Mol 1996 Neonatal Food and The Politics of Theory Some Questions of Method PDF

Neonatal Food and the Politics of Theory: Some Questions of Method
Author(s): Annemarie Mol and Jessica Mesman

Source: Social Studies of Science, Vol. 26, No. 2, Special Issue on 'The Politics of SSK:
Neutrality, Commitment and beyond' (May, 1996), pp. 419-444
Published by: Sage Publications, Ltd.
Stable URL: http://www.jstor.org/stable/285425 .
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The Politics of SSK: New Directions/Places/People/Things
* ABSTRACT
The nurses on an intensive care ward for new-borns feed babies with food
and doctors with information. Showing that this is so is one of the ways in
which scholars working in humanist traditions of social analysis, such as
symbolic interactionism, reveal the politics of hospital relations. However,
semiotics, along with similar 'non-humanist' theoretical traditions, is no
less political; neither, as is sometimes suggested, does it necessarily side
with the strong. Here we demonstrate that semiotics implies another style
of political theory - one in which the relevant axes of difference are not
primarily between groups of people, but between ways of ordering the
world. Thus the differences between two modes of feeding or of
calculating the contents of a bottle can be understood as both 'political'
and 'technical' matters.
Neonatal Food and the Politics of Theory:

Some Questions of Method
Annemarie Mol and Jessica Mesman
In this paper, we address some questions of method. We don't

expect to find a warrant for truth. Nor do we need a method to link
up with reality in a looser manner. Reality, we feel, is overwhelm-
ing enough as it is. No: our aim is different. We want to unravel
and understand how the methods we're caught up in, make us
observe and write. We want to know what they do to us and to our
fields of study. And we especially want to know about their
politics.
For a long time, discussions of method were all about how to
avoid 'taking sides'. It was hoped that by setting rules, villains
could be ruled out. But such hopes have proved problematic. We
won't repeat that story here.' Instead we set out with the idea that
when a retreat into more and more protective measures isn't
working, it is better to try and turn the question around. So the
problem we deal with here is not how to avoid politics in theory,
but how to do it well.
Social Studies of Science (SAGE, London, Thousand Oaks, CA and New

Delhi), Vol. 26 (1996), 419-44
420 Social Studies of Science
'Normative questions deal with what ought to be done or

believed'; this is the opening line of a paper in which Hans Radder
pleads for more reflection on such questions in science and
technology studies.2 His words sound like a truism, but they hide
another - articulated in the very same paper - which is that
normative questions don't start after the facts, with what ought to
be done or believed. Instead they start right at the beginning, with
the business of framing what is the case. For normativity doesn't
simply reside in the subject-author but in the subject-matter too.
How to investigate it there? In what ways may one's writings relate
to the normative order of one's field of study? That is the 'politics
of theory' question that we explore here.3
We tackle this question by comparing the politics inherent in
two major theoretical traditions, both of which are extensively
drawn upon by authors in the social studies of science, technology
and medicine. These two traditions have a common enemy: all
those versions of realism which assume that words somehow stand
for objects or matters of fact. But they take the linguistic turn in
different ways. One of these traditions is verstehende sociology.
Instead of treating social facts as if they were natural phenomena,
sociologists within this tradition try to unravel what reality is like
for the people they study. Their motto is: humans may be turned
into objects, but they are subjects, too. They speak. They interpret
the world they live in, and their own ways of living in it. From all
the versions of verstehende sociology which we might explore, here
we choose to look at symbolic interactionism.4
The second tradition is that of semiotics. Semiotics originated
not in sociology but in linguistics. So its primary object is not
humans, not even talking humans, but language. Instead of treating
language as a bag of labels each fitting an object, semioticians
analyze it as a system of interrelated signs. Instead of treating
language as an instrument people use pragmatically, semioticians
analyze it as a set of juxtaposing grids each of which has a history and
momentum of its own. There are, again, several ways to go from this
point. We'll try carefully to articulate our own.
This text is a hybrid: it moves between sociology, anthropology
and philosophy. Our questions of method are informed by our
empirical practice. Therefore we'll present you with some stories
set in the neonatology ward of hospital M, a Dutch university
hospital. This is a place where tiny babies lie in glass cages, with
lots of machinery attached to them. Adults dressed in white move
Politics of SSK: Mol & Mesman: Questions of Method 421
around. They read and write, adjust dials, inspect the children's
bodies and talk endlessly.
However, you'll get to know only a little bit about the ward.
Because time and again we interrupt our stories to address big and
important questions. So we come to speak about human voices
and giving voice; about order, noise and alternative orderings.
Thus our empirical stories end up resembling the babies in the
ward: there are so many theoretical wires and tubes attached to
them that they cannot live without them.
'Nice material', empirically-minded readers are likely to tell us;
'why don't you show us more of it? Why bother with all these
theoretical distractions?'. And if philosophers were to read this
text, most of them would wonder why we went to so much trouble
finding 'illustrations' in the first place. What to do? Defend
empirical philosophy in our turn as the only genre worthy of being
printed? We prefer to get on with what we set out to do. Talk
method. Post-method?
If we discuss method here, it isn't objectivity we're after, nor
new rules which warrant political correctness rather than empirical
soundness.5 We hope, instead, to find out more about handling
commitment, compassion. Passion. We want to be/come more
articulate about this unbounded, unfinishable project: that of doing
politics in theory.
After Epistemology
J said: 'Can I ask you some questions of method?'. Whereupon A

said: 'Well, sure'. And that is how, long before these lines were
written, this article got started.
J was planning to do fieldwork in a neonatology ward in order to
gather material for her PhD thesis.6 She wanted to write about the
co-existence of different perspectives or orderings and there was
no doubt that this high density zone of doubt would be a rich site of
study. Intermingled facts and values, complicated human relations,
interactions between bodies and machines: everything J' s favourite
books talked about would be there, co-existing. And so much
morality!7 So the question was how to go about studying it. Since
A was the nearest person with fieldwork experience in hospitals, J
sought A's advice.
A was reluctant. She had never believed in 'method' as a

warrant for whatever it may be taken to be a warrant for.8 Worse:
she had loathed the obligatory 'methods-section' of her own PhD
thesis, which risked talking about what she took to be interesting
findings as if they were preliminary thoughts. In the few years
since she had finished her thesis A had tried hard to forget about
method. Discussing it somehow always seemed mainly restrictive.
She would gladly have underscored Steve Woolgar's words (if
they'd been written at the time): 'Those attracted by the intellectual
challenge will note with regret that their potential allies' obsession
with method bespeaks a poverty of imagination and excitement'.9
But then: as a PhD student J had every right to ask for advice.
'Of course it all depends on what you want to know, on what your
aims are', was the first passe-part-tout she got for an answer. J,
who had been immersed in various constructivisms from the very
beginning of her academic training, thought that this was pretty
obvious.10 'Sure, but which methods help me to "know" what?
And which "aims" can I hope to achieve by which "means"?'. One
could hear the quotation marks as J spoke. But we soon realized
that there were problems here; a lot of problems.
In the first instance, problems of method are practical. To do
fieldwork is to do something. So you get up early in the morning
and ride your bicycle to the hospital. Attend this meeting or the
other. Drink coffee with the nurses - who take drinking coffee as
their break, but for the observer all the chatting is hard work. So
you walk around the ward. Ask the parents of the baby who came
in yesterday if they'd mind talking with you. Go and find a place to
talk. Face their fear. Listen. But make it clear that you're not a
doctor and you don't know if their child is going to be all right.
You sit behind a desk for a while, making notes. You stand up to
go and see what is happening at the other side of the ward, where a
machine has suddenly started to bleep alarmingly. Instead of
simply switching off the alarms and doing nothing as they often do,
several nurses and doctors gather around the incubator. What are
they up to?
J had read that she should follow the actor. But after following
the medium care neonatologist around for a day, J came home
exhausted because the man walked so fast. And what about the
pieces of paper that travel from the ward to the dispensary? J
couldn't enter the hospital's postal system with them, for its plastic
tubes were big enough for forms, but far too small for human
bodies. Yes, these problems were soluble. The secretary advised J

to carry the forms to the dispensary herself - which would serve
the extra function of proving that she was trustworthy as well as
making sure she was at the scene of the action right from the
beginning. And A advised J to take a day off as soon as she was
tired. 'That's the one rule of method I'm sure about', A said, 'an
extra weekday off during periods of fieldwork'. ('Do you practise
that yourself?' J asked with a tone of wonder in her voice.)
Taking free time was difficult. Even when she came to the ward
for eight hours a day, five days a week, J felt like a failure.11
Observe here. Put the video camera elsewhere and have it observe
for you. Did those parents leave? Hmm, it would have been nice
to interview them. And gosh: the child whose case seemed to offer
a good example of the complexities of 'withdrawing treatment',
died during the night. How did he go? 'Quietly', the nurses say.
Just that: 'Quietly'. The emotions they had at the time are lost to
the observer.12
So the practicalities aren't easy to deal with. But then a second
set of problems start to surface. What are these practicalities
linked up with? Why do they occur? Do they yield anything good
in the first place? What is all this fieldwork for?
Talking about that, we wondered how J could avoid using the
neonatology ward as the mere decor for yet another story about
construction. Sure, it could be done. The construction of breath,
blood sugar levels, the ideal parent, hope or despair, could all be
traced. It was possible, but why would one do so? By now,
supervisors in science studies have been telling their PhD students
to write up their cases in this way for decades, as if it were the
students' task to stabilize the constructivist programme by adding
to its mass. Go and unravel the construction of an object. Any
object! It doesn't matter what. The laws of gravity, a nuclear
power plant or the HIV virus - anything will do. Just show that
the thing doesn't exist by itself, but depends on something else.
Which is true. But why repeat it? The only reason for doing so
seems to be to undermine epistemology. Again. And again. And
yet again. And once you've shown your object doesn't rest on sure
foundations you can sit back and relax.13
Some of the people who supervise theses even argue that it's
enough to undermine epistemology, that this is what needs to be
done. They don't care about the content of their subjects' work.
Let them go ahead with whatever they're doing: it's just that they
should do so with less pretensions. 'The discovery that the

foundations of physics are not as secure as was once believed
makes no difference to what it means to be a good physicist -
though it does mean that physics cannot claim authority over
competing knowledge claims in virtue of epistemology', write
Collins and Yearley with self-assurance.14 We think they've got it
wrong.
Let's face it: taking away foundations makes a difference. Once
legitimations are no longer called upon, something has changed.
Once the local god is no longer in its shrine, receiving offerings of
candles and coca cola, it may still be wrong to go about committing
murder, but this has to be asserted in another way; and it isn't easy
to see how. Therefore a lot of people cling to some variety of
epistemology, even after its death.15 We prefer to try and address
the good in another way. Instead of reinventing epistemology or
being proudly anti-epistemological, we think it is about time to
leave foundational questions behind. And to confront, instead, the
content of whatever it is one studies: the work of people, texts,
technologies, theories. This implies that in one's writing one
does try to make a difference to what it means to be a good
physicist (a good nurse, a good intravenous line). Not by throwing
around judgements or by spelling out how everybody and every-
thing should behave. Addressing the good may also be practised
through attending to the normative ordering of one's field of study.
How?
Nurses' Food
A tradition that has some credentials when it comes to being

explicit about its own politics, is that of symbolic interactionism. It
sets out to protect people from the dangers of being dehumanized.
That is its politics, its normative stance. Those parts of social
science that try to mimic the natural sciences are treated as the
enemy. They are wrong because they study people as if they were
'mere objects'. They forget that human beings have a language
with which they interpret the world around them. For humanist
social scientists, language is important. Its mastery is what dis-
tinguishes humans from non-humans. Thus language is at the core
of the methodological appeal always to listen to what people say,
instead of getting stuck in just watching what they're doing.
The politically outspoken symbolic interactionists radicalize this

approach. They listen, but not just to anyone. They listen for
silenced voices. That is, they pay special attention to those people
whose interpretations and activities tend to get erased from public
awareness. In the words of Leigh Star: 'To do a sociology of the
invisible means to take on the erasing process as the central human
behaviour of concern, and then to track that comparatively across
domains. This is, in the end, a profoundly political process, since so
many modem forms of social control rely on the erasure or silencing
of various workers, on deleting their work from representations of
the work.'16
In the neonatology ward, this seemed like a good method. It
seemed helpful to treat the ward as a site where people belonging
to different worlds and talking in different languages gathered.17 It
would, for instance, make it possible for J to study the relations
between doctors and nurses while neither moralistically blaming
the doctors for their power, nor assuming medical authority to be
inevitable. Symbolic interactionism seemed to offer the possibility
of clearly exposing professional hierarchies and the way they are
ingrained in daily practice. Thus here was a method with which we
could investigate the normative order of the ward.18
So for a while J became the unfailing shadow of nurse N.19 The
day-shift nurses start at seven. Before leaving, the nurses of the
night shift tell about the night: whether the children they took care
of were quiet or restless, and whether their food and medicine
made it to their bloodstream. All the nurses on the day shift have
to pay attention, because responsibility for the children is only
divided between them at the end of the meeting. 'Thus', says N, 'if
one of us is out for coffee, the others know enough to replace her'.
(The nurses in hospital M do not take care of the same child every
day. As N explains during a lunch break: 'You'd get too attached
to them that way. That isn't wise'.) It is almost seven-thirty when
N fetches water in a wash basin, puts it on a cart beside an
incubator and starts to wash Sarah, 33 weeks from conception,
born five days ago.
The field notes provide many more pages of detailed description
of N's working day. But where does this go? On and on, a lot
longer than your patience, and most other readers', is likely to
last. Maybe, we thought, it is better to focus. The frictions,
hierarchies and interweavings between various ways of living
reality are easier to see if a specific part of that reality is outlined.
'You might try blood', A suggested - as blood is her own

favourite object of study, and this seemed a nice way of learning
more about it. But J thought that 'blood' would yield doctor-
centred stories. She had a better idea. Food.
Doctors decide how a new-born should be fed. For this decision
they need data: the child's weight, blood levels of all kinds, the
nurse's report on what happened yesterday. Nurses feed the chil-
dren. When they do so, they are taken to be replacing the parents,
which isn't the case when they do other things, like adjusting the
sensors of a monitor.
For intravenous feeding, the nurse must wash her hands, link the
perfusor to a line attached to one of the baby's blood vessels and
set the pump going. In the case of gavage (stomach-tube) feeding,
the food has to be heated, taken into a syringe, and slowly injected
into the gavage. Sometimes the child regurgitates her food and
then its small body and its bed have to be cleaned. Bottle feeding
requires a nurse to heat the bottle, pull up a chair, take the child
out of its incubator, persuade it to suck, and wait for it to belch.
And every individual act of feeding is only over once the appro-
priate forms have been filled in.
Nurses have to adjust their other activities to the task of feeding.
In the case of intravenous feeding this is easy so long as the lines
remain open, for the foodbag is changed only once a day. But
gavage feeding and bottle feeding have to be done every few
hours. Nurses have to watch the clock as well as watching the
child.
Nurses feed babies with food. And they feed doctors with
information. Nurse N tells how important her observations are to
the doctor. 'I see how this baby eats. So I report this back. Well,
usually if we have a suggestion, then, . .. like if we think the child
is still hungry after a bottle, they reckon with that, the doctors,
they do'. The doctor depends on the observations of the nurse and
takes them into account. But the doctor decides all alone, or in
consultation with other doctors. If N's arms hurt because she has
had to hold a bag containing food high above the baby's head for a
long time with lots of other things waiting to be done, she may say
so. 'So I suggested that we attach the gavage to a pump but the
doctors didn't want that. I don't think it would make any
difference to the child. But they don't want a drip system. So they
don't want a pump. And there I stand, my arm trembling. The
doctors only think about the child, not about my work.'
The doctors subordinate the work of the nurses to their own

decisions in the name of the child. Doctors literally prescribe the
food, and thus have a large say in the nurses' feeding activities.
That the nurses do the actual feeding, meanwhile, is easily
forgotten. In the files where everything that is happening to a child
is noted, the 'food intake' is mentioned. Together with other
elements of the 'total intake', it is balanced against the 'total
output'. All numbers are noted down. But who it was who did the
feeding only becomes relevant if something went wrong. Neo-
natologists who give a case report to their colleagues will look at a
file and say: 'We gave the child seven bottle feeds a day of 50
millilitres each'. But 'we' never did this: the doctors decided it
should be done and the nurses warmed the appropriate fluids, put
them in a bottle, took the baby out of its incubator, woke it up
whenever it fell asleep again, waited for it to belch, and put it back
to bed again.
Using symbolic interactionism as a source of inspiration, we can
show the subordination of nurses' activities to doctors' decisions.
And we can show the way the nurses' work is hidden. So this is the
politics inherent in symbolic interaction. It makes the silenced
(nurse) audible and brings the processes that lead to (her)
subordination into view. No one is blamed, no one is praised, no
rules are laid out. It is through its articulation of the hierarchies of
the ward that symbolic interactionism intervenes in them.
Food Itself
But what about the child, who sleeps, or cries, or tries with more
or less enthusiasm, to engage in the art of sucking? It isn't easy to
get at the child's perspective. New born babies don't talk. We
cannot ask them what they feel and smell and see. With some
imagination, however, we might get a sense of how they experi-
ence the world. Nurses and doctors do so all the time. 'He's
unhappy', they say when they look at a child gasping for breath.
Or: 'Gosh, she's really fighting for her life, isn't she?'. Expanding
upon this skill, we could talk about the huge effort it takes to suck
one's own food and about the satisfaction that follows from it. We
could address the horrors of being woken up time and again in
order to eat. We could mention the pain caused by the needle
which is used to fill one's veins with more and more fluids. Now
we've spoken for the nurses it would make perfect sense to try and
listen to the babies as well. Yet, instead of doing so, we'll pose a
different question.
This is the question: What about the gavages, the pumps, the
incubators, the food? For if we keep giving voice to silenced
people while treating 'things' simply as objects manipulated by
humans, before long Bruno Latour will point his finger at us and
ask severely: 'Are you aware of your discriminatory biases? You
are discriminating between the human and the inhuman'.20 So
what are we doing? Are we simply pushing the line of discrimination
'downwards' a little, from doctor to nurse, from nurse to child,
only to stop short at the boundaries of the human species? Are we
wrongly being asymmetrical?
There is a huge complication here. As we noted, the verstehende
tradition thrives by trying to liberate itself from the natural
sciences. So it is asymmetrical, but takes this to be a virtue. How
else to liberate humans from a fate as 'mere things'? Against this
historical background the additional appeal to liberate 'things'
seems like a sick joke. In lots of places in sociology, it looks like
little more than a way of subscribing to the exploitation of people
who have to sell their labour as a commodity on the market. In
science studies, it looks like a way of putting natural scientists back
in power. We quote: 'Because the special power and authority
of natural scientists comes from their privileged access to an
independent realm, putting humans at the centre removes the
special authority.'21
Meanwhile, however, the method which our accuser Latour
wants us to use to focus on 'things' and make sure that they are not
deleted, doesn't come from the natural sciences at all. Semiotics
comes, instead, from the other end of the intellectual spectrum:
from linguistics. That doesn't seem like something fearful. Why
should one be afraid of the power and authority of a science of
signs? Should one? Since we're still looking for the politics
inherent in theories, and since semiotics promises to be very
different from symbolic interactionism, we will take it along to the
neonatology ward and see what happens. Is semiotics a way to
empower 'the enemy' or does it lead to a form of emancipation
larger than life?
Semiotics started out as a way to analyze language. Instead of
taking words to be labels designating objects on a one-to-one

basis, semiotics treats language as a system of related signs. The
value of any one sign depends on that of the others to which it
relates.22 From this starting point there have been many analyses
of texts. A semiotic analysis doesn't work on the assumption that
the words of a text become clear the moment one leaves the text
for the world. What words mean can be found out by analyzing
what they make each other mean. It can be found out by digging
out their mutual relations.
In the light of such disdain for what happens outside texts, it
may come as a surprise that semiotics might be used as a method
for doing fieldwork in a ward. But, to begin with, wards produce
texts. There are many studies in which researchers listen to and
record talk for later analysis of the resultant texts. It is also
possible to go beyond words by extending the semiotic method
from language to other sign systems. A big desk may mean that a
big person sits behind it. And a lot of bleeping machines signal the
drive to control.23 And then semiotics may also go so far as to
forget about signs and signification, and only retain the stress on
interdependence. Madeleine Akrich and Bruno Latour put it thus:
'Semiotics is the study of order building or path building and may be
applied to settings, machines, bodies and programminglanguages as
well as texts'.24 This version of semiotics is not about meaning: it
makes one try to find out instead what elements, of whichever
character, associated in whichever way, make each other be. We
started to use it.
J went to the ward again and tracked down all kinds of
interdependencies. Do you see that machine, over there, that
records the electrocardiogram? It marks the heart beat by detect-
ing the rhythmically changing field of potential, just as electro-
cardiograms do in any intensive care ward. Its graphs are made by
the baby's beating heart, and in turn they make her heartbeat.
And look: there's a big baby - though he's only big because the
others are so very tiny. But wait a minute. It would be nice if our
semiotic materials were more focused and easily compared with
our symbolic interactionist findings. So J set out once again to
follow food.
But what is 'food'? When words aren't labels designating single
objects, this becomes a difficult question: not of meaning, but of
being; and indeed, an empirical question. When J posed it in an
empirical way, she found not one, but many answers. When, in the
morning, the intern has finished her calculations, food is a series of
numbers. These are put into the computer where they change from
the outcome of a calculation - in the ward - into an instruction to
act - in the dispensary. In the sterile space of the dispensary,
small bottles are filled, fluid by fluid, not child by child. Food is
fluid. One assistant concentrates on bottles with lipid solutions,
the other on those containing glucose. So here food is either a lipid
or a glucose solution. At a quarter-to-five a nurse comes to take all
the bags and bottles on a trolley from the dispensary to the ward.
A weight, that's what food is. To become Matthew's dripping
infusion once the food supplies of all babies on intravascular
feeding schemes are attached.
The single word 'food' takes the semiotician from one object to
another. And the transitions aren't necessarily smooth. Let's
taken an example. First 'food' is a number written down by an
intern as the outcome of calculation. Then, in the dispensary the
number changes into an instruction to mix nutrients in proper
quantities. From being a part of a calculation the number turns
into a part of a manipulation. The two activities relate to numbers
differently. This doesn't necessarily lead to friction. It is easier to
count '10 ml' than '9.734 ml', and manipulating 10 ml is easier than
manipulating 9.734 ml. But sometimes it does. Often it is easier to
do arithmetic with a 30% solution than one of 33.33%. While in
the dispensary, diluting a fluid to one-third of its original concentra-
tion is easier than making a 30% solution. While numerical measure-
ments are needed to get 30%, diluting by a third only requires
adding double the amount of the solvent to the original fluid, and
any container can be used. This is what our semiotic analysis
brings to light: that using one set of numbers as opposed to
another isn't 'innocent'. It facilitates either the calculation, or the
manipulation, of food. Or it represents some compromise between
the exigencies of both practices.25
J wanted more examples. Instead of starting her investigation
from a word again, she sat down and observed the sticky fluid in
the bottle hanging above Matthew's incubator. What is it? There
isn't one word for it. There are many. The bottle contains food for
the baby. It contains the infusion dripping into a vein. And a sugar
suspension. Or part of the 120 calories for every kilo a day.
And then again the bottle's content is a fluid with a particular
composition. Every 120 ml of it is composed of: 45 ml Aminovernos

Paed 6; 40 ml glucose 20%: 4 ml PED-EL; 0.6 ml KCl 7.45%:
1.17 NaCI 10%; 10.3 ml Ca gluconaat 10% and micronutrients. But
it is also nutrition. It is classified as intake. And it is definitely
everything that this small patient is going to get for the next 24
hours.
So there are many words for the content of a single bottle.26
They relate to different concerns and their value doesn't need to
stay the same. The implication that the fluid is a 'sugar suspension'
is that a medicine which is soluble in fat needs to be attached to
another line. The practice in which the fluid is 'intake' requires a
balance with the 'loss'. Or take this divergence that comes back
time and again in discussions about medical practice: as 'food for
the baby', the dripping infusion is a meagre substitute for the
warmth of a breast flowing with milk. Where food is valued as an
element of the relation between people, a gift, a reflection of care
and love, infusions are horrendous. While in terms of nutrition
there's nothing wrong with them: it is food enough to live on, of
good value so long as it comes in appropriate amounts.
In a neonatology ward, the frictions between such different
orderings of food and their concomitant normativities can be
observed. For they are lived in the relief of the parents that their
child is fed - and in their disappointment that this is done through
an intravenous line instead of by mouth. And they also surface in
the discussions of the morning round. 'What are we doing with
Matthew? Do we keep him on a line for a few more days?', a
resident asks. 'Hmm, we might try a bottle, it would be nice for
him to suck', says the attendant. 'Yes, it would be nice, and he has
to get used to it at some point', says a nurse, 'but I think Matthew
isn't getting enough sleep as it is, with all these investigations he's
submitted to all the time. If we were to start with bottles, that
would mean much less sleep. He's not going to thrive on that'.
This discussion is concerned with the work to be done by doctors
and nurses and the emotions of the parents. But it is also about
what will happen with the body and soul of the patient. Semiotics
is a method that helps to show that a discussion about food is also a
discussion about the way Matthew's life is ordered. Which logic
will inform it: that of food supply, the need for love and cuddling,
or that of want of sleep? And the next question to dig out is the
nature of the compromise between them.27
Two Political Styles
J and A sat down to talk about this paper with a draft of it on the
table between them. There: at last both methods were out in
the open. Our version of the difference between them would help
J to improve her next round of fieldwork.28 'For some reason', J
said, 'if we hadn't unravelled it like this, I might have sympathized
too much with people and their perspectives. It must be that, like a
good nurse, I've had a lot of training in human relations. Semiotics
is more for doctors. They are in the habit of linking signs that are
visible on the surface of a body with the diseases that are hidden
inside it'. J suspected that A's love for semiotics was her way of
playing at medicine without being a doctor.29
We might have developed this. Our conclusion could have
shown that the theoretical variants analyzed so far do not stand in
a comfortable meta-position in relation to neonatology. They are
inside it, too. They circulate from one place to another, from a
field to its self-reflections. We might also have gone into an
analysis of how individuals get involved with methods in the course
of their personal theoretical histories. But here and now, we're
after something different. We want to understand more about
being passionate in theory. Committed. We want to unravel which
- one
politics one performs when one uses - or gets caught up in
theory rather than another.30 What do methods make of the
normative order of a field of study?
Symbolic interactionism asks one to follow different people and
see and hear the world through their eyes and ears - even if one is
not supposed to go native, and is allowed to remember that one
has senses of one's own, too. Without being a nurse, J can, if she
follows N, write stories about N's work. If J were a nurse herself,
she wouldn't have time to write stories. And she wouldn't,
moreover, be able to juxtapose N's perspective with that of
doctors, parents or babies. Symbolic interactionism opens up a
space in which the worlds of all these groups are made audible -
the voices of those who are usually able to make themselves heard,
as well as those who are usually silenced or forgotten. As Howard
Becker put it: 'The question is not whether we should take sides,
since we inevitably will, but rather whose side we are on'.31
Symbolic interactionists try to be on the side of the weak.
Does semiotics, as it is sometimes alleged, attend not to the
silenced, but to heroes who network so cleverly and scream so
loudly that all the action is attributed to them?32 Does it take sides
with the strong? But no: this cannot be right. Semiotics is not
about people, whether winners or losers. It is about signs, or other
entities, co-constituting each other and together forming a dis-
course, a network, a logic or another 'Order of Things'. What is
left out of such an order is not people who are forced to be silent,
but signs which are not incorporated as information. Noise. Noise
is constantly differentiated from order.33 Semiotics shows the
effort that this takes. It makes the fragility of the established order
visible, and shows that it is constantly in the process of being
established.
In classical semiotic studies, individual orders were studied as if
they were wholes: the Text, Medicine, Reason. Whatever does not
form a part of these orders was depicted as their noise: the
unarticulated, lay traditions, madness. However, semiotics also
allows one to assume that everything which is noise in relation to
one order, is information in another. It's not chaos, but another
kind of tune. Then a different question comes to the fore: how is it
that different orders (discourses, networks, modes of ordering,
logics) co-exist?.34 As opposed to food there are non-foods,
ranging from infections to sleep. As opposed to foodstuffs, there is
care. As opposed to calculations, there are manipulations. All
these oppositions beg the question of the nature of the relation
between the two sides that have been differentiated- the relation
between one order and another.
So Latour's liberal rhetoric is potentially misleading.35 By
pressing the importance of talking about non-humans with the
very words that symbolic interactionism uses to propel its human-
ism - unjustified discrimination and giving voice - Latour creates
a continuity between the politics of semiotics and that of symbolic
interactionism.36 They are both about liberation, the only differ-
ence is that semiotics encompasses a wider domain. But no! The
originality and the radical potential of semiotics as a political
method isn't like this. Rather, the study of the co-existence of
different orders shows how normativities clash and support one
another in a given field. Order doesn't oppose chaos, there are
many orders. 'On fait toujours la meme erreur. On croit qu'il y a
du barbare et du civilise, du construit et du dissolu, de l'ordonn6 et
du d6sordon6.' Hey, wait a minute, where did we read this outcry
that implies that, in fact, there are multiple orders? Yes: it comes
straight out of Latour's own Irreductions.37 So he knew all along!
434 Social Studies of Sclence
Semiotics tells that life (or non-life) could have been different
for all humans, animals, objects: in short, the entities that populate
the world. There is a historical, diachronic, version which says that
what seems like noise now could, if things had happened slightly
differently, have been incorporated into 'the Order': another
order. Once upon a time, when this or that piece of science was
still in action, the current version rather than some alternative
managed to get established, for contingent reasons that might be
examined. But there is also a topographical, synchronic, version
which says that at any given time there is more than a single order.
Rather, different orderings co-exist. So 'our' version of semiotics,
committed to present-day multiplicity, has another element in
common with symbolic interactionism: not that of giving voice, but
rather that of the co-existence of different 'worlds'.38 But whereas
in symbolic interactionism worlds are created by people who
attribute meaning, in semiotics they are complex orderings of
bodies, food, machines and numbers.39
The difference between symbolic interactionism and semiotics,
then, is not that one is politically sensitive whereas the other is not.
Or that one sides with the weak and the other with the strong.
Rather, it is that their political styles are different. Symbolic
interactionism sets out by thinking about the way in which
different groups of people make sense of the world. In line with
this, its politics has to do with the relations between different
groups of people: between those who speak up and those who are
silenced. Semiotics starts from the way entities co-construct each
other. It tracks the way orderings are generated. In line with this,
its politics is one which explores and exposes the orderings we
currently live. Its archaeological versions dig out alternatives that
have been forgotten. And those versions that are committed to
multiplicity, unravel the relations, the frictions and the resonances
between modes of ordering that co-exist in the present.
This doesn't mean that symbolic interactionism is about people
and semiotics about 'things'. Nurse N's stories told above contain
many 'things'. Nurse N is certainly not indifferent about whether
she has to hold up a gavage herself, or can make use of a pump.
And she has lots of other stories about the way in which some
things are convenient, while others are designed with no thought
for the way in which she works.40 Again, semiotic stories are not
simply about the orderings of bodies, food, machines and
numbers. They also tell about the humans who write down the
numbers or put the food into containers. If sleep is lost because of

physical examinations, then the doctor's needs are met by over-
ruling the immediate desires of the baby.
So the symbolic interactionist method doesn't prevent one from
learning about the way in which humans live with things. And
semiotics allows one to learn about the ordering of the lives of
doctors, dispensary assistants, nurses and babies in incubators.
But there is a difference. For symbolic interactionism, language
separates humans from 'things'. Humans are the active pole: they
use language to attribute meaning to things. By contrast, in
semiotics there is no hierarchy between humans and other entities,
mediated by language. Instead, when language is extended from
words to something larger (whether this be a discourse, a network,
a mode of ordering or a logic), this extension absorbs things within
the linguistic order. And when this process is extended, a point is
reached where the order is no longer linguistic, but a medium of
interdependent entities in which humans, too, are dissolved. They
become part of such a medium when they learn to talk and to
manipulate tubes, bags and sticky fluids.
Making a Difference
Two theories, two methods, two political styles. No, we aren't

going to decide between them.41 But we do want to say something
more about the way in which they relate. For in the framing of this
text, we haven't handled the way they relate in a neutral way.
Each time symbolic interactionism came first. We never criticized
it, but we did use it as the contrast, the background for our account
of semiotics. Even at the point where we explained to semioticians
why humanist sociologists might consider it offensive to level
humans and things, we wrote as if to explain to humanists how the
'misunderstanding' might ever have come about. In short: this text
isn't a passive description of facts about theories, it is an active
move in a theoretical discussion.
So the history of this text doesn't begin with J and A talking
method, but a lot earlier: with the clashes between theoretical
humanism and its others. Perhaps especially when these discussions
take place in English, it seems that humanism has the better
credentials. Since symbolic interactionism is about the liberation
of one group of people from (the complicated and subtle)
domination by another, it fits in neatly with traditional humanist

images of politics. For semiotics it is different. It is a lot further
away from the common sense of traditional political theory. The
politics of semiotics - or maybe it's better to say by now: the
politics we try to articulate here - is unconventional. Its location,
its substance, and the way it relates to differences are all fairly
recent inventions.42
This politics doesn't reinforce or undermine the great divides
between groups of people that seem to have been politicized for
ever. Instead it generates new axes of difference. It creates new
political categories.43 And these do not meet in some centre from
which the world is ruled. For there is, in this politics, no unique
parliament where one needs to be represented; no single place for
speaking up or being heard. Instead of being concentrated in a
privileged location, this politics is everywhere. It is in the king's
palace, but also in the neonatology ward. It is in the prescriptions
of the doctor, but also in the rate at which a fluid drips through a
line. Thus neither is there any favourite political substance. For as
well as 'the subject' and 'the citizen', the substance of this politics
includes such entities as the body, food, or the temperature of an
incubator. As well as groups of people, it includes the shape of a
building, the rhythm of the day, or systems of calculation.
Politics, then, is not an activity that can be separated from
others. For while using '0.3' or 'one-third' is a political matter, it
also remains an arithmetical question. And while 'sleep' and
'hunger' are elements of different modes of ordering the world,
this doesn't mean that they stop being infant desires, or pro-
fessional assignments. Thus this politics may well be about medicine
(or any other field of study) but it is inside it, too. Every tension,
every difference, is thus simultaneously caught up in a range of
evaluative logics. Which means that there is never a single metric
or system for weighing different things and comparing them with
one another: rather, there are many. So someone who comes from
another political tradition, hoping to measure the value of one
mode of ordering against another, will be disappointed. There are
no zero-sum games that lead to conclusions here: instead there is
complexity.
Which need not prevent one from acting. After all, we wrote
this text, didn't we? It is clear and distinct about lots of different
things. It just doesn't sum together at the end. There is no final
word. The move is made, but the movement isn't over. This text
does something: it favours semiotics, as if it were a silenced voice

that deserves to be listened to. But it does not argue for semiotics
and against symbolic interactionism, as if we needed to make a
choice. This is not because we are indifferent, but because we do
not hold the difference between symbolic interactionism and
semiotics to be a conflict that needs to be, or can be, resolved.
Neither deserves to win when it is measured against a neutral
standard - for there is no such standard. And equally, there is no
firm ground for a compromise. So a fusion between the two will
never be smooth. There are many hybrids around. Fine! But
remember: they all show the traces of irreducible difference.
Look at this text. At one point we write about 'symbolic
interactionists' and 'semioticians' as if we were comparing people
who interpret the world in different ways. At another point this
text is about 'symbolic interactionism' and 'semiotics' as if these
were two modes of ordering that exist as theoretical repertoires.
We write/the text is. That's hybrid. In the very words of this article
both sociologies appear. Irreducible.
A: 'It's a bit dense, here and there. And there's plenty more to
say, as always. But I think this is as far as we can get now.
Any more suggestions?'
J: 'Listen maybe we should do something with these little
stories about us that we inserted. Why are they there,
anyway?'
A: 'Don't you like them any more? In the previous version
you did'.
J: 'Oh no, I mean yes, fine, they're all right. I've got quite
attached to them by now. But I mean, are they symbolic
interactionist, or semiotic?'
A: 'Hmm. Good question. [Pause] Now that I think about it, I
think they are both'.
J: 'A compromise?'
A: 'No. They are both. Another hybrid, one in which some-
thing is either the duck or the rabbit. But not both at once.
A symbolic interactionist might say that they show that this
text is the product of two human beings collaborating, you
and me. These stories are a way of exposing ourselves, of
being honest, of not pretending that we didn't sweat. On
the other hand, a semiotician might take them to be a
rhetorical device. Something to liven up the text a little. A
trick used to glue the pieces together and to engage in an

implicit discussion about some of the problems of supervis-
ing and co-authoring. Like who did the fieldwork and who
chewed on the theory. Or who asks the clever questions
and who pretends to answer them. Do you see what I mean?'
J: 'Let's write down that, yes, of course I do. But we can't
know about the reader'.
* NOTES
We want to thank first and foremost the neonatology staff, parents and patients
who so generously allowed Jessica Mesman to witness life on the intensive care
ward. We also thank The Netherlands Organization for Scientific Research, whose
grant gives Annemarie Mol the time to write. And for their criticism and
encouragement our thanks go to Malcolm Ashmore, Marc Berg, Wiebe Bijker,
Nicolas Dodier, Ruud Hendriks, Stefan Hirschauer, Marianne de Laet, Mike
Lynch, Gerard de Vries, Rein de Wilde and Dick Willems. Finally we would like to
thank John Law who worked on the English in this article several times and each
time made suggestions about how its argument might be improved, too.
1. But see Robert Lifton, The Nazi Doctors: Medical Killing and the Psychology
of Genocide (New York: Basic Books, 1986).
2. Hans Radder, 'Normative Reflexions on Constructivist Approaches to
Science and Technology', Social Studies of Science, Vol. 22, No. 1 (February 1992),
141-73.
3. We do not claim that this is the only or best way to be political in theory, but it
surely warrants being explored. For a defence of the investigation of the
normativity residing in one's field of study as opposed to 'being critical', see Luc
Boltanski, L'Amour et la Justice comme Competences (Paris: Metaile, 1990).
4. As categorizations go, it is both right and wrong to present symbolic
interactionism as a subspecies of verstehende sociology. We know that they have
different historical backgrounds - the former in American pragmatism, and the
latter in the German discussions about explanation versus understanding. Yet in
the contrast with semiotics that we set up in this paper, it is useful to group all
'humanist' approaches together. But since we cannot deal with all of them at once,
and do justice to all the varieties, we have picked out symbolic interactionism. One
of our reasons for doing so is that our work is also part of medical sociology, a
domain where this tradition is particularly strong.
5. The question of the politics of theory has been extensively dealt with in
feminism, one of our backgrounds and sources of inspiration. We don't take up an
analysis of the various feminisms in science and technology studies here, but we
think it would be possible to make a more or less similar division between a
verstehende and a semiotic tradition there, too. This division might well run right
through some of the best studies, such as: Ludmilla Jordanova, Sexual Visions:
Images of Gender in Science and Medicine between the Eighteenth and Twentieth
Centuries (New York: Harvester Wheatsheaf, 1989); Londa Schiebinger, The Mind
Has No Sex? Women in the Origins of Modern Science (Cambridge, MA: Harvard
University Press, 1989); and Donna Haraway, Primate Visions: Gender, Race and
Nature in the World of Modern Science (New York: Routledge, 1989).
6. A neonate is a new-born child. Neonatology is the subspecialism in paediatrics
which takes care of new-born babies with medical problems. In severe cases, new-
born babies with medical problems are kept in the hospital. In very severe cases
they stay in incubators in 'neonatal intensive care'. That's where J did most of her
observations (but she also went to see what happened in the low- and medium-care
parts of the ward). J first observed for several months in a Dutch hospital, and later
in one on the east coast of the United States.
7. Among J's favourite books there were several based on fieldwork in hospitals,
such as the famous study of the regulation of norms among surgeons: Charles Bosk,
Forgive and Remember: Managing Medical Failure (Chicago, IL: The University of
Chicago Press, 1979); and of course that other book situated in a neonatology
ward, investigating the local meaning of 'ethics': Fred Frohock, Special Care:
Medical Decisions at the Beginning of Life (Chicago, IL: The University of Chicago
Press, 1986). Though these two are clearly part of the verstehende tradition, recent
anthropological studies often show a theoretical mixture: see some of the studies in
Margaret Lock and Deborah Gordon (eds), Biomedicine Examined (Dordrecht:
Kluwer, 1988); and in Shirley Lindenbaum and Margaret Lock (eds), Knowledge,
Power and Practice (Berkeley, CA: University of California Press, 1993).
8. For the undermining of the hope that methods or any other form of
epistemology could function as a shield against sexism and racism, see Annemarie
Mol, 'Wombs, Pigmentation and Pyramids: Should Feminists and Anti-Racists
Show Biology Its Proper Place?', in Alkeline van Lenning and Joke Hermes (eds),
Sharing the Difference (London: Routledge, 1991), 149-63.
9. Steve Woolgar, 'Some Remarks about Positionism: A Reply to Collins and
Yearley', in Andrew Pickering (ed.), Science as Practice and Culture (Chicago, IL:
The University of Chicago Press, 1992), 327-42, quote at 339.
10. Traditional epistemology isn't appreciated as a 'received view' by (former)
students of constructivist teachers. They get the impression that the books and
articles they are encouraged to read, written by such authors as Latour, Haraway,
Mulkay, Bijker, Knorr-Cetina, Cowan, name them, present them with well-
established views. And so they do.
11. Others have also reported on the dreadful feeling that may haunt a
fieldworker, that she is never where the action is. See, for a particularly vivid
example, John Law, Organizing Modernity (Oxford: Blackwell, 1994). And, for
another ethnography in which the work of doing fieldwork is reflected upon in an
intriguing way, see Dorinne Kondo, Crafting Selves: Power, Gender and Discourses
of Identity in a Japanese Workplace (Chicago, IL: The University of Chicago Press,
1990).
12. For questions to do with treatment and not-treatment, see Jessica Mesman,
'Machines en Moraal: Verslag van een Onderzoekservaring', Krisis, Vol. 48
(1992), 5-18.
13. For a similar criticism, in a feminist mode, see Stefan Hirschauer and Anne-
marie Mol, 'Shifting Sexes, Moving Stories: Feminist/Constructivist Dialogues',
Science, Technology, & Human Values, Vol. 20, No. 3 (Summer 1995), 368-85.
(Anti-)epistemological preoccupations also dominate the other recent attempt

to unravel differences between different kinds of construction-stories: Sergio
Sismondo, 'Some Social Constructions', Social Studies of Science, Vol. 23, No. 3
(August 1993), 515-54. Sismondo, however, misses the point of the semiotic
strands in science and technology studies.
14. H.M. Collins and Steven Yearley, 'Epistemological Chicken', in Pickering
(ed.), op. cit. note 9, 301-26, at 324. Quoting another text of Collins', which
defends a similar position, Radder remarks that Collins asks us to 'respect the norm
of not criticizing science' - thereby nicely revealing the normativity of this
position: see Radder, op. cit. note 2, 143.
15. Hans Radder (ibid.) is a good, thoughtful example of this. Radder argues
that a modest realism is needed to account for any politics of the risks technological
systems entail.
16. Susan Leigh Star, 'The Sociology of the Invisible: The Primacy of Work in
the Writings of Anselm Strauss', in David Maines (ed.), Social Organization and
Social Processes: Essays in Honor of Anselm L. Strauss (Hawthorne, NY: Aldine
de Gruyter, 1991), 265-83.
17. For an example of a study using the concept 'world', in the sense of 'social
worlds', see Adele Clarke, 'A Social Worlds Research Adventure: The Case of
Reproductive Science', in Thomas Gieryn and Susan Cozzens (eds), Theories of
Science in Society (Bloomington, IN: University of Indiana Press, 1989), 15-42.
18. In medical sociology many texts have an undertone of either admiration or
anger. Parsons' enthusiasm for the medical profession, which he saw escaping
the dichotomy between Gemeinschaft and Gesellschaft, keeps on clashing with
Freidson's moral outrage, provoked by the sad outcomes of a wide range of
empirical studies. For a further analysis of the theoretical roots of medical
sociology, see Uta Gerhardt, Ideas about Illness: An Intellectual and Political
History of Medical Sociology (Basingstoke, Hants.: Macmillan, 1989). Symbolic
interactionism, as we have mentioned, is also strong in the field of medical
sociology: see, for a good example, Anselm Strauss, Shizuko Fagerhaugh, Barbara
Suczec and Carolyn Weiner, The Social Organization of Medical Work (Chicago,
IL: The University of Chicago Press, 1985).
19. 'The nurse' may of course be a problematic point of departure. Nurses aren't
all alike, nor are the ways they work with food and the meanings this has for them.
For a defence of breaking down all group categories and taking individuals, and the
different situations they find themselves in, as the appropriate units of analysis, see
Nicolas Dodier, L'Expertise Medicale: Essai de Sociologie sur l'Exercice du
Jugement (Paris: Metaile, 1992).
20. In the rest of Latour's text the word 'nonhuman' is used, instead of
'inhuman': Bruno Latour, 'Where Are the Missing Masses? The Sociology of a Few
Mundane Artifacts', in Wiebe Bijker & John Law (eds), Shaping Technologyl
Building Society: Studies in Sociotechnical Change (Cambridge, MA: MIT Press,
1992), 225-58, quote at 236.
21. Collins & Yearley, op. cit. note 14, 310.
22. For most English-language writers this is confusing. Semiotics includes the
early Wittgenstein among its enemies, for it doesn't take words to refer. But
semiotics doesn't follow the later Wittgenstein when he presents words as actions.
Semiotics links words to each other, not to the situations in which they are spoken.
It localizes signs in sign systems, not in pragmatics. For a serious introduction to
semiotics, see Algirdas J. Greimas, Semiotique et Science Sociales (Paris: Editions

du Seuil, 1976). For a series of examples from outside the field of science studies,
see Marshall Blonsky (ed.), On Signs (Oxford: Basil Blackwell, 1985).
23. There are a lot of studies of medicine that semiotically analyze 'sign systems',
ways of talking, of making sense. In so far as they go into the field, they turn it into
an assemblage of spoken words. Others take up events and objects but only in as
far as they are 'signifying'. See, for instance, Kathryn Vance Staiano, Interpreting
Signs of Illness: A Case Study in Medical Semiotics (Berlin: Mouton de Gruyter,
1986). In this mode, semiotics comes close to and is linked up with hermeneutics;
see, for example, Byron J. Good and Mary-Jo Del Vecchio Good, 'The Meaning of
Symptoms: A Cultural Hermeneutic Model for Clinical Practice', in Leon Eisenberg
and Arthur Kleinman (eds), The Relevance of Social Science for Medicine
(Dordrecht: Reidel, 1980) 165-96.
24. Madeleine Akrich and Bruno Latour, 'A Summary of a Convenient
Vocabulary for the Semiotics of Human and Nonhuman Assemblies', in Bijker &
Law (eds), op. cit. note 20, 259-64, quote at 259. This version of semiotics draws on
a Foucauldian tradition of attending to material elements. And it doesn't always go
by the name of 'semiotics'. There are a variety of names around, each indicating
something slightly similar and slightly different: discourse analysis, actor-network
theory, post-structuralism. See, for some of the background, Christopher Tilley
(ed.), Reading Material Culture (London: Basil Blackwell, 1990).
25. For other examples of the politics entailed in different modes of calculation,
see Malcolm Ashmore, Michael Mulkay and Trevor Pinch, Health and Efficiency:
A Sociology of Health Economics (Milton Keynes, Bucks.: Open University Press,
1989).
26. In semiotics, everything is what it is relative to the other elements of the
practice (network, order, . . .) it is a part of. This means that semiotics is a
powerful method for putting the natural sciences in their place. Instead of
confronting the natural scientists' stories with those of other people, it confronts all
the various practices with which the natural sciences are intertwined with each
other, and with other practices linked up with other truths and norms.
27. For an interesting analysis of relations between different orderings, see the
study of the way people justify their actions and plans in Luc Boltanski and Laurent
Th6venot, De La Justification: Economies de la Grandeur (Paris: Gallimard, 1991).
For an analysis of medical judgement that comes out of this tradition and is also
closely related to what we are doing here, see Dodier, op. cit. note 19.
28. And her writing. For an analysis of the importance of numbers in the
regulation of decisions and doubt in the neonatology ward, see Jessica Mesman,
'The Digitalisation of Medical Practice: Uncertainty in the Neonatal Intensive Care
Unit' (paper presented at the 4S Annual Meeting, Purdue University, West
Lafayette, Indiana, 19-21 November 1993).
29. The classic example of an analysis of semiotics in medicine, that is also in
some ways semiotic, is of course Michel Foucault, La Naissance de Ia Clinique
(Paris: PUF, 1963). Foucault himself, meanwhile, is a good example of someone
who imported elements of medical thought into social theory. In taking 'bodies'
rather than 'persons' as the starting point of social theory, his sociology is social
medicine rather than social psychology.
30. There's a lot left to say about theory-passion: see also, Janet Rachel, 'Acting
and Passing, Actants and Passants, Action and Passion', American Behavioral
Scientist, Vol. 37 (1994), 809-23.
31. Howard Becker, Sociological Work (New Brunswick, NJ: Transaction
Books, 1970), 123.
32. For this accusation, followed by a beautiful attempt to save the alleged 'good
elements' of semiotics by absorbing them into symbolic interactionism, see Susan
Leigh Star, 'Power, Technologies and the Phenomenology of Conventions: On
Being Allergic to Onions', in J. Law (ed.), A Sociology of Monsters? (London:
Routledge, 1991), 26-56.
33. For an intriguing study on noise and its exclusion, on the dream of purity and
the parasites who constantly come and spoil it, see Michel Serres, Le Parasite
(Paris: Grasset, 1980).
34. We're comfortable with none of these words, but know none that are any
better. 'Discourse' is the word drawn from Foucault's work: see Michel Foucault,
L'ordre du discours (Paris: Gallimard, 1970). For the use of 'network' in a semiotic
way, see Michel Callon and John Law, 'On the Construction of Sociotechnical
Networks: Content and Context Revisited', in Lowell Hargens, R. A. Jones and
Andrew Pickering (eds), Knowledge and Society: Studies in the Sociology of Science
Past and Present (Greenwich, CT: JAI Press, 1989), Vol. 8, 57-83. 'Modes of
ordering' is the term used by John Law, op. cit. note 11. For an example of a study
that analyzes the co-existence of several medical 'logics', see Annemarie Mol and
Marc Berg, 'Principles and Practices of Medicine: The Co-Existence of Various
Anemias', Culture, Medicine and Psychiatry, Vol. 18 (1994), 247-65.
35. For a fiercer attack on the liberalism of what it calls 'actor-network theory',
see Steve Brown and Nick Lee, 'Otherness and the Actor Network: The
Undiscovered Continent', American Behavioral Scientist, Vol. 37 (1994), 772-90.
36. And Latour is not alone. We're only attributing all the action to him. So see
also, John Law, 'Introduction: Monsters, Machines and Sociotechnical Relations',
in Law (ed.), op. cit. note 32, 1-23. Law urgently warns us not to be speciesist while
attempting to avoid classicism, sexism and ethnocentrism, thus locating his call for
attending to non-humans in the best of liberal traditions. But see, for a different
approach, Law, op. cit. note 11.
37. Bruno Latour, Les Microbes: Guerre et PaixllIrreductions (Paris: Metaile,
1984), 180.
38. For some interesting reflections on multiplicity, using the notion of 'versions'
of the world in a way that borders on symbolic interactionism, see Nelson Goodman,
Ways of Worldmaking (Indianapolis. IN: Hackett Publishing Company, 1978).
39. This talk about 'our' semiotics implies neither that we claim it as our
invention, nor that we want to stick to it. For an example of network semiotics
being used and then supplemented with another method (or non-method), see
Annemarie Mol and John Law, 'Regions, Networks and Fluids: Anemia and Social
Topology', Social Studies of Science, Vol. 24, No. 4 (November 1994), 641-71.
40. Maybe this explains why symbolic interactionists incorporate the semiotic
attention to 'things' so gratefully and eagerly. Clarke and Gerson, for instance,
write that Latour 'insists, correctly we believe, that we view all participants in a
setting as actors, not just humans. ... This point is an important extension to basic
interactionist principles and ties to issues of meaning and action which Mead
explored philosophically': Adele Clarke and Elihu Gerson, 'Symbolic Interactionism
in Social Studies of Science', in Howard Becker & Michal McCall (eds), Symbolic
Interaction and Cultural Studies (Chicago, IL: The University of Chicago Press,
1990), 179-214, quote at 198. We hope that we have managed to make it clear that
matters are a little more complicated than this suggests.
41. The easy sociology here is that this is because we're Dutch authors. 'We
Dutch' prefer not to get caught up in international fights. Instead of taking a stand,
we specialize in importing and exporting. Thus our compatriots Wiebe Bijker and
Gerard De Vries even managed to keep their cool in the 'Chicken' debate in which
Harry Collins and Steven Yearley directed all their aggression at Bruno Latour and
Michel Callon, who didn't miss the opportunity to strike back: see Collins &
Yearley, op. cit. note 14; Collins and Yearley, 'Journey into Space', in Pickering
(ed.), op. cit. note 9, 369-89; and M. Callon and B. Latour, 'Don't Throw the Baby
Out with the Bath School! A Reply to Collins and Yearley', in ibid., 343-68. As De
Vries commented, 'I happened to be present in Bath at the meeting where the first
shots were fired. After this meeting, as a true citizen of a trading nation, I tried to
keep in touch with both parties' (Gerard De Vries, 'Bath/Paris, SSK and ANT: Two
Rival Philosophies', [paper presented at Groningen University, 27 November 1993]).
42. In our framing of 'the political', we mostly draw on Foucault and discussion
about his work. See also, for recent shifts in the meaning of 'political' in political
theory, Agnes Heller and Ferenc Feher, The Postmodern Political Condition
(Oxford: Blackwell, 1988).
43. This in part explains the uneasy relation between feminism and semiotics.
Non-feminist semioticians tend to defend themselves against attacks from non-
semiotic feminists who say that 'they're not paying enough attention to gender
questions', by arguing that the difference between the genders - and indeed the
sexes - isn't pregiven. Semiotically-attuned feminists, meanwhile, try to find out
if, when and how sex differentiations are locally made. For a series of interesting
struggles with this matter, see Donna Haraway, Simians, Cyborgs and Women: The
Reinvention of Nature (London: Free Association Books, 1991); and, for an
example of the way this may work out in an analysis of medical practice, see
Vicky Singleton and Mike Michael, 'Actor-Networks and Ambivalence: General
Practitioners in the UK Cervical Screening Programme', Social Studies of Science,
Vol. 23, No. 2 (May 1993), 227-64.
Annemarie Mol studied medicine and philosophy, and

contributed to the writing of this paper while she was a
Constantijn en Christiaan Huygens fellow of The
Netherlands Organization for Scientific Research, and
attached to the Department of Philosophy at the University
of Limburg. She publishes in philosophy, feminism and
social studies of science, technology and medicine.
Jessica Mesman studied nursing and theory of the health
sciences. She is currently writing a thesis on ethics in the
clinic, for which she did fieldwork in the neonatology wards
of a Dutch and a North American hospital.
Authors' addresses: (AM) Willem de Zwijgerstraat 25; 3583

HB Utrecht; The Netherlands; e-mail: a.mol.@cc.ruu.nl
(JM) Department of Philosophy, Faculty of CulturalStudies,
University of Limburg, P.O. Box 616, 6200 MD Maastricht,
The Netherlands: e-mail: J.Mesman@tss.rulimburg.nl

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Neonatal Food and the Politics of Theory: Some Questions of Method

Author(s): Annemarie Mol and Jessica Mesman

Neonatal Food and the Politics of Theory:

Annemarie Mol and Jessica Mesman

In this paper, we address some questions of method. We don't

Social Studies of Science (SAGE, London, Thousand Oaks, CA and New

'Normative questions deal with what ought to be done or

J said: 'Can I ask you some questions of method?'. Whereupon A

A was reluctant. She had never believed in 'method' as a

bodies. Yes, these problems were soluble. The secretary advised J

should do so with less pretensions. 'The discovery that the

A tradition that has some credentials when it comes to being

The politically outspoken symbolic interactionists radicalize this

'You might try blood', A suggested - as blood is her own

The doctors subordinate the work of the nurses to their own

taking words to be labels designating objects on a one-to-one

composition. Every 120 ml of it is composed of: 45 ml Aminovernos

Two Political Styles

numbers or put the food into containers. If sleep is lost because of

Two theories, two methods, two political styles. No, we aren't

domination by another, it fits in neatly with traditional humanist

does something: it favours semiotics, as if it were a silenced voice

trick used to glue the pieces together and to engage in an

(Anti-)epistemological preoccupations also dominate the other recent attempt

semiotics, see Algirdas J. Greimas, Semiotique et Science Sociales (Paris: Editions

Annemarie Mol studied medicine and philosophy, and

Authors' addresses: (AM) Willem de Zwijgerstraat 25; 3583

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