The significance of this narrative is its interpretation of the experience of illness as "everyday experience," providing an ethnomethodological insight into chronic illness. The context is a return to research in the Philippines which comes at the same time as an uncertain and early diagnosis of ALS ("Lou Gehrig’s disease,") For this reviewer, there are striking similarities between this process of self-discovery and my own construction of a disability consciousness after acquiring progressive MS. Like Robillard, I depended on a portable computer to counterbalance the erosion of my handwriting, and looked at technological alternatives to the loss of body control. However, Robillard enriches his experience through significant reinterpretation of his relationships with medical personnel, caregivers (especially his wife,) and with the students trained to communicate with him and administer suctioning. This is a tale of the loss of bodily function and the re-categorization of significant others as personally derived solutions to problems of "communicative competence." Self-denial, discussed by Murphy and others as part of disablement, accompanies wheelchair "confinement" and an obsessive interest in motor neuron disease. After considering his unexpected limitation to body movement, Robillard’s discussion focuses on the moral worth of paralytic people by focusing on their exclusion from everyday conversation. Body movements become part of a social text that is inaccessible to the chronically ill or disabled.

Screens and monitors in an intensive care unit (ICU) together with devices like a manual alphabet board, lead to a displacement of self, a "self distancing" which marks the entering of a "forbidden pool" in sociological analysis. This emerges in ethnomethodological fieldwork during three months of in hospital ‘suctioning,’ which becomes a demonstration of how Zola emphasizes disability opens larger issues of social order. Using contrasting metaphors of communication, Robillard uses everyday communication to compare "flying nurses," (mainland visitors) who import their expectations of patient behavior as a form of non-contextualized medicine, with local nurses who situate behavior in everyday contexts.

The inadequacies of adaptive devices and of some assistants as substitutes for oral and body communication, lead Robillard (and metaphorically disabled people) to isolation from everyday textual intricacies, particularly when these are supported by body language. His solution is a system of lip reading to communicate with his wife and graduate students. The reader might ask why technology is not used more intensively. However, Robillard demonstrates that his solution creatively maintains communicative competence and promotes independent living. His solutions, especially his communicative support system, resemble how Ingstad and Whyte demonstrate "personhood" is maintained in "Southern" societies. (Although, in this narrative, these observations do not extend to support systems in the Philippines.)

The paralytic, unable to respond in nonverbal body language, does not participate in the full text of everyday conversations. The pacing, context, timing, and inter-subjectivity of communication are difficult to maintain. There is also an absence of meaning in most modern contexts such as the ICU, with its wall of electronic readouts which are not displayed to the sick or disabled person. When reciprocal competence in communication is difficult to maintain Robillard shows that there may be anger brought about by the failure of the person in a wheelchair to respond in face-to-face encounters. It is this inability to establish mutual gaze or coordinate body movement which leads to the failures to synchronize timing in conversation were one-party depends on an interpreter who lip reads. Speakers may position themselves to avoid interaction, leading to further anger, especially in settings like parties, where the disabled are often positioned to be in no one’s gaze (or anchored in a single gaze from which no one easily escape.) This familiar script of anger for disabled people also emphasizes their supposed ‘passivity,’ which might be an inability to respond with their bodies. However, offering a useful alternative approach, Robillard situates anger as part of a collaboratively constructed setting to which the body reacts intersubjectively. The body becomes a text and the actors are "the judgmental dopes" of Garfinkel. A significant conclusion is that disabled bodies are less able to capture the focused rituals of everyday experience.

Part of the everyday relationships of disabled bodies, particularly relevant to interaction with caregivers and almost any kind of medical personnel, is whether communication is IN or OUT of context. It is in these relationships where communicative competence can transmit subtle cues not available through speech and which are subject to frequent misinterpretation through a misreading of the timing and pacing of messages. In that context, unauthorized movements of the body may generate anger or become threats to competence.

Without the benefit of ‘clock time’ or of mutual gaze, Robillard demonstrates that encounters with the disabled are often characterized by ‘botched’ communication. Thoughts are misread because of the complexities of nonverbal communication that are frequently beyond the gaze of the disabled who cannot use body and voice to maintain "dissipation." Anger is also interpreted as situated in the intersubjectivity of everyday events in which the disabled body becomes part of the text of a collaboratively constructed social structure.

In original thinking Robillard looks at the isolation of disability, and the separation from colleagues and others, specifically from the perspective of body and voice. Rituals of body performance, viewing television and other events, are particularly relevant to interaction with caregivers and almost anybody else. For the disabled, may become limited opportunities of gaze. (After 12 years of working with MS, I consider this to be a credible representation of the everyday performance constraints of a disabled professor constructing experience with assistance of students, caregivers and attendants.) The re-situated body is placed in an interactional environment that is limited by restrictions and scheduling of those daily rhythms which create meaning. For Robillard this involves an interaction ritual including scheduled avoidance, involving three parties, himself, the person pushing his chair (usually his wife!), and the person with whom he is interacting. This pattern is only somewhat different using a power chair, although in this case, the isolation is even more complete. From personal experience, the flow of communication is similar except that I find some colleagues and some students (similar to Robillard’s assistants) take regular responsibility to see that there is a steady flow of communication between myself and the outside world of the academy.

Communication at faculty events is more problematic. I usually find myself positioned, together with my wife, with one or two interlocutors who will communicate with us for the rest of the evening. That is often an uncomfortable arrangement unless they position themselves before mutual communication. E-mail provides one technique of escaping this isolation. By positioning Robillard in academic space, e-mail, as Foucault stresses, resolves issues of space and place. However, situating communication in cyberspace resolves barriers of interactional competence.

Discussion of evening rituals emphasizes differences between disabilities and also the relationships between assistants or caregivers and a disabled person (or academic.) To what extent are these encounters transformed by metamorphosis of the body? What visual manifestations of incompetence are avoided or hidden in everyday situations (such as an "idiot bib," half-full urinals, bodily restrictions imposed by a wheelchair, positional restrictions which channel speech and other forms of communication? Like Robillard, I find that some colleagues and students regularly assist with covering and managing these stigma, allowing the maintenance of interactional competence. These are interactional issues which must be included in a sociology of disability.

The disabled are left "alone in the company of others" and body gestures cannot confirm verbal messages. As I can confirm, "the hard work of interaction" exacerbates the reduced communicative possibilities of the disabled scholar who cannot invest consistently the energy and motion required by everyday competence in academic life. Robillard deals with the so-called "tragedy of disability" by focusing on these everyday contexts rather than on specific discussions of advertising media and literature.

Subsequent discussion of the role of assistive devices in channeling and limiting communication or interaction are strikingly familiar. Were I to accept a technologically fixed environment, I would have to stop independent thinking and writing (which, at this moment, I am doing by voice) and retreat into a narrowly defined social world defined entirely by the limitations of assistive devices. This is a narrative about the rejection of these devices from the story board, to in adaptive computer, and stick and puff technology all of which was supported by well intended salespeople and even colleagues. The choice of lip reading translators to permit continuation of communicative competence is evocative of solutions to disability in Africa, discussed by Ingstad and Whyte.

Much of the discussion of the financial limitations on the disabled would not apply to some Canadian or European contexts where assistive devices are provided as social goods. However, limitations imposed on the social experience of the disabled is similar in both contexts. The disabled often reject technology as a means of retaining their independence, choosing instead to retain their social relationships with caregivers or to maintain other dependencies which provide them strength as isolated people. In this context of assistance in "northern countries,"there are still an expectation that persons with disability will exempt themselves from an everyday context of work and possibly living.

The technological "fix" for Robillard was a University designed computer which used an electronic beam to compensate for loss of muscle control and voice. The reader is left with what I think his the message that for the disabled in our society must rely on administrative or technological solutions – "flying nurses" who can manage disability without contextual relevance. Using the assistance of others and a combination of body movements, lip reading, and head movements, Robillard is able to continue his role as a thinker. The speech therapist and others offer technological fixes (such as a device to enunciate phrases like "I want to urinate now") which are not substitutes for natural conversation.

This narrative recalls my own experiences with the proposed technological fixes of occupational therapists (a sophisticated mechanical page turner and a motorized lift device attached to rails which would "permanently" resolve primarily for others, who would no longer be needed, the "burden" of immobility and disability. The opportunity of independent thinking and creativity, a priority for the disabled academic, is not a resolution that occurs to the therapist seeking to "fix disability." Like Robillard they may be labeled as labeled as "stubborn" when they do not opt for devices offered by those who sell assistive devices. This seemingly endless array of devices corresponds to a natural history in which the disabled are progressively isolated from everyday experience. (Salesman: "I’m only here to help you help yourself.")

The dominant theme, which Robillard sees in media images like hearing aid commercials, is that disabled people will find the financial support to give them independence, primarily from others. These financial demands contradict the assertion by Parsons that social expectations are suspended for this sick. Another way to interpret this resistance is that disabled persons reject technology as a means of retaining their independence or as a means of retaining those social relationships which provide them strength as isolated people. The context offered here is that the isolated disabled are expected to make these arrangements with those who will correct or fix them. In many ways, it is an experience that is not completely applicable to some national contexts where the state would provide this assistance regardless of individual means. However, the larger metaphor of isolation through technological dependence is applicable to almost any "Northern" society.

From a perspective of ethnomethodology "how do everyday tasks become accomplishments" to the paralyzed body? For several years, I shared the frustration of attempting to continue what had become an accepted and well-known style of research and interpretation. Like Robillard, I did not expect the disorientation of my own body to become a focus of research and thinking. Returning to teaching created similar problems of communication which require socially–conceived rather than technologically--engineered solutions. It is these solutions which are the enduring contribution of this book.