Fox, Nicholas J. (1989) Surgical healing, power and social structure : an ethnographic and historical study. PhD thesis, University of Warwick.

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Abstract

How the everyday activities of surgery mediate and reproduce
surgical authority and privilege is studied by ethnographic
study and interview material in and around the operating
theatres of a large district general hospital, on surgical
wards, and in a day surgery unit, using a case study approach.
Routinised movements of staff, patients and instruments within
the operating theatre suite (0T) order the activities by which
patients pass through surgery. These movements are structured,
and culturally designated, to ensure the safety of the patient
during the dangerous transgression of boundaries in surgery.
The history of surgical sterility indicates the symbolic
significance of sterile garb, to mask the polluting bodies of
the surgical staff and designate them purifiers of corrupting
nature. Sterile techniques signify the superiority of cultural
definitions over those based in 'nature'.
While the surgeon is concerned with a patient's Illness, the
anaesthetist is concerned with her/his Fitness. This interaction
enables all operations other than those where both Fitness
is reduced and Illness is not reduced, to be proclaimed
'successful'. Consequently, patients may be allocated a
socially defined status of 'healed', despite no improvement in
physiological status.
Cross-cultural comparison suggests that surgical healing
involves a social status passage from a negative status of
victim to a positive one of survivor. Healing is socially reintegrative:
it re-creates apparent congruence between the
life-scales of the sick person and social structure, which is
destroyed by illness.
Case studies refine the hypothesis that this social recategorisation
legitimates surgical authority and privilege.
Both the operation's 'success' and patient discharge are found
to be necessary for a full claim to have healed.
The potential to generalise the model to all medical
intervention, and the implications for surgery and the
sociology of health and healing are discussed.

Item Type:	Thesis (PhD)
Subjects:	R Medicine > RD Surgery
Library of Congress Subject Headings (LCSH):	Social medicine, Surgery, Healing
Official Date:	April 1989
Dates:	Date Event April 1989 Submitted
Institution:	University of Warwick
Theses Department:	Department of Sociology
Thesis Type:	PhD
Publication Status:	Unpublished
Extent:	ii, 363 leaves
Language:	eng

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