Part III.2 -- Social Fact and Local Construction

Sacks (Schegloff? Ref.) warned sociologists against the dangers of analyzing absences. Some have talked about "accountable absences"--absences that are specifically, though indirectely, mentioned as being absent during the interactional sequence itself. What we have shown here is that neither a simple dichotomy, nor a tripartite classification, is enough. What is most accountably present (Contraction and Medical Visit on the one hand, and pain negotiations on the other) must itself be understood in a more complex manner if only to distinguish between what is overwhelmingly "present" but often only indexically, and what specifically emerges in speech and may be directly negotiable. The presence of "chitchat" presents a different problem since there is a strong likelihood that this will be found in all labors, must have a content but one that may not be fully specifiable by the hospital frame itself. What does emerge during chitchat may then become locally accountable in a possibly altered form (from how it might be held accountable elsewhere) if only because the Labor (Contraction or Medical Visit) frame might at any time reassert itself. We thus have a double level of what might be called "contingent accountabilities." The prime example in this case may be the videotaping of the labor to the extent that all participants, in one way or another, become accountable to its requirements (if only by having to move around the researcher and her cameras to accomplish their other tasks). Lonnie's status as a medical doctor, available but mostly unused must belong to this world of what may become accountable within the Labor frame, but only within this frame, that is as subordinate to it.

The point here is that Labor, as scene within a broader play, is both highly structured in the sense that one can easily abstract a structure in the L‚vi-Straussian sense and wide open to significant variation as it allows for the inclusion of matters that are quite tangentially related to it on formal grounds. The boundary between "presences" and "absences" can thus not be drawn absolutely (though it may be drawn statistically, should we have a large enough stratified sample of talk within hospital labor). What can be drawn, because it is repeatedly drawn by the participants, even if only in anticipation, is the interactional moments when higher order activities can override others. In this way, the Medical Visit can override anything, the Contraction can override anything but the Medical Visit but only to the extent that someone (not necessarily the woman since she may have been medicated to the point of insensitivity) can specifically point at a physical event within the woman's body. All this is of course only true during Labor, a scene with a specific, socially marked beginning, and a similarly specific, socially marked ending. At one point in this labor physical contractions became relatively unavailable for the social reorganization that had until then accompanied them. They were "too frequent" and this was taken by all (though not quite on the same schedule) as a sign that it was time to Push, a part of the next scene, Delivery. Pushing and Delivery are themselves subjected to the Medical Visit as the nurse who herself decides that Time for Pushing has arrived (Lonnie seemed unsure since "I have never pushed before") attempts to delay actual pushing until the obstetrician appears and the bed is transformed.

It is possible that, "everything else" is itself organized. We suspect that what Cotter calls "spousal moments" may themselves interrupt other processes. What never interrupted anything and was eminently interruptible was "Lonnie-as-medical-doctor" moments. These were always performed "between" labor moments, around familial moments and research moments, and never indexed outside these moments. Lonnie's status as anything else than a laboring woman remained inconsequential in the strong sense of the word: it did not have a consequence, it did not interrupt anything when it emerged and almost anything could bury it again.

Still, the status was mentioned, as well as a host of other matters. Thus, the important thing here is that accountability to the higher order processes is a potentiality. At any particular time as could be said to be the case during most of the time that the labor took what is most powerful in that it could interrupt everything else may be "absent" in any specific way. For example, the medicalized organization of this labor is not specifically discussed and, during many of the interstitial chitchats, neither contractions nor medical visits emerge in the spoken stream as something that might be negotiable. One could argue that the all the cues are visual and thus do not have to be specifically indexed: the woman is lying on a bed, under a sheet and hooked to several machines. This may be all that is needed to scream "hospital." Mentioning it may have been too obvious to be interesting. The hospital authority to organize interaction is always already constructed as the overwhelming social fact in the setting fully constraining on individual action.

These comments on "absence" are intended to place the original question with which we started, the unmarked status of Lonnie as a medical doctor, within a broader context not only of what was marked within this labor, but also of interactional, thus social, theory in general. It is now well established that locating the source of social order in the hypothesized "internalization" of social norms is a trap and that the great virtue of Garfinkel's critique of Parsons was explicating why this must always be so (Hilbert 1992). That people like Bourdieu, searching for a "theory of practice" reinvented Parsons searching for a "theory of action" is testimony to the difficulty of this search. Recently, Bourdieu, while granting some value to ethnomethodological theorizing, criticize it for allegedly failing to see that "the principle of the construction of social reality" is something that is share in common because of the habitus as inculcated (my translation. 1994:137). That the alleged failure to see is in fact the strength of a type of analysis that does not imply consensus where all evidence points to its absence. Social structuring can be accounted for with no explanatory reference to individual constitution (habitus or socially constructed self) why preserving the evidence that society is a matter of the concrete performances of individuals at work reconstructing the world together. Co-membership does not have to imply acceptance if one moves to the assumption, supported by the evidence, that all interaction is controlled by Others with the authority to identify what happened as (not)relevant to a scene and to mete consequences from silencing through failure to identify, to reference to the police power of the State. "Society" is not an abstraction floating our dimensions of space and time. It is rather in the authoritative power of the "third," of the "interpreter," that is of the "Other" who hold the local interactants accountable "when push comes to shove." The local interactants say Lonnie, her husband and the researcher when they are left alone in the delivery room as they often are can go into all sort of interactional directions but they may be at any time called upon to give an account of their activities within the framework of certain Others who can claim authority on them. Whether they know who this Other is, or the basis of this authority, whether they agree with it or not, is besides the point if each person finds itself alone in possible opposition, with no support from any of the other interactants. In that sense, even opposition would be framed by the preliminary construction of the setting, and by the immediate agreement of the interactants with their placement within broader interactional processes