A metal duckbill speculum, the tool commonly used for vaginal examination, confronts us on the cover of Feeling Medicine: How the Pelvic Exam Shapes Medical Training. The speculum, traditionally seen as an instrument of clinical authority and patient passivity, is put to work by Kelly Underman within this examination of ‘emotional socialization in medical education’ (p. 203). In six chapters, Underman leads us through the evolution of approaches to the pelvic examination, explores the drive towards standardisation in medical education, and ultimately proposes that expert systems of knowledge act on and through affect (our capacities to sense, feel and relate), to uphold the interests of the medical profession in the United States.

Biopolitical contentions of the 1970s saw Women’s Health Movement activists perform ‘pelvic exams on themselves and one another in an attempt to pry the tools of reproductive healthcare out of the hands of physicians’ (p. 33). Underman explains how these feminist challengers transformed medical teaching of the pelvic examination. Specifically, Underman considers the influence of Gynaecological Teaching Associates (GTAs), trained lay people who teach students ways of using language and touch, while honing their technical skills during pelvic examination carried out on their own bodies. Underman explains that she worked as GTA from 2005 to 2015, continuing this role while conducting her research for the book.

Underman draws on document analyses and interviews with 23 medical students, 26 GTAs and GTA programme coordinators, and seven faculty members and staff at medical schools in Chicago. These three groups of interview participants bring insights into experiences of those closely involved in GTA programmes, though broader perspectives were not necessarily conveyed. Reflections of clinicians at later stages of their career might have helped to situate Underman’s claims that the pelvic examination represents a foundational and pivotal moment in medical training, by allowing some consideration of the larger assemblages of clinical training and practice.

Outlining the historical trajectory of American doctors’ professionalisation, Underman contrasts the ‘detached concern’ that characterised doctor‐patient interactions in the mid‐twentieth century (that is, doctors’ maintenance of emotional distance in the face of patients’ suffering), with a contemporary ambition for ‘clinical empathy’ that incorporates affective experiences into the shaping of behaviours during the clinical encounter. Underman interprets affect as a ‘vital force’ (p. 17), invoking it as a tool through which doctors are disciplined to manage the subjectivities of patients. Underman claims that medical students’ simulated clinical encounters with GTAs (in ‘one or several one to three hour workshops’, p. 3) form a crucial stage in their emotional socialisation. Using technologies of patient empowerment ‘coopted’ by medical education from feminist health activism, she argues that the GTA sessions enable medical students to learn the affective dispositions through which they will later cultivate and discipline ‘good patients’ (p. 176): those who are made responsible for their own health and will participate in their own health care.

Underman closes by proposing the concept of affect as biovalue, to account for ‘capital‐generating strategies… that extract profit from the impressionability, ability to form connections, or emotional labour of health professions’ (p. 207), through which clinical medicine guides the public’s conduct to meet the interests of corporatised healthcare. Less explored is that GTAs’ ‘caring commitments to and with medical students’ (p. 198) also exist within forces of for‐profit pursuits that have, for example, seen GTAs setting up their own businesses in response to demand for these teaching services.

I wondered about the limits to the circling of affect in the field of practice of GTAs, which frequently seems to be portrayed as a unidirectional ‘modification of the affective capacities of a trainee’ (p.204), while ‘not making them feel incompetent’ (p. 94). I would have liked to read more on what else might be possible in GTA‐student interactions, such as negotiation of information and modelling of ways that power structures might be subverted. I wondered about the rationale for separating out medics from other healthcare professionals who perform pelvic examinations (for example, nurses and physician associates) and yet are scarcely mentioned. The book could have been further strengthened with additional discussion on interprofessional learning opportunities and the implications for professionals’ emotional socialisation. Finally, although GTA programmes have been established in around three‐quarters of medical schools in the USA, they are used by only around one‐third of medical schools in the UK (Janjua et al., 2018), suggesting that some international comparison might have been useful to extend arguments beyond the structural context of corporatised healthcare.

Overall, Feeling Medicine offers considerable depth of content that will appeal to a range of readers’ interests, including sociology of emotions, healthcare interaction, gender studies and medical education.

金属鸭嘴窥镜（一种通常用于阴道检查的工具）在《感觉医学：骨盆检查如何塑造医学培训》的封面上对付我们。窥镜传统上被视为临床权威和患者被动的工具，由凯利·安德曼（Kelly Underman）在对“医学教育中的情感社会化”的审查中投入使用（第203页）。在六章中，Underman带领我们完成了骨盆检查方法的演变，探索了医学教育标准化的动力，并最终建议专家知识系统对情感产生作用并通过其产生影响（我们的感知，感觉和联系能力），维护美国医学界的利益。

1970年代的生物政治论战使妇女健康运动的积极分子进行了“自我检查和相互检查，试图从医生手中撬开生殖保健工具”（第33页）。Underman解释了这些女权主义者如何改变盆腔检查的医学教学。具体来说，安德曼（Underman）考虑了妇科教学协会（GTA）的影响，这些受过训练的非专业人士向学生传授使用语言和触觉的方式，同时在对自己的身体进行骨盆检查时提高其技术技能。安德曼（Underman）解释说，她在2005年至2015年期间担任GTA的职位，并在进行本书研究期间继续担任该职位。

Underman进行了文档分析和采访，采访了23名医学生，26名GTA和GTA计划协调员以及芝加哥医学院7名教职员工。尽管不一定传达更广泛的观点，但这三组访谈参与者使人们深入了解了与GTA计划密切相关的人员的经验。临床医生在职业生涯后期的反思可能有助于安德曼声称，骨盆检查代表了医学培训的基础和关键时刻，这是通过考虑一些较大的临床培训和实践组合而提出的。

Underman概述了美国医生专业化的历史轨迹，将“分离的关注点”与20世纪中叶医生与病人之间的互动（即面对病人的痛苦，医生保持情感距离）的特征进行了对比。当代对“临床共情”的雄心壮志，将情感体验融入了临床遭遇中的行为塑造。Underman将情感解释为一种“生命力”（第17页），将其作为一种工具来规范医生来管理患者的主观性。Underman声称，医学生模拟的与GTA的临床接触（在“一个或几个一到三个小时的研讨会”中，第3页）构成了他们情感社会化的关键阶段。

Underman最后提出了将影响作为生物价值的概念，以解释“产生资本的策略……从可感知性，形成联系的能力或卫生专业的情感劳动中获取利润”（第207页），临床医学以此为指导满足公司医疗保健利益的公众行为。较少被探讨的是，GTA的“对医学生的关怀承诺”（第198页）也存在于营利性追求的力量中，例如，看到GTA响应这些教学服务的需求而建立自己的业务。

我想知道在GTA的实践领域中影响力传递的局限性，这似乎经常被描绘成单向的“对学员情感能力的修改”（第204页），同时“不会让他们感到无能” '（第94页）。我希望阅读更多有关GTA与学生互动中可能发生的事情的信息，例如信息协商和权力结构颠覆方式的建模。我想知道将医务人员与进行骨盆检查的其他医疗保健专业人员（例如，护士和医师助理）分离开来的理由，但却很少提及。通过对跨职业学习机会及其对专业人员情感社会化的影响进行更多讨论，可以进一步加强该书。最后，2018），这表明一些国际比较可能有助于将论点延伸到公司化医疗保健的结构性背景之外。

总体而言，Feeling Medicine提供了相当多的内容深度，可以吸引一系列读者的兴趣，包括情感社会学，医疗保健互动，性别研究和医学教育。