Biomedical Engineering Reference
In-Depth Information
'subjective engagement' for better or worse (Okely 2001: 101). For worse, as
with any human interpretation in the realm of medicine, it is possible to make
mistakes. For better, the cytodiagnosticians present themselves as well aware
of the interpretative nature of, and the risks inherent in, classifying cells. It is
also notable that in contrast to the previously mentioned distinction made by
Cartwright (1995) about 'static' and 'moving' technologies (regarding the co-
evolution of medical knowledge and technology), the cytodiagnosticians used
the microscope as
both
a static and moving instrument of visualisation.
The challenges in cytological classifi cations were not the same for all
cytodiagnosticians in this study. For some, the main challenge was to be able
to correctly fi t the cells into classifi cations, to 'get it exactly right'. For others
the main challenge was to keep normal and deviant cells separate, that is,
to guard the border between normal and deviant cells. These features of
classifi cations in the cytology laboratory can be related to Douglas (1979).
She argues that although classifi cations are relative to cultural contexts,
classifi cations generally determine what belongs to a particular category, and
that which cannot be combined and should be kept apart. Classifi cations
in the cytology laboratory were used in both ways with emphasis either on
assigning cells to a predetermined classifi cation or to draw a line between
normal and deviant cells. The interpretative process whereby cells that
perfectly match are deemed 'beautiful' and those cells that are impossible to
classify are deemed 'slops' indicates that something more is going on in the
work with cells.
First, although the classifi cations represent a kind of
biological map
of
cells, the map does not randomly land on the cells and does not exactly
mirror the entire cellular variation. As in any classifi catory system, cytological
classifi cation generates its own by-products. The cells that could not be
classifi ed were referred to as the 'slops group'. The slops group can be related
to Douglas' (1979) discussion on dirt. There is no such thing as absolute
dirt, Douglas argues. Dirt is the by-product of order, that which offends
order. Even the word 'slops' used for this category of unclear cells connotes
garbage or refuse - that is, the dirty in the laboratory world. The signifi cance
of dirt involves refl ection on the relationship between order and disorder,
being and non-being, form and formlessness and even life and death. The
cytological classifi cations thus also produce their own by-products of order, in
this ambiguous species that connotes disorder and formlessness. In Douglas'
view, ambiguous species created by (all) classifi catory processes symbolise
both danger and power and have to be controlled. In cytology, cells that are
not straightforwardly classifi able - the ambiguous cells - are thus controlled
by creating special groups for such cells. However, the 'slops' group may
contain a mix of both normal and cancerous cells, and thus constitute danger
and a threat to the mandate of the cytology laboratory. Second, in cytology
in general, no two slides have an identical amount, composition, and pattern
of cells. Therefore it is rare that a picture of cells unambiguously and with
little interpretative effort matches a particular predetermined classifi cation
