Getting a medical diagnosis there’s this expectation of just absolute precision exactly it’s supposed to be like engineering to break your arm you go into a clinic and the x-ray shows that you know that jagged white line on the black background the doctor just points it says there it is that’s the problem it’s definitely a comforting thought I mean we desperately want biology to be binary broken or not exactly infected or clean we want things to be visible and easily categorized into these neat little boxes but then you know you step out of that idealized textbook and into the actual sprawling world of systemic healthcare and suddenly that x-ray machine is the machine works but the building housing is operating on a totally different set of rules right you're looking at this diagnostic and institutional landscape that isn’t it isn’t binary it is  ...