Doing Expertise in Transnational Hospital Settings

• In Event: Unpacking Expertise - III: Boundaries, Technologies, & Translation

Abstract

This paper considers how expertise is done in transnational hospital settings where particular material or ideational global flows converge to accomplish medical care. It proposes and develops the concept of “expert assemblage” to make sense of the contingent and unstable combinations of heterogeneous human and nonhuman elements that form and disperse during outpatient hospital visits of immigrant and refugee patients. It draws its analysis from 9 months of fieldwork in 2012 that included following 69 adult immigrant and refugee patients in one hospital in Maine and observing encounters with healthcare interpreters and clinic staff. First, it looks at how assemblages of architectural elements and human and non-human actors participate in producing knowledge and configuring power relations (Bell 2018). The accumulated history of the hospital gives it multiple layers of different sets of local and global linkages. In this respect, the hospital is both a unique point of intersection and a place that is extroverted and connected with the wider world, an articulated moment in networks of social relations and understandings (Massey 1994). Second, it looks at healthcare interpreting, practiced in highly diverse and dynamic clinical environments, with patients drawn from communities characterized by a complex interaction among race, ethnicity, immigration, culture, and geographical mobility. It asks who has the right to produce knowledge and make normative judgements where the patient and clinician dyad is expanded to include remote or face-to-face interpreters. It concludes by reflecting on the contribution of “expert assemblage” to STS perspectives on “expertise.”

Author

• Susan E. Bell, Drexel University