The Dehumanizing Impact of Biomedical Surveillance

Writer Adam Bessie was diagnosed with a form of brain cancer six years ago. Since that time, he’s had at least 30 MRIs. In the six-week period it took him to complete his most recent writing project, he had radiation treatments and x-ray scans five days a week. That’s 30 more scans! It stands to reason that biomedical surveillance could have a marked impact on one’s feelings of personhood.

In “A Scanner Constantly” illustrated by Josh Neufeld, Bessie explains the surreal impact that habitual medical monitoring can have on the post-diagnosis lives of cancer patients. Even though the middle-aged Bessie “looks healthy” with his full beard and just slightly balding head, he often feels reduced to a mere histological representation of himself.

I Feel More Like A Scan

“Living with a brain tumor, sometimes I feel less like a person… and more like a scan.”

The dividing line between representation and lived experience seems to narrow with each scan. Bessie knows that these images are just a “fragment” of reality but because they appear to be “real absolute TRUTH,” it is sometimes difficult to separate one from the other.

Looking at my brain

“I’m looking at my brain–WITH my brain–and I wonder…which one is me?

Even as Bessie struggles with medicalized perceptions of himself, he rails against them.

“The scan shows the inside of my brain, but not into my mind — and certainly not down into my heart.”

The comic strip highlights vividly how increasingly difficult it is becoming to keep the realms of technoscience and humanity separate as high-tech biomedicine shapes our lives to greater degrees, especially in the in the face of illness.

In one of the most profound and ambitious books I’ve read on Biomedicalization by medical sociologist Adele Clarke and colleagues, the authors argue that people negotiate and produce a sense of self through the framework of technoscience and its practices. For example, a person might use biomedical classifications and diagnostics to confirm particular diagnoses or genetic predispositions and then strongly identify with them. The book demonstrates generally how individuals engage with technological choices and options, access technoscientific identities [1] through biopolitical economies of health and illness, engage in discourses and practices of biomedical risk and surveillance, and receive institutional and interactional reinforcement for enacting particular forms of identity.

This type of engagement, however, is not always positive. For Adam Bessie, developing a technoscientific identity is one of those unintended and unwanted consequences of biomedicalization and routine surveillance. Like one of his role models, Salvatore Iaconesi, a man with the same type of brain tumor as Bessie, he is “not content to disappear behind the scan.”

salvatore crop

“In a way, you cease to exist because you are a patient. In more than one way, you are not a human being anymore…you are replaced by your clinical records. It’s as if you disappear, replaced by your disease.”

1 A Technoscientific Illness Identity (TSI) involves applying biomedical information and characteristics to a person’s sense of self in the face of illness, transferring biomedical information and characteristics directly to the person. Instead of acknowledging that one has a particular biomedical classification, the TSI encourages the person to become – think of oneself in terms of – the classification. [Definition taken from Sulik, G. “‘Our Diagnoses, Our Selves’: The Rise of the Technoscientific Illness Identity.” Sociology Compass 5/6 (2011): 463–477.]

“A Scanner Constantly” by Adam Bessie and Josh Neufeld was published in the Pacific Standard on February 8th, 2016. Read it here.

Click here to find my review of the book Biomedicalization: Technoscience, Health, and Illness in the U.S by Clarke, A., Mamo, L., Fosket, J.R. Fishman, J.R. and Shim, J. (Edinburgh : Duke University Press , 2010).

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