Of the currently forming: an anthropology of traumatic brain injury

Of The Currently Forming is an ethnographic exploration of a relatively recent diagnosis in clinical biomedicine – 'traumatic brain injury' or TBI. TBI has become a central preoccupation for researchers, clinicians, trauma centers, and public health departments across North America and Europe. Its epidemiological character is of startling concern, as its prevalence among the population is extraordinarily high. TBI is one of the most common causes of death in adults, and the leading cause of death and disability amongst young persons. Furthermore, TBI has become the "signature injury" of the US military in the Iraq and Afghanistan conflicts. Yet, the way we have come to know injury to the head and brain has changed fundamentally in the last thirty years. This has situated TBI as an important category for public and political debate; hospitals, neuroscientists, the CDC, and the WHO have all, within the last decade, narrowed their focus to traumatic brain injury – the "invisible injury" - as a cause for concern for both the public health sector as well as the clinical and laboratory sciences. The first section attempts to bring into focus why and how this problematic generated this kind of interest; it is one mode of understanding the dramatic visibility of an 'invisible' injury. The second section is about the conceptual and practical changes in clinical and experimental work on TBI and mild TBI today. Mild TBI, for instance, remains without widespread consensus as to its underlying pathophysiology or clinical presentation. Such indeterminacy has effectively opened up a new conceptual space for TBI research - particularly in the areas of neurological imaging and its relationship to neuropathology, applied clinical practices, post-injury assessments, and rehabilitation. Fundamental biomedical concepts – such as the 'normal' and 'pathological' – take on particular conceptual form in the midst of these spaces of uncertainty. Here, a series of ethnographic vignettes trace the interconnections and arrangements as certain clinical technologies and practices converge, giving shape to this dynamic and emergent diagnostic category. By superimposing the historical account of TBI's emergence alongside its ongoing clinical and experimental re-negotiations, Of The Currently Forming attempts to give a glimpse into the spaces of the incomplete – an exploration of the complexity, heterogeneity, and creativity that underpins contemporary brain injury medicine.

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