William J. Mitchell, among others, has called our attention to the invisible network of radio signals that permeates twenty-first century society. Urban landscape has become all the more superimposed by an e-topia, a virtual territory that we access by means of an increasing number of electronic devices and gadgets. According to Mitchell, these gadgets have become “extensions of our mobile bodies” (Mitchell, 2005:182). They make up the technological accessory of daily modern life and merge our virtual and physical realities into a seamless whole.

From the perspective of contemporary medicine and health care, the emergence of this electronic habitation has yielded a set of new technologies by means of which the body can be observed in different ways. Digitization, miniaturization and wireless communication have paved way for a displacement of patient monitoring, health care advice, and drug delivery routines.

Healthwear technologies, i.e. portable devices that can be connected to the computer or the cell phone, are still in their initial phase. At least three different kinds of products and usages can be discerned.

1. Life style regimes
Gadgets that measure health quality indicators such as daily caloric needs, resting metabolic rate and sleep duration. Present-day sensor technology is easily attached to the body of the user. One wears it like one wears a watch, a pair of glasses or jewellery and uses it with the same ease as one brushes one’s teeth or sets the alarm clock. As stated on the homepage of BodyMedia, a company specialized in user-friendly healthwear technology, the purpose of these wearable healthcare registers is to encourage people to switch unhealthy habits for more healthier lifestyles: “Know your body. Change your life”. On the BodyMedia homepage, people who radiate of health and fitness, demonstrate products like the SenseWear®WMS Armband and the GoWear®Fit, two light wireless sensors that are comfortably worn while riding a mountain bike, going for a run or playing with the kids.

2. Home monitoring
Through healthwear technologies, patients can manage their medication and keep an eye on their conditions at home or while at work. Healthwear techniques like the MIThril system, a biosensor that measures pulse oximetry, respiration, blood pressure and blood sugar, are predicted to revolutionize medical health care in the 21st century (Pentland, 2005). Likewise, remote access of patient data in real time has become possible thanks to mobile health toolkits like Java-based middleware and Bluetooth-enabled sensors. In this manner, at-risk heart patients can have their blood pressure checked regularly via a specific interface that transmits the data from their mobile phone to the clinic. Not only do healthwear technologies make patients feel more reassured, they also heighten their awareness of signs and symptoms that could be life threatening. The fostering of health-minded citizens lies at the core of home monitored medicine.

3. Subcutaneous sensors
Recently, innovations in drug delivery technology have launched subcutaneous sensors as the next revolution in home-based health care service. Inserted under the skin, the domestication of clinical reading devices becomes twofold domestic; a technique employed at home and a technique which makes itself at home in our bodies. Biomedical engineers have pointed out hidden risks involved in wireless remote drug delivery (Wang et al, 2009). Patients monitored through wireless remote systems could easily fall victim to either malevolent intentions or harm caused by disturbances in the network systems. These new forms of personalized healthcare are vulnerable to the technological insecurities posed by hacking, cracking and jamming.

With the development of healthwear technology, the list of functions performed by means of portable electronic equipment is added with yet another usage, that of health maintenance.

Regarded strictly as material objects, the range of products that make it possible to tend, nurse and monitor oneself today, is difficult to tell apart from other electronic, computerized devices that facilitate communication, information flow, orientation and entertainment in the 21st century. Museums of medical history who wish to preserve and document the present may hesitate to collect healthwear techniques for this very reason. Wouldn’t museums of technology, communication and media be more appropriate places for these kinds of objects? And even if they were to be collected, how is one to display objects that look like they could have been taken from any broken down transistor radio or other home electronic equipment? The aesthetic motive for obtaining them is difficult to find. However, if we shift focus from form to function, a number of issues that open up for museological consideration, promptly come to mind, issues that both relate to the older collections that medical history museums normally hold as well as to spatial/institutional/professional boundaries that have determined the relation between doctors and patients historically.

So, for instance, the issue of keeping the body under constant observation via various recording and registration apparatus is one that is well represented in most medical history museums. From manually driven sphygmographs to modern EEG-registration equipment, the ideal of rendering the physiological body traceable to the eye constitutes a significant part of modern medicine. Today’s healthwear gadgets do not seem to have much in common with the bulky brass instruments that medical scientists used in the late nineteenth- and early twentieth century. Yet, they nonetheless build on the same principle of continuous registration and omnipresent observation. Through digital technology, miniaturized sensors and wireless transmission, the scope of physiological registration has extended beyond the laboratory and the clinic and merged with the pace of everyday life. This transference of medical technology does not only imply the actual domestication of experimental and clinical measuring methods as such. Above all, it entails the implementation of clinical values such as ubiquitous monitoring, rigorous precision and steady access to the vital functions of the body, into the domicile sphere of wireless network society.

Healthwear devices and ubiquitous health monitoring also imply the question of surveillance and contemporary debates on how notions of private and public have imploded in network society. This particular aspect is also well represented in medical history collections were instruments such as endoscopes, ophthalmoscopes, laryngoscopes and speculums, evoke medicines scopic regimes. While these techniques of medical examination, depended fully on the proximal relation between the one doing the observation and the one being observed, contemporary techniques build rather on systems of telepresence, electronic mediation, digital networks and image databases. This disintegration of the spatial unity in which bodies and gazes once where inscribed, has not only had considerable implications for diagnostic procedures. It has also had bearing on the means through which patients are rendered observable in the name of health. But then again, in a culture saturated with surveillance cameras, webcams, cell phones and social media, 24-hour health monitoring at home or while at work can only make sense.

Both of these issues, ubiquitous health monitoring and surveillance, have in one way or another to do with the question of what it means to be a patient today. Concepts such as biological citizenship, personalized medicine, Virtual patients, Patient 2.0 and Informed patients indicate that the role and identity of patients might be undergoing significant changes in contemporary society. From the point of view of the patient, technologies like the ones described above, are clearly altering the relation between physicians and patients. This relation which is so distinctly ingrained in museum objects such as dentist chairs, ophthalmoscopes and stethoscopes, is not as evidently present in portable healthwear devices. Not only that the correlation between expert and layman is spatially disintegrated. It so happens that the layman is taking over some of the tasks that traditionally have been carried out by the expert; applying the device to the body, checking with the user manual, making it work, becoming aware of it’s signs, if it is not functioning correctly, in short learning how to operate the medical technology and of course learning how to live with it. So, if not as objects to display in their own right, these gadgets can, alongside items from the older collections, contribute to the discussion of where medicine is taking us today.

References:
- Mitchell, William J. (2005) ‘Homo Electronicus’ in Placing Words: Symbols, Space and the City, Cambridge; MIT Press, 181-185.
- Pentland, Alex (2005) ‘Healthwear: Medical Technology Becomes Wearable’, in Renata G. Busko (ed.) Future of Intelligent and Extelligent Health Environment,
Amsterdam: IOS Press: 55 – 65.
- YanYan Wang, John Haynes and Carey Thaidorf (2009) “Security risks for remote intelligent Pharmacy-on-a-Chip delivery systems”, Int. J. Biomedical Engineering and Technology, 2009, 2, 135-151.
- http://www.bodymedia.com

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