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Article Excerpt
In the opening of The Birth of the Clinic, Michel Foucault describes his scholarly project about medical epistemology as being "about space, about language, and about death" and "about the act of seeing, the gaze" (ix). Although Foucault exploits the image of the "membrane" as it is observed in living or dead tissue and acknowledges the prominence in cultural life of the generally held assumption that "the human body defines, by natural right, the space of origin and the distribution of disease: a space whose lines, volumes, surfaces, and routes are laid down in accordance with a now familiar geometry," he challenges this commonsense spatializing of disease in the body as "neither the first, nor the most fundamental" (3). For Foucault, it is the disciplinary spaces of the built environment of the clinic, which include and potentially exclude particular observers, that define the regulatory character of knowledge through an architecture of prohibition and license that separates medical practitioners from the ranks of the general public. Now that government agencies and public health organizations are constructing virtual learning environments to train medical personnel and emergency first responders to respond to radioactive or chemical contamination or outbreaks of disease, it is worth considering how these self-identified "virtual clinics" or "virtual academies" similarly delineate the relations of power and subjectivity. In these programs that simulate professional duties, users in front of a computer screen are situated and initiated in a topography of computer-generated 3D models that represent the physical boundaries of bodies, equipment, buildings, and landscapes.
To understand the context for these virtual clinics, it is useful to look at two developments in the emerging discipline of computer game studies: 1) the rise of so-called "serious games" in the independent games movement as an alternative to commercial "hardcore" and "casual" gaming, and 2) new scholarship about the rhetorical character of videogame technologies that draws attention to message-making in the user's experience of navigating the spatial environment as defined by the mechanics of the game's interface.
In recent years, the field of "serious games" has burgeoned with a number of taxpayer-funded initiatives designed to develop specialized videogames for military training, the modeling of scenarios for emergency first responders, disease prevention and health maintenance, physical and mental patient rehabilitation, geopolitical or cross-cultural sensitivity training, conflict resolution, religious enlightenment, public diplomacy, social marketing, and teaching and learning at all levels from early childhood education to exit certification from medical school. The rationales for these software development projects generally promise to deliver greater pleasure and social gratification for recalcitrant or nontraditional learners, or even claim that conventional students or professional apprentices will benefit from greater realism and transferability of game skills to the actual world. As the niche field of serious games within the larger electronic game development community has created its own national and international venues for sharing knowledge and showcasing new projects with competitions, websites, electronic mailing lists, professional associations, and annual conferences, it has propagated disciplinary structures of recognition that protect its claims on expertise.
At the same time, the increasing influence of rhetorical studies on the methods for scholarly interpretation of digital games has encouraged game developers to examine fundamental questions about ideology and the status of game players as discursive actors. For example, the journal Games and Culture is currently edited by rhetorician Douglas Thomas, and other rhetoricians have made contributions to the critical canon in the field. In his work on "rhetoric in the art of computer game development," Ken McAllister argues that game developers must create games that are responsive to a variety of audiences and also appropriate to the specific occasion of the game's launch. McAllister claims that these rhetorical negotiations can be understood by examining several essential contradictions:
(1) computer games require art to be practiced under the constraints of big business; (2) computer games must be realistic enough to hook players with their intuitive interfaces, game rules, and physics engines, but not so realistic that they're experienced as tedious, disturbing, and as irreversible as real life; and (3) computer games can be disturbingly unsavory and still be popular among many gamers. (79)
More recently, game designer and critic Ian Bogost has given more authority to rhetorical methodologies within game studies after the high-profile publication of his book Persuasive Games, in which he argues that "procedural rhetoric is the practice of using processes persuasively, just as verbal rhetoric is the practice of using oratory persuasively and visual rhetoric is the practice of using images persuasively" (28). Drawing on the "2,500-year history of rhetoric," Bogost asserts that videogames are capable of "authoring arguments" designed "to change opinion or action," although those arguments may not always be explicit because they express ideologies that cannot be easily articulated as specific, sequential, logical claims.
In videogames about health that explicitly combine the pedagogical with the rhetorical, the membranous character of the boundaries of specific regions of play is worthy of critical attention, particularly if constraints on what is revealed to and concealed from the learner can be read as making manifest a spatial representation of the rituals and rules of medical knowledge. For example, in the game "Immune Attack," most of the action takes place from the perspective of a fluid-borne nanobot for which the vessels of the human body serve as a combination of exploratory classroom and chaotic...
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