The anomaly, the chronic patient and the play of medical power.

In the middle of the twentieth century, the anomaly, the person whose body suffered the effects of an accident and who elicited a compassionate response designed to protect the anomaly from the effects of the accident, disappeared. The 'disabled', the 'handicapped', and the 'chronic patient' replaced the anomaly in medical discourse. This change is reflected in specific, technical aspects of medicine - medicine's understanding and treatment of two anomalous bodies - and in general medical ideology and the organization of medical care. The change extended the medical gaze to the most intimate aspects of life and to the fine seams of society where the anomaly used to wander. We must understand this change as part of the paradoxical play of medical power. Medical power became more totalizing, integrative and rapidly responsive just as it became more unobtrusive, humane and liberating.