Biomedical Engineering Reference
In-Depth Information
into which 'all pre-malignant epithelial abnormalities' are put (Robertson
1989: 273).
Classifi catory systems and boundaries have also been of interest to social
scientists (e.g. Douglas 1979, Star and Griesemer 1989, Clarke and Casper
1996). In her classical text Douglas (1979) has shown that classifi cations
should be analysed and related to cultural contexts and involve notions
about order and disorder. According to Douglas classifi cations can be seen as
a sorting process, and as part of the creation and maintenance of some kind
of order. This order centrally includes the labelling of objects. The labelling
as such affects how objects are perceived since 'once labelled they are more
speedily slotted into the pigeon-holes in future' (ibid.: 36). Although there
is a kind of 'conservative bias built in' as 'we make a greater and greater
investment in our system of labels' (ibid.: 36), classifi cations may also be
subject to change and modifi cation. For example, the discovery of ambiguous
species may create disorder, and disorder spoils patterns. Adopting such an
analytic approach, combined with ethnographic methodology, allows one to
move beyond ideas about classifi cations as static taxonomies and to explore
the dynamics and meanings that evolve in the daily work with classifi cations
in a clinical medical context.
In the empirical section that follows I will describe how cytological
analysis and classifi cation is performed, exemplifi ed by quotes and fi eld
notes from both Cyto lab and City lab (pseudonyms for the public and
private lab). I will start by showing the meaning of the term
screening
,
which captures the cytodiagnosticians' expertise and skills in cytology. I
will then describe two main aspects of screening: the
biological mapping of
cells
and the
enculturalisation
7
of cells
. Finally, the cytodiagnosticians in this
study presented themselves as highly aware of the interpretative nature of
cytological classifi cations and also of ways in which such aspects of screening
could be handled.
Screening cytology down the microscope as (em)bodied
seeing
The cytodiagnosticians at both labs defi ned screening cytological samples,
including the Pap smears, as looking at
all
cells (or the
whole
material) on
the
whole
microscope slide, as exemplifi ed below by Anna and Pia, two
cytodiagnosticians at Cyto lab:
Yes, you must look at all of the cells, you must look at all of the material.
That's screening.
Many cytodiagnosticians fi rmly believe that there are more than fi fty or
seventy thousand cells on the slide. And you must check everything.
