Biomedical Engineering Reference
In-Depth Information
the microscope, which involves interpreting and classifying cells along a
continuum between normal and pathological cells (Posner 1993). There have
been very few qualitative studies on the cytodiagnosticians' work with this
technology (see Singleton's 1998 UK-based study and Morris
et al
. 2001). As
pointed out by Casper and Clarke (1998), commonly used technologies that
are supposedly simple are often under-studied.
In this chapter I will discuss how the cytodiagnosticians create meaning
in their daily work of analysing and classifying cells, and how they use the
microscope and visual knowledge in such work. I will draw on data from
a one-year ethnographic study conducted at one public and one private
clinical routine cytology laboratory in urban Sweden, documented by fi eld
notes and interviews, in which the personnel were followed in their daily
work.
4
The cytology laboratory as ethnographic fi eld
Ethnographic and/or qualitative studies on personnel's work with cells in
cytology laboratories are scarce. When mentioned in the literature, the
cytology laboratory is mostly enmeshed in the cervical cancer screening
'success story' (Koss 1989, Singleton 1998a, 1998b) and thereby implicitly
rendered as a site where truths are created. Symonds (1997: 276) claims
that Sweden is one of the countries with successful 'well-organised screening
programmes', which 'can substantially reduce cervical cancer deaths'. The
cytology laboratory may however, in contrast, also be part of cervical
cancer screening 'failure stories' (Koss 1989, Singleton 1998a, 1998b). For
example, occasionally various forms of misconduct associated with this type
of screening are revealed.
5
When the cytology laboratory has been described as a part of the success
or failure discourses of cervical cancer screening, the cytology laboratory
personnel's work has been concealed rather than revealed. When part of
a success story, the test and results are most often understood as solely
the outcomes of a mechanical process. Here, the interactions between
technology (the Pap smear procedures), scientifi c disciplines (cytology and
public health), a laudable social goal and value (cancer prevention through
population screening), and a practice (professionals using technology to
interpret and classify human cells within the context of both cytology and
screening aims) are overlooked. When part of a failure story, human beings
are often understood as the weak link in an otherwise advanced system.
The mistakes and misinterpretations are explained by 'the human factor'.
The cytology laboratory personnel's understandings of their work remain
unstudied.
Ethnographic studies have previously been performed in
scientifi c
laboratories (Lynch 1985, 1988; Latour and Woolgar 1986; Traweek 1988;
Knorr Cetina and Amann 1990; Rabinow 1996) as well as in routine
clinical
laboratories (Rapp 1999; Mol 2000; Keating and Cambrosio 2000). Although
