Two moments reveal the complex relations of bodies and technologies in
the increasingly mediated world of biomedicine.
A surgical fellow delicately and painstakingly works to excise a tumor located
deep in a patient’s liver. He has spent several cautious hours opening the man’s
abdomen, peeling away layers of muscle, and retracting ribs to expose the
cancerous organ. The fellow, whom I will call Dr. Marcos Alexander, is by all
accounts an excellent surgeon.∞
Dr. Nick Perrotta, the sta√ surgeon supervising
the operation, uses ultrasound to visualize the tumor and then, while watching
the ultrasound monitor, uses a cautery to sear a line on the liver’s surface.
Marcos uses this line to guide his deep dissection of the tumor. At one point, his
knife accidentally strays perilously close to one of three hepatic arteries, which
supply blood to the liver. Nick, who has watched Marcos work for much of the
tumor dissection, guides him past the artery, verbally helping him navigate
between artery and tumor. Had Marcos severed the artery, the patient could
have died. After the narrow miss, Nick jokes about the e√ect the accident could
have had on Marcos’s career: ‘‘[Marcos] would have some time, do some
ﬁshing.’’ No one in the operating room laughs, but the joke told Marcos what
was at stake.
I am eating lunch with two surgeons, Dr. Harry Beauregard and Dr. Ramesh
Chanda, as I have done most days for several months. Harry and Ramesh have
been working together to build a virtual-reality simulator for teaching mini-
mally invasive pelvic surgeries. To perform minimally invasive or ‘‘keyhole’’