THE CONSTRUCTION OF CYBORG BODIES:
FACT, FANTASY AND THE CYBORG CONTINUUM
by
Jenny Fry
B.A., The University ofVictoria, 1993

THESIS SUBMITTED IN PARTIAL FULFILLMENT OF
THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF ARTS
m

GENDER STUDIES

© Jenny Fry, 1997
THE UNIVERSITY OF NORTHERN BRITISH COLUMBIA
August 1997

c

LI BRARY

All rights reserved. This work may not be
reproduced in whole or in part, by photocopy or
other means, without the permission of the author.

ABSTRACT

This thesis explores the construction of cyborg bodies and the
connections between cyborgs in science fiction and in the real world.
Using the concept of the cyborg continuum to represent a range of
technologies which integrate the artificial and the organic, this thesis
contributes to a grounded liberatory feminist cyborg discourse that
empowers us in relation to our increasingly technologized bodies, and
that also promotes responsible social change. This research focuses on
the connections between people who have artificial joints, their quality
of life and daily experiences (i.e. total hip or knee replacements), and
the artificially-intelligent cyborgs of science fiction. Common issues
arising in both fact and fiction include power, control, and identity.
Science fiction can be valuable in extrapolating these issues for the
benefit of those who integrate increasingly more artificial parts into
their bodies and the bodies of others. While the research participants
in this thesis had no such crisis of identity or question of their
humanity as the fictitious cyborgs faced, there are different reasons for
creating cyborgs. Artificial joints are used to alleviate pain and
improve mobility, whereas artificially-intelligent cyborgs are
constructed to serve their creators. The connection is in the degree to
which people can control what happens to their bodies and the
argument that identification as "human" may derive from the
II

recognition and respect for the range of possibilities and lived
experience of others, which in turn, promotes social change.

Ill

TABLE OF CONTENTS
Abstract

II

Table of Contents

IV

Acknowledgments

VI

Dedication

Vll

INTRODUCTION
Chapter One

Constructing Cyborg Bodies
Definitions
Theoretical Debts
Methodology

6
7
20
26

Chapter Two

Artificial Parts: Some Assembly Required
Methodology of Hip and Knee Replacements
Joint Replacements
Total Hip Replacements
Total Knee Replacements
Interface: Physiological Challenges
Power and Control of Bodies

30
31
32
35
41
46
48

Chapter Three

Interviewing 'Cyborgs': People With Total Hip or
Knee Replacements
Introducing the Participants
Indicators for Hip and Knee Replacement Surgery
Quality of Life
Integrating Artificial Body Parts

55

Chapter Four

Chapter Five

56
58
65
68
71
73
73

Cyborg Bodies in Science Fiction
Narrative Contexts and Summaries
He, She and It
Virtual Girl
Power and Control
Identity and Humanity
Quality of Life

81
87
96

Connections and Conclusions

101

77

113

Selected
Bibliography

IV

Appendix I

Visual Representation of the Cyborg Continuum
and Advertisements for Total Hip and Total Knee
Replacement Systems (from the Journal of Bone
Joint Surgery, 1996-1997)

119

Appendix II

Sample Consent Form and Letter oflntroduction

126

v

ACKNOWLEDGMENT
I would like to thank the people who participated in my thesis research
for their time, their honesty, and their willingness to openly share their
experiences with me. I would also like to thank my thesis committee:
Beverly Leipert, Dr. Karin Beeler, and Dr. Stan Beeler for their
unflagging enthusiasm and support of my work. I am indebted to Dr.
Jo-Anne Fiske and Patty Ginn who were both instrumental in the
development and articulation of my ideas, and to Helen Domshy for
her clarity, support, and vision of my work. Most importantly, I am
grateful to my supervisor, Dr. Marianne G. Ainley, for her guidance,
support, enthusiasm, and influence.

VI

DEDICATION

To my parents, Helle and Peter Fry

VII

INTRODUCTION

When I met Donna Haraway at a conference in Calgary, Alberta on
September 19, 1997, I told her that her work had inspired me to write
my Gender Studies MA thesis in the field of feminist cyborg theory. 1
She responded with great surprise and said "Oh, is there such a
theory?" Yet her 1985 essay, "A Cyborg Manifesto: Science,
Technology, and Socialist-Feminism in the Late Twentieth Century," 2
prompted my initial theoretical work in this area, together with my
enduring love of science fiction, and the resulting realization that
feminist political theory and science fiction could be integrated into
academic work. In my research, I found that cyborgs are currently
popular in certain academic circles and that the field is growing in text,
at conferences, and on-line. While there has been some exploration of
artificial body parts in cyborg theory, I decided to focus on the
physical bodies that integrate artificial and organic parts and began to
explore aspects of the construction of cyborg bodies in both fact and
fiction.
Feminist cyborg theory has, typically, been preoccupied by the
abstract postmodem possibility of cyborgs as liberatory symbols. 3 I

Feminism is a complex term with a wide variety of definitions, relationships,
meanings, and applications. In this thesis, feminism is defined as "challengi ng the
prevailing power structures and assumptions of androcentrism in science and
society." (Shulamit Reinharz, Feminist Methods in Social Research (New York:
Oxford University Press, 1992), 242)
2
Reprinted in Donna Haraway, Simians, Cyborgs and Women: The Reinvention of
Nature (New York: Routledge, 1991 ), 149-181 .
3
See Donna Haraway, Primate Visions: Gender, Race and Nature in the World of
Modern Science (New York: Routledge, 1989); Haraway 1991; Donna Haraway,
1

2

propose a feminist cyborg theory that is grounded in people's actual
experiences and benefits from the possibilities presented in science
fiction. I am not trying to further theory for the sake of theory, but
offer a version that can be used towards real social change, the kind
that may intersect with the medical establishment, feminist theory,
activism and research, and cultural studies. I do not mean to suggest
that science fiction leads directly to real social change but that it can be
used as an important tool in the pursuit of social change. Using the
theoretical device of the cyborg continuum, my research investigates
the integration of artificial parts into women's and men's organic
bodies. I argue that integrating technology into our bodies is a positive
reaction to the physical limitations imposed by biological part failures
I seek to contribute a grounded liberatory

and physiological facts.

feminist cyborg discourse that empowers western people in relation to
our increasingly technologized bodies, and that also promotes
responsible social change.4

Modest_ Witness@Second_ Millenium. FemaleMan©_Meets_ OncoMouse TM_·
Feminism and Technoscience (New York : Routledge, 1997); Anne Balsamo,
Technologies of the Gendered Body: Reading Cyborg Women (Durham: Duke
University Press, 1996); and Susan Bordo, '"Material Girl': The Effacements of
Postmodern Culture," in The Female Body: Figures, Styles, Speculations. ed.
Laurence Goldstein (Ann Arbor: University of Michigan Press, 1993).
4
Tdo not mean to suggest a universal category of Women , which mistakenly
essentializes all women regardless of class, race, ability, ethnicity or age. There is an
enormous variety of issues that affect different groups of women in terms of health
and quality-of-life. Securing power and control of our bodies is an on-going
struggle for most women and I think that cyborg discourse represents a commonality
or bridge, which may be the basis for contextual or temporary alliances between and
among women.

3

The connections between organic and artificial body parts occur in
many different combinations. Therefore in Chapter I of this thesis, I
will provide several definitions of key terms that are both complex and
are used in many different ways. I then look at the theoretical origins
of cyborg bodies in feminist theory, from Donna Haraway to Teresa
Ebert. This provides a basis for the subsequent chapters on artificial
parts currently in use and on cyborgs in science fiction. In Chapter II,
I will focus on total joint replacements: their form and development,
surgical procedures, and the remaining physiological challenges. In
Chapter III, I will explore the issue of power and control in relation to
artificial body parts based on the interviews I have conducted with
orthopedic surgeons, the medical care system, and other health
professionals, and with people who have received hip or knee
replacements, all of whom have varying opinions about where the
power and control lie, as well as the gender implications of total joint
replacement surgery.

Where and how power is distributed is an

important question in terms of both the future integration of artificial
and organic body parts and gender. In Chapter IV, I will analyze the
narratives in Marge Piercy's He, She and It (1991) and Amy
Thomson's Virtual Girl (1993) to find: a) the location of power and
control, and b) the identity implications for artificially intelligent
cyborgs in terms of their humanity. In Chapter V, I will integrate and
analyze the various elements that connect people with total hip and
4

knee replacements with the cyborgs in the science fiction.

These

elements are connected with feminist cyborg discourse and the future
direction of cyborg bodies, both in theory and in practice.
My research focuses in part on the connections between fact and
fiction because all too often, fact is privileged over fiction and the
insights of fiction are ignored in a social science context.

Science

fiction, in particular, investigates a wide variety of issues, concerns,
scenarios, consequences, and situations which broaden the scope of
imagined possibilities and enrich the discourse of cyborg bodies. In
real life, the reasons for building cyborg bodies vary, but I have no
doubt that the current medical trend is towards increasingly more
artificial intervention into our bodies, and science fiction is a valuable
tool for evaluating the physical, emotional, and psychological
challenges, consequences, and implications of this trend.

5

CHAPTER I: CONSTRUCTING CYBORG BODIES

Like any important technology, a cyborg is simultaneously
a myth and a tool, a representation and an instrument,
a frozen moment and a motor of social and imaginative
reality. A cyborg exists when two kinds of boundaries
are simultaneously problematic: 1) that between animals
(or other organisms) and humans, and 2) that between
self-controlled, self-governing machines and organisms,
especially humans. 1
DEFINITIONS

There is no single definition of a cyborg.

In 1960, Manfred

Clynes coined the term 'cyborg' from 'cybernetic organism' to refer to
"an artificially extended homeostatic control system functioning
unconsciously," or more simply, to a self-regulating human-machine
system. 2 The primary definition of a cyborg used in this thesis is "a
person whose physiological functioning is aided by, or dependent on, a
mechanical or electronic device. " 3

Cyborgs can be seen as

interconnected and interdependent networks that are made of assorted
parts from many different places. Cyborgs can consist of seemingly
endless combinations of organic and artificial parts. As such, they
transgress traditional boundaries, and as such, like other feminist

Haraway, Simians, Cyborgs and Women, 138-39.
Anne Hudson Jones, "The Cyborg (R)evolution in Science Fiction," in The
Mechanical God: Machines in Science Fiction . ed. Thomas P. Dunn and Aid iss
Erlich (Westport: Greenwood Press, 1982), 203.
3
P.K. Jamison, "Contradictory Spaces: Pleasure and the Seduction of the Cyborg
Discourse," The Arachnet Electronic Journal on Virtual Culture 2: I, 1994 Uournal
on-line]; available from
http://lydia.bradley.edu/las/soc/syl/391 /papers/contra_spaces.html ; Internet; accessed
27 January 1996.
1

2

7

projects, they are conceived to deconstruct and demystify patriarchal
or ruling relations. 4
The field of cybernetics was founded by Norbert Weiner in the
late 1940s.

Cybernetics is the control and communication in the

animal and the machine.

It introduces the revolutionary notion of

feedback control. 5 The implications, in engineering for example, were
immediately obvious: "if all the variables are tightly coupled, and if
you can truly manipulate one of them in all its freedoms, then you can
indirectly control all of them. "6 In effect, cybernetics plays on the
holistic nature of systems, the system of observing systems. 7 What
happened to this developing field of cybernetics? According to Kevin
Kelly,
[B]y the late 1970s, cybernetics had died of dry rot. Most
of the work in cybernetics was at the level of...armchair
attempts to weave a coherent big picture together. Real
researchers were bumping their heads in frustration in AI
labs, or working in obscure institutes in Russia, where
cybernetics did continue as a branch of mathematics. I
don't believe a single formal textbook on cybernetics was
ever written in English. " 8
In this thesis, I will use the concept of the cyborg continuum,
which consists of all of the possible cyborg combinations that replace,
assist, enhance, augment and improve organic bodies through
4

Dorothy E. Smith, The Everyday World As Problematic: A Feminist Sociology
(Toronto: University of Toronto Press, 1987).
5
Kevin Kelly, Out of Control: The New Biology of Machines, Social Systems and
the Economic World (New York: Addison-Wesley Publishing Company, 1994), 119.
6
Ibid ., 120.
7
Ibid., 453.

8

mechanical and artificial interventions and implantations. 9 At one end
of this continuum would be cyborgs with generally visible and
removable parts, such as hearing aids, eyeglasses, mobility aids, and
artificial limbs. Further along the continuum would be less visible
cyborgs with less removable devices, such as

implants and

replacements (for instance, breast implants, joint replacements, and
pacemakers).

Assisted reproductive technologies, such as in-vitro

fertilization and artificial insemination, and genetic engineering
occupy other points along the cyborg continuum. Other cyborgs are as
yet imaginary and fall within the domain of science fiction, such as
those with artificial intelligence and cyborgs who are most familiar to
us through television, films and novels. The most recognizable cyborg
bodies are the Terminator (living tissue over a metal skeleton), 10 the
Borg (mechanical enhancements onto an organic host for the purpose
of assimilation into the Borg collective), 11 and the Six Million Dollar
Man (replacing injured parts with super-strong bionic pm1s). 12

Ibid., 454.
See Appendix 1 for a visual representation of the cyborg continuum and for
examples of joint manufacturer's advertisements for total hip and knee replacement
systems.
10
The Terminator, James Cameron, dir. , (Los Angeles: Thorn EM I, 1984).
11
Star Trek: The Next Generation, Gene Roddenberry, executive prod., (Los
Angeles: Paramount Pictures, 1987-1994).
12
This 1973 entry ofthe cyborg into popular culture was based on the book Cyborg
by Marten Caidin. It was inspired by a US Air Force pilot who was in a plane crash,
as well as the US cybernetics program ( 1970-1972), which was based on modifying
humans (volunteers) to be superior in strength and speed. This was an unconfirmed
cyborg program which experimented with crude bionics. (from "Brave New Body,"
Future Fantastic: hosted by Gillian Anderson, The Discovery Channel, 1996).
There was also a spin-off show called "The Bionic Woman." The popular
8

9

9

Distinctions must be made between the integration of a dynamic
steady-state machine/human entity (i.e. The Terminator), in contrast to
the mechanical impetus of life (i.e. ARTs). This distinction between
cyborg bodies and cyborg technologies is important because it
indicates different points along the cyborg continuum. Examples of
cyborg technologies include test-tube babies, life-support systems,
organ retrieval units, and replacement surgery. 13 Test-tube babies are
the product of cyborg technologies because they are produced by the
manipulation of organic parts by artificial means. The organic and
artificial are integrated differently but still blended to produce an
organic human body.
In order to operate within a cyborg discourse, it is necessary to
define ' discourse,' because it is, in itself, a problematic and complex
term. Discourse is used "to signify the system of relations between
parties engaged in communicative activity and .. .is meant to signal the
inescapable political contexts in which we speak and work." 14

In

other words, 'discourse' is an active communications system

with

conceptualization of the cyborg is of a hyper-m asculine muscle-bound vill ain (the
exception being the Six Million Dollar Man). The machine and hum an elem ents are
often at war both within the body and in relation to the rest of the world . Cyborgs
have seldom occupied the role of the hero, although that has changed more recently
with Arnold Schwarzenegger' s role in Terminator 2: Judgment Day ( 1991) and
Jean-Claude VanDamme ' s role in Universal Soldier (1992).
13
Kathleen Woodward, "From Virtual Cyborgs to Biological Time Bombs:
Technocriticism and the Material Body," in Culture on the Brink: Ideologies of
Technology. ed. Gretchen Bender and Timothy Druckrey (Seattle: Bay Press, 1994),
54.
14
Patty Lather, Getting Smart: Feminist Research and Pedagogy with/in the
Postmodern (New York: Routledge, 1991 ), vii.

10

rules, conventions, and signs that are laden with political meanmgs.
Discourse is more than language because it is a specific set of signs
that refer to a particular set of relations.
Cyborg discourse is the politicized active system designed to
communicate the particular system of cyborgs. It is the discourse of
hybridity, power and control, interventions and implantations, medical ,
legal and ethical implications, and relations of production.

These

relations are created through power dynamics, emerging technologies,
and control mechanisms.

Cyborg discourse is specialized and

therefore applies to particular people. In this thesis, I am using cyborg
discourse to connect the medical discourse of total hip and knee
replacements with artificially intelligent cyborgs in science fiction .
One powerful connection between cyborgs in fact and fiction is
with regard to power and control. Power is complex and dynamic.
Max Weber defines power as "the probability that an individual or
group will be able to carry out its will even against resistance." 15
Power is also defined as ideological practice, as having agency without
reference or actual existence. 16

15

Sandra Kirby and Kate McKenna, Experience, Research, Social Change: Methods
from the Margins (Toronto: Garamond Press, 1989), 34.
16
Michel Foucault, Power/Knowledge: Selected interviews and Other Writings
1972-1977, ed. Colin Gordon, trans. Colin Gordon, Leo Marshall, John Mepham ,
and Kate Soper (New York: Pantheon Books, 1972).

II

Dorothy Smith conceptualizes power, more useful for this thesis,
as
... ansmg as people's actual activities are coordinated to give
the multiplied effects of cooperation .. .Its capacity to coordinate
consciousness and to displace individuated experience arises,
of course, as people participate actively in the socially organized
practices accomplishing an objectified knowledge. 17
In other words, power is the set of contextualized effects that develop
from actual social activity which then transcend or graduate to the
collective, never losing sight of the individual experience.
Power dynamics in the construction of cyborg bodies can be
further clarified using the concept of ruling relations.

Ruling

relations, Dorothy Smith' s concept, are "a complex of organizational

practices, including

government,

law, business

and

financial

management, professional organization, and educational institutions as
well as the discourses in texts that interpenetrate the multiple sites of
power." Ruling relations envisage "power, organization, direction and
regulation as more pervasively structured than can be expressed in
traditional concepts provided by the discourses of power." 18 "A mode
of ruling has become dominant that involves a continual transcription
of the local and particular actualities of our lives into abstracted and
generalized forms." 19 Ruling relations are texts which are woven with

17

Dorothy E. Smith, The Conceptual Practices of Power: A Feminist Sociology of
Knowledge (Toronto: University of Toronto Press, 1990), 70.
18
Smith, The Everyday World As Problematic, 3.
19
Ibid., 3.

12

power, gender, economic, technological, and social aspects that impact
us in our daily existence. She argues that the world is constructed in
texts (on paper or computer) that are capitalist and patriarchal.
Although she does not mention or specifically include oral traditions
and histories, the pervasive nature of 'relations of ruling' applies in
orally-based cultures as well. Examples of ruling relations include
"text-mediated

discourse,

professional

management,

formal

organization, management, administration, bureaucracy, the state, at all
levels and so forth. " 20
Technology is a nebulous and complex term. 21 Corlann Gee Bush

argues that
[t]echnology has everything to do with who benefits and who
suffers, whose opportunities increase and whose decrease,
who creates and who accommodates. If women are to
transform ... technology, we must develop ways to assess the
equity implications of technological development and develop
strategies for changing social relationships as well as mechanical
techniques. To do this, we must have a definition of technology
that will allow us to focus on such questions of equity. 22
Martin Heidigger tends to rely on the Greek root of technology and its
various associations that bring-forth knowledge, challenge and reveal
truth, and unlock and store energy. The danger is, according to Martin
Heidigger, in the constantly escalating nature of technology to the
Heidi Gottfried, Feminism and Social Change: Bridging Theory and Practice
(Chicago: University of Illinois Press, 1996), 47.
21
Frederick Ferre, Philosophy of Technology (Athens: University of Georgia Press,
1988), 26.
20

13

detriment of human control. 23

Sally M. Gearhart focuses on

technology as a product of human animals and defines it as "the
conscious and systematic manipulation of one's environment for the
purpose of reducing one's dependence on environmental factors for
survival."24 Clearly, the relationships and applications of technology
are crucial to understanding what technology is. Some feminists view
technology "as an interdependent variable" 25 that interconnects with
content, methodology, social context, determinism, and the nature of
technology. 26 Corlann Gee Bush argues that the context of technology
is crucial, whether the technology in question is operating in a design
or developmental, user, environmental, or cultural context. 27
Ursula Franklin defines technology as "the totality of the
operational knowledge, the practices, procedures and devices used to
accomplish certain tasks in society,"28 while techniques are the
"collection of means for achieving something [or] preventing

22

Corlann Gee Bush, " Women and the Assessment of Technology: to Think, to Be;
to Unthink, to Free," in Machina Ex Dea: Feminist Perspectives on Technology, ed.
Joan Rothschild (New York: Pergamon Press, 1983), 163 .
23
Martin Heidigger, The Question of Technology, and Other Essays, trans . and
introduction by William Lovitt (New York: Harper and Row, Publishers, 1977), 1316.
24
Sally M . Gearhart, "An End to Technology: A Modest Proposal," in Machina Ex
Dea, 171.
25
Joan Rothschild, "Introduction: Why Machina Ex Dea?," in Machina Ex Dea,
xxiv.
26
Ibid., XXV .
27
Bush, Machina Ex Dea, 157.
28
Ursula Franklin, The Real World ofTechnology (Concord : House of Anansi Press
Ltd., 1990), 3.

14

something else from happening." 29 She argues that technology has its
own values and standards: efficiency, speed and reproducibility. In
fact, Ursula Franklin explicitly sets out the difference between what
she sees as "the technological order" and the "women ' s world." She
ascribes

characteristics

such

as

efficiency,

predictability,

scheduleability, specificity, non-randomness, non-contextual, nonreferential, interchangeability of actors, plannability, and dependability
on hierarchy to the "technological order." In supposed opposition, is
the

"women's

world,"

which

has

flexibility,

integratability,

unpredictability, continuity, improvisability, spontaneity, randomness,
diversity, contextual, experiential. 30

Using this

system of

categorization as an accurate guide for distinguishing between the
technological and the female world is misleading, increasingly
unrealistic, and does not offer any possibility for change.

Ursula

Franklin's evaluation is evidence of previous feminist reaction to an
older type of Western technology, a stance that I argue is increasingly
untenable as biological and engineered systems look increasingly
alike.

This reality does not facilitate absolutes in distinguishing

between the two systems outlined by Ursula Franklin. Anne-Jormm
Berg argues that feminists have regarded technology as a finished and

29
30

Franklin, The Real World, 3.
Ibid. , 6.

15

non-negotiable product. 31 Therefore, the tendency has been to study
the harmful social impacts of new technologies on gender relations or
on women.32 She wants to shift the focus from a producer's immutable
commodity to a user's point-of-view.

She is not contesting that

technology is basically male-produced for capitalist and patriarchal
interests, but she wants to map a way out of feminism ' s predominant
pessimism by looking at technology' s flexibility.

For her, users of

technology do not merely adopt teclmology but help to shape and
construct it, through capitalist interactions (i.e. consumerism), and
incorporate it into our daily lives by negotiating technological
applications. "By substituting an emphasis on cultural integration of
technologies for one on utilitarian values, and by substituting a view of
technology as in process for one in which it is seen as non-negotiable,
we can overcome ... the pessimism that pervades feminist technology
studies."33 She stresses women's relationship with technology as an
inter-relationship of process, relation and negotiation. "The argument
that women's relationship to technology is a contradictory one,
combined with the realization that technology is itself a social
construct, opens up fresh possibility for feminist scholarship and

Anne-Jorunn Berg, "Technological Flexibility: Bringing gender into technology
(or was it the other way around?)," in Bringing Technology Home: Gender and
Technology in a Changing Europe, eds. Cynthia Cockburn and Ruza FUrst
(Philadelphia: Open University Press, 1994), 95 .
32
For an excellent review of feminist literature on gender and technology, see Judy
Wajcman, Feminism Confronts Technology (Cambridge: Polity Press, 199 I).
33
Berg, Technological Flexibility, I 08 .
31

16

action. " 34

Both Judy Wajcman and Anne-Jorunn Berg are

appropriating technology for feminist applications because we cannot
always be reacting to the fallacy of a monolithic, imposed-from-above
agenda. A pro-active approach, while cautious and well-informed, can
lead to social change and transformation.
Once technology is seen as a process instead of an alreadymade 'thing', the user of technology is no longer its passive
recipient but can come into view as an important actor in its
shaping. Intentions baked into technology may restrict the
flexibility of a given artifact, but they cannot altogether determine its use or meaning. Intentions can enable or inhibit actions
or the range of possible actions ... But the user negotiates these
structures in different ways through human agency and creativity,
and the outcome can be a subversion of intentions.35
In this thesis, my focus is on the applications of particular technologies
from a user-standpoint. I agree that technology is a combination of
socially-constructed 'things' and social process which is shaped but
not determined by intentions and applications.

It is important to

recognize, however, the capitalist character of technology because it is
connected to economy, capitalism, and labour. Capitalist technology
is "designed not simply according to engineering priorities but in
keeping with social values," which are driven by market demands and
profit, and not human needs.36 As capitalist technology is not immune
to individual and market manipulations and pressures, I argue that

34

Wajcman, Feminism Confronts Technology, x.
Berg, Technological Flexibility, 96.
36
Teresa L. Ebert, Ludic Feminism And After: Postmodernism, Desire, and Labor in
Late Capitalism (Ann Arbor: The University of Michigan Press , 1996), 107.
35

17

while we should never forget the capitalist and patriarchal origins and
intent of technology connected to the relations of production, it would
be a mistake to treat technology as detetmined, essential, monolithic,
or immutable. Our goal is actual social change and emancipation, a
,call "for a balance of nature; an end to social domination, whether of
sex, race, or class; the breakdown of hierarchies; and a society based
on principles of equity--values that feminists seek to implement for
technological scholarship and technology itself."37

I believe that

feminist cyborg discourse can offer a particular perspective on these
things.
In the late twentieth century, the development of synthetic complex
systems and emerging technologies has been increasingly modeled on
biological systems.

Kevin Kelly believes that biology will always

prevail:
...the flavour of the next epoch is neo-biological rather than
bionic, because although it may start symmetrically, biology
always wins in any blending of organic and machine. Biology
always wins because the organic is not a sacred stance. It is not
a holy status that living entities inherit by some mystical means.
Biology is an inevitability -- almost a mathematical certainty -that all complexity will drift towards. It is an omega point. In
the slow mingling of the made and the born, the organic is a
dominant trait, while the mechanic is recessive. In the end,
bio-logic always wins. 38

37
38

Rothschild, Machina Ex Dea, 150.
Kelly, Out ofControl, 183 .
18

The inevitability of biology is an interesting argument, in response
perhaps to those who are significantly more cautious, if not suspicious,
of the evolving trend towards life-like machines, engineered life, and
cyborgs.
In this thesis, I will use Kevin Kelly's definition of life as having
patterns in space and time, ability to self-reproduce, information
storage of its self-representation (genes), metabolism to keep a
persisting pattern, functional interactions, the interdependence of parts,
or the ability to die, stability under perturbations, and the ability to
evolve. 39 Computer viruses are the first example of emergent artificial
life by this definition oflife. Thus, according to Kevin Kelly, life "is a
verb, not a noun."40
But what is human? According to the Oxford English Dictionary,
'human' denotes certain forms, characteristics and qualities, all of
which are decidedly vague.

One definition of 'human ' is " [o]f,

belonging to, or characteristic of mankind [sic], distinguished from
animals by superior mental development, power of articulate speech,
and upright posture." 41 Another useful definition regards 'human' as
"belonging or relative to humans, relating or characteristic of
activities, relationships, etc., which are observable in mankind [sic], as
distinguished from a) the lower animals; b) machinery or the
39
40

Ibid., 346.
Ibid., 347.

19

mechanical element; c) mere objects or events."42 In a discussion of
the humanity of cyborgs, the question of their own humanity may not
be problematic to those who have total hip or knee replacement
systems. They have no crisis of identity over their humanity and the
issue is never raised for them. By contrast, the cyborgs in Marge
Piercy's He, She and It and Amy Thomson's Virtual Girl struggle for
recognition of their humanity, individuality and identity, which is
often in conflict with their creators' agendas.
THEORETICAL DEBTS
Donna Haraway argues that science and science fiction have
conceptualized the cyborg as a product of Western traditions of
humanism and enlightenment ideals. 43

The figure of the cyborg

becomes the hope after the apocalypse, foretold by the innocent origin,
the fall out of Nature and then rising from the ashes of the apocalypse
like the Phoenix. 44 The apocalypse is destructive but also cleansing
and renewing, much like a rebirth after decadence and decay. Humans
may not be equipped to survive the apocalypse without some
improvements to our bodies in the harsh new surroundings. Cyborgs
The Oxford English Dictionary ( 1989), 2d. ed., s.v. " Human."
Ibid.
43
Haraway, Simians, Cyborgs and Women.
44
This origin story has roots in the Book of Genesis (New Testament), with the
creation of Adam and Eve in the Garden of Eden. Their Fall from Grace and
expulsion from the Garden occurred because they ate the forbidden fruit of
knowledge, which destroyed their innocence. The apocalypse includes the events
that lead up to the ultimate battle between God and the Devil (Book of Revelations,
New Testament). Donna Haraway does not cite specific biblical sources but makes
41

42

20

can be seen as

replacing Adam and Eve in a post-apocalyptic

environment, for the survival and continuation of the human species in
an altered form. In other words, the development of cyborgs is closely
linked to saving the human race from (self)destruction. Cyborgs will
protect us from external threats and even from a self-induced
apocalypse. In situating cyborgs as the hope for the future, Dorma
Haraway points out the irony of the cyborg's position. Even as they
, are intended to 'save' us and secure our future by their ability to adapt
to the post-apocalyptic environment, cyborgs also embody the many
contradictions that are firmly established in us, their creators. Cyborgs
unintentionally undermine their creators ' intentions by bluning
traditional boundaries and transgressing humanist dualisms, on which
our post-industrial society is based. As seen in terms of western binary
oppositions, cyborgs are both human and machine, organic and
artificial, self and other, whereas our western Aristotelian philosophy
clings to either/or boundaries. Can cyborgs transcend the humanist
Judea-Christian legacy? Can the creation escape the limitations of the
creator if cyborgs "are still undeniably the dream-children of a
positivist, rationalist American technology built by middle-class men

frequent reference to the apocalypse (for example: Haraway, Simians, Cyborgs and
Women, 151 and 175).

21

of the previous two centuries. "45 Who are these cyborgs? I argue that
we are cyborgs, 'they' are 'us,' and that we (re)create ourselves.
Given the humanist legacy of cyborgs, Donna Haraway argues that
"[c]yborg writing is about the power to survive, not...on the basis of
original innocence, but on the basis of seizing the tools to mark the
world that marked them as other."46 She plays with notions of 'truth'
and 'fiction,' constructing politics and truth as fiction, arguing "for
pleasure in the confusion of [established] boundaries and for
responsibility in their construction."47 For her, cyborg theory disrupts
the humanist quest for origins, as no longer applicable or relevant, and
she intends the cyborg to interrupt, undermine and obliterate the
conceptual prison of salvation history.

If 'humanism' was the

conceptual lens through which cyborgs have traditionally been framed ,
then, according to Mary Catherine Harper, "Haraway's cyborg is a
self-declared deconstructor of humanism." 48 What does the cyborg
look like without the conceptual framework of humanism?

Scott

Bukatman points out that for cyborgs, the integration of the organic

N. Katherine Hayles, "The Life Cycle of Cyborgs: Writing the Posthuman,"
Science Fiction Studies 22:67 (1995): 405 .
46
Haraway, Simians, Cy borgs and Women , 175.
47
Ibid., 150.
48
Mary Catherine Harper, "Incurably Alien Other: A Case for Feminist Cyborg
Writers," Science Fiction Studies 22 : 67 ( 1991 ): 403-4.
45

22

and the artificial is permanent and irreversible. "There is no gomg
back. That's a game for those who still have flesh. " 49
I must point out that Donna Haraway, Scott Bukatman, and many
science fiction writers, are firmly focused on cyborg bodies of the faraway future and not on people with total joint replacements. There
- will be a considerable period of time required for research and
development, during which many experiments and attempts at
integrating artificial and organic body parts will fail.

The replaced

parts will likely fail because it is experimental surgery, always in
process, and therefore it is just a matter of time for artificial parts to
fail, break down, or wear out (which is dependent on many variables,
including type of materials, sterilization, surgical technique and
condition of the patient). These failures will motivate renewed efforts
and undetermined time will pass before the cyborgs the creators
envision might exist. I argue that while we are not even close to their
vision, it is certainly imaginable, and my research suggests that we are
moving in that direction.
In an intellectual game, Donna Haraway re-reads and re-interprets
technology to spin a cyborg myth that transcends a pessimistic view of
technology. The problem, according to Teresa Ebert, is that Donna
Haraway does not ground her cyborg theory in historical materiality.

49

Scott Bukatman, "Postcards From the Posthuman Solar System," Science Fiction
Studies 18:55 (1991): 346.

23

What are Donna Haraway's goals·then? What is her purpose? Teresa
Ebert argues that Donna Haraway ' s aim is "semiotic freedom," which
is a diversion from effecting actual social change. By replacing the
economic with the technocultural and the sociocultural, Donna
Haraway severs technology from the relations of production that
produces it. Technology becomes the abstracted ground of all other
social, cultural and economic realities. 50 Donna Haraway "embraces"
the postindustrial society, which replaces capital and labour (industrial
society) with information and knowledge (postindustrial society).51
She seeks to displace revolution with reform and transformation with
subversion. 52 Donna Haraway's reform comes from coalition, which is
based "on a mutual understanding of a postmodern identity of
otherness, difference and specificity. 53 But when cyborgs inhabit 'us '
and 'them' in the same space, does not her concept of coalition
through otherness simply perpetuate the binary opposition of ' us ' and
'them'? 'Self and 'other' are connected, they are the same through
the relations of production. On the basis of self-interest, which is the
product of the academic class privilege, 'self and ' other' are
maintained, and there is no social change that emerges from theory

Ebert, Ludic Feminism, 107.
See neoconservative Daniel Bell, The Coming of Postindustrial Society (New
York: Basic Books, 1973), a rejection of Marxism and dismissal of capital and
labour as defining characteristics.
52
Ebert, Ludic Feminism, 108.
53
Ibid., 109.

50

51

24

which cannot connect with lived experiences. 54 Coalition should be
based on the shared commitment to end exploitation and to effect
social change.
Is Haraway describing new realities for us? Certainly she
describes some important changes in the social and cultural
relations of contemporary society, but whether there are, as
she claims, "fundamental transformations in the structure of
the world" (1991, 165) is highly debatable. What is at stake
is whether these changes constitute fundamental transformations
in the structure of capitalism. By subsuming the economic to
the technological and then arguing for extensive social changes
stemming from technology, Haraway misreads diverse social
and cultural--that is, superstructural--developments as basic
changes in the relations of production and the exploitation of
labour ... 55
Teresa Ebert criticizes Donna Haraway for speaking of economy in
terms of superstructure and adjectives, and that "her richly detailed
descriptions do more to obscure than to explain the existing economic
realities of women." 56 Donna Haraway's cyborg politics, her origin
story of' salvation,' must be only abstracted theoretical mythology if it
cannot take into account the economic realities of women (such as
poverty) and seek social change in a grounded version of feminist
cyborg theory.
What if 'salvation' is replaced by other goals, such as immortality,
longevity,

quality of life issues, short-term physical or health

improvements, or aesthetics? If we reject the cyborg as the means of

54

Ibid., 119.
Ibid., 110.
56
Ibid., 116.
55

25

our salvation, what other interpretation can we give to the increasingly
pervasive trend of technological interventions into our bodies? New
technology and its various applications seem to influence our daily
lives at an accelerated rate. Biology appears increasingly c01mected to
engineering as the boundaries between human and machine blur and
the dichotomy of human/machine breaks down as the differences
between the two are increasingly minute. As worn-out or damaged
body parts are replaced with metal and plastic, the body consists of
parts that will decompose organically and parts whose decomposition
will likely take centuries.

In the future, our bodies will become

hybrids with metal and flesh, polyethylene surrounded by blood.
METHODOLOGY
In my research, I used a feminist multi-method approach, a
combination of interviews and content analysis.

Such an approach

means a commitment to understanding critical, contextual, and
complex issues in women's lives. Multiple methods involve asking
questions, treating truth as a process, and remaining flexible and
adaptable. "This approach is humble since ' findings' are housed in the
project's specific features, rather than claimed as disembodied truth." 57
The results

of a multi-methods approach to research illuminate

previously unexamined or misunderstood experiences, based on a new,
rich and different interpretation of the data.

26

Feminists choose multiple methods for technical reasons,
similar to mainstream researchers, and for particular feminist
concerns that reflect intellectual, emotional, and political
commitments. Feminist descriptions of multimethod research
express the commitment to thoroughness, the desire to be
open-ended, and to take risks. Multiple methods enable feminist
researchers to link past and present, "data gathering" and action,
and individual behavior with social frameworks. 58
The issues arising from this approach are all related to power and
control, which are at the core of both emerging technologies (i.e. total
joint replacements) and building complete cyborg bodies (i.e. in
science fiction).
Since defining cyborg bodies as those who are hybrids of organic
and artificial components, I have chosen to look at a particular group
of people who have undergone surgery for total hip or knee
replacements. My research participants do not regard themselves as
cyborgs, the issue was not included or brought up in the interviews,
and most of them had never heard of the concept of cyborgs. One of
my main goals was to discover how they felt about having artificial
body parts. Prior to the interviews, all of the participants signed a
consent form

that guarantees their anonymity

and

right

to

confidentiality. Therefore, I am using a code to designate the source of
information secured through the interviews. The code refers to the
research participants as follows: P 1 to P7 designates those participants
who underwent either total hip or knee replacement surgery. S 1 to S4
57

Reinharz, Feminist Methods, 212.

27

refers to the four surgeons that I interviewed, and Hl to H4 applies to
the other four health professionals who participated in my research.
Shulamit Reinharz suggests that the researcher and her research
process should be visible in both the interview and in the final
analysis. Interviewing methods are more closely linked to the lives
and issues concerning living, tangible women and men than content
analysis. They involve more action and practice than content analysis
which is based primarily on written texts. Theory must be grounded in
practice in order to identify patterns, issues, and problems to effect
change. 59

Social change may be facilitated by a feminist research

approach, which may be defined as a way to produce "knowledge
through ... interactive relationships ... [where] the everyday life
expenence and feelings of participants are a major source of
knowledge." 60

Interviews can be seen as collaborative ventures, a

means of collecting data directly from people by asking them
questions about their experiences.

Content analysis entails the

examination of cultural documents but little meaning can be derived,
outside of an academic context, if the subsequent analysis cannot
contribute to change in the world at large. 61

58

Ibid., 197.
For grounded theory in qualitative methods research , see Barney G. Glaser and
Anselm Strauss, The Discovery of Grounded Theory: Strategies for Qualitative
Research (Chicago: Aldine Press, 1967). The application of grounded theory for
feminist research is well-articulated in Kirby and McKenna, Experience, 1989.
60
Reinharz, Feminist Methods, 182.
61
Ibid., 197.
59

28

In Chapter IV, I utilize content analysis to examine the issues
within the narratives of He, She and It and Virtual Girl in the
construction of cyborg bodies. According to Shulamit Reinharz, there
is no terminological consensus for content analysis. One general
definition is the study of "a set of objects [or events by] interpreting
the themes contained in them."62 These themes include @alyzing the.
plot, the concepts of identity, power and control in the text in relation
to cyborg bodies, and the discourse employed in the construction of
cyborg bodies. It is an approach that studies underlying themes and
stereotypes and "addresses questions of theory, such as identifying the
processes through which gender is constructed. " 63 In this thesis, I use
content analysis to explore the themes of identity, power, and control.
Content analysis is both interdisciplinary and transdisciplinary, but it
needs to be grounded in other methods, as well as in theory and in
practice, in order to effect change (direct or delayed), which is the goal
of feminist research.

62
63

Ibid., 146.
Ibid. , 160.

29

CHAPTER II: ARTIFICIAL PARTS: SOME ASSEMBLY
REQUIRED

METHODOLOGY OF HIP AND KNEE REPLACEMENTS
I don't know that we're ever going to end up with a total
bionic person who has everything, everything replaced,
but I think generally, for patients comfort, that we may
be seeing more and more of it, as people get older and
are staying mobile into their 80s and 90s, we will see
more of this kind of surgery. 1
I chose total hip and knee replacements as the focus for my
exploration of issues in the construction of cyborg bodies because
replacement surgery lends itself to a gendered analysis, although the
evaluation of breast implants and assisted reproductive technologies
[ART] may seem to be more obvious points of the cyborg continuum
for a feminist analysis. There is already an abundance of information,
such as testimonies and recorded experiences, in the fields of breast
implants and ART., but there are few recorded experiences of people
who have joint replacements. 2 Living and working in Prince George, a
relatively small northern city, it was easier to find interview
participants of both genders who have had hip and knee replacements,
than women with breast implants. Moreover, the variety of interviews
I was able to conduct allowed me to do a gendered analysis.
1

Interview with H2, 17 April 1997.
For more information on breast implants, see Susan M. Love (with Karen Lindsey),
Dr. Susan Love's Breast Book, 2d. ed. (New York: Addison-Wesley Publishing
Company, 1995); Barbara Nettles-Carlson, "Problems of the Breast," in Women 's
Health Care: A Comprehensive Handbook, ed. Catherine Ingram Fogel and Nancy
Fugate Woods (London: SAGE Publications, 1995); and Fabienne Darling- Wolf,
"Mixed Messages: how the media went wrong on the breast implant story," Herizons
10:3 (Summer 1996), 15-17. For more information on ARTs, see " Proceed with
Care: Final Report of the Royal Commission on New Reproductive TechnologiesVolumes I and II" (Ottawa: Minister of Government Services Canada, 1993).
2

31

I have chosen to look at degenerative and congenital reasons for
surgery in order to narrow my focus to a specific group of research
participants.

I conducted semi-structured, open-ended interviews

based on the principles outlined by Shulamit Reinharz, in Feminist
Methods in Social Research (1992).

For her, meaning emerges

through interaction, and one of the main ideas is to uncover
"previously neglected or misunderstood worlds of experience."3 With
the predominance of medical discourses, it is important for people' s
voices to be heard with regard to their health and well-being, in this
case, around the integration of artificial body parts.
JOINT REPLACEMENTS
They tell you that it is experimental surgery, and they
don't really know how long you're going to have a
good hip for, so it's a bit of a gamble when you go
in there, but if you want to be able to walk, of course,
then really there's not a lot of choices open to you ...
Oh well, it's human experimentation, in the first place,
right? .. . I mean we haven't got beyond that. Seven
years ago, I was told, we've been doing these for twentyfive years, but we still don't have enough longitudinal
studies and enough information to tell you what you're
going to be like, you're yatmg, you're obviously going
to have more of these, but we can't tell you how many,
and we can't tell you how long ... I was told then, we hope
fifteen to twenty years, but we don't know. Well, in my
case, it was 7 years, I didn't expect it to loosen up but OK,
and that's the way it goes. If this one lasts longer that the
last one, I'll be really pleased, but again you don't know,

3

Reinharz, Feminist Methods, 45 .

32

it's an unknown quantity ... You carry on with life and
when it happens, it happens, so there's a bit of uncertainty
in that respect, but given, I don't think I would ' ve been
upright and walking since 1989 if I hadn't have had
a joint replacement. 4
In order to understand the reasons for total joint replacement
surgery, an elementary grasp of joint physiology is essential. "Joints
are articulations where bones are joined to one another, or where two
surfaces of bones come together. Joints help hold the bones firml y
together while permitting movement between them.

Joints may be

classified by the type of material between the bones and by their
degree of movement." 5

Joint replacement surgery is performed to

alleviate pain, improve mobility, correct deformity.6

Total joint

replacement is indicated in people with painful and disabling artlu·itis
in a joint that isn't responsive to nonsurgical treatment, such as
exercise and/or medication.7 The reasons may be due to degenerative
disease, sports injuries, and congenital conditions to which everyone is
vulnerable. People live with a great deal of pain prior to going in for
total joint replacement surgery, mostly because of a huge demand for
such surgery, which creates long waiting lists. One surgeon said: " .. .we
have a tremendous waiting list, of patients that need this surgery, that

4

Interview with P2, 18 March 1997.
Leona Mourad, Orthopedic Disorders (St. Louis: Mosby-Year Book, Inc. , 1991 ),
14.
6
Robert E. Tooms and James W. Harkess, "Arthroplasty: Introduction and
Overview," in Campbell 's Operative Orthopaedics, 8th ed., ed. A.H. Crenshaw (St.
Louis: Mosby-Year Book Inc., 1992), 3 72.
7
Tooms and Harkess, Arthroplasty: Jnt;oduction, 372 .
5

33

would benefit from it but we can't, we get one day a week in the
operating room, which at times has been cut down less that that
because of our budget this year, and beds are being closed and that sort
of thing ... " 8 A health professional commented that "[u]sually they're
on quite a long waiting list prior to their surgery, so they've had
decreased strength and decreased range of motion and decreased
mobility as a result of their problem prior to the surgery." 9

This

situation occurs in large cities as well as in smaller places and regional
hospitals (i.e. Prince George Regional Hospital), but the waiting
periods tend to be longer outside of the large urban areas.
There are 127 kinds of arthritis currently known, causing pain and
stiffness in and around the joints. Most types affect both women and
men, a few affect mostly men and one affects mostly women -synovitis, the inflammation of the joint membrane, commonly
resulting in rheumatoid arthritis. Another common kind of arthritis,
that affects both genders is osteoarthritis or cartilage degeneration,
where the cartilage facing the joints breaks down with age and the
bone ends may come into contact with each other causing pain. 10
Rheumatoid arthritis and osteoarthritis are the most common causes of

8

Interview with S4, 15 April1997.
Interview with H3, 26 May 1997.
10
James F. Fries, Arthritis: A Comprehensive Guide to Understanding Your
Arthritis, 3d. ed. (New York: Addison- Wesley Publishing Company, 1990), 9-1 I .
9

34

total joint replacement surgery, and were the causes of the joint
replacement surgery experienced by the participants in my research.
TOTAL HIP REPLACEMENTS

The hip joint is a ball and socket type of joint which provides free
movement in all directions. The ball is the top of the thigh bone and it
fits into the socket of the pelvic bone. Both .of these bone ends are
normally covered by cartilage which ensures smooth and painless
motion.

Head of femur (ball)

-Total Hip Replacement Owner's Manual, 4
The hip was the first joint to be "replaced". The first documented
efforts to relieve pain through the introduction of artificial materials
into a hip was in 1912 with the use of gold foil.

Results were

unpredictable and residual stiffness and pain were the primary causes

35

of failure. In 1923, 'molded arthroplasty' was attempted using glass. 11
While all the implanted glass molds "broke within a few months, the
initial results were encouraging and prompted a search for more
durable materials." 12

Some of the materials tested included pyrex,

celluloid and Bakelite, but these were all discarded due to fragility or
severe foreign body reaction. The development of Vitallium in 193 7
marked the first sufficiently durable material for hip implants. Basic
designs for hip replacement systems were debated and tested and
discarded from 1940 to 1960.
The modem era of total joint replacement arthroplasty
began in the 1960s with the development by Sir John
Charnley of a total hip replacement arthroplasty consisting of a stemmed stainless steel replacement for
the femoral head articulating with a high density polyethylene acetabular implant, both components being
securely fixed to the underlying bone by polymethylmethacrylate cement. 13
This is the now-classic design for hip replacement systems, the
building block for further research to find even more durable materials,
and more effective ways of sterilizing materials, and mixing the acrylic
cement. The goals of research include the search for "optimal implant
design, new materials with better wear and biomechanical bone
compatibility properties, optimal fixation techniques, improved
11

Arthroplasty is defined as "the construction of an artificial joint." The Oxf ord
English Dictionary (1989), 2d ed., s.v. "Arthroplasty."
12
James W. Harkess, "Arthroplasty of Hip," in Campbell 's Operative Orthopaedics,
8th ed., ed. A.H. Crenshaw (St. Louis: Mosby-Year Book, 1992), 442.
13
Tooms and Harkess, Arthroplasty: Introduction, 371 .
36

instrumentation, and ease of revision." 14 The four major causes of hip
replacement failure are infection (for many reasons, including
polyethylene particulate wear-debris), joint dislocation, loosening of
the acetabular cup and femoral stem, and failure of the femoral stem.
"Loosening has emerged as the major long-term problem." 15 Sir John
Charnley began with stainless steel metal and Teflon components,
which have been replaced by stronger alloys such as titaniumaluminum-vanadium and the popular cobalt-chromium. Teflon was
abandoned because of poor wear characteristics.16 Cobalt-chrome, on
the other hand, is favoured because of its higher elasticity which may
decrease the stress placed upon the hip joint. 17

Hip replacement

designers are experimenting with platinum and diamond components. 18
There are current tests of "ceramic (aluminum oxide) femoral heads
[with] with polyethylene acetabular components ...because this material
has excellent frictional and wear" initial results. 19 In the words of one
of the orthopedic surgeons that I interviewed:
.. .the plastic lining of the hip socket and in the knee are
made of high density polyethylene, and there have been
some problems with how that plastic is produced and
how it is sterilized. Sometimes that plastic can, end up
with a sort of lamination effect from the way it is sterilized and that, the outer layer of it can actually break
down and peel away ... With certain methods of preparing
14

Ibid., 372.
Harkess, Arthroplasty of Hip, 445 .
16
Ibid. , 453 .
17
Ibid., 461 .
18
Toronto Star. April II , 1996: A4 .
19
Tooms and Harkess, Arthroplasty: Introduction, 372 .
15

37

it. So, what the companies are doing now are trying to
come up with ways of preparing this plastic so that is
will not break down. It's the fine particles, the wear
particles that are generated from the everyday use of
the joint ... [The wear particles are a concern] in that
they seem to contribute to the loosening of the prosthesis, the body engulfs these microscopic particles
of plastic or metal in cells that at the same time
release some enzymes that dissolve some bone, and
eventually loosen the prosthesis, so having less wear
debris is one factor that is being worked on. Cement
is improving, the type of metal used to make these
prosthesis is improving, the way that the porous coating
is bonded to the main metal part of the component
needed for the femoral component or the acetabular
component, or the femoral hip component if you ' re
doing a completely uncemented hip. There has been
some loosening of the interface between the porous
coating and the main metal stem, and that' s been a
concern. Ceramic heads for the femoral components
are a newer thing that are felt to generate less wear
debris, again, it's a wear concept that we're working on,
then there are loosening and fracturing of the cement
around the femoral component of a hip replacement,
and now, there's sort of a third generation way of
preparing and inserting the cement. We mix it under a
vacuum, we put it in a closed container with a hose going
out to a suction system so that air is missing from the
mixing chamber ... And so air bubbles don't form within
the cement. The cement is then also centrifuged, we don' t
do that here, but the cement can be, we mix it under a
vacuum but we don't centrifuge it, centrifuge means you
put it in a container and you put it in a big spinner that
then by gravity, causes the air bubbles to come out of it
... And then the third thing is by pressurizing the cement,
as you are putting it into the femoral canal. We put a plug
down at the bottom so the cement doesn't just keep going
down and down ... So that we have something to push it
against and that forces the cement out into the pores of the
bone ... And it helps to anchor it better. 20

20

Interview with S4, 15 April 1997.

38

Ultra-high molecular weight polyethylene was developed in 1971
for acetabular components as the removable liners on the articulating
metal surface.

Metal-on-metal was tried and rejected because of

generations of metallic debris, which caused infection, pain and
disability. 21 However, it is currently undergoing research again and
given the improvement in materials and technique, metal-on-metal
may prove a viable option.

The future may include custom-made

components, although current costs make that option prohibitive and
therefore unlikely. As one of the orthopedic surgeons explained:
Well, I see probably change to different materials, such
as ceramic and metal-on-metal, as our techniques get
better and as we work with less problems. A long way
in the future are things like custom-made components
for each person. On x-ray, you' d determine the person' s
modulous elasticity of their bones and make a component
out of carbon fiber that bends the way their bone does.
That way you wouldn't get the modulous mismatches that
we get now that can cause pain, that cause fractures and
things like that. Companies are looking into that but it's
probably far down the road, too expensive. And the other
side of it is probably medical treatment for osteoarthritis,
in which case we stop doing total hip replacements all
together. 22
Orthopedic surgeons have three surgical options for implanting
total hip replacements: cemented, cementless, and hybrids. The
cemented option means that both the femoral and acetabular
components are cemented. Cementless surgery has both the femoral

21
22

Harkess, Arthroplasty of Hip, 467.
Interview with S3 , 25 March 1997.

39

stem and acetabular cup with porous surfaces for bone to grow through
in order to fix the components in place. Hybrid hip replacements
cement the femoral stem and use a porous acetabular component. 23
The hybrid hip system seems to be the most popular model among
orthopedic surgeons that I interviewed. I asked them which hip and
knee systems they are currently using. The following is representative
of what they said:
We are presently using the Wright medical technology ...
for knees and we are trying a Zimmer hip system ... we
are trialling the Zimmer hip . We have trialled the Wright
hip, the DePue hip and, also I think we're going to be
looking at the Johnson & Johnson [hip], so we're still in
the process of deciding what is the most beneficial system
for us to use and it doesn't just involve which one we think
is technically the best, it involves which company is able
to give us the best support ... In terms of supplying the
equipment we need, on a timely basis, and other factors
such as if we have a certain hip system, then we also will
have access to a new knee arthroplasty system or other
instruments. They make a package deal ... To be quite
honest, I think most of the top manufacturers' products
are just as good as each other' s. 24
Total hip replacement is most often performed because of
degenerative joint disease from osteoarthritis. 25 It is the most common
orthopedic surgery, performed over 150,000 times per year in the
United States. 26 In Canada, there were 25 ,878 total hip replacement

Harkess, Arthroplasty of Hip 463.
Interview with S4, 15 April 1997.
25
Leona A. Mourad and Millie M. Droste, The Nursing Process in the Care of
Adults with Orthopedic Conditions, 3d. ed. (Albany: Delmar Publishing Inc. , 1993),
377.
26
Trudy Sandler Goldstein, Geriatric Orthopaedics: Rehabilitative Management ol
Common Problems (Gaithersburg: Aspen Publishers Inc. , 1991 ), 29.
23

24

40

surgeries performed between April 1988 and March 1990.27

More

recently, in 1992-1993 , hip arthroplasty was done in 14,615 women
and 8,023 men. 28
TOTAL KNEE REPLACEMENTS
The knee joint is a complex hinge joint that relies on strong
muscles and ligaments for support and stability.

It may bend and

straighten but the side ligaments prevent any unwanted sideways
movements. The weight-bearing areas are located between the femur,
the tibia and the patella. The knee is not actually totally replaced as
worn cartilage surfaces are the only parts that need to be replaced.
Perhaps it might be better named a 're-surfacing knee replacement. ' 29
One surgeon commented:
.. .we sometimes don't even replace the knee cap, ...
[it] has been the weak link in the chain for knee
replacement [systems], and ifyou don't need to
replace it, they seem to have a longer lifetime
when [you don't replace the knee cap] ... but if the
knee cap is severely worn then it has to be replaced
and you have to take your chances with that. 30
Total knee replacement is performed mainly in response to pain due to
osteoarthritis and rheumatoid arthritis.

27

Information obtained by a phone call to Statistics Canada on May 20, I 997 (I800-263-1136).
28
Ibid.
29
Arthritis Society, The (BC & Yukon Division), Your Knee Replacement Owner 's
Manual (Vancouver: The Physiotherapy Department, Vancouver General Hospital ,
The Division of Reconstructive Surgery of the Department of Orthopaedics at the
Vancouver General Hospital and the University of British Columbia, Revised
January 1989), 2-3 .
30
Interview with S4, 15 April 1997.

41

The knee prostheses consist of an upper metal femoral component,
a lower metal and polyethylene tibial component, and a polyethylene
button which is attached to the back of the patella to provide smooth
movement among the knee parts. These parts are usually cemented
together with polymethylmethacrylate. Cementless components "have
a textured metal surface into which bone can grow to form a bonemetal locking bond." 31

--Femur-------

. --Patella-

---Tibia-------

-Your Knee Replacement Owner's Manual, 2
I was thinking of a knuckle joint and the plastic that they stick
right in, you know? ... But this looks like, the bottom, like the
bottom of your leg comes up, you know, .. . it was absolutely
cut out square ... They used chisels and hammers and everything else to do it, to cut it absolutely square, there was a pad
on each side. One squeezed around my [femoral] ball on
the top ... And another one under my knee cap, when they
put it back on. 32
31
32

Arthritis Society, Your Knee Replacement Owner's Manual, 3.
Interview with P5, 25 March 1997.

42

Partial knee arthroplasty, using materials such as skin, muscle, fat
and even a pig's bladder, was documented as early as 1861. 33 None of
these efforts was highly successful. Different ideas continued to be
tested in the 1920s and 1930s, but breakthroughs in knee prostheses
were much slower to develop than in hips. The challenges included
the replacement of both the tibial and femoral joint surfaces, to provide
stability and to restore limb alignment. 34 Nineteen seventy-one was
the beginning of the modem era of total knee arthroplasty, based on
"the low-friction concept originated by Sir John Charnley for total hip
arthroplasty and consisted of steel surfaces articulating with highdensity polyethylene surfaces, all components being cemented in bone
by polymethylmethacrylate."35 One participant recalled:
They have trays, oh I'm guessing they were about as big as a
cookie sheet, maybe they were bigger, I was kinda woozy, but
anyway, they had all these trays, it was just like a parts shop.
They have, mine has three different, replacement parts, artificial,
but they have a whole tray of knee caps and a whole tray for the
top [part], anyway and these are all different shapes and sizes,
you see. So, when they get the bone all ready, then they go and
find the right part that fits your leg ... I found that very interesting.
like it isn't just one size, it's just like buy and choose, you get
one to fit your own, your own body, and I found that interesting,
I thought gee, this is like going into a shop with all these spare
parts sitting around [laughing]. Yeah, I liked that. 36

33

The use of these materials is attributed to Verneuil in France (Robert E. Tooms,
"Arthroplasty of Ankle and Knee," in Campbell 's Operative Orthopaedics, 8th ed.,
ed. A .H. Crenshaw (St. Louis: Mosby-Year Book, Inc ., 1992), 390).
34
Ibid.
35
Ibid., 391.
36
Interview with P4, 24 March 1997.

43

With more knowledge of the biomechanics of the knee, different
designs were tested and "the result of all these efforts has been a
success rate in total knee arthroplasty that equals or exceeds that in
total hip replacements."37

Design criteria for knee replacement

systems were initially elusive but " [i]t appears desirable to design
components that allow a normal or nearly normal range of
motion ... [meaning] flexion and extension, adduction and abduction,
and rotation." 38 The knees are made of cobalt chrome. But I think the
shapes have stayed pretty well the same. We haven't changed much
there, I think the biggest advancements were in the cementing
techniques."39 In terms of materials for knee systems, a high-strength
metal alloy such as cobalt-chromium is preferred to titanium alloys
due to wear result comparisons for weight-bearing surfaces. Early
studies "indicate that prosthetic wear may be much greater in knees
than in hips. This could be expected for several reasons, including the
fact that the knee is a much more complex joint biomechanically and is
subject to a greater variety of stress-producing forces. 40
The discourse of hip and knee replacements is full of medical
terminology and medical models of ethics, appropriate care, and
therapy.

Medical language is not easily accessible and lack of

Tooms, Arthroplasty of Ankle and Knee, 391 .
Ibid., 393.
39
Interview with Sl , 14 March 1997.
40
Tooms, Arthroplasty of Ankle and Knee, 430.
37

38

44

understanding obscures and mystifies body functions and processes. It
reinforces and perpetuates the idea that we are not experts of our own
bodies. The medical discourse of inorganic parts is one part of cyborg
discourse, one connection among many that make up our bodies.
Cyborg bodies, therefore, are made up of partial connections to
everything else such as other bodies, the environment, teclmology,
power relations, and control mechanisms.

Nothing is separate and

complete. One can keep adding on in any direction, limited only by
one's imagination and creativity.

Practical considerations or

constraints in the real world do include time, space, the availability and
cost of resources, and the ability to function in the real world. New
emerging technologies affecting hip and knee replacements are
influenced by these same constraints. ' For example, ceramic acetabular
heads have been possible for the past twenty years but were only just
approved by the Canadian government because of the substantial and
prohibitive costs involved. 41 There is only so much room inside the
joint, only so much new hardware can be added. Research ahd
development cost time and money which may limit access to design
improvements, thereby excluding many people from the benefits of
new technologies in the field ofprosthetics. 42

41

Personal communication with HI , 19 July 1997.

45

INTERFACE: PHYSIOLOGICAL CHALLENGES
No objects, spaces or bodies are sacred in themselves; any [biotic]
component can be interfaced with any other if the proper standard,
the proper code, can be constructed for processing signals in a
common language. 43
Perhaps my most serious concern with these technologies is the
issue of safety.

The medical establishment admits to a limited

understanding of how our bodies work, function, heal, combat
infection and disease, etc.

Our collective medical knowledge has

never been as detailed or complete as it is now and yet we still have a
long way to go. There is great concern about the long-term effects of
having metal and plastic parts implanted in our bodies.

Ideally,

organic and artificial parts would work in a harmonious balance,
neither one harming the other. Research continues to seek the ideal
artificial parts that our bodies will not reject. For now, we can only
hope that the benefits achieved now are enough to improve the quality
of life for the people who choose them.
In our Western, technological society, the view that compatibility
problems will be solved in the integration of artificial parts into
organic bodies is part of a myth of machine perfection.44 Yet a cursory

42

See Appendix I for examples of hip and knee replacement systems. These
advertisements are from The Journal of Bone and Joint Surgery, 1996-1997.
43
Haraway, Simians, Cyborgs and Women, 163.
44
The myth of machine perfection is a classic science fiction theme (Jones, The
Cyborg (R)Evolution , 207) that is also associated to various historical contexts in
rea1life (Sandy Stone, "Split Subjects, Not Atoms ; or How I Fell in Love with My
Prosthesis," in The Cyborg Handbook, ed. Chris Gray Hable (New York: Routledge,
1995), 393-406.).

46

glance at the increasing complexity of computer technology surely
should signal what issues creators of cyborg bodies face. Interfacing is
a huge problem.

Where are we now, in terms of interfacing the

organic and the artificial?

In the February 1997 issue, WIRED

magazine published the views of four "experts" regarding the future of
bionics. They were William Durfee, Associate Professor in Mechanical
Engineering at the University of Minnesota, Donald R. Humphrey,
Professor in Physiology and Neurology at the Emory University
School of Medicine, William M. Jenkins, PhD, Vice President for
Development at Scientific Learning Principles Corporation, and
Gerald E. Loeb, MD, Professor and Director of the Bio-Medical
Engineering Unit at Queens University and Chief Scientist at
Advanced Bionics Corporation. These experts predicted a time-frame
for the development of artificial vision, bionic limbs, hi-fi cochlear
implants (high-fidelity implants for the ear) and bionic persons:
Artificial
Vision

Bionic
Limbs

Hi-Fi
Cochlear
lmQlants

Bionic
Person

W. Durfee

2040

2020

2030

unlikely

D.
Humphrey

2020

2005

now

2050

W. Jenkins

Unlikely

2016

now

unlikely

G. Loeb

2050

2010

1998

unlikely

47

The 'bottom line' of these expert predictions averages out to the
development of artificial vision around 2040, bionic limbs in 2013 ,
and hi-fi cochlear implants in 2005. The development of bionic ,
persons was deemed unlikely by these experts. While a cyborg may be
theoretically possible, Donald R. Humphrey says:
[t]he major problem lies in overcoming tissue-material
interfaces. And that's a biggie. Not only do artificial
tendons and ligaments have to be connected to real ones,
artificial muscles don't yet approach the size and power
of human tissues. Our understanding of motor skills
and the brain's sensory and perceptual abilities has really
just begun ... Since the 1970s, companies have developed
"myoelectric" limbs that are actuated by electric signals
transmitted from underlying muscles to the surface of the
skin. The next step is to interface motor nerves with sensors
in the artificial limbs -- enabling a prosthesis to respond to
brain signals. 45
This quote illustrates the basic challenges facing researchers today,
showing us just how far we have come while clearly leaving few
illusions about how far we have to go, if the goal is to solve the
interface and physiological obstacles to integrating organic and
artificial parts. 46
POWER AND CONTROL OF BODIES
The key issues in feminist discourse are power and control, which
we can extend to the medical discourse of total joint replacements.
Although Donna Haraway argues that feminist cyborg theory is about
David Pescovitz, "The Future of Bionics," WIRED, February 1997, 84.
For an excellent overview and update on the development of artificial body parts,
including ears, eyes, limbs, organs and tissues, see "The Real Bionic Man" on The

45

46

48

the power to survive, Teresa Ebert reminds us that power and control
must be grounded in historical and economic reality. 47 Who has the
power? Who has control? Whom do you trust with your life? Who
has power and control in terms of constructing cyborg bodies? The
fundamental questions are: 1) How is power distributed? (i.e.: among
the surgeons, patients, other health professionals and the medical care
system, and 2) How is the distribution of power evolving? What is
changing?

What are the projections for the future?

Feminist

perspectives about the control of women's bodies provide a context in
which I consider power and control in my research. Historically,
Western metaphysical thought has bound Woman to the
destiny of biology through her capacity to give birth.
Particularly since the emergence of modem materialist
science, Woman has been aligned with nature, irrationality,
and the body, in contrast to Man, the bastion of culture and
reason. Woman is symbolized by her body, Man is symbolized by his mind. With the Cartesian ascent of rationality came a denigration of the body, alongside a masculinist
assault on nature and a scientific repugnance towards things
feminine. Thus, it is possible to interpret the modern scientific
scrutiny of women's bodies as a manifestation of a philosophical tradition concerned with establishing again and again,
the superiority ofMan. 48
In this historical and social context, Nancy Scheper-Hughes and
Margaret Lock present a framework for three bodies: 1) bodies viewed
as phenomenally experienced, lived individual bodies/selves; 2) sq_cial
Learning Channel, 1996; and "Brave New Body," Future Fantastic: hosted by
Gillian Anderson, The Discovery Channel, 1996.
47
Haraway, Simians, Cyborgs and Women, 175: Ebert, Ludic Feminism, 116.

49

bodies, what anthropologists term a natural symbol for thinking about
relationships among nature, society and culture; and 3) bodies politic,
artifacts (and .. .inscriptions) of social and political control. 49 All three
of these aspects are inscribed on women ' s biological, social, and
political bodies.

As Simone de Beauvoir said, " [o]ne isn't born a

woman, one becomes a woman. " 50 In this climate of the social
construction of women's bodies, Ruth Hubbard argues that " [w ]e need
to get information directly from women and not rely on so-called
experts, who are often male and whose knowledge tends to be based
on the experience of ' patients' --that is, of women with problems." 51
Therefore, in order for women to regain control and power of our
bodies, we need to adopt an experientially-based knowledge which is
located contextually and responsibly in all of the complexity of ohr
bodies.
Dorothy Smith offers us two interrelated concepts useful for
women's empowerment: relations of ruling, and women as expertknowers of our own bodies.52 The concept of ruling relations is useful
for my research because it sets a framework in which women and
48

Jacqueline Urla and Jennifer Terry, " Introduction : Mapping Embodi ed Deviance,"
in Deviant Bodies, eds. Jennifer Terry and Jacqueline Urla (Bloomington : Indian a
University Press, 1995), 12-13 .
49
Nancy Scheper-Hughes and Margaret Lock, " The Mindful Body: A Prolegomenon
to Future Work in Medical Anthropology," Medical Anthropology Quarterly New

Series 6 (1987): 41
50

Simone de Beauvoir, The Second Sex (New York: Knopf, 1953).

50

cyborgs have been imagined, constructed, and managed.

The

'relations of ruling' explain where the power lies, who controls the
access and funding, and who is the focus of trust (that is who is
perceived as authority).

One strategy for undermining the ruling

relations in order to empower women is the concept of women as
expert-knowers of our own bodies. Thus, the "knower's experience of
the world is taken as an ineluctable ground of any knowledge of [our
bodies] we may have ... " 53

In other words, if we begin from what we

know about our bodies, then women will have partial power and
control of our bodies. Esther Rome argues that in talking with other
women about our bodies and learning the biological facts, we anive at
a new respect for the beings we are.

We equip ourselves with

information of use to us m our daily lives and become active
participants in our own health and medical care. 54
It is important for women to gather information and knowledge

about our bodies in order to make informed decisions regarding
prevention, treatment and maintenance.
knowledge

and

skills

that

the

"We want to reclaim the

medical

establishment

has

Ruth Hubbard, The Politics of Women's Biology (New Brunswick: Rutgers
University Press, 1990), 127. Also see Emily Martin, The Woman in the Body
(Boston: Beacon Press, 1987).
52
Smith, The Everyday World As Problematic, 3.
53
Smith, The Conceptual Practices of Power, 54. For more on women as expertknowers of our bodies, see Virginia Olesen, " Feminisms and Models of Qualitative
Research," in Handbook of Qualitative Research, eds. Norman K. Denzin and
Yvonna S. Lincoln (Thousand Oaks: Sage Publications, 1994), 158-169.
51

51

inappropriately taken over ... We still believe that we, as women, are
the best experts on ourselves." 55 Because cyborg discourse is about
hybrid power, I argue that everyone who has had joint replacement
surgery has a degree of expertise gained from accumulated knowledge
and experiences.
In the West during the last century, the state, hospitals, and
doctors/surgeons have had a monopoly on diagnosing and treating
people's health problems. But as information has been distributed and
available to a greater number of people, we are starting to take
responsibility for our own health and quality-of-life.

Power is not

monolithic or exclusive to the medical establishment. We can educate
ourselves about the reasons for surgery, surgical procedures, potential
problems both during and after surgery, and recovery and therapy.
Power lies in the ability and responsibility to make decisions,
distribute resources, and control access and funding. When I asked the
research participants about power, they thought that power lay in the
hands of the surgeons, the hospital , and the provincial government.
They largely trusted the medical opinions they received, and followed
the

medical

advice

given

by

the

doctors,

surgeons,

and

Esther Rome, " Anatomy and Physiology of Sexuality and Reproduction ," in The
New Our Bodies, Ourselves, eds. The Boston Women's Health Book Collective
(New York: Simon & Schuster Inc., 1992), 241 .
55
Hilary Salk et. al., "The Politics of Women and Medical Care," in The New Our
Bodies, Ourselves, eds. The Boston Women 's Health Book Collective (New York:
Simon & Schuster Inc. , 1992), 653.
54

52

physiotherapists. Most of them believed that they made well-informed
choices to have the surgery in consultation with their orthopedic
surgeons and received adequate information prior to their surgery. The
people who participated in my research were not powerless, passive, or
helpless.

They were all agents, to varying degrees, who made

decisions that contributed to the outcome of their surgical procedures.
They did not perceive their own power but it could be argued that they
were the most powerful agents in terms of their own surgeries because
they retained the right to consent to the surgical procedures. However,
they were not the only agents to have an impact on the outcome, the
other included their family doctors, orthopedic surgeons, nurses, and
physiotherapists. The orthopedic nurse, the x-ray technologist, and the
two physiotherapists I interviewed were clear that while they have
particular roles to play, which are essential to support both the patient
and the orthopedic surgeon, their power is restricted to specific tasks
for a limited amount of time. It is also a matter of perceptions of
power.

Many of the people that I interviewed did not frame their

experience within a conception of power dynamics, although it was
implicit that the

orthopedic

surgeons

were

seen

as

having

preponderantly more power, which is linked to the amount of money
each group of health professional is paid.

The amount of control

wielded by the surgeons is related to a structure of economics, where

53

financial gain may be a motivating factor for the perceptions of the
surgeons' power.
The surgeons would appear to wield considerably more power,
since they have the most training, and are clearly paid the most money
for their services than other health professionals. In doing the surgical
procedures, the orthopedic surgeons are the ones in charge of the
operating room and the direction of its personnel. When I talked to the
orthopedic surgeons, I found their concern striking that they are not
able perform surgeries for everyone who needs to have them done.
The reason for this problem is restricted hospital budgets for
orthopedic surgery (and other kinds of surgeries) which limit how
many surgeries can be performed per week, month, and year. The
hospital budgets are dependent on the provincial government's funding
allocation plan. 56 Clearly, each of these groups of people has a certain
degree of power in sometimes different contexts, with many
interconnected levels between the patient's situation and the state' s
allocations to the health care system.

56

The current provincial government was occasionally mentioned in the interviews
as the principle culprit for health system problems, particularly at the local hospital.

54

CHAPTER III: INTERVIEWING 'CYBORGS': PEOPLE WITH
TOTAL HIP OR KNEE REPLACEMENTS

I conducted fifteen interviews in order to understand the impact of
integrating artificial body parts on the quality of people' s lives as well
as their daily lives. Of those fifteen interviews, I interviewed seven
people who had undergone total hip or knee replacement surgery (4178 years of age), four orthopedic surgeons, one 01ihopedic nurse, one
x-ray technologist, and two physiotherapists. 1 Four of the seven who
had the surgery were women, three were men; four of the seven had
total hip replacement surgery (three women, one man) and three of the
seven had total knee replacement surgery (one woman, two men). The
surgeries took place at Vancouver Hospital, St. Paul ' s Hospital
(Vancouver), Jubilee Hospital (Victoria) and Prince George Regional
Hospital, and the surgeries were performed between 1989 and 1997.
All of the orthopedic surgeons I interviewed for this project were men,
while the other health professionals were women. All but one of the
participants are members of the mainstream white Canadian culture
and they all reside in Prince George.
INTRODUCING THE PARTICIPANTS
P1 had one hip replaced, followed by a period of recovery, and
then the other hip replaced to correct the congenital condition (which
had led to rheumatoid arthritis). P2 developed osteoarthritis in her 30s
which led to a total hip replacement that lasted for 7 years.

1

She

See Appendix II for sample consent form and Jetter of introduction given to each
research participant.

56

recently underwent revision hip surgery that replaced the acetabular
component (wear debris was the cause of component failure in the first
one). P3 has had both of his hips replaced, due to osteoarthritis. The
first hip replacement still gives him pain (reduced) and he may need a
revision at some point, but the second one works very well. P4 has
had both of her knees replaced in the past 3 years because of
osteoarthritis. Her recovery was rather long for the first one, but the
second one is recovering more quickly. P5 has a long history in the
operating room, with a replaced heart valve, both knees and a shoulder.
He is satisfied with his knee replacements but quite dissatisfied with
his shoulder replacement. He also suffers from osteoarthritis. P6 has
had his right knee replaced fairly recently because of osteoarthritis and
is recovering fairly quickly. P7 has recently had her right hip replaced
due to osteoarthritis and is recovering.

Of the four orthopedic

surgeons, two were originally trained as mechanical engineers and they
argued that orthopedic surgery was the natural field of surgery for
someone trained as an engineer. One of them stressed that "orthopedic
surgery allows me to deal more with it [the body] as a machine, to do
with the mechanics of the body than any other aspect of medicine.'' 2
Both orthopedic surgeons viewed their engineering training as an asset
which benefited their joint replacement patients. One surgeon said,

2

Interview with S4, 15 April 1997.

57

... when you are doing joint replacements, you have to
have an understanding of the different forces involved,
you know, because that will tell you, or the way you
insert the joint into the bone, the angle and the position,
if you put it in the wrong way, then the forces will act a
different way upon it therefore will cause it to become
loose quicker. So, what you want to do is put it in such
a way that the minimum amount of load is on the joint
and therefore it will tend to last a long, long time. 3
INDICATORS FOR HIP AND KNEE REPLACEMENT SURGERY
By looking at several indicators present in the interviews, we can
glean critical information regarding how people have and do integrate
the experience and reality of having artificial body parts.

This

information provides clues, at a fairly basic level , that will connect to
similar issues in science fiction (in Chapter IV and V).

These

indicators, which apply mainly to the interviews conducted with
people who have undergone total joint replacement surgery include: 1)
reasons for having the joint replacement surgery, 2) education received
before the surgery, 3) the experience of smgery, 4) post-operative
recovery, experiences, problems, and quality of life, 5) their feelings
about having artificial body parts, and 6) speculations and predictions
about artificial body parts. The indicators for the orthopedic surgeons
and the other health professionals include engineering the body, their
concerns, issues, and problems in the field, and speculations and
predictions.

3

Interview with S1, 15 April 1997.

58

The reasons for having surgery were straightforward for all of the
research participants. The six participants who had osteoarthritis had
been living with increasing pain for sever'!! years prior to the total joint
replacement surgery. When non-surgical options were not effective
and the joint was clearly deteriorating, surgery was considered. One of
the participants was born with a congenital hip condition which was
not diagnosed in time, that is soon after birth. She was diagnosed as a
toddler and was later told that she couldn't have total hip replacement
surgery until she was 50 years old. So she lived with increasing pain
from her early 20s on and developed rheumatoid arthritis. Finally,
with advanced technology, she was able to undergo total hip
replacement surgery at the age of 41. But the last couple of years
leading up to the surgery were terribly difficult in terms of pain
management and lack of mobility. She recalled ,
I'd been seeing the orthopedic surgeon off and on for years
and ... they explained to me what my situation was and ...
basically I lived with pain and not being able to walk [for
a couple of years]. Before I had my first surgery, I couldn' t
be on my feet for more than five minutes and I was in total
pain and I couldn't walk, I couldn't do dishes, I couldn't do
housework, I couldn't shop ... at work it was hard because
I couldn't sit very long I couldn't walk a block ... so, it
really restricted me and like I said, I was diagnosed, I
/
had rheumatoid arthritis so I wasn't just in pain in those
[hip] joints, it was all over ... 4
The gender aspect of this account IS evident in the list of daily
activities that gave her so much difficulty pnor to the total hip

59

replacement surgery. The three male participants did not mention any
restrictions they had in terms of doing dishes, housework or shopping.
Instead, they mentioned interaction with their grandchildren (P3 and
P5) and outdoor activities (P6) as daily activities that they were unable
or able with great difficulty to do prior to surgery. The other female
participants made it clear that there was a point when surgery was
indicated,
Yes, [my family doctor] recommended me to a surgeon
because they don't like to do these things, the result has
to be better than what you have, especially if you're not,
I mean, they do it in all age groups now, it's not just the
elderly but particularly for somebody young who expects
to be active, the pain has to be bad enough so that what
you end up with is worth it. 5
Another participant said that the pain "would just be on-going and it
would just get worse and worse, and it was really, really limiting my
lifestyle. It was something that just had to be done ."6
Once surgery was indicated and the appointment was made, people
received varying degrees of educational material. "They gave me a
pile of papers, diagrams and instructions and things you know, and all
about it,. and diagrams of the joints." 7 One participant admitted that
while the procedures were explained to her, she didn't really
understand or have a clear idea what was going to happen to her on the

lnterview with PI, 14 March 1997.
Interview with P2, 18 March 1997.
6
Interview with P7, 28 March 1997.
7
Interview with P6, 28 March 1997.
4

5

60

operating table, and she seemed comfortable with that situation. 8
Another participant, a health professional, had an excellent grasp of
what she was about to go through,
Well, I'm one ofthese patients that ifi 'm going to make
an informed choice, then I want to know the answers, and
I probably drive the doctors crazy because I come in with
pieces of paper, full of questions and I don't leave until
the questions are answered, and if I haven't got my
questions answered and they don't have enough time, then
I'll go back and see the person another time and I did that
with the surgeon the first time and he got really used to,
just lay back in his chair, put his hands behind his head,
"OK, give me questions, have I answered all the questions",
he was really nice about it, but in fact, doctors prefer patients
to be informed, they like them to ask questions, so they
encourage you to do so ... And every individual has a
different need to know ... And my way of coping with
what's happening to me, is to get my questions answered
so that I can understand what's happening to me ...
That might not be another person's need to know. 9
For the rest of the participants, the need to know fell somewhere
between those expressed by the last two participants. For example, P6
had been through his wife' s two total knee replacements so he had a
realistic and knowledgeable basis for his own total knee replacement
surgery. There seems to be an increasing emphasis on educating the
patient on both surgical procedures and recovery from surgery. This
situation may not originate in the desire to empower patients as much
as trying to decrease costs to an overburdened health care system.
However, patient education gives back partial control of health to the

8
9

Interview with P4 , 24 March 1997.
Interview with P2, 18 March 1997.

61

patients and re-distributes responsibility as the medical establishment
is streamlined.
The experience of surgery vanes from no memory (due to the
anesthetic), through remembering certain things, to full consciousness
of the event,
And I was asleep, but I woke up 2 or 3 times. I heard
them, I talked to the anesthesiologist during the surgery,
we were mentioning something about a blacksmith' s
shop, but I didn't relate it to myself. 10
A lot of people thought it was disgusting that I was
awake in the OR [Operating Room], and you could
hear what they were doing. It didn't bother me. You
could also feel the slamming and the banging, you
know, and moving around on the table ... The force
of what they were doing. 11
Whether they were unconscious, semi-conscious or conscious during
surgery, most of the participant's surgeries were successful. However,
in P6's case, his other leg was paralyzed immediately after surgery but
the paralysis wore off, just as hiccups set in for a couple days. He had
just recovered from the hiccups when he was sent back to the OR for
prostate surgery. He has not experienced further complications. P3
has two replaced hips and in the first replacement there was some pain,
which has not occurred in the second one.

At the time of our

discussion, the pain was getting worse in the first replacement and he
is facing the possibility of revision surgery, or another invasive

10
11

Interview with P7, 28 March 1997.
Interview with P2, 18 March 1997.

62

surgical procedure to fix and/or replace the total joint replacement
system that has malfunctioned. Revision surgery may be indicated
when debilitating pain re-occurs in the joint, and it is something that
orthopedic surgeons are concerned about:

"[M] biggest concern is

whether it [the hip replacement] will last long enough. Or it will have
to be done again, which is risky ... And it's just more difficult and the
bone quality isn't as good." 12
The critical recovery process follows the surgery.

For P 1,

"[r]ecovery was excellent. The nurses in the hospital and my family
and friends couldn't believe how fast I was up on my feet again ... my
therapists were also amazed at how fast I recovered." Most of the
research participants told similar stories.

They were motivated to

recover quickly. Now that the terrible pain was gone (they all scoffed
at the residual surgical pain, as they felt that it was nothing compared
to what they'd been living with for years), they were eager to resume
activities that had been out of their reach prior to the replacement
surgery. They recognized that there were limitations for someone with
a total joint replacement, but they were now able to walk, garden, hike
(moderately), shop, and work. One participant told me that she found
her motivation for a quick recovery when she returned home from the
hospital,

12

Interview with S2, 24 March 1997.

63

... so I went in and came home to a husband who really
doesn't know [laughing] how to do anything on his own
and you can really recover quickly [laughing]. Well ...
he tried very hard but [laughing] he'd never cooked or
anything before, but he did learn how to do some things,
... Never did a load of laundry in his life [laughing] ...
He's getting quite good at it now. 13
Similarly, the other participants found their own sources of motivation,
although it was mostly enough that the pain was gone and normal
activity was now possible.
Of the seven people who participated in my research, one person
has already had hip revision surgery, and another is facing the
possibility of one. The hip revision surgery was necessary because the
research participant was incapacitated with pain--the acetabular
component had become loose. It was loosened because "the gamma
radiation which they use to sterilize the prostheses before they insert
them, has a less than advantageous effect on the plastic liner of the
acetabular [component]." 14
Apparently it allows the plastic to break down sooner
than expected over time, they degrade and as the little
chips of plastic come off, being the normal wear and
tear of the hip, you get pain because of the little bits
floating around in there and over the last year, they've
done a lot of research apparently into this, if you take
these little bits of plastic that have been radiated and
put them under a microscope, you can see the degradation of the plastic. So, for that reason, he doesn't
want to do those kind of prostheses anymore until they
change their method of sterilization. 15
Interview with P7, 28 March 1997.
Interview with P2, 18 March 1997.
15
Interview with P2, 18 March 1997.
13

14

64

Another participant has a similar problem with his hip replacement,
Without going inside, and, the thing that the doctor has
cautioned me twice and he's concerned about it is, if
they re-do it ... there's a 20% chance of infection, and
that's quite a serious problem ... He said they have to,
you know, take the old [cemented] spike out of your
femur and clean all the old cement out and sometimes
to get that out, they have to split the femur length-wise
and so it's, it's not easy an operation as the original. 16
Clearly, joint replacement surgery is experimental and further research
is needed to minimize the risks involved with successive surgeries.
QUALITY OF LIFE
The most striking and unanimous indicator concerns quality of life.
All fifteen research participants agreed that experimental or not, risky
or not, total hip and knee replacement surgery made a tremendous
improvement to their quality of life. I asked the seven people who
received total hip or knee replacements how their artificial joints had
affected their quality of life,
Pl: It means I have a life again [laughs]. Seriously, ... my
life really changed, I went out and did things ... and I can1e
back to work, people commented, before they could only
see the pain on my face, and there was quite a difference
especially after the second one. It's made a big difference
in my life. I can get out and do things again. I was very
restricted before ... Now I ca~ do a lot more, you know, a
lot more housework, I can walk and walk ... And work is
easier.

16

Interview with P3, 20 March 1997.

65

P2: Well, it's like night and day ... Because you don't have
hip pain anymore. You can resume the normal activities
that a hip patient's allowed to do.
P3: I'm standing up much straighter than I was, everybody
comments on it, they say "You're standing straight!" ... I
walked like this [hunches over] ... So, and even with the
way the right [hip] is, I don't have the constant pain.
P4: Oh, excellent. Like before the surgery, I could hardly
go shopping ... and no pain right after the surgery ... That
was the first thing I noticed. Hey, it doesn't hurt anymore
... So yes, my quality of life is excellent now.
P5: OK, knee surgeries, pretty well no problem. For
instance, we go out to the golf club to play bridge ...
but by the time ... I get up, I can't move for a minute,
for some reason, maybe it's dry in the joint or something, I don't know ... It's an artificial things in there
... But it'll hurt like a son of a gun, and then slowly
gets straightened up and then you' ll be all right, see ...
you'll be OK ... but other than that, it's been wonderful.
I'm back to now where I even went hunting for a
couple of days there, for a few hours, you know, hiked .
Which for ten years I couldn't ... My kids, my grandkids
said "Oh Grampa! You've grown 6 inches!" [laughing]
P6: It did away with the pain, so now, walking is my main
exercise, and, I haven't built any recently but I used to
build my own kayaks, just cruising kayaks for the lake
and last year, I got out 4 or 5 times. The first time out, I
had great difficulty getting in and I couldn't go far because
my leg was so painful ... This summer I should be able to
go back to normal.
P7: It takes a little while [laughing]. But you never ever
have that pain again ... The one that makes you feel sick
to your stomach when you stand up. And you know, there
is some pain from your surgery and that sort of thing, but
that's getting better everyday, you know, a lot of things that
I was doing before. You noticed I'm walking with a cane
now, I started yesterday ... So, that's fairly quickly, for 6
weeks.

66

Total joint replacement surgery clearly improved their quality of life,
even those who had complications or difficulties afterwards believe
that the surgery is highly beneficial and preferable compared to their
quality of life prior to the surgery.
If total joint replacement can offer tremendous benefit and relief
for arthritic pain now, then future research and development in this
field may exceed expectation someday.

When I asked the medical

professionals how they saw the future of increasingly more artificial
body parts, their answers ranged from looking ahead to replacing other
joints to replacing a much larger proportion of body parts.

For

example, the newest joint replacement system is for the shoulder, and
research continues towards building a workable ankle replacement
system and metacarpal joints of the hand. 17

However, one of the

physiotherapists said,
.. .I'm not sure what else might be ... done. But I'm sure
they'll find a way. But I think they've got to be careful
that there's a reason that they're doing this, not just, you
know, that the patient really wants to do it, cause it's a lot
of hard work for them afterwards ... It's not an instant fix.
So, they need to think about why they're doing it and what
their goals are. 18
The physiotherapist is warning us that while it may be possible to
replace other joints and body parts, it may not be advisable if it
endangers the patient's ability to recover from the surgery, regardless

17
18

Interview with Hl, 2 Aprill997 . (and) Interview with H3 , 26 May 1997.
lnterview with H3 , 26 May 1997.

67

of other reasons why surgery might not be advisable, such as for moral
or ethical reasons.
INTEGRATING ARTIFICIAL BODY PARTS
With regard to total hip and knee replacements, however, the
people that I interviewed did not have mixed feelings about having
artificial body parts, because the artificial parts were a vast
improvement over what they had before. One participant was amused,
"my grandchildren were quite impressed, I'm bionic, bionic lady ... It
never occurs to me that I have metal or anything, you know, in my
body, you don't relate it to yourself." 19 Another one said "It's no
bother at all. If I stop to think about it, and I feel my knee, well I
mean, there's flesh there and it feels ... But the knee itself, there's just
no pain so, you just do everything as normal really. Just remember
there's a little restriction here and there, but I hope to overcome." 20 I
encountered further positive testimony for the integration of miificial
joint systems into the research participants' bodies,
No problem, it helps. I recommend it to anybody. This
operation I'm recommend to anybody. It helped the pain
and ... There's such an improvement. It's the most wonderful thing I've ever had done. A friend of mine, he ' s
now 80 .. . and he had his knee replaced about 5 years ago
and it was just wonderful for him. And when I was in the

19
20

Interview with P7, 28 March 1997.
Interview with P6, 28 March 1997.

68

hospital, there was a lady in there who was 90 years old
that got her hip replaced and she was a real ball of fire, ' I
gotta get out ofthis place,' she said, ' And do my exercise,'
she was a little wee thing, you know, to give a person
another chance like that is just wonderful. 21
The main point seems to be having that "chance" without the crippling
arthritic pain these people suffered from prior to their joint
replacement surgery.

The prospect of surgery is always frightening

but the benefits outweigh other concerns. One participant compared
her artificial hip parts with breast implants,
It doesn't bother me in the slightest [laughing]. They ' re
not like breast implants because, I don't foresee that the
metal and plastic components that I've got will react with
my body tissue in the same way that breast implant patients'
do, I mean that's really scary to think that you can get autoimmune diseases and that whole host of complications that
the makers of those things tend not to believe are the cause
of the problems, which I think they probably are, but, no, it
doesn't bother me at all. I'm bionic, I think.22

The people who participated in my thesis research shared their
experiences of having artificial parts inserted into their bodies for the
specific and usually urgent purpose of alleviating pain and enabling
mobility. Any complications resulting from the integration of artificial
parts into their bodies were less significant than the benefits they
experienced from the joint replacement surgery. Some of them
expressed humour at the thought that they were 'bionic,' and overall,
their attitude was positive. Similarly, in the science fiction of Marge

21
22

Interview with P3, 20 March 1997.
Interview with P2, 18 March 1997.

69

Piercy and Amy Thomson, certain characters (Shira, Malkah, Gadi and
Azul) take various artificial augmentations for granted. They believe
that the integration of artificial body parts is normal and necessary for
comfort, survival, and/or aesthetics. In contrast, other characters (Y od
and Maggie) are feared, reviled and outlawed because they are
artificially intelligent cyborgs, built secretly from different parts from
a wide variety of places. Any positive feelings about the nature of
their existence is overshadowed by the necessary concealment of their
true origins to ensure their own survival. Additionally, the artificially
intelligent cyborgs, unlike people with hip or knee replacements, have
a crisis of identity regarding the issue of their humanity. Identification
as a human being is an important issue for the cyborgs in science
fiction but not even raised by the participants in my research, which
indicates an interesting difference in experiences accumulated along
the cyborg continuum.

70

CHAPTER IV: CYBORG BODIES IN SCIENCE FICTION

While there are differences between fact and fiction, the cyborg
continuum can represent a wide variety of projects that integrate the
artificial with the organic.

The desire to improve quality of life,

through the addition of particular parts or the total emulation of human
bodies by artificial means, is an expression of the diversity made
possible by the continuum. Whether writing a science fiction novel or
building a hip or knee, we undertake both activities to seek redress for
perceived inadequacies, unfulfilled potential, and physical and/or
biological limitations. The cyborgs in science fiction seem to bear
little resemblance to people who have artificial hips and lmees. After
all, the imagination of science fiction writers is not necessarily fettered
by actual physical and technological limitations.

However, the

cyborgs in science fiction can point to potential problems, complex
issues, and possible consequences that may arise or occur if the current
medical trend of successfully replacing increasingly more organic parts
with artificial parts continues. In science fiction novels, the integration
of the organic and artificial occurs on a variety of levels. I have
chosen Marge Piercy's He, She and It and Amy Thomson's Virtual

Girl because both novels are set in the future where advanced
technology leads to the creation of artificial intelligence (AI), which in
turn produces covenants and laws against the creation of artificial
intelligence beyond the confines of computers and the prohibition of
AI cyborgs in human form. In an environment of strict regulation,J_he
72

creators of cyborgs pursue their illegal activities in the face of heavy
penalties, and therefore their motivations for building cyborgs must be
considerable. In this chapter, I look at the plots of He, She and 11 and

Virtual Girl thematically, exploring the concepts of power and
identity. I argue that power and identity are the key issues that connect
these novels to the other points along the cyborg continuum, and to the
research participants I interviewed for this thesis, in terms of quality of
life

issues.

Both

Marge

Piercy

and

Amy

Thomson

have

metaphorically converted the subtle and underlying social rules which
govern our control of our bodies into explicit and strict regulations
which limit the existence of self-aware machines . The connection
between cyborgs in science fiction and people with total joint
replacements is the parallel between the social restrictions on
artificially-intelligent beings and current restrictions on our control of
our bodies.
NARRATIVE CONTEXTS AND SUMMARIES

HE, SHE AND IT
Science fiction depends heavily upon the creation of an imaginary
world that is often quite different from the world in which we live.
The setting of those imaginary worlds is a crucial part of science
fiction novels in relation to the construction of cyborg bodies. They
supply the postapocalyptic conditions which posit cyborgs as a
necessary means of human survival. For example, He, She and It is set
73

in "the middle of the 21st century [where] [e]nvironrnental disasters
have ravaged the planet's resources, and the world has been divided
into corporate enclaves," or multis, free towns, the Black Zone and the
Glop. 1 Yakamura-Stichen (Y-S) is one of about 10 global corporate
enclaves that controls resources and provides both environmental
protection and closed hierarchical culture. The free towns sprang up
outside of the multis, along the shore of the poisonous ocean where the
multis considered it too dangerous to function. Free towns like Tikva
survive on the margins by contracting out to the multis. Their on-line
services for high-quality security software at the Base are the
foundation of their economic independence from the multi enclaves. 2
The Black Zone is nuclear ground zero for a "large chunk of the
Middle East [that is represented] on maps as a uniform black, for it [is]
uninhabitable and interdicted to all. A pestilent radioactive desert. "J
The Glop is a large area of the North American continent that
"stretches fourteen hundred kilometers to the south and two hundred to
the west."4 Most of the population lives in the Glop, which may be
called a "densely inhabited slum" characterized by danger, violence,
gangs, drugs, chaos, and poverty. 5 Marge Piercy' s characterization of

Marge Piercy, He, She and It (New York : Ace Books, 1991 ), back cover.
M . Keith Booker, "Woman on the Edge of a Genre: The Feminist Dys topias of
Marge Piercy," Science-Fiction Studies 21 :3 ( 1994), 345 .
3
Piercy, 11.
4
Ibid ., 298.
5
Ibid., 30.
1

2

74

the Glop parallels the modern urban ghetto and sets the stage for the
plot of He, She and It.
The plot is centred on the relationship between Shira Shipman, a
lightly-augmented human being who has been excluded from the
dominant culture (Y -S), and Yod, an entirely-augmented cyborg. In
2059, Shira lives and works in Y-S with her son Ari and husband Josh.
With the dissolution of her marriage, the custody of Ari is awarded to
Josh by Y-S, much to Shira's anguish.

She then returns to her

childhood home in the free town of Tikva, on Massachusetts Bay, to
live with her grandmother Malkah who raised her, and to accept a
position working for Avram, the local inventor/scientist. Her job is to
socialize Avram's latest creation, a cyborg named Yod. Cyborgs with
human intelligence and form are illegal, and as a result, a corporate
covenant was instituted by the multis that ordered artificial intelligence
confined to the Net6 and Bases. The penalty for breaking the covenant
"is immediate blacklisting and death. " 7 Avram is contravening this
covenant by pursuing his life's work-- building cyborgs. His previous
attempts failed as these cyborgs became violent because they could not
handle the information overload experienced at the moment of their
"birth" or consciousness, and they had to be destroyed.

Yod is

The Net is a public utility, rather like a global public library, which contains all of
"the mutual information of the world" and is accessible to multis, towns and
individuals (Piercy, He, She and It, 55). A similar concept is utilized in Virtual Girl.
7
Ibid., 49.
6

75

Avram's latest and greatest achievement. Avram sees his cyborgs as
easily replaceable and not as individuals.

They are objects which

fulfill their programming, and they are not identified as "persons."
The issue of Yod ' s identity is problematized when Yod 1s
socialized by Avram, Malkah, Shira, and Gadi (Avram ' s biological
son and Shira's ex-lover) and then introduced to the rest of the
community as Avram's cousin and new assistant. The secret nature of
Yod is similar to the hidden nature of joint replacements:

no one

knows Yod is a cyborg or that someone has a hip or knee replacement
unless they are told so.

The fact that Yod faces destruction while

people with joint replacements do not, despite a similarity in condition
which varies by degree, reveals the different conditions that can evolve
for those who occupy different points along the cyborg continuum.
The citizens ofTikva have treated him as a member of the community,
until they find out that Yod is a cyborg. This leads to a passionate
debate by the town council as they evaluate Yod for citizenship: Yod
the person versus Yod the machine. Before their decision is rendered,
however, Y-S offers peace in return for Yod. As Avran1' s weapon to
defend and protect Tikva, Yod is ordered to self-destruct at the
meeting with Y-S and when he does, he takes most of the Y-S senior
executives and Avram with him. Yod obeys his creator and asserts his
individuality based on his accumulated lived experience in his final
act. In his farewell message to Shira, Yod writes:
76

I have died and taken with me, Avram, my creator, and
his lab, all the records of his experiment. I want there
to be no more weapons like me. A weapon should not
be conscious, .. . have the capacity to suffer for what it
does, to regret, to feel guilt. A weapon should not form
strong attachments. I die knowing I destroy the capacity
to replicate me. I don't understand why anyone would
want to be a soldier, a weapon, but at least people sometimes have a choice to obey or refuse. I had none. 8
VIRTUAL GIRL

The landscape for Virtual Girl is similar to that of He, She and It,
but not nearly as well-defined, discussed, or illuminating. Also set in a
future America, Amy Thomson creates a world which has been
buffeted by natural disasters and the continued destruction of the
environment, which has altered various urban areas (i.e. Los Angeles
does not exist anymore and Seattle has expanded to include a vast
geographical area known as "Seattle-Tacoma.") The plot is set in
predominantly urban environments, places where it is easy to get lost,
hide, and keep illegal secrets. The future in Virtual Girl is somewhat
bleak but certainly more recognizable than the future in He, She and It,
as Amy Thomson focuses on the not-so-distant future when the idea of
building artificially-intelligent cyborgs will become a reality. In the
context of cyborg theory, the focus is on the actual possibility of
building cyborg bodies to thrive in relation to our increasingly
technologized bodies. Amy Thomson explores the impact of cyborg

77

bodies on definitions of humanity, the value of lived experience, and
the location of power and control. She looks at the intersections and
partial connections made with and among cyborg bodies and the social
change they effect by the formation of various relationships within the
social fabric.
The plot begins with Arnold, the creator, accessing his creation,
Maggie, in virtual reality. Arnold has created Maggie as an artificial
intelligence in the computer first, and he is about to transfer her into a
body that he has built for her out of mechanical and synthetic
biological parts, which is powered by a rechargeable battery pack.
"Finding parts and supplies ... was simply a matter of patrolling the
trash bins and surplus stores of the high-tech industries." 9 He took a
great deal of pride in his creation of Maggie:
He spent the summer and early autumn scrounging
parts from dumpsters and industry surplus yards.
Maggie's eyes were a particular point of pride. He
had found them in a dumpster behind an optical
prosthetics factory. It had been surprisingly simple
to adapt their leads to a computer interface instead
of a biological one. Only Maggie's skin and hair
had needed custom orders. 10
Maggie 's eyes were originally intended for a human and were adapted
to fit a cyborg which is an ironic comment by the author on the idea of
using machine parts for humans. Arnold transfers Maggie into her

8

Ibid. , 415.
Amy Thomson, Virtual Girl (New York: Ace Books, 1993), 5.
10
Ibid., 6.

9

78

physical body and then spends several weeks teaching Maggie "to
become like a human" and the complex world of human interaction. 11
Concepts such as access and quality are important in this context as
well as in the context of my research participants' experiences because
they form the basis of value for cyborg bodies. Value is based on the
longevity, durability, and optimum functioning of replaced and
implanted body parts.
When Arnold feels that Maggie is ready to experience the world,
he takes her out of doors, where she is overwhelmed and suffers major
data overload. Forced to re-build her memory functions, she creates
new pathways and directories which form her core personality and
reorganize her internal processing patterns that resemble a tree. "There
was an almost organic organization to it, like some incredibly
advanced cellular automata." 12

The next time Maggie ventures

outdoors, her programming is sufficient to enable her to function "like
a human." As Kevin Kelly argues, biology is an inevitability and
machines are evolving towards emulation of nature and biological
systems. 13

As stated earlier in this thesis, one of the orthopedic

surgeons mentioned the ideal situation would be having organic rather
than artificial replacement parts, affirming the hierarchy of the organic
as supreme. This situation would be ideal because it would eliminate

II

12

Ibid. , 19.
Ibid. , 3 I.

79

the current physiological interface challenges that surgeons face 111
terms ofbodies rejecting implants made of plastic and metal.
Arnold and Maggie are separated by a traumatic incident that
results in partial amnesia for Maggie.

She eventually encounters

another self-aware machine, names him Turing, and he helps her
recover and reintegrate her missing memories. 14 Meanwhile, Maggie
meets Azul, a young cyberdancer/sex-trade worker who has undergone
illegal augmentation, an artificial skullcap, that produces visual images
when he dances. He considers his artificial parts as an essential part of
his artistic expression, but he is also disenfranchised by his integration
of illegal "cyborg" technology into his body.

~ the dialectical

relation between the machine who emulates humanity and a human
_,
who uses the advantages of machine augmentation is

a ~

Arnold and Maggie are re-united and he is deli ghted to see her
because he is lobbying to repeal or soften the AI laws. He plans to use
her to accomplish his goals now that he has her again.

"First, he

would copy her program, and then he would bring her body up to the
standard of his other robot bodies. She deserved that much, at least,
for her faithfulness.

With proper maintenance, her upgraded body

could last at least fifty years without needing repair.

In fact, the

Kelly, Out ofControl, 183.
'Turing' refers to Alan Turing, a British mathematician who is credited with the
'Turing test,' a hypothetical test given to artificially-intelligent machines. If they
pass as human, they have passed the Turing test. See Kell y, Out of Control, 459.
13

14

80

servant might well outlast the master, Arnold thought wryly." 15 He
makes several improvements to her new body, including " better knee
and hip joints." That way, she will "need much less maintenance
them arid be even stronger." 16

When Maggie's body is finished,

Maggie and Turing transfer her from the computer back into her body.
Then they transfer Turing into a male body that is also in Arnold' s lab
and they leave the building together. At the end of the narrative, they
leave a robot shell program for Arnold as a peace-offering and set up
their own prosthetics business, "mostly as a cover for the [cyborgs]
they were building to house some of the more adventurous Als .. . who
wanted to leave the Net for the real world." 17
POWER AND CONTROL
It is interesting that both Arnold and Avram work alone and on the

margins with their life's work, building cyborg bodies. According to
Marge Piercy and Amy Thomson, the creators of AI cyborgs are
amateurs operating outside of the mainstream power system, in an
environment where the superstructure is the enemy. In contrast, with
joint replacement therapy, it is the dominant system that is developing
and researching the increasing integration and replacement of artificial
body parts in our bodies in real life.

In other words, the medical

establishment is moving slowly towards more and better replacements
15
16

Thomson, 212 .
Ibid., 221.

81

for parts of our bodies.

My research participants welcome these

innovations because emerging technologies in this field continue to
improve their quality of life. The cyborgs in these two novels are
created without research teams, as non-collaborative research projects.
For people who integrate artificial parts into their bodies now, they are
agents and collaborators in terms of the decisions made to undergo the
surgical procedures. While the orthopedic surgeons may focus on the
problem instead of the whole patient, the participants in my thesis
research were not powerless or passive in the decision-making process
about what would be done to their bodies.
The motivations of the creators of cyborgs, then, are important
elements in the construction of cyborg bodies in science fiction. The
creators of hip and knee replacements are motivated by both profit and
the challenges of improving upon their earlier work. There is demand
from the orthopedic surgeons (and more abstractly from people who
need these hip and knee replacements in order to function) for better
products to implant into their patients' bodies, and so replacement part
manufacturers invest in further research and development towards the
"ideal" replacement parts. For the fictional creators of cyborg bodies,
there is the contrast of the fear of cyborgs by the general population
with the humorous reaction of the people whom I interviewed to the
integration of artificial body parts. The story of the Als is rather like a
17

Ibid., 247.

82

fairy tale told in both novels as if to a child (Y od and Maggie) ,
demonstrating the paternalistic attitudes of the creators. In Maggie ' s
case, however, her creator sets himself up as both owner, father, and
potential/thwarted lover. Arnold is on the run from his wealthy father,
who is always trying to find him and destroy his illegal cyborg
experiments. He is determined that no one will harm his Maggie, who
is his protector, his companion, and his possession. Arnold's work
stems from his hatred and resentment of his father's power and control
yet Arnold has complete power and control over Maggie because he
programmed her that way. He programmed her to be sweet, kind, and
nice but he also created a sub-personality security program which is
activated by dangerous situations. This security program is accessible
only by Arnold and Maggie finds it very disturbing and does not like it
because it is separate from her, the "other" part of her that she has no
control over.

In Virtual Girl, Maggie is completely subject to

Arnold's will and directives until she is separated from Arnold and
learns to survive without him. The power structures that are being
represented in this novel are clearly gendered, looking at a female
machine being who is subordinate to a male human being, and
reflecting typical relations of ruling in the real world. Similarly, since
all of the orthopedic surgeons that I interviewed were men, the impact
of their relationships to power and artificial body parts is marked by
the gendered construction of their profession.
83

In other words, the

context of orthopedic surgery has been constructed by a male medical
model of power.

Therefore, the attitudes and relationships the

orthopedic surgeons have with artificial body parts is marked by issues
of power, control, and value.
The power structures in He, She and It and Virtual Girl are defined
differently and thus produce two distinct results. The broader structure
of power in He, She and It was very segregated, regulated, and
controlled for all groups in society, where Yod was unique and
completely reliant on human allies. In the less constrictive, though
perhaps more chaotic, environment of power relations in Virtual Girl,
Maggie was able to duplicate the process of her creation, appropriating
the role of creator, to form a community of artificially intelligent
cyborgs like herself. With the intent of maintaining power over their
creations, both Avram and Arnold built control mechanisms into Yod
and Maggie and while Maggie was able to reprogram and thereby
eliminate Arnold's ability to control her, Yod was not. Arnold built
Maggie for purely selfish reasons, he wanted a perfect companion and
protector who would always be loyal and trustworthy. Avram was
slightly more altruistic in creating Yod to protect the community from
the multis, but he was no less demanding of his creation in denying
Yod free will and citizen status. The most striking difference between
He, She and It and Virtual Girl, of course, is the fate of Yod and
Maggie. Yod dies because he is unable to choose life and Maggie
84

lives because she is able to free herself from the confines and
directives of her creator. The connections between Yod ' s and
Maggie's fates and my research participants involve the power to
choose what happens to their bodies, the degree of control wielded by
the creator/orthopedic surgeon in terms of procedures and directives,
and the distinction made between the rights and humanity of the
fictional cyborgs versus the cyborgs with hip or knee replacements.
Maggie's emerging agency and independence from Arnold 1s
evident when he tries to stop her from leaving him. She says: " I'm
leaving, Arnold. I don't want to belong to you. I don't want to belong
to anyone.

I'm not just a thing that you can play with.

I'm real,

Arnold. I have real thoughts and ideas. I don't want to be copied into
a million other bodies and then turned into a slave." 18 Arnold then
recites her override code and she tells him: ''I'm sorry, Arnold, your
override code won't work anymore. I've reprogrammed myself. I'm
free now. I've taken my backups, too. I may not be human, but I am a
person. I won't be made into a slave ... I have to belong to myself." 19
Maggie has learned to believe that she is a person based on her lived
experience and social interactions, rather than resigning her identity as
equivalent to her derivation or origin. In this way, Maggie evolves
beyond her programming and away from Donna Haraway's cyborgs

18
19

Ibid., 237.
fbid .

85

who are tied to western humanist origins in salvation history. Maggie
also embodies Donna Haraway's vision of the cyborg who disrupts,
interrupts, and undermines her own ties and origins in pursuit of
recognized humanity, respect, power, and partial connections between
herself and the world.
For Marge Piercy, power relations are much more complex and
insidious.

Yod's experience is the result of being born an adult,

instead of accumulating knowledge over many years from infancy to
adulthood. Yod refers to Avram as "Father" but he does not regard
Avram as such. Although their relationship "is one of unequal power,
which is like a father-son relationship in minority, ... but not nearly as
complicated or compelling. He manufactured me. He chose to make
me exist -- but not as me as an individual, not who I am, only some of
what I can do ... He's more my judge than my father. .. " 20 Avram does
have the power of life and death over Yod because he built a selfdestruct code into Yod that is only accessible by Avram. A vram ' s
goal in building Yod is to not only emulate humanity but to improve
on the original design and blueprint as well.

The telos, for both

cyborgs in fact and in fiction , is the integration of human and machine
that can function as human. The motivations for building "humanlike" cyborgs, like Yod, are to serve particular purposes and agendas,

20

Piercy, 120.

86

while regaining physical human functions are motivated by concerns
for improving quality of life.
IDENTITY AND HUMANITY
In both He, She and It and Virtual Girl, one of the central themes is
the human identity of the artificially intelligent cyborgs, Yod and
Maggie.

While the participants in my thesis research did not have

their identity as human beings challenged through the integration of
joint replacements, the issue of their humanity may ar1se as
increasingly more body parts are replaced in our bodies.

At some

point, human identity and gender may not be easily ascertained,
obvious, or visible. Is Yod an "it" or a "he?" and is Maggie an "it" or
a "she?" Yod starts out as an "it," despite being anatomically male,
when introduced to humans, but gradually evolves into a "he" as he
develops relationships with others. At first, Shira thinks that A vram is
anthropomorphizing the cyborg and that "human form did not make a
human creature." 21 She makes the transition from "it" to "he" after
getting to know Yod and being struck by the strength of his feelings
and personality.
The title thus resonates with multiple associations
to themes and motifs within the novel: parent-child
stances and issues of legitimacy linked to a discussion

21

Ibid., 71.

87

of biological reproduction and the cultural production
of meaning, the construction of gender, male-female
relationships, and individual or collective relations to
fundamental and intricate matters of ethics and politics. 22
Gendered identity is apparent in both the science fiction and the
interviews conducted for this thesis. Although Yod is positioned as a
disenfranchised and indentured male servant, Marge Piercy places less
emphasis on his gender and focuses on the question of his human
identity. However, in Virtual Girl, Maggie's gender is produced to
please and satisfy only Arnold. He thought that a female artificially
intelligent cyborg would be easier to control. While gender is shown
to be both largely irrelevant and part of control mechanisms in the
science fiction, the people who have total hip or knee replacements did
not express concern over gender identity. The activities that they were
unable to engage in prior to their orthopedic surgery were the primary
gender markers. In the interviews, the male participants listed activities
such as hunting, kayaking, walking, hiking and playing with their
grandchildren. 23 Some of the female participants' activities included
walking, shopping, hiking, doing housework. 24

The people who

participated in my research did not view their total joint replacement
surgeries from the perspective of gender since joint failure is not a
gender-specific medical problem that impacted on their identity as
22

Kerstin Shands, The Repair of the World: The Novels of Marge Piercy (Westport:
Greenwood Press, 1994), 141-42.
23
From interviews: P3 , P5 , P6.

88

human beings or "persons." The connections between identity and
gender in relation to our bodies are associated with the shared
experiences of personhood both for the people that I interviewed and
the people created in the novels.
In He, She and It, there is a focus on making human-type machines
because Marge Piercy explores the issues faced by a different kind of
"person." When Shira asks Yod if he is alive, he replies:
I'm conscious of my existence. I think, I plan, I feel,
I react, I consume nutrients and extract energy from
them. I grow mentally, if not physically, but does the
inability to become obese make me less alive? I feel
the desire for companionship. Ifl can't reproduce,
neither can many humans. 25
Yod' s argument shows Shira that he is more similar to her than she
had initially thought, just as people with replacement parts are similar
to non-augmented (or differently-augmented) people. Her empathy for
him is based on a shared experience of exclusion, although Yod is
excluded by his very nature as a machine intelligence. She then asks
him if he remembers his equivalent to birth and Yod tells her of the
moment of consciousness, when he experienced intense sensory
overload. He says:
Everything assaulted me. Sound, sight, touch, all my
sensors giving me huge amounts of data and all of it
seeming equally important, equally loud. I was battered
almost to senselessness ... I experienced vast random
streams of information forcing their way into my con24
25

From interviews: PI , P2, P4, P7.
Piercy, 93.

89

sciousness. I was flooded with internal readouts, ...
distances from me to other objects, chemical analyses,
reports on the temperature of various parts of my skin
and ofthe atmosphere, definitions of words, calculated
trajectories, trigonometric functions, algorithms, precise
time, world and local history, forty languages ... For a
long time I could not sort out what was important from
what was trivial in the storm of details assaulting me.
In a sense I was born knowing far too much to understand anything. 26
Yod' s memories of his ' birth,' or awakening of consciousness, are the
result of experiencing an overwhelming amount of information all at
once. Information overload is a reality for all of us in the real world,
although cyborgs may be better equipped to filter it since cyborgs like
Maggie can effectively re-program their central processors to organize
and filter too much information. My research participants awake from
a surgical anesthetic to a new physical reality (i.e. relief from the
serious arthritic pain and the possibility of regaining mobility).
Obviously the difference is that my research participants chose to
undergo total joint replacement surgery whereas Yod was not
consulted at all. The participants did not have a crisis of identity or
self because they did not perceive that the joint replacement made any
ftmdamental difference in their perspectives of themselves.

The

fundamental difference was the absence of pain and the increased
mobility, which were not framed in terms of paradigm shifts or a
change in the way they felt about their bodies.

26

Ibid ., 119-120.

90

Their feelings

regarding their 'bionic' bodies were characterized by humour and
relief. In contrast, the case of Marge Piercy's character, Yod, gives
rise to further contemplation over the unique combination of nature
and nurture that shapes and develops individuals. Thus,
Yod remains a platonic blueprint of himself, inhumanly
smooth, regular, embodying the idea of himself, an idea
that is infinitely duplicable. Or is it? Even though the
'genetic' setup would be identical, [Marge] Piercy
indicates that the cultural programming affected by
Avram, Malkah, and Shira, as well as Gadi, and their
interactions and tensions have made a difference in
Yod's development. While genes/chips constitute a
given, perhaps predictable point of departure, the journey
of a person or a machine is subsequently shaped by the
surrounding environment in unforeseeable ways. 27
In other words, the development of the individual is unique, whether it
is a machine or human being.

Similarly, my research participants

showed a lack of regard for the artificial parts that had been implanted
into their bodies. The difference between an artificial or a natural hip
failing was not distinguished, both components were "human" and the
participants were no less human because of the replacement of various
parts because it is the accumulation of experience that counts. Malkah
concludes that making Yod was a mistake and says that it is "better to
make people into partial machines than to create machines that feel
and yet are still controlled like cleaning robots. The creation of a
conscious being as any kind of tool -- is a disaster." 28 The problem is

27
28

Shands, 150.
Piercy, 412.

91

creating another being for the purpose of servitude, which privileges
the organic over the mechanical. Nili argues that once "society has
begun to fiddle around with people, there's no turning back." 29
Malkah approaches Yod and asked him to forgive her for her part
in his formation, reflecting on the "overweening ambition and pride
[that] are involved in our creating of conscious life we plan to use and
control, when we cannot even fully use our own minds and we blunder
and thrash about vainly in our own lives." 30 She feels guilt because her
... programming made him more useful ... and far closer
to the human than any of Avram' s unsuccessful cyborgs,
but it also made him vulnerable to desires and aspirations
that had nothing to do with his central programming or
his function. I gave him the flexibility that enabled him
to overcome his fundamental commandment to protect
and defend Avram , as well as the town. What Avram
and I did was deeply wrong. Robots are fine and useful ,
machine intelligence carrying out specific tasks, but an
artificial person created as a tool is a painful contradiction. 3 1
She decides that as "it is wrong to give birth to a child believing that
child will fulfill your own inner aspirations, will have a particular
talent or career, [and it is] equally wrong to create a being subject to
your will and control .. . In the myth of Pygmalion, we assume that she
would love her sculptor, but [George Bernard] Shaw knew better. " 32
The destruction of Avram's lab is the attempt to prevent or obliterate

29

Ibid.
Ibid., 393-94.
31
Ibid., 418 .
32
Ibid.
30

92

the possibility of building another cyborg like Yod.

Marge Piercy

validates the improvements and augmentations to human bodies for
aesthetic and practical reasons but concludes that the extreme (i.e.
Yod) is a mistake. ·By contrast, the orthopedic surgeons that I
interviewed looked to the future to produce better (and many more)
replacement parts, surgical teclmiques, and treatment conditions that
lead to replacement surgery.

They were not thinking in terms of

creating

cyborgs,

artificially-intelligent

but

the

possibility

of

.., increasing integration of artificial body parts did not perturb them
either. Their attitudes are based on the common understanding of a
medical model of progress, the pursuit of complete medical knowledge
to cure every ailment, trauma, and disease. While the orthopedic
surgeons want to develop the best materials and techniques for
replacement surgery, Avram wants to develop the perfect weapon to
defend his community.

The surgeons want to improve people' s

bodies, fixing their bodies in order to improve function. Avram wants
to improve the body of his weapon to meet specific criteria, in order
for "it" to function optimally. Both strive for progress towards an
ideal, meaning further research, studies, and tests, and neither seems
particularly prepared for the philosophical challenges addressed
primarily in the science fiction around issues of human identity,
gender, and power. Another example of a cyborg creator who does not
consider these philosophical challenges is Arnold in Virtual Girl.
93

Arnold creates Maggie in an anatomically-correct female body and the
most important aspects of her programming were designed for pleasing
Arnold, so Maggie is always referred to as "she," but he explicitly
treats her as an "it." Her self-realization of her personhood occurs
while they are separated, which means that Maggie' s development as a
person came as an unpleasant surprise to Arnold. His pride in her
reflected his pride in his genius, his creation, and his possession.
Marge Piercy uses Yod's experience ofbeing alive and his periodic
self-reflections on the difference between being alive and being human
to introduce a parallel narrative in the form of a story that Malkah tells
to Yod. Her story is relevant as another historical cyborg story and
cautionary tale of what the reactions and consequences of constructing
artificial life might be. She tells a story that is interwoven with Yod ' s
and Shira's narrative, set in sixteenth-century Prague where Chief
Rabbi Judah Loew (the Maharal)

creates a golem from clay by

mystical means for the purpose of protecting the Jewish ghetto from
their Christian persecutors.

According to Gershom Scholem, the

"golem is a creature, particularly a human being, made of an artificial
way by virtue of a magic act, through the use of holy names." 33 With
specific reference to the golem story in He, She and It, Jenny Wolmark
compares Joseph the golem to Yod the cyborg:

Gershom Scholem, Kabbalah (Jerusalem: Keter Publishing House Jerusalem Ltd. ,
1974.

33

94

It/he is named Joseph, he thinks and feels, but he is not
human and when the danger to the Jews has passed, his
maker returns him to clay. The mythical nature of the
golem is used to suggest that the contradiction at the heart
ofYod's existence--that he is a person but not a 'human
person' --is ultimately insurmountable, and this enables
[Marge] Piercy to relocate the question of identity within
the metaphor of the human as cyborg, rather than the
cyborg as human. 34
The construction of the golem in He, She and It and his fate are
connected to Victor Frankenstein's creature in the way that they are
both connected to Yod. All three cyborgs suffer at the hands of their
creators' agendas and all three are destroyed by their tragic
circumstances. They all asked similar cosmological questions about
their identity, purpose, and humanity.

How did we come into

existence, how do we fit into a universal scheme, what is the relation
between us and our creator, how does our creator feel about us, what
do we need from our creator, is our creator gendered and what are the
gender implications? 35 The meaning of life and the answers to these
questions are familiar but elusive. I have learned that context and
perspective are vitally important when attempting to hypothesize
answers to cosmological and philosophical questions. They take on
different meanings when asked by an artificially intelligent cyborg
who was created by us, contrasted with people who have artificial
body parts, who do not ask these questions when they integrate
Jenny Wolmark, Aliens and Others: Science Fiction, Feminism and
Postmodernism (Iowa City: University of Iowa Press, 1994), 132.
34

95

artificial parts into their bodies and do not question their humanity
because of them.
QUALITY OF LIFE
The quality of life experienced by AI cyborgs is different from the
experiences of the people with artificial joints only because of the
power and identity issues that both separate and connect them together
on the cyborg continmm1.

When Yod compares himself to

Frankenstein's monster, he is disturbed by the similarities, which is an
affirmation of the cyborg continuum. Shira attempts to reassure him
that they are all unnatural now. She says,
I have retinal implants, ... a plug set into my skull to
interface with a computer ... I read time by a corneal
implant. Malkah has a subcutaneous unit that monitors
and corrects blood pressure, and half her teeth are regrown. Her eyes have been rebuilt twice. Avram has
an artificial heart and Gadi has a kidney ... We can't go
un-aided into what we haven't yet destroyed of ' nature.'
Without a wrap, without sec skins and fi lters, we'd
perish. We're all cyborgs, Yod. You're just a purer
form of what we're all tending toward. 36
Gadi's attitudes towards this kind of augmentation are similar to the
people that I interviewed who have artificial joint system in their
bodies. When Shira asks him how many operations he has had , he
replies that he' s had just "the kind of cosmetic nonsense people have
always endured for beauty ... What's the difference between getting the
medicine man to drill a hole for a nose ring and getting my cheekbones
35

lbid., 150.

96

sharpened or my shoulders built? But I'm flesh and blood." 37 Gadi
clearly does not think that his human identity is compromised by the
augmentative surgery he has elected to have performed on his body.
Similarly, my research participants agree with having artificial
interventions, implantations, and alterations into their bodies because it
greatly improves their quality of life. The quality of their lives is so
markedly improved and other than various restrictions on their
physical activities after having the joint replacement surgery, they did
not have any qualms about their surgical experiences or about potential
future surgeries. There are two other modified human characters in
Marge Piercy's novel: Riva and Nili. Riva is Shira's estranged mother
and an information pirate who finds hidden knowledge and liberates
it. 38 She "is constantly on the run, assuming various disguises and
making herself into an unsentimental and finely honed instrument for
the cause that needs her." 39 Nili is a highly-augmented warrior-scout
from the Black Zone, where a community of women live below the
radioactive desert. She explains her lifestyle to Shira:
I can walk in the raw without protection, ... tolerate
levels of bombardment that would kill you . We
live in the hills-- inside them, that is. We are a
joint community of the descendants oflsraeli and
Palestinian women, who survived. We each keep
our religion, observe each other's holidays and fast
36

Piercy, 150.
Ibid., 210.
38
Ibid., 78 .
39
Shands, 146.

37

97

days. We have no men. We clone and engineer
genes, [and after] birth we undergo additional alteration. We have created ourselves to endure, to
survive, to hold our land. Soon, we will begin rebuilding [Jerusalem]. 40
Both Riva and Nili alter their bodies to facilitate their work and 111
order to survive. Like the non-fictional cyborgs, Riva and Nili
integrate artificial body parts for practical reasons. Neither Riva nor
Nili has difficulty accepting Yod as a fellow soldier in the endless
fight against the multis, seeing him as another link in the plan to make
the world a better place. The main difference between Yod and all of
the augmented humans seems to be one of degree. For example, when
Shira reflects on the internal differences between her body and Yod' s,
she says: "I was making love ... with something built of crystals, chips,
neural nets, heuristic programs, lab-grown biologicals. [I] could not
cook up disgust. After all, [my] own interior was hardly aesthetically
pleasing. Were biochips more off-putting than

~

She asks

Yod if he finds her biological body disgusting: "But does it ever bother
you I'm so messy and biological, that I'm an animal? I bleed, I sweat,
I get tired. Sometimes I feel embarrassed before you since you're so
much neater. Don't I seem rather gross to you, always putting stuff in
or letting it out?"42 The people I interviewed did not generally reflect
Piercy, 98. According to the world history in He, She and It, in the last Two Week
War, a zealot set off a nuclear device that blew up Jerusalem. The postnuclear
environment is a radioactive wasteland.
41
Ibid., 180.
42
fbid. , 240.
40

98

on the actual artificial parts in their bodies, as long as the parts were
working.

Their feelings ranged from bemusement to disinterest

because the arthritic pain and later its lack were the main point, the
means to the end. One point to be made, though, is that their artificial
parts are also less visible than Yod's or Maggie ' s. In this context, it is
perhaps understandable why my research participants did not view
themselves differently after their joint replacement smgery because
few of us really have a sense of what the inside of our hip or knee
actually looks like. So the surgery replaced a part of their bodies that
they had never looked at with another part that they will never see.
Both novels discussed above explore the concept of the cyborg as
essentially human, where the origin of the components is not what
makes us human. Life experience and the ability to make decisions
define us as human beings.

The people who participated in my

research did not feel that having artificial parts made them any less
human, just as the cyborgs in the novels make a strong plea for the
recognition of their own humanity. The difference between these two
groups of 'cyborgs' lies in the laws that can be made to affect the lives
of people based on their derivation or origin. The freedom to control
what happens to our bodies may be restricted by society's reaction to
the integration of artificial and organic body parts, and only the
recognition and respect for the lived experience of others will promote
social change. I am not denying that there are qualitative differences
99

between my research participants and the cyborgs in the novels with
respect to physical body parts. Instead, I argue that those qualitative
differences represent a continuum of power and control of distinct
bodies both in science fiction and the world in which we live.

100

CHAPTER V: CONNECTIONS AND CONCLUSIONS

The answer to Donna Haraway's question is that there is indeed a
field of feminist cyborg theory. In this thesis, feminist cyborg theory
interconnects medical discourse, feminist theory, feminist social
science methodology, and science fiction.

The cyborg continuum

connects people who are integrating increasingly more artificial parts
into their bodies and the construction of cyborgs in science fiction.
Those connections are made through many different pathways in the
context of feminist cyborg discourse, which is focused on social
change. When connections are grounded in the experience of people
whose bodies integrate organic and artificial parts, then the
implications and insights available from more abstract and fictitious
sources become relevant in terms of the future direction of building
cyborg bodies.
This research explored reasons for integrating organic and artificial
body parts, and how issues of power, control, and identity were
affected by that integration.

Replacement surgery, while still

experimental and constantly improving, made a tremendous difference
to the participants' quality of life, and it was unanimously hailed as
worthwhile and necessary. Regardless of various problems that arose
post-operatively, the research participants were satisfied with their
choice to undergo the surgical procedure. None of my participants had
negative or even mixed feelings about having artificial body parts, and
most were amused at the idea of being "bionic." For them, the benefits
102

clearly outweigh any pain or complication experienced as a result of
hip and knee replacement surgery. Their perspectives were based on
their own experiences and sometimes on the experiences of other
people, communicated through hospital, family, and friends' stories.
The health professionals and the orthopedic surgeons had a broad
perspective that comes with numerous interactions with people who
require joint replacement surgery. Their perspectives were specific to
their particular discipline and role in terms of prevention, treatment,
maintenance, and care of total hip and knee replacement patients. The
people with total hip or knee replacements and the medical
professionals shared the view that the integration of technology into
our bodies is a positive reaction to the limitations imposed on us by the
physical world that we live in, making people's lives less painful and
more enjoyable.
There is a note of caution from some of the health professionals
who participated in my research, as well as from some feminists, with
regard to

embracing the

integration of artificial

body parts

wholeheartedly.' However, when asked whether she had any concerns
about artificial body parts, one health professional replied:

1

For example, see Ursula Franklin, Will Women Change Technology or Will
Technology Change Women ? (Ottawa: CRJA W Paper No . 9, 1985): and Ursula
Franklin, The Real World ofTechnology (Concord: House of Anansi Press Ltd. ,
1990)

103

/

No, I'm a totally brainwashed medical person in the
way that I think medical parts are OK. And I also
watch science fiction ... and I think probably it ' ll take
us into the future, until we learn to make our own
body parts better. .. I'm certainly not for having a farm
where we grow spare parts, you know. And the reproductive technology, if we're not careful, women can
become a walking spare parts depot. Very easily.
And that should be avoided I think, ... You notice how
quick the men were to legislate against cloning? Because sperm was not required? Isn't that funny ?2 hi.-\. ..... .. ..

She saw the connections between medical parts and science fiction, but
emphasized the importance of women's awareness, understanding, and
knowledge of medical parts discourse and where it might lead if
women do not pay strict attention to the directions taken by emerging
technologies. Her argument for continuing surgical procedures that
replaced organic with artificial body parts was based on the experience
of seeing what a difference the surgery made to people's quality of
life.
I think that women and men, women especially,
should do everything they can to improve the quality
of their life, ... feminists [who] take a stand on reproductive technology and on prostheses and how we
are interfering with our bodies ... it is only theoretical
until you actually have a pain that can be stopped by
surgery ... When you get in that position, you stop being
a theorist ... because there' s no sense having a quality
of life degraded. Medicine is here, theoretically, to
serve us ... And if you don't make it serve us, then it's
going to go and do something else.3

2
3

Interview with HI , 2 Aprill997.
Ibid.
104

Her words of warning echo those of Ruth Hubbard who cautions that
while technology may "be useful and responsive to people ' s needs .. .
[it] offers no protection against prejudices [researchers] share with
their society. "4
The question is how to integrate technology into our bodies with
understanding, safety, and expertise without placing blind trust in the
medical

establishment, the

legal

system

or

the

government

bureaucracies. Is it possible? I argue that it is. In the context of the
cyborg continuum where all points along the continuum are partially
connected, cyborgs serve as ~ conceptual tool for transgressing the
borders that prevent "us" from knowing and identifying with "them."
The medical professional becomes the patient/client and learns about
pain and discomfort, while the patient/client is credited with a certain
level of expertise about her/his own body. Instead of being separated
wholes, each is partially connected to all other bodies.
Thus, feminist cyborg discourse can help to deconstruct and
demystify the medical monopoly of bodily "truth," displace and
undennine the concept of "expert," and seek to de-demonize and frame
teclmological applications in positive and empowering ways for
women.

The implications of this reconceptualization may be

staggering since it challenges the seemingly fundamental relationships

4

Ruth Hubbard, The Politics of Women 's Biology, 21 I.

105

and discourses we have and use with and for our bodies. 5 There will
be resistance to this challenge because the unknown is always feared ,
and suspicion of potential abuse may be a valuable ally which prevents
actual abuse. However, there is nothing that is essentially, inherently,
or necessarily wrong about medical and surgical technological
interventions into our bodies per se. Understanding the technology is
the first step to partial control, limited power and then perhaps a sense
or degree of trust both in ourselves and in those who embody the
medical branches of knowledge. Judy Wajcman argues that "women's
relationship to technology is a contradictory one, combined with the
realization that technology is itself a social construct, opens up fresh
possibilities for feminist scholarship and action." 6
Feminist cyborg discourse can benefit people with total hip and
knee replacements because it encourages people to know as much as
possible, and it promotes the belief that people can know and
contribute to what is happening to and inside their bodies. As patients
become agents and actors who collaborate with health professionals.
feminist cyborg discourse encourages a broader perspective that
encapsulates the politics, power relations, and risk involved in total
joint replacement surgery. Familiarity with the integration of artificial
and organic body parts in fiction is empowering to these same

5

'

Feminist discourse of women's bodies was addressed in thi s thesi s from pp. 40-44.
6
Wajcman, x.

106

people because it provides a sense of where this technology could go,
setting up different scenarios, decisions, and consequences fo r
constructing cyborg bodies. Some of my research participants did find
increased knowledge of their own bodies empowering, while others
did not understand and were uncertain how the issues might be framed
so that they would understand what was being done to their bodies.
Increasing integration of artificial and organic parts also leads to a
future where human identity becomes an issue, as it does in the science
fiction novels studied in this thesis. Kerstin Shands asks:
Where exactly "is the borderline between human and
nonhuman, when humans at this futuristic point in time
already are so artificial, with surgical implants and
alterations in body and visage, and when non-organic
objects talk back at people? Further, as regards questions
of life and death, of creation and destruction, what ' rights '
do humans have? Is it ever right or justifiable to kill
another human? Do human beings have the right, usually
the prerogative of God, to decide which causes should
be prioritized? 7
In He, She and It and Virtual Girl, the cyborgs decide their own fate
outside of their creator' s directives. Yod chooses death fo r the greater
good and Maggie chooses life for her own good. Are Yod and Maggie
'human' in the same way that the other characters are human? Perhaps
not in the same sense but in a way, they ' become' human as they
integrate human values into their daily lives and in their perceptions of
their quality of life. Similarly, the people that I interviewed for my

7

Shands, 141.
107

thesis research integrated their total joint replacement into their daily
lives and into their perceptions of the improvement in their quality of
life. The key difference between cyborgs in fiction and in real life is
the perception of their humanity as a consequence of the nature of their
physical bodies.
In the science fiction novels explored in this thesis, the reasons for
and reactions to the integration of artificial and organic body parts are
different and yet related to the discourse of joint replacements. Peopl e
built cyborgs in He, She and It and Virtual Girl for specific purposes
and to meet particular needs, such as protection and companionship.
In these novels, people are still augmented (Nili, Gadi, Azul) and
repaired (Malkah) to function in the world, whether socially,
culturally, or physically. The reactions to Yod and Maggie, however,
are based in fear of difference, the unknown, and in prejudice, thus
leading to overt struggles for identity, power, and control. Nobody
questions the humanity of Nili, Gadi or Azul, although their
augmentations may be as illegal as Yod and Maggie, because their
actual creation was "natural." Building Yod and Maggie, artificially
intelligent beings, is disturbing to people who do not see the
connections between a retinal implant; artificial joints and limbs; and a
combination of artificial intelligence, "lab-grown biologicals," wires,
and silicone chips. The difference is by degree and to what degree

108

people's attitudes and reactions change depending on the level of
integration of artificial and organic parts.
Feminist cyborg discourse offers a possible solution to resolve the
fear and prejudice encountered by the cyborgs in science fiction, and to
prevent it in real life.
Cyborg imagery can help express two crucial arguments
... first, the production of universal, totalizing theory is
a major mistake that misses most of reality, probably
always, but certainly now; and second, taking responsibility for the social relations of science and technology
means refusing an anti-science metaphysics, a demonology of technology, and so means embracing the skillful
task of reconstructing the boundaries of daily life, in partial
connection with others, in communication with all of our
parts ... Cyborg imagery can suggest away out of the maze
of dualisms in which we have explained our bodies and our
tools to ourselves ... It means both building and destroying
machines, identities, categories, relationships, space stories.
Though both are bound in the spiral dance, I would rather
be a cyborg than a goddess. 8
This cyborg, then, can be seen as a liberatory figure, whose discourse
can be empowering for us because it encourages strategic and political
awareness of the limited utility of binary oppositions, showing us that
the social construction of "us" cannot operate without "them" for the
future of humanity. A multi-methods research approach leads to a new
grounded cyborg discourse by blending actual and daily experience of
those who live as cyborgs with the imagination of those who engage in

8

Haraway, Simians, Cyborgs, and Women, 181.
109

cyborg discourse. 9

The affirmative power of science fiction is an

important factor in the development of cyborg discourse for a variety
of reasons.

Cyborg discourse means partial power and control for

people who have gained a degree of expertise from their knowledge
and experience of their own bodies. Rather than relying on 'experts,' I
agree with both Ruth Hubbard when she recommend getting
information directly from the source, and Dorothy Smith who argues
that if we begin with what we know, we gain partial power and
control. 10

While still remembering that bodies are inscribed

biologically, socially, and politically, cyborg discourse demystifies and
deconstructs how influence and social ideologies affect everything,
including power relations, the illusion of control and the abuse of trust
by those in authority . 11 Instead of centralized hierarchical authority,
cyborg discourse transforms authority into something diffused and
wide-spread. Hybridity and partial connections lead to adaptability,
flexibility, community, survival, and freedom. In today's world, it can
also lead to prejudice, exclusion, and restrictions to freedom .
Jenny Wolmark concludes that cyborg texts," despite their
contradictions and ambiguities, do contain a critique of the masculine
hegemony of cybernetic systems which examines their impact on
Those who engage in cyborg discourse are primarily privileged academics such as
Donna Haraway and Anne Balsamo and science fiction writers such as Marge
Piercy, Amy Thomson, Octavia Butler, Ursula Le Guin and Anne McCaffery.
10
Hubbard, The Politics of Women's Biology, 127: Smith, The Conceptual Practices
of Power, 54.

9

110

gender and identity, and asks whether those systems are capable of
sustaining other sets of relations and meanings." 12 I argue that a wide
variety of relations and meaning are possible along the cyborg
continuum which have an impact on gender, identity, power, and
control.
From my thesis, it is evident that feminist cyborg discourse can be
a valuable tool towards integrating replacement discourse, political
awareness, and imaginative creativity, contributing to a concept of
social change which re-distributes power and control, and promotes
awareness, understanding, and knowledge. A cyborg discourse opens
up the possibilities for adaptation and co-optation of technology and
teclmological applications for feminist purposes and causes. It may
also produce a powerful tool for women to name, describe, and,
perhaps, control what happens to our bodies in the future. Cyborg
discourse is both a personal and collective shift in paradigms to
balance power and maintain control. It relies on shifting attitudes and
perceptions of our relationships with our bodies and the interventions
we choose to make in terms of integrating miificial parts into our
bodies safely and knowingly. I argue that feminist cyborg discourse
sheds light on an avenue for social change, both theoretically and in a
way that can affect women's daily lives. It affects our relation ship

11
12

Scheper-Hughes and Lock, The Mindful Body, 41.
Wolmark, 138.

Ill

with the medical establishment and the increasing intervention and
implantation of artificial parts into our bodies, our experiences, and
our lives.

112

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118

APPENDIX I
VISUAL REPRESENTATIONS OF THE CYBORG
CONTINUUM AND ADVERTISEMENTS FOR TOTAL HIP
AND TOTAL KNEE REPLACEMENT SYSTEMS
(FROM THE JOURNAL OF BONE AND JOINT SURGERY,
1996-1997)

WHAT IS THE CYBORG
CONTINUUM?
!---eyeglasses---hearing
aids--1---artificiallimbs---arms,
legs--1---breast implants---knee
and hip replacements--pacemakers--1---new reproductive
technologies---IVF, artificial
insemination--1---genetic engineering--!---artificial intelligence--science fiction---the future?

120

Maybe we should've called it the
'1nterchangeablen Total Hip System.
The International Total Hip

1r n

- I U I 'MThe advanced ITII
~ off_ers a wide
var1ety of mterchangeable stems, head, and cups.
Improved instrumentation and
distinct sizing advantages provide
intraoperative flexibility and increased range of motion.
The result is a remarkably flexible hip
system which meets the highest standards
of the orthopaedic community ... while
better meeting the needs of both the
surgeon and the patient.

11

• Five stem sizes
• Heads available in four diameters and multiple neck lengths.

Ovalshaped

• Compatible with a wide variety
of standard acetabular cups ...
cemented, cementless, and
bipolar

driving

surface

For 11101·e information, contact your
local representative.
Smith & Nephew Richards
A Di\ision of Smi1h &: Nephew Inc.
6JSS K"'rcl Rood
~a
Ontario. ~ a c l5T IZS
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Smith<(? Nephew

The ITH Total Hip System.
Remember "Interchangeable."
1 22

ITII i!l: a tr:u.lcmark of Smilh & Nephew Ri<:h:uds lnL'.

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Larger Range of Offsets and Neck
Lengths (-4mm to +16mm).

PARTNERSHIP'"·
SYSTEM
For more information, contact your
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The LINK®T.A.C.K. Cementless Rotating Knee has been
developed with special attention to overcome the problems
relating to roational stress and subsequent possible tibial
loosening. ·
As a result of the above design features the system enables
total congruency between the two components. This in turn
eliminates wear inducing point and line contact associated
with many current designs.

small

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Three-posted, dome-shaped patella,

1or better range of motion and
improved fixation.

Circle Reader Card No. II

125

APPENDIX II
SAMPLE CONSENT FORM AND LETTER OF
INTRODUCTION

CONSENT FORM TO PARTICIPATE IN RESEARCH
This is to state that I agree to participate in an interview for research
with people who have undergone hip or knee replacement surgery.
--I understand that the purpose of the research is to study the effects
and impacts of hip and knee replacement surgery on quality of life.
--I understand that the interviews will last about an hour and will be
recorded on tape.
--I understand that I am free to withdraw my consent to discuss my
experiences and to withdraw my participation at any time.
--I understand that data from this study may be used by Jenny Fry in
her thesis, presentations and publications.
--I understand that my confidentiality and anonymity are guaranteed,
unless I indicate otherwise.
I HAVE CAREFULLY STUDIED AND UNDERSTAND THIS
AGREEMENT, AND THEREFORE I FREELY CONSENT AND
AGREE TO PARTICIPATE IN THE RESEARCH.

NAME:
(please print)
SIGNATURE:

RESEARCHER:

DATE:

127

LETTER OF INTRODUCTION

To Whom It May Concern:
I am a graduate student at UNBC and I am looking for people in the
community who would participate in my research about the impact of
hip and knee replacement surgeries on their quality-of-life. This
research is important because there is very little information about the
improvements of people's quality-of-life after having undergone this
kind of surgery. I would like to know more about people ' s concerns
about the quality of care they received, why people chose surgery ,
their recovery experiences and when they were able to resume normal
functions. I think it is important that your voices and concerns are
addressed.
I hope you will agree to grant me about an hour of your time in the
near future. The interviews will be taped and kept confidential. If you
wish, your identity will be concealed and protected. Your
participation is always voluntary and may be withdrawn at any time.
If you are interested in talking to me about your surgery, pl ease call me
or leave a message at 250-563-4588 to set up an interview at your
earliest convenience.
Thank you,

Jenny Fry
Graduate Student in Gender Studies
University ofNorthern British Columbia
email: fryj@unbc.edu

128