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.It assumed every patientpossessed a unique microbial load that should be secured within its ownindividual environment.Furthermore, the introduction of a patient toan isolator required careful coordination of the technology, personnel(including several nursing and medical staff), and the patient.When the Life Island was used for the care of a badly burned child, for example,staff reported that the work of establishing the isolator126.Schlich, Surgery, Science and Industry (n.15), 35 41.127.M.Berg, Rationalizing Medical Work Decision Support Techniques and Medical Practices(Cambridge, Mass.: MIT Press, 1997); S.Sturdy and R.Cooter,  Science, Scientific Man-agement, and the Transformation of Medicine in Britain, 1870 1950, Hist.Sci.36 (1998):421 66.128.Sturdy and Cooter,  Science, Scientific Management (n.127).272 robert g.w.kirkwas accomplished with delay and mass-confusion . . . only two of the person-nel donned sterile gowns, gloves and masks.Two others wore masks . . . thestretcher was too far away from the unit, thus there was over exposure of thechild as she was carried to the Island.Upon insertion, the head of the nursecarrying the patient became inserted within the unit and the bare hand of oneof the observers moved within the unit to hold the stethoscope out of the way.129The experience of working with the isolator was  not the easiest. Routinenursing was reported to be possible but  difficult ; nursing staff sufferedmany  bumps and bruises and became  drenched in perspiration afterjust a few minutes enveloped in the plastic. 130Moreover, total isolation prevented a medical practice that, howeverephemeral, was widely considered crucial to proper care: that of touch.Medical technology has long been accused of distancing the physician (ornurse) from the patient.131 Technologies of blood pressure measurement,for example, were highly controversial when first introduced because theyreplaced the traditional method of measuring the pulse by touch.132 By for-bidding any form of touch not mediated by plastic, germ-free technologyremoved a practice that, though lacking objectively established therapeu-tic value, nonetheless was widely known to be an important, albeit tacit,aspect of care.133 The unnaturalness of human relations within isolationwas consequently a recognized though difficult to articulate problem.Guidance for the use of the  Life Island, for example, emphasized how personnel should be adept, well informed, and confident in order toensure  a  calm, confident attitude that would  lessen the apprehensionand fear of the patient. 134 Conventionally, fear would have been overcomeby a momentary touch.Despite every effort to make the isolator simple,efficient, and comfortable, germ-free technology continued to demandhigher levels of labor and remained experientially different in ways thatcould not be easily effaced.Constituting a willingness of use was made all the more difficult becauseit was never clear that the technology was necessary.In the clinical ward129. Life Island Isolation, ca.March 1967, 1, box 1, folder 2, SHPI.130.Ibid., 7.131.Stanley Joel Reiser, Medicine and the Reign of Technology (Cambridge: CambridgeUniversity Press, 1978).132.Hughes Evans,  Losing Touch: The Controversy over the Introduction of BloodPressure Instruments into Medicine, Technol.Cult.34 (1993): 784 807.133.Sally Gadow,  Touch and Technology: Two Paradigms of Patient Care, J.ReligionHealth 23 (1984): 63 69; Margarete Sandelowski, Devices and Desires: Gender, Technology andAmerican Nursing (Chapel Hill: University of North Carolina Press, 2000).134. I.Purpose: To Provide a Contamination Free Environment for a Patient with LowResistance to Infection, Life Island Instructions, p.14, SHPI.Life in a Germ-Free World 273and the operating theatre, germ-free technology was preventative, notcurative, and thus governed by a logic that denied a choice in its use.Antibiotics, in contrast, could be deployed to combat specific infectionsas and when their use was necessary.Their necessity and efficacy was tan-gible and confirmable through bacteriological tests.The credibility andnecessity of germ-free isolators as a preventative tool, however, was moredifficult to establish because of the inherent difficulty of proving one hadprevented something that had not occurred.Only when the microbialthreat shifted from the patient to the medical professional, as in the earlyencounters with Lassa and Ebola, was the new technology deemed neces-sary.The redistribution of risk perception promised to move the germ-freeisolator from a peripheral to a central medical technology [ Pobierz caÅ‚ość w formacie PDF ]