Science, Medicine, and Anthropology
Des Fitzgerald’s excellent Tracing Autism: Uncertainty, Ambiguity, and the Affective Labor of Neuroscience is not strictly a book about autism. It is, rather, as the author observes, more about neurosciences than it is about autism (171); or drawing on the title, it is more about the activity of “tracing” than about “autism.” Tracing describes the “act of pursuing, enacting and enabling” autism neuroscience research “through forms of difference, ambiguity and entanglement” (29). And the book does a good job of carefully examining the activity of “tracing” autism, and its implications not just for autism research, but also for the social studies of neurosciences, which is the main interest of the author. In this sense, the sociologist Fitzgerald admits that when he started his investigation he “went looking for the monolith” (177); but after interviewing the neuroscientists he was surprised to find uncertainty, ambiguity and affect where he expected certainty, exactness and rationality. And this is the main claim of the book. Neuroscience research is not defined by “neurobiological chauvinism” (25) or hardcore neuroreductionism, as the standard social science account state. Instead, it is defined by disappointments, tensions, uncertainties, very low expectations, ambiguities and self-criticism.
Therefore there is no point in fueling social science anxieties and “paranoid” readings of neuroscientists’s discourses and practices. Instead the time is ripe for “reparatory” attitudes (Fitzgerald draws on Eve Kosofsky Sedgwick’s distinction between “paranoid” and “reparative” readings) and interdisciplinary collaborations that embrace ambiguity and contradictions in an experimental setting as indicators of nuance and care and not of epistemological naivety or of the constrain of social and cultural factors. Fitzgerald goes so far as to declare the “sheer redundancy of the critical theorist’s wagging finger” (82) that he locates in critical neuroscience and other paranoid versions of social science analysis of the neurosciences. Such critique is no longer needed since the neurosciences are sufficiently (self-) critical and capable of recognizing entanglement and context, to reject naïve objectivity and “to produce a much richer, less settled, and much more entangled account of the crossing bodies, affects and politics” (82). Moreover, neuroscientists always think about “the social,” and the social at stake in neuroscience and epigenetic research is sometimes “the social as most sociologists would understand the term” (133). Reading Fitzgerald one wonders whether sociology and anthropology of science have not become superfluous disciplines given that neuroscientists’ critical attitudes display “a much deeper and richer form of entanglement than most sociological and anthropological accounts are themselves capable of” (82).
Tracing Autism is a terrific book, original and elegantly written, and opens new paths to think about neuroscience research and more specifically research on autism, as well as to encourage a “postcritical mood” (183) and promote interdisciplinary collaborations. I favor interdisciplinary collaborations and nonparanoid readings of the neurosciences and agree that this attitude does not turn us into “vacuous cheerleaders for the new brain sciences” (168). However, at the risk of being labeled “paranoid” and “in danger of totally missing a moment of striking openness in the practice of neuropsychology” (143), I believe some caution is needed before embracing fully Fitzgerald’s enthusiastic account of autism neuroscience research. In the interest of dialoguing with the author, I offer three observations.
First, Tracing Autism provides a moving and heroic account of autism neuroscientists, pursuing their research amidst disappointment, low expectations, selflessness, uncertainty and ambivalence. It is touching to see that the scientists engaged in autism research are haunted by negative expectations and yet still enthusiastically follow their research. It is also moving to read the frankness of some of Fitzgerald’s interviewees, who acknowledge that neuroscience doesn’t necessarily “add value” to what we already know, and that after two decades of scanning brains it is not clear that the field has dramatically moved forward (74). This raises broader ethical and epistemological questions. How can we justify spending billions of dollars in genetic and neurobiological autism research when much of this knowledge has very limited value for people living with autism, who are largely more concerned with navigating daily social interactions and communication barriers (Singh 2016)? The needs of people living with autism are not at the forefront of research priorities. In the U.S., for instance, only 10% of public and privately funded projects related to autism research between 2008 and 2010 were dedicated to the needs of adults living with autism, while 90 per cent related to some aspect of genetic research (Singh 2016, 154). Fitzgerald tangentially mentions this issue when he admits that “from a research strategy point of view, there is perhaps room to be more circumspect about the role that neurobiological (and genetic) research is likely to play in improving the day-to-day lives of autistic people” (174). Moreover, Tracing Autism lacks a convincing examination of the economic, academic and other compensations that explain the pursuit of neuroimaging research despite their limited results. As Jennifer Singh (2016, 105) observes regarding genomic research, “it makes no sense for the future of research labs and scientific careers to jump off the autism genetics research bandwagon”, which results in peer review articles, scientific prestige and enormous amounts of research funds.
The second observation is closely associated with the previous one. Fitzgerald convincingly argues that neuroscience research is characterized by disappointments, tensions, uncertainty, negative expectations, ambiguities and selflessness. But this is only one side of the story. Something else happens, however, when these same scientists go public, write grant applications, or speak with funders or science journalists. Then we frequently see a triumphalist discourse embedded with high expectations, hype, certainties, neuroreductionism and self-confidence. Of course, a lot is at stake (prestige, research funds, publications) and funders don’t appreciate ambiguity or low expectations. Fitzgerald does not follow his interviewees beyond the lab to observe whether they maintain the same disposition toward their work. Therefore, perhaps it is premature to call for reparation, even if we are “in danger of totally missing a moment of striking openness in the practice of neuropsychology” (143).
Finally, despite Fitzgerald’s claim that neuroscientists are capable of recognizing entanglement and social and cultural contexts, and are inclined to see a symmetrical interplay between the “social” and the “natural” (82-3), we find recurrently in neuroscience research a non-explicit epistemic hierarchy in which, since the neurosciences ultimately account for psychological, social, and cultural phenomena, the neurobiological approach ranks above other forms of inquiry and knowledge (Vidal and Ortega 2017). In Being Brains Fernando Vidal and I illustrate this epistemic hierarchy through the burgeoning field of cultural neuroscience. In spite of an emphasis on the two-way processes that turn brain into culture and culture into brain, a common feature of the neurodisciplines of culture is their belief in the ontological primacy of the brain that reduces culture to an external factor that “shapes,” “influences” and “impacts on” neural activity, function and processes.
Merriam-Webster defines reparation as “the act of making amends, offering expiation, or giving satisfaction for a wrong or injury.” Fitzgerald’s plea for a reparative attitude induces us to think that social scientists should apologize for the harm done to the neurosciences with their paranoid readings. This claim is overstated, and my observation is that the author’s enthusiastic claims about the neurosciences should be tempered somewhat.
Works Cited
Singh, Jennifer S. 2016. Multiple Autisms. Spectrums of Advocacy and Genomic Science. Minneapolis: University of Minnesota Press.
Vidal, Fernando and Francisco Ortega. 2017. Being Brains: Making the Cerebral Subject. New York: Fordham University Press.
Francisco Ortega is Full Professor in the Institute for Social Medicine of the State University of Rio de Janeiro and Research Director of the Rio Center for Global Health. His main books include Corporeality, Medical Technologies and Contemporary Culture (Routledge, 2014), and with Fernando Vidal Being Brains: Making the Cerebral Subject (Fordham University Press, 2017) and Neurocultures: Glimpses Into an Expanding Universe (Peter Lang, 2011).