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”There’s No Language for This”: Communication and Alignment in Contemporary Prosthetics
- NYU Press
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8 “There’s No Language forThis” Communication and Alignment in Contemporary Prosthetics Steven Kurzman THIS ESSAY IS about how contemporary lower-extremity amputees and prosthetists communicate with each other during the process of fitting and aligning a prosthesis in clinic. Amputees approach the use of prostheses from a subjective perspective, while prosthetists speak about fitting and aligning prostheses in the language of biomechanics. Since fit and alignment are essential to using a prosthesis, prosthetists and amputees must find ways to communicate with one another about prostheses and the subjective experience of using them. This essay describes how they collaboratively invent a language to do this. I explore the clinical language, silence, and experience of prostheses in an effort to imbue this text with a flavor of these two perspectives and to show how they are in embodied dialogue with each other. I am both a cultural anthropologist and a below-knee amputee, and this dialogue also expresses my own peculiar position during my dissertation fieldwork in the prosthetics field in Chicago. Ultimately, I believe that juxtaposing the subjective experience of using a prosthesis and the clinical work of constructing bodies has potential to disrupt our habitus (in Marcel Mauss’s terms), or learned techniques, of how we think about, talk about, and use our bodies, walking, and able-bodiedness (Mauss 1992). 227 THERE’S NO LANGUAGE FOR THIS The process of fitting and dynamically aligning a prosthesis is integral to making and using one, and Kevin and I were ready to start. Kevin is a certified prosthetist who, during my fieldwork, worked at a prosthetics shop that served as one of my field sites. We were working on an informal experiment, a prototype for an inexpensive, easy-to-use belowknee prosthesis intended for geriatric amputees. It was a collaborative project in which Kevin designed the limb and did most of the fabrication , while I tested it and offered feedback. And now it was time to align the check socket. As we entered the fitting room and closed the sliding door behind us, we shifted our roles from prosthetist and amputee/researcher to clinician and patient. Half kidding and half serious, Kevin began to speak in a more clinical tone, addressing me as “Mr. Kurzman” and giving me gentle but authoritative descriptions and instructions about how to use the new prosthesis. After removing my everyday leg, I pulled on silicone and cloth stump socks and donned the prosthesis. I stood up, shifted my weight around, and began to walk in the parallel bars. I didn ’t get very far, though, before the fiberglass tape binding the check socket to the pylon ripped with a loud cracking sound. After a quick repair , I walked in the bars for a few minutes and, quickly getting a feel for the limb, moved out of the fitting room and started trotting up and down the hallway. I tried to walk evenly and smoothly, looking straight ahead, and paying attention to where my body was and how it was moving. How were my feet rolling over during the gait cycle? Was my trunk leaning after heel-off? Meanwhile, Kevin gazed intently at my feet and body, asking himself similar questions, while Noah and Milton, the two shop technicians, cracked jokes about the prosthesis hurting. After a few minutes of this, I informed Kevin that the prosthesis didn’t feel right. He posed questions in an effort to pinpoint the problem : Where does it hurt? Does it feel like you’re walking up a hill? Does it feel like you’re walking into a hole? We moved to the workshop in the back of the facility, where I doffed the prosthesis and he made some adjustments . I was soon pacing the hallway again and we repeated the cycle of walking, feeling, observing, questioning, and readjusting. My attention focused on my legs and the effort of thinking about what it feels like to walk and how to articulate this feeling, while Kevin alternately observed my legs, face, and body language. We repeated the 228 STEVEN KURZMAN [54.84.65.73] Project MUSE (2024-03-19 08:15 GMT) process over and over again, grinding out tight areas of the socket, plantar flexing or dorsiflexing the foot, adducting and a-b-ducting the socket, and toeing the foot in and out.1 “Is that better or worse now? Or the same?” he asked after each adjustment. Finally, we reached that moment when the prosthesis just felt right...