"A Flavor of Alzheimer's": Phenomenology in the Clinic
Résumé
The diagnosis of neurodegenerative diseases, such as Alzheimer’s disease and Frontotemporal dementia, is characterized by a persistent degree of uncertainty and instability. Based on fieldwork conducted for 16 months in a world famous US clinic for the diagnosis of dementia, this presentation shows how the clinician’s “flair” and her elusive clinical “sense” actually mediates the making of a diagnosis. Accompanying contemporary technologies and instruments of objectification, I describe the emergence of a “clinical phenomenology” via the doctor’s attention to the phenomenon of the disease and only the phenomenon. Drawing on observations of clinical consultations and team meetings, I inquire as to how the clinicians’ “feelings” are an essential part of the diagnosis, how they are shared and discussed by the medical team and ultimately take part in the making of knowledge about brain diseases. This inquiry, situated on the terrain of everyday diagnostic practices, thus brings out how medical expertise is bound to a concrete, or phenomenological, experience of the world, to doctor’s affects and, more broadly, is linked to connoisseurship. I conclude that medical expertise, as described by these cardinal features, nevertheless retains an uneasy rapport with the generalization of knowledge that is developed on their epistemic foundation.