Mundanely Miraculous: The Robot in Healthcare Norman Makoto Su∗, Leslie S. Liuy, and Amanda Lazary ∗School of Informatics and Computing yBiomedical and Health Informatics Indiana University Bloomington University of Washington [email protected] [email protected], [email protected] ABSTRACT The texts which surround our everyday lives and the methods As both hero and villain, robots have played prominent roles by which their meaning is conveyed are powerful forms of in media such as films and books. Now, robots are no longer knowledge [25]. Discursive strategies socially construct a re- hidden away from the public conscious in fictive worlds or ality that we intersubjectively [4] share on what robots are and real-life factories. Robots are becoming a real part of our should be; at the same time, it narrowly delimits what robots everyday encounters in environments such as healthcare set- are not. Hence, our encounters with real-life robots are neces- tings. In this paper, we describe a discourse analysis of 60 sarily influenced by discourse. Scholars have found that scifi, YouTube videos that showcase robots in healthcare activities. traditional stories, religious texts, and cultural mores shape or Our narrative weaves three discourses that construct visions reinforce attitudes towards robots [8, 19, 16, 28]; for exam- of the healthcare robot: (1) the miraculous robot as the robot ple, users interacting with robots that do not meet their “ex- that enhances patient care; (2) the mundane robot as the in- pectations” may feel uncomfortable and have difficulty with nocuous robot that integrates into the workflow seamlessly; accepting robots’ professed benefits [8]. and (3) the preternatural robot as the robot that is miraculous As real-life robots move out of factories and into our daily but never mundane. We propose several contrary visions to lives, human-computer interaction and computer supported this dominant narrative of healthcare robots as a framework cooperative work researchers have become interested in our for future fieldwork that, we argue, should investigate the in- social interactions with robots [14, 13]. Robots in various stitutions of robotics. guises have become increasingly important in the healthcare industry. According to the IFR (International Federation of Author Keywords Robotics) [1], almost 16,000 service robots (robots that aid Robots; telemedicine; service robots; YouTube; human-robot people in non-industrial settings) were sold in 2012 world- interaction; health informatics; critical theory; discourse wide and 1,308 medical robots were sold in 2012. Manu- analysis. facturers have been aggressively making and selling medical robots because they are the most costly service robots; sales ACM Classification Keywords in 2012 have totaled “$1,495 million, accounting for 44% of H.5.m. Information Interfaces and Presentation (e.g. HCI): the total sales value of...service robots” [1]. In the health- Miscellaneous care domain, there exists a good body of work understanding our interactions with service robots [22, 29], therapy robots INTRODUCTION in nursing homes [20, 9], and telemedicine robots [23, 30]. HAL in 2001: A Space Odyssey was an intelligent yet coldly In this paper, our focus will not be on the observed usability calculating robot. The eponymous star of WALL-E was a or sociotechnical problems of robots in healthcare, but, rather, love-forlorn robot with a trash compactor. Rosie was the the online discourse of robots in healthcare and the institu- motherly, warmhearted robot maid of The Jetsons. The repli- tions within which these discourses are produced and promul- cants of Blade Runner were rebellious and reflective robots gated. Because of their novelty in healthcare environments, cognizant of their second-rate status in a world dominated striking appearance, and interactivity, video, we argue, is a by humans. Through these and other media depictions, the particularly potent site of discourse for robots. Instead of hav- robot has left an indelible and variegated imprint on the pub- ing a preconception of what a healthcare robot was, we strove lic consciousness. Science fiction represents but one type of to understand the definition of a healthcare robot through the discourse on robots. This mishmash of robot texts reflects lens of online videos. Specifically, our study unpacks the dis- a complex and contradictory discourse [27] on technology’s course of 60 videos in YouTube. We ask: how do videos con- relationship to society [2]. struct a particular reality for robots in medicine? What discur- sive strategies are utilized? How do institutions—robot man- Permission to make digital or hard copies of all or part of this work for personal or ufacturers, researchers, and hospitals—legitimize robots? classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation Our paper makes the following contributions: on the first page. Copyrights for components of this work owned by others than the author(s) must be honored. Abstracting with credit is permitted. To copy otherwise, or 1. The first, to our knowledge, analysis of videos from online re-publish, to post on servers or to redistribute to lists, requires prior specific permis- organizations, health media groups, and government/non- sion and/or a fee. Request permissions from [email protected]. NordiCHI’14, October 26–30, 2014, Helsinki, Finland. profit agencies featuring transport, telepresence, and com- Copyright is held by the owner/author(s). Publication rights licensed to ACM. ACM 978-1-4503-2542-4/14/10 ...$15.00. http://dx.doi.org/10.1145/2639189.2641216 391 panion robots in different healthcare environments: hospi- In addition to science fiction and media, robotics researchers tals, clinics, and nursing homes. also played a part in shaping (or attempting to shape) pub- lic perceptions of robots. Sabanovic et al. [28] examined re- 2. Explication of a complex and contradictory discourse of searcher discourse on robots in Japan and found that roboti- robots: Some robots are both miraculous—drastically im- cists create and position robots uncritically in ways that nor- proving and augmenting healthcare capabilities—and as- malize robots and create a place for them by rewriting culture sured to become mundane—a routine part of our everyday in a way that creates roles that only robots can fill. lives. By contrast, some robots are preternatural, mirac- ulous, but encountered on their own terms to become an important and meaningful being in our health. Robots in Healthcare Robots have had a presence in the healthcare environment for 3. A set of contrary narratives that critique the dominant dis- some time. In 1991, Preising et al. [26] provided an overview course in media of healthcare robots. These narratives seek of robots in medicine, including laboratory, rehabilitation, to pry out what realities of robots are marginalized and is- and surgical robots in a literature review. In a more recent sue a call for future studies to investigate the problems of review of current and possible uses for robots in healthcare, disenfranchised actors/institutions in these utopian visions Dahl & Boulos [11] divided robots into the following two of healthcare robotics. classifications: surgical or rehabilitation robots and versatile robots supporting “softer” HRI tasks. Softer robots are fur- The structure of our paper is as follows. We first present re- ther subdivided into sub-classifications including robots pro- lated work on robots in media and in healthcare. We then viding logistical assistance in hospitals, such as feeding and describe our data collection of YouTube videos and our ana- transport robots, and telepresence and companion robots. lytic perspective. Next, we present three types of discourse of robots in healthcare through these videos of robots in action. There have been many studies of robots in healthcare settings Lastly, we critique this discourse and discuss a proposal to including transport robots used to deliver medications and study up (and down) institutions of robotics in healthcare. supplies, telemedicine, or telepresence, robots used to diag- nose and interact with patients, and companion robots de- RELATED WORK signed to provide companionship to older adults in care fa- cilities. In a study of staff use and perception of a transport We now discuss previous work on robots in two different robot in a hospital, Ljungbald et al. [22] found four quali- fields: media and healthcare. In studies of media, there is ties ascribed towards the robot: alien, machine, worker, and a large body of research that has examined how our innate work partner. In another study of transport robots in a hos- fascination with robots are manifested in forms like books, pital, Siino & Hinds [29] examined the role gender played film, and television shows. In the healthcare field, scholars in how female and male workers made sense of the robot. have categorized and studied the role of robots in providing Telepresence robots have been examined as well. For ex- better care to patients. ample, Mariappan et al. [23] described a telemedicine robot used by surgeons to diagnose patients remotely, and Sucher et Robots in the Media al. [30] interviewed patients and their families who had inter- Researchers have examined media discussing and portraying acted with a telemedicine robot in an intensive care unit and robots and its effect on viewers. Many studies examining me- found that the use of robots in this setting was viewed favor- dia portrayal of robots focus on science fiction. One point ably. Robotic companions such as Paro, a soft robotic seal, in that has been repeatedly emphasized is the mixed messages nursing homes have also been studied. In one study, Chang et of science fiction. In a review of concepts commonly put al. [9] used Paro with older adults with dementia and found forth in science fiction movies, Bartneck [2] included both that with time, participants increased their usage and will- threatening ideas, such as the idea that robots will take over ingness to use Paro.