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or prototypical picture
of a particular disease. While assessing cytology
during screening and the joint diagnostic sessions (i.e. the 'demm'), the
issue implicitly addressed by the enthusiasm surrounding beautiful cases is
that cells occasionally provided strong and unambiguous visual evidence
for a match between pictures of cells and classifi cations. Conceptualising
something as beautiful by virtue of being exceptional has been described by
Brunius (1986) and may be called
the aesthetics of the exceptional
.
To avoid possible misunderstanding, the cytodiagnosticians and the
cytologists did not make their assessments based on aesthetic notions. Rather,
notions about the beautiful and the slops were communicated in addition
to scientifi c knowledge about cells during assessment and classifi cation.
This repertoire can, on the one hand, be seen as esoteric: only a limited
group, including cytodiagnosticians and cytologists, can see the beautiful
in an exceptionally clear 'CIS' or 'colon cancer'. On the other hand, it can
also be argued that the biological notions of the body expand to the realm
of the social when technologies are used to classify cells. Also, by means
of cytology and the classifi cation systems used in the daily assessment of
cells, the realm of the social - which is commonly assumed to be outside
and external to the body - 'enters' the cells in the biological body. As such,
cytology, including the Pap smear and its classifi cations provides an excellent
entry point to problematise the notion that the biological body - composed
of billions of cells, that are only accessible via medical technology, i.e. a host
of representational manipulations, and fundamental to Western biomedicine
- constitutes a black box, or a tabula rasa that tells us brute facts about
the normal and the pathological. Cytological classifi cations can be said to
exemplify Lloyd's (1998) arguments that fi rst, human judgement on health
and disease in general inevitably involves questions of classifi cations, and
second, classifi cations about normality and abnormality are not simply
'extracted' from organisms. The organism
itself
will not tell us what counts
as the ideal functions. Paraphrasing Hannerz (1996), between our cells and
what we know about them, 'there is an information gap, and we fi ll that gap
with culture' (p. 35). What counts as normal involves human judgement,
although it is commonly assumed that science informs us about what is
normal or abnormal, diseased or healthy, and that 'the social and moral
issues begin where the science leaves off ' (Lloyd 1998: 552). In cytological
assessments, 'living organisms' and 'living people' (Ingold 1990) do not
form mutually exclusive realms, as in order for a cytodiagnostician to answer
the question 'What's in a Pap smear?' biology, culture, technology and self
constitute intersecting realms.
Acknowledgements
Gareth Morgan and Ulla-Liina Lehtinen have provided valuable support
in an early draft of this chapter. Economic support for this work has been
gratefully received from the Swedish Foundation for Health Care Sciences
