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natural as stable and objective and the social as tightly linked to it. For the ICD this means describing disease in a way that folds the socially and legally contingent into the classification system itself, and so naturalizes it. Inversely, the disease entity out there in the world is brought into the laboratory where the social and organizational work of its stabilization can best be guaranteed. |
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To tell stories of the sort we are most familiar with, one needs objects in the world that can be cut up spatially (Berg and Bowker 1997) and temporally into recognizable units. Narrative structures are typically formed with a moving time line, protagonists, and a dramatic structure unfolding over time. The ICD does in fact operate this kind of dissection, which we will discuss below. In the last section we saw the constitution of a context within the ICD, in this section we will see the constitution of actants to populate that context and those stories. |
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Time Story One: The Life Cycle |
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Temporally, the classification system provides a picture of acute (temporally bounded) episodes within an otherwise well-ordered life. It is notoriously bad for describing chronic diseases: the interest is in the episode of treatment (Musen 1992). |
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Let us go through some temporal units presented by the ICD. Birth is extremely important and is very closely defined: |
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Live birth is the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered live born. (ICD-10, 2: 129) |
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We will discuss in chapter 4 the political and religious dimensions of this definition, which have been very closely attended to throughout the period of the ICD's development. For our present purposes, it is sufficient to note that time flows very quickly for the newborn, and so temporal units vary accordingly: |
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The neonatal period commences at birth and ends 28 completed days after birth. Neonatal deaths (deaths among live births during the first 28 completed days of life) may be subdivided into early neonatal deaths, occurring during the first 7 days of life, and late neonatal deaths, occurring after the seventh day but before 28 completed days of life. |
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