“Going After the High-Brows”: Frank Gilbreth and the Surgical Subject, 1912–1917

CAITJAN GAINTY

“Going After the High-Brows”: Frank Gilbreth and the Surgical Subject, 1912–1917

Introduction

On December 11, 1912, Frank Gilbreth, a renowned expert in industrial efficiency, wrote to the superintendent of the Society of New York Hospital, announcing: “I will install scientific management at your hos-pital at 16th Street without any charge for my services.” As part of the free price tag, Gilbreth demanded free range of the facility and full authority—particularly over the surgeons—to direct bodily motions as he saw fit. The administrator accepted Gilbreth’s offer enthusiastically, and Gilbreth’s scientific study of surgeons began.1

Gilbreth made this brief foray into the operating room in 1912 and con-tinued to pursue surgical motion study until about 1917, when his interests, influenced by the end of World War I, turned elsewhere.2 During this period, he applied his “motion study” technique, born in the factory, to surgery, studying the motions of hundreds of surgeons and nurses and imposing upon operating rooms in New York, New Jersey, Pennsylvania, and Massa-chusetts his extraordinary experimental design. Reams of visual evidence of Gilbreth’s surgical motion study remain. They document for us still the transformation of operating rooms into gridded cages; of surgeons and sur-gical nurses into color-coded and numbered sets of hands and eyes, intermi-nably watched and measured by a battery of cameras and clocks; and, finally, of motions disembodied and abstracted into stand-alone models.

The suspicion of nearly all scholars who have narrated Gilbreth’s studies has been that his science was about the establishment, and extension, of the power of management over its workers, a process that invariably obscured

abstract This article offers a close examination of the early twentieth-century studies of surgical motion conducted by Frank Gilbreth, the celebrated industrial efficiency expert. The willingness of sur-geons to submit to Gilbreth’s studies challenges conventional historical narratives, which have read these studies primarily as examples of the individual-effacing effects of technocracy. Through an explo-ration of the multiple motivations that brought surgeons and Gilbreth together, the article raises new interpretive possibilities for the study of American medicine, and also of industrial work and American culture in this period. Representations 118. Spring 2012 © The Regents of the University of Cali-fornia. ISSN 0734-6018, electronic ISSN 1533-855X, pages 1–27. All rights reserved. Direct requests for permission to photocopy or reproduce article content to the University of California Press at http://www.ucpressjournals.com/reprintinfo.asp. DOI: 10.1525/rep.2012.118.1.1. 1

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and eroded the agency of the individual worker. And though some scholars have usefully nuanced this power and found it to be contestable, recursive, and a great deal more fluid than the dominant narrative would indicate, the general understanding of Gilbreth’s study as fundamentally about the efface-ment of the worker by management still pervades the historical literature.3

The particular historiographical tradition associated with Gilbreth, and with scientific management more generally, has characterized the signifi-cance of motion study as an illustration of a deeply problematic turn toward technocracy, marked in the literature by management’s absolute control over workers and their work at the specific cost of worker agency and indi-viduality.4 The endurance of this analysis perhaps helps to account for the all but complete dismissal of Gilbreth’s study of surgical motion as a moment of significance in American medicine’s history.5 This literature indicates either that surgeons in this period simply would not have acquiesced to a study that threatened their authority in any way (thus implicitly designating the remark-able visual evidence of surgical motion study that we have now as anomalous, when it is not overlooked) or that surgeons may have taken part in motion study to further their own interests in efficiency but quickly recognized its goals for what they really were: the subjugation of surgical subjects, not the reform of medical motions.

In both of these permutations, authority, the maintaining of surgical authority specifically, emerges as a key explanatory element upon which the disavowal of Gilbreth’s motion study as an entity of historical significance implicitly turns. This focus on authority not only provides further evidence that the significance of motion study has been read chiefly in terms of power—a power, moreover, that surgeons at the time recognized and resisted—but also bears the historiographical marker of a reading of Ameri-can medicine in this period that, though it has been rigorously contested over the past ten years, has also remained remarkably resilient.6 Under this reading, the subjugation of surgeons to motion study seems to run afoul of medicine’s more general power-acquisition process, in which the establish-ment of an irrefutable public authority was a primary goal.7 This process was clearly complicated by the fact that medicine in general did not have an obvious arsenal of cures to point to as evidence of the rightfulness of its claim to be the arbiter of the nation’s health. Consequently, medicine’s pro-fessionalization process is sometimes characterized as a moment in which medicine sought to demonstrate its power over the public by “medicalizing” everyday life, so that even birth and death became medical—rather than social or biological—entities, for which one required medical care.8

These conventional analyses of scientific management and medical pro-fessionalization therefore have something in common that, however, makes them seem mutually exclusive as explanations for this episode: both were

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implicitly about the acquisition of power via the appropriation of worker/patient qua subject. Scientific management was successful when the power of management over the worker was total; surgeons, and the medical profes-sion, were successful when their authority over the public’s health was com-plete. Given the importance of maintaining a unidirectional flow of power in both of these narratives, Gilbreth’s surgical motion study should not, in a historiographical sense at least, have happened.9

But it did. More, there is evidence to suggest that his surgical subjects did not just acquiesce; they were willing, even eager in some cases, to take part. When Gilbreth summoned surgeons, for example, from the New York Hospi-tal to his home in Providence, Rhode Island, for what he later described as a “standardization conference” in 1915, they came. They were willing to travel almost two hundred miles, to accede to Gilbreth’s demand that they come to him, and to be monitored by a battery of measurement technologies as they performed mock surgical procedures in Gilbreth’s dining room, using his dinner table, frying pan, and other assorted props in this surgical cinema. These were ready, even eager, subjects who, in the months after this “confer-ence,” actively pestered Gilbreth to see the images he had made.10 And though this was perhaps the most unusual, it was not the only medical confer-ence in which Gilbreth took part: he was asked to speak at multiple medical efficiency conferences; he acquired many medical followers; and, in fact, his work influenced his surgical conferees in particular, and many other medical and surgical practitioners more generally, to become skilled in and to write about medical efficiency, spreading the word about what, in medicine, consti-tuted good, proper, efficient practices.11

These were not the recalcitrant or unwilling “workers” who had been forced to take part in this conference by “management” at the presumed cost of their individuality and agency that predominating analyses of indus-trial efficiency have presumed. Nor were they power-hungry professionaliz-ers who would by necessity reject Gilbreth’s study for the threat it posed to their own power-acquisition project. Instead, this surgical human-subject population, which could choose to opt out of its own subjugation, in an act of utter defiance to the historical trajectory set out for them since, opted in.

In this essay, I examine this apparently counterintuitive relationship between Gilbreth and his surgical subjects and explore some of the reasons why Gilbreth’s surgical motion studies did not meet with emphatic rejection and, in some cases, were entertained with great enthusiasm. The rationale underlying surgical responses is intricate, reflecting the intrinsic complexities and tensions that governed the surgical profession in this period. Though this examination of Gilbreth’s surgical motion study unearths some of the very particular historical tensions that governed the professionalization of surgery at the time, it also, in so doing, points to a new direction for the

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historical conceptualization of the relationship between the working individ-ual and the new and developing technocracy of American work and culture. I show here, finally, that Gilbreth’s motion studies in general, and his surgical studies in particular, have quite often been treated too reductively and viewed too monolithically as having a stranglehold on individuality, on agency, on self-expression. Arguably far more dangerous than Gilbreth’s filmic efface-ment of his worker-subjects has been the historiographical effacement of these human actors, who are too often treated solely as worker-subjects. In constructing identity as only discernible within the limited confines of tech-nocracy, the presence of other constitutive factors in the production of these actors is missed. We are left either with a notion of individuality as an absence—the price exacted by the modern technocratic world of work—or as “subjugated history,” the (re)actions of “those individuals and communities who were the objects of the surveillant and analytical . . . gaze.”12 Individuality is envisioned there as at best constrained: a victim of an omnipresent techno-cratic regime that had become increasingly inescapable.

Motion: The Cure for “Tayloritis”

By the time Frank Gilbreth turned to the study of surgery in 1912, he had already made a name for himself in industrial circles as an efficiency expert, or, as he preferred to be called, a “scientific manager.” He had begun his career as a bricklaying apprentice and went on to become, in the early years of the twentieth century, an independent contractor whose skills and advice were frequently called upon to reform practices and revise building techniques. His methods were a model of turning theory into practice: his 1908 Concrete System was a tour de force, for its fully illustrated, extensively detailed, and all-encompassing “set of rules” that would ensure that any team of his own fieldworkers performing “speed work,” as Gilbreth called it, could quickly and efficiently produce an object or building that would, importantly, not fall down.13

In the opening years of the twentieth century, Gilbreth had become increasingly captivated by the “scientific management” methods of Frederick Winslow Taylor, which, like his own, were intended to make all aspects of the industrial process maximally efficient.14 Taylor’s efficiency reforms concerned the best possible way for workers to work as much as it did the best possible working environment. It was the control of the efficiency of all the working parts of a trade that made it as a whole maximally efficient. Though Gilbreth’s methods were holistic in a similar manner, as his Concrete System indicates, over the years his methods deviated from Taylor’s in important ways, particularly as a result of the technologies Gilbreth used to measure efficiency. Still, the relationship between Gilbreth and Taylor was, at least initially, one more like


that of protégé to mentor than it was of peers. That is, though it has retro-spectively seemed that Gilbreth had as much to teach Taylor as Taylor had to teach Gilbreth, Gilbreth described his own enthusiasm for Taylor’s methods (to Taylor) as having gotten so out of hand at one point that it might result in an illness: “Tayloritis.”15

As many scholars have described it, one, if not the most, meaningful point of similarity between Gilbreth’s and Taylor’s iterations of scientific management was the retrospective presumption that Gilbreth’s efficiency studies largely re-articulated a central Taylorist precept, that maximum pro-ductivity fundamentally required that worker individuality be overcome. Tay-lor imagined workers as simply one more variable in the factory that needed to be controlled for maximum efficiency to be attained.16 Though Taylor’s understanding of precisely what this precept meant or how it interacted with agency was arguably more complex than this, one functional repercussion of Taylor’s methods, especially as they were encapsulated in the reactions of union members, clearly centered around the notion that scientific manage-ment irrevocably entailed workers losing their status as experts in their own craft—losing, in that sense, the very thing that made them distinctive as indi-viduals in the workplace in the first place.17 This aspect of scientific manage-ment seems a particularly clear demonstration of technocratization, which, even if it did make labor more efficient and productive, clearly spelled a new “modern” world in which individual workers lost their identity, and thus their power, not only in the workplace but also in the broader cultural milieu.

Even though Gilbreth’s process of implementing scientific management was quite different from Taylor’s, and Gilbreth was always far more ambigu-ous in his articulations of his goals, Gilbreth’s historical significance has, if anything, been more heavily predicated on this issue of the loss of worker agency, precisely because the elements in Gilbreth’s visual technological armamentarium—at the center of which was the motion picture camera—have been read as having an intrinsically far greater capacity to subjugate than did anything Taylor had in his. These visual technologies, it was thought, ostensibly captured everything and missed nothing, “trapping” the motions of their subjects in what was apparently the unambiguously objec-tive frame of motion study. Writing about one of his most celebrated (and retrospectively worried over) visual technological apparatuses, Gilbreth crowed, “The chronocyclegraph is a perfect record . . . free from the errors of prejudice, carelessness, and all other personal elements.”18

Indeed, it was precisely this difference between them that elevated Gil-breth’s methods over those of Taylor in the 1910s. In the years just before Gilbreth’s foray into surgical study, Taylor’s methods had come under con-siderable scrutiny, particularly by unions, which focused on what had turned out to be an enormously consequential weakness in his methodology: the

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use of the stopwatch. Though the stopwatch was accepted by and large as an objective and scientific technology that could produce objective, scientific data, only part of the measurement of a particular task depended on that technology. “The other part,” Hugh Aitken has noted in his classic study of the failure of scientific management at the Watertown Arsenal in 1911, an important turning point for Taylorism, “had been set by a whole series of conventional decisions, in which the values and preconceptions of the indi-vidual doing the timing were foremost.”19

Taylor himself had long understood something of the limitations of this method—the potential for improvements to it was, in fact, part of what histo-rians have argued attracted Gilbreth to Taylor—but as Gilbreth would later report to students in his summer school of management, clearly having recov-ered from his close call with Tayloritis a few years earlier, the “limitations” of the stopwatch were so severe as effectively to render that technology useless to the task set out for it. Though Gilbreth’s mention of the stopwatch was no doubt in part made to remind students of the clear superiority of Gilbreth’s non-stopwatch method, he was in fact reiterating what was by that time a clear consensus: the usefulness of the stopwatch was ironically contingent on the skills—the “craft expertise”—of the “stop watch man.”20

Indeed, by 1911, the subjectivity of the scientific manager had become ammunition for unions struggling to nullify the validity of Taylor’s studies and return power to the workers on the factory floor. And this was, as Aitken notes, the issue that finally came to a definitive head in the foundry of the Watertown Arsenal. The scientific manager who had been assigned to mea-sure the tasks of these foundry workers clearly knew little, if anything, about the work that he was meant to measure. His palpably arbitrary clicking away at his stopwatch not only precipitated a strike, which ultimately ended with the removal of scientific management from the arsenal (and some very bad publicity), but also effectively revealed the ironic fly in scientific manage-ment’s ointment as actualized by Taylor. Its claims to an absolute and author-itative objectivity could not be upheld so long as the scientific manager was human. The critique that Taylor had leveled at workers, that their “machine” status was limited by their problematic individuality (a problem that obedi-ence to time study corrected), had, in the hands of the unions, spelled his undoing.

During this period, as Taylor’s time study gradually unraveled, Gilbreth began a strategic distancing of himself from Taylor, emphasizing his new study of motion as the corrective for Taylor’s now tainted study of time. Gil-breth traded Taylor’s stopwatch for a newer and infinitely more exciting cast of visual technologies, centered ultimately around the motion picture, since these obviated the essential subjectivity problem of the stopwatch and specifically addressed its attendant issues: chiefly, that the stopwatch simply missed those


motions that were too small to be clearly seen or too quickly undertaken to be accurately measured and that the trace it created of these motions could only ever be accessed through the limited language of time. Indeed, the stopwatch could not “see” or capture the motions of individuals themselves; it could only produce a report about these motions. This, declared Gilbreth, was simply not adequate to the analytic task of understanding motion, nor of determining which motions were the most efficient.

Gilbreth’s deployment of visual technologies began with the photo-graph, which he used in his analysis of bricklaying as early as 1909. By 1912, Gilbreth had also included the motion picture camera. The full battery of Gilbreth’s impressive arsenal of visual technologies, including the problem-atic chronocyclegraph, was not far behind. Apart from offering what Gil-breth touted as a more truly scientific method of the study of motion, these technologies offered a practical way out of Taylor’s bind. There was little if any room for the kinds of accusations that had plagued Taylor: Gilbreth quite ostentatiously left the measurement of worker motions entirely up to his cameras.

Today, whatever the reasons for Gilbreth’s separation from Taylor—and they were at least in part about the practical and financial benefits of separat-ing from Taylor’s now besmirched methodology—the understanding of Gil-breth’s introduction of camera technologies into scientific management has circulated around this idea that cameras were even more insidious tools of technocracy. While unions had already shown that they could take on Tay-lor’s stopwatch men on the grounds that the data these men produced could not ever be entirely objective, no such claim could be made about Gilbreth’s cameras. In the historical reconstruction of this period, these machines have been described as capturing objectively and completely the real reality, since they simply recorded everything that they saw and, later, reproduced it, over and over again, in precise detail for scientific managers to study, critique, and analyze. This is an idea that seems well supported by Gilbreth’s rigid set design.

Experimental Design

Since the particular variable Gilbreth sought to isolate and study was motion, and this included any kind of motion at all, from the intricate motions of the hands to the larger-scale movement of workers on the fac-tory floor, his study relied heavily upon not only visual technologies but also a host of other ancillary methods meant to further isolate motion as the sin-gular object of study. These methods typically included the drawing of lines at intervals of twelve inches over all areas of the walls and floors, and in some cases all of the surfaces, of the “experimental space,” that is, the space

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that was in the camera shot. Gilbreth felt that this grid allowed the organic motions of the hands and bodies in the space, from macro to micro, to be isolated and reinvented as inorganic, one-dimensional shapes with angles, lines, and trajectories that could be scientifically measured and, ultimately, corrected into motions of “least waste.”

Monitoring this laboratory space were not only the cameras but also Gil-breth’s clocks, first the larger chronometer (Gilbreth’s own time-measuring device, emblazoned with his own name and meting out time in units as small as one thousandth of a minute), and the smaller, twelve-hour clock that registered the passage of time in the more conventional way.21 These clocks, and Gilbreth’s name, usually inhabited a large portion of his laboratory images, serving as an immediate and overwhelming reminder that depicted here were not motions, but Gilbreth’s science (fig. 1).

figure 1. Still from film clip entitled “Dating Requisitions One Handed Motion Pattern—1900 per Hour,” showing the gridding and clocks characteristic of Gilbreth’s experimental design. “The Original Films of Frank Gilbreth (Part 2),” Prelinger Archives, Internet Archive, http://www.archive.org/details/OriginalFilm_2.


To his surgical subjects, Gilbreth often also advised that his hospital “lab-oratories” be more fully and more indelibly cross-sectioned. Indeed, he felt that it was worthwhile not only “to go to the time and expense to cross sec-tion the entire laboratory” since “in those cases where we have tried to be economical, we have always regretted it” but also to do so “in a manner that will remain permanent.” He assured T. H. Russell, the superintendent of Mount Carmel Hospital in New York in 1917, that he would find this cross-sectioning the “best expenditure that [he had] ever made after [he saw] the benefits that will accrue from it.”22 Precisely what these benefits were (or exactly for whom they would be beneficial), however, Gilbreth did not at that time explain.

Gilbreth also added a permutation to his experimental design, requiring that his surgical subjects be numbered and color-coded. He wrote to another correspondent at Mount Carmel Hospital, in preparation for his visit there in 1917, that he requireddifferent colors of different numbers on the various hoods of all the people in the operating room, beginning with No. 1 for the head surgeon, and running down in accordance with their relative authority or rank. I suggest that No. 1 be purple and that No. 2 be blue; the colors to be well known shades, so that they will never be confused; in other words, [I would] like to have the corresponding colored num-bers on the cuff, at least for the present, so that we can see in the close-up whose hands are being photographed.23

Although surgeons did not, as a rule, necessarily wear either caps or face masks while conducting surgical procedures (these were “uncomfortable,” noted his correspondent at Mount Carmel Hospital, and likely “a passing fad [that was] only of real use to those in the habit of talking over an open wound”), Gilbreth’s experimental design for the motion study of surgery demanded that they be worn.24 Gilbreth predicated this demand on the need to tell surgeons and nurses apart scientifically. That is, he required a way to translate their individual identities into the objective information that his science required. In retrospect especially, the physical discomfort of these hoods among Gilbreth’s subjects seems as though it ought to have been the least of their problems. Their hoods ineluctably necessitated the almost complete obliteration of those features of his subjects that presum-ably made them identifiable as singular individuals in the first place (fig. 2).

Taken together, then, the requirements of Gilbreth’s experimental design have offered to scholars palpable evidence for the assertion that Gil-breth’s studies were indeed intended systematically to obscure the individual subjectivity of the worker.25 Gilbreth, after all, imposed his experimental design directly onto their workplaces, transforming these spaces into scien-tific laboratories of motion study. His workers were effectively confined to gridded cages where cameras and clocks silently measured and critiqued

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their every motion. In these cages, those aspects that normally had defined them as workers and individuals—their experience, intuition, their own “craft knowledge,” the subtle hierarchies and nuances implicit in their rela-tionships—suddenly became devoid of meaning. In the case of surgeons, if Gilbreth’s more usual demands for acquiescence were not enough, certainly the exceptionally oppressive requirements of his experimental design (of extra gridding, of hoods and color-coding) which implicitly replaced the relationship among workers and between workers and their work with the scientifically determined markers of these relationships, served as an insidi-ous and powerful reminder that the enactment of his particular science of motion study mattered most.

figure 2. A typical “set” for Gilbreth’s motion studies of surgery. In addition to requiring the usual grid lines on the walls (and floors) of the operating theater, Gilbreth also demanded that face masks be worn and that surgeons and nurses be number- and letter-coded. The Frank and Lillian Gilbreth Collection, Archives Center, National Museum of American History, Behring Center, Smithsonian Institution, Washington, DC.


In this sense, Gilbreth has seemed an early and great villain in a now long lineage of technocratic villainy. And even those historians who have ele-gantly nuanced the significance of Gilbreth’s motion study in important cul-tural terms have not entirely dislodged the image of Gilbreth’s motion study as a thinly veiled panopticon, invited in at the behest of management to extend its reach over the factory floor.

Gilbreth and the Surgical “High-Brow”

At first blush, Gilbreth’s studies of surgery seem to reinforce the totalizing nature of his iteration of scientific management. But while Gil-breth’s stated goals for surgical study were simply that his study would be undertaken as publicity for future employers of his work (in a showy and public enactment, in other words, of authority over his surgical subjects), it was also quite explicitly a demonstration offered to those to whom he sub-jected his science in the factory: the working class.

On the one hand, Gilbreth arrived at the study of surgery because he believed that subjecting the “right kind of people” to his science would add legitimacy, and customers, to his iteration of scientific management. Work-ing with American society’s elite professionals would guarantee him the “right” kind of publicity. Particularly when selling his motion study to sur-geons, Gilbreth emphasized that surgery was clearly the most “delicate” of all of the trades by virtue of being the one that dealt with the most valuable “product” of all, the surgeon’s own human subject, the patient. If Gilbreth could establish himself as the expert in surgical motion study, the “most deli-cate trade in the world,” he could also establish himself as the irrefutable expert of every trade.26 So long as surgeons were willing to go along with Gilbreth’s study, so long, that is, as they were willing to acquiesce to his expertise, Gilbreth’s position as the sina qua non of scientific managers would be irrefutable. “There is no question,” he wrote to his patent agent James Butterworth early in 1912, “but that my work on surgery and the doctors will make a much greater sensation than anything that has been done in scien-tific management to date,” and, he enthused, “it is being backed by the right kind of people.”27

But at the same time, Gilbreth’s message in the popular press evidenced a continued commitment to publicity along somewhat different lines. For here Gilbreth pitched his motion study of surgery by offering to his readers the potentiality of a new, most valuable product to come out of his motion study of surgery: democracy. Indeed, on the muckraking pages of the American Magazine, Gilbreth traced the reason for his selection of surgeons as his new

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subjects back to a conversation with a college professor who committed the cardinal sin of doubting the usefulness of Gilbreth’s study beyond the factory doors. Gilbreth, incensed at this “top-lofty” criticism, “served notice . . . that henceforth [he’d] give the bricklayers and shovelers and dock-wallopers a rest—[he] was going after the high-brows.”28

It is not hard to understand why Gilbreth would have been particularly attracted to surgery. Aside from its clear focus on motion, it is certainly true, as Gilbreth himself implied, that surgeons were among the most successful of the medical practitioners in the early-century period. They were, in a sense, the crown of the highbrow, and, indeed, the improved antiseptic practices and new ways of visualizing the body’s interior (the X ray was a turn-of-the-century addition to the surgical arsenal) of the early twentieth century had begun to distinguish surgery from medicine in important ways. Surgery had real, tangible procedures to offer that came in the very palpa-ble packaging of an actual intervention into the interior of one’s body. Tumors and other growths could be removed, for example, quite suddenly changing the shape of the body’s inner landscape and sometimes also visi-bly altering its outer geography. In contrast, medical practitioners had rela-tively little that was as tangible or as evidently curative to show for their practices, even though their scientific understanding of disease etiology had improved dramatically. Consequently, surgical organizations began to see themselves as the appropriate agents for medical reform more gener-ally. The American College of Surgeons, originally founded in 1913 to stan-dardize surgical practices, had expanded its agenda by 1920 to include also the standardization of all American and Canadian hospitals. Its surgical leaders emphatically felt that this task clearly fell within their purview, and, if willingness to be standardized is an appropriate metric, then the hospitals of the United States and Canada seemed to agree. The rise of surgery in particular, then, has seemed to be even more autocratic than that of medi-cine as a whole.

Gilbreth’s choice of surgeons seems like it might have been made, then, in part to titillate the audience of the American Magazine, who presumably delighted in this implication that the “high-brow” surgeon was scientifically akin to the “dock-walloper,” irrefutably equal in his inability to move his body properly and scientifically. Indeed, Gilbreth goes on to say, his study of motion had nothing to do with which trade one practiced or what part of society one inhabited. Elsewhere, Gilbreth had even more particularly addressed the arti-ficiality of the distinction that doctors made between their work and everyone else’s. He noted that, in their tendency to believe themselves “peculiar” or special, “doctors are like everyone else in that every man I have ever talked to has almost invariably believed that his business has peculiarities that are


fundamentally more peculiar than the elements of any other business.”29 For Gilbreth, efficient work was efficient work, which ultimately should be classi-fied according to “nervous and muscular coordinations. The principle,” he continued “is simply that it takes more time and motion to move your hand from A to B by the way of C than to move it directly from A to B, whether your hand holds a trowel, a scalpel, a brick or a monkey-wrench.”30 In an impor-tant sense, the dehumanizing nature of Gilbreth’s motion study, which reduced identity to a series of “muscular coordinations,” made motion-study science potentially the ultimate tool of American democracy.

Seemingly, there would be little reason for surgeons to be attracted to this sort of study, if, beneath its rhetoric of science and efficiency, it was ulti-mately to be concerned with bringing them down a peg or two, righting arti-ficial social inequities through what Gilbreth claimed was the culturally blind, and emphatically equalizing, language of motion. This ought to have been especially true, given surgeons’ own well-established desire to mark, precisely through claims about the supposed “peculiarity” of their profes-sion, an authoritative presence in American society.

But Gilbreth’s description of the supposed “high-brow” nature of these surgeons is far more complex than it has seemed. The struggles of surgeons to professionalize had a very particular context that made their professional-izing goals more inwardly focused and less overtly autocratic (in regard to the public in general) than they appear at first glance. Since surgeons were not, by license, by credential, or even necessarily by training, actually distinct from other medical practitioners at the time, every medical practitioner could, and frequently did, practice surgery.31 Until the interventions of the American College of Surgeons into surgical training and accreditation got off the ground in the 1920s, national standardized training patterns that dis-tinguished surgeons from other medical practitioners did not exist, and medical schools with real surgical training programs were few and far between. As a result, surgeons were, as a body, diverse in ability and back-ground, and, though surgery itself was both highly elite and efficacious rela-tive to medicine, it could also be utterly ad hoc and, in the wrong hands, deadly to patients. Thus, a chief goal of surgical professionalization, at least in an initial way, was to consolidate and separate out real surgical practition-ers as a group distinct from medical practitioners.

The controversy over this from within the profession was quite marked. For physicians who saw in this separation a violation of their right to self-determine their field of practice, the consolidation of surgery, in the hands of the American College of Surgeons in particular, seemed downright anti-American.32 Surgery thus inhabited a somewhat ambivalent position in relation to medicine: in its potential it was the most efficacious medical

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practice in the period, and it seemed that surgeons would become the mouthpiece of medicine in general. But it was also a specialty continually striving for professional separation from medicine, in a way that some within the profession felt was in absolute violation of a critical feature of American medical practice: the right to practitioner self-determination.

The ambivalent position of the surgical profession vis-à-vis medicine as a whole, and the particular concerns about whether or not surgery would be democratic and, in this way, properly American, may have catalyzed efforts to demonstrate publicly a surgical commitment to democracy. At the Ameri-can College of Surgeons, for example, these efforts took the form of a long series of traveling community health meetings, which strongly recalled the tradition of itinerant patent medicine salesmen who had roamed the coun-try hawking their wares throughout the nineteenth and into the twentieth century. By bringing their “messages of health” directly to the people, sur-geons were able simultaneously to uphold their position as the proper mouthpiece of medicine in general, even while they performed their explicit commitment to democracy.33 In this way, on the surface, the ambitions of surgeons were both authentically democratic and autocratic and were, thus, potentially oddly parallel to the very goals Gilbreth described as having brought him to the study of surgery in the first place. The mutual trajecto-ries of Gilbreth and surgeons in general were on display in particular in the dining room of his home, where Eugene Pool and Frederick Bancroft, sur-geons from the New York Hospital, enacted their surgical motion studies.

The Dining Room Surgeries

On March 1, 1915, Pool, the senior surgeon, and Bancroft, an assistant surgeon, from the New York Hospital, arrived on the doorstep of Gilbreth’s Providence home ready to be guided in the ways of motion study. Though the atmosphere of the conference was convivial, and Gilbreth was, as seemed his wont, quite talkative, the three were not there to chat. One of the primary reasons that Pool and Bancroft had to travel to Gilbreth was, in fact, because Gilbreth intended to take visual images—and particularly chronocyclegraphs—of Pool and Bancroft in action (the apparatus was, Gil-breth had explained in an earlier letter, too bulky to bring to them).34

Gilbreth’s dining room table had been covered with a black cloth for the occasion, and Pool, as the senior surgeon, took the leading role, performing nearly all of the mock surgical procedures, with Bancroft as his eager costar/assistant. Pool put the lights of the chronocyclegraph onto his fingers, the cameras turned on him, and, after some minor technical difficulties (the lights on Pool’s hands had to be resituated twice), the study began. Gilbreth initially dictated what he saw in the camera, instructing Pool on how to get


the best images (this was the cause of the lights being resituated), and then, judging as they went which images would be good, which less so, and which ought to be done in the “right way” as well as in the “wrong way” so that any-one who watched these images—Gilbreth had the idea that they ought to be sold as educational films—would understand more precisely the differ-ence.35 In general, though, in his notation of this surgical cinema, Gilbreth appeared to be quite admiring of Pool’s technique: “That last,” he inter-jected at one point, “will not make a pretty picture for the reason that you have such a good habit that the lines will coincide.” He further praised Pool, saying that he “does not shift his eye in the slightest degree from the contact of the patient and tool” (fig. 3).36

As the operations got under way, however, it was Pool who primarily nar-rated what was happening from a surgical standpoint, and also offering occa-sionally his own thoughts as to why one way (of “holding the artery clamp” for example) was sure to be better than any other.37 For his part, Bancroft spent much of his time manning the frying pan, which had been set on the table to

figure 3. Eugene Pool (right) and Frederick Bancroft (left) taking a break from Gilbreth’s Standardization Conference at Gilbreth’s home in Providence, Rhode Island, March 1, 1915. The Frank and Lillian Gilbreth Collection, Archives Center, National Museum of American History, Behring Center, Smithsonian Institution.

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figure 4. A chronocyclegraph of “two cycles of a foreman’s left hand on the same machine.” Frank Gilbreth and Lillian Gilbreth, Applied Motion Study (New York, 1917), 90.

serve up the “artery clamps, forceps, scissors, wipes” as Pool needed them to undertake what seemed not to be any procedure in particular, but rather the generic but fundamental motions that might be a part of any procedure in gen-eral. There was the making of the “preliminary incision,” denoted by Pool as “forceps taken in left hand, and knife in right, and incision made,” followed by a series of images of the repeated clamping and unclamping of arteries before, finally, a performance of artery ligation. From there, the surgeons moved on to the stitches—the motions of sewing and the tying of knots.38

The images of Gilbreth’s chronocyclegraph were produced by capturing the lights on his subjects’ hands with a slow-exposure camera, which turned the dis-crete points of lights into lines, resulting in a visual image, a “graph,” of motion: a chaotic mass of intersecting rays against a black background. No remaining trace of the individual, or even the hands, that produced these lines remains, a fact Gilbreth himself acknowledged, jokingly noting that the chronocycle-graphic image looked more like a “plate of macaroni” than a serious scientific study of motion.39 Gilbreth used these “diagnostic studies” to produce three-dimensional wire models, the sculptural reading of the kinetic cursive, and from these, finally, to extrapolate and prescribe the lines of least waste (fig. 4).40

To some, chronocyclegraphy was more of a publicity stunt than it was a useful addition to the study of motion. Indeed, Gilbreth himself rather cheerfully admitted the macaroni-esque nature of his chronocyclegraphs, and the images also appeared on his 1914 holiday-greeting cards (as well as


greeting cards for other occasions), making it clear that aesthetic spectacle was at least part of their appeal.41 That publicity was on Gilbreth’s mind in this conference is clear, though, given what seems to have been Gilbreth’s tacit understanding of how his interests in surgical motion study might have overlapped with those of his surgical subjects, it was publicity he was willing to share. In a letter from Gilbreth to Pool prior to the conference, in which Gilbreth pitched the idea that the conference might focus on chronocycle-graphs, Gilbreth lit on the profile-raising power of chronocyclegraphy. He explained that not only would Pool and Bancroft have the opportunity to experience the chronocyclegraph but they would also be able to “get the publicity that would go along with it.”42

As with many of Gilbreth’s other prominent chronocyclegraphic studies, the images that emerged out of this standardization conference were appar-ently disappointing. Though there is no precise clarification of why these images were a letdown, it seems likely that part of the fault lay with the problem-atic nature of the chronocyclegraphic apparatus. This had also been the case in other chronocyclegraphic undertakings, most notably in Gilbreth’s 1916 collab-orative chronocyclegraphic study of golfers’ swings with Walter Camp, the famous former Yale football coach.43 In the Camp study, for instance, some of the champion golfers felt the lights weighed down their hands, effectively shift-ing their swing, rendering the resulting image inaccurate. Other difficulties included the problem of attaching the lights to the operator’s finger tightly enough that they would not wobble (yet they could not be too tight, as many feared that this might result in electrocution or at least an electric shock). And, similarly, if lighting conditions were not perfect, the images produced were bound to be very poor.44 Gilbreth’s surgeons seem to have been afflicted with similar technical problems, as the resituating of Pool’s lights perhaps indicates.

What, then, made Drs. Pool and Bancroft so excited about the project, both before the Rhode Island trip and after, when they continued their own efficiency projects back in their New York hospital? As I have already indi-cated, part of the answer lies in the complex interplay of relations that gov-erned surgery’s professionalization, making some surgical goals fall into line with Gilbreth’s. But there is yet more to this story. It is important to take seri-ously the promise surgeons might have seen in the chronocyclegraph as an investigative technology. The notion that these images, as captured by Gil-breth’s cameras, would reveal representations of motion that were not visible to the naked eye easily echoed the parallel promise of the X ray. The X ray promised to reveal what seemed at the time to medical practitioners to be the “hidden truths” of the human body; the chronocyclegraph promised to add a new dimension to these “hidden truths,” not a snapshot, but truth in motion.

Surgeons were perhaps distinctly attuned to the importance of realities that lay hidden beneath the physical surface. Indeed, they were professionally

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afforded access through surgery to another level on which reality was always taking place: the body’s inner landscape of organs and tissues, all of which fol-lowed its own internal logic. This reality belonged uniquely to surgeons; it was theirs to map and traverse with their scalpel or probe before restoring it—via sutures—to the universally accessible reality of the human body in its conven-tional form. The X ray provided an instantaneous view of interior realities, suddenly emphasizing in an entirely new way the notion that interior and exte-rior realities could exist side by side in real time. No longer were these states separated by a dermal barrier. The X ray and the body could peaceably coexist and, what’s more, inform each other. Such was also the case for the chronocy-clegraph. Like the X ray, it did not mark the absence of the more conventional reality of the human body; it marked the presence of a new dimension of the body, previously unseeable. These chronocyclegraphic images, which we have most often thought of as significant in terms of what they do not show, did not, of course, show nothing. In their potential, at least, these images captured a previously inaccessible, invisible reality: the abstracted body leaving its unique signature across time and space. In this sense, the much heralded new and more “real” reality that visual technologies seemed to offer to viewers is shifted a bit, since the promise of the X ray and the chronocyclegraph were not that they demonstrated the “real” reality that had not before been seen, but that they demonstrated another reality that could happily coexist with other, longer-standing iterations.

Significantly, and second, this shifted understanding of reality points to another way in which surgery demonstrated its “democratic” nature, which, in turn, shifts our view of surgery as an entity in this period. For this lesson about the multiplicity of realities was not a lesson to which surgeons alone were privy. In the first several years after its introduction in 1895, and before its radiative effects were well known, the X ray had also been a technology of the people. X ray machines were inexpensive and easy to build, and X-raying one’s own body parts was a particularly popular element of high-class par-ties.45 It was also widely used, for example, at shoe stores as a way of measur-ing the size of one’s foot.46 Though the chronocyclegraph did not achieve this kind of notoriety, its similarities to the X ray marked it as a technology of similar potential, particularly for its ability to show a new reality of the human body simultaneous with the everyday, tangible reality of that same body. The notion that these realities could occur at the same time affirmed the kind of ineffable character of a self-consciously modern reality as multiple and per-haps, thereby, implicitly mutable. Far from imposing only a subjugating gaze, then, these technologies seemed positioned to reveal exciting new realities suitable both for the amusement of the masses and for the study of their bodies. These two goals, far from being mutually exclusive, were part and


parcel of the same general stance toward these new technologies, which made of their subjects not subjugated individuals or objects of scientific inquiry, but individuals participating in and experiencing the modern world, and perhaps even actors, able to create and play their own part. And this offered yet another potential way in which realities multiplied, since here the performers themselves could be very aware that they controlled and cre-ated their own starring “roles,” which were separate from, but irrevocably tied to, their self-expression.

But this view of scientific marvels was not limited to the X ray or, its paral-lel in motion, the chronocyclegraph, nor was it held only by efficiency experts and highly-educated professionals. It also mapped onto one way in which the public greeted surgery and medicine in general, not as expert-mediated tech-nologies of life and death, but, especially in the case of surgery, as exciting exemplars of what was thrilling, modern, and new in American society. In this way, then, the surgical performance of democracy, which the American Col-lege of Surgeons community health meetings perhaps marked, could not ever be solely a self-conscious attempt on the part of surgeons to appease their critics. Implicit already in the preceding examples are the ways in which, whether surgeons liked it or not, their technologies were already circulating throughout American society. This is true of the X ray quite explicitly, but it is also true of the nature of surgery more generally, which, as I have noted, also involves a similar kind of reality-multiplying: that is, it involves an investiga-tion of the body’s interior landscape, a reality we never see but of which we are always aware. And this perhaps explains the cultural interest in surgery as a “great adventure,” as a 1924 article in Harper’s Magazine put it. Unnecessary surgical procedures were undertaken with some frequency, precisely because they promised thrill seekers the experience of a paradigmatically modern (and relatively risk-free) event. In this respect, having surgery was more like buying a Model T or taking a ride on a roller coaster than experiencing ill-ness or disease. Indeed, the Harper’s article continued, it was an ostentatious, and inappropriate, example of the American propensity for materialist consumption.47

This connection between consumption and surgery had a positive side, however, even for those in the profession who disliked the fact that surgery might seem a consumer good rather than an expert-mediated health inter-vention.48 Namely, the same nexus of new, modern, and spectacular that made surgery seem such an obviously unmissable event to the wealthy and adventurous also marked it as an unmitigated, paradigmatically modern good. Even as some reformers called for caution in approaching medicine as a consumer product, and chastised their colleagues who did so, medical prac-titioners and public alike were almost ineluctably drawn to the spectacle, both

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as publicity and as interventions in human health, that these ostentatiously new, modern technologies promised. Thus, for example, the massive under-taking of designing new hospitals and other medical institutions that occurred in this period was marked by an underlying desire to incorporate the most modern, and modern-looking, technologies into their design. One 1914 design for a dispensary, for example, called for pneumatic tubes and escala-tors (which the author described as the “dispensary roller coasters”) that would ferry patients through the building.49

As a final illustration of the idea that surgery was somehow viewed as intrinsically democratic, surgeons did not remain the only high-profile sub-jects that Gilbreth would study. In addition to his studies of golfers with Walter Camp, he also undertook a massive study of the New York Giants, at a pregame batting practice in 1913, in front of the “forty thousand eyes” of the spectators that day at the Polo Grounds and alongside seventy “half-sized Cubans,” part of a marine band from a visiting battleship, who were also on the field entertaining the crowd.50 The characteristic that these study subjects shared was not necessarily delicacy or even social position; rather, they were all, each in their individual way, illustrative of the new shared, consumerist, spectacular, and modern characteristics of American life. Like the experience of the X ray, the chronocyclegraph, the baseball game—which had been transformed, in part by Camp himself, into a mas-sive exemplar of the democratically infused spectator culture of the United States—surgery too seemed to capture some part of what it meant to be modern and American in the early twentieth century. These players and surgeons qua performers and entertainers were potentially a part of a new American highbrow, carved out not by social class but by a shared, almost ineffable characteristic of modernity that the American public both recog-nized and participated in.

Stars and Subjects

Contextualizing what surgeons saw in motion study and what they, and Gilbreth, thought they might get out of it, does not necessarily mean that workers in factory contexts cannot have understood themselves as subjugated subjects. However, it does suggest that there were other possibilities, other frames, within which these individuals might have seen themselves. That is, given what seems to have been the marked excitement about technologies like these, and given the possibilities for participants to see multiple, coexisting realities in modern American life, workers were able to envision their own posi-tion before the cameras as something shifting and even empowering, offering them a clear connection to this new highbrow. Gilbreth actively encouraged this connection, emphasizing always the agency of the worker in the production


and analysis of his industrial cinema and asking individual workers, often quite explicitly, to perform as “stars” in his films. Indeed, in 1916, this relationship of “director” to “star” would cause Gilbreth rather excitedly to describe his female workers as each aspiring to be the next Mary Pickford (herself a former secre-tary turned Hollywood legend).51 Inside the doors of the factory itself, as he had more implicitly outside, Gilbreth actively cultivated this view, preparing for the acting debuts of workers a “set” on which they would perform, and taking a series of test shots for which workers willingly posed to see how they would look on camera. Gilbreth insisted too that workers be included in the viewing ses-sions of these films and that they be allowed to critique themselves, their coworkers, and their practices on film while sitting alongside the same manag-ers who dictated in general terms the running of their working lives.

But is there any other way to establish the self-understanding of these fig-ures who did not publish their thoughts in professional correspondences? Per-haps there is something in the very camera footage that has been said to take away their agency. If we look at figure 5, we see Margaret Owen, a secretary he trained to break the world typing record multiple times and one of Gilbreth’s subjects. In the first part of the clip (fig. 5a), we see her as subject, circum-scribed in the machinery of Gilbreth’s experimental space. And she, in some way herself a part of that space, performs her role as typist with great concen-tration, the worker-machine that scientific management required her to be. In the footage that follows, however (see fig. 5b), Owen is no longer the cham-pion typing machine; instead, she is aware of and interacting with the camera. Though the task of the camera in this second image was ostensibly to measure her eye movements in relation to the motion of her typing, she is now star of her own film, aware of an audience behind the camera and reflecting her sense, her own experience, of what it was like to be living in this decade of fin-gerprints, roller coasters, escalators, and motion pictures and of finding her-self at the experiential center of one of those technologies. Clearly running with this new conception and her new celebrity, Owen actually went on to pen her own work of efficiency, in which she calls the adaptation of her own par-ticular fingers to Gilbreth’s system “The Owen Idea,” and devotes an entire chapter to the proper care of the hands.52 Here she also tellingly plays on Gil-breth’s notion that female workers saw themselves as budding Hollywood stars, writing that in fact “we cannot all be Mary Pickfords,” but, she concludes, “we all have our little groove to fill in this great, busy world.”53 And those grooves, if her story is any indication, were neither restricted nor limited; they instead offered the opportunity for one to star in one’s own life.54

If the more visible historical situating of surgeons as actors (not subjects) is instructive, then the notion that what we see in the factory are workers resisting, “talking back” against their repression as individuals, is perhaps misleading. For here, as with the surgeons cum actors, it might be that what has shifted with the

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advent of Gilbreth’s visual technologies is the nature of the subject position. That is, the nature of individual agency relocated from one informed only by lived experiences to one informed also by the recognition of the multiplicity of views that new technologies offered, coupled with the knowledge that these views were there for the manipulation and reconstruction of the worker at the center of them. The concomitant recognition that these technologies empow-ered individuals in entirely new ways to take part in and experience modern life—whether this was in the motion picture theater, in the baseball stadium, on a roller coaster, or even through the experience of surgery—marked this period as one where individual identities, and the identity of the nation as a whole, were in formation, in a productive and potentially quite enjoyable flux. If this is so, then perhaps the most equalizing aspect of Gilbreth’s surgical study was the recognition, on the part of workers of all kinds—highbrow or not—of one’s self as a conscious and willful actor in the conduct of his or her own work and in the construction of the country as a whole.

Gilbreth’s study of surgeons therefore opens up the question of how (not whether) technocracy and the individual could more peaceably interact. It might indicate that some of our deeply held intuitions about technocracy, about individuals, about Americans in this period are artifactual: the historio-graphical anxieties of a later period or a different place, built to serve the needs of another historical moment. At the least, it suggests that conventional narratives about this period must also take into account articulations of selfhood that point to an experience of American life not bounded by the logic of technocracy.

figures 5a and 5b. Two views of Margaret Owen, whom Gilbreth “trained to be a champion typist.” Owen won her first Typing World Championship in 1913 and won consecutive titles from 1915 to 1917. These stills are from a clip entitled “After considerable study of the development of skill Gilbreth trained this lady to be a champion typist.” “The Original Films of Frank Gilbreth (Part 2).” Prelinger Archives, Internet Archive, http://www.archive.org/details/OriginalFilm_2.


Notes

I am grateful to Alison Winter, Denis Gainty, and especially Lucas Canino for their insightful comments and support over many, many drafts. I also thank Lor-raine Daston and the attendees of the 2010 “Human Science-Human Subjects” Max Planck-University of Chicago Workshop for their suggestions about this paper in its earliest form.

1. Frank Gilbreth to Thomas Howell, December 11, 1912, Box 96, 0816-40, MSP 8, Gilbreth Library of Management Research and Professional Papers, Archives and Special Collections, Purdue University Libraries.

2. Elspeth Brown, for example, documents Gilbreth’s attempts to address what was known as “the crippled soldier problem” in the aftermath of World War I. See Brown, The Corporate Eye: Photography and the Rationalization of American Com-mercial Culture, 1884–1929 (Baltimore, 2005), 108–11.

3. Richard Lindstrom, “‘They All Believe They Are Undiscovered Mary Pickfords’: Workers, Photography, and Scientific Management,” Technology and Culture 41, no. 4 (2000): 725–51, and Scott Curtis “Images of Efficiency: The Films of Frank B. Gilbreth,” in Films that Work: Industrial Film and the Productivity of Media, ed. Vinzenz Hediger and Patrick Vonderau (Amsterdam, 2009), 85–99, in addi-tion to Brown, have offered far more nuanced readings of Gilbreth’s studies.

4. This analysis has retained its rhetorical force, despite important challenges from more recent scholarship on the history and sociology of technology and science. In her study of efficiency, Jennifer Karns Alexander cites Jacques Ellul’s 1964 The Technological Society as evidence of the irrevocability of this antithetical relation-ship between “human freedom” and efficiency. Alexander, The Mantra of Effi-ciency: From Waterwheel to Social Control (Baltimore, 2008), 1. In his description of Marx’s “liberatory view” of technology, David Noble cites Max Weber, Lewis Mumford, and Ellul by way of contrast as proponents of this school of thought, in which technology constrains and controls the development of the individual. See Noble, America by Design: Science, Technology, and the Rise of Corporate Capitalism (New York, 1977), xx–xxii. Lisa Cartwright approaches Gilbreth from a cinema-studies perspective that relies heavily upon Michel Foucault’s notion of the “gaze.” One of her chief claims is, in fact, that the “cinematic apparatus can be considered as a cultural technology for the discipline and management of the human body, and that the long history of bodily analysis and surveillance in med-icine and science is crucially tied to the history of the development of the cinema as a popular cultural institution and a technological apparatus”; Cartwright, Screening the Body: Tracing Medicine’s Visual Culture (Minneapolis, 1995), 3.

5. In those instances in which Gilbreth is brought into the narrative at all, it is most often as a way of emphasizing the unwillingness of surgeons to acquiesce to his studies. See Rosemary Stevens, In Sickness and in Wealth: American Hospitals in the Twentieth Century, rev. ed. (Baltimore, 1999) and her more general discussion of scientific management, 75–79. Here she implicitly notes the desire of surgeons to achieve an autonomy and authority entirely of their own. See also Susan Rever-by’s study of Ernest Codman, who was a Gilbreth devotee: “Stealing the Golden Eggs: Ernest Amory Codman and the Science and Management of Medicine,” Bulletin of the History of Medicine 55 (1981): 156–71. Joel Howell has a much more

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thorough discussion of Gilbreth’s studies but ultimately attributes the signifi-cance of efficiency in medicine to Robert Latou Dickinson, a Gilbreth devotee. See Howell, Technology in the Hospital: Transforming Patient Care in the Early Twenti-eth Century (Baltimore, 1995). It is interesting to note that Gilbreth felt Dickinson was seriously misinformed about the nature of scientific management more gen-erally. For Gilbreth’s comments on Dickinson, see “Conference on the Standard-ization of Hospital Practice by Mr. Gilbreth and Dr. Pool and Dr. Bancroft of the New York Hospital,” Folder 124, 0877, MSP 8, Gilbreth Library of Management Research and Professional Papers, 26–27.

6. See for example Rosemary Stevens, “Public Roles for the Medical Profession in the United States: Beyond Theories of Decline and Fall,” Milbank Quarterly 79, no. 3 (2001): 335; John Harley Warner, “Grand Narrative and Its Discontents: Medical History and the Social Transformation of American Medicine,” Journal of Health Politics, Policy, and Law 29, no. 4–5 (2004): 757–80.

7. Jerold S. Auerbach, Unequal Justice: Lawyers and Social Change in Modern America (New York, 1976), quoted in Daniel Rodgers’s “In Search of Progressivism,” Reviews in American History 10, no. 4 (1982): 118. See also Rodgers’s larger dis-cussion of professionalization, 116–18.

8. This analysis is characteristic of what has been a very influential, although also much contested, school of thought in medicine’s history. See esp. Paul Starr, The Social Transformation of American Medicine (New York, 1982).

9. In her discussion of the history of bioethics, M. L. Tina Stevens makes an explicit connection between these two narratives, ultimately suggesting that they are, in fact, one and the same. In her explanation of why bioethics emerged in the 1960s, she points to this literature on technocracy (see note 4), marking Ellul and Mumford (and also Theodore Roszak) as points of origin for bioethics’ humanist challenge to medicine’s dangerous technocracy. She thus elides the terms of these two narratives (see notes 4 and 7), by implicitly viewing medical-ization and professionalization simply as forms of technocratization. Stevens, Bio-ethics in America: Origins and Cultural Politics (Baltimore, 2000), 8–45.

10. Eugene Pool to Gilbreth, July 11, 1915, Box 96, 0816-42, MSP 8, Gilbreth Library of Management Research and Professional Papers.

11. Gilbreth’s name peppers the medical journals and Gilbreth appeared at many medical standardization conferences in this period. For articles Gilbreth wrote himself, see Frank Gilbreth, “Motion Study in Surgery,” Canadian Journal of Medicine and Surgery 40 (1916): 22–31; “Hospital Efficiency from the Standpoint of the Efficiency Expert,” Boston Medical and Surgical Journal 172, no. 20 (1915): 774–78; and “Scientific Management in the Hospital,” Modern Hospital 3 (1914): 321–24. With Lillian Gilbreth, Gilbreth almost completed a manuscript, “Hos-pital Study” (unpublished manuscript, n.d.) Box 125, 0877-3, MSP 8, Gilbreth Library of Management Research and Professional Papers. Surgeons and physi-cians who were scientific management devotees, Robert Latou Dickinson, Ernest Codman, Michael Davis, Eugene Pool, Frederick Bancroft, and others, drew heavily upon Gilbreth’s work. See esp. Dickinson, “Hospital Organization as shown by charts of personnel and powers and functions,” Bulletin of the Taylor Society 3, no. 5 (1917): 2–10; and “The New ‘Efficiency’ Systems and their Bear-ing on Gynecological Diagnosis,” American Journal of Obstetrics 80 (1914): 865–84. See also Eugene Pool and Frederick Bancroft, who were themselves Gilbreth’s surgical subjects, “Systematization of a Surgical Service,” Journal of the


American Medical Association 69 (1917): 1599–603. This list is, of course, merely exemplary; it is far from a comprehensive compendium of the medical effi-ciency literature influenced by Gilbreth and scientific management.

12. Cartwright, Screening the Body, xv.13. Frank Gilbreth, Concrete System (New York, 1908).14. The term “scientific management” is here somewhat anachronistic; it would not

be coined until the Eastern Rate Case in 1910, when Louis Brandeis famously argued before the Interstate Commerce Commission that freight rates would not have to be increased if Taylor’s efficiency principles were put in place. According to some sources, Brandeis’s use of the term “scientific management” to describe Taylor’s efficiency principles was so popular—appearing in every account of the day’s proceedings—that Taylor used it in his next book, The Prin-ciples of Scientific Management in 1911. Taylor himself is considered by some to be the “father of scientific management.” (Robert Kanigal notes that this is the phrase inscribed on Taylor’s tombstone, see Kanigal, The One Best Way: Frederick Winslow Taylor and the Enigma of Efficiency [Cambridge, 1997], 6.) I use this term here specifically because it is marginally more value-neutral than the term “Tay-lorism,” which, according to most scholars, has taken on a rather derogatory meaning.

15. Gilbreth to Taylor, March 19, 1908, quoted in Brown, The Corporate Eye, 69.16. Brian Price, “One Best Way: Frank and Lillian Gilbreth’s Transformation of Sci-

entific Management, 1885–1940.” (PhD diss., Purdue University, 1987), 3–5. Here Price views both Taylor and Gilbreth as “social and human engineers.”

17. Others have reflected upon the shifting nature of Taylor’s rhetoric; Kanigal in his The One Best Way and Daniel Nelson in his “Scientific Management in Retro-spect,” in A Mental Revolution: Scientific Management Since Taylor, ed. Daniel Nelson (Columbus, 2005) soften this view a bit, noting the complexity of the interaction Taylor was forging between workers and managers and describing in sometimes great detail how this interaction shaped and reframed his rhetoric.

18. Frank Gilbreth. Applied Motion Study: A Collection of Papers on the Efficient Method to Industrial Preparedness (New York, 1917), 116.

19. Hugh Aitken, Scientific Management in Action: Taylorism at Watertown Arsenal, 1908–1915 (Princeton, 1985), 26.

20. Ibid.21. For descriptions of this chronometer, see Brian Price, “Frank and Lillian Gil-

breth and the Motion Study Controversy, 1907–1930,” in Nelson, A Mental Revo-lution, 60. See also Brown, The Corporate Eye, 78.

22. Gilbreth to T. H. Russell, February 27, 1917, Box 56, 0416-4, MSP 8, Gilbreth Library of Management Research and Professional Papers.

23. Gilbreth to J. F. Baldwin, March 29, 1916, Box 56, 0416-4, MSP 8, Gilbreth Library of Management Research and Professional Papers.

24. Baldwin to Gilbreth, March 4, 1916, Box 56, 0416-4, MSP 8, Gilbreth Library of Management Research and Professional Papers. Gilbreth has several exchanges with surgeons who are confused by his request for surgical “hoods.”

25. See Sharon Corwin, “Picturing Efficiency: Precisionism, Scientific Manage-ment, and the Effacement of Labor,” Representations 84 (2003): 139–65.

26. Albert Jay Nock, “Efficiency and the High-Brow: Frank Gilbreth’s Great Plan to Introduce Time-Study into Surgery,” American Magazine 75, no. 3 (1913): 49. See also Gilbreth’s “Motion Study in Surgery,” 25–27.

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27. Gilbreth to James Butterworth, April 10, 1912. Box 97, 0816-54, MSP8, Gilbreth Library of Management Research and Professional Papers. In a letter to his wife Lillian, during a stay in Berlin, Gilbreth wrote that he hoped it would be widely known that he was in Germany to study medicine. “Do not hesitate to tell everyone that I am here for hospitals. It is Psychologically right from every standpoint to have me on hospitals”; Frank Gilbreth, Letter to Lillian Gilbreth, January 2, 1914, quoted in Brown, The Corporate Eye, 102.

28. Nock, “Efficiency and the High-Brow,” 49.29. Frank Gilbreth, “Undated and Untitled Notes on Surgery and Medicine,” Box

125, 0877-3, MSP 8, Gilbreth Library of Management Research and Profes-sional Papers.

30. Nock, “Efficiency and the High-Brow,” 50.31. A great deal of consternation about “who or what was a surgeon” circulated

in particular around the founding of the American College of Surgeons. See in particular Philip Mills Jones, “The Costume of the College,” Califor-nia State Journal of Medicine 12, no. 2 (1914). See also Rosemary Stevens, American Medicine and the Public Interest, rev. ed. (Berkeley, 1998), 49–50.

32. Loyal Davis, Fellowship of Surgeons: A History of the American College of Surgeons (Chicago, 1996), 75. See also “Editorial: the College of Surgeons,” New York Medical Journal 98, no. 2 (1913); Walter Brickner, “Editorial: The College of Surgeons,” American Journal of Surgery 27, no. 6 (1913); H. B. Young, “On the Economics of New Medical Titles,” American Medicine 8, no. 10 (1913); “Graft at the Bottom,” Los Angeles Times, December 24, 1913.

33. See the Franklin H. and Isabelle H. Martin memoirs, Archives of the American College of Surgeons, Chicago, which offer a vivid “scrapbook” style documentation of these meetings. See also C. B. Moulinier, “Hospital Standardization and the Medical and Nursing Profession,” Hospital Conference, October 22–23, 1923, Congress Hotel, Chicago, 30, and Robert Greenough, Chairman of the Medical Service Board at their October 8, 1933, meeting in the Stevens Hotel, Chicago, each of which offers a description of what these meetings accomplished; Minutes of the Board of Regents, Archives of the American College of Surgeons, 45.

34. Gilbreth to Pool, Box 96, 0816-42, MSP 8, Gilbreth Library of Management Research and Professional Papers.

35. “Conference on the Standardization of Hospital Practice by Mr. Gilbreth and Dr. Pool and Dr. Bancroft of the New York Hospital,” Folder 124, 0877, MSP 8, Gilbreth Library of Management Research and Professional Papers, 34–35.

36. Ibid., 19.37. Ibid., 17–19.38. Ibid., 16–25.39. Gilbreth as quoted in Brown, The Corporate Eye, 96.40. Corwin, “Picturing Efficiency,” 139–65.41. Brown, The Corporate Eye, 102–4.42. Gilbreth to Pool, July 7, 1914, Box 96, 0816-42, MSP 8, Gilbreth Library of Man-

agement Research and Professional Papers.43. Walter Camp, “A Photographic Analysis of Golf and the Lessons Learned from

a Series of New Chronocyclegraphic Pictures,” Vanity Fair, August 1916, 62–63.


44. Lindstrom, “‘They All Believe They Are Undiscovered Mary Pickfords,’” 731–33.45. Howell, Technology in the Hospital, 133–64. See also Percy Brown, American Martyrs

to Science Through the Roentgen Rays (London, 1936); Ruth Brecher, The Rays: A History of Radiology in the United States and Canada (Baltimore, 1969); Tom Gun-ning, “From the Kaleidoscope to the X-Ray: Urban Spectatorship, Poe, Benja-min, and Traffic in Souls (1913),” in Wide Angle 19, no. 4 (1997): 25–61; Yuri Tsivian, “Media Fantasies and Penetrating Vision: Some Links Between X-Rays, the Microscope, and Film,” in Laboratory of Dreams: The Russian Avant-Garde and Cultural Experiment, ed. John Bowlt and Olga Matich (Stanford, 1996), 81–99. See also “About X-Ray Photography,” New York Times, September 6, 1896, SM12; “Her Latest Photograph: It Is an Electric Picture, and the Woman Has the Interior of Her Hand Shadowed Forth,” New York Times, May 29, 1898, 14; and “Making the X-Ray Practical,” New York Times, November 26, 1901, 8.

46. Jacalyn Duffin and Charles R. R. Hayter, “Baring the Sole: The Rise and Fall of the Shoe-Fitting Fluoroscope,” Isis 91, no. 2 (2000): 260–82.

47. An article in Harper’s magazine took this critique directly to the public. Address-ing this abhorrent habit of seeing surgery as what the article characterized as a “great adventure,” the public, the article noted, had misapprehended what was essential and special about medicine, its power to save lives, and in doing so had replaced an interest in the prolongation of life and the health of the nation with a materialistic preference for consumption. “Let an American of a certain class become very rich,” the article continued disapprovingly, “and he immediately does three things: Buys a limousine, buys furs for his wife, and then tries to have an operation performed on himself or on her by the most famous surgeon in his community”; William Shepard, “The New Control of Surgeons,” Harper’s, February 1924, 303–14.

48. One of the most outspoken critics was the surgeon Ernest Amory Codman, who in 1915 expressed his distaste for this practice in an eight-foot-long car-toon. For Codman’s description of this event, see Ernest Codman, Rupture of the Supraspinatus Tendon and other Lesions on or About the Subacromial Bursa (Boston, 1934), xxvi–xxviii. See also “Medical Society Divided: Cartoon of Dr. Ernest Amory Codman Criticising a ‘Ring’ Has Caused Resignation from Committee,” Boston Daily Globe, January 19, 1915.

49. Michael Davis, “How to Make a Dispensary Efficient,” Modern Hospital (1914): 293–94.

50. “Movies to Help Baseball Players Economize Force,” New York Tribune, June 15, 1913, 3.

51. Lindstrom, “‘They All Believe They Are Undiscovered Mary Pickfords,’” 745.52. Margaret Owen, The Secret of Typewriting Speed (Chicago, 1918).53. Ibid., 12.54. There are clear overtures here to the personal efficiency movement. See Alex-

ander, The Mantra of Efficiency. For a prominent example of this movement see the work of Edward Purinton, a self-proclaimed expert in personal efficiency who proselytized “personal efficiency” from the pages of his popular “Efficiency Series” and his “Efficiency Question Box,” which ran in the journal The Independent from about 1914 to 1917.

“Going After the High-Brows”: Frank Gilbreth and the Surgical Subject, 1912–1917

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