Sustaining cyborgs: Sensing and tuning agencies of pacemakers and implantable cardioverter defibrillators

Abstract

Recently there has been a renewed interest in cyborgs, and particularly in new and emerging fusions of humans and technologies related to the development of human enhancement technologies. These studies reflect a trend to follow new and emerging technologies. In this article, I argue that it is important to study 'older' and more familiar cyborgs as well. Studying 'the old' is important because it enables us to recognize hybrids' embodied experiences. This article addresses two of these older hybrids: pacemakers and implantable cardioverter defibrillators inserted in the bodies of people suffering from heart-rhythm disturbances. My concern with hybrid bodies is that internal devices seem to present a complex and neglected case if we wish to understand human agency. Their 'users' seem to be passive because they cannot exert any direct control over the working of their devices. Technologies inside bodies challenge a longstanding tradition of theorizing human-technology relations only in terms of technologies external to the body. Cyborg theory is problematic as well because most studies tend to conceptualize the cyborg merely as a discursive entity and silence the voices of people living as cyborgs. Inspired by feminist research that foregrounds the materiality of the lived and intimate relations between bodies and technologies, I argue that creating these intimate relations requires patients' active involvement in sustaining their hybrid bodies. Based on observations of these monitoring practices in a Dutch hospital and interviews with patients and technicians, the article shows that heart cyborgs are far from passive. On the contrary, their unique experience in sensing the entangled agencies of technologies and their own heart plays a crucial role in sustaining their hybrid bodies.

Hybrid bodies and the materiality of everyday life: how people living with pacemakers and defibrillators reinvent everyday routines and intimate relations

“…Posted 28 August 2012. 20 In addition to disentanglement work they also have to engage in forms of labour required to protect their body from internal threats, most notably inappropriate ICD shocks, and fractured leads, and work involved in taking care of appropriate adjustments of pacemakers and ICDs to their activities during the two-yearly device controls at the cardiology clinic (Oudshoorn 2015 and. 21 People living with pacemakers and ICDs are not allowed to engage in full contact sports such as boxing; deep sea diving is not allowed either, whereas users of defibrillators are forbidden to work as professional taxi drivers, driving instructors, or couriers (Anonymous 2013).…”

“…Scholars in science and technology studies and medical sociology have described how contemporary medical devices permeate all aspects of human life and contribute to a reconfiguration of human bodies (Brown and Webster 2004, Casper and Morrison 2010, Lehoux 2006. Whereas most studies have addressed technologies external to bodies, more recently there is a growing interest in devices that operate under the surface of the body, including artificial hips, knees and hearts, breast and cochlear implants, prosthetic arms and legs, pacemakers, implantable cardioverter defibrillators (ICDs), spinal cord stimulators, and emerging human enhancement technologies such as brain implants and nano-chips for diagnosis and drugs delivery (Brown and Webster 2004, Blume 2010, Dalibert 2014, Mauldin 2016, Morrison and Bliton 2011,Oudshoorn 2015, Pollock 2008. Because this increased (bio)medicalisation of the body (Clarke et al 2003) has important implications for what it means to be human and to live with disorders, one major concern of research involving implants and prostheses is to understand this fusion of bodies with machines.…”

“… In addition to disentanglement work they also have to engage in forms of labour required to protect their body from internal threats, most notably inappropriate ICD shocks, and fractured leads, and work involved in taking care of appropriate adjustments of pacemakers and ICDs to their activities during the two‐yearly device controls at the cardiology clinic (Oudshoorn and ). …”

Cyborgs, Robots and Society: Implications for the Future of Society from Human Enhancement with In-The-Body Technologies

“…Mass production is associated with notions of individuals being pacified by cultural content that is provided with such convenience that it requires little, if any, thought [17]. Mass produced culture includes deferential acceptance of medical professionals' advice for standard medical services involving implanting of mass produced in-the-body technologies to restore natural capabilities [12,18]. Beyond the restoration of capabilities, such as hearing and heart functioning, mass produced culture also includes surgical implants to progress towards mass produced exemplars for female and male health and beauty [19,20].…”

“…Nonetheless, there are numerous examples of technologies that involve implanting and are beneath the skin. Well-established examples of in-the-body technologies include cochlear implants and heart pacemakers, which are implanted by medical professionals [12]. By contrast, body hackers imagine novel capabilities for themselves; cutting themselves open and implanting their own in-the-body technologies [13,14].…”