Arguing on Facebook about COVID: a case study of key beliefs, rationales and strategies

Throughout the COVID-19 crisis, social media platforms have become well-known for both disseminating misinformation and conspiracy theories as well as acting as valuable information sources concerning the novel coronavirus and governments’ efforts to manage and contain COVID. Facebook in particular – the world’s most popular social media site – has been singled out as a key platform for naysayers such as anti-vaccination exponents and ‘sovereign citizens’ to express their resentment at containment measures such as lockdowns, quarantine and self-isolation regulations, vaccination mandates and face-covering rules.

What rationales and beliefs underpin these arguments? How and to what extent are they contested or debated on Facebook? What rhetorical strategies are employed by commentators to attempt to persuade others that their views/facts are correct?

To explore these questions, I chose a case study of a short video (2 minutes 5 seconds long) shared by the World Health Organization (WHO) on Facebook on 19 February 2022. I came across the video three days after it was published on the platform as part of my routine Facebook use. It turned up in my feed because a Facebook friend of mine had shared it (which it how the average Facebook user is presented with content from organisations like WHO if they don’t follow these accounts themselves.) I noticed how much engagement this post had received in those three days. There were 6,000 reactions: including 5k likes but also 551 laughing face emojis (suggesting viewers found the video content risible), 1.2k comments, 2.2k shares and 244k views. I decided to delve into the comments thread to see what people were saying in response to the video.

WHO’s official Facebook page has a huge follower base: at the time that I viewed this video, their page listed over 14 million likes and over 38 million followers. It is clearly a highly trusted Facebook presence. Many of its posts have thousands of reactions (the use of emojis to respond to posts), likes, comments and shares. WHO shares content at least once a day and often more frequently: most of this content is made by WHO itself in its role to communicate preventive health messages globally. In reviewing their latest content, it is evident that WHO has a very busy and accomplished team making their social media content.

The video featured two WHO experts: Dr Mike Ryan (pictured above from the opening section of the video) and Dr Maria Van Kerkhove, both of whom feature regularly in WHO’s social media content. Ryan was introduced in a caption as ‘ED, WHO Health Emergencies Programme’ and Van Kerkhove as ‘COVID-19 technical lead, WHO Health Emergencies Programme’.

In this video, both people spoke to camera as if to an unseen interviewer, explaining why they were concerned about governments beginning to loosen COVID restrictions too quickly.

The written introduction to the video stated:

Some countries are lifting all public health and social measures despite high numbers of COVID-19 cases/deaths. Dr Mike Ryan and Dr Maria Van Kerkhove explain why a slow approach is better.

Ryan and Van Kerkhove went on to use simple English to acknowledge that there is a strong desire on the part of governments and citizens to ‘open up’ and remove all COVID restrictions and ‘go back to normal’. They warn, however, that such actions could lead to the pandemic continuing ‘much longer than it needs to be’ due to ‘the political pressure to open up’ in ‘some situations’, and that replacing abandoned control measures would be difficult if a new variant emerged. Ryan and Van Kerkhove emphasise the importance of ‘a slow, step-wise approach’ to lifting COVID restrictions rather than an ‘all-or-nothing approach’ that ‘many countries’ are adopting at this point in the COVID crisis.

Both speakers are careful not to single out individual leaders or governments for criticism in these quite vague statements, leaving it up to the viewer to make a judgement about exactly to which ‘situation’ they are referring. These experts also ‘acknowledge uncertainty’ and that their concerns may be unfounded but emphasise the need for caution. They note that they do not ‘blame anyone’ for feeling confused, given the continual flux in governments’ COVID measures. Van Kerkhove ends by stating firmly that ‘you [the video viewers] have control over this’ regardless of government actions and then Ryan chimes in by asking ‘every individual just to look at your situation’ and ‘be smart, protect yourself, protect others, get vaccinated and just be safe and careful’.

There’s a lot that could be said about the statements made by these two WHO experts in this video: the veiled critique of ‘many countries” government actions and health communication efforts, the focus on individual responsibility in the face of government inaction and lack of responsibility. But I wanted to direct my attention to the more than 1,000 comments Facebook users wrote in response to this video.

I noticed first that comments came from all over the world – evidence again of the global reach and popularity of Facebook. When commentors were responding to each other, therefore, there were many examples of someone in Asia, South America or Africa engaging with Facebook users located in the USA, Australia, Canada, Europe or the UK.

Another observation was that a vigorous debate was occurring in the comments section, with supporters of the video’s messages seeking to argue with those who decried what they saw as an overly cautious or even unscientific argument from the WHO experts. Those who did not support the WHO’s points made such arguments as (my paraphrasing):

  • opening up will help the economy – people need jobs
  • people’s lives need to get back to ‘normal’
  • most populations are now adequately vaccinated, so there is no need for further restrictions
  • governments are lying to their citizens and spreading false information as a way of exerting greater control over them
  • the novel coronavirus does not exist and nor does COVID
  • it is risk to one’s health to wear masks for prolonged periods of time
  • other health conditions kill more people than COVID
  • COVID mass testing and mass vaccination have been conducted as a profit-making enterprise serving Big Pharma and governments
  • WHO’s facts are wrong and they are spreading lies and fear, trying to promote their own interests for political purposes
  • WHO has shown little leadership during the pandemic and is ineffectual
  • face masks give a false sense of security and are useless as a preventive measure
  • people who follow government restrictions are being controlled and can’t think for themselves
  • the pandemic has been going on for two years and governments and health agencies like WHO are still not controlling it adequately
  • the person commenting does not like to feel forced to do anything by government authorities, especially if restrictions/mandates do not help the situation (in their view) – ‘my body, my choice’
  • even vaccinated people can still become infected with or transmit the coronavirus, fall ill or die of COVID – they are therefore pointless
  • COVID is ‘real’ but controllable like influenza or no worse than the common cold
  • governments who continue to impose restrictions/mandates are ‘Socialist’
  • people’s immune systems can be strengthened without vaccines due to basic health promoting strategies
  • people are dying from being given too many COVID vaccines (including children), not from the disease itself
  • vaccines are ‘bioweapons’
  • the medical establishment and the government are forcing COVID vaccines on people and hiding evidence of their serious side-effects
  • there is a difference between ‘dying with COVID’ and ‘dying from COVID’ – governments and health agencies are deliberately obscuring this
  • people need to be freed from living in fear
  • scientists and medical experts are controlled by governments to serve political agendas
  • ‘commonsense’ practices such as eating a healthy diet, taking Vitamin D and washing hands regularly will adequately protect against COVID

People who supported the points made by the WHO experts in the video tended to be reactive in their comments, responding to the naysayers using such rationales as:

  • COVID is a real threat and has killed many people – we still need to be cautious to protect ourselves and others
  • even though the situation seems to be improving in many countries, new variants could emerge that could pose major challenges
  • scientific and medical knowledge and expertise should be trusted over other information sources
  • many people are still dying
  • opening up too quickly will lead to many more deaths globally
  • vaccines do protect against serious disease and death and everyone should accept them: the benefits outweigh any risk
  • face masks are important protective agents against infection (just as shoes, for example, protect against foot injuries)
  • people who don’t want to conform to COVID restrictions/mandates are being selfish and don’t understand the importance of self-sacrifice to protect others
  • wearing face masks and getting vaccinated are small sacrifices to make for the greater good and saving others’ lives as well as self-protection
  • economies are damaged if too many workers become ill from COVID and can’t go to work
  • the person commenting still feels at high risk from COVID and is happy to continue to engage in preventive measures such as wearing masks and accepting vaccination
  • young children have not yet been protected by COVID vaccination in many countries and therefore are vulnerable to infection
  • mass vaccination programs have worked well globally to protect people against other serious diseases, such as polio
  • people who support dropping all restrictions are engaging in magical thinking or do not want to face reality
  • low income countries do not have enough medical support to help people who become ill with COVID
  • countries should work together in a global response to COVID rather than simply pursing nationalistic interests

Rhetorical strategies on the part of both ‘sides’ of the argument included:

  • giving examples from their own lives/health (e.g. they had avoided COVID because of wearing face masks and getting vaccinated or they avoided COVID because their immune systems were naturally strong and not weakened by vaccines)
  • describing the situations of people they knew personally (e.g. those who died from COVID vaccines or those who died because they refused COVID vaccines)
  • urging people to ‘do their research’ or ‘due diligence’ and not just rely on television, social media or what their friends tell them
  • accusing those who are disagreeing with them of ‘lying’, ‘making up facts to suit their agenda’, as ‘stupid’ or simply gullible (to either misinformation or in believing the science)
  • providing hyperlinks to articles or blog posts outside of Facebook to support their claims and urging others to read them as part of educating themselves about the ‘facts’
  • claiming ‘truth’ in response to ‘non-truths’, ‘lies’ or ‘fake news’
  • contrasting the value of all human lives versus the value of individual freedom
  • the use of large numbers to support the validity of the arguments

As just one example of a pithy exchange between two commentators:

Commentator 1: We can’t stop living.

Commentator 2: 900,000 Americans have.

These findings demonstrate the kinds of beliefs and rationales underpinning Facebook users’ concepts of COVID risk and their attitudes towards COVID restrictions. Both sides received ardent support from others. Comments sometime descended into ad hominem attacks but most of the content was focused on presenting opinions or ‘facts’ and responding to these arguments with counter-claims. Most of the commentators attempted to act as educators, challenging the misinformation or extreme views put forward by the naysayers. Emotions ran high as people defended their position or accused others of stupidity, blindness to the truth or making up facts. Some extreme misinformation positions and conspiracy theories were advanced (e.g. ‘the holy blood of Jesus Christ is our only protection’) but many arguments concerned topics such as whether vaccines were necessary or effective (and how many there should be) or raised issues around the politics of COVID control.

The main insight from this single case study of COVID commentary in response to a peak health agency’s video posted to Facebook is that there was little evidence of an echo-chamber or filter bubble where only one main viewpoint was put foward. Instead, vigorous debate and contestation about ‘the truth’ went on in the comments section, suggesting an open forum for many opinions to be aired. However, it was also clear that people’s opinions or beliefs were not challenged in and through the debates or comments. Despite all the argumentation and presenting of examples from personal experience or hyperlinks to other material, no consensus or acceptance of other people’s opposing views was evident in these comment threads.

Have large numbers of Australians left Facebook? It seems not

I am currently working on analysing interviews from my newest research project ‘Facebook and Trust’. This project was designed in response to the huge publicity given to the Facebook/Cambridge Analytica scandal in March this year. I was interested in investigating how Australian Facebook users were using the platform in the wake of the scandal and what their feelings were about how Facebook make use of the personal information that is uploaded.

Following the scandal, numerous news reports claimed that large numbers of Australians were deleting their Facebook accounts as part of the #DeleteFacebook trend. As one report contended,

Many Australians are for the first time discovering just how much Facebook knows about them and many are shocked, leading them to quit the platform.

A Pew survey of US adults conducted soon after Cambridge Analytica found that around a quarter of respondents had deleted the Facebook app from their phone in the past 12 months, and more than half had adjusted their privacy settings  The survey did not ask directly about why the respondents had taken these measures, and as the time-frame related to the past year there may have been other reasons that these respondents had taken these actions (for example, different controversies over ‘fake news’ or poor content moderation on Facebook that have also received high levels of news media publicity).

Indeed, it is interesting to compare these findings with a previous Pew survey undertaken at the end of 2012, in which over two-thirds of the respondents who were current Facebook users said that they had sometimes voluntarily taken a break from using the platform and one-fifth who said they were not current Facebook users had used the platform at one time but had stopped using it. Those who had taken an extended break or had stopped using Facebook referred to reasons such as not wanting to expend too much time on the platform or finding the content overly personal, trivial or boring. As this survey suggests, some Facebook users have long had ambivalent feelings about using the platform.

There are no reliable statistics that I can find on how many Australians have deleted their Facebook account post-Cambridge Analytica. According to the Social Media Statistics Australia website, which provides a monthly report on Australians’ use of social media, in September 2018 approximately 60% of Australians (across the total population, including children) were active Facebook users, and 50% of Australians were logging on once a day. A similar proportion of Australians were regular YouTube users: both platforms had 15 million active monthly users. Next in order of popularity were Instagram (9 million users per month), Snapchat (6.4 million), WhatsApp (6 million), Twitter (4.7 million), LinkedIn (4.5 million) and Tumblr (3.7 million).

In terms of age breakdown, the site reports that in September 2018, Australians aged 25 to 39 years were the largest group of Facebook users (6.1 million), followed by those aged 40 to 55 (4.1 million), 18 to 25 (3.5 million), 55 to 64 (1.6 million) and 65 years and over (1.2 million). Less than a million of Australians aged 13 to 17 years used Facebook,

I compared the report for February 2018 (the month before the Cambridge Analytica scandal was publicised) and May 2018 (soon after the scandal) with the figures for September 2018. The website reports that in both February and May 2018, there were 15 million monthly active Australian users, just as there were for September 2018. So if large numbers of Australians have deleted their accounts, this is not showing up in these data.

The interviews I am currently analysing should cast some light on how Australian Facebook users have responded (if at all) to the Cambridge Analytica scandal and other privacy-related issues concerning the personal information they upload to Facebook. I’ll provide an update on the findings once I finish working through the interviews.

Findings from the Young Australians and Digital Health Project

Digital technologies for health-related topics and practices such as websites, online discussion forums, social media, content-sharing platforms, mobile apps and wearable devices are now available as a means for young people to learn about and promote their health, physical fitness and wellbeing. Young people are often assumed to be ardent users of digital health technologies by virtue of having been born into the age of new digital media. Thus far, however, few social research studies have directed attention to the details of how and why young people use digital technologies for health-related purposes and how other, non-digital sources also contribute to the ways in which they learn about their bodies and health and engage in practices to support their health and wellbeing.

The Young Australians and Digital Health Project, a qualitative interview-based study of 30 young Australians (aged 16 to 25 years) was designed to address these issues. The participants were recruited to ensure equal numbers of female and male participants and a spread of ages, ethnic backgrounds and geographical locations across Australia. The interviews took place in April-May 2018. Participants were asked a series of questions relating to how and why they sourced health and medical information and support, and which of these they found most and least useful and helpful. They were asked if anyone had recommended that they use digital health technologies and whether they had any concerns about their personal health data privacy and security. The final question had a future-oriented perspective, asking participants to imagine and describe an ideal digital health technology for their everyday needs.

The interview questions and analysis of transcripts of participants’ responses were designed to draw attention to the affordances of the actors involved (human and nonhuman), relational connections between these actors, affective forces and agential capacities. The affordances of fleshly human bodies include their sensory perceptions, emotional responsiveness, embodied expertise, memory and the ability to learn and to move in certain ways. The affordances of nonhuman objects such as digital technologies relate to the design features of these technologies and what they potentially allow people to do with them. Relational connections include the ways in which humans interact with and respond to other humans, as well as with nonhumans, and how these relationships contribute to or generate bonds and affects.

As the table below shows, all participants said that they sought information from doctors and other healthcare providers, and most also turned to advice from friends and family members. Very few young people used books for health information, but pamphlets were still read by around a third of participants (usually picked up in doctors’ surgeries while waiting for a consultation). In terms of digital tools and resources, search engines were used by everyone, with health websites a close second. All the participants said that they were routinely online throughout the day and were accustomed to searching the internet as a habitual practice for various purposes. They generally searched between once or twice a week or once a month for health-related topics.

Youtube, online discussion groups and social media groups were fairly well-used, but by less than half of the participants. Participants noted that these sources were often found from an initial search using Google Search. Only five of the 30 participants said that they had signed up to My Health Record (Australia’s nationwide patient electronic medical record), with the remainder noting that they had not heard of it.

Sources of health and medical information used currently

SOURCES

 

Number of respondents (n=30)
Non-digital sources  
doctors and other health care providers 30
friends and family 21
pamphlets 11
books   5
Digital sources  
search engines 30
health websites 26
YouTube 13
online discussion forums 12
wearable devices 12
social media groups 10
apps   9
digital exercise games (e.g. Wii Fit)   8
electronic medical record (My Health Record)   5
physical activity platforms (e.g. Strava)   6

 

The convenience, accessibility and detail and diversity of information offered by digital media and devices were valued by the participants.

So I would initially just google my query and do a little bit of research on my own but then I would take my problems to a doctor and they would have more detail and more answers for me. I would usually just look up, kind of, symptoms and triggers for certain things. I would mainly just look up information, possibly finding a solution on my own. I like going online for the ease of use, ease of access, variety of information available, all that kind of stuff. (male, 24 years)

The young people also appreciated being able to source others’ personal experiences online by using online discussion forums, social media groups and viewing people’s stories on YouTube. They felt connected to the physically distant others they encountered online through their sharing of experiences and affective responses on these platforms.

Well, probably I just read forums to find information on the forums, the one thing I find useful is that they have allowed people to express their own feelings with different kinds of diseases. And I find that if it relates to me, then I guess it doesn’t make me feel so alone – knowing that what I’m going through, someone else is going through it with it. (male, 24 years)

Apps and wearable devices (mostly Fitbits) were used for mental health and wellbeing and booking medical appointments, as well as for self-tracking sleep, heart rate, steps and other physical activities, and menstrual cycles. Digital exercise games such as Wii Fit and physical activity platforms like Strava were the least used of all the technologies listed. Few participants who did use them did so regularly, with several participants noting that exercise games were too time-consuming to set up.

Doctors were highly valued as the pre-eminent source of health information authority because of their training and expertise. Young people noted that it could be difficult to distinguish between different opinions and details about health and illness expressed online, requiring them to assess which sources were most valid and reliable. By comparison, a doctor’s expertise was individualised to patients’ specific needs and they could offer knowledgeable interpretations based on their training. Young people could then defer to this expertise.

I guess online there’s a lot of different opinions on what something – like, if you think you’ve got a cold or something like that then you go online and I guess you’re not really qualified yourself to go, this is actually what symptoms I’m experiencing and this is what it actually is. Whereas I feel like if you go to a doctor they’re able to pinpoint it quite well. (female, 22 years)

The participants highly valued the capacity of digital technologies to generate detailed information about their bodies and health states and imagined new technologies that would be able to achieve even more detailed personalisation and customisation. However, they expressed little knowledge or concern about how their personal health data may be exploited by other actors or agencies, despite the fact that the interviews took place a matter of weeks after the Facebook/Cambridge Analytics personal data scandal. Several participants said that they had noticed that companies like Facebook and Google were monitoring their online searches and content for advertising purposes, but these practices were accepted as the norm for online engagement.

Obviously, Google, because they’re finding ways to link to merchandise, or that’s what I believe, personally.  If I look up fitness they’ll say, “Oh look at this fitness gear; why don’t you buy it?” I think it’s just society today – I can’t really stop it. (female, 18 years)

The participants’ accounts highlight the importance to this demographic group of the relational and affective dimensions of seeking health-related advice and information. While all the participants went online routinely and regularly to find advice and information, particularly because the internet affords convenience, ready access and a wealth of diverse opinions, it was evident that their connections and relationships with other people, both face-to-face and digitally mediated, were very important. Other key affordances offered by digital technologies included offering material that could be viewed anonymously and unobtrusively.

Feeling understood by and connected to other people was an agential capacity generated through various combinations of humans with each other and with technologies. The ideal digital health technologies that were imagined by the participants also evoked the affordances of convenience and accessibility. These imaginaries also suggested the importance to young people of technologies that could ‘know’ and ‘understand’ them better than those they had already tried.

In summary, these findings highlight that gaining a better knowledge of bodies, illness and healthcare and feeling more in control of health and wellbeing states were important to the young people. They valued face-to-face as well as online relationships and personal connections with other people for providing information and support, including family members and friends as well as medical professionals.

These were the vibrancies that animated the participants’ enactments of seeking and finding health information and support, that kept them googling, reading the content of websites, social media platforms and online forums, watching videos and using apps and wearable devices. While the young people’s consumption of this content may overtly appear to be passive, given that they tended to view rather than create online content, the young people were actively making sense of the material they were accessing and gathering, deciding how relevant or valid it was for their needs, how they would respond to it and whether they needed to seek further advice from doctors or others.

 

 

 

Food porn, fitspo, bonespo and epic food feats: bodies and food in digital media

 

I have just finished a book chapter for a edited collection on alternative food politics. The chapter is entitled ‘Vitalities and visceralities: alternative body/food politics in new digital media’ (the full chapter preprint is available here).

In the chapter, I focus on the ways in which human bodies and food consumption are represented in social media platforms like Facebook, Tumblr, Twitter, YouTube and Instagram using visual media such as selfies, videos, memes and GIFs, and organised with the use of hashtags. Once I began searching for this material online (using search terms like ‘fat memes’, ‘food porn’, ‘food GIFs’, ‘fitspo’, ‘vegetarian’ and ‘pro ana’), the strength of emotions expressed about bodies and food was particularly noticeable.

Bodies and food in digital portrayals express and circulate visceral feelings that are often dark, centring around broader ambivalences concerning human and nonhuman corporeality. For example, disgust and repulsion for food that is not ‘clean’ or is high in calories and for fat bodies that are considered to be undisciplined was a key theme. This reached its apotheosis in images and discussions relating to self-starvation practices, in which food consumption of any kind was portrayed as contaminating the ideal of the extremely thin body.

A contrasting portrayal, however, was that of the transgressive pleasures of excessive food consumption, often as resistance to body shaming and food policing. In the digital media I examined, vegetarians and vegans were often positively portrayed for their ethical and healthy food stance, but also derided as bores and moralisers. The promotion of fleshiness and excessive food consumption was found in fat activist and body positivist digital media, but also in the grotesque feats of cooking and eating dude food performed by the ‘Epic Meal Time’ men and food-related GIFs and memes.

Food consumption in these media was often sexualised. People uploading or sharing ‘fitspo’ images idealised slim, toned bodies, both male and female, displaying their physiques in tight, revealing gym or swim wear. Supporters of the pro-anorexia ‘bonespo’ meme portrayed emaciated young women as beautiful and sexually appealing. The ‘notyourgoodfatty’ approach highlighted the sensuality and erotic appeal of both fat bodies and excessive food consumption.

More disturbingly, the ‘Epic Meal Time’ YouTube videos made frequent references to the erotic appeal of meat the suggested women were meat for the consumption of men. This misogynistic approach was even more evident in memes and GIFs about meat, in which men were portrayed as aggressors and women their prey.

I conclude the chapter by arguing that expressions of alternative food politics in new digital media are underpinned by affects that display broad and deep-seated ambivalences about what kind of food is morally and ethically justifiable and what types of bodies people should seek to achieve. In some cases, the emotional power that animate the agential capacities of these types of media can impel transformation and change in the interests of alternative food politics. In others, they express and facilitate conservative and reactionary responses, serving to reproduce and magnify dominant norms, moral meanings and practices about ideal bodies, sexuality, and gender.

Social media and self-representation in health and medical domains

Funny-Meme-about-Depression-4-300x300This is an excerpt from chapter 3 (on digitised embodiment) in my forthcoming book Digital Health: Critical and Cross-Disciplinary Perspectives, due to be published this August – details here.

It is not only medical technologies that have contributed to new forms of digitised embodiment. Many popular forums facilitate the uploading of images and other forms of bodily representations to the internet for others to view. Pregnancy, childbirth and infant development represent major topics for self-representation and image sharing on social media. Since the early years of the internet, online forums and discussion boards have provided places for parents (and particularly women) to seek information and advice about pregnancy, childbirth and parenting as well as share their own experiences. Apps can be now be used to track pregnancy stages, symptoms and appointments and document time-lapse selfies featuring the expansion of pregnant women’s ‘baby bumps’. Foetal ultrasound images are routinely posted on Facebook, Twitter, Instagram and YouTube by excited expectant parents (Thomas and Lupton, 2015; Lupton and Thomas, 2015; Lupton, 2016).

Some parents continue the documentation of their new baby’s lives by sharing photographs and videos of the moment of their birth (Longhurst, 2009) and milestones (first steps, words uttered and so on) on social media. Wearable devices and monitoring apps allow parents to document their infants’ biometrics, such as their sleeping, feeding, breathing, body temperature and growth patterns (Lupton and Williamson, 2017). The genre of ‘mommy blogs’ also offers opportunities for women to upload images of themselves while pregnant and their babies and young children, as well as providing detailed descriptions of their experiences of pregnancy and motherhood (Morrison, 2011). These media provide a diverse array of forums for portraying and describing details infants’ and young children’s embodiment. A survey of 2,000 British parents’ use of social media for sharing their young children’s images conducted by an internet safety organisation estimated that the average parent would have posted almost 1,000 images to Facebook (and to a much lesser extent, Instagram) by the time their child reached five (Knowthenet 2015). Contemporary children, therefore, now often have an established digital profile before they are even born offering an archive of their physical development and growth across their lifespans.

People with medical conditions are now able to upload descriptions and images of their bodies to social media to share with the world. YouTube offers a platform for such images, but they are also shared on other social media such as Facebook, Instagram, Tumblr and Pinterest. Pinterest offers a multitude of humorous memes and images with inspirational slogans designed to provide support to people with various conditions such as chronic illness. Humorous memes include one with a drawing of a young woman sitting on a bed with her hand over her face and the words ‘Why are there never any good side effects? Just once I’d like to read a medication bottle that says, “May cause extreme sexiness”’. Other images about chronic illness are less positive, used to express people’s despair, pain or frustration in struggling with conditions such as autoimmune diseases, endometriosis and diabetes. Examples include a meme featuring a photo of a person with head bowed down (face obscured) and the words ‘When your chronic illness triggers depression’ and another showing a young woman’s face transposed over an outline of her body with the text: ‘The worst thing you can do to a person with an invisible illness is make them feel like they need to prove how sick they are.’

‘Selfie’ portraits enable people to photograph themselves in various forms of embodiment. There is now a genre of selfies showing subjects experiencing ill-health or medical treatment. These include self-portraits taken by celebrities in hospital receiving treatment for injuries. A larger category of health and medical-related selfies include those that show people in a clinical or hospital setting undergoing treatment, experiencing symptoms or their recovery after surgery. Among the social media platforms available for such representation, Tumblr is favoured as a forum for posting more provocative images that challenge accepted norms of embodiment. One example is Karolyn Gehrig, who uses the #HospitalGlam hashtag when posting selfies featuring her self-identified ‘queer/disabled’ body in hospital settings. Gehrig has a chronic illness requiring regular hospital visits, and uses the selfie genre to draw attention to what it is like to live with this kind of condition. The photographs she posts of herself include portraits in hospital waiting and treatment rooms in glamour-style poses. She engages in this practice as a form of seeking agency and control in settings that many people find alienating, shaming and uncertain (Tembeck, 2016).

People who upload selfies or other images of themselves or status updates about their behaviour on social media are engaging in technologies of the self. They seek to present a certain version of self-identity to the other users of the sites as part of strategies of ethical self-formation (van Dijck, 2013; Sauter, 2014; Tembeck, 2016). In the context of the ‘like economy’ of social media (which refers to the positive responses that users receive from other users on platforms like Facebook, Twitter and Instagram) (Gerlitz and Helmond, 2013), users of these platforms are often highly aware of how they represent themselves. This may involve sharing information about a medical condition or self-tracking fitness or weight-loss data (Stragier et al., 2015) as a way of demonstrating that the person is adhering to the ideal subject position of responsibilised self-care and health promotion.

It can be difficult for users to juggle competing imperatives when sharing information about themselves online. Young women, in particular, are faced with negotiating self-representation practices on social media that conform to accepted practices of fun-loving femininity, attractive sexuality or disciplined self-control over their diet and body weight but do not stray into practices that may open them to disparagement for being ‘slutty’, fat, too drunk or otherwise lacking self-control, too vain or self-obsessed or physically unattractive (Hutton et al., 2016; Ferreday, 2003; Brown and Gregg, 2012).  It is important to acknowledge that as part of self-representation, people may also seek to use their social media forums to resist health promotion messages: by showing people enjoying using illicit drugs or alcoholic drinking to excess, for example. Fat activists have also benefited from the networking opportunities offered by blogs and social media to work against fat shaming and promote positive representations of fat bodies (Cooper, 2011; Smith et al., 2013; Dickins et al., 2011).

More controversially, those individuals who engage in proscribed body modification practices, such as self-harm, steroid use for body-building or the extreme restriction of food intake (as in ‘pro-ana’ and ‘thinspiration’ communities) also make use of social media sites to connect with likeminded individuals (Boero and Pascoe, 2012; Center for Innovative Public Health Research, 2014; Fox et al., 2005; Smith et al., 2013). Most social media platforms have polices in place to prohibit these kinds of interactions, but in practice many users manage to evade them. The platforms have a difficult task, because they want to support people’s attempts to communicate with each other about their management of and recovery from health conditions like self-harm or eating disorders but are loath to be viewed as promoting the efforts of those resisting recovery and promoting these behaviours. Their attempts to police the representation of nude human bodies for fear of contributing to pornography are also controversial. Until it changed its policy in 2014, Facebook was the subject of trenchant critique for censoring photographs that women have tried to share on the platform portraying them breastfeeding their infants because of concerns that they were showing their nipples, a body part that Facebook usually prohibits in users’ posts because they are deemed to be obscene. Facebook’s new policy also allowed mastectomy survivors to post images of their post-operative bare torsos, even when nipples were displayed (Chemaly, 2014).

References

Boero N and Pascoe CJ. (2012) Pro-anorexia communities and online interaction: bringing the pro-ana body online. Body & Society 18: 27-57.

Brown R and Gregg M. (2012) The pedagogy of regret: Facebook, binge drinking and young women. Continuum 26: 357-369.

Center for Innovative Public Health Research. (2014) Self-harm websites and teens who visit them. Available at http://innovativepublichealth.org/blog/self-harm-websites-and-teens-who-visit-them/.

Chemaly S. (2014) #FreeTheNipple: Facebook changes breastfeeding mothers photo policy. Huffpost Parents. Available at http://www.huffingtonpost.com/soraya-chemaly/freethenipple-facebook-changes_b_5473467.html.

Cooper C. (2011) Fat lib: how fat activism expands the obesity debate. Debating Obesity. Springer, 164-191.

Dickins M, Thomas SL, King B, et al. (2011) The role of the fatosphere in fat adults’ responses to obesity stigma: a model of empowerment without a focus on weight Loss. Qualitative Health Research 21: 1679-1691.

Ferreday D. (2003) Unspeakable bodies: erasure, embodiment and the pro-ana community. International Journal of Cultural Studies 6: 277-295.

Fox N, Ward K and O’Rourke A. (2005) Pro-anorexia, weight-loss drugs and the internet: an ‘anti-recovery’ explanatory model of anorexia. Sociology of Health & Illness 27: 944-971.

Gerlitz C and Helmond A. (2013) The like economy: social buttons and the data-intensive web. New Media & Society 15: 1348-1365.

Hutton F, Griffin C, Lyons A, et al. (2016) ‘Tragic girls’ and ‘crack whores’: alcohol, femininity and Facebook. Feminism & Psychology 26: 73-93.

Longhurst R. (2009) YouTube: a new space for birth? Feminist Review 93: 46-63.

Lupton D. (2013) The Social Worlds of the Unborn, Houndmills: Palgrave Macmillan.

Lupton D. (2016) Mastering your fertility: the digitised reproductive citizen In: McCosker A, Vivienne S and Johns A (eds) Negotiating Digital Citizenship: Control, Contest and Culture. London: Rowman & Littlefield.

Lupton D and Thomas GM. (2015) Playing pregnancy: the ludification and gamification of expectant motherhood in smartphone apps. M/C Journal, 18. Available at http://journal.media-culture.org.au/index.php/mcjournal/article/viewArticle/1012.

Lupton D and Williamson B. (2017) The datafied child: the dataveillance of children and implications for their rights. New Media & Society.

Morrison A. (2011) “Suffused by feeling and affect”: the intimate public of personal mommy blogging. Biography 34: 37-55.

Sauter T. (2014) ‘What’s on your mind?’ Writing on Facebook as a tool for self-formation. New Media & Society 16: 823-839.

Smith N, Wickes R and Underwood M. (2013) Managing a marginalised identity in pro-anorexia and fat acceptance cybercommunities. Journal of Sociology.

Stragier J, Evens T and Mechant P. (2015) Broadcast yourself: an exploratory study of sharing physical activity on social networking sites. Media International Australia 155: 120-129.

Tembeck T. (2016) Selfies of ill health: online autopathographic photography and the dramaturgy of the everyday. Social Media + Society, 2. Available at http://sms.sagepub.com/content/2/1/2056305116641343.abstract.

Thomas GM and Lupton D. (2015) Threats and thrills: pregnancy apps, risk and consumption. Health, Risk & Society 17: 495-509.

van Dijck J. (2013) ‘You have one identity’: performing the self on Facebook and LinkedIn. Media, Culture & Society 35: 199-215.

 

 

Fat, thin and fit bodies in digital media

 

I have just completed an introduction for a special issue of the journal Fat Studies on digital media and body weight, shape and size. Here’s an edited excerpt from the introduction. (Update: the introduction has now been published, and can be viewed here.)

Numerous researchers have called attention to the ways in which often very negative portrayals of fat embodiment circulate in the popular media. Despite the growing presence of attempts to counter these portrayals, online representations of fat bodies that seek to challenge accepted norms and engage in fat activist politics continue to be far outnumbered by those that continue to stigmatize and shame fat people and portray thin bodies as more desirable, healthy and attractive. A content analysis of the representation of “obesity” on YouTube (Yoo and Kim 2012) found that highly negative representations of fat people were common, as were those that attributed personal responsibility for body weight (such as showing fat people eating unhealthy food) and made fun of fat people. Another study of YouTube videos using the search term “fat” (Hussin et al. 2011) revealed that many highly-viewed videos included content that devalued fat people. Men were targeted for fat stigmatization twice as often as women, and white people were the targets far more frequently than other ethnic or racial groups. The antagonists engaging in active shaming or vilification of fat people were also overwhelmingly white men.

My own search for the term “fat people” on YouTube in September 2016 returned many top-ranked videos in which fat people are held up to ridicule and scorn. These bore such titles as “Fat People Fails,” featuring fat people falling over, breaking furniture or otherwise publicly humiliating themselves as well as “The Top Fattest People in the World,” and “Fat People Cringe,” all featuring fat bodies in the style of the freak show. These videos all have millions of views. A Google search for “fat memes” similarly found memes that not only stigmatize fat bodies but are blatantly abusive and often cruel. Just some examples I came across include unflattering images of fat people with texts such as “I’m fat because obesity runs in my family. No-one runs in your family,” “I’m lazy because I’m fat and I’m fat because I’m lazy,” and “Sometimes when I’m sad I like to cut myself … another slice of cheesecake.” When I looked for “fat GIFs” on the GIFY platform, here again were many negative portrayals of fat people, including cartoon characters like Homer Simpson as well as real people, again engaging in humiliating bodily performances. Many of these GIFs showed people jiggling their abdomens or dancing to demonstrate the magnitude of their flesh, belly flopping into swimming pools, eating greedily, smeared with food and so on. Here again, fat white men predominated as targets of ridicule.

Apps are another dominant media form that often focuses on the monitoring, representation and even gamification of human embodiment. As I have argued elsewhere, the ways in which game apps portray social groups can often reproduce and exacerbate negative or misleading stereotypes, including racism, sexism, healthism and norms of feminine embodiment privileging highly-groomed, youthful, physically fit and slim bodies (Lupton 2015, Lupton and Thomas 2015). When I searched the App Annie platform using the term “fat,” a plethora of apps portraying fat bodies in negative ways were identified. These included several game apps that represented fat people as ugly, greedy, lazy and gormless figures of fun who need encouragement to engage in weight-loss activities. Many other apps involve users (who are assumed not to be fat) manipulating images of themselves or others so that they look fat. These include “FatGoo”, marketed by its developers in the following terms: “Gaining weight is now fun! FatGoo is the ultimate app for creating hilarious fat photos of your friends and family.” Others of this ilk include “Fatty – Make Funny Fat Face Pictures,” “Fat You!,” “FatBooth” and “Fatify – Get Fat.” Another fat app genre is that which uses abusive terms to shame people into controlling their diet and lose weight. One example is “CARROT Hunger – Talking Calorie Counter.” It is marketed by its developer as a “judgemental calorie counter” which will “punish you for overindulging.” The app can be used to scan foods for their calorie content. If it judges food as too high in calories, users are abused with insulting epithets such as “flabby meatbags” and even tweets shaming messages about them to their Twitter followers. While such apps may be considered by some as harmless fun, they play a serious ideological role in stigmatizing and rendering abject fatness and fat people.

… Thinspiration is a profoundly gendered discourse. Far more female than male bodies feature in digital images tagged with #thinspiration or #thinspo. I noted earlier that white men tend to be targeted for ridicule in memes and GIFs. Interestingly, my search for “skinny” or “thin” memes and GIFs also hold up white male bodies to derision, this time drawing attention to thin men as lacking appropriate muscular strength. Many memes show half-naked thin men in body-building poses, seeking to highlight their lack of size. When skinny women are featured in memes and GIFS, it is usually in relation to women who falsely claim or complain about being fat or else are sexualized images of young women in swimwear displaying their lean bodies (often tagged in GIFs with #hot #beauty, #perfect and #sexy as well as #thin, #thispo or #skinny). Thin women, these memes suggest, are to be envied because they conform to conventions of female attractiveness. In contrast, thin men are deficient because they fail to achieve ideals of masculine strength and size. The fitspiration or fitspo terms are more recent, but they also take up and reproduce many of the ideals of thinspiration, and similarly have a strong focus on physical appearance and conventional sexual attractiveness. The bodies that are championed in fitspiration are physically toned, active, strong and fit as well as slim (but not emaciated), and are similarly eroticized, with both female and male bodies featuring (Boepple et al. 2016, Boepple and Thompson 2016, Tiggemann and Zaccardo 2016).

References

Boepple, L., Ata, R.N., Rum, R. and Thompson, J.K. (2016) Strong is the new skinny: a content analysis of fitspiration websites. Body Image, 17 132-135.

Boepple, L. and Thompson, J.K. (2016) A content analytic comparison of fitspiration and thinspiration websites. International Journal of Eating Disorders, 49 (1), 98-101.

Hussin, M., Frazier, S. and Thompson, J.K. (2011) Fat stigmatization on YouTube: a content analysis. Body Image, 8 (1), 90-92.

Lupton, D. (2015) Digital Sociology. London: Routledge.

Lupton, D. and Thomas, G.M. (2015) Playing pregnancy: the ludification and gamification of expectant motherhood in smartphone apps. M/C Journal (5). Accessed 22 October 2015. Available from http://journal.media-culture.org.au/index.php/mcjournal/article/viewArticle/1012.

Tiggemann, M. and Zaccardo, M. (2016) ‘Strong is the new skinny’: a content analysis of #fitspiration images on Instagram. Journal of Health Psychology, online ahead of print.

Yoo, J.H. and Kim, J. (2012) Obesity in the new media: a content analysis of obesity videos on YouTube. Health Communication, 27 (1), 86-97.

 

 

Cycling self-tracking and data sense

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This week I am delivering a paper at the joint 4S (Society for the Social Studies of Science) and EASST (European Association for the Study of Science and Technology) conference in Barcelona. The paper is in the track ‘Everyday analytics: the politics and practices of self-monitoring’. In the paper I discuss elements of my Living Digital Data research program and describe one of my research projects, which investigates the self-tracking practices of commuting cyclists who use digital devices to monitor their rides.

The research team (myself and Christine Heyes Labond from the University of Canberra and Sarah Pink and Shanti Sumartojo from RMIT Melbourne) conducted empirical research with 18 participants living in Canberra and Melbourne about their self-tracking practices. We used a combination of interviews, enactments of people getting ready for and completing their cycling trips and footage of the cycling trips themselves taken from the perspective of the cyclists (using a GoPro mini action camera mounted on their helmet).

Here are the slides from the paper, which outlines details of the project and some of the findings. Data sense 4S Barcelona

Lively devices, lively data and lively leisure studies

This is a foreword I wrote for a Leisure Studies special issue on digital leisure cultures (the link to the journal version is here).

In the countries of the Global North, each person, to a greater or lesser degree, has become configured as a data subject. When we use search engines, smartphones and other digital devices, apps and social media platforms, and when we move around in spaces carrying devices the record our geolocation or where there are embedded sensors or cameras recording our movements, we are datafied: rendered into assemblages of digital data. These personal digital data assemblages are only ever partial portraits of us and are constantly changing: but they are beginning to have significant impacts on the ways in which people understand themselves and others and on their life opportunities and chances. Leisure cultures and practices are imbricated within digital and data practices and assemblages. Indeed, digital technologies are beginning to transform many areas of life into leisure pursuits in unprecedented ways, expanding the purview of leisure studies.

These processes of datafication can begin even before birth and continue after death. Proud expectant parents commonly announce pregnancies on social media, uploading ultrasound images of their foetuses and sometimes even creating accounts in the name of the unborn so that they can ostensibly communicate from within the womb. Images from the birth of the child may also become publicly disseminated: as in the genre of the childbirth video on YouTube. This is followed by the opportunity for parents to record and broadcast many images of their babies’ and children’s lives. At the other end of life, many images of the dying and dead bodies can now be found on the internet. People with terminal illnesses write blogs, use Facebook status updates or tweet about their experiences and post images of themselves as their bodies deteriorate. Memorial websites or dedicated pages on social media sites are used after people’s death to commemorate them. Beyond these types of datafication, the data generated from other interactions online and by digital sensors in devices and physical environments constantly work to generate streams of digital data about people. In some cases, people may choose to generate these data; in most other cases, they are collected and used by others, often without people’s knowledge or consent. These data have become highly valuable as elements of the global knowledge economy, whether aggregated and used as big data sets or used to reveal insights into individuals’ habits, behaviours and preferences.

One of my current research interests is exploring the ways in which digital technologies work to generate personal information about people and how individuals themselves and a range of other actors and agencies use these data. I have developed the concept of ‘lively data’, which is an attempt to incorporate the various elements of how we are living with and by our data. Lively data are generated by lively devices: those smartphones, tablet computers, wearable devices and embedded sensors that we live with and alongside, our companions throughout our waking days. Lively data about humans are vital in four main respects: 1) they are about human life itself; 2) they have their own social lives as they circulate and combine and recombine in the digital data economy; 3) they are beginning to affect people’s lives, limiting or promoting life chances and opportunities (for example, whether people are offered employment or credit); and 4) they contribute to livelihoods (as part of their economic and managerial value).

These elements of datafication and lively data have major implications for leisure cultures. Research into people’s use of digital technologies for recreation, including the articles collected here and others previously published in this journal, draws attention to the pleasures, excitements and playful dimensions of digital encounters. These are important aspects to consider, particularly when much research into digital society focuses on the limitations or dangers of digital technology use such as the possibilities of various types of ‘addiction’ to their use or the potential for oppressive surveillance or exploitation of users that these technologies present. What is often lost in such discussions is an acknowledgement of the value that digital technologies can offer ordinary users (and not just the internet empires that profit from them). Perspectives that can balance awareness of both the benefits and possible drawbacks of digital technologies provide a richer analysis of their affordances and social impact. When people are using digital technologies for leisure purposes, they are largely doing so voluntarily: because they have identified a personal use for the technologies that will provide enjoyment, relaxation or some other form of escape from the workaday world. What is particularly intriguing, at least from my perspective in my interest in lively data, is how the data streams from digitised leisure pursuits are becoming increasingly entangled with other areas of life and concepts of selfhood. Gamification and ludification strategies, in which elements of play are introduced into domains such as the workplace, healthcare, intimate relationships and educational institutions, are central to this expansion.

Thus, for example, we now see concepts of the ‘healthy, productive worker’, in which employers seek to encourage their workers to engage in fitness pursuits to develop highly-achieving and healthy employees who can avoid taking time out because of illness and operate at maximum efficiency in the workplace. Fitness tracker companies offer employers discounted wearable devices for their employees so that corporate ‘wellness’ programs can be put in place in which fitness data sharing and competition are encouraged among employees. Dating apps like Tinder encourage users to think of the search for partners as a game and the attractive presentation of the self as a key element in ‘winning’ the interest of many potential dates. The #fitspo and #fitspiration hashtags used in Instagram and other social media platforms draw attention to female and male bodies that are slim, physically fit and well-groomed, performing dominant notions of sexual attractiveness. Pregnancy has become ludified with a range of digital technologies. Using their smartphones and dedicated apps, pregnant women can take ‘belfies’, or belly selfies, and generate time-lapse videos for their own and others’ entertainment (including uploading the videos on social media sites). 3D-printing companies offer parents the opportunity to generate replicas of their foetuses from 3D ultrasounds, for use as display objects on mantelpieces or work desks. Little girls are offered apps which encourage then to perform makeovers on pregnant women or help them deliver their babies via caesarean section. In the education sector, digitised gamification blurs leisure, learning and physical fitness. Schools are beginning to distribute heart rate monitors, coaching apps and other self-tracking devices to children during sporting activities and physical education classes, promoting a culture of self-surveillance via digital data at the same time as teachers’ monitoring of their students’ bodies is intensified. Online education platforms for children like Mathletics encourage users to complete tasks to win medals and work their way up the leaderboard, competing against other users around the world.

In these domains and many others, the intersections of work, play, health, fitness, education, parenthood, intimacy, productivity, achievement and concepts of embodiment, selfhood and social relations are blurred, complicated and far-reaching. These practices raise many questions for researchers interested in digitised leisure cultures across the age span. What are the affordances of the devices, software and platforms that people use for leisure? How do these technologies promote and limit leisure activities? How are people’s data used by other actors and agencies and in what ways do these third parties profit from them? What do people know about how their personal details are generated, stored and used by other actors and agencies? How do they engage with their own data or those about others in their lives? What benefits, pleasures and opportunities do such activities offer, and what are their drawbacks, risks and harms? How are the carers and teachers of children and young people encouraging or enjoining them to use these technologies and to what extent are they are aware of the possible harms as well as benefits? How are data privacy and security issues recognised and managed, on the part both of those who take up these pursuits voluntarily and those who encourage or impose them on others? When does digitised leisure begin to feel more like work and vice versa: and what are the implications of this?

These questions return to the issue of lively data, and how these data are generated and managed, the impact they have on people’s lives and concepts of selfhood and embodiment. As I noted earlier, digital technologies contribute to new ways of reconceptualising areas of life as games or as leisure pursuits that previously were not thought of or treated in those terms. In the context of this move towards rendering practices and phenomena as recreational and the rapidly-changing sociomaterial environment, all social researchers interested in digital society need to be lively in response to lively devices and lively data. As the editors of this special issue contend, researching digital leisure cultures demands a multidisciplinary and interdisciplinary perspective. Several exciting new interdisciplinary areas have emerged in response to the increasingly digitised world: among them internet studies, platform studies, software studies, critical algorithm studies and critical data studies. The ways in which leisure studies can engage with these, as well the work carried out in sub-disciplines such as digital sociology, digital humanities and digital anthropology, have yet to be fully realised. In return, the key focus areas of leisure studies, both conceptually and empirically – aspects of pleasure, performance, politics and power relations, embodiment, selfhood, social relations and the intersections between leisure and work – offer much to these other areas of enquiry.

The articles published in this special issue go some way to addressing these issues, particularly in relation to young people. The contributors demonstrate how people may accept and take up the dominant assumptions and concepts about idealised selves and bodies expressed in digital technologies but also how users may resist these assumptions or seek to re-invent them. As such, this special issue represents a major step forward in promoting a focus on the digital in leisure studies, working towards generating a lively leisure studies that can make sense of the constantly changing worlds of lively devices and lively data.

Review of Social Media for Academics

I have written many times on this blog about my own experiences of using social media and other digital tools for academic work and my research focusing on how other academics are doing this.

One of the people I have encountered along the way is Mark Carrigan, an early career British sociologist. Appropriately enough, we first met on Twitter a few years ago, around the time I began experimenting with various digital tools for professional purposes. Since then, we have had many discussions there and on other online forums, as well as by email, about using social media in universities (and a couple of in-person meetings as well). Mark has now written a book on Social Media for Academics. It is the first book I know of to present a ‘how-to’ manual combined with reflections on the wider implications of  academic social media engagement.

Mark is a great example of someone who has strategically used social media while still in the very early stages of his career (completing his doctorate) to create a high profile for his work. He has now built on this experience not only to work in various positions involving promoting academic journals, departments and organisations, but to produce this book. In its chapters, Mark employs a casual, chatty style to painlessly introduce readers to the art of academic social media.

The book is distinctive because Mark’s sociological training allows him to contextualise the social, cultural and political implications of academic social media use. Yes, he offers  a multitude of helpful tips and advice about how best to communicate online, what platforms and tools are the most effective, how to develop your own voice, how online engagement helps in promoting one’s research and reaching wider audiences outside academia, building networks, curating interesting material you have found on the internet, finding time to use social media and so on. But there are also reflections offered on what academic social media means for professional identities and for academic work in general. In addition there are many pithy remarks drawing on Mark’s observations, for example, of the awkwardness that sometimes accompanies the experience of colleagues meeting in the flesh after having developed a hitherto purely online relationship, or the potential pitfalls of live-tweeting conferences or writing a tweet or blog post in haste and anger that then becomes widely circulated well after the initial irritation has subsided.

This book is highly recommended for higher degree students and faculty staff members who are interested in the possibilities of academic social media for both research and teaching, as well as researchers interested in future directions for the university workplace and academic identities.

 

Digitised dissection: medical procedures on the internet

 

This is an excerpt from my book in progress, Digital Health: Critical Perspectives, to be published by Routledge in 2017.

With the advent of websites, social media platforms and apps, the internal organs and workings of the body have moved from being exclusively the preserve of medical students and surgeons. Digital medical devices have entered into the public arena of the internet, offering new possibilities for lay people to gaze inside the spectacle of the human body. A vast volume of computerised medical images of human life from conception to death are now readily available online. Tapping in such keywords as ‘human anatomy’ will call up many apps on the Apple App Store or Google Play which provide such details. While these apps have been explicitly designed for the use of medical and other healthcare students and trainees, they are readily available to any person who may wish to download them. The Visible Human Project developed by the US National Library of Medicine is an earlier example of how human flesh can be rendered into a digital format and placed on the internet for all to view. The developers of The Visible Human Project used digital technologies to represent in fine detail the anatomical structure of two cadavers (one male and one female). Each body was cross-sectioned transversely from head to toe. Images of the sections of the bodies using MRI and CT scans and anatomical images were uploaded to the Project website. They can also be viewed at the National Museum of Health and Medicine in Washington DC. A similar website, The Visible Embryo, displays images of embryos and foetuses from fertilisation to birth, with a week-by-week display showing the stages of foetal development. The data used for this website were drawn from digitising microscopic cross-sections of human embryo specimens held on slides in The National Institutes of Health’s Carnegie Collection of Embryos as well as from 3D and 4D digital foetal ultrasound images.

Many opportunities are provided on the internet for people who want to view detailed images of surgical and other medical procedures in their full gory detail. YouTube has become a major provider of anatomical and surgical technique videos for medical training. Some medical specialists and surgeons upload images and videos of their work to Snapchat and Instagram, mostly in the effort to promote their services (cosmetic surgeons are in the forefront in this practice). Instagram does not allow users to upload images that are considered too explicit (such as those portraying surgery on breasts or genitals), so some doctors have turned to Snapchat as an alternative forum. One infamous such specialist is Sandra Lee, a dermatologist known as ‘Dr Pimple Popper’. Her Instagram photos and YouTube videos showing her at work have received many millions of views. Perhaps the best-known Snapchatting medical specialist is the cosmetic surgeon ‘Dr Miami’ (Michael Salzhauer), who uploads detailed photos and videos of his surgical procedures (including controversial procedures like labiaplasties, or surgery designed to reshape women’s external genitals). ‘Dr Miami’ is unafraid to Snapchat images of himself brandishing a wad of body fat he has just excised in a tummy tuck. He employs two full-time staff members to manage his social media accounts.

The use of web-streaming services is employed by a number of hospitals to host webcasts of surgical procedures for any interested person to view. The US National Library of Medicine provides a list on its website of several such webcasts with hyperlinks, from numerous different American hospitals. Lay people may now even view live-streamed surgical procedures using a smartphone app and wearing a virtual reality headset to provide a 3D immersive effect, as offered by the Medical Realities company in April 2016. This technology is designed principally for training medical students, but also allows lay people who participate to feel as if they are present in the operating theatre.

Pinterest, an image-curating and sharing platform, features many collections of images related to medical matters. Several of these relate to patient experiences of health, but others are curated by medical and nursing students and practising healthcare providers. Some are humorous, featuring memes, cartoons or other images designed to appeal to medical and nursing students and other trainees in the health professions. Other Pinterest photographs feature novelty commodities, again clearly directed to the same audience (for example, anatomical heart or ECG heart beat cookie cutters, human-organ and stethoscope-shaped jewellery, coffee mugs in the shape of spinal vertebrae). While these images are vastly outnumbered by the serious photographs in Pinterest collections that show anatomical images and other medical information (some of which are explicit photographic images that detail flesh, bone and blood), they offer alternative representations of the ways in which human bodies and the practice of healthcare are represented online.

The major differences offered by the latest digital technologies that document and monitor the human body are the continual nature of the surveillance opportunities they present, their expansion from the clinic into domestic and intimate spaces and relationships and their feedback mechanisms, which allow their subjects to ‘read’ and interpret their own bodies via biometric measurements. Medical practices that were once embodied in the flesh, including the development of doctors’ expertise in touching the patient’s body and determining what is wrong, have increasingly become rendered into software such as the video conferencing services offered in remote telemedicine technologies. Virtual bodies have been developed for medical training purposes, allowing students to conduct virtual surgery. To achieve this virtuality, the processes by which doctors practice – their customs, habits and ways of thinking – are themselves digitised. Both doctors and patients are rendered into ‘informatic “body objects”, digital and mathematical constructs that can be redistributed, technologized, and capitalized’ (Prentice, 2013: 20).

Many digital health technologies are directed at illuminating the exterior or interior of the human body with the use of metrics that may represent features of the body as numbers or graphs. The use of apps to collect information about body functions and movements, for example, generates a continuing set of images that represent the body. Biometric data serves first to fragment the body into digitised pieces of information and then to combine these pieces into a recombinant whole that is usually presented in some kind of visual form. Amoore and Hall (2009: 48) use the term ‘digitised dissection’ to refer to the ways in which biometric whole body scanners at airports operate. This term is even more apposite when adopted to discuss the fragmentation of bodies in the context of digital health. Digital technologies are able to peer into the recesses of the body in ever-finer detail, creating new anatomical atlases.

References

Amoore, L. & Hall, A. (2009) Taking people apart: digitised dissection and the body at the border. Environment and Planning D: Society and Space, 27, 444-64.

Prentice, R. (2013) Bodies in Formation: an Ethnography of Anatomy and Surgery EducationDurham, NC: Duke University Press.