Skip to main content

Repair Work as Inquiry and Improvisation: The Curious Case of Medical Practice

Abstract

Cornelius Schubert draws on ethnographic observations in hospitals to highlight the importance of repairing technical equipment and adjusting organisational procedures in medical practice. Routinely faced with divergent breakdowns and failures, nurses and doctors constantly engage in situated inquiries into the causes, nature and consequences of material and organisational problems, and improvise more or less robust remedies to them, thereby taking responsibility for vital issues. Drawing on pragmatist philosophy, Schubert highlights the constitutive dimensions of inquiry and improvisation in repair, notably with respect to how priorities are negotiated and established in medical practice. He shows how technical and organisational breakdowns are often interrelated and how technical fixes may resolve organisational problems and vice versa.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-981-13-2110-8_2
  • Chapter length: 30 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   119.00
Price excludes VAT (USA)
  • ISBN: 978-981-13-2110-8
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Hardcover Book
USD   159.99
Price excludes VAT (USA)

References

  • Atkinson, Paul A. 1995. Medical Talk and Medical Work: The Liturgy of the Clinic. London: Sage.

    Google Scholar 

  • Becker, Howard S. 2000. The etiquette of improvisation. Mind, Culture, and Activity 7 (3): 171–176.

    CrossRef  Google Scholar 

  • Becker, Howard S., Blanche Geer, Everett C. Hughes, and Anselm L. Strauss (eds.). 1961. Boys in White. Student Culture in Medical School. Chicago: University of Chicago Press.

    Google Scholar 

  • Berg, Marc, and Annemarie Mol (eds.). 1998. Differences in Medicine: Unraveling Practices, Techniques, and Bodies. Durham: Duke University Press.

    Google Scholar 

  • Blumer, Herbert. 1954. What’s wrong with social theory? American Sociological Review 19 (1): 3–10.

    CrossRef  Google Scholar 

  • Bosk, Charles L. 2003 [1979]. Forgive and Remember: Managing Medical Failure. Chicago: University of Chicago Press.

    Google Scholar 

  • Bourdieu, Pierre. 1977 [1972]. Outline of a Theory of Practice. Cambridge: Cambridge University Press.

    Google Scholar 

  • Bruni, Attila, Trevor J. Pinch and Cornelius Schubert. 2013. Technologically dense environments: What for? What next? Tecnoscienza 4 (2): 51–72.

    Google Scholar 

  • Clark, Colin, and Trevor J. Pinch. 2014 [1995]. The Hard Sell. The Art of Street-Wise Selling. London: HarperCollins.

    Google Scholar 

  • Collins, Harry M., Gerard H. de Vries, and Wiebe E. Bijker. 1997. Ways of going on. An analysis of skill applied to medical practice. Science, Technology & Human Values 22 (3): 267–285.

    CrossRef  Google Scholar 

  • Crossan, Mary M. 1998. Improvisation in action. Organization Science 9 (5): 593–599.

    CrossRef  Google Scholar 

  • Cubasch, W. 1884. Die Improvisation der Behandlungsmittel im Kriege und bei Unglücksfällen. Vademecum für Ärzte und Sanitätspersonen. Wien: Urban & Schwarzenberg.

    Google Scholar 

  • Dant, Tim. 2010. The work of repair. Gesture, emotion and sensual knowledge. Sociological Research Online 15 (3).

    CrossRef  Google Scholar 

  • Denis, Jérôme, and David Pontille. 2015. Material ordering and the care of things. Science, Technology and Human Values 40 (3): 338–367.

    CrossRef  Google Scholar 

  • Dewey, John. 1916. Essays in Experimental Logic. Chicago: University of Chicago Press.

    CrossRef  Google Scholar 

  • ———. 1930 [1929]. The Quest for Certainty. A Study of the Relation of Knowledge and Action. London: Allen & Unwin.

    Google Scholar 

  • ———. 1938. Logic: The Theory of Inquiry. New York: Henry Holt.

    Google Scholar 

  • Fox, Renée C. 1957. Training for uncertainty. In The Student-Physician. Introductory Studies in the Sociology of Medical Education, ed. Robert K. Merton, George Reader, and Patricia L. Kendall, 207–241. Cambridge: Harvard University Press.

    Google Scholar 

  • Freidson, Eliot. 1970. Profession of Medicine. A Study of the Sociology of Applied Knowledge. New York: Harper & Row.

    Google Scholar 

  • Garfinkel, Harold. 1967. Studies in Ethnomethodology. Englewood Cliffs: Prentice-Hall.

    Google Scholar 

  • Garud, Raghu, and Peter Karnøe. 2003. Bricolage versus breakthrough: Distributed and embedded agency in technology entrepreneurship. Research Policy 32 (2): 277–300.

    CrossRef  Google Scholar 

  • Gießmann, Sebastian, and Gabriele Schabacher. 2014. Umwege und Umnutzung oder: Was bewirkt ein “Workaround”? In Umnutzung. Alte Sachen, neue Zwecke, ed. Stephan Habscheid, Gero Hoch, Hildegard Schröteler-v. Brandt, Volker Stein, 13–26. Göttingen: V&R unipress.

    CrossRef  Google Scholar 

  • Goodwin, Dawn. 2007. Upsetting the order of teamwork. Is ‘the same way every time’ a good aspiration? Sociology 41 (2): 259–275.

    CrossRef  Google Scholar 

  • Graham, Stephen, and Nigel Thrift. 2007. Out of order: Understanding repair and maintenance. Theory, Culture & Society 24 (3): 1–25.

    CrossRef  Google Scholar 

  • Harper, Douglas. 1987. Working Knowledge: Skill and Community in a Small Shop. Chicago: University of Chicago Press.

    Google Scholar 

  • Heath, Christian, Paul Luff, and Marcus Sanchez Svensson. 2003. Technology and medical practice. Sociology of Health & Illness 25 (3): 75–96.

    CrossRef  Google Scholar 

  • Henke, Christopher R. 2000. The mechanics of workplace order. Toward a sociology of repair. Berkeley Journal of Sociology 44: 55–81.

    Google Scholar 

  • Hughes, Everett C. 1951. Mistakes at work. Canadian Journal of Economics and Political Science 17: 320–327.

    CrossRef  Google Scholar 

  • Jackson, Steven J. 2014. Rethinking repair. In Media Technologies. Essays on Communication, Materiality, and Society, ed. Tarleton Gillespie, Pablo J. Boczkowski, and Kirsten A. Foot, 221–239, Cambridge: MIT Press.

    Google Scholar 

  • Joas, Hans. 1996. The Creativity of Action. Cambridge: Polity Press.

    Google Scholar 

  • Kalthoff, Herbert. 2010. Beobachtung und Komplexität. Überlegungen zum Problem der Triangulation. Sozialer Sinn 11 (2): 353–365.

    Google Scholar 

  • Kamoche, Ken, Miguel Pina e Cunha, and João Vieira da Cunha. 2003. Towards a theory of organizational improvisation: Looking beyond the jazz metaphor. Journal of Management Studies 40 (8): 2023–2051.

    CrossRef  Google Scholar 

  • Knorr, Karin. 1979. Tinkering toward success: Prelude to a theory of scientific practice. Theory and Society 8: 347–376.

    CrossRef  Google Scholar 

  • Landström, Catharina, Sarah J. Whatmore, and Stuart N. Lane. 2013. Learning through computer model improvisations. Science, Technology and Human Values 38 (5): 678–700.

    CrossRef  Google Scholar 

  • Middleton, David. 1996. Talking work: Argument, common knowledge, and improvisation in teamwork. In Cognition and Communication at Work, ed. Yrjö Engeström, and David Middleton, 233–256. Cambridge: Cambridge University Press.

    Google Scholar 

  • Mol, Annemarie, Ingunn Moser, and Jeannette Pols (eds.). 2010. Care in Practice. On Tinkering in Clinics, Homes and Farms. Bielefeld: Transcript.

    Google Scholar 

  • Montgomery Hunter, Kathryn. 1991. Doctors’ Stories. The Narrative Structure of Medical Knowledge. Princeton: Princeton University Press.

    Google Scholar 

  • Mort, Maggie, Dawn Goodwin, Andrew F. Smith, and Catherine Pope. 2005. Safe asleep? Human-machine relations in medical practice. Social Science and Medicine 61 (9): 2027–2037.

    CrossRef  Google Scholar 

  • Mort, Maggie, Carl R. May, and Tracy Williams. 2003. Remote doctors and absent patients. Acting at a distance in telemedicine? Science, Technology & Human Values 28 (2): 274–295.

    CrossRef  Google Scholar 

  • Orr, Julian E. 1996. Talking About Machines: An Ethnography of a Modern Job. Ithaca: ILR Press.

    Google Scholar 

  • Parsons, Talcott. 1951. The Social System. New York: Free Press.

    Google Scholar 

  • Pinch, Trevor J., Harry M. Collins, and Larry Carbone. 1996. Inside knowledge: Second order measures of skill. The Sociological Review 44 (2): 163–186.

    CrossRef  Google Scholar 

  • Popitz, Heinrich, Hans Paul Bahrdt, Ernst August Jüres, and Hanno Kesting. 1957. Technik und Industriearbeit. Soziologische Untersuchungen in der Hüttenindustrie. Tübingen: Mohr Siebeck.

    Google Scholar 

  • Ryle, Gilbert. 1976. Improvisation. Mind 85 (337): 69–83.

    CrossRef  Google Scholar 

  • Sawyer, R. Keith. 2000. Improvisation and the creative process: Dewey, Collingwood, and the aesthetics of spontaneity. The Journal of Aesthetics and Art Criticism 58 (2): 149–161.

    CrossRef  Google Scholar 

  • Schubert, Cornelius. 2006. Die Praxis der Apparatemedizin. Ärzte und Technik im Operationssaal. Frankfurt am Main: Campus.

    Google Scholar 

  • ———. 2007. Risk and safety in the operating theatre: An ethnographic study of socio-technical practices. In Biomedicine as Culture: Instrumental Practices, Technoscientific knowledge, and New Modes of Life, ed. Regula V. Burri, and Joseph Dumit, 123–138, London: Routledge.

    Google Scholar 

  • ———. 2011. Making sure. A comparative micro-analysis of diagnostic instruments in medical practice. Social Science & Medicine 73 (6): 851–857.

    CrossRef  Google Scholar 

  • ———. 2012. Distributed sleeping and breathing: On the agency of means in medical work. In Agency Without Actors? New Approaches to Collective Action, ed. Jan-Hendrik Passoth, Birgit Peuker, and Michael Schillmeier, 113–129. London: Routledge.

    Google Scholar 

  • Strauss, Anselm L. 1978. Negotiations. San Francisco: Jossey-Bass.

    Google Scholar 

  • Strauss, Anselm L., Shizuko Fagerhaugh, Barbara Suczek, and Carolyn Wiener. 1985. Social Organization of Medical Work. Chicago: University of Chicago Press.

    Google Scholar 

  • Strauss, Anselm L., Leonard Schatzman, Danuta Ehrlich, Rue Bucher, and Melvin Sabshin. 1963. The hospital and its negotiated order. In The Hospital in Modern Society, ed. Freidson, 147–169. New York: Free Press.

    Google Scholar 

  • Suchman, Lucy A. 1987. Plans and Situated Actions. The Problem of Human-Machine Communication. Cambridge: Cambridge University Press.

    Google Scholar 

  • ———. 2007. Human-Machine Reconfigurations. Plans and Situated Actions. Cambridge: Cambridge University Press.

    Google Scholar 

  • Sudnow, David. 1978. Ways of the Hand: The Organization of Improvised Conduct. Cambridge: Harvard University Press.

    Google Scholar 

  • Timmermans, Stefan, and Marc Berg. 1997. Standardization in action: Achieving local universality through medical protocols. Social Studies of Science 27: 273–305.

    CrossRef  Google Scholar 

  • ———. 2003. The practice of medical technology. Sociology of Health and Illness, 25 (3): 97–114.

    Google Scholar 

  • Wright, Peter, and Andrew Treacher (eds.). 1982. The Problem of Medical Knowledge. Edinburgh: Edinburgh University Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cornelius Schubert .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2019 The Author(s)

About this chapter

Verify currency and authenticity via CrossMark

Cite this chapter

Schubert, C. (2019). Repair Work as Inquiry and Improvisation: The Curious Case of Medical Practice. In: Strebel, I., Bovet, A., Sormani, P. (eds) Repair Work Ethnographies. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-13-2110-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-981-13-2110-8_2

  • Published:

  • Publisher Name: Palgrave Macmillan, Singapore

  • Print ISBN: 978-981-13-2109-2

  • Online ISBN: 978-981-13-2110-8

  • eBook Packages: Social SciencesSocial Sciences (R0)