UNIVERSITY OF CALIFORNIA, SAN DIEGO Tracking the Human: Posthumanism, Ethics, and Critique in Health Tracking Technologies A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in Communication By Todd Christopher Woodlan Committee in charge: Professor Val Hartouni, chair Professor Patrick Anderson Professor Martha Lampland Professor Stefan Tanaka Professor Clinton Tolley 2016 This Dissertation of Todd Christopher Woodlan is approved, and it is acceptable in quality and form for publication on microfilm and electronically: Chair University of California, San Diego 2016 iii TABLE OF CONTENTS Signature Page ............................................................................................................... iii Table of Contents .......................................................................................................... iv List of Figures ................................................................................................................. v Vita ................................................................................................................................ vi Abstract of the Dissertation .......................................................................................... vii INTRODUCTION .......................................................................................................... 1 CHAPTER 1 Reclaiming the Human in Posthumanism .............................................. 21 CHAPTER 2 Diabetes Self-care Techniques ............................................................... 55 CHAPTER 3 Biopower and Quantified Self .............................................................. 104 CHAPTER 4 Genetic Capital ..................................................................................... 150 CONCLUSION .......................................................................................................... 188 WORKS CITED ......................................................................................................... 200 iv LIST OF FIGURES Figure 1: Visualization of blood glucose measurements and running ......................... 84 Figure 2: Visualization of blood glucose measurements and running, text added ...... 85 Figure 3: Finn’s visualization of sleep quality .......................................................... 121 Figure 4: Finn’s visualization of sleep quality .......................................................... 122 Figure 5: Finn’s visualization of his sleep stages ...................................................... 124 Figure 6: Finn’s visualization of his sleep stages ...................................................... 125 Figure 7: McCurdy’s visualization of Myasthenia Gravis flare ups ......................... 129 Figure 8: Wolfram’s visualization of email volume .................................................. 139 Figure 9: Wolfram’s visualization of email volume .................................................. 140 Figure 10: Wolfram’s visualization of email volume ................................................ 140 Figure 11: Wolfram’s visualization of events ........................................................... 141 Figure 12: Wolfram’s visualization of email data alongside events ......................... 142 Figure 13: 23andme heightened risks ........................................................................ 160 Figure 14: 23andme recommendations ...................................................................... 162 v VITA 2005 Bachelor of Arts, Emory University 2009 Master of Arts, New York University 2016 Doctor of Philosophy, University of California, San Diego FIELDS OF STUDY Major field: Communication vi ABSTRACT OF THE DISSERTATION Tracking the Human: Posthumanism, Ethics, and Critique in Health Tracking Technologies by Todd Christopher Woodlan Doctor of Philosophy University of California, San Diego, 2016 Professor Val Hartouni, Chair This dissertation attempts to identify a new way in which individuals are using health tracking technologies to create localized versions of what counts as human. These new versions of the human stand in opposition to the humanist model of the human, which posits a universal model that should be replicated in individuals through techniques of self-care – a model that has proven to be deeply problematic by defining the human largely as rational, white, male, and Western and excluding those who do not fit this model. However, the new forms of the human that emerge from vii contemporary health tracking technologies rely on individual datasets, making it difficult to expand the resulting model of the human to a population at large and create a universal model along the lines of traditional humanism. Moreover, these models can create a basis upon which others can engage in self-critical dialogue with their own data, creating unique models of self-care that promote localized ideas of health. Here, in the decline of a universalized notion of “the human” and the rise of a risky type of sharing, this dissertation will show that it is possible to see the beginnings of a type of humanism – one that retains the idea of a human in place of the human in order to re-invigorate Enlightenment ideals of critique, justice, and ethics. viii INTRODUCTION The Star Trek episode “Space Seed,” which first aired in 1967, opens with the USS Enterprise crew beaming onto a mysterious ship filled with sleeping people, all within glass containers. Dr. McCoy pulls out a black box and points it toward one of the sleeping bodies. The box allows him to collect vital signs such as temperature and heart rate, even though the physical body of the person is isolated away from the machine. These vital signs initially read as typical, but the heart rate quickly drops, allowing McCoy to identify a potential medical emergency and act quickly to free the body from its cryogenic chamber. The person trapped is saved from death. Ironically, he turns out to be the future nemesis of the crew, the genetically modified Khan. Although the device that McCoy uses to diagnose and save Khan, called a medical tricorder, is almost unremarkable amongst the other retro-futurist technology of Star Trek, it is perhaps one of the most significant. It allows for a portable solution to quickly and accurately read medical metrics while also continually processing these metrics for real-time feedback on the patient’s health. The usefulness of the medical tricorder may be hidden behind much of the other flashier Star Trek technology like phasers or transporters, but it has not been lost on the contemporary medical community. Practitioners currently rely on a number of different, bulky devices to perform the same tasks as the tricorder, including thermometers, heart rate monitors, and blood pressure cuffs. Creating a portable all-in-one device would greatly aid in the ability of practitioners to assess and diagnose patients easier, more frequently, and in - 1 2 less accessible locations. In the past few years, industry efforts have been mobilized to create such a device. The XPrize Foundation is one such effort. The foundation has created a $10 million award for the first company which successfully creates a product that approximates much of the functionality behind the Star Trek device. Appropriately called the Qualcomm Tricorder XPrize, the reward requires that the device must be small and portable, while still able to (1) accurately diagnose 16 health conditions (anemia, atrial fibrillation, chronic obstructive pulmonary disease, diabetes, Hepatitis A, leukocytosis, pneumonia, otitis media, sleep apnea, stroke, tuberculosis, urinary tract infection, absence of conditions, airborne allergens, cholesterol screen, food- borne illness, HIV screen, hypertension, hypothyroidism/hyperthyroidism, melanoma, mononucleosis, osteoporosis, Pertussis, shingles, and strep throat) and (2) monitor five vital signs (blood pressure, heart rate, oxygen saturation, respiratory rate, temperature).1 Though this is a tall order, there are currently seven finalists working toward a solution. Scanadu is the forerunner among these finalists, launching a successful Indiegogo campaign in 2014 and shipping to early backers in 2015. The device is called the “Scout” and, after being placed on the user’s forehead for a few seconds, provides information on heart rate, core body temperature, blood oxygenation, and systolic and diastolic blood pressure.2 The data is then sent to a mobile app, where the user can access the raw data as well as commentary by the app that helps interpret the data. 3 Much like the medical tricorder in Star Trek, Scanadu hopes that their Scout product will make gathering medical data on individuals easier by putting it in the hands of the patients themselves. The website boasts that the device will be “your doctor’s new best friend” and that the user can “check [their] health as easily as [their] email.”3 The concept behind the device seems to be to bring the hospital into the daily life of the individual and to promote a healthy style of living. On first glance, Scanadu’s focus on self-monitoring appears to be in line with Michel Foucault’s claim that clinical medicine is concerned with not just curing illness, but in placing an individual under surveillance to understand their issues. This constant observation is termed the “medical gaze” and sees illness through direct observation of bodies, rather than through laboratory controlled experiments that isolate