Books at Duke University Press

CT Suite: The Work of Diagnosis in the Age of Noninvasive Cutting
Barry F. Saunders

416 pages (November 2008)
42 b&w photographs

Cloth - $89.95	0-8223-4104-2
[ISBN13 978-0-8223-4104-8]

Paperback - $24.95	0-8223-4123-9
[ISBN13 978-0-8223-4123-9]

In CT Suite the doctor and anthropologist Barry F. Saunders provides an ethnographic account of how a particular diagnostic technology, the computed tomographic (CT) scanner, shapes social relations and intellectual activities in and beyond the CT suite, the unit within the diagnostic radiology department of a large teaching hospital where CT images are made and interpreted. Focusing on how expertise is performed and how CT images are made into diagnostic evidence, he concentrates not on the function of CT images for patients but on the function of the images for medical professionals going about their routines. Yet Saunders offers more than insider ethnography. He links diagnostic work to practices and conventions from outside medicine and from earlier historical moments. In dialogue with science and technology studies, he makes a significant contribution to scholarship on the visual cultures of medicine.

Saunders’s analyses are informed by strands of cultural history and theory including art historical critiques of realist representation, Walter Benjamin’s concerns about violence in “mechanical reproduction,” and tropes of detective fiction such as intrigue, the case, and the culprit. Saunders analyzes the diagnostic “gaze” of medical personnel reading images at the viewbox, the two-dimensional images or slices of the human body rendered by the scanner, methods of archiving images, and the use of scans as pedagogical tools in clinical conferences. Bringing cloistered diagnostic practices into public view, he reveals the customs and the social and professional hierarchies that are formulated and negotiated around the weighty presence of the CT scanner. At the same time, by returning throughout to the nineteenth-century ideas of detection and scientific authority that inform contemporary medical diagnosis, Saunders highlights the specters of the past in what appears to be a preeminently modern machine.

“In this remarkable ethnography Barry F. Saunders guides his readers through a suite of hospital rooms, in so doing immersing them, chapter by chapter, ever deeper in the practices of computerized tomography (CT scanning). Saunders argues that the discourse and practices associated with the ‘noninvasive’ gaze of CT are haunted by the nineteenth century, in particular by the anatomized corpse and the techniques of knowing associated with it. Drawing to great advantage on the works of Edgar Allan Poe and Walter Benjamin, he highlights the ‘intrigue’ associated with CT rituals that result in diagnostic evidence and ultimately the designation of diseases in living bodies. Beautifully written, this book is a must read for everyone captivated by technologies of bodily knowledge.”—Margaret Lock, author of Twice Dead: Organ Transplants and the Reinvention of Death

“This pathbreaking ethnographic study brilliantly analyzes the untidy rituals that make up quotidian clinical practice to illuminate just how physicians create meanings from CT scans and how CT scans create meanings for physicians. It will be thought-provoking reading for social scientists, medical historians, art historians, clinicians, and anyone else who wants to understand better the rituals that make up what we have come to see as modern medicine.”—Joel D. Howell, author of Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century

“CT Suite is a fascinating interpretation of the processes of medical imaging—from scanning to learning to filing to diagnosing. Barry F. Saunders’s ethnographic material is excellent. He captures the constant negotiation over the stories that scans tell, and he locates these stories in a history of medical detective work stretching back to Poe.”—Joseph Dumit, author of Picturing Personhood: Brain Scans and Biomedical Identity

Barry F. Saunders is Associate Professor of Social Medicine, Clinical Associate Professor of Medicine and Family Medicine, and Adjunct Associate Professor of Anthropology and Religious Studies at the University of North Carolina, Chapel Hill. He is also an emergency room doctor at Chatham Hospital in Siler City, North Carolina.

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Winner, 2009 Gregory Bateson Prize for best interdisciplinary ethnography, presented by the Society for Cultural Anthropology