It is a mistake to think of representation as superficial and of representationality as dwelling on the surfaces of things, while the depths with disuse go septic. So it is a mistake to view pathologies as bubbling up from the underneath, bursting through, worming their way up like the evil doubles of roots, and pocking the surface, cratering it, oozing out, crusting over, forming subcutaneous – and sub-representational – reservoirs of infection, which will need before disease spreads to be lanced and drained. So it is mistake that is fun to make. Theatrical.
It is not also the visual field which is occupied. The visual field is the last to be occupied, the most despotic once its territory is claimed. Consider the images on the screen of the ultrasound scan. The usually monochrome architecture of a living organism, perhaps yours. Are these images primarily visual? Or given the instrument acting on them, are they acoustic images? The socalled delivery mechanism relies on a visual index, from which a diagnosis can be made, or, again, it relies on a visualised place on which the performance of diagnosis can take place.
The diagnosis is a negotiation with the representation. For there to be a diagnosis there must be a representation. The trick lies therein that the depths are seemingly brought to light in the representation, they are revealed on the surface. But this simply reinforces the impression of the representation, of something in the depths of the bios being represented to our eyes, shifting the emphasis away from the delivery mechanism, the media – or medium. The representation becomes an index to pathology by sleight of hand.
The diagnosis is a technical performance, with instruments, as well as taking place in a territory described by technological limits. The latter, the lab and the machine which carries the signal interpreting it into a visual sign, precede an instrumentalization of the surface, the performance proper, made possible by the fact of representation. Both patient and specialist or the doctor and both the subject and technician are complicit in the performance as the signs are there for both to read.
The difference is not one of interpretation. The interpretation has already occurred in the ultrasound scan conveying its information to the screen. The difference is juridical, resting on a jurisprudence of who may by law take up the tools, of who can claim the authority to act on the information represented on screen, and subsequently in photos of the scan.
The lab technician will usually demur from giving a definitive reading. What they say will be some kind of rehearsal for the official diagnosis and prognosis, the handing down of the sentence. And you yourself will be able to play your part in the performance, which, when it comes down to it, involves no more than a shuffling of amortized planes, the instrumentalization of given representations.
In other words, the representation enables the instrumentalization which usually has surgery as its primary metaphor. Even when the shadowy figure in the scan is moving independently,the institutional hierarchy in medicine acts from the cutters down: they would rather have it that the baby is cut out of the womb. Which is to say no more than that the surgeons are at the top of the pyramid. But the fact that they are despotically colours the whole field, the whole drama, all the performances, yours included. Or, you could say, this is how it works in a surgical theatre: the light falls on all unequally; there is the instrumentalization enabled by the representation and then the performance of which the wielding of glinting steel plays only a part, a lie that tells its own truth. The truth is a metaphor.
Simply this: representation is a way of cutting up the actual in order to redeploy it according to specific knowledges and understanding and prevailing doxa. What cannot be got away from is this deathlike insistence, capturing, indexing the real, and giving it a virtual halflife in representation.
