Thesis: [p168] "When the work of classification abstracts away the flow of historical time, then the goal of standardization can only be achieved at the price of leakage in these classifications systems."
[p165] TB was a horrible problem and was difficult to classify. Classification and bureaucracy is a fourth strand of science and tech studies along with nature, culture and discourse. [p169] Why has TB disappeared?
There are multiple causes that were poorly understood.
[p172] The ICD has a hard time classifying it because it is based on a cause and effect representation that resembles blanks on a form.
[p180] TB patients got different privileges based on a classification of how good their health was.
[p183] TB patients argued with the uncertain standards and looked at their own privileges as earned by time rather than the state of their health. Doctors sometimes did this too. Timetables are created.
In the TB sanitorium, time takes on a different character. It's slower and disconnected from the rest of the world.
Timmermans (1996) notes the importance of the identities attributed to patients during the course of a disease [p187]. For example, when giving CPR, the identity is of the body-machine.
The Strauss-Corbin model includes 2 trajectories, body and biography. Body is the state of the body's health; biography is the normal life of the patient (appointments, work, etc.) The authors wish to include a third trajectory, as seen on p 191, the role of classifications. Patients try to fit their experiences according to the metrics and classifications used on them at the time.
The classification of TB is based on space. Which body? Which part? It breaks down when thinking about TB over time, because the vocabulary used to describe changes over time is impoverished. [p192]. Medical texts differ from paient accounts of time in that patients view their sickness cyclically.
Discussion questions:
This chapter argues against a simple-minded, pure-type classification system and in favor of complexity when applying racial categories. [p218]
[p223] Torque: "the twisting that occurs when a formal classification system is mismatched with an individual's biographical trajectory, memberships, or location."
Thesis: categorizing people causes torque, particularly for those between categories.
Discussion Questions:
Making a good classification scheme involves tradeoffs: visibility and control vs intimacy; comparability and visibility against manageability; comparability and control against standardization.
Comparability: regularity in what gets classified as what.
Visibility: Things in the "other" category.
Intimacy: Instructions need not be voiced because all involved with the use of the classification know it intimately.
Control: Reigning in the wildness. Too much wildness means non-managability.
Some categories in the Nursing Interventions Classification (NIC) are extended over time (e.g. humor) and others are more short (reduction of nose bleeds). [p133] Data was taken from analysis of NIC meetings, publications and interviews. [p237]
The classification itself helps define nursing as a field on its own, with its own body of knowledge.
At one time indirect care (like checking a chart) was not classified, and thus nurses were not reimbursed for it. This is an example of an "invisible" category.
The visibility aspect of the classification sometimes conflicts with how they want nursing to look to the public. [p248]