Training the Auscultative Ear: Medical Textbooks and Teaching Tapes (1950-2010)

Medical auscultation is an important example of how scientific work relies on more than vision alone. If listening through a stethoscope remains one of the most non-invasive, accessible diagnostic practices, its legitimacy as a means for producing medical knowledge has been increasingly questioned in light of abundant evidence-based tests introduced to Western medicine after 1950. This article examines how shifts in auscultation's epistemic status can be observed in medical textbooks and audiocassettes that teach novices the listening and bodily skills necessary for lung auscultation. Specifically, the pedagogical strategies and medial tools used to instruct the listening practice are analyzed. As all stages of teaching auscultation are somehow rooted in familiar sensorial experience, a main didactic method for recognizing and remembering lung sounds uses metaphors and mnemonic devices drawn from culturally specific, everyday sounds and music. Yet, the textbooks also illustrate attempts to standardize nomenclature and scientifically ground lung sound descriptions in order to overcome such individual and time-bound approaches, including the adoption of new sound technologies. While certain tensions exist, all these pedagogic strategies strive for the stabilization of auscultation as a practice. Finally, the article discusses how these didactic strategies find popular cultural "reworkings" in radio shows to teach the general public about auscultation.