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BIBLIOGRAPHICAL NOTE My study traces the careers of a pair of artifacts, the pacemaker and the implantable defibrillator, and the ideas and aspirations of the social groups that have created and managed them. Historians of medicine and technology told us relatively little about the invention and social shaping of medical devices such as these until interest in the subject began to burgeon in the last twenty years as an aspect of the broader societal debate over the benefits and costs of new medical technology. For the reader seeking an introduction to the study of technological change, the most helpful textbook is Ron Westrum, Technologies and Society: The Shaping of People and Things (Belmont, Calif.: Wadsworth, 1991). Other works I have found useful include John M. Staudenmaier, Technology’s Storytellers: Reweaving the Human Fabric (Cambridge: MIT Press, 1985) and Does Technology Drive History? ed. Merritt Roe Smith and Leo Marx (Cambridge: MIT Press, 1994). The essays in The Social Construction of Technological Systems, ed. Wiebe E. Bijker, Thomas Hughes, and Trevor Pinch (Cambridge: MIT Press, 1987), have strongly influenced recent scholarly thinking. Thomas Hughes’s concepts of technological systems and technological momentum have helped me organize this study of cardiac-rhythm management. See ‘‘Conservative and Radical Technologies,’’ in Managing Innovation: The Social Dimensions of Creativity, Invention and Technology, ed. Sven B. Lundstedt and E. William Colglazier Jr. (New York: Pergamon, 1982), 31–44; ‘‘Machines and Medicine: A Projection of Analogies between Electric Power Systems and Health Care Systems,’’ Int J Tech Assess in Health Care 1 (1985): 285–95; ‘‘The Evolution of Large Technological Systems,’’ in The Social Construction of Technological Systems, ed. Bijker, Hughes, and Pinch, 51–82; and ‘‘Technological Momentum,’’ in Does Technology Drive History? ed. Smith and Marx, 101–13. On medical technology specifically, Stanley Joel Reiser presents a rich overview in Medicine and the Reign of Technology (Cambridge: Cambridge Univ. Press, 1978). Reiser shows how the use of artifacts such as the stethoscope has facilitated the scientific framing of formal, discrete disease entities, reinforced the authority of the physician, and added satisfying new rituals to the physician-patient encounter. See also Reiser’s essay ‘‘The Machine at the Bedside: Technological Transformations of Practices and Values,’’ in The Machine at the Bedside: Strategies for Using Technology in Patient Care, ed. Reiser and Michael Anbar (Cambridge: Cambridge Univ. Press, 1984), 3–19. Historians of technology and of medicine, including Reiser, have told us more about the invention, dissemination, and societal impact of diagnostic technologies than about modern technologies of treatment such as the pacemaker. Important works on imaging technologies have appeared in recent years, particularly Ellen B. Koch, ‘‘The Process of 354 BIBLIOGRAPHICAL NOTE Innovation in Medical Technology: American Research on Ultrasound, 1947–1962,’’ Ph.D. diss., University of Pennsylvania, 1990; Stuart S. Blume, Insight and Industry: On the Dynamics of Technological Change in Medicine (Cambridge: MIT Press, 1992); and Bettyann Holtzmann Kevles, Naked to the Bone: Medical Imaging in the Twentieth Century (New Brunswick, N.J.: Rutgers Univ. Press, 1996). Koch and Blume are interested in the way groups of specialists stake claims to the control of new technologies and in how the technologies in turn induce specialists to redefine their activities. Kevles also addresses these questions, but in addition explores how professionals and the broader public have ascribed cultural meanings to X rays and other imaging technologies. Nancy Knight, ‘‘ ‘The New Light’: X-Rays and Medical Futurism,’’ in Imagining Tomorrow: History, Technology, and the American Future, ed. Joseph J. Corn (Cambridge: MIT Press, 1986), 10–34, is a case study of the twentieth-century belief that new machines of diagnosis and treatment will refashion the conditions of life and health. The historical literature on twentieth-century artifacts of treatment is not a large one. Lewis Thomas’s thoughts on ‘‘halfway technologies’’ (which manage but do not cure a disease) are a good place to begin. Thomas’s essays are collected in The Lives of a Cell (1974; reprint, New York: Penguin, 1995), The Medusa and the Snail (1980; reprint, New York: Penguin, 1995), and Late Night Thoughts on Listening to Mahler’s Ninth Symphony (1983; reprint, New York: Penguin, 1995). He presents his ideas about the technology of medicine more formally in ‘‘Report of the Overview Cluster: The Place of Biomedical Science in Medicine,’’ in Report of the President’s Biomedical Research Panel: appendix A, The Place of Biomedical Science in Medicine and the State of Science (DHEW Publication No. [OS...

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