The social sciences have experienced a “mobilities turn” in the last two decades, which critiqued fixed and sedentary notions of social life and drew attention to the constant flows of people, ideas and objects that permeate our daily lives. This emerging field of thought proposed to study mobilities “in their own singularity, centrality and contingent determination” (D’Andrea et al. 2011, 150), creating a new, dynamic, lens through which to (re)examine social thought and practice (Soderstrom et al. 2013, vi).
Mobility forms were considered as acting in dialectical relationship with the immobile, where flows of people, information or objects might be interrupted, fixed or suspended at specific time points (Hannam et al. 2006; Urry 2007). Recent work has highlighted the importance of thinking about the relation between mobility and immobility, where movement intersects with processes that might entail episodes of transition, waiting, emptiness, uncertainty and fixity (Adey 2006; Khan 2016; Leivestad 2016; Szakolczai 2009). These moments when motion seems to be frozen in time and space (Adey 2006), when things are stuck, incomplete or in a state of transition can point to new theoretical, methodological and practical dimensions in social studies of medicine.
Social studies of health, illness and medicine have drawn from the mobilities literature to explore the flows of people, patients, medical technologies and healthcare workers through concepts such as healthscapes (Llewellyn et al. 2017), biotech pilgrimage (Song 2010), medical travel (Inhorn 2015; Sobo 2009; Holliday et al. 2019) and mobilities of wellness (Masuda et al. 2017). Considerable work has been carried out on mobile technologies in healthcare delivery, mainly in the form of mhealth or virtual care, such as telemedicine (Lupton 2018). A significant amount of attention has been placed on the study of mobility, but not always in relation to immobility (Vindrola-Padros et al. 2018). This represents a significant gap in knowledge, as episodes of standing still or “doing nothing” are critical in shaping daily life routines. As Ehn and Lofgren (2010) have argued, these mundane activities allow us to explore how habits, thoughts and feelings are culturally shaped and might even provide insight into larger and existential social issues.
In this edited volume, we bring the concept of immobility to the forefront of social studies of medicine to answer the following questions:
- How does immobility shape processes of medical care?
- How does the medical context develop forms of movement and stasis?
- What are the theoretical and methodological challenges of studying immobility in medical contexts?
- How can we change the ways in which we conceptualise and study immobility to address these challenges?
We believe that the study of immobility can make contributions to our understanding of health, illness and medicine by highlighting previously invisible processes concerning movement and inaction in health and medicine, particularly in relation to the nature of immobility, that is, how inaction can lead to the (re)constitution of people, places and things (Khan 2016). It can illustrate the unequal distribution of mobility as a resource, mainly when movement is required to maintain health (Vindrola-Padros et al. 2018), shedding light on how immobility imaginaries enable or limit certain kinds of movement and action (Salazar and Smart 2011). Finally, a study of immobility can foster methodological innovation by experimenting with new ways to capture movement and stasis, but also by using stillness or remaining in a fixed place as a method in itself (Coates 2017). All of these contributions have implications not only for our current understanding of health, illness and medicine, but also for the analysis of mobility and immobility in other areas.
“Thinking with” Immobility
The tension between mobility and immobility is made explicit in several scenarios or cases throughout the book. As we were developing the content, we encouraged contributors to think about some concepts that might help frame different manifestations of immobility such as: (1) liminality, (2) stillness, (3) emptiness, and (4) motility. The chapters are organised in relation to these different manifestations, alluding to material culture and materialities, practices, imaginaries and emotions.
Liminality has been widely used in anthropology and other disciplines to explore conditions and practices of uncertainty, in-betweenness, never-ending transition and waiting (Szakolczai 2009) and how these are (re)produced. As Horvath et al. (2015) have argued, liminality captures situations where established structures might be dislocated and hierarchies reversed, where outcomes are uncertain. These spaces of ambivalence are, nonetheless, central to sustaining social reality (Horvath et al. 2015). In medicine, the concept of liminality has been used to explore topics such as clinical staff and parents’ experiences of dealing with uncertain new-born screening results (Timmermans and Buchbinder 2010), liminality and breastfeeding (Mahon-Daly and Andrews 2002), or waiting for care (Day 2015). The concept of liminality represents a useful heuristic tool to move beyond binary oppositions (as the liminal often relates to states of in-betweenness) and focus on incompleteness and processes of becoming.
The concept of stillness considers physical and imagined restrictions of movement and a sense of “stuckedness”, fixity or “going nowhere” (Hage 2009). In medicine, stillness is often understood as the state of remaining motionless or stuck, which can be desired or undesired. For instance, Gask et al. (2011) have explored the relationship between depression, isolation and feeling “stuck”, while the gradual loss of motion and slow succumbing into a “fixed” state has been studied in patients’ experiences of disrupted motor coordination (McMillan, this volume). An interesting dimension of the concept of stillness is its potential for uncovering different mobility empowerments (or capacities for movement), where not all who desire to move will be able to do so.
Emptiness has been associated with processes where markers of certainty are eroded, leading to a sense of vacuum, where everything seems to melt into a void. According to Khan (2016), the concept of emptiness sheds light on the affective dimension of immobility, by pointing to states or emotions that might be unavailable (Deleuze and Guattari 2004). Political anthropologists have theorised emptiness in relation to empty places of power, instances of “authority vacuum, where the place of power is empty and can only be appropriated temporarily” (Wydra 2015). In medicine, feelings of emptiness have been analysed in the context of women’s experiences of miscarriage (Adolfsson et al. 2004) and couple’s experiences with infertility (Phipps 1993).
Motility refers to the potential for movement, aspirations for movement that are never materialised, movement imaginaries, ideas of incompleteness and never-arriving (Leivestad 2016). It allows us to explore more symbolic dimensions of immobility in the sense that movement might only rest in the imaginaries of individuals and never enacted in practice. In medicine, dimensions of motility are present in the concept of disnarration proposed by Vindrola-Padros and Brage (2017) to analyse parents’ stories of their child’s illness, where parents reflect on past and future scenarios that did not...