Washing and Assessing: Multiple Diagnosis and Hidden Talents

Abstract

In the following chapter we juxtapose two clinical procedures: 'whole-bodywashing' and the SMART-assessment-technique. Both have been developed in the context of the neuro-rehabilitative care setting where people who are physically dependent, medically vulnerable and cognitively impaired spend years of their lives. This juxtaposition, on paper, refers to an 'experiment' in the real world where, among others, multiple medical and nursing diagnostic and treatment practices are carried out to take care of these patients. This experiment was originally initiated to improve the 'knowing' concerning these bodies/persons. However, it might also be considered as a dynamics of unknowing that plays an important role when carers intend to become, together with their patients, talented bodies themselves. Furthermore, this account of events should give an impression of the transdisciplinary involvement of ourselves as members of a research group interested in the exploration of scientific and artistic methods that allow the displacement of issues, questions and positions, and the creation of renewed and surprising arrangements, co-operations and agreements between the actors involved. 1 Washing the bodyThe sick room of a nursing home, nine o'clock in the morning: A nurse is about to undertake a so-called 'whole-body washing' of a young man. The 28-year old patient suffers from the consequences of traumatic brain injury caused by a motor-cycle accident in 1998. After 14 months at an early rehabilitation centre, and without evident improvement in his state, he was transferred to the ward of a long-term rehabilitation and nursing unit. He is living there to this day.He receives nutrition and liquids through a (PEG-)tube that penetrates the abdominal wall and discharges into the stomach. The man is quadriplegic, ie he is totally paralysed. Despite a drug delivery system that continuously administers a muscle-relaxant medicine into the spinal fluid, his extremities show increased muscle tonus. Both hands are clenched to fists. If one tries to move his knee or elbow joints through their range of motion, one feels a strong resistance. He wears a urinary and fecal collection system. Everyday he is transferred to a wheelchair, where he stays for up to four hours. He has no trunk and head control. His general condition is described as stable. In the records, the medical diagnosis reads: 'vegetative state after traumatic brain injury'.

Intimate Entanglements: Affects, more-than-human intimacies and the politics of relations in science and technology

“…Practices that organise intimacy in as a critical means of knowing, can transform understanding and help people resist the entanglement that emplaces them in dominant power relations (e.g. Kraeftner & Kroell, 2009; Tironi, 2018; Tironi & Rodriguez-Giralt, 2017). As well as examining how technologies of governing attempt to organise intimacy out in ways that are dysfunctional (as Menzies Lyth’s work, discussed above, showed), intimacy as an affect of particular socio-material distributions, attachments and detachments can recover something of what animates the assembling and reassembling of the social.…”

The media of sociology: tight or loose translations?

“…After having ethnographically analysed the medical forms of assessing mental states, they went on to develop their own assessment project. Ethnographic details, strongly based on drawings (Kräftner and Kröll ), showed that observing (comic) interactions with patients may provide better ways of assessing the states of these patients than medical imaging based on non‐interference. The research team then built an apparatus that shows patients video feeds of humoristic videos while at the same time filming the patients facial reactions to these videos.…”