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Ultra-sound, art and geography, or, On the difficulties
of taking pictures of the insides of your body.
Eric Laurier
An essay to accompany the work of Wendy Kirkup.
First draft. February 1999
‘Places with a similar
set of elements and similar relations between them are close to one another,
and those with different elements or relations are far apart.’ Mol &
Law (1994: 649).
A geographer and an artist share an office as part of a plan
to shift the relations between geography and art. Except neither the artist
nor the geographer are very sure whether they qualify as either an authentic
artist or an authentic geographer. They are both somewhat suspicious of
what might be understood by accepting those terms as their identities and
they are happier in general with inauthenticity than authenticity. Each
seeks to clarify to the other what they might be able to share by discussing
what they have done, what they are doing now and what they figure they
might be doing afterwards. So, in a way, they are sharing already. They
also try to establish what the other knows about the fields within which
they operate. Part of this comes about through the artist trying out a
joke about producing a painting. Her practice seldom produces paintings,
which is something the geographer understands, since she has further defined
herself as having trained as a sculptor and now being a kind of site-specific
artist. So when she tells her story about the head of the geography department
nervously asking whether there will be a watercolour or something at the
end of her residency, the geographer and the artist laugh together. It
is perhaps, a terrible ‘in-joke’, but it helps establish what being ‘in’
should involve knowing. The difficulty with specialist disciplinary knowledges
is that they carve out vast interior spaces where strange arguments about
what constitutes ‘interesting work’ can occur. And all too often this results
in disciplinary places, so tightly squeezed together in university campuses,
being far apart.
As the artist has begun to notice in the geography department
that she has joined, there are (at least) two geographies inhabiting the
same building, sometimes the same office, yet they are very far apart.
There are physical geographers and there are human geographers. The first
claims to be a natural science with nature and space as its domain of study
and the other claims to be a social science with society and space as its
zone of interest. It’s an act of purification which allows the geographers
to get on with their dualistic profession, which in no way holds true for
the world they are busy analysing and yet keeps them very productive (Latour
1993). What is much more obvious to the artist is that members of these
two geography camps frequently make jokes about each other’s methods and
knowledge. Coming ‘in’ to a geography department has meant learning about
this mild mockery which performs one of modernity’s great divides in the
daily banter of staff rooms, corridors and offices.
As the academic year progresses, the geographer and the
artist are fairly random in their attendance in their shared office in
the geography department. Neither it seems are very good at doing to the
9 to 5. On the other hand they frequently meet up at ‘Little Italy’, a
sandwich and coffee bar near the university, where they talk excitedly
about what they are up to. The strange thing they have discovered is that
they seem to be doing their work in a very similar manner and on a shared
topic – technologies of medicine - even though what they are trying to
produce at (and as) their works’ closure are quite different. At different
times they have both visited an expert in the history of medicine at the
university for some advice on the development of medical imaging. The geographer
is thinking of studying a magnetic resonance imaging (MRI) unit and investigating
how it orders visual knowledges. On a slightly different tack the artist
has been considering doppler ultrasound and the possibilities it offers
for visual and audio material as resources for a performance.
It’s never totally clear, and perhaps it never can be,
how similar the artist and geographer’s methods are. Although they are
tracing similar routes around the city in picking up bits and pieces of
knowledge about medical imaging, they cannot observe one another doing
so. They just tell one another stories from the field afterwards about
what they noticed, what they learnt and what got them confused, amused
or angry when they met members of the medical community. What amazes the
geographer is the ease with which the artist slips in and out of various
medical institutions as she goes about her research, he is obsessed with
the complication accessing institutions has usually posed for him. They
speculate on whether a clinician would be less worried about an artist
asking to be shown around than a geographer. Certainly the geographer has
had to go through long explanations to doctors of medicine and clinical
physicists about why he wants to visit a nuclear medicine facility. He
says that he is interested in the social interactions that go on around
‘hi tech’ machines and the social nature of knowledge. It’s a kind of geography
of the workplace, he adds, and, that it’s surprising how many similarities
there are between land and body mapping systems.
Perhaps the art and medicine agreement is forged on the
artifact since ultrasound trades in images as (sometimes) does art. That
an artist should be interested in the images that ultra-sound produces,
does not raise suspicions from doctors or technicians, or rather does not
yet raise suspicions. The artist was able to exploit her status as coming
from a place which was highly subjective and far away from the objectivity
and rationality of medical science.
‘...[T]he production
of social order in these [scientific] disciplines is inseperable from the
dense texture of understandings and concerted practices that make up disciplinary-specific
language games. Sociology’s general concepts and methodological strategies
are simply overwhelmed by the heterogeneity and technical density of the
language, equipment, and skills through which mathematicians, scientists,
and practitioners in many other fields of activity [such as medicine] make
their affairs accountable.’ M. Lynch (1992: 298-299).
Meanwhile the geographer was mostly overwhelmed. He spoke
to a clinical physicist, took a trip around an MRI unit and there watched
a patient slide into a round hole in a white wall. From the invisible side
of the one-way window in the observation room he felt a sense of mortal
anxiety as he saw a slice of the interior of the patient’s head displayed
on several different computer screens. A luminiscent midnight blue filled
with grey symmetrical webs and shining over one hemisphere the deadly moon
of a tumour. Even as he looked at these sublime images, his attention was
also held by the busy activity going on in the observation room. There
were three hospital staff attending to VDUs, paperwork and each other.
Just outside the room where the MRI scanner was located there was a nurse
waiting in the corridor for the patient to be finished. He would have liked
to stay longer but his guide around the facility was anxious to return
to his office. If you’re not part of the staff then hospitals are a hard
place to hang around, unless you are a patient or associated with a patient,
and even those categories of humans are hurried along.
‘Relations are not
all of a kind. They will produce differing temporalities and spatialities,
different weights and waits.’ Hinchliffe (1999: nyp)
One Friday evening the artist and the geographer join the
crowd of geographers who regularly go drinking to mark the end of the working
week in a bar that has a fine view of the university’s neo-gothic tower
and quadrangles. The artist recounts her experiences of the week to the
geographer and a professor there who is an expert in the historical geography
of madness. Problems had begun for the artist when she had returned to
the hospital to ask to have further ultra-sound scans of her body. In fact
she wanted to have as much of her body scanned as possible and then take
the ‘results’ away with her. There was some confusion from the operators
of the doppler ultrasonograph over why she would want such a ‘test’ done,
to go beyond the usual ‘show and tell’ session laid on for hospital tourists.
Why she would undergo a procedure that involves a degree of self-mortification,
such as exposing her thighs, being smeared in a gel and then having a phallic
shaped emitter run across her gelled skin, normally only agreed to in a
diagnostic situation. Confounding the sonographers further, the artist
did not want a test done, she wanted to collect some pictures and sounds
of her body produced by doppler ultrasound. She is an artist, she repeats,
by way of explanation. Such an account is not a ratified and rational account
in a medical mode of ordering. Other procedures are brought into place.
As is often commented by those who study clinics and clinicians, it is
very difficult to escape the ascription of an illness or to avoid diagnosis
by medical ways of knowing.
…[I]t has been argued
that doctors asks themselves ‘what to do?’ from the very moment they first
meet a patient. The detection of disease and the design of treatment cannot
be seperated. Instead, they form a single process, sometimes called the
‘work up’ of patients or the ‘construction of a medical disposal’. Mol
(1996a)
Although there are a number of ways of ‘passing by’ doppler
ultrasonography if you want to have a quick look, when the artist wanted
to have a more sustained encounter with the process and even take away
some its ‘results’ it was at this point that she was drawn into its mode
of ordering (Law 1994). The artist’s entry to this socio-technical network
exposed (her to) the ‘distributing of the conventional’ (Leigh Star 1991)
which was doing its leveling best to bring about a decision on what to
do with a non-patient human. What this meant for the artist was that she
had to undergo a psychiatric evaluation - to submit to another ‘test’ which
might describe her as mentally ill, which might then be a significant result
of the process, though not one that she was after. This is because only
mentally healthy people are allowed to obtain ultrasound images of their
interiors. It’s a catch of course since mentally healthy people would not
ask for images of their interiors. Indeed an ordinary person would not
ask to be exposed to ultra-sound in the first place unless they were (potentially)
ill. Even then they would not ask but would likely be sent by their GP
who would have thereby turned them into a ‘patient’ which is a kind of
human that medicine finds much easier to dispose of. The artist’s struggle
to explore the emancipatory margins between the conventional and the unconventional
was starting to bear fruit. Or perhaps this was just the geographer’s way
of framing the situation since, as was noted earlier, he had an obessive
interest in problems of access.
It’s a simple enough rule, the geographer suggested, ordinary
people don’t collect ultrasound images. Yet there is one glaring exception,
he added, parents or parents-to-be frequently collect ultra-sound images
of their unborn children. Not only that, they show them around – they share
them out and post them to their friends and family. The geographer had
recently been staying with friends who showed him an image of their child-to-be
which he reckoned needed a considerable leap of faith to be accepted as
any kind of discernable human form. It was closer to abstract impressionism
than photography. ‘It’s a polar bear in a snowstorm’, he joked with them.
Even though the artist was having difficulty extracting
doppler sounds and images from the socio-technical assemblages within which
they normally circulated, like fish swimming in water, she was learning
all kinds of interesting things from talking to doctors and technicians.
So just as the ‘pregnant’ friends had begun to explain to the geographer
how to look at an ultrasound image, passing on the instructions of their
gynecologist by tracing along a thickly dotted line and saying ‘there!
See! That’s the spine. That’s the head. Or, is that the hips?’ So it was
that the artist stood by the sonographer looking at a lot of white-noise
and was shown some significant lines and then told to think about the images
as comparable to slices through a loaf of bread. Then the lines should
make sense. ‘Uh-huh’ agreed the artist co-operatively. Though as she explained
it to the geographer later, she guessed that the semiotic skill of the
sonographer was in matching a medically trained, detailed three dimensional
memory of internal anatomy to the shifting light and shadow of the ultrasound
images. He commented that it was a reminder of this kind of diagnostic
imagery as still being involved in actions and translations, skillful picturing
rather than an easy picture.
Reading a little more about ultrasound in the library
the geographer was intrigued by the difficulties that were presented to
the engineers of ultra-sound machines in ‘improving’ their images. The
craft of the sonographer was slowly acquired and with a great deal of effort
by its human operatives since it required substantial metaphorical work,
turning human bodies into bread slices, remembering anatomies and practical
work in the movements of the emitter across the gel coated skin of patients.
An improvement in image, or rather a ‘redistribution of competencies’ between
human and machine (Latour 1997), would mean less time and attention should
be required from the sonographers, since they would be less distracted
by ‘speckle.’ ‘Speckle’ what a wonderful word, the geographer was distracted
already.
‘As a result of the
dominating effect of coherent speckle noise, the images have a characteristic
mottled or granular structure, which causes many anatomic features to break
up and meaningless fine detail to appear where there should only be a uniform
gray level.’ Bamber (1993: 55
This ‘meaningless fine detail’ which created the distinctive
mottling and graining of ultrasound images was exactly what seemed give
the ultrasound images their aesthetic appeal. When the artist finally did
manage to extract a strip of ultrasound images they were not of her insides
but those of the hindquarters of a horse called Jock. And it was their
graininess which made them seem to ‘echo’ the images generated from remote
sensing techniques in geography. The grain of the speckle was something
for the artist and the geographer to latch onto. Some noise to disrupt
the signal, some different tunes that the artist’s insides were playing.
Dealing with speckle was one of the reasons that a skilled operator was
still required for sonograph. Just as humans are very good at ‘listening
in’ to conversations in crowded bars, so it was that a human operative
was good at bringing the meaning out of speckle. As Mol & Mesman (1996)
note, taking a semiotic approach to understanding socio-technical assemblages
brings out the fragility of meaning, the skill and effort of its achievement
in the face of noise. While paying this compliment to the remarkableness
of ultra-sound, it also reminds critical thinkers that the ambitions of
a network like sonography is to either exclude noise or turn it into ‘information.’
And so it is with speckle:
‘Speckle in real-time
ultrasound scans also may carry useful information, particularly about
the motion of unresolved structure, but such additional information is
probably best extracted by digital processing and encoded using (for example)
color.’ (Bamber 1993: 56).
What the artist wants to do with her material is harder to
say. Or perhaps the site-specific work is what might come about as a result
of the artist, the geographer and some speckle trying to share a place
for a while.
The artist and the geographer have had less and less time
together, as he has started a new job in a different city and she has had
to return to teaching sculpture in her old institution which is in yet
another city. Before that happened they had time one sunny day to amble
along the street in Glasgow listening to some doppler ultrasound that the
artist had, with the effort suggested above, managed to extract from its
medical network. Using a personal stereo they discovered, hardly surprisingly
that they could not translate the noise of the artist’s interiors the way
that a sonographer would. Laughing at the oddity of listening irreverently
to body science they say: sounds like whale-song, sounds like birds twittering,
sounds like creepy background music from a David Lynch film. Sounds interesting.
Bibliography:
Bamber, J.C. (1993) ) Speckle Reduction, 55-68 in Advances
in Ultrasound Techniques and Instrumentation (ed. Peter Wells) Churchill
Livingstone Inc. New York,
Hinchliffe (1996) Technology, power and space - the means
and ends of geographies of technology, Environment and Planning D: Society
and Space, 14: 659-682
Hinchliffe (1999) Entangled humans : specifying powers
and their spatialities, not yet paginated in, Entanglements: Geographies
of Domination / Resistance Eds. J Sharp, P Routledge, C Philo, R Paddison
(Routledge, London), pages not yet known
Latour, B. (1993) We Have Never Been Modern, Harvester
Wheatsheaf, Hemel Hempstead
Latour, B. (1997) Aramis, or the love of technology,
Routledge, London
Law (1994) Organizing Modernity, Blackwell, Oxford
Leigh Star, S. (1991) Power, technology and the phenomenology
of conventions: on being allergic to onions, 26-56 in A Sociology of
Monsters: Essays on power, technology and domination (ed. John Law)
Routledge, London
Lynch, M. (1992) From the "Will to Theory" to the Discursive
Collage: A Reply to Bloor's "Left and Right Wittgensteinians", 283-300
in Science as practice and culture (ed. Andrew Pickering), University
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