Images and image: technology and the social politics of revealing disorder in a North American hospital

Abstract

In the United States and elsewhere diagnostic activities are now prominently centered on images derived from technologies such as magnetic resonance, computed tomography, and angiography. In this article I examine language, actions, and interactions in a multidisciplinary team of biomedical specialists whose members meet routinely to visually interpret and assess such images. Convened behind the scenes, in a conference room from which patients are excluded, these meetings are examined as privileged performances in which team members exercise their visual faculties and interpretive skills to address issues that include their statuses and reputations, and to politically position themselves and their specialties. Ethnographic data derived from close observation of 23 such diagnostic meetings are presented. I suggest that problems posed by the attempt to synthesize information from diagnostic images serve as vehicles for evaluating or "diagnosing" the professional capabilities and "image" of the participating physicians. Team-based divisions and attempts to reassert challenged autonomies also characterize this socially oriented diagnostic process.