Normal x-ray images and liminal seeing: The process of transition between the normal and the abnormal frontier
Peter Winter (University of Sheffield)
Paper short abstract:
I explore medical imaging professionals value of expectation as a process of 'liminal seeing' in x-ray image interpretation training. The focus is on the specific ways in which highlighting/graphic representation feature as a transitory force in cultivating expectations of abnormality.
Paper long abstract:
The broad range of forces shaping the delivery of medical image interpretation, including what some sociologists believe to be the accumulation of anatomic expectations within biomedical training (Cohn, 2009), draws attention to the unique process of liminality in learning to see radiographic anatomy. What is of interest here (besides differences in image content and conceptual structuring of critiquing anatomy) is that this represents a distinctive break from traditional (e.g. cognitivist) views of image interpretation training. Previous sociological research has observed professionals anatomic knowing whose clinical work offers a prior sense of how normal anatomy 'should be' within medical images (Saunders, 2008). However, limited research exists on how professionals initially receive this knowing and the discursive forces that cultivate expectations of visual-anatomic information. This paper explores the ways these anatomic expectations can be learned in normal radiographic anatomy training, and extents of pedagogical technique that reproduce problematic-anatomic knowledge for seeing and expecting the abnormal. Focusing on highlighting/graphic representations (Goodwin, 1994), I will demonstrate how professionals cultivate abnormal expectations in radiographic anatomy so that abnormality (which is absent in the anatomy) is made present (in the expectant sense). Normal x-ray images become constructed as having sites of trauma/pathology and accomplish the expectation of both normal anatomy (ideal) and potentially abnormal anatomy (bad). Whilst normal x-ray images have become a generative means for the expectation of normative forms of normal anatomy, I argue that a deeper expectation of anatomic concerns are also deployed in normal images that cultivates a type of 'liminal seeing'.
Meeting the visual