Maastricht-Combining their ethnographic material from hospitals and medical schools in Australia, Anna has published an article with Australian-based sociologist Sarah Maslen in the high-profile journal Social Science & Medicine. Entitled "Becoming a diagnostic agent: A collated ethnography of digital-sensory work in caregiving intra-actions", it concerns the digital sensory work entailed in caregiving interactions involving children. Anna drew from her fieldwork with doctors who engage in sensory training themselves, as well as with patients, while Sarah drew on her fieldwork with parents. You can read the full abstract below. The article would be of interest to those interested in parenting apps, diagnostic decision making, sensory learning and/or digital-sensory ways of knowing the world, as well as researchers exploring experiments in bringing ethnographic or other research material together in virtual collaborations across the world.
Sociological contributions on digital health have acknowledged the enduring significance of sensory work in diagnosis and practices of care. Previous explorations of these digital and sensory entanglements have focused separately on healthcare providers or patients/caregivers, rarely bringing these worlds together. Our analysis, based on the collation of ethnographic fieldwork in clinics, medical schools, and homes in Australia, offers rare insights into caregiver and practitioner perspectives. We interrogate the work involved in digital-sensory becoming, as caregivers (in our case parents) learn to assign diagnostic meaning to potential childhood disease. Working with Karen Barad’s concept of ‘intra-action’, we demonstrate how diagnostic knowing is enacted between practitioners, parents, senses, and devices. We identify seven aspects of digital-sensory learning: attention to the change from normal; testing/searching for signs and symptoms; confirmation and direction from more experienced others; mimicry; analogy/metaphor; digital archiving; and reference to validated digitised signs. We found that this learning does not take place discretely in the clinic or at home. Doctors and parents both do digital-sensory work to register, co-witness, and mutually enact disease by interpreting signs and symptoms together in their caregiving intra-actions. Our article also champions collated ethnography as a methodological approach for making sense of complex assemblages in healthcare.
The first issue of the journal has a host of wonderful articles by artists and scholars interested in exploring the boundaries of modality. Many of them explore a theme close to the heart of Making Clinical Sense: bodies, and touch. They look specifically at how this is enacted in times of quarantine. You can find pieces by Dutch artist Marloeke van der Vlugt, Kate Elswit, Carey Jewitt and others, on dance, diaries, touch documentation, technology, architecture and movement amongst other fascinating topics. In my own essay I try to expand what it means to think about learning anatomy beyond the walls of the medical school, through learning anatomical Latin with everyday fabrics in the home (see my photos below).
In A Sensory Education Anna shows that our sensing is not innate or acquired, but in fact evolves through learning that is shaped by social and material relations. The chapters feature diverse sources of sensory education, including field manuals, mannequins, cookbooks and flavour charts. The examples range from medical training – drawing from fieldwork from the Making Clinical Sense project – to forest bathing and cooking classes. With hand-drawn illustrations and sensory lessons throughout, the book looks at the uncanny and taken-for-granted ways in which adults are trained to improve their senses. It may be of interest to those teaching courses related to everyday life, technologies and the senses or teachers looking for sensory exercises for their students; to students and scholars from across the social sciences, particularly of the senses and embodied expertise; to workshop organisers looking for creative ideas; and to anyone who takes a personal interest in learning sensory practices like cooking, knitting, bird watching, wine tasting and gardening, to name a few.
Thanks to funding from the European Research Council, the book is Open Access and you can download both the chapters and shorter sensory lessons for free from Routledge.
Dutch call, English is below ….
Kunst & Geneeskunde #4: Dissecting Touch
In de vierde bijeenkomst van de serie Openbare Lessen: Kunst & Geneeskunde verwelkomt de Jan van Eyck Academie beeldend kunstenaar Eva Spierenburg. In haar beelden, tekeningen en video’s onderzoekt zij het lichaam, aanraking en materialiteit. Ter gelegenheid van deze bijeenkomst gaat zij het gesprek aan met Anna Harris, assistent-professor en medisch antropoloog aan de Universiteit Maastricht, wiens onderzoek zich richt op de zintuigelijke training van artsen in het digitale tijdperk.
In deze tijden van de wereldwijde coronacrisis krijgt het idee van aanraking een extra lading en betekenis. Welke verschillende vormen van aanraking kunnen we onderscheiden in een artistieke en medisch praktijk en op welke manier verschillen deze vormen van elkaar? Kunnen deze bevindingen zelfs nieuwe perspectieven bieden op de huidige situatie van sociale terughoudendheid? Samen met u als publiek willen we onderzoeken wat lichamelijk en zintuiglijk leren kan betekenen binnen artistieke en medische beroepspraktijken. Tegelijkertijd zullen we de rol van aanraking in het werk van Spierenburg en Harris verder ontleden.
Openbare Lessen: Kunst & Geneeskunde
Vanuit de gemeenschappelijke nieuwsgierigheid en verwondering naar de mens en het menselijk lichaam hadden geneeskunde en kunst ooit een sterke band met elkaar. Door de vele maatschappelijke en technologische ontwikkelingen, zijn deze twee werelden jarenlang tegenover elkaar komen te staan. De medische wereld stond voor objectiviteit, de kunstwereld symboliseerde de subjectiviteit. Sinds enkele jaren zien we echter dat de vakgebieden een nieuwe interesse in elkaar krijgen. In een reeks Openbare Lessen bekijkt de Jan van Eyck Academie wat er gebeurt als deze twee domeinen samenkomen. Door de dialoog tussen de kunsten en de geneeskunde te stimuleren, onderzoeken we samen met het publiek wat de meerwaarde kan zijn. Dit is het vierde event in deze serie.
Openbare Lessen: Kunst & Geneeskunde is een initiatief van Onderzoek & Educatie, een deelinstituut van de Jan van Eyck Academie.
Ondersteund door: BankGiro Loterij Fonds
Art & Medicine #4: Dissecting Touch
For Part 4 of the Open Courses: Art & Medicine, Jan van Eyck Academie welcomes visual artist Eva Spierenburg whose sculptures, drawings and video works investigate the body, touch, and materiality. For this occasion, she will delve into a conversation with Anna Harris, an assistant professor and medical anthropologist of Maastricht University whose research falls on doctors’ sensory training in the digital age.
The notion of touch becomes extra complex in these times of the COVID-19 pandemic. What are the different types of touch within artistic and medical practices, and how do these distinguish from one another? Moreover, can the findings lead to a new understanding of the current situation of social distancing? Together with you, we would like to explore sensorial and embodied learning within artistic and medical professions, and shape the conversation by dissecting the role of touch in Spierenburg and Harris’ practices.
Project Art & Medicine
Based on their mutual curiosity and interest in the human and human body, both art and medicine once held a very strong bond. With many societal and technological changes and developments, these two worlds began opposing each other, with the discipline of medicine representing objectivity, and the art world symbolizing subjectivity. Recently, however, we have been able to see these two domains moving towards each other with a new fascination for one another. In a series of Open Courses, the Jan van Eyck Academie zooms in on what happens when these two domains meet. Together with the public and by stimulating a dialogue between the arts and medicine, we wish to discover what the added value of this connection could be.
This is the fourth event in this series.
Open Courses: Art & Medicine is an initiative of the institute for Research & Education of the Jan van Eyck Academie.
Supported by: BankGiro Loterij Fonds
1. Instead of keynotes, we asked inspiring scholars in our field to make 10 minute audio postcards, which we compiled in a folder for participants to listen at leisure in the week leading up to the event. They did so while running, cooking, sitting at computers, and it gave many a welcome relief from their laptops.
2. We made kids activities.
3. Rather then then dive into online discussion, we arranged walk-talks as the first activity for the day, with pairs of participants who lived near each other meeting up and discussing their thoughts during a one-hour stroll in their neighbourhood. Many not only had a chance to meet a new/old colleague they hadn’t seen for months, but also to see their area anew.
4. Next was slightly larger group brainstorming. Utilising the breakout room function on Zoom, we added to this a dedicated Google Doc, for making rapid notes. We all joined the main room and heard 3 min recaps of the discussion.
5. After this intense online part of the event, we took a break for stretching, coffee, cat patting, but also brainwriting, every participant having access to all the Google Docs for individual writing.
6. Finally we all came together for a short group discussion, followed by an optional movie night that evening.
You can read more about the event on the MUSTS website here: https://www.maastrichtsts.nl/musts-thematic-event-embodied-expertise-in-art-science-and-medicine/
The stethoscope goes digital: Learning through attention, distraction and distortion
For centuries, those training doctors have been faced with the challenges of standardising subjective experiences and constructing “the universal body” in learning situations. Various technologies have been introduced to address these challenges, with varying degrees of success. In this article we focus on the stethoscope, specifically the electrical and digital stethoscope models. Historical and social studies of medicine have already underlined the sociomateriality of learning in medicine. In this article we underscore the performative nature of teaching and learning in the sociomaterial context. We do so by juxtaposing ethnographic and historical events that stage electrical and digital stethoscopes. These are not documentations of everyday practices but rather reconstructions of choreographed performances for learning about the body. In these stagings, the novice is taught to focus attention and avoid distraction, when learning the sounds of “the body”. Through engaging with, and comparing, different ethnographic and historic materials and artefacts, and through methodological reflection, we examine the importance not only of attention and distraction in learning a bodily skill, but also of dealing with distortion. We argue that these ethnographic and historic insights into distortion illuminate a neglected aspect of medical training, and more generally, in shaping sensory perceptions.
Read more here.
This article draws on research funded by a Dutch NWO Vici Grant entitled Sonic Skills: Sound and Listening in the Development of Science, Technology, Medicine (1920–now) awarded to Karin Bijsterveld (grant agreement No: 277-45-003). Melissa Van Drie further developed the article’s historiographical approaches to sensory experiences of sound devices and did archival research on hearing disabilities during a postdoctoral position in the European Research Council (ERC) funded project Sound and Materialism in the 19th Century awarded to David Trippett at the University of Cambridge (Horizon 2020 scheme, grant agreement No. 638241). Final corrections were completed during Melissa’s current ERC funded Marie Skłodowska-Curie Individual Fellowship project called Sounds Delicious at the University of Copenhagen (grant agreement No. 753565). The article also draws on Anna Harris’ current research on digital doctors funded by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreement No. 678390). Anna would like to thank the participants in her studies for their time and for sharing their experiences, skills and stethoscopes with her, and Ruth Benschop for introducing Hirschauer’s work. Melissa and Anna would like to thank the Sonic Skills team for their constructive feedback on our collaborative project along the way, as well as Whitney Laemmli, Kate Smith, Josh Grace, Caitlin Wylie, Johanna Gonçalves Martin, Stewart Allen, Nina Lerman and Dagmar Schäfer for their comments on earlier drafts during our time together at the Max Planck Institute for the History of Science in Berlin. Finally, Melissa and Anna are grateful to the anonymous reviewers, and to Thibault Walter and Vincent Barras for encouraging them to develop a conference presentation into this piece, and for their support along the way.
Travelling histories: An ancient jar of starter?
Sensory memory fragment, written April 2016, unpublished, archived in Dropbox
One Sunday I was handed, somewhat ceremoniously, a warped little take-away container of bubbly brown goop. My husband and I were taking a free sourdough bread making workshop, part of a skills sharing scheme in our very ecologically friendly new home town of Totnes, in the heart of the Devon countryside. Our cheerful instructor Holly had given us both (and the other six bread-making novices in the class), what is called “a starter”. She was learning how to make bread herself and thought she would learn alongside us. With post-it-noted library books spread out on her kitchen table, we poured over the advice from the best bakers in the UK. It looked easy enough: flour, water, salt. Some kneading. A warm place to rise. A hot oven. The tricky part seemed to be the yeasty and bacterial starter. We had known this from our previous attempts at making bread. Kilner jar after kilner jar of tepid brown muds that we had created from flour, water and raisins, were emptied into the kitchen sink, not a bubble of microbiological activity in sight. But now we had something special, so Holly told us. A starter that was not created last week in her kitchen, but rather one that was over a hundred years old. Handed down from hessian wearing monks keeping themselves warm during a Devon winter with woodfires baking their sourdough loaves. My husband and I looked down at our goop, which had now transformed into something ancient and mythical. [unfinished]
Sourdough starters: The sticky archives of quarantine 2020
Written July 2020, for Sensate Memories
Nearing the end of this historic-ethnographic project on learning sensing in medicine, I am wading into the dropboxed digital-sensate memories of past ideas, those like travelling bacteria. Rereading the sensory artifact above, I can smell those starters we made in Devon, our starter travelling with us around the world – wrapped carefully in suitcases, snaplocked into friends’ freezers during our holidays, through customs dried onto parchment paper, into many loaves of bread – only now to lay dormant in our fridge, not a bubble in sight. I recently read many newspaper articles and saw lots of Instagram photos of the sourdough craze sweeping those crazed by lockdown during the current pandemic. With no daycare for months, my husband and I struggled to keep it together, let alone keep our starter alive. But so many seemed to be finding security, creativity, distraction and visual delight in the simple act of making of a sourdough starter.
When lockdowns spread around the world, something stopped spreading besides a virus: our own bacteria. Sequestered in our homes, our travelling germs had nowhere to go, could not be shared in our contact with others, plants, animals in the outside world. Instead, our own homes and their large inhabitants became isolated microcosms of tiny creatures, breeding and diverging. And where was one of the places they found a home? Those multiplying sourdough starters. Microbiologists have found that some of the bacteria and yeasts in starters come from the bodies of bakers, and moreover, that the bodies of bakers start to grow the lactic acid bacteria of their starters. So these starters born into the world in quarantine kitchens in fact become like sensory archives of the bodies of its inhabitants, and their new habits and routines and ingredients in lockdown life. At the same time, the inhabitants also become sensory archives of their new engagements with the microscopic world.
These are literally sticky threads of history, which cling, reproduce and diverge with our bodies. Our research team thinks a lot about the sticky threads of history in our medical education project, particularly the historian on the project, John Nott, as there are so many ideas and ways of sensing that stick to the materials with which medical students learn sensory skills. Our object of focus has been tools and technologies, and we explore the materiality of sensing through these artifacts in medical schools. The great starter project of quarantine makes me think of other ways to trace sticky threads of micro-histories in bodies, jars, the food we eat. I wonder how we might trace these archives, in ways beyond text, something which the Centre for Imaginative Ethnography, and the creative sensory ethnographers affiliated, have been exploring with inspiring results. Overleaf is the germ of an idea that explores a more textile based experiment with sensate memories and bodily archives in embroidery. These are embroidered microbes I made previously, but I also imagine what it might be like to share and look microscopically at quarantine starters, and perhaps even to trace, with fabric and thread, what has grown in these sour, gloopy, bubbling and stagnate jars, how this might speak to another kind of historical record of our times.
In an essay for Cultural Praxis, I wrote about playing with my toddler in lockdown, and with my father too, and how our Making Clinical Sense project is also imbued with, and inspired, by playful research methods and forms of gathering. I consider at the end how, “in the future, I would like to try and engage in more open-ended methodological experiments that have an “underwater” or “extra-terrestrial” feel, of further escape and open-ended possibility, for it seems to be this is where we can learn not only about the not-yet, but about ordinary life too, and question the status quo”.
Medicine has long been criticised by STS for its measuring practices. The racist use of tools such as measuring tapes, even in today’s public health programs, has shown to problematically shape the worlds measured and overshadow alternative narratives (García-Meza and Yates-Doerr 2020/Yates-Doerr and García-Meza 2020). To date, focus has been on the clinician/healthcare worker/medical researcher at work, with their tools of measurement to hand. In this paper I step back into the training of clinicians. I draw on ethnographic fieldwork in medical schools (part of a larger project, Making Clinical Sense) where bodies as standards of measurement are continually formed and calibrated. I look at how, through the very same instrument that interests critical scholars of metrics – measuring tapes – numbers get implicated into doctors’ embodied knowledge. With this soft and flexible tape, medical students learn to calibrate their own sensory knowledge as they measure lung expansion, gestation on plastic models and the length of their fingers. In doing so they create their own bodies as the standard or measure of things (Hoel and Carusi 2018). I suggest that unpacking this inexpensive teaching device, part of medical knowledge creation that wraps itself around and into bodies, offers new insights into the study of metrics in medicine (Adams 2016). Tracing the making of measuring bodies, as well as measured bodies opens up questions about the implications of the sociomateriality of learning, the politics of using one’s own body as standard, and the never-ending quest for the numerical objectification of sensory knowing.
Dr. Auzoux’s developed his papier-mâché anatomical models after finding it difficult to source and preserve cadavers. They were soon being made for medical schools around the world, to teach anatomy. His workshop later went on to make animal and botanical models too. It is a fascinating history worth delving into, when more time becomes available.
For now though, in my own quarantine workshop, one thing I have realised about the papier-mâché things we are making is how easy it is to mold the paper into whatever form you want to make. There comes a point of firmness however, when the object is fixed, and unlike more dynamic models made from other materials, knitting for example, there is no way to make it move, other than with your hands (flying the rocket through the air on blast-off for example).
In such flight, I also realise how fragile these paper models are. Below I have included some other fragile models, these made of glass and photographed during a visit to the Natural History Museum in Vienna after last year’s AMEE (European medical education association) conference. These paper and glass models, digital on our screens, are material objects with their own properties, lessons and fragility, something that is almost tangible if we look in tactile ways.
Image of models are all used under a Creative Commons Lisence, the pregnancy model downloaded from Wikimedia, originally uploaded from the Boerhaave Museum; the flower model also downloaded from Wikimedia originally uploaded by MuseeEducation, and the eye model from Wikimedia originally uploaded by Gmogicato (CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0))