Paper short abstract:

Learning skills of diagnosis in medicine requires a dynamic reorientation of the body. Drawing on fieldwork in a Dutch medicine school, this paper explores this process of making, measuring and unsettling.

Paper long abstract:

Medical education is a sensory re-education. The bodily reorientation entailed in learning diagnostic skills is explored in this paper in five inventive spaces, where the body as a standard of measurement (Hoel and Carusi 2018) is continually formed and calibrated. First, oscillations are made between figure/ground, as body parts are brought in and out of awareness (Strathern 2002) [e.g. abdomen becomes pregnant]. Second, the body is cut along new axes [e.g. pelvic cavity is divided into five planes, demarcating an emerging infant's head]; this requires landmarks, anatomical points that act as compass and help "grid" the body. Third, in explicit practices of measurement [e.g. umbilicus to pubis in centimeters and gestational weeks] measured (bodies) and measuring (bodies) are visibly co-constituted. Fourth, skills are broken down, their parts isolated and assembled with different technologies [e.g. bony pelvis to show descent, rubber uterus shows scale]. Fifth, skills, while always in movement, are freeze-framed to explore details of technique [e.g. leather of the pregnant mannequin slows down the delivery]. Through this education, habits of perception are altered. I explore these empirical examples from fieldwork in a Dutch medical school (part of a larger comparative ethnographic-historic project, Making Clinical Sense) with focus, as indicated, upon the skills of guiding birth. Looking at teachers' expressive instructions and students' practices, in correspondence with Hoel and Carusi's notion of the "measuring body", the dynamic, ecological nature of learning skill is opened up in refreshing ways, and fleshy boundaries, once again, unsettled.