The term ‘cyborg’, a portmanteau word coined by Clynes and Kline in 1960 to describe the cybernetic adaptations necessary to enable organisms to live in space, has since come to refer to any being that is part organism, part machine – a definition that would certainly apply to individuals with implanted cardiac devices. Resilient Cyborgs: Living and Dying with Pacemakers and Defibrillators, by Nelly Oudshoorn, draws upon recent feminist post-humanist studies to fill the gaps left by (and dispel the myths created by) traditional cyborg studies.

Literary and cultural approaches to cyborg studies, by focussing on the fictional and metaphorical, have exacerbated the stereotypical view of cyborgs as male, devoid of emotion and monstrous. Medical and psychological discourses, by focussing on the agency of the medical technology, have traditionally rendered human recipients as passive. Both fields have thus occluded the actual lived experiences of real-life cyborgs. By bringing the voices and experiences of ‘wired heart cyborgs’ into the discussion, Science and Technology Studies (STS) scholar Oudshoorn sets out to foreground the materiality of the body, the agency and identity of device recipients, and the work involved in becoming and remaining a resilient cyborg.

While Oudshoorn’s book could be used as a heuristic to consider other implantable technologies, the specific focus on pacemakers and defibrillators enables exploration of the active human engagement required to manage lifelong co-existence with a potentially life-saving device that operates under its own agency and outside the will of its recipient. Despite the irrefutable agency of such devices, Oudshoorn rejects the resultant passive role often assigned to recipients and, with frequent reference to the concept of ‘everyday cyborgs’, argues that living with a pacemaker or implantable cardioverter-defibrillator (ICD) requires ‘active involvement’ in the constant reinvention of the everyday and ‘thus should be considered as an achievement’ (p. 18). Oudshoorn’s ‘techno-geographical’ approach posits that pacemakers and ICDS are not (as information distributed to patients might suggest) isolated technological devices, but are rather ‘embedded in a larger infrastructure of care’, depending on ‘the active involvement of different actors, including everyday cyborgs’ (p. 47). Oudshoorn is therefore able to address the complex infrastructure of responsibility, considering various social and power relations across a range of settings: hospital, home, work, airports, etc.

Oudshoorn’s use of interviews with wired heart cyborgs and their associates, along with her intersectional approach to identity as the interaction of a range of culturally constructed differences, is often very successful at exemplifying the individuality of experiences and how these might vary from cyborg to cyborg. Actively foregrounding intersectional differences such as gender enables Oudshoorn to ‘correct the image’ (18) that wired heart cyborgs must be male, for example. In fact, when it comes to ICD implantation, wired heart cyborgs are most often male and, with no known medical reason for this gender imbalance, the study and representation of non-imaginary (and female) cyborgs is vital and long overdue.

Oudshoorn’s book does give a rich and nuanced overview of many individuals’ experiences of becoming resilient cyborgs, but omits the consideration of differences other than age or gender that, says Oudshoorn, are equally relevant, for example race and disability. While Oudshoorn suggests the book’s intersectional approach provides a heuristic to address these other differences (p. 319), I hope they are given due and direct consideration in future publications on the topic, as the persistent assumption that cyborgs will be white and able-bodied remains to be corrected.

In the final part of the book, How Hybrid Bodies Fall Apart, the consideration of end-of-life care demonstrates the distress that can be caused by misperceptions concerning cardiac devices, for example when medical communication prioritises the explanation of these devices’ methods of prolonging life, thus excluding discussion of the devices’ potential role in a so-called good death. Oudshoorn relates several accounts of unnecessary anxiety and suffering due to patient or physician misunderstanding around the possible impact of devices at end of life.

The concluding discussion of the practicalities and legislation relating to the removal, recycling or reuse of devices after death, while fascinating, was, I felt, slightly incongruous in tone with the preceding chapters, and ran the risk of undermining the book’s portrayal of wired heart cyborgs as vital and active participants in the techno-geography of resilience.

Nevertheless, I found Resilient Cyborgs to be an excellent discussion of the shared work required in order to live (and die) with a pacemaker or defibrillator. Oudshoorn is particularly successful in placing patient experience and expertise front and centre, without ever under-(or over-)stating the role of medics, technicians, friends and family, society and politics. As a young, female wired heart cyborg myself, I frequently found my own experiences reflected in the book (a rare occurrence) but also encountered many new-to-me aspects of life with a cardiac device.

With the introduction in recent decades of so many technologies that operate under the surface of the body (cochlear implants, spinal cord stimulators, etc.), Oudshoorn argues that ‘understanding the agency, vulnerabilities, and resilience of people living as cyborgs has become even more urgent’ (p. 11). Resilient Cyborgs: Living and Dying with Pacemakers and Defibrillators begins to render visible the work involved in keeping hybrid bodies alive and, in doing so, can prepare individuals, institutions and society ‘for what needs to be done in order to live and die with technologies that operate under the skin’ (p. 307).

术语“cyborg”是由 Clynes 和 Kline 于 1960 年创造的一个混合词，用来描述使有机体能够在太空中生存所必需的控制论适应，此后已经指代任何部分有机体、部分机器的存在——该定义将当然适用于植入心脏装置的个人。弹性机器人：与起搏器和除颤器一起生活和死亡，由 Nelly Oudshoorn 撰写，利用最近的女权主义后人文主义研究来填补传统机器人研究留下的空白（并消除由其创造的神话）。

对赛博格研究的文学和文化方法，通过关注虚构和隐喻，加剧了赛博格作为男性、缺乏情感和可怕的刻板印象。医学和心理论述通过关注医疗技术的代理，传统上使人类接受者处于被动状态。因此，这两个领域都掩盖了现实生活中的半机械人的实际生活体验。通过将“有线心脏机器人”的声音和经验带入讨论中，科学与技术研究 (STS) 学者 Oudshoorn 着手将身体的物质性、设备接收者的代理和身份以及参与成为和仍然是一个有弹性的机器人。

虽然 Oudshoorn 的书可以用作考虑其他植入式技术的启发式方法，但对起搏器和除颤器的具体关注使人们能够探索管理终身共存所需的积极的人类参与，该设备在其自己的机构下运作，并可能挽救生命。超出其接受者的意愿。尽管此类设备具有无可辩驳的代理权，但 Oudshoorn 拒绝通常分配给接受者的被动角色，并经常提到“日常机器人”的概念，认为与起搏器或植入式心律转复除颤器 (ICD) 一起生活需要“积极参与” '在日常生活的不断改造中，'因此应该被视为一种成就'（第 18 页）。Oudshoorn 的“技术地理”方法假定起搏器和 ICDS 不是（正如分发给患者的信息可能表明的那样）孤立的技术设备，而是“嵌入更大的护理基础设施中”，这取决于“不同参与者的积极参与，包括日常的半机械人（第 47 页）。因此，Oudshoorn 能够解决复杂的责任基础设施，考虑到一系列环境中的各种社会和权力关系：医院、家庭、工作、机场等。

Oudshoorn 使用对有线心脏机器人及其同事的采访，以及她将身份作为一系列文化构建差异的相互作用的交叉方法，通常非常成功地体现了体验的个性以及这些体验如何从机器人到机器人的变化。例如，积极地预测诸如性别之类的交叉差异使 Oudshoorn 能够“纠正图像”（18），即有线心脏机器人必须是男性。事实上，当涉及到植入ICD，有线心脏机器人作战是最常见的男性，并没有已知的医学原因的性别失衡，研究和代表性非虚（和女性）半机器人是至关重要的，并姗姗来迟。

Oudshoorn 的书确实对许多人成为有弹性的机器人的经历进行了丰富而细致的概述，但忽略了年龄或性别以外的差异，Oudshoorn 说，这些差异同样重要，例如种族和残疾。虽然 Oudshoorn 认为这本书的交叉方法提供了一种启发式方法来解决这些其他差异（第 319 页），但我希望在未来关于该主题的出版物中给予适当和直接的考虑，因为持续假设机器人将是白人和健全的仍有待纠正。

在本书的最后一部分“混合体如何分崩离析”中，对临终关怀的考虑表明了对心脏设备的误解可能导致的痛苦，例如，当医疗通信优先解释这些设备的方法时延长寿命，因此排除了有关设备在所谓的“好死”中的潜在作用的讨论。Oudshoorn 讲述了由于患者或医生对设备在生命终结时可能产生的影响的误解而引起的不必要的焦虑和痛苦的几个描述。

关于与死后移除、回收或再利用设备相关的实用性和立法的结论性讨论虽然引人入胜，但我觉得与前几章的语气略有不一致，并冒着破坏本书对有线心脏的描绘的风险半机械人作为韧性技术地理学的重要和积极参与者。

尽管如此，我发现Resilient Cyborgs很好地讨论了与起搏器或除颤器一起生活（和死亡）所需的共享工作。Oudshoorn 尤其成功地将患者体验和专业知识放在首位和中心位置，从未低估（或高估）医生、技术人员、朋友和家人、社会和政治的作用。作为一个年轻的女性有线心脏机器人，我经常发现自己的经历反映在书中（很少发生），但也遇到了许多对我来说是心脏装置生活的新方面。

近几十年来，随着许多在身体表面下运作的技术（人工耳蜗、脊髓刺激器等）的引入，Oudshoorn 认为，“了解作为机器人生活的人们的能动性、脆弱性和适应力已经变得更加平等。更紧急”（第 11 页）。弹性机器人：与起搏器和除颤器一起生活和死亡开始使保持混合身体活着的工作变得可见，并且这样做可以让个人、机构和社会“为用技术生存和死亡而需要做的事情做好准备”皮下操作”（第 307 页）。