Seductions of the Transparent Body: X-Rays, A.I. Body Scans, and Cancer

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There is no escaping cancer in the algorithm. In the months after finishing chemotherapy, targeted ads for A.I.-powered body scans filled my social media feed with stories about lurking malignancies invisible to mainstream (insurance-covered) medicine. Living on “after” cancer is a constant practice of tempering the drive to know what’s happening in one’s body at every moment. Too easily, a mysterious bruise becomes leukemia; constipation, tumescent bowels. The assault of ads warped my attempts to re-inhabit the body without this all-consuming paranoia.

Scanning startups play up the dangers of bodily opacity and the life-extending power of medical imaging. Prenuvo, a luxury celebrity-backed preventative MRI service, promises to show patients a “full picture” of their health through $2,500-per-visit scans through the power of its proprietary “empathic AI.” Walking past the NYC Prenuvo clinic on my way to work, I am enjoined to “See today what could happen tomorrow,” to “take control of [my] own health” with a scanning subscription. As a fledgling academic for whom health insurance year-to-year is not guaranteed, expensive body scans feel out of reach. Still, part of me feels that by not consuming, I am forfeiting control of my health.

Yet, as a historian of medicine, I recognize that rhetorical inflations around AI-powered MRIs share features with the first radiological craze after the discovery of the X-ray: inflated promises of bodily visibility yielding improved relationships to our bodies and an eroticization of radiology to counter anxieties about inviting the medical gaze deeper into the body. Placing today’s AI-powered surveillance technologies in the long history of medical imaging reveals how appeals to the fantasy of bodily transparency have historically obfuscated the complex harms that shadow the medical good enabled by new imaging regimes. The history of medical imaging reveals we must be wary about fetishizing bodily transparency and fearmongering opacity, for the overlay of this moral axis on real bodies ironically impedes the forging of an honest relationship with the body – one’s own, and those ecologically, infrastructurally, and historically bound together with it.

Early X-Ray practitioners turned to highly theatrical stagings of the new technology to inspire awe at its potential to disclose the body’s secrets. Within months of Wilhelm Röntgen’s discovery of the X-ray in November 1895, Thomas Edison and Nikola Tesla, along with doctors, occultists, and the daily press, blurred elements of scientific demonstration and magic show. Journalists wrote in frothy terms that “all the hitherto hidden recesses of the body may yet yield their tribute to the new light,” and that the “unfortunate darkness of the human body” may soon be behind humanity.^[1]

We are still chasing this dream 130 years later. The nineteenth century’s theatrics manifest today in reality TV and influencer reels. The modern analogue of Edison’s matinee is Keeping Up with the Kardashians, where, in the Season 7 premiere cliff-hanger, Kim undergoes a Prenuvo scan that reveals a brain aneurysm – presented as life-threatening, but later revealed to be small and unlikely to have ever caused symptoms. The scan’s dramatization imbues bodily transparency with an affective significance uncoupled from its actual diagnostic value. Radiologists warn that full-body MRIs’ limited resolution by-and-large reveals incidental masses that would never develop into problems, and that over-imaging can result in hazardous follow-up procedures that spike healthcare costs for all without necessarily reducing cancer mortality.

Such data joins many emotional obstacles to the uptake of speculative radiology, e.g., the aversion to the medical image’s reminder of mortality and record pessimism about American healthcare. “Who would actually want to know what’s going on in there?” a mentor of mine asked, echoing Bertha Röntgen’s exclamation upon submitting her hand to the first human X-ray, “I have seen my death!” The X-ray’s advent was met both with exhilaration and anxiety about a loss of bodily privacy. As one journalist comically put it,

The every-day man went about yesterday with a new and strange fear. He did not know what moment one of the army of [Röntgen] rays investigators might cast the mysterious energy upon him, read all the plans he had in his mind […] and make a photograph showing him to have a very small heart.^[2]

Visual pleasure – the erotic fascination in looking and being looked at – was, and is, at the core of speculative radiology, recoding the medical gaze’s expansion as thrilling and empowering.^[3] The X-ray was initially referred to as “the new photography,” and its first manuals were directed at both technical and amateur audiences, pointing to the entanglement of medical and aesthetic modes of looking. As one amateur poet wrote, “If the electric eye,/Can see through wet and dry,/Inside of you and I/What charms can it descry?”^[4] Today, it’s no accident that Cindy Crawford, Paris Hilton, and Kim Kardashian are Prenuvo’s most visible backers, celebrities who pioneered new modes of erotic looking, from the supermodel to the selfie. The medical scan is just another way to aestheticize the body, becoming pleasurable in itself. (One Prenuvo ad, for example, likens scanning to a couples massage.)

From the nineteenth century’s iconic X-ray images of women’s body parts to boutique body scan influencers, women have been central to speculative radiology’s expansion. Laura Mulvey argues that because men have traditionally controlled the means of image production, women have historically been the subject of a “male gaze” that seeks to possess, penetrate, and control them as a means to pleasure.^[5] In a modern neoliberal context that has absorbed feminist critiques of medical abuse, companies like Prenuvo present themselves as tools by which women can wrest agency from mainstream medical hostility. “Women have spent decades being told their concerns weren’t urgent enough. A growing number are done waiting for permission,” reads a Prenuvo ad. Kim Kardashian’s Prenuvo promotion adds to this empowerment narrative, given her penchant for seizing control of an initially exploitative gaze, be it releasing her already leaked sex-tape to reap profit or wrestling visual control of her image away from the paparazzi through selfie aesthetics.

In the nineteenth century, amidst gathering feminist critiques of the male medical gaze, the popular press recast women’s submission to an untested and radically penetrative male-wielded visual technology in terms of erotic frisson.^[6] Take the front page coverage of the first X-ray of an adult heart made by Dr. William Morton. Morton stands erect over the female subject, Kate Swan, who is physically bound to a bed. The sexual charge of this encounter is underscored by Swan’s firsthand account. She describes Morton reaching into the folds of her gown to reveal her silk underskirt, resembling foreplay to the scan itself, which is filled with all the animal noises of sex. Morton tells her she’s allowed to “scream” during the procedure; from her perspective, it’s the X-ray machinery itself that “groans” and “vibrate[s]” with “enthusiasm.” “Does it hypnotize you?” Morton asks, evoking the gendered psychosexual dynamic of Charcot’s hysterics.

Another 1896 comic lays bare the resemblance between doctor and Peeping Tom. Miss Camerer and Mr. Kathode steal away in private to canoodle. Miss Camerer’s randy-looking father, the Professor, deploys X-ray to spy on them. The X-ray image reveals an amorous liaison that shocks the Professor.

This is an arresting picture, insofar as it juxtaposes the heat of youthful sexuality with skeletal mortality. It is subversive insofar as it exposes the double-edged quality of the X-ray practitioner’s visual omnipotence. On the surface, the X-ray’s capacity for expanding surveillance reinforces the Professor’s patriarchal control over his daughter. But what this surveillance reveals is the disturbing limits of the Professor’s paternal omnipotence. His face turns from smug bemusement, knowingly meeting the reader’s gaze, to shock. The comic’s ambivalence captures the way the X-ray simultaneously inflated fantasies of visual omnipotence at the same time that it could just as sharply induce impotence, on the part of the practitioner as much as the subject.

This image points us to an important difference between the X-ray and the A.I. scan: the increasingly inequitable distribution of harm. Many of the first male practitioners of X-ray photography were also the first to be maimed by acute radiation syndrome. Dr. Morton, so erect in the first image, partially lost his vision from radiation exposure. Edison, one of the earliest and most enthusiastic boosters of the X-ray, disavowed the technology in 1903, declaring, “Don’t talk to me about X-rays; I am afraid of them.” This followed from radiation poisoning suffered by his beloved assistant Clarence Dally, who, very much in keeping with the theme of emasculating mortality, prematurely lost his hair, developed wrinkles, and had to have both his arms amputated, before dying of mediastinal cancer less than a decade after Röntgen’s discovery.

Today, users of services like Prenuvo tend to be economically and geographically removed from the predominantly working-class, Black, and Latinx areas most harmed by data centers and associated energy infrastructure. These areas are becoming carcinogenic “sacrifice zones,” hotspots for rare, pollution-related cancers. The real consequence of our present radiological craze, then, may not be more bodily transparency, but less, as classed fantasies of absolute medical legibility make the ecological entanglements of our bodies increasingly opaque. Consequently, we lose sight of cancer’s etiology in environmental and sociopolitical conditions, identifying it instead with underconsumption and the body’s still unvanquished darkness.

Notes

1. H. J. W. Dam, “The New Marvel in Photography,” McClure’s Magazine, April 1896, Mss.arc, Box 2, William J. Morton Papers, Library at the New York Academy of Medicine, New York, NY. ↑
2. “X Ray Wonders Next,” 1896, Mss.arc, Box 2, William J. Morton Papers, Library at the New York Academy of Medicine, New York, NY. ↑
3. Lisa Cartwright, Screening the Body: Tracing Medicine’s Visual Culture (University of Minnesota Press, 1995), 107-125. ↑
4. William James Evans, “Lays on Rays,” 1896, Mss.arc, Box 2, William J. Morton Papers, Library at the New York Academy of Medicine, New York, NY. ↑
5. Laura Mulvey, “Visual Pleasure and Narrative Cinema,” in Film Theory and Criticism: Introductory Readings, eds. Leo Braudy and Marshall Cohen (Oxford University Press, 1999), 833-44. ↑
6. Writings by Charlotte Perkins-Gilman and Dr. Elizabeth Blackwell were among the most influential late nineteenth-century feminist critiques of the male medical gaze. ↑

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Featured image courtesy Gustavo Fring.