Real diagnostic work takes place away from the patient; bedside is secondary to screen side. For diagnostic and even treatment purposes, the image on the screen becomes the “true” patient, of which the bedridden body is an imperfect replicant, less worthy of attention. In the screens’ simulations our initial certainty of the real (the body) becomes lost in hyperreal images that are better than the real body. (Frank 1992: 83)
The “Visible Human Project” (VHP), described on the US National Library of Medicine, National Institutes of Health website as:
the creation of complete, anatomically detailed, three-dimensional representations of the normal male and female human bodies. Acquisition of transverse CT, MR and cryosection images of representative male and female cadavers has been completed. The male was sectioned at one millimeter intervals, the female at one-third of a millimeter intervals. (National Library of Medicine 2008)
Fascinated by this undertaking, Catherine Waldby (2000) subjects the VHP to sociological scrutiny and highlights some intriguing features. Not only do images of the inner reaches of the body become accessible to a wide audience, but also the transformation of bodies into a “digital substance” contributes to the blurring of boundaries between the real and the unreal, the private and the public, and the dead and the living (Waldby 2000: 6). She argues that the whole exercise represents a further extension of Foucault’s notion of bio-power. The VHP is at once a means of both examining and experimenting on the body and, therefore, it is also a means by which knowledge of bodies is generated and circulated.
In addition, the establishment of knowledge contributes to the production of “surplus value” in that there are significant commercial interests that benefit through the related production of medical technologies be they equipment, drugs, and so on. This is what Waldby calls “biovalue,” which refers to the yield of vitality produced by the biotechnological reformulation of living processes” (Waldby 2002: 310). Two factors precipitate the generation of biovalue. First, the hope that biotechnologies will result in a better understanding and thereby treatment of disease. Second, the pursuit of exchange value of biomedical commodities – be they patents or pills – that are the yield of the interventions. Indeed, biovalue is “increasingly assimilated into capital value, and configured according to the demands of commercial economies” (Waldby 2000: 34).
The counterpart to the VHP, observes Waldby, is the Human Genome Project (HGP) in that both projects are means by which the body comes to form a database, an archive and so a source of bioinformation. The digitization of bodies however further complicates the dualism between virtual and real bodies presumed in the work of Frank and Waldby. The infiltration of the bodies of the relatively mobile and relatively wealthy by smart, wearable biosensor technologies creates further scope for biovalue and commodification of bodies as evidenced through on-line platforms that harvest biodata, such as 23andMe and other genetic testing organizations (Saukko 2018).
Historically, perhaps one of the most profound impacts of the production of images is in relation to pregnancy. Barbera Duden (1993) argues that the use of technologies which enable the fetus to be visually represented has contributed to the transformation of an unborn fetus into a life. The imagining of the unborn has meant that the fetus has become an emblem, a “billboard image.” Her study addresses the following puzzles: How did the female peritoneum acquire transparency? What set of circumstances made the skinning of women acceptable and inspired public concern for what happens in her innards? And pertinently: how was it possible to mobilize so many women as uncomplaining agents of this skinning and as willing? (Duden 1993: 7). In an amazingly short space of time, “the scan” became a routine and ubiquitous experience for most pregnant women in many Western societies. This prompts tensions between the way the body is experienced or lived and the way the body is observed and described by “medical experts” (Dumit 2010). This tension is explored empirically by Lie and her colleagues (2019) in their study of parents’ experiences of an in-utero MRI (iuMRI) device that has been developed to increase accuracy of diagnosis of foetal brain abnormalities, it is not therefore used routinely but accessed in addition to ultrasound anomaly scanning. From their analysis of the parents experiences they conclude that while, the “‘medical’ gaze may work to separate the foetal body from its social identity” by contrast “the ‘parental’ gaze often does the opposite, reconstructing or reinforcing foetal and parental identities” (p. 376). Thus the lived experiential, embodied view of the body is retained even in instances where it becomes reduced to representation in a digitized form.
SOCIOLOGY OF EMBODIMENT
A sociology of embodiment has developed out of a critique that the literature on the body has failed to incorporate the voices of bodies as they are experienced or lived (James and Hockey 2007). Drawing on phenomenological analyses, this approach proposes that much of the existing literature has failed to challenge a whole series of dualisms such as: the split between mind and body; culture and nature; and reason and emotion. Such socially created dualisms are pernicious, not only because they are false, but also because they serve to reinforce ideologies and social hierarchies. “These dualisms,” Bendelow and Williams (1998: 1) argue, “have been mapped onto the gendered division of labour in which men, historically, have been allied with the mind, culture and the public realm of production, whilst women have been tied to their bodies, nature, and the private sphere of domestic reproduction.” But most important, from a sociological point of view they hinder any effective theorizing which must assume the inextricable interaction and oneness of mind and body. Studies of pain and emotion have, perhaps more than any other, revealed that the body and the mind are not separate entities (Bendelow and Williams 1998).
Phenomenology: The “Lived Body”
The phenomenological perspective focuses on the “lived body” and the idea that consciousness is invariably embedded within the body. The human being is an embodied social agent. The work of Merleau-Ponty, in particular his text The Phenomenology of Perception has been revisited, and it is regarded by many as critical to our appreciation of embodiment (Crossley 1995, 2006; Csordas 1994). Essentially, he argued that all human perception is embodied; we cannot perceive anything, and our senses cannot function independently of our bodies. This does not imply that they are somehow glued together, as the Cartesian notion of the body might suggest, but rather there is something of an oscillation between the two. This idea forms the basis of the notion of “embodiment.” As Merleau-Ponty (1962) writes:
Men [sic] taken as a concrete being is not a psyche joined to an organism, but movement to and fro of existence which at one time allows itself to take corporeal form and at others moves toward personal acts … It is never a question of the incomprehensive meeting of two casualties, nor of a collision between the order of causes and that of ends. But by an imperceptible twist an organic process issues into human behaviour, an instinctive act changes direction and becomes a sentiment, or conversely a human act becomes torpid and is continued absent-mindedly in the form of a reflex. (Merleau-Ponty 1962: 88, cited by Turner 1992: 56)
Thus, while the notion that embodied consciousness is central here, it is also highlighted that we are not always conscious or aware of our bodily actions. We do not routinely tell our body to put one leg in front of the other if we want to walk, or to breathe in through our nose if we want to smell a rose. The body in this sense is “taken for granted,” or as Leder puts it, the body is “absent.” Whilst in one sense the body is the most abiding and inescapable presence in our lives, it is also characterized by its absence. That is, one’s own body is rarely the thematic object of experience … the body, as a ground of experience … tends to recede from direct experience (Leder 1990: 1).
Within this perspective, the lived body is presumed to both construct and be constructed by, and within, the lifeworld. The lived body is an intentional entity which gives rise to this world. As Leder (1992: 25) writes elsewhere:
in a significant sense, the lived body helps to constitute this world as experienced. We cannot understand the meaning and form of objects without reference to bodily powers through which we engage them – our senses, motility, language, desires. The lived body is not just one thing in the world but a way