Magnetic Appeal: MRI and the Myth of Transparency

3. Seeing Is Believing: The Transformation of MRI Examinations into Authoritative Knowledge

3 Seeing Is Believing The Transformation of MRI Examinations into Authoritative Knowledge B odies: The Exhibition,” a traveling museum exhibit, displays room after room of body parts in display cases and preserved full bodies in poses set throughout the exhibition halls. When one enters the exhibit, written on the wall are the words, “The study of human anatomy has always operated on a basic principle—to see is to know.” The “educational” premise is that visitors will learn about health and disease by seeing the muscles, nervous system, organs, and bones of dissected bodies. In the final exhibition room, displays of physical bodies give way to displays on medical treatments for illnesses, which includes a lengthy discussion of MRI technology. It is one of few technologies mentioned specifically by name in the exhibit; most medical branches and interventions are mentioned in broad categories (e.g., genomics or pharmaceuticals). As a result, the exhibit positions MRI as an advanced diagnostic technology—one that allows people to “see” and thus “know” the body. Within the exhibit narrative , this knowledge is perceived as crucial to healing. The presentation of MRI in this exhibit is indicative of the highly privileged position that the technology occupies in relation to other technologies and to the goals of medicine: the identification and cure of disease. Similar claims for MRI are often made in sources as diverse as popular science books, television dramas, news articles, museum displays, and Hollywood films. Such claims rely in part on cultural beliefs that link seeing with knowing. “ Far removed from its historical roots in atomic research, MRI technology is now a visualization technology—one understood to transform the inner body into an anatomical picture. As such, it produces a cultural artifact important to contemporary questions of identity, truth, and health. This chapter demonstrates how popular accounts produce and magnify particular ideas about MRI examinations while marginalizing alternative ways of understanding them. This chapter identifies three common rhetorical practices used to discuss MRI in the news media, science exhibits , and popular science books: (1) MRI reveals the body and produces health; (2) MRI is compared to other medical techniques and is declared to be superior; and (3) MRI is portrayed as an agent and is represented as a machine that speaks and acts. Such narratives—whether intentionally or unintentionally constructed—create and reinforce the belief that MRI exams provide definitive knowledge that is more precise than information provided by other methods. In analyzing these narratives, I attend not only to those discourses most visible but also to processes rendered invisible, showing how dominant accounts “black box” crucial decisions made by technologists and the interpretive work of radiologists and referring physicians.1 Each of these actions shape the use and quality of MRI exams in medical practice yet are seldom discussed in popular culture narratives. Examining the relationships that surround and inform the production of medical images demonstrates that MRI scans are highly mediated representations that are influenced by decisions and values during all aspects of the production process. The images do not reveal the inner body, but instead produce the body, bringing together aspects of physical bodies, technology, and cultural, social, and economic factors in ways that both include and exceed the physical body. Moreover, textual analysis and ethnographic research combined show that current medical practices and policies rely on the invisibility of physicians and technologists’ knowledge about and use of MRI. Imaging policies that require only one interpretation of an image or promote the idea that the image alone offers the “truth” about a patient’s condition are sustained and maintained through an erasure of everyday work practices. Popular Narratives about MRI Medical imaging is a source of fascination for news media and popular science and a common feature in science exhibits at museums and other 48 MAGNETIC APPEAL 1 For a discussion of black-boxing, see Latour (1987). sites. MRI is often represented in such accounts, and is understood by health care workers, research scientists, and the public as one of the best and most complicated imaging technologies. Popular narratives construct a singular understanding of MRI images—one that represents them as authoritative knowledge—while simultaneously downplaying other ways of comprehending these artifacts. The many translational processes involved in producing an MRI image, which include human manipulation of the technology, sociotechnical transformations of the data from numerical to pictorial form, and human interpretation of...