When tinkering goes wrong: innovating to care or caring to innovate?
Hannah Cowan (London School of Hygiene and Tropical Medicine)
Paper short abstract:
This paper reassesses the concept of tinkering using the ethnographic example of hip replacements. Through looking at when tinkering goes wrong it highlights the relationship between morally good and caring intentions to improve care and the pressure to constantly innovate and make something new.
Paper long abstract:
"The problem is when surgeons start tinkering." Patient Representative Much of the literature on tinkering focuses on how people with morally good and caring intentions play with medical processes and protocol to give patients a better recovery or experience (Mol, Moser and Pols, 2010). But this paper looks at when tinkering goes wrong (it is of course a process of trial and error) using the ethnographic example of the operation and recovery of hip replacements. I will describe how slight changes in mixing the anaesthetic to improve recovery results in everyone getting sick; how physios helping people on the "easier" practice stairs results in falls and fear, and also when it seems tinkering is done for tinkering's sake - when surgeons tinker with their technique but look only to the patients' flesh to assess their results. Furthermore, I use these examples to question how many tinkering practices are related to the current political desire to innovate, to constantly make anew, and even to have something to call your own. By tracing the network of everyday action beyond the specific time and place of their performance, I look at how the everyday of policies and politics play out in care itself. This has wider implications for STS and the (normative) judgement of where to cut the network (Strathern, 1996). Here I suggest we reinforce Deleuze and Guattari's (1987) method of flattening the network in our research to ensure we do not reinforce, recreate the hierarchies that affect the everyday.
Exploring relations of authority