in North America. By way of data collected via interviews, analyses of documents, participant observation, and informal exchanges, she (Martin 1994: xvii) found that “flexibility is an object of desire for nearly everyone’s personality, body and organization.” Flexibility is associated with the notion of the immune system which now underpins our thinking about the body, organizations, machines, politics, and so on. In her interviews with ordinary men and women, the idea of developing a strong immune system appeared to be in common currency. To be effective, that is to protect the body against the threats of disease and illness, the immune system must be able to change and constantly adapt.
These notions of immunity found on the street reflect those found in laboratory science where immunological understandings of immunity transformed from understanding of an immune “self” working to defend and discriminate against the foreign “non-self” (Tauber 1995). Tauber documents the fragmentation of the self-versus-non-self (S/NS) system, as immunological understandings of, for example autoimmunity, chimerism, transplantation and parasitism come to see the immune system reconfigured as an “immune-nervous system” with the creative capacity to be “over-written.”
Cohen (2009) in his book A Body Worth Defending finds congruence between judicial, political and biological cultures. Network conceptions of immunity displace bounded systems in all these spheres in ways that have led scholars to reflect on immune-political life (Davis et al. 2016) and the begin to forge a “biopolitics of immunity” (Brown and Nettleton 2018). Brown points to the merits of Italian philosopher Esposito’s (2008) notion of an “immunity paradigm” in which the political and biological become inextricably intertwined. While modernist notions of immunity implied enclosure, protection and defense, we now recognize that immunity also requires a degree of openness, “hospitable forms of immunity” that can “preserve life” (Esposito 2008: 53–54). Perhaps, the most readily obvious examples are organ transplantation and vaccination. The latter involving the introduction of a pathogen for individual and collective benefit, something Durkheim (1982) recognized when writing about how by inoculating ourselves with smallpox, where a vaccine increases our chances of survival through collective, herd immunity. The biopolitics of immunity are foregrounded in these and other immunological matters, for example debates on antibiotics and antimicrobial resistance are found to manifest as debates on public politics and personal responsibility (Brown and Nettleton 2017, 2018). What this scholarship offers is not only provides a valuable analysis of late modernity but also reveals how our accounts and interpretations of our bodies are historically and socially contingent, and that they are not “immune” from broader social transformations (see also the discussion about the work of Elias above). How we experience our bodies is invariably social, and one of the central thrusts of modern times is the sociology of the body that we feel compelled to work at creating a flexible and therefore adaptable and socially acceptable body.
The Body as a Project
Shilling (2012) also argues that the body might best be conceptualized as a “body project”; an unfinished biological and social phenomenon, which is transformed, within limits, as a result of its participation in society. The body is in a continual state of “unfinishedness;” the body is “seen” as an entity which is in the process of becoming; a project which should be worked at and accomplished as part of an individual “self-identity” (Shilling 2012: 4). Body projects become more sophisticated and more complex in a context where there is both the knowledge and technology to transform them in ways that in the past might have been regarded as the province of fiction. There is a vast array of medical technologies and procedures to choose from if we want to shape, alter, and recreate our bodies – from various forms of techniques to “assist” conception, to gene therapies, to forms of cosmetic surgery and so on.
These projects are also gendered as illustrated by Brumberg’s (1998) feminist historical analysis of adolescent girls where she finds the contemporary imperative to perfect the appearance of the body displaces the constraints imposed by the social conventions and restrictions placed on young women in the nineteenth century. There is, of course, an irony here. As we expand our freedoms, knowledge, technologies and expertise, to alter bodies we become more uncertain and insecure we become about what the body actually is and what its boundaries are. And yet it also seems that as the opportunities to work on our bodies proliferate they coalesce around a limited range of repertoires that are rooted in ideologies of individualism. This is evidenced by Gill et al.’s (2005) study of body projects and the regulation of masculinity. Based on 140 qualitative interviews with men aged between 15 and 35 from differing regions in the UK sampled to ensure representation of class, race, and sexual orientation found the authors found “an extraordinary homogeneity” ran through the men’s talk (p. 56). There was a shared set of discourses that were consistently embraced the merits of: individualism and being different; libertarianism and having an autonomous body, rejection of vanity and narcissism, the value of being well balanced and not obsessional and the importance of being a morally responsible body. Men’s body and identity talk the authors argue is structured by a “grammar of individualism” (p. 57).
Bio-value and Virtual Bodies
Whilst the above discussion has highlighted the body as an unfinished and malleable entity which has become central to the formation of the late modern reflexive self, other postmodern analyses have suggested that the body is not so much uncertain as un/hyperreal. In other words, the body has disappeared – there is no distinction between bodies and the images of bodies. Drawing on the work of Baudrillard, Frank (1992) challenges the conventional idea that the body of the patient forms the basis of medical practice. It is the image of the body which now forms the basis of medical care.
Real diagnostic work takes place away from the patient; bedside is secondary to screen side. For diagnostic and even treatment purposes, the image on the screen becomes the “true” patient, of which the bedridden body is an imperfect replicant, less worthy of attention. In the screens’ simulations our initial certainty of the real (the body) becomes lost in hyperreal images that are better than the real body. (Frank 1992: 83)
The “Visible Human Project” (VHP), described on the US National Library of Medicine, National Institutes of Health website as:
the creation of complete, anatomically detailed, three-dimensional representations of the normal male and female human bodies. Acquisition of transverse CT, MR and cryosection images of representative male and female cadavers has been completed. The male was sectioned at one millimeter intervals, the female at one-third of a millimeter intervals. (National Library of Medicine 2008)
Fascinated by this undertaking, Catherine Waldby (2000) subjects the VHP to sociological scrutiny and highlights some intriguing features. Not only do images of the inner reaches of the body become accessible to a wide audience, but also the transformation of bodies into a “digital substance” contributes to the blurring of boundaries between the real and the unreal, the private and the public, and the dead and the living (Waldby 2000: 6). She argues that the whole exercise represents a further extension of Foucault’s notion of bio-power. The VHP is at once a means of both examining and experimenting on the body and, therefore, it is also a means by which knowledge of bodies is generated and circulated.
In addition, the establishment of knowledge contributes to the production of “surplus value” in that there are significant commercial interests that benefit through the related production of medical technologies be they equipment, drugs, and so on. This is what Waldby calls “biovalue,” which refers to the yield of vitality produced by the biotechnological reformulation of living processes” (Waldby 2002: 310). Two factors precipitate the generation of biovalue. First, the hope that biotechnologies will result in a better understanding and thereby treatment of disease. Second, the pursuit of exchange value of biomedical commodities – be they patents or pills – that are the yield of the interventions. Indeed, biovalue is “increasingly assimilated into capital value, and configured according to the demands of commercial economies” (Waldby 2000: 34).
