Visualizing the invisible in neuro-critical care
Hanne Bess Boelsbjerg, Lise Marie Andersen and Mette Terp HøybyeZoom
Assessing the ambiguous state of consciousness in patients with severe acquired brain injuries employs multiple technologies including neurological and behavioural measure, monitoring of vital functions and clinical observations. Together they contribute towards establishing assessments of consciousness in neuro critical care which are at the core of evaluating the potential for some level of recovery in the severely damaged patients.
In an extensive anthropological fieldwork in two highly specialized intensive care units, we followed health care professionals (HCP) in their clinical routines and assessments of consciousness in such patients. Through these practices HCP seek to trace ‘signs of consciousness’, and turn them into something that can be visualized and articulated.
By unfolding the subtle sensations related to registering patient’s ability to respond to stimuli provided through touch, movement and audible prompts, we illustrate how HCP establish an understanding of the patient’s condition and potential.
HCP articulate their registrations using metaphors like ‘she is just underneath the surface’ or ‘it’s an island of consciousness’. Combining the sensory metaphors and the monitored bodily functions HCPs are enabled to produce visualized expressions of consciousness. This leads to our discussion on how the assessment of consciousness depends upon visualizing the invisible through articulation and representation.