title: Self, agency and the surgical collective: detachment.
abstract: In this article, I describe the socio-technical organisation of surgical rehabilitation. After having gone through surgical intervention, patients are implicated within various types of medical work aimed at adjusting their bodies to post-operative social and material environments. My argument is that the process of re-establishment of a 'self' is mediated through a re-disposition of agency in the socio-technical ensemble upon which the patient depends immediately after surgery. Drawing on one year of ethnographic fieldwork in a neurosurgical clinic, and theoretical resources from science and technology studies, this paper is an attempt to describe how, within surgical post-operative practices, the relational dynamics of social and material components endorsed within those practices may re-institute patients' sense of themselves, and re-organise their relationship with the world and other people. In surgery, the outcome of this dynamic process is the reorganisation of forms of agency for the patient. I will refer to this reorganisation as 'detachment'. It is my contention that this research may contribute to the literature on the experience of chronic illness by specifying the socio-technical conditions for the local achievement of self and agency.
authors.affiliation: Centre for Health Services Research, University of Newcastle-upon-Tyne. t.e.moreira@ncl.ac.uk
authors.forename: Tiago E
authors.initials: TE
authors.lastname: Moreira
mesh_terms: D004532:Ego; D006761:Hospitals; D006801:Humans; D019635:Neurosurgical Procedures / Q000523:psychology*; D010819:Physician's Role; D010817:Physician-Patient Relations; D011184:Postoperative Period; D012917:Social Adjustment; D012962:Sociology, Medical