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Download Them Bodies of Information: Reinventing Bodies and Practice in Medical Education Rachel Prentice A.B., Comparative Literature, Columbia University New York, New York, 1987 Submitted to the Program in Science, Technology, and Society in Partial Fulfillment of the requirements for the Degree of Doctor of Philosophy In this History and Social Studies of Science and Technology At the Massachusetts Institute of Technology [:1.x'e d-e"X)t-U May 2004 © Copyright Rachel Prentice. All rights reserved. The author hereby grants to MIT permission to reproduce and distribute publicly paper and electronic copies of this document in whole or in part. /! /'1/7 /) Signature of Author . '(;611 ~ - - Program in the History aneOfucial Study of§cience and Technology r? /J . Certified by~ . _ Sherry Turkle, PreJfess6l{bf the Social Studies of Science and Technology May 27, 2004 ~~) Joseph Dumit Associate Professor ~~OPOI~dScience and Technology Studies. (S!S) /' ~ Hugh Gusterson -+--+--+-----.'''0---'---'''-------------===---­ Associate Professor of A tmo a 0 y and ~~ience a ~~ Evelynn M. Hammonds _ ) Professor of the History of Science and "frican and African American Studies (Harvard) MASSACHUSETTS IN OF TECHNOLOGY ." ARCttIVES!, ';. , JC~ 0 1 200~ lt _._. _ ~ . ~ ~ ?/:.RIF:: S - --' ~.- .•_---- BODIES OF INFORMATION Reinventing Bodies and Practice in Medical Education By Rachel Prentice A.B., Comparative Literature Columbia University, 1987 SUBMITTED TO THE DEPARTMENT OF SCIENCE, TECHNOLOGY AND SOCIETY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN SCIENCE, TECHNOLOGY AND SOCIETY AT THE MASSACHUSETTS INSTITUTE OF TECHNOLOGY June 2004 © Rachel Prentice. All rights reserved. The author hereby grants to MIT permission to reproduce and to distribute publicly paper and electronic copies ofthis thesis document in whole or in part. Signature ofauthor: 7-.."r--~------'7f"----7Ii"--7---" Rachel Prentice Program in Science, Technology and Society Certified by: Sherry Turkle Pro~or ofthe Soci~l Studies ofScience and Technology /' ~ Thesis Supervisor ----:::... ' -"~..-.__ .~. __ ._.~ ... .-., ...- .. .. ...... Hugh Gusterson '._."... Asst5c'iate Professor ofAnthropology and Science and Technology Studies Director ofGraduate Studies Bodies ofInformation: Reinventing Bodies and Practice in Medical Education By Rachel Prentice Submitted to the Department ofScience, Technology and Society in Partial Fulfillment of the Requirements for the Degree ofDoctor ofPhilosophy in Science, Technology and Society ABSTRACT This dissertation recounts the development ofgraphic models ofhuman bodies and virtual reality simulators for teaching anatomy and surgery to medical students, residents, and physicians. It considers how researchers from disciplinary cultures in medicine, engineering, and computer programming come together to build these technologies, bringing with them values and assumptions about bodies from each oftheir disciplines, values and assumptions that must be negotiated and that often are made material and embedded in these new technologies. It discusses how the technological objects being created privilege the body as a dynamic and interactive system, in contrast to the description and taxonomic body oftraditional anatomy and medicine. It describes the ways that these technologies create new sensory means ofknowing bodies. And it discusses the larger cultural values that these technologies reify or challenge. The methodology ofthis dissertation is ethnography. I consider in-depth one laboratory at a major medical school, as well as other laboratories and researchers in the field ofvirtual medicine. I study actors in the emerging field ofvirtual medicine as they work in laboratories, at conferences, and in collaborations with one another. I consider the social formations that are developing with this new discipline. Methods include participant­ observation oflaboratory activities, teaching, surgery, and conferences and extensive, in­ depth interviewing ofactors in the field. I draw on the literatures in the anthropology ofscience, technology, and medicine, the sociology ofscience, technology, and medicine, and the history ofscience and technology to argue that "bodies ofinformation" are part ofa bio-engineering revolution that is making human bodies more easily viewed and manipulated. Science studies theorists have revealed the constructed, situated, and contingent nature oftechnoscientific communities and the objects they work with. They also have discussed how technoscientific objects help create their subjects and vice versa. This dissertation considers these phenomena within the arena ofvirtual medicine to intervene in debates about the body, about simulation, and about scientific cultures. Thesis supervisor: Sherry Turkle Title: Professor ofthe Social Studies ofScience and Technology 2 Biographical note Rachel Prentice obtained a Bachelor ofArts (A.B.) degree in Comparative Literature (with extensive coursework in biology) from Columbia College, Columbia University, New York, New York, in 1987. She was awarded a Hugh Hampton Young Fellowship (MIT) in 2003. She was a Jacob K. Javits Fellow (U.S. Department ofEducation) from 1998 to 2002. And she was awarded the Ida Green Fellowship for female graduate students (MIT) in 1997. She has received the Siegel Prize for best paper on an STS topic for "Calculating Women, Calculating Machines: The Rise of Scientific and Technical Computation in England, 1920-1945" (1998). Her publications include "The Anatomy of a Surgical Simulation: The mutual articulation ofbodies in and through the machine" (Social Studies 0/Science, forthcoming) and Your Child in the Hospital: A practical guide o/parents (O'Reilly, 1997). She has worked as a newspaper reporter for ten years and has authored thousands ofnewspaper and magazine articles. At MIT, she has taught an undergraduate seminar, "From Surgery to Simulation," a course on medical technologies, and she has been a teaching assistant for "Drugs, Politics, and Culture." 3 Acknowledgments One ofthe best moments offinishing a dissertation is to write thanks to everyone who helped and to discover just how large that group is. It does, indeed, take a village, though all the mistakes are my own. The Stanford University Medical Media and Information Technologies laboratory was my home from November 2001 through August 2002. Without the wisdom, patient teaching, and enthusiasm ofall laboratory members, this dissertation would not exist in this form. The group at SUMMIT not only shared their lives with me, but also provided an extraordinarily rich and diverse model ofresearcher collaboration. My work and my life are profoundly enriched for knowing and working with this extraordinary group of people. I also thank researchers in other laboratories at the University ofWashington and elsewhere who shared their work in the field ofvirtual reality in medicine with me. My encounters with these researchers were often brief, but highly informative. lowe tremendous thanks to my dissertation committee: Sherry Turkle, Joseph Dumit, Hugh Gusterson, and Evelynn Hammonds. Sherry, my advisor, has provided intellectual inspiration, exceptional support, and insightful readings ofpapers and chapters throughout IT1Y graduate school career. She has known when to push for something better and when to send kudos. Joseph Dumit has been a constant mentor, particularly as I finished writing this year. His influence appears on most pages ofthis dissertation, especially the good ones. Hugh Gusterson has provided careful readings ofpapers and chapters over the years and he has pushed me to keep in mind political, ethical, and economic themes. Evelynn Hammonds has been an inspiration since my first semester of graduate school, helping me keep history, race, and gender in mind and pushing me to do my best work. To all four committee members, lowe more than I can say here. Deborah Fitzgerald, Susan Silbey, David I. Kaiser, Rosalind Williams, Barbara Johnson, and Lucy Suchman deserve special mention as scholars who, at different times and in different ways, have influenced me, supported me, and taught me a great deal. And will never forget the gray day that Roe Smith sang "The Sun Will Come Out Tomorrow." My friends and fellow students in STS and elsewhere have been among my greatest supporters and best teachers. Special thanks go to Ruthanne Huising, whose comments on several iterations ofthis introduction have strengthened it immensely. Ruthanne also kept me company on the last, critical days ofdraft writing and helped me feel less alone in the back stretch. And my deepest thanks also to Rebecca Slayton, who has read drafts, provided excellent feedback, and been a steady friend. My writing workshop buddies, Lori Harrison Kahan, Cara Delay, and Sarah McKibben have been extraordinary. Chloe Silverman has been a good reader and a good friend. STS students have been some ofmy best critics, reading repeated drafts, listening to practice talks, and providing daily inspiration wi th their wisdom, friendship, and sound advice. I especially want to thank Alexander Brown, Nick Buchanan, Anita Chan, Meg Hiesinger, Natasha Myers, Esra 4 Ozkan, Anne Pollock, Peter Shulman, Kaushik Sunder Rajan, Will Taggart, Bill Turkel, who have cheerfully read more drafts and participated in more workshops ofmy drafts than any group should have to endure. The STS staff, especially Debbie Meinbresse, Judy Spitzer, May Maffei, and Kelly Gray, are the finest group ofadministrators I have known, but that pales
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