalence of interdisciplinary approaches, the centrality of anthropological methods, and the use of technical jargon, some more traditional readers of T&C may be put off. This would be unfortunate, as this book offers historians an exciting, albeit rigorous, entry into science studies and medical anthropology. In the introduction to the book, the editors cite two sources as central to the thematic bounds of the essays: Barbara Smith’s 1981 article “Black Lung: The Social Production of Disease” (International Journal of Health Services), on the mediation and construction of black lung as a disease among West Virginia coal miners, and Donna Haraway’s 1991 Simians, Cyborgs and Women: The Reinvention of Nature, from which they quote: “But if there has been recognition of the many non-, para-, anti-, or extrascientific languages in company with biomedicine that structure the embodied semiosis of mortality in the industrialized world, it is much less common to find emphasis on the multiple language within the territory that is so often glibly marked scientific” (p. 3). Marc Berg and Annemarie Mol note that “it is this territory—‘so often glibly marked scientific’—that we venture to explore” (p. 3). These essays examine five commonalties that distinguish and analyze the bounds of biomedical practice: the medical profession, Western medicine, the present, science, and the patient. In many cases, these commonalities [End Page 178] explore the relationships, institutions, technologies, and practices within medicine from the viewpoint of the patient, physician, nurse, and technician. Although these essays deal with different geographic locations as well as different topics, they are generally thematically unified in their examination of the limits of practice broadly defined in biomedical environs. Especially thought-provoking are Stefan Hirschauer’s essay on the construction of sex within German transsexual treatment programs and Monica Casperon’s article on the interaction of fetal surgeons, obstetricians, and social workers and their differing approaches to fetal surgery in California. Annemarie Mol’s essay on atheroscleroses examines the ontological status of various diagnostic, research, and treatment practices within the hospital and the nexus between these practices and the body under examination. Mol’s essay in particular raises philosophical questions about material culture, medical practice, and the natural world that historians of technology might find applicable to their own work. Although written for a specialist audience, the reference section insures that interested nonspecialists will be able to engage the literature in science studies that Differences in Medicine: Unraveling Practices, Techniques, and Bodies draws upon. This affordable book would be a useful addition to a graduate seminar on medicine and technology. In addition, it is required reading for scholars interested in the latest work on biomedical practice, material culture, and medical technology. Gerard J. Fitzgerald Mr. Fitzgerald is a doctoral candidate in the history and policy program...