Steven Mentor
Department of English
University of Washington
Seattle, WA 98195
Chapter for Davis-Floyd and Dumit, eds., Cyborg Babies: From Techno-Sex
to Techno-tots (Routledge, forthcoming)
1995 by Steven Mentor
It is a fact of life in the late twentieth century that technoscience lends itself to locutions out of The National Inquirer ("Woman gives self caesarean") and The Sun ("Gorilla Has Human Baby"). My wife Margann and I have struggled with both infertility and with its "cures" for many years, and our experience with In Fertilization (IVF) could easily yield such medicine-bites-dog stories: Doctor suppresses woman with her permission! Pornography found in andrology lab! Miracle process harvests eggs from inside woman's body, then puts them back!
Regardless, here are the facts: female infertility leading to high tech surgery followed by "natural" conception and then "unnatural" ectopic pregnancy, followed by even more high tech medicine followed by "unnatural" conception and then natural pregnancy, all coming to a head (!) when our baby, Bailey, emerged from his mother at 4 am on Summer Solstice, born at home with midwives attending.
His first view of life on earth was his father's face peering down at him, and the ceiling fan.
So, our first narrative genre is a comedy: all's well that ends well, as you like it. I could show you pictures. And the pictures would do what all pictures do: make some things visible at the expense of making other things invisible. We don't have pictures of the daily needle injections (addicted to breeding?) or the lapyroscopic view of Margann's ova follicles, though we do have the quintessential 90's baby artefact, Baby's First Ultrasound. These pictures side by side in the wallet would show the ghosts in the machinery of reproduction: behind, as it were, the organic coherent body (and he does look cute in that outfit) an entire techno-journey, a Nova special of the interior of the uterus before conception, the endometrial lining as jungle/future cultivated land.
Or I could tell you stories. But is IVF a comedy, or a tragedy? Romance of miracle technology, or farce of Frankenstein human reproductive and genetic engineering? Consider, if you will, a (not the) primal scene. Fall, 1995. My wife is lying on a hospital bed, sedated with Versed. It is nine in the morning by the large clock. The room is square, white and chrome. In the room are a nurse, an andrologist, a patient's advocate. Also in the room is a fine needle attached by Teflon tubing to a transvaginal ultrasound probe and a vacuum regulator and pump. We're waiting for the doctor to arrive and aspirate Margann's hyperstimulated egg follicles. The andrologist wheels in the humidicrib - the 37 degree controlled environment box the eggs will end up in - containing a stereomicroscope and petri dishes. I chat with the nurse, with the andrologist, they chat with each other. In a back room the radio is on; it's playing classical music of some kind: loud but low fi.
As the minutes pass I find myself split between two worlds and two paradigms for this reality. On the one hand, I am trying to stay present emotionally for my wife; this is a serious if not necessarily life threatening procedure, and it will involve some degree of pain for her. So I hold her hand, stroke her forehead, worry, try to stay calm. At the same time, I'm drawn into the surgery room banter. Television remotes; the nurse tells a story about how men control them, always flipping between stations; the andrologist confirms this, telling a funny story about her husband; I defend channel surfing, so does the advocate, and there's a lot of laughing and teasing of the male doctor when he arrives. He starts to rib the andrologist...
And all of a sudden I'm in the Twilight Zone. It's not a hospital, it's a...garage! And my wife is the car and these are the greasemonkeys, down to the bad radio blaring and the power tools. I feel a surge of anger at this; how could they treat my wife's body as if it is a machine? Then I waver - no; it's just that they've done this so many times it is mechanical for them, it shows confidence not disrespect. After all, I'm in their shop/hospital.
The entire time I flip back and forth between worlds. The body and/as the machine; machines and humans making humans by turning humans into machines; my wife's body as an organic, whole thing and her body as a car up on blocks. The heroic humanism of a symphony - Brahms First? - pathetically reduced, bravely escaping the tinny speakers of a little music machine; the amazing ultrasonic vision of human ova delicately enticed out along a tube, each journey ending with the terse "Got it" of the andrologist bent over her microscope. Each time we hear it, we as a group get that thrill, and I get the ghost of a chill.
This complex set of feelings, this hybrid of machinery and human bodies - this is a primal scene of IVF. Following Bratton (1995) I argue that this experience of schizophrenia may help guide us through the social and cultural production of reproductive science and technology. I've come to believe that our relationship to reproductive and most other technologies in the late 20th Century is fundamentally schizophrenic and ambi-valent. Different voices tell me that IVF, for example, is simply science giving infertile women and men more choices, or simply science making progress in knowledge and over ignorance/s, or simply patriarchal eugenics or techno-apocalypse. Each voice, each text wants to keep its body pure, its boundaries intact, but just as women's bodies are dis- and reassembled in cyborg technologies of reproduction, so too linguistic bodies representing these technologies fragment, circulate in a larger linguistic economy, trade metaphors and transform figures. It is this parallel linguistic economy that I wish to invoke/explore in this paper; within this economy, strategies of naturalization and legitimization are crucial, for they reveal the always/already constructed nature of birth as well as its cyborgian transformations well underway in 1995 (Clarke, 1995). Textual bodies are constructed out of lending discourses, multiple genres, and reflect the political tensions and body anxieties of postmodern reproductive biotechnology.
Late 20th Century humans are faced with staggering decisions: which transforming technologies to use, when, on whom and with whose permission, for whose benefit. Much of the ethical debate surrounding IVF ignores the politics of its language. Naturalizing strategies obscure the shadows of a technology; in turn, resistance strategies that rely on apocalypse narratives often miss the narrative resonances and figural depth of naturalized technologies, and thus often fail to raise objections effectively (Killingworth and Palmer, Cohn). I want to suggest a notion of cyborg competencies: an ability to see the myriad ways humans are intimately connected with technologies (including textual and representational technologies), and to make decisions based on a more hybrid, intertextual notion of meaning/s making. Seeing, for example, both hospital and home birth as itself the site of technologies, many of them subjugated knowledges, may help (some) us depathologize reproduction and birth, place it along a continuum of technologies. The alternative is schizophrenic dual dystopias, where conception, gestation and birth are routinely hospitalized, narrated and surveilled by high technology, de facto genetic engineering and protocols of paranoia, while home birth is further criminalized, its technologies driven more underground.
Off of/into the supposedly coherent body of IVF jut various textual prosthetics: medical realism mixing with science fiction, discourses of animal breeding, eugenics, progress, marketing, all violating each other's boundaries. The "object" is a collage whose figures become ground for other figures, a discourse that constantly disassembles and reassembles genres (Ulmer, 1983); linguistic Legos for adults. The cyborg figure helps us see IVF as a hybrid of human and machine, as physical practices and textual practices. IVF combines old and new reproductive technologies, modern and postmodern economic constructions, multiple genres of representation and rhetoric (including "organic" narrative bodies and "systemic" scientific rhetoric that end up shading into each other). Cyborgs are made, and help us see, retrospectively, the constructed nature of conception and birth, their narrative technologies and conflicting genres, and, prospectively, the processes of "naturalization" alien biotechnologies (and their equally alien resistances) undergo. Successful technologies mobilize multiple narratives along networks that reveal economies of (asymmetrical) power. Any attempt to resist or modify IVF and reproductive technology will have to confront the network of legitimizing narratives, and also take responsibility for its own technologies of birth, even those dubbed "natural."
In this essay, I analyze the legitimizing and naturalizing narratives of IVF and postmodern reproductive technology as seen in various semipopular texts (pamphlets, newspapers, popular and professional magazines, fiction, ultrasound imagery). I link these analyses to moments in my own narrative of infertility, technoconception and midwife assisted home birth. For both IVF and home birth/midwife narratives, I want to ask: What role do different cyborg discourses play in legitimizing, naturalizing, helping people make sense of, the new technologies? What do these narratives hide/ignore?
Not only journalistic approaches to reproduction but also academic approaches pretend to stay within generic bounds, ignore internal contradictions in favor of false closures, and fail to explore the situated knowledge of their production. Technology like IVF is overdetermined, a network or confluence of several types of narrative and discourse tied to larger cultural narratives (Davis-Floyd, 1992) Therefore my writing wants to be a cyborg to simulate that confluence, to immerse us in different types of narratives and generic representation and its effects, as well as continually search for both political analytic and critical clarity (which technology, which control or choice or transformative ability is good for whom?) and move toward finding silences and suppressions and shadows of current biotechnological "advances." Rather than ex-plain (i.e., "flatten") contradictory voices and narratives, choose one voice or story to be master, I want to immerse you, gentle reader, in these contradictions, while also deploying, bricoleur-like, different tools of discourse analysis, to periodically pluck us out of the flood/network for a moment. The goal is not to hang, de-pend, on the purity of analysis, but to catch our breath for the inevitable reentry into the net of discourse, the schizophrenic stream of voices.
IVF and reproductive technology as a body is invaded by all sorts of prefiguring discourses, including the abortion debate (when does life begin? when is an embryo a person?), genetic engineering (with its implications of engineered life, controlling reproduction at the microscopic level) embryo research (arguably the driving force behind much early research that resulted in IVF), eugenics, and animal husbandry . Just as technologies and techniques circulate now through the body of human reproduction, terms from these discourses circulate through the linguistic economy of IVF. This intertextuality mirrors the strategies of feminist and other resistances to the medical model and pathological models of pregnancy: both are hybrids that borrow from widely differing genres and discourses.
This doesn't mean that IVF or genetic engineering or homebirth are "just" language. "Post structuralism and intertextuality both suggest that social practices are always mediated by modes of thought which are themselves practices whose immediate expressions are linguistic." (Shapiro 1988) Because IVF is a relatively new body of knowledge, we can witness the construction of privileged representations, both within scientific texts and crucially within science journalism and popularizations of IVF. Shapiro stresses looking at the "social depths" of certain forms of representation (in this essay, gambling and miracle metaphors). Potentially monstrous (because alien) languages are normalized and naturalized, partly by borrowing from other, uncontested discourses (Clarke, Shapiro). We need to ask why this figure is dominant, why these others are subjugated. Linguistic productions/fictions are zones of contested meanings: is it "genetic engineering" or "biotechnology"? Is IVF therapeutic or experimental? Driven mainly by concerns for women or for fetuses? This means looking at the recent history of IVF discursive practices and representation. Different conclusions imply differential engagement of the stock of signs and metaphors/discourses with which people make their everyday lives intelligible. People tend to "naturalize their lived structures of intelligibility" (Shapiro 1988) and so fail to see historically developed constructs of authority and legitimation built into those structures. Hence the immense power of representations which accommodate these naturalized forms of the 'real' (including what I will call "medical realism" in this paper).
So to understand IVF we must historicize the production and acceptance of prevailing representational practices; and we must understand the economies of those representational practices, ways they achieve their value effects. What "lending discourses" lend is precisely social depth, global currency, the effect of the "natural" and so conceivable. This means that to contest dominant figures and narratives, you must produce alternative networks, themselves impure, constructed, cyborgian collages. One alternative to the metaphors of gambling, apocalypse and pathologized birth I discuss below is the notion of cyborg competencies. We might ask, what competing ways of narrating IVF exist? How are different readers able to tolerate contradictions in the discursive modes through which thinking about IVF is produced?
When Margann and I leave the IVF clinic, we leave with a lot of reading, including one of the ubiquitous Serono pamphlets on infertility therapies. It is exactly the same size as Witches, Midwives and Nurses, and so the two texts sit side by side on my bookshelf for the duration of the IVF cycle and subsequent pregnancy. I now think that the Serono pamphlet is one side of the Janus faced medicine that Ehrenreich and English discuss: the sober, clinical, reasonable, careful prose of Science. It reflects a master Fiction: that science is beyond fiction, beyond the rhetoric of persuasion.
Alan Gross argues that scientific discovery is properly described as invention, where invention "captures the historically contingent and radically uncertain character of all scientific claims, even the most successful." (Gross, 1990). And implicit in all scientific texts is persuasion, because only through persuasion are importance and meaning established in scientific inquiry. I want to ventriloquize the pamphlet as a technology, make it speak its unspoken strategies that lie behind its powerful reality effects.
The pamphlet is titled ART: Assisted Reproductive Technologies, by Serono Symposia USA. Serono is in small letters, as an author would be; but below this is a large logo Serono, with a corporate motto ("The world leader in infertility therapy"). This same logo is repeated on the back, along with a graphic depicting (presumably)the nuclear family. The graphic (figure one) deserves some comment. The heads of the two parents are schematic enough to be any race, even any sex; their mouths are separated from their faces by the outline of the child's head, creating a surreal image of infertile couples as expressionless and fertile couples as returned to language and expression. The child's head is huge, immense, unrealistic as a Byzantine ikon; its face is trisected. Sitting in the clinic waiting room, I stare at it as if it was one of those images that defy one reading: the young woman and/or the old crone. Two faces or a goblet. But I kept seeing the picture of a child who has been assembled: brain section, face section, with a middle headband section that could also be a helmet. The whole square resolves into a jigsaw puzzle of fragmented humans, which ends up being a fairly accurate image of IVF technology in a cyborg world.
When you open the pamphlet, you see what looks like a preface by the author, but which is really a discussion of the authors (Drs. Asch and Marrs) by the authorizing institution. In case this isn't clear after reading, the authors' names are boxed in the left hand corner of the inside cover. If the authors represent the human face of IVF therapies, they in turn are actually authorized (or in the terms of the preface, "produced") by the economic bodies of corporate and academic biotechnology. The pamphlet's scientific prose, with its rhetoric of factuality, is always/already embedded in a deal: you are reading this in order to buy or not buy a therapy. Serono Laboratories are the sole purveyor of Pergonal (a widely used fertility drug) in the US, though the pamphlet somehow fails to mention this. Doctors and drug laboratories underwrite each other, write under the authority of each other.
New evidence perhaps for Foucault's death of the author. But the cyborg authorship allows a convenient confusion between doctor and corporation, therapy and sales. This confusion is repeated with the acronym ART. The cover refers to assisted reproductive technologies, but everywhere else in the pamphlet ART means Advanced Reproductive Technologies. This isn't accidental. Assisted is so much more user friendly; the etymology of assisted is L sist, to cause to stand ad or by, hence to stand by someone. In this case ART is standing by (ready to be used, but never pushy) and will stand by women and men suffering from infertility. Amazingly it is used only twice, once the cover - this is the face of IVF - and once on page 14, in a discussion of women over 40, who presumably don't want to hear the word "advanced."
Everywhere else, this technology is "advanced" -where advanced means better than old reproductive tech (including of course the human body) and also advanced in a progression of therapies: "after other surgical and hormonal methods have failed." Advanced is from van, the front of an army, avant garde; with ad, L for toward, one imagines the Serono corporate army marching behind a banner reading "the last and best hope" (Serono p i). Or perhaps this is the late 20th Century avant garde of medicine, fulfilling the Surrealist project of a marriage of ART and science! The scientists are ARTists, and they produce artpieces (children) from materials at hand, even throwaways. In fact, read with only slightly squinted eyes (say, after a day of hospitals and injections) the book can simply be a surreal manifesto on A/art: "ART - Alternatives" involve IVF, GIFT, ZIFT, Cyropreservation and so on. The posthuman body here, as in so many cyberpunk novels, is canvas, assemblage zone. "To prepare the body for...ART, various hormonal medications are used alone or in combination." (Serono, p.5) This can be read either as a prediction about 21st Century museums, or as a forbidding surrealist character: ART as the corporate doctor, the virile high tech Father.
More seriously, the pamphlet assumes a fairly high degree of education on the part of the reader - and this is borne out in many studies of IVF patients as "advanced" in their experience and medical knowledge (Crowe, Modell). The text discusses human fertilization, ART procedures, and reproductive technologies in detail, anticipating and constructing the doctor's own discussions with patients. The effect is one time honored in medical language, what Alan Gross calls "overdescription" - defined as "the characterization of sense objects in detail far beyond a reader's ordinary expectations." (Gross, 42-3) It creates a "referential presence" which connects with literary realism in that it seems to present language unproblematically in relation to the real world. I call this medical realism. Medical realism thus produces the "effect of the real" (Barthes 1986) while hiding the persuasive and narrative elements of the text.
Medical realism conflates scientific factuality with generic rules of the beautiful description; the linguistic technology shows me the ZIFT procedure, but also implants a story about ZIFT that is hidden to the eye (it is legitimate, benign, shadowless). The genre is literally "in vitro," a rhetoric of glass: it promises complete visibility, but in fact operates at a level invisible to most readers. The Serono text assumes the ideal reader is a patient-consumer who wants to choose between technologies; it puts possible risks in the least prominent places textually, and downplays those risks. Locutions generally erase women and instead focus on their parts: Ovarian Hyperstimulation Syndrome (OHSS), for example, "causes enlargement of the ovaries accompanied by abdominal discomfort and/or pain. In severe cases additional symptoms may require hospitalization of the patient." Ovaries and symptoms first, patients last. The problems associated with ovarian stimulation are not given a separate heading but instead buried in a long paragraph which sandwiches OHSS between shift of responsibility ("talk to your doctor") and reassurance of no increase in birth defects. Dangers to pregnancies and fetuses eclipse parallel dangers to the women who carry fetuses while pregnant; doctors and technologies have agency, while women are patients, implied or in the object position.
This may be another "real" meaning of assisted: women stand by the technologies, the advances in medicine. In fact, the actual fertile field in the pamphlet is the proliferation of technologies: ZIFT, GIFT, MESA, PZD (note here). There are no pictures of women undergoing IVF or the related procedures, but we do see diagrams of lapyroscopy and ultrasound aspiration. Potentially this field is narratable as invasive, Frankensteinian; thus, one of the burdens of IVF narratives is to normalize or naturalize its existence. After an overview of the new reproduction technologies, bristling with acronyms, the Serono pamphlet provides "a review of "normal," "natural" fertilization..." In this locution normal is marked, abnormal, while the procedures in ART pamphlet are normalized and naturalized as "basic elements."
Accompanying this process is an erotics of language. As Carol Cohn (cite) points out for nuclear discourse, even "resisters" must learn the complexities of the language, the acronyms and theories, in order to speak at the table. This seductiveness gives one the illusion of power and control - at the same time that it makes impossible certain questions one had before. The Serono booklet surrounds prospective IVF patients with the tools to appear knowledgeable, even completely so, before they enter the Final Phase of their search for fertility. I recall many discussions involving HCG levels, live pregnancy and take-home baby rates, even OHSS risks. One feels a strange pleasure in taking about the highest technologies; it combines the communality of computer worshippers with the desire for control over the technological body that is about to envelop and invade your own. In some sense, it is a kind of foreplay before the technological coitus.
But these are insider pleasures. A more common cyborg body is the narrativeless (sic) text of science wedded to the organic narratives of science journalism and the popular press. Here the implicit persuasion of scientific prose is made visible, narrated, while remaining separable from (prosthetic to) the purer body of Science. Much of the early discussion of IVF, beginning with the "miracle baby" of Louise Brown in 1978, has been epideictic (concerned with praise) whereas professional science writing appears forensic (concerned with fact) in its bid for medical realism. (Fahnestock, 19??). And this praise is complex: doctors are doubly articulated as heroic and humble, miracle workers and careful men of science. This carefulness can be and indeed must be narrated as epic (overcoming all odds) and quest (the doctor's search for Truth merging with the infertile woman's search for fertility, ending in "our" society's quest for advanced medicine) in order to transmit the persuasion embedded in all science writing.
Often the epideictic praises the doctors and the technology at the expense of women's bodies and experience; the same is true when the inevitable happens, when the miracle technology fails as a secular miracle, when the inflated truths deflate. In this case journalism has other organic narrative bodies: the tragedy, and its diminutive cousin, the farce. Dr Ricardo Asch, one "author" of the Serono ART pamphlet and inventor of the GIFT technique, is now a protagonists in the UC Irvine fertility clinic scandal. He and 2 other doctors are charged with unapproved experiments on patients, falsified research, insurance fraud and stealing human eggs (in this case, ART mirrors art: this is the central plot of the film Junior). According to the University, Ash and his colleagues took donated eggs from fertile women and, without their knowledge or permission, used these eggs in other women.
News stories like Ellen Hale's "God's work" (Hale 1995) focus on the men: "They were young, handsome, rich and respected throughout the world for helping thousands of childless couples have babies." (Hale) Dr Asch reportedly often was introduced by a colleague as "a man whose goal in life is to get every woman pregnant." The miracle stories of early IVF turn easily into stories of the Fall, of mere men-doctors who play God (the role they are cast in), usurp God's work. Playing God means ignoring the rules of these doctors' real authors, in this case the University (who, like Serono, rake in millions from the doctor-medical center arrangement), though there is evidence the doctors repeated these practices at private clinics in other places, including Las Vegas.
The article frames the scandal as both "high drama" and as a cautionary tale, the latter acknowledging that IVF in the U.S. lacks proper oversight. Dr Stanley Krenmen suggests that the case is a "Greek Tragedy" complete with "little gods" and the breach of trust between doctor and patient (Hale). Perhaps he has in mind Oedipus (whose lands and people are infertile), or Hippolyta (in which the maddened women tear the male protagonist to pieces). But whether tragedy or farce, the organic narrative highlights individual error while maintaining the boundaries between medical realism and its prosthetic, changeable rhetorics of persuasion. Both the pamphlet and the subsequent scandal serve to naturalize IVF discourse, make it thinkable, give it the semblance of the human even as it dis- and reassembles the human.
Journal entry: September 1994. Today we spoke with our doctor about undergoing IVF. We are a little too bright, like nervous beginners at a high stakes poker table, and we admit it. Our doctor talks about the psychology of "the last chance." Up till now nothing, not even the high tech operations and infertility work, has been the last choice. Lapyroscopy and lapyrotomy were aimed at allowing "natural" conception; when natural ended up in an emergency ectopic surgery, we had come down to: In vitro, or risk another ectopic, or adopt. Or accept the limits of, the betrayal of, the body. So the in vitro has a lot riding on it and this is very emotionally trying. What did he say? I can't remember; all I remember is the gambling metaphors. The last chance; the last roll of the dice; betting it all emotionally. And this gambling is the highest stakes I'll ever play: after a certain point, you have to pay $8K to stay at the table, and to win you bet against a House that holds 70% odds (at least). This gambling metaphor tends to obscure others: "will you win the lottery" rather than the emotional costs of buying all those psychic tickets every day. The emphasis is on blind luck, on all this technology coming down to just upping your chances from none to slim on the biological craps table. And you have to keep winning; it isn't a single throw, it is one throw (suppression) and another (hyperstimulation of ovary production) and another (successful harvest) and another (successful fertilization) and another (successful reintroduction of ova) and another (successful implantation on endometrium). How do you handicap a miracle?The Washington State Lottery jingle on a tape loop in my head: "Feel lucky? Well, do you?" Disturbing overtones of a Dirty Harry movie...
Gambling and miracles: both the popular press and participants in IVF use these lending discourses not only to make sense of potentially alien technologies, but also to gain a kind of rhetorical control over the experience. Researching media coverage of a women over 40 having babies via IVF ("miracle" babies by women betting against Time), I came across a Time magazine (Andersen, 1994) proclaiming Las Vegas as the new all American city: "America has become Las Vegasized." The Temple of gambling has gone family: Luxor and MGM Grand have built Disneyesque worlds around the gaming tables, and the article displays a toddler in backpack accompanying Dad into the blackjack parlor. A photo of hands and chips bears the caption, "A nonstop flow of insane hunches and wishful superstitions."
Anyone who has dealt with infertility will read such an article with a strange sense of deja vu. IVF in the US is figured, narrated, contained and contested with gambling metaphors. I remember saying over and over, "Yeah, we just put down $8K on one roll of the dice" as a description of our IVF cycle. Kids and odds circulate in the same linguistic economy, days in the hospital merge with nights at Circus Circus. Standing in front of a slot machine, dropping coins in, and pulling: the illusion of doing something, but the ultimate passivity. IVF today can resemble a slot machine with Latour's actant technologies inside: at a certain point in the discussion of fertility odds the doctor casts the shadow of an oddsmaker, a blackjack dealer calmly stating the odds to the next player/mark.
So what are the odds? Worse than a scratch card for most: numbers vary, but Science (May 14 1993) puts the US birth rate per IVF treatment cycle at 14%. Percentages go up with the number of embryos transferred, but so does the risk for multiple pregnancy, prematurity, and perinatal mortality. It doesn't help when IVF clinics advertise rates based on pregnancies rather than live births (Feldman, Raymond, Spallone, Winston et al.); at least in Vegas, when your number comes up you win money every time. In fact, among the infertile there is a neverending search for the right game, the clinic where your odds are best, where your miracle has the best chances of defeating chance.
If you feel the preceding language has been flip, glib, cruel even, you are right. Anyone who has dealt with infertility would sense all that is missing from this description. In fact, the gap between the gambling metaphor and narratives of conception and reproduction defines some of the schizophrenia of IVF, a cyborg schizophrenia. In "Last Chance Babies," Judith Modell argues that the discussion of "odds" in IVF reflects differential rhetorical strategies of medical experts and patients. On the one hand, IVF patients know an unusual amount about bodies, medical condition, and available treatments. They could count as particularly powerful patients. But the rhetoric of "odds" has different emotional valence for patients (our own child) and doctors (the success rate of our procedures).
Modell cites the odds language in ways that bear out my own experience: doctors frequently refer to Vegas, roulette wheels, IVF as a gamble with no sure outcome. When doctors use this language, they put risk primarily as losing money "which [has] the unforseen effect of downplaying the medical risks (e.g. of multiple births) outlined to patients before they entered the program." (Modell, 129). Paul Feldman, in "The IVF roulette - helping your patients beat the odds," extends the metaphor to include women's emotional "stakes" (inconvenience and pain, the trauma of failure), but his trope leads him to argue mainly for the regulation of published IVF success rates (as in other forms of gambling) and against premature IVF diagnosis: "Does the one attempt at GIFT entice the patient to repeat attempts at GIFT just as the losing roulette player keeps putting down more and more $5 bills after each spin of the wheel?" (Feldman)
Modell argues that patients, unlike doctors, don't "think of IVF as one gamble among several - and a better one than Las Vegas." Instead, the stakes seem to involve everything, including one's identity and dreams: IVF is the end of road, the last chance, when I play all my cards with nothing to lose. In this context, optimism is essential for continuing (I only need to win once), and while doctors see this as naive it isn't hard to see how it is also the pull, the hook into the baby casino. Under these narrative circumstances, IVF looks like a particularly bizarre cyborg technology . The body has let me down; its "meat" is even more to be transcended, it needs technology to even become meat again, an animal capable of reproducing. So I come to reproduction's Las Vegas and bet a wad on complex biotechnologies, which I constantly handicap with/against my own body in the schizo medical version of the racing sheet.
The rhetoric of gambling here merges with the rhetoric of medicine; IVF is a technique, an application of technology, but it is also an intense merging of technology and body narrated as a gamble. Notice that this is different than the narrative of risk: for example, the risk of OHSS, of multiple cycles of drug treatments, of using a technology in its infancy. As a gambler I retain sense of agency, even if at a slot machine; I don't think of myself as a guinea pig or a victim.
Symbiotic with gambling and reproduction (Vegas has spawned, cloned, so that large US cities are test tube Vegases) is magic and miracle. Vegas is the capital of stage magic in the U.S.; magic and gambling are rooms in the same temple. In "Tonight! Miracles, Live!" magician Penn Jillette suggests that magic is one of the few things that must happen in real time, that doesn't work on TV: "Miracles have to be seen live." (Jilette, 1994) Change the pronunciation of "live" and you have IVF: beyond the spectacle of miracle babies in the press, beyond the IVF magician sawing the body in half, if your gamble pays off you experience the magical: a live child which then transforms your life utterly. Part religious rhetoric, part stage rhetoric: explicable via Serono pamphlets and yet miraculous: for me, a plastic strip turning colors replaces the body and blood, as sign for the shock of the magically real.
In this case we can let the pregnancy test qua artefact speak. "The Price of Hope," an article from Forbes magazine, quotes the head of Quidel Corporation on why his company's Conceive pregnancy test (with a smiling baby on the package) costs more than his company's RapidVue, an identical product with plainer packaging: "'The market definitely divides between the women who want babies and those who don't,' explains Quidel Chief Executive Steven Frankel. The smiling baby sells for more than the plain-wrapper product because 'It's like what Charles Revson said about cosmetics: People buy hope. In our case, they pay more for hope than for possible relief.'"
Gambling metaphors for IVF circulate in a larger linguistic economy that gives it "depth" in this culture. Attempts to pose ethical issues by purifying technofertility discourse into either cost-benefit-risk or religious language will fail to plumb these hybrid depths.
I'm assuming Hugh has had more than one epiphany, actually: this one refers to the divine moment in the film 9 Months, wherein the heretofore terrified child psychologist is won over to the True and Good (the reality of his responsibility to mother, to child, and the sudden realization that he wants this new responsibility) by confronting the ghost like vision of his developing child on the screen of an ultrasound machine. Everything in the film turns on this moment; it is his Rite of Passage into fatherhood, and in some ways,adulthood. Suddenly, the invisible becomes visible, the unreal real; the fetal deity appears to the unwilling Mage, and he becomes a wise man instead of just a wise guy.
Margann and I have undergone so much ultrasound imaging we could be poster children for the med tech community. I've travelled in amazement into my wife's body, first looking for signs of pregnancy, then signs of a heartbeat; then the screen showed, instead of a bouncing baby fetus, an ectopic pregnancy. The suddenness of the shock - a picture on a screen, the physicians face, and within minutes we are preparing for surgery. And all that was before IVF: ultrasonic Jacques Cousteau type trips into the uterine world, scanning for ova development; then watching ultrasound guide the harvesting tube into place, literally seeing the resistance as embedded egg follicles and aspiration vie for dominance.
Finally, my Hugh Grant moment: after technoconception, after the little plastic pregnancy tests (the price of Hope!) passed us, we are in a room looking for a fetus, looking for normality, a heartbeat, the right shape. The tension is thick: my wife, myself, our midwife friend, the technician, and the doctor, all waiting for the electronic curtain to rise on either a comedy or a tragedy. The machine is turned on - and we see nothing; the technician moves the probe, and we see nothing, nothing - and then, right off the pages of Life magazine, a living being - fetus, baby, nipper - the whole room erupts. Screams, yells, the whole decorum of Medicine broken, as if we were watching a baby being born, or the climax to a particularly suspenseful film. Like a computer switch, like a byte of drama, this was on/off, yes/no - and the answer is yes, alive, moving.
I want here to convey the awe-fullness (Romanshyn) of ultrasound technology. We were all a-mazed, in awe - in a world that values sight over sound and other senses (including the feeling, perhaps, of carrying a baby), seeing our baby alive was a kind of miracle of reassurance and existence. This was magic, the making visible of the invisible world, and perhaps as importantly, the "direct" (sic) representation of the invisible insides of female fertility (see Mitchell and Georges, this volume). The moment reframed the experience of the pregnancy for Margann, certainly: from a mark on a plastic stick, a set of readings, to a body image, in real time, and an affirmation of her hopes. The power of the surface image here is the power to tap depths - of fear, of hope, of the abyss of not knowing, fears of every parent. But I keep thinking back to Hugh and the male gaze of cinema: this was my first vision of my child, a vision unmediated (sic!) by Margann's own reported experiences, or plastic sticks. (note couvade experiences and rela to women's subjugated knowledge)
Let's look at this looking. First, Margann is lying on a table as the technician/doctor manipulates the vaginal probe; as the screen flickers on, all of us, including Margann, are looking at it, away from the literal location of the fetus/child (i.e., in Margann's belly). The externalization of the image takes the "real" from inside her, and reframes it as a medical movie, over here, subject to various manipulations (using point and click computer technology, the doctor measures, freezes frames, downloads the pictures). At that moment the screen is a virtual forceps, taking the baby out, but also taking the kinds of knowledge of the baby out of the mother, and replacing this with technical knowledge. In this sense the ultrasound is simply a metonym for the technocratic medical model of reproduction and birth: as one form of bioknowledge ascends, another descends, to become Foucault's subjugated knowledge. Ultrasound (even the name sounds 90's - etymological kin to ulterior, ultimate, and outrageous) not only externalizes images, it autonomizes them. It is no accident that the fanatic fetalism of the late 20th Century has used such images as this (my son!) to reassert patriarchal control over "life" - as one feminist puts it, everywhere you look there are fetuses but no women (Laborie). The image on the screen vibrates inside an electronic virtual womb, kept alive not by the mother (over there) but by the on switch, brought into view not by birth but by a turn of the probe, now appearing now disappearing.
External, autonomous - and real. This is the third term of Hugh's epiphany - ultrasound combines the "realism" of photography with the real-time experience of motion, in an age defined by televisual and screen environments. These images take linguistic medical realism one step further: that "really" is the baby, the uterus, the umbilical cord. The depth of a mother's insides, both literal and experiential, are exploded, flattened into a surface image, the sublimity of deep ocean space caught on a 15" screen. But the very mimesis of the image is what 20th Century theories of representation calls into question: is this really the interior in which babies survive? The interior which women carry, define, encounter, imagine? No - and yes.
The medical model as villain; patriarchal medicine using technology to wrest even reproduction from women's control - this is an old story. But the combination of realism (as a genre of representation) and externalization in ultrasound reflects a replacement of "insides" - depth now resides in the fetal image, reverberating down a new set of discursive networks (fetalism, abortion, medical interpretation, elaborate technical protocols), while eclipsing other possible insides (the imaginative moment of carrying a child; maternal body-knowledge). This isn't simply because medicine overwhelms the patient - rather, the embedded realism of TV ultrasound deploys the dominant reality-engine of our time.
By putting women's wombs on the outside and by using photographic realism to render dependent developing babies independent, body-coherent, ultrasound reflects the trend in medicine to render fetuses as individuals and mothers as di-viduals (Mies, 1988). Di-viduals are made up of (sellable) parts: wombs (for rent, synthesizable), embryonic tissue for research, eggs. Like the protagonist in Gibson's Count Zero, posthuman women's bodies are exploded, and then reassembled, starting with externalized eggs. ( Though all the king's medicine can't make an egg). Harvested eggs, women as resources for increased embryo research, "scrambled" or cloned eggs; in some senses these eggs, too, gain a kind of autonomy, a commodity identity superior to that of the women who produce them.
Margann and I have pictures of our son at one egg, or rather a microsnapshot of the egg we think he developed from. We have a picture of him at two cells. Oddities to us, these images are not innocent - they have corporate and technical sponsors, they are mobilized in regimes of reactionary politics, they come out of women's bodies partly to threaten those bodies. And they mark the assembly zone not only of future designed children, but also of hybrid discourses for naturalizing genetic engineering and postmodern eugenics.
As Margann and I were submitting ourselves to the rigors of IVF bootcamp (4 shots a day of Pergonal and Metrodin for 9 days, estradiol level assays, Synarel and Progesterone, parking in Seattle), I was teaching Bruce Sterling's "Our Neural Chernobyl." The story (set in 2056) recounts the future history of gene hacking, arising from therapeutic uses of recombinant DNA to cure AIDS. Unexpectedly, the cure overwhelms popular fears of "genetic tampering" as "one ailment after another fell to the miracle of RNA transcriptase techniques: sickle-cell anemia, cystic fibrosis, Tay-Sachs disease - literally hundreds of syndromes now only an unpleasant memory." (Sterling, 2)
The story's trajectory follows a classic cyborg arc, from the use of technologies as therapeutic (that is, to "unnaturally" bring someone back to "whole" human) to the next use of the same technology as an augmentation of normal. (Recall the scene in RoboCop where they cut off his remaining "good" arm because it isn't as strong or invulnerable as the prosthetic model). The successes of therapeutic gene recombination lead to mass production of the tools to "rewrite" genetic inheritances, the augmentation first of animals (dendritically enriched, hyperintelligent "Raleigh collies") and illegally of humans (hackers using dendritic growth hormone wetware on themselves and others) and finally to disaster (unexpected terrible effects on humans, unleashed epidemics of genetic change in animals, Luddite reactions, an elite of superhuman scientists).
Maureen Barr argues (Barr, 1988) that feminist science fiction writers tend to blur generic conventions when discussing reproductive technology; their science fictions bear strong resemblances to the "facts" of late 20th Century reproductive engineering, just as reproductive engineering is narrated by a normative discourse that slides easily into fiction and the awe-ful. Sterling's story readies us for the discussion of genetic engineering below, but it also prepares us (as do feminist science fiction texts like "Twenty First Century Mother" (Katherine Marcuse, 1976) for yet another repetition of the Frankenstein story: lone individual scientist bucks system and creates a monster. This perspective penetrates science journalism on IVF, and obscures the new hybrid institutional agents, the bureaucratic cyborg-bodies, driving much of the new reproductive engineering.
Much of IVF terminology and technology overlaps with animal husbandry. This creates a linguistic economy in which terms and metaphors circulate back and forth across a permeable boundary, much as "cow" discourses in Joyce's Portrait of the Artist circulate as "mother" allegories, and representations of "mother" affect future visions of cows and cattle in the text. Narratives that serve to legitimize and naturalize IVF (infertility as disease; IVF as heroic attempt to help women become full humans qua mothers; medicine as human/e epic) also function to obscure the exchange between animal and technodoc "husbandry." For the history of IVF is in most ways the history of technology transfer, from animals to humans.
Consider the semipopular science article "Scientists set to ripen human eggs in millions." (Miller 1988). If we place human eggs with "sheep eggs" or "pig eggs" in the headline we have the miracle science of the sixties and seventies. The article deploys medial realism (detailed description of egg incubation baths, hormones, blood serum and growth factors) in language that does not change whether one is speaking of mammals or humans. Human becomes simply an adjective, albeit a crucial one; the shock of the headline depends both on the human and the sense that the human is being disassembled and reassembled. The main issue of the article is what scientists can do, not why they are doing it: it connects "egg ripening" with the shortage of (human) eggs and embryos that cripples embryo research. Dr Ditta Bartels, science policy analyst at University of New South Wales, is quoted as saying,"Once egg ripening becomes perfected, human embryos will become available for research. The shortage of raw materials - eggs and embryos - have been impeding research far more than any law. Researches will become pushier about their rights to experiment on these eggs and embryos." (Miller, 1988).
Once we've established the agents in this paragraph (Researchers who perfect and become, research which is being impeded) we can see the ideological layer added by the ripener of these millions, Dr. Osborn. He explains that this will help infertile women, who will have less need for superovulation drugs and other hormones, while more eggs and embryos can be implanted. Here the rationale is clearly sutured onto the drive for the technology. Osborn developed this technology using the eggs of sheep and pigs. Test tube babies, cyropreservation, technosperm analysis, sex determination all were developed for animal breeding. Current "smart farming" technology includes a portable kit to sex animal embryos and split them to double their numbers in a three hour procedure that can take place on the farm." (Glasgow, 1989) In this article, not only are terms interchangeable for humans and cattle (cows are superovulated, inseminated, embryos are flushed, DNA testing is done on blood) but the embryos are transferred to "surrogate mothers." The cycle of linguistic borrowing is completed, as it is in the article "Test Tube kids bred at Rye" which refer to kid goats. "Ordinary" feral goats are used as surrogate mothers to carry the embryos of pure bred Angoras. Besides the easy transfer to class and race discourses (ordinary women used to breed pure strains of extra-ordinary people) this article reminds us that with linguistic borrowing from the breeding/husbandry world come terms of commodification and eugenics. The process produces "goats with high value characteristics which therefore have a high market value..." (Test Tube, 1988). Investors ("business-men farmers") lease pregnant animals and "newborns" are owned by them; when the animal is born, the lease ceases.
These discourses could easily be found in The Handmaid's Tale, or Sterling's writing; along with technology transfer come particular ways of conceiving (sorry) the processes involved. But instead of individual Frankensteins (say, Dr Osborn) working outside of normative science and its safeguards/humaneness, these science fact/fictions yield strange new institutional cyborgs as the real protagonists. For example, the Rye test tube kids are the product of Monash (a large IVF company with private clinics and research labs) and International Breeding and Technology. Monash provides the technology (developed on/"for" humans) for "a financial return, and a chance to use the research facilities." The head of IBT is on the ethics committee of Monash IVF; Dr Alan Trounson, cofounder of Monash and internationally renowned IVF researcher, started in animal IVF research in the sixties.
Another kind of cyborg body is the Animal Research Station in England. Formerly an academic body, it was privatized under Thatcher, and is now Animal Biotechnology Cambridge Limited. The company offers courses on IVF techniques open to animal and human fertility personnel, and many of the "firsts" of the researchers there (nonsurgical embryo transfer in cattle, first calves and lambs born from frozen embryos in 1970s) are now commonly practiced on humans. More often the academic body is joined to, instead of ingested by, the corporate breeding body: for example, University College Dublin and Masstock, an international farm company, who sell businessmen-farmers test tube calves. The joint venture develops, freezes, and implants embryos; scientist collect ova from slaughtered cows, nurture in lab to full maturity, fertilize, freeze, (New Scientist 1988)
Both animals and institutions are becoming cyborgs: boundaries are being broken down in both cases, with strange and disturbing hybrids as a result. If we follow the trajectory of cyborg fictions, both these cyborgs will be imported into human IVF practices. Traditional hospitals will become even more intimately connected with genetic engineering labs, pharmaceutical companies; discourses of market and commodification will weave even more tightly with discourses about health, fertility and birth; and humans, like animals, will experience cyborg assembly and disassembly.
The future of dis/re/assembly will certainly involve a constant borrowing between animal and human genetic research and their respective language systems. Here is a description of the Animal Biotechnology Cambridge Limited's work:
"In recent years the lab has created an array of farm animals produced by techniques involving cellular and genetic manipulation of eggs and embryos. These animals include genetically identical twins and quadruplets from embryo splitting, cross species transplantation using chimaeric techniques, in vitro maturation and fertilization of sheep and pig eggs resulting in live offspring, sheep from eggs receiving foreign nuclei [an important step toward animal cloning] and two generations of transgenic pigs carrying exotic gene constructs." (ABCL, 1988). Simply replace farm animals with "humans" and you have the logic of cyborg assembly. Chimaeric techniques, indeed. The wildest realms of fiction, say, transgenic humans "grown/constructed" and copyrighted, here meet the excited language of late 20th Century biotech marketing.
As human IVF researchers mingle on ABCL grounds with businessmen-farmers, trading stories of surrogate feral goats and HCG levels, discourses mingle with them. Eugenic language pervades breeding, as Animal Biotechnology's own pamphlet shows: "Controlled preselection of both maternal and paternal genes [allow] prime genetic resources to be multiplied on a large scale... for the multiplication of elite progeny." (ABCL, 1988). "Quality control" here merges with ethnic purification (we shan't be cryopreserving those ordinary feral goats). There are even parallels to the legitimizing discourses of IVF helping women: animal infertility (i.e., endangered species and rare breeds) can be overcome as well.
Besides cyborg farm animals, including "super pigs" and "test tube chickens" with foreign DNA , there are transgenic mutant mice that secrete TPA a human gene for tissue plasminogen activator; other mice are used to make human growth hormone, thus becoming "living factories" or "bioreactors". These technologies intimately involve the alteration of genetic materials in animal reproduction; technology transfer includes microinjection of human sperm into eggs (zona pellucida drilling) and current work on genetic disease in humans.
I look at my cyberson and wonder, is he the thin edge of the VIF discursive wedge? Not a T2 (pace Schwarzenegger) but a B2, to be followed by the B1000? The cyborg logic of biotechnology is clear: once you have externalized the different functions (industrial egg production, procurement, fertilization, delivery) then you have the means of enhancing those eggs. And biotechnology will combine with social narratives to do this, in one form or another.
So let's renarrate the IVF story: in the late 20th Century the amazing ability to help infertile couples (almost always heterosexual, Northern, wealthy) and test for fetal genetic disease (amniocentesis, chorionic villus sampling) overcomes social unease (from feminists of FINNRAGE, Church groups, scientists) and results in mass and niche production of recombinant DNA technologies, further unrestricted experimentation on animals, and complex forms of State/corporate/academic body-suturing. Already we have sex identification and preselection, and genetic testing for Downs Syndrome, other chromosomal abnormalities and neural tube defects. These are arguably B1 cyborg tech: they allow for a crude quality control (from ending a future Downs baby's life to modernizing the practice of aborting female babies) and aim at "whole" natural babies. But gene manipulation of human embryos is on the horizon, as many have pointed out (Ewing; Bradish; Mies; Winston et. al.). The metaphors of writing (DNA transcription, RNA translation, nucleotide messages, genetic codes) and collage (cutting DNA with restriction enzymes, recombining DNA, manipulating, rearranging, cloning, reproducing), all imply editing. And as in postmodern writing, as in 20th Century collage and its progeny (photomontage, the cut/paste operations on my keyboard), the traditional body (of art, of writing) is cut up, rearranged, the logic of prosthesis rather than synthesis.
Work on somatic cell and germ line manipulation, oncomouse and other transgenic animals, microinjection of rat growth hormone into mice, all suggest that genetic embryo work is the real fertility in fertility technology. Human fertility work itself remains pathetically infertile ground (Gibbs et. al., Spallone). Many critics label this trajectory "eugenics" - and cite the Nazi experiments and the continuity of eugenic attitudes and laws from the late 19th Century to the present (Kaupen-Hauss; Ewing). The sexist, racist, classist elements of eugenics are alive and well as dangers in IVF and GE; but they will look different, be narrated differently (see Rapp, this volume). A parallel: those Nazis in the film "Indiana Jones" with their uniforms and leather and swastikas make a certain fascism visible, but make another kind - a more contemporary version - invisible. Contemporary moves to eugenics will look less like Brave New World's state control and more like niche marketing and consumer choice (Clarke, 1995). Postmodern eugenics will involve boundary-shifting discourses that import breeding logic into medicine, cloaked in the language of technology that mediates and "humanizes" this logic. This will happen partly because current discourses on pregnancy and birth already include elements of eugenics and market language, so that "I want what's best for my baby" moves easily into a demand for medicalized versions of "the best."
It will also happen because of journalistic containment strategies, perhaps best seen in the New York Times "cloning" controversy. The Times reported, page one, that George Washington University embryologists had made a breakthrough in cloning human beings [cite here]. The breakthrough involved "splitting' an embryo by dissolving the surrounding zona pellucida and then using sodium alginte as an artificial zona for the two now distinct cells. These cells then divide and become embryos. Subsequently, Newsweek ran a large 3 part story called "Clone Hype" which argued that such experimentatino reflected neither a slipper slope of ethics nor a valid reason for public protest. Jeremy Rifkin is marginalized ("gadfly") and "left" opposition ("Rifkin's troops...parading outside) is joined to conservative fetalist opposition as examples of "apocalyptic" overreactions. The obligatory Nazi eugenic fear is invoked and revoked ("A lock of Hitler's hair, even if scientists could extract its DNA, would only give rise to the world's most disgusting hairball." 61), linked to fictional (Jurassic Park) and fraudulent (David Rorvik's "nonfiction" fiction about a cloned millionaire) paranoias about "nightmare scenarios" (Adler)
The containment strategy revolved around - what else? - IVF and helping women, in this case by allowing embryologists to artificially reproduce embryos. And this legitimizing narrative is itself contained within abortion discourse (the embryos were nonviable). Yet the article simultaneously reflects that something momentous is, after all, going on: the huge header "Clone Hype" is wonderfully ambi-valent (this is one more hyping of cloning and embryo biotechnology, as well as its putative critique) and the graphics of identical babies in versions (1994 a and b, 20007 a, b, c and d) legitimately reflect the possibilities of the technology. By deploying popular representations such as the film "Boys From Brazil" and then debunking these using embryology science as medical realism," Newsweek obscures its own narratives (opposition to science is simply anti-progress; science is not political; the best source of rules for genetic engineering is not the government or a frightened and unscientific populace).
The same strategy attempts to build (or maintain) boundaries between therapeutic genetic testing and eugenic possibilities. Clone Hype's companion piece "The View from the Womb" (implying not only the fetus's but the embryologist's point of view; mothers are again nowhere to be found) discusses BABI (blastomere analysis before implantation), which allows doctors to analyze the genetic code of in vitro embryos for hereditary diseases such as Tay-Sachs (Cowley). Obviously, the more diseases and behaviors that are "discovered" to be genetic, the more control such externalization of embryos allows. But the article moves directly to the most extreme case ("made to order" babies who are smarter or have particular personalities) and again mobilizes medical realism to debunk and contain. Such articles reflect the schizophrenia around cyborg dis/assembly zones, as well as generic ways of resolving crises (celebrating the public airing of these issues while basing the reporting on the overreaction to and fear of science in the media).
BABI babies must be separated from the discourse of animal breeding, eugenics and the industrialization of reproduction, in order to naturalize externalization and assembly. The answer is Smart Birth. What is (or might be) Smart Birth? Cyborg augmentation; the move from lists of the qualities of sperm bank donors, to the same qualities as genetically engineerable traits in one's own child. Sex choice is already off the shelf; growth hormone is a likely next step (since it is already common to animal husbandry); and as Ewing points out, a whole host of quasi-scientific narratives (sociobiology, among others) see the Human Genome Project as the map of behaviors to be technologically controlled, enhanced or eliminated. (Ewing, 1988)
Smart birth is the (narrative) end product of the desire for postmodern niche market quality control (Clarke 1995). If now IVF techniques are seen as extreme, only for the infertile, this is only to say that they have not yet been naturalized. Consider: genetic screening via amniocentesis, ultrasound imaging, fetal scalp monitoring are all routine now: it is considered a lapse not to use them. And the only way to really know the genetic Truth about one's progeny is to externalized embryos, test them, and fix them before reimplantation. Smart birth contains most of the contradictions and injustices found in the linguistic economy of the new "smartness" - "Smartness is intelligence that is cost efficient, planner responsible, user friendly, and unerringly obedient to its programmer's designs." (Ross, 331).
If infertility allows science to externalize and then test/repair, and if testing becomes natural, indicated, postmodern birth quality control, then the argument, unless contested by other (subjugated) knowledges, proceeds from the technology to the practice. The gen(i)e is out of the bottle. "Honey, can you change the baby?" will comprehend diapers and DNA, unless of course (as proposed in the original Clynes and Kline cyborg article) we get rid of human elimination itself.
"As Goethe said, theory is gray, but the golden tree of life is green." Donald Barthelme, "City Life."
When Margann delivered our son at home, she labored at the site of two overlapping and constructed technologies. On the one hand, she rode out wave after wave of painful contractions in a constant negotiation of body knowledge and the techniques of midwifery, including not only ways of pushing or breathing but ways of conceiving such activity (see Miller, this volume). Her labor was an intense dance/ordeal within culturally specific modes of understanding these things, accompanied by herbs, tinctures, postures. On the other hand, the oxygen tank and the waiting car symbolized the powerful medical technologies virtually present at any home birth. The hospital, with its routine fetal scalp monitors and maze of medical protocols, is present as supplement, necessary intervention,
Yet this supplement is Derridean: the hospital paradoxically both adds to and replaces home birth, just as technoconception with its genetic testing adds to and replaces "natural" conception (which is itself ringed round with cultural-fictional practices and rules). Technoscience turns animals and humans into cyborgs, but its discursive practices naturalize this process, turn it into the new nature. This new linguistic economy parcels out value and valuelessness in parallel with the money economy, so that homebirth becomes a bankrupt idea, and genetic testing an unproblematic source of valuable information and therapy.
Changing economies is perhaps the hardest thing humans try to do. Yet instead of dualist models (do you want embryo science or preventative medicine?) and the rhetoric of consumer choice and free markets (which ask an absurd leap of faith concerning choice and freedom, and reinforce the mythic individual in a time of cyborg institutions - see Raymond, Mies) we need, I think, to open up the economies by which we represent reproductive reality. If the cyborg figure helps us see the always already constructed nature of medical and reproductive bodies, then perhaps it will allow us to assemble wider discursive nets, nets that include more voices in a wider discussion. Beyond realism and mimesis, we need to learn to read collages and montages of discourse and practice, continue to unmake and remake disciplinary and bodily boundaries.
Currently, IVF as a cyborg technology produces autonomous fetuses and erases/disassembles women's bodies; it reflects the externalization of the organic, and the organicization of biotechnique. IVF and technobirth work to obscure subjugated knowledges, including midwifery networks and body-knowledge as technique (see Miller, Hill this volume). I don't want to romanticize the latter - I simply want to deploy them within the discursive space of late 20th Century conception and birth, as Margann and I have in our own lives. We have gambled on the IVF miracle road, conceived a child using oocyte aspiration and an avant garde of biotechnologies. The child, conceived from deep within the medical model, grew under a hybrid regime of herbs and HCG, ultrasound and the sound of a mother's voice (and a father's) crossing the tight drum of skin. His story imagines a cyborg competence - never forgetting the machines and technologies, never losing the bodies, in a struggle that is also a dance.
Last Updated 10/21/95