The World's Fair

Part 3 with Kelly Joyce, author of Magnetic Appeal: MRI and the Myth of Transparency, follows below. All entries in the author-meets-bloggers series can be found here.

WF: Let me risk a more blatantly social sciency question. Did you ever become part of the clinical work in your role as the social scientist? I don't mean intentionally, but by virtue of your presence and your kind of knowledge. I think this is a question about "going native" and if that was bad or if it happened.

KJ: Yes, I was clearly present, and at times I became part of the clinical work. For example, patients often made eye contact with me and small talk as they walked in and out of the MRI exam room. Plus, MRI units in hospitals are hectic places. Emergency situations occur, patients need immediate MRI exams, and, as a result, the exam schedule gets rearranged. Or, if there is a free spot (because of a no-show or whatever) technologists call different units in the hospital to get someone waiting for an MRI into the schedule sooner. I definitely pitched in (by answering a phone, getting coffee, etc.) if it helped.

This kind of presence or participation is an integral part of doing field work. I don't think it is good or bad, but simply what it means to do ethnographic research. Do you agree? Disagree?

WF: If the social scientist is always somehow, in some way, part of the research they study (getting beyond an impoverished model of the "objective" researcher), I wonder how one uses that space to think more deliberately about how that happens and what else you could get out of it. Like, by "what you could get out of it" I mean: are there things you could bring to the research program being studied? STS scholars talk so often about expertise. In science studies, the model of the social scientists going into the field sets up a dynamic between the expert being studied (MRI folks, in your case) and the expert doing the studying (you). This is something different than an anthropologist going to study a culture in Papua New Guinea, which doesn't carry with it the same dynamics of expert-a-expert. So, given that you know stuff, that you have skills too, do you think there's a way to integrate those into the process? For the sake of making MRI better, or patient care, or hospital protocol, not just your book?

KJ: Some ethnographers (regardless of where they do their fieldwork) present their findings back to the people associated with fieldwork sites. This makes the research process more reciprocal--an exchange between experts instead of an exchange between experts and non experts. Given the power differences between physicians and technologists, this type of reciprocity didn't make sense in my research. When I started my fieldwork, technologists often wondered if I was hired by administrators to evaluate their work practices. I had to actively reassure the technologists that I was not hired by administrators or physicians--this reassurance in turn helped people feel comfortable talking to me. A presentation back to the actual locations I observed might have disrupted that sense of openness and stifled people's participation in the project. I could and would, however, be happy to participate in discussions at other organizations (e.g., hospitals, health insurance companies, medical schools). More dialogue between social scientists and scientists could only be a good thing.

WF: I'll go in a different direction here. I was thinking about the different uses of the MRI in pop culture--which you do too, which is what got me thinking about it. On Scrubs, they use it in two ways. In one episode, I recall, the "machine" has a technician who really takes ownership of it and gets pissed off when someone messes with his stuff. He is represented as this authorized expert protecting his turf. Very sophisticated. But then again, in other episodes, they treat the MRI (and other body scanners) as a kind of commodity, as revenue-generating toy that they licked up at Office Depot or something. Very mundane. So, that's interesting. How about that.

KJ: In my book I highlight the most common narratives used to represent MRI (e.g., MRI as progress, MRI as interchangeable with the body, MRI as agent). But, there are clearly exceptions. The Scrubs episodes you mention are excellent examples of counter or divergent narratives. They are particularly unusual because they make technologists visible. Many popular narratives erase technologists and their role in medical imaging work. The TV show HOUSE provides another intriguing exception.

WF: Oh that's good. I can use this when I talk to my in-laws. They're big fans.

KJ: As are many....On HOUSE, MRI is portrayed as a routine diagnostic tool. Many of the fictional patients get exams as part of a routine diagnostic work-up. The show also emphasizes the human actors (i.e., the physicians) as crucial diagnostic workers (in contrast to privileging the machine) and the information created by MRI use doesn't always provide the correct diagnosis. It will be interesting to see if the representation of MRI as routine/mundane becomes more common in the future. Popular portrayals of MRI may change overtime, and we will have to see what happens.