Department of Communication, UCSD

For the past few hundred years, many books and articles have begun with a phrase such as: “We are entering a period of rapid change unimagined by our ancestors”. The statement is both as true and as false now as it has been over the previous two centuries. It is true because we are as a society adjusting to a whole new communication medium (the Internet) and new ways of storing, manipulating and presenting information. We are, as Manuel Castells and others remind us, now in many ways an information economy, with many people tied to computers one way or another during our working day and in our leisure hours. It is false because we are faced with the same old problems – getting food, shelter and water to our human population; living in some kind of equilibrium with nature – as ever we were. How is the new knowledge economy impacting and potentially can impact science and technology policy concerned with sustainable life?

"A classified and hierarchically ordered set of pluralities, of variants, has none of the sting of the

miscellaneous and uncoordinated plurals of our actual world." (Dewey, 1989: 49)

"We do many things today that a few hundred years ago would have looked like magic". We all know versions of this banal assertion - we've probably all made it ourselves at some point or another. And if we don't understand a given technology it looks like magic: we are perpetually surprised by the mellifluous tones read off our favorite CDs by (we believe) a laser. Star (1995b) notes that even engineers black box and think of technology `as if by magic' in their everyday practical dealings with machines. A common description of a good waiter or butler (one thinks of Jeeves in the Wodehouse stories) is that she clears a table `as if by magic'. Are these two kinds of magic or one or none?

The following paper is an attempt to answer this question, which can be posed more prosaically as:

* What work do classifications and standards do? We want to look at what goes into making things work like magic: making them fit together so that we can buy a radio built by someone we have never met in Japan, plug it into a wall in Champaign and hear the world news from the BBC.

* Who does that work? We want to explore the fact that all this magic involves much work: there is a lot of hard labor in effortless ease[1]. Such invisible work is often not only underpaid - it is severely underrepresented in theoretical literature (Star and Strauss, in press). We will discuss where all the missing work' that makes things look magical goes.

* What happens to the cases that don't fit? We want to draw attention to cases that don't fit easily into our created world of standards and classifications: the left handers in the world of right-handed magic, chronic disease sufferers in the world of allopathic acute medicine, the onion-hater in MacDonalds (Star, 1991b) and so forth.

These are issues of great epistemological, political and ethical import. It is easy to get lost in Baudrillard's (1990) cool memories of simulacra. The hype of our times is that we don't need to think about the work any more: the real issues are scientific and technological - in artificial life, thinking machines, nanotechnology, genetic manipulation... Clearly each of these are important. However, we endeavor to demonstrate that there is rather more at stake - epistemologically, politically and ethically - in the day to day work of building classification system and producing and maintaining standards than in these philosophical high-fliers. The pyrotechnics may hold our fascinated gaze; they cannot provide any path to answering our questions.

Through looking at classification systems and standards, we will move towards an understanding of the stuff which makes up the networks of actor network theory. Latour, Callon and others within the actor-network approach have developed an array of concepts in order to describe the development and operation of technoscience. Their valuable concepts include: regimes of delegation; the centrality of mediation; and the position that nature and society are not causes but consequences of human scientific and technical work. The position that a fact may be seen as a consequence, and not as an antecedent, is axiomatic to the American pragmatist approach as well, particularly in the work of John Dewey (e.g., Dewey, 1929). As he noted in his Experience and Nature:

For things are objects to be treated, used, acted upon and with, enjoyed and endured, even more than things to be known. They are things HAD before they are things cognized....the isolation of traits characteristic of objects known, and then defined as the sole ultimate realities, accounts for the denial to nature of the characters which make things lovable and contemptible, beautiful and ugly, adorable and awful. It accounts for the belief that nature is an indifferent, dead mechanism; it explains why characteristics that are the valuable and valued traits of objects in actual experience are thought to creative a fundamentally troublesome philosophical problem. (1989 [1925]: p. 21)

We draw attention here to the places where the work gets done of assuring that delegation and mediation will work: to the places where human and non-human are constructed to be operationally and analytically equivalent. And following both Dewey and Latour, we also question the indifference -- of nature, and of machines. So doing, we explore the political and ethical dimensions of actor-network theory, restoring the interlinked and webbed relationships between people, things, and infrastructure.

This paper argues that the medical record is an important focus for sociological research. In medical work, the modern patient's body Foucault has so aptly described is produced through embodied, materially heterogeneous work - and the medical record plays a crucial role in this production. It does not simply represent this body's history and geography: it is a central element in the material re-writing of these. Simultaneously, the record fulfills a core role in the production of a body politic. As the record is involved in the performance of the patient's body, it is also involved in the performance of the clinic in which that body comes to life. Finally, we argue that different records, different practices of reading and writing are intertwined with the production of different patient's bodies, bodies politic, and bodies of knowledge. As organizational infrastructure, the medical record affords the interplay and coordination of divergent worlds. Seen in this light, as a site where multiple stories about patients and about organizations are at stake (including the interoperability between these stories), the medical record becomes highly relevant both analytically and politically.