Patient-centered record

“ . . . the patient-centered record became a crucial actor in the performance of a new mode of embodiment (Berg & Bowker, 1997). . . . Partly mirroring the compartmentalization of the hospital organization, a compartmentalized yet unified body emerged here, in which organs or organ functions are each allotted a separate section in the file, or a separate portion of a preformatted form. In the interrelation of proliferating techniques, patient-centered record, doctors, nurses, and the patient, a body emerged whose dimensions do not map the everyday sites and events on the ward or in the clinic. This body extends in an anatomical/pathophysiological space and time which is traveled by blood cells and growing tumors, and which is explored through urinalysis and endoscopies (Berg & Harterink, 23-24). . . . “the new space-time that emerged between the covers of the record was a novel phenomenon. The embodiment of patients was loosened from the workings of the day-to-day life networks that permeated the hospital walls; the space-times that doctors now traveled in were less and less measure by moral worth and social standing. Rather, studying the X-rays and other forms, doctors could enter the space of a tumor that grows, or a fracture that heals (24). . . [This temporality is exemplified in the graph,] transcriptions that transform events occurring in the space-time of a hospital ward or laboratory into repetitive phenomena, occurring in and linking across a linear time that is lifted out of the ward’s time zones. . . . They establish a historical continuity in a double sense. The graph’s grid, first extends reassuringly into both the past and the future: the grid’s basic structure in unbounded and completely regular. . . In addition, a historical continuity is produced because the graph is accessible at any moment. The specific tracing can be rescrutinized at any later time; it can be compared to other processes, of other physiological entities, or of the same individual later in time” (25-26). . . . Compared to the series of disjointed, brief narratives in a casebook, the patient-centered record affords a physiological historization of the body in myriad ways (27). . . . Processing the body in medical practice, [now] had also become embodying the patient-as-process. . . . The patient-centered record performs a historized body; it invests the patient’s body with a linear, accessible and continuous history. . . . Recurrent tests now subjected patients to daily routines . . . Likewise, therapies began to perform the body-as-process (28).