In her book Resilient Cyborgs, Nelly Oudshoorn, with a background in feminist and Science and Technology Studies (sts), develops what she calls “a sociology of resilient cyborgs”. The author focuses on two long-established and widely practiced medical devices, pacemakers and implantable cardioverter defibrillators (icd s), both of which are invasive and surgically implanted in persons diagnosed with life-threatening heart conditions. Technologies are often accompanied by what is called “technological solutionism” (Evgeny Morozov), that is, the belief that technology can solve social problems of any kind and, in the case of implanted tech, medical “problems”. Challenging these kinds of argument, Oudshoorn insists on the social embeddedness of implanted technologies. Against the bracketing of the social dimension and the elision of the dependencies of technologies on human and nonhuman elements, her sociological perspective addresses key issues of agency and resilience. Focusing on devices that inhabit under our skin, the author offers an insightful contribution on the thorny issue of the agency of implanted bodies.

The book is divided into four parts. In part 1, Chapter 1, Oudshoorn introduces us to the subject of the book. After a brief survey of the existing literature regarding the relations between humans and technologies, the author points to a sizeable lacuna within sts, Feminist Studies, and Philosophy of Technology. While human-technology relations have been extensively researched and theorized, under-the-skin technologies are considerably less studied, while posing, at the same time, serious challenges to researchers. For instance, implanted people are not users, since they cannot be said to “use” the implant; on the other hand, it is not clear who “acts”, the implant or the body? For Oudshoorn, the merging of bodies and technologies is a complex procedure, involving many materialities, and requiring a considerable amount of maintenance and caregiving work. Facing this issue, she suggests a “rematerialization of cyborgs”, a subject developed in the second chapter, elaborating an approach that takes into account both the fragility of the technological part and the vulnerability of the hybrid body.

In the second part, Oudshoorn first addresses the resilience of techniques and material resources, expanding on what she calls the “techno-geography of care”. “Resilience”, a concept echoing a neoliberal agenda (Neocleous 2013), according to Oudshoorn is “not a given or a static characteristic of humans or technologies, but it has to be achieved actively” (p. 63). Furthermore, resilience “involves the inextricable intertwinement of humans and machines” (p. 63). By defining resilience as a process, the author places the emphasis on “becoming”, thereby avoiding essentialist views (p. 305). In Chapter 3, Oudshoorn shows that the successful merging of the technological with the biological element needs constant work, in this case, provided by health professionals in the policlinic. She argues that persons with implanted devices are part of a “techno-geography of care”, in the sense that they are part of complex infrastructures, involving a series of actors and actants, both medical personnel and caregivers, as well as various devices. Insisting on the fact that implantations are not a “one-time procedure”, Oudshoorn conceives the follow-up visits as the spaces in which the “wired heart cyborgs” build up their material resilience. Chapter 4 offers an expanded account of vulnerabilities and resilience in spaces besides policlinic. Here the author examines how patients learn to cope with the shocks, both appropriate (conforming to the normal functioning of the device) and inappropriate (accidental), of their implanted devices. In Chapter 5, Oudshoorn shows that implanted technologies not only reduce vulnerabilities, but can potentially create new ones. She argues that everyday environments and familiar devices can become “unknown”, and sometimes dangerous for implanted bodies, as environmental factors can sometimes interact unintentionally with the implanted device. Here, Oudshoorn introduces the concept of “disentanglement work”, in order to account for the efforts of cyborg people to avoid potentially harmful events and situations.

In the third part of the book, entitled “Resilience and Difference”, Oudshoorn expands upon the challenges involved in the making of resilient cyborgs. Adopting an intersectional approach, the author examines how gender and age matter to cyborg bodies. Chapter 6 shows the ways in which gendered mismatches between devices and bodies have shaped the experiences of living with pacemakers and icd s. As implanted bodies transgress the Western cultural norms of femininity and beauty, they shape a techno-geography of resilience, delegating more responsibilities to women. Chapter 7 offers a comparison between two different age groups, young and elderly implanted people, showing that age matters when it comes to anxieties, and showing the different forms of emotional work needed in order to cope with the necessities imposed by hybridization.

The fourth part of the book, entitled “How Hybrid Bodies Fall Apart”, examines the life cycle of cyborg bodies. Complementing the earlier focus on living with pacemakers and icd s, the last part examines death and dying. In Chapter 8, Oudshoorn shows how the technological parts of the cyborg bodies shape the processes of dying. Chapter 9 examines what happens to the technological parts after the implanted person is dead.

In the final chapter (Chapter 10), the author develops the guidelines for a sociology of resilient cyborgs in five heuristics: “1. conceptualizing the active engagement of everyday cyborgs in building resilience as work; 2. accounting for their expertise by including sensory experiences and resilience techniques; 3. conceptualizing internal devices as body-companion technologies; 4. following the whole life cycle of hybrid bodies, including dying and death; and 5. a sensitivity to difference” (p. 304). One could wonder, nevertheless, why Oudshoorn, having used the term “cyborg” widely in her book (including the title), turns, in her final chapter, to the elaboration of another concept introduced by Donna Haraway, namely, “companion species”, modified by Oudshoorn to “companion technologies”. Having in mind the criticisms of cyborg (as techno-optimistic) and the reasons for the adoption of the companion species terminology expressed by Haraway, both the extensive use of the concept of cyborg and its final replacement appear unwarranted.

This book offers an sts perspective to the tricky issue of the agency of cyborg bodies, an issue that has also attracted the interest of scholars working in the philosophy of technology and more specifically of postphenomenology. Oudshoorn offers us a convincing relational analysis of the techno-geographies of care that surround and sustain cyborg bodies. But in some parts of the book (pp. 15, 311), she seems to underestimate the potential of postphenomenology to provide us with valuable toolkits for addressing the nuances of the hybrid body’s experiential relationship with technology, something that sts perspectives generally lack. As the work of Robert Rosenberger has shown, there is much to be gained by a combination of these two perspectives.

Well-documented, this book offers valuable insights on implanted technologies originating in the field of sts. Based on an array of sources and methods, Oudshoorn builds a sociology of real-life, resilient cyborgs, showing the social embeddedness of technologies. Hence, this book is, without doubt, an important and original contribution.