Annemarie Mol likes to tease. Her literary template is the detective novel and her conversational style, full of asides, verges on a manipulative confessional. She likes to tease. Her multiple body is not in the library (like Agatha Christie’s) nor is it being viewed by Lord Peter (as is Dorothy L Sayers’). It is being enacted by the cast of a hospital somewhere in the Netherlands, particularly in relation to atherosclerosis. Quite what atherosclerosis is, is what the book is about. It is an exercise in ontology, the study of things, using atherosclerosis as the thing to be studied. Or rather, the set of nested, spread around and organised things she finds in this hospital when she goes on the trail of so-called ‘atherosclerosis’.
The book-club interrogated The Body Multiple¸ an Actor-Network-Theory (ANT) account of a disease in a hospital, straight after Latour’s Reassembling the Social, a handbook for doing ANT. It was good to have an extended example of ANT to think about the application of Latour’s five uncertainties and his exhortation to ‘go slowly’. Elsewhere, Annemarie Mol has called ANT ‘an adaptable, open repository’ and her approach here is flexible and simultaneously inward and outward looking. Irritating some book-club members and pleasing others, The Body Multiple has a running commentary on its own text that locates the text in the bigger picture, a device like the voice-over of the hardboiled detective in a film noir.
Mol’s purpose in the first text is ‘to investigate the way tensions between sources of knowledge and styles of knowing are handled inside present day allopathic medicine’ (p.1). What she finds is not a single thing but multiple things, enacted by different players in different parts of the hospital in different, often incommensurate, ways. The chapters follow the three main ways in which these competing and conflicting objects are managed in the hospital: through coordination, through distribution and through inclusion.
Mol’s own assessment of both her investigative and reporting style is that it is ‘reflective rather than argumentative’ (p.viii). No finger poking Kojak here. She spent a lot of time in this hospital, not spying but observing. She used observation as ‘a means to get to know their [the actors] standards rather than an occasion to apply my own’ (p.3). Annemarie does not like to commit.
She resist the sociological model that adopts the position of The Help; one that grants medicine its dominion over the body then meekly claims there ‘is more to tell about sick people than is told in biomedicine’ (p.12-13). This rejected model takes the body as given but adds the social, sociology sitting alongside medicine with each investigating in their own domain. Instead medicine is one of the ways in which the body is enacted (a powerful one, but still one among many). And her approach to investigating objects is one about doing rather than thinking. She suggests researchers should ask people ‘about what they do and about the events that happen to them rather than about their thinking’ (p.16). This is one of the ways she demarcates the object/s. The study is an attempt to ‘attend to enactment rather than knowledge’ (p.vii). It is a ‘story about practicalities. About events’ (p.53).
Mol’s claim is that we live in a world of enacted objects, including (quintessentially) ourselves. The idea that personhood is performed has been around for a while. Mol relates to Judith Butler’s claim in Gender Trouble (1990) that identity “is not given but practiced. The pervasive and mundane acts in which this is done make people what they are”. Rather than the more common ‘performance’ Mol prefers the term ‘enactment’ (p.33). She sees herself as having carried out a praxiography of a disease. Crucial to the enactments are the tools used to enact with. In some departments of the hospital ‘several critical requirements for enacting atherosclerosis’ in other modes are missing (p.35) and so the disease is enacted in a different way. The way the disease is enacted is different in different departments and is related to what people do there and what they use to do it. When incompatible enactments collide (not least because ‘there are clashes between the knowledge articulated in technoscience societies and the knowledges embedded in their practices’, p.31), Mol finds that what triumphs is the stronger account, the one that can be imposed. She quotes Latour’s dictum ”The strongest reason always yields to the reason of the strongest” (p.108). Medicine, like science, is not the objective application of procedures but an exercise in power.
Reflective, teasing, meandering. The Body Multiple is a Marmite book, thoughtful and stimulating for some, overly poised and exasperating for others. Suck it and see.