Sounds & Medicine

"During auscultation, the diaphragm, the small, generally circular disk at the end of the stethoscope, is applied at a series of designated points which are known to offer the best acoustic perspective on the organ, or section of organ beneath. This creates a particular auditory focus on a small part of the body – a single heart valve, for example. Through an intense auditory concentration, the listener then isolates a particular sound, momentarily excluding other noise coming either from the patient’s body or the surrounding environment. Auscultation allows individual sounds to be heard in such a way that they are drawn apart, made the distinct objects of acoustic scrutiny. The length and elasticity of the stethoscope creates distance between the doctor and patient. For Jonathan Sterne (2003), the significance of this separation is perceptual rather than spatial. It makes “distance between knower and known” and reflects the doctor’s disengagement from all but the body sounds of the patient (ibid.: 196). He or she can obtain a kind of detachment, independently evaluating the significance of the heart sounds as empirical signs. The stethoscope allows the doctor to operate in what Sterne describes as “the quiet, rhythmic, sonorous clarity of rationality” (ibid.: 215)." as “the quiet, rhythmic, sonorous clarity of rationality” (ibid.: 215)."

"While patients report negative experiences of feeling “objectified” through auscultation, value judgments should not be attached to objectification per se. Objectification may be understood as a key perceptual strategy in the production of medical knowledge, the conceptualization of the body and disease. Also, as Lewis (2000) and Jackson (1994) point out, objectification can be valuable inorganizing and structuring illness experience and responses to symptoms within biomedicine. The tendency of stethoscopic listeningto objectify patients in negatively experienced ways may, however, be used to debunk the vague myth that hearing is somehow an intrinsically positive, receptive and benevolent sense, creative of inclusive and sympathetic cultural systems. The voices of patients suggest otherwise."

Tom Rice “Beautiful Murmurs”: Stethoscopic Listening and Acoustic Objectification. The Senses and Society, Volume 3, Number 3, November 2008 , pp. 293-306.

Tom Rice describes his project:

This research explores the importance of sound in the context of a London Hospital cardiology unit. It presents a detailed analysis of the acoustic dynamics of day-to-day life in that environment, but also examines the role which sound plays in diagnosis through auscultation (listening with the stethoscope) and cardiac ultrasound or echocardiography. Sound is shown to be integral to the construction and imagination of the body, being strongly implicated in the processes through which clinical diagnosis is performed. The research also draws on illness narratives in detailing the impact which acoustic events, particularly those created during the application of diagnostic technologies, can have on a patient's individual ‘illness experience’. It builds on a growing interest in the senses and sensory experience within the social sciences, and reflects a developing enthusiasm for auditory culture studies which provide critical insights into the deep-seated visual bias through which the social sciences have traditionally constructed and analysed culture. The research galvanizes sound and sensory economy as an important issue in understanding the lived dynamics of public and private space, commenting on how people seek to create, control or resist the particular sounds which they encounter within institutional contexts.

Pictures from the performances of Chiharu Shiota: 1) In Silence, 2007. 2) During Sleep, 2002