From easily reversible eyestrain to crippling back, hand, and wrist pain, the physical problems of computing have important things in common. They are incremental. They develop slowly, often without a noticeable onset. There can be a sudden crisis of disabling pain, the result of conditions that have persisted for weeks or months. These are only indirectly measurable. X-rays and other imaging can show anomalies consistent with pain, but men and women with similar physical images may not have similar feelings.
Above all, these conditions are shaped socially. Political conservatives usually insist on the existence of an objective reality and deny that scientific and even technological knowledge is socially constructed. But partly because there is no "dolorometer," no recognized test for pain -- only at best devices that may reveal suspiciously inconsistent responses -- conservatives and especially neoconservatives deplore the economic cost of computer-related claims and see neurosis at work, if not fraud. Liberals, who otherwise perceive the self-interest of medical providers in "new" syndromes and diagnoses, consider computer-related illness to be objectively real. Both sides would agree that injury rates tend to be higher where work is more stressful. Organizations using similar hardware and software have had such different experience with injuries that social processes must be responsible for part of the difference. But nobody understands yet what the processes may be and how they operate.
In the outbreak of reported cumulative trauma disorders in Australia in the 1980s -- "the largest, most costly and most prolonged industrial epidemic in world history," according to one medical critic there -- there was agreement that medical attitudes were part of the problem and actually helped make it worse. But who was creating the unintended consequences? Was it the office workers who were reporting it, or their labor and feminist allies who helped promote oversensitivity to minor symptoms and even encourage outright malingering? (Australian trade unions are among the world's most socially and politically active, and workers' compensation laws reflect labor's political influence.) Or were sympathetic physicians helping "the powerless and dependent, and those who cannot otherwise express their righteous rage at their supervisors, employers and spouses," to use their "exquisitely symbolic pain and incapacity" to communicate distress, as one Australian doctor has suggested? Or
were skeptical physicians helping to create chronic symptoms by refusing to take early reports seriously and putting the burden of proof on patients, as other analysts have argued? Either way, the epidemic was in part an unintentional consequence of medicalizing what the Australians called (following Commonwealth practice) repetitive strain injury.
Not paying attention leads to injuries. But focusing on the physical problems of computing or anything else might have amplified the symptoms. Are sufferers hard workers who have driven themselves too far, coming forward reluctantly only when the pain is unendurable? Or are they consciously or unconsciously trying to escape from responsibility by medicalizing their problems? Questions that begin with seatpans and backrests, forward and backward tilts, microswitch clicks and wrist supports turn out to have answers that are psychological, organizational, and even political. The question is whether the ethical burden is on employers to control stress even at the expense of profits and "competitiveness," or on workers (whether data tabulators or editorial writers) to stiffen their upper lips as well as their lower backs.
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