from psoriasis to a number and back

Information and Organization 19 (2009) 103–128

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Information and Organization

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From psoriasis to a number and back

Ann-Christine Frandsen *

School of Business, Economics and Law, Göteborg University, SE 405 30, Gothenburg, SwedenWarwick Business School, The Warwick University, Coventry, CV4 7AL, UK

a r t i c l e i n f o a b s t r a c t

Article history:Received 18 April 2007Received in revised form 29 January 2009Accepted 2 February 2009

Keywords:Chain of translationsAccounting in practiceSpacePlaceTimeMoney valueAssociationsNamed numbersTaken-for-grantednessSpace/time/value machine

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This paper will argue that accounting can be understood as a spe-cial kind of Latourian Actor – a ‘space/time/value machine’ [Frand-sen, A. -C. (2004). Rum, tid och pengar – En studie om redovisning ipraktiken. Doctoral Thesis, Göteborg: BAS]. It starts conceptuallyby seeing accounting and its references as a ‘chain of translations’[Latour, B. (1998). Artefaktens återkomst. Stockholm: Knowledgeand Society; Latour, B. (1999). Pandora’s hope. Essays on the realityof science studies. Cambridge: Harvard University Press]. Empiri-cally it follows a puzzling set of such references, from a psoriasisclinic where accounting is unfamiliar – so part of what [Tuan, Y.-F. (2001). Space and place, 8th ed. London: University of MinnesotaPress] would call a ‘space’ – to a central finance function where it istaken for granted embodied knowledge, and so part of ‘place’, andthen back, to observe how these references become integrated intomedical everyday work and its embodied ways of knowing, estab-lishing the clinic as an accounting ‘place’ for those who work there..It then argues that as these references become more taken forgranted, accounting acts as a special Actor because of the way itcirculates inside and outside both human and non-human ‘actants’,as a machine which always names and counts, so constitutingspace, time and valuing through its flexible ‘named numbers’.. Ittracks how accounting moves to becoming familiar and expandsits reach through four categories: ‘the character of the associations’,‘the integration of associations and the delimitation of movement’,‘order and its relation to change; and ‘the production of other spaces’.This illuminates how accounting draws actants into its chains orcircuits of value, thus extending its ability to construct both factsand acts. Here the paper supplements the actor-network approachwith ideas drawn from the work of Hoskin and colleagues [e.g. Ezz-amel, M., & Hoskin, K. (2002). Retheorizing the relationship

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1 The names of all individuals encountered in thi

104 A.-C. Frandsen / Information and Organization 19 (2009) 103–128

between accounting, writing and money with evidence from Mes-opotamia and ancient Egypt. Critical Perspectives on Accounting, 13,333–367; Hoskin, K. (1981). The history of education and the historyof writing, Unpublished paper. Department of Education, Universityof Warwick; Hoskin, K., & Macve, R., (1986). Accounting and theexamination: A genealogy of disciplinary power. Accounting, Orga-nisation and Society, 11, 105–136] which see accounting as a visiblesign system naming and counting from before the invention ofwriting, and so having a special priority in settings concerned withcoordinating action in space and across time. In modern manage-rial worklife settings, its named numbers circulate as paper andelectronic texts which are strategically central to both financialand non-financial coordination of resources and actants. This helpsclarify why accounting should be such a special Actor, as well ashow it functions as machine.

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1. Introduction

Maria – a nurse in a ward where they treat Psoriasis (hereafter PSO) – is busy with some admin-istrative duties when the intercom phone rings. Beep! Maria and I walk into the room where Kallewants ointment put on his back.1 After this is done, Maria and Kalle walk to the room where theTL01 box (an apparatus providing UVB light treatment for psoriasis) is located and I follow them. BeforeMaria turns the box on, she asks Kalle about his symptoms and chats with him. Kalle, dressed only in atowel, turns to me after Maria has explained why I am accompanying her today. He puts the towel awayand says to me: ‘‘This is how I look”. Maria examines his skin, asks how he feels. It seems that his skin isgetting more ‘‘normal”.

Maria: This looks good. Have you had any redness since after the last treatment? (Her voice is softand kind).Kalle: No, I have not.

He takes a quick glance over his body as if to look for an answer to her question. He looks satisfiedand smiles.Maria is continuing to make small talk when the intercom telephone rings again. There is anotherperson who wants help with ointment. Maria says that she soon will be there.

Maria: I think we should increase the time by 10 s.

Kalles nods in an agreement. Maria turns on two countdown timers outside the box.

Maria: Ready?
Kalle: Yes, go ahead.
Maria presses a button. The TL0I box starts. Maria walks to her room passing the mail trays. There isa letter for her. It is an income statement from last month. On the last page, she can read the value ofher ward’s results which is expressed in Swedish Krone as: SEK 917,401. 42. This is a number express-ing monetary value. On the same page there is another non-monetary number, 761220, which refersto the PSO operational unit where Maria is in charge. This is a dramatic shift: from touching Kalle’sskin to focussing on numbers which, since they constitute together an accounting text relating to Mar-ia’s unit, demand attention. Not only is this way of describing what the ward is doing new to Mariaand alien to her previous training and experience, but the numbers also generate many questions,for which she has been trying, not always successfully, to find answers. What then happened was that,

s study are anonymised.

A.-C. Frandsen / Information and Organization 19 (2009) 103–128 105

even though I had initially gone to the clinic to undertake research, I found myself intervening in hereveryday life, to help her find some of the elusive answers to questions posed by the accounting text,in particular a strange accounting number in her results relating to the rent and the difficulties ofunderstanding what it referred to.

This paper focuses upon a question which it believes is as yet inadequately addressed: how canaccounting numbers have so many wide-ranging effects on everyday work in very different environ-ments? It proposes an answer which sees accounting as a ‘space/time/value machine’ (Frandsen, 2004)which works by having its references circulate (Latour, 1999) inside and outside human and non-hu-man ‘actants’, thus connecting them into and as a network. It sees this as happening since its refer-ences are always embodied in ‘named numbers’ (Frandsen, 2004). This is because the practice ofaccounting is always to ‘name and count’ through visible signs which are arrayed in textual formats(Ezzamel & Hoskin, 2002; cf. Hoskin & Macve, 1986). What accounting names and counts thus be-comes not only textually stable but the basis for coordinating thinking, acting and the use of resourcesin ‘lived’ space while designating whatever is articulated in its named numbers as ‘valuable’. In thisrespect, where accounting as Actor constitutes actants into networks where action is coordinated, itturns the space of everyday work into what (Tuan, 2001) describes as a ‘place’, insofar as accountingbecomes part of what is familiar and taken for granted and embodied knowledge, with its ‘value’ ac-cepted as legitimately linking space, time and action.

A similar issue has been addressed in an earlier fieldwork-based study by Schultze and Boland(2000) which uses Tuan’s idea of how ‘space’ becomes ‘place’ to theorize about the nature and rolesof information technology based on what they observe happening in the everyday work of managingan outsourced computer system. For Tuan (2001), as the body moves through and experiences somenew part of the world, it experiences that unknown and unfamiliar part of the world initially purely as‘space’. But where the body moves through that part of the world repeatedly, the succession of itsmovements and experiences establishes associations which change that ‘space’ into what becomethe familiar and known and so a ‘‘place”. This transition is the result of the repetition of un-dramatic,fluid everyday experiences.

As with Schultze and Boland’s paper, this paper traces how, both in the PSO clinic and at successivepoints where accounting is observed at work, spaces turn into places. By the end of its process of fol-lowing the accounting object and the development of the nurse’s new understanding of what the unfa-miliar accounting number means, accounting begins to become part of her ‘place’ too, leading to a newengagement with accounting as text and practice, along with other texts and practices already familiarto her as a nursing professional. As that occurs, new time–space configurations open up as she incor-porates accounting as part of being a nursing professional. In adopting Tuan’s insight, the roles ofaccounting in practice and as text can then be opened up to examination in a way that does not over-state their significance but recognises how, when studied close up, accounting plays its active andcomplex roles in shaping what gets done and valued in action and increasingly becomes part of arange of specific work ‘places’.2

The paper seeks to achieve two aims. First it draws on Latour’s paper ‘Circulating References:Sampling Soil in the Amazon’ (Latour, 1999, pp. 24–79), which shows how chains of translationsare critical to the doing of everyday science work, to follow how they may operate similarly ineveryday medical work, tracing the path from acts in a psoriasis clinic to accounting ‘numbers’and back. In the episode described above, accounting has already entered a psoriasis clinic but isencountered by Maria as something which cannot be taken for granted. Starting from that event,the accounting ‘numbers’ are followed along a ‘large’ circuit of translations to the central financefunction for the hospital system within which the clinic was located, and then back. As the unfamil-iar is then rendered familiar, a new small circuit of translations can be seen emerging within theclinic and Maria.

2 It should be stressed that the full ‘research journey’ was not limited to following accounting just in this PSO site. It was alsofollowed in two other sites, one a transportation company and the other an investment house, in each of which accountingoperated in different ways. I began to see accounting as space/time/value machine through my research and reflections acrossthese different sites.


Thus the paper seeks to extend the use of ANT-work in the study of accounting and its practices, byadding to the considerable body of work already undertaken on Latourian lines (e.g. Andon, Baxter, &Chua, 2007; Bloomfield, Cooper, & Rea, 1992; Briers & Chua, 2001; Ezzamel, Lilley, & Wilmott, 2004;Jones & Dugdale, 2002; Kallinikos, 2004; Lowe, 2000a, 2000b; Mouritsen, Larsen, & Bukh, 2001; Mou-ritsen & Thrane, 2005; Pinch, Ashmore, & Mulkay, 1992; Preston, Chua, & Neu, 1997; Quattrone & Hop-per, 2006; Robson, 1991; Vollmer, Mennicken, & Preds, 2008). However in doing so it arguably goesbeyond earlier studies which have focused particularly on accounting as a form of translation in ac-tor-networks or as knowledge object (e.g. Andon et al., 2007; Lowe, 2000b, 2004a, 2004b), throughthe way it follows the suggestion of Czarniawska (2004, p. 4) always to ‘follow the object’, so focusingon following the accounting ‘object’ wherever its chain of translations leads. Consequently the journeygoes beyond specific organisational spaces rather than treating the organisation as an implicit bound-ary or frame within which accounting operates. While this may not have been an intended restrictionon prior studies, the effect has arguably been to restrict the path across which the accounting object isfollowed compared to the study here. So this study may help to theorize accounting’s role in under-standing organisation ‘as a type of final product’ (Czarniawska, 2004, p. 4).3

The second aim is to seek to advance our understanding of how accounting has such hard-to-resistand wide-ranging effects through extending the Latourian understanding of chains of translations byconsidering accounting’s distinctive role in managerial worklife contexts as ‘space/time/value ma-chine’. In this case it arguably not only supplements but also displaces existing (here medically fo-cussed) chains of translations with those between acts, facts and its ‘named numbers’. With asteady focus on how the accounting object shapes the process of ‘reduction and amplification’ (Latour,1999) in everyday work and bodily movements (Tuan, 2001) a new contribution may arguably bemade to the argument over what accounting ‘is’, which Baxter and Chua (2003) have identified asan issue still too little addressed.

Here the study perhaps contributes not only to ANT-work but to the wider use of STS groundedapproaches to the study of work in managerial settings (e.g. Bijker & Law, 1992; Bonner & Chiasson,2005; Holmström & Stalder, 2001; Madon, Sahay, & Sahay, 2004). A recent special issue of Organisation(2009), ‘Does STS Mean Business?’, contributes still further to this body of work and contains animportant review of its emergent lines of investigation (Woolgar, Coopmans, & Neyland, 2009). Butinterestingly, despite the wide range of promising lines identified, there is a virtual silence over theroles of accounting in such settings, as Czarniawska indeed observes later in the same issue (2009,p. 157), referring to collaborations back in the 1990s between people in each field, such as Richard Bo-land and Susan Leigh Star. Given the extensive range of accounting-focussed and STS-based researchjust noted, this is arguably surprising. At the same time, such a silence may help explain why the pos-sibility of accounting operating as a central Actor in managerial networks has not even considered asyet.

That possibility is raised here by supplementing the Latour inspired work with its focus not only onANT and wider issues in STS but also on the roles of ‘inscription’ with the work of Hoskin and col-leagues from within accounting which started from very similar concerns (and often sources) to thosearticulated by Latour in the 1980s (e.g. Latour, 1986) but has gone in an arguably complementarydirection. This work initially considered the connections between the different historical manifesta-tions of writing as textually embedded visible sign system and historically changing practices ofteaching and learning (e.g. Hoskin, 1981) but then went on to consider how human ways of knowingand the forms of knowledge we produce are shaped by the particular mix of writing and pedagogicpractices through which we learn as children. The work of Hoskin and Macve (1986, 1988) then ex-tended this approach to considering how historically specific practices of writing and pedagogy con-stituted forms of powerful knowledge, in particular the double-entry system of accounting and the

3 For instance Andon et al. (2007, p. 7) observe that: ‘[. . .] we seek to appreciate how accounting ontologies are manifestedwithin organizations’ which then leads them to see accounting as ‘a performance measurement system, a means to a more‘commercialized’ future, a symbol of a new organizational regime and/or a way to monitor and reward” (Andon et al., 2007, p. 7). Inother words the actor is already acting as an actor and presents itself as various forms of accounting object constrained by theorganizational locale. This is not to deny that it is legitimate to ‘have’ organization as a starting point in order to study the‘interplay between heterogeneity and stability’ (Jones, McLean, & Quattrone 2004, p. 731).


expanded forms of capital and management accounting which feature so centrally in modern mana-gerial forms of ‘administrative coordination’ (cf. Chandler, 1977).

Ezzamel and Hoskin (2002) then extended the analysis back before the invention of writing, to con-sider how to understand accounting in the light of Schmandt-Besserat’s (1992) work, which estab-lished that the first known accounting is a system of token-accounting dating to c. 8000BC, i.e. fivemillennia before the invention of writing. This shows accounting as already ‘naming and counting’in the form of the man-made clay tokens, formed into different shapes, then stabilised into ‘textual’clusters so naming and counting amounts of different resources. This accounting therefore constitutesthe first form of visible sign system, but one which differs from those which follow as ‘writing’, sincewriting’s signs (and signifiers) are divided into separate linguistic and numerical forms which can thenbe inscribed in conventional ‘texts’.4

Drawing on this work to supplement the Latour approach, I came to recognise during my journeyfollowing the circulating references that something that was constant was that accounting ‘numbers’were always ‘named numbers’, and that accounting’s translating practice never deviated from produc-ing its references to things through naming and counting, and in this way designating them as ‘havinga value’ or ‘valuable’, and assembling named numbers in texts as the means to getting streams of‘named numbers’ which circulate.

I then came to see that this textual assembling of named numbers constructs a distinctive relationbetween space, time and value. For in any given text, the named numbers can convey the ‘value’ theydesignate only by being assembled in a stable way within the textual space, e.g. through being setdown as a series of ‘entries’, or in a tabular form establishing a ‘balance’ of values (Hoskin & Macve,1986; Quattrone, 2009). Meanwhile the values conveyed in this space are measures taken at specificfrozen moments in time. So every accounting text implicates space and time in very specific ways inits practice of ‘valuing’. Accounting as translating practice can then repeat and extend this space/time/value relation across whole series of texts while the flexible character of the named numbers is keptconstant while being passed on in different forms from node to node.

Thus I began to see accounting as operating as a space/time/value machine in two connected ways.First through its repetitions it establishes this way of relating space and time to value as a reality thatcomes to be taken for granted as part of ‘place’ (Tuan, 2001). Second it has machine-like effects on thecoordination of activity in lived time and space, particularly in managerial contexts, to the extent thatit becomes a central part – as translating practice and text, reducing and amplifying– of lived workexperience.

This way of seeing, however, was by no means articulated at the outset of my journey. In the nextsection, I return to that starting point and to the research approach and methods through which I be-gan ‘always following the object’.

2. Research approach and initial methods

2.1. A guide for fieldwork and analysis process

The fieldwork method used here was initially inspired by anthropology (especially Crump, 1990;Wax, 1985) and then follows in a tradition of management and organisation studies which have takenup such research methods in using such an approach (e.g. Czarniawska, 1998; Jönsson & Macintosh,1997; Watson, 1994). The STS work recommends that such field studies should be done from a per-spective of symmetrical anthropology (Latour, 1998, 2005; see also Czarniawska, 2007; Lowe,2001a, 2001b, 2004a). This means that one needs to trace all types of potential associations, both thosethat are successful and those that fail, and trace how they involve translations between human and

4 The term ‘text’ is used here rather than ‘inscription’ which has also been applied to accounting (e.g. Ezzamel et al., 2004;Robson, 1992) in developing a Latour-influenced approach. This is partly to give prominence to the way that inscriptions arealways rendered visible in text form, and how accounting signs are only able to ‘make sense’ as named numbers and to ‘remain thesame’ across the processes of reduction and amplification through their textual expression. It is also to underline the point thataccounting as visible sign system precedes ‘inscription’ in its first token-accounting form, so that accounting is not properly a formof ‘inscription’, but inscription instead is one form of visible sign system.


non-human actors. It also means avoiding a priori assumptions about what constitute associations andtranslations and about the nature of key constructs.

Here Latour proposes the use of a ‘flatland’ metaphor to denote the idea that one must start as if onan empty smooth and level plain, and then let the elements or actants involved (human and non-hu-man) get to work and so generate and materialise links/associations that will bring and hold the net-work/object together. By following the materialised links through the flatland the researcher can traceand record the references that are attached to the object at each link in the chain. If there is any asym-metry produced at any point in the chain, then it will be apparent that the smooth surface of the flat-land is disturbed. This does not mean that the asymmetry is to be ignored or removed. On thecontrary, it is important in its own right, as is the disturbance of the flatland. In summary, the re-searcher has to follow the links until returning to the point of departure.

In this instance the journey starts from the location where the psoriasis treatment was undertaken,where the delivery of care to the patient was already part of the clinic as ‘place’, and where links de-signed to translate care into accounting references were also established, but not yet internalised asfamiliar and taken for granted parts of everyday worklife. The next step, once it became clear thatthe accounting number in the opening episode relating to the rent was not understood, was to followthis accounting ‘object’ in order to discover what links it then led me to. Following the object quicklyled me far away from the ward unit and the clinic. By moving from place to place, seeking to discoverwhat references emerged to produce accounting facts, I was able to establish how these places wereconnected to each other. I could then focus on the medium (Latour & Hermant, 1998; Quattrone, 2009)that held these places together as a network circulating the accounting references into an object. Hav-ing followed the route of the materialised references circulating and discovered how it is maintainedas a stable route (via the concepts of translation, association and black boxing), I could observe the‘performative process’ through which definitions circulate along it, producing various kinds of con-structs. I could also observe how accounting played such a major role in constructing and maintainingasymmetries typical of managerial settings.

This journey involves necessarily Latourian processes of reduction/amplification. First there is areduction in the complexity of action taking place with and around the object at each link, in orderto discern the chain as a whole. Then as the references pause in a particular site, there is a necessaryamplification, to understand the rich detail of how the accounting ‘facts’ work and have effects in situ,with a particular interest in their amplification as they find their way back to be translated into PSOeveryday work, especially as to how they become part of the worksite as ‘place’.

In this double process four Latourian concepts – those of ‘translation’, ‘association’, ‘black boxing’and ‘performative process’ – proved particularly useful for the initial theorising of how accountingworks in this specific case (For a more detailed review of these concept and their value in followingaccounting object, see Appendix 1) But additionally I found value in Tuan’s analysis of space and placein order to capture how accounting can get ‘embodied’ in actants as they become more familiar withits named numbers and their chains of translations. For he shows the significance of both ‘space’ and‘place’, and how the way in which space becomes place involves all the personal modes of experience,i.e. not just the visual and conceptual, but also the auditory, the tactile, and the olfactory.5 Getting toknow an unfamiliar landscape and have it become a ‘place’, Tuan argues, involves learning step by step,i.e. via each successive next movement, rather than a process of coming to know, at a distance, a spatialshape. What is learned is often unnoticed at the time, so space becomes recognised as ‘place’ only afterthe event. At the same time, there is always still more ‘space’ which lies beyond the familiar, as the des-tination not yet reached, and the freedom of the unknown.

‘Space’ therefore has its own positive value for lived experience. Starting from within the livedbody, according to Tuan, space can constitute a sense of freedom, as when my legs and arms can movewithout restriction. When I am alone within my lived body, then my thoughts can associate freelywithin mental space. On the other hand, when I am in the presence of others, some thoughts become

5 So for instance, the personal experience of smell and taste is an integral and enriching part of the experience of the spatial, andaffects or alters people’s understanding of ‘the distant’ and ‘the nearby’, which can then be seen as a compound of degrees ofgeographical distance and interpersonal intimacy. In other words, it is as ‘lived bodies’ engaging in interpersonal relations thatpeople produces their relations with space and place.


held back, because I have to pay attention from within my body towards others, while they may beinteracting and having ideas about the same issue as me. Space also emerges as positive throughthe ability to move (and move beyond ‘place’), as this ability to move is connected to the change ofthe conditions of the here and now.

In contrast, ‘place’ is ‘home’ in a general sense (not necessarily restricted to one’s house or place ofwork). Place has its positive value as what is more concrete and immediate, or determinate, thanspace. As noted, a space becomes a place when its routes and passages are no longer unfamiliar. How-ever, as Tuan argues, this means that time has a key role to play in the constitution of space as place,for it takes time to get a feeling for a place. At the same time, as objects become familiar and so quasi-invisible stable parts of what is now place they help to anchor the sense of time as duration and con-tinuity (and so of place as enduring and continuing too). In short, establishing associations that make aspace into a place relies on everyday experiences, which are un-dramatic and fluid. My feeling of aplace can then be potentially experienced and sensed with every cell of the body, as I move throughtime (and change) with embodied confidence in ‘stability’ as a characteristic of place.

2.2. From a mobile ethnology towards a theorised account

These ideas of Latour and Tuan came alive for me as I undertook on my journey what has been de-scribed as a ‘mobile ethnology’ – that is, a ‘‘study of the ways of life and work of people who movearound a great deal” (Czarniawska, 2004, p. 1). Following the references I had to talk to people whowork in various organisations, joining them for coffee breaks, at lunches and during their meetings,with my notebook and sometimes with my camera, and sometimes during interviews using a tape re-corder. The ‘mobile ethnology’ journey is presented here in an impressionistic style (van Maanen,1988), to convey the performative nature of the research approach and to remain faithful to the flat-land idea of seeing just what is produced and circulated across the time of the journey, thus incorpo-rating a temporal dynamic into the tale (Boland, 2001). It is envisaged that this is as faithful an accountas possible of how accounting translations happen and what translation steps need to be there to beable to reduce psoriasis treatment into a summary form that can be grasped at a glance, and as such away to provide new insights on the complexity of accounting practice in everyday work.

The steps towards the construction of a theorised account then proceeded via a systematic codingof the collected material including field notes, interviews, documents, pictures and annual reports.Coding was done in the spirit of the grounded theory of Glaser and Strauss (1967), focussing on suchquestions as: ‘‘What is circulating and produced here?”, ‘‘What medium and techniques are used?”and ‘‘How does accounting speak with its voice, as an actor?” Posing these questions led me to provi-sional answers, based on my reading of the collected material, and enabled me to establish provisionalcategories concerning how accounting operates in and as practice, and eventually to the idea of thespace/time/value machine.6

The next section is thus a travel report, in which the traces of the translations I found are presentedusing a different font. Reflections are added between the reported traces. This textual organisationprovides a way to avoid the distinction between description and explanations, where the explanationswill emerge once the descriptions are saturated (Czarniawska, 2007; Latour, 2005; Quattrone, 2004).These traces and reflections along the way are the ground for my theorising, which may therefore beseen as a grounded theory of accounting in practice. The journey is organised into two main circles oftranslations, one that follows the apparent accounting and medical references in the psoriasis houseand is the ‘smaller’ chain of translations. This first circle is where accounting practice is not as yet ta-ken for granted but medical practices are. It is here where accounting practice tries to finds its way toestablish links and references. The other ‘larger’ circle first moves away from the house to differentsites of health care administration and archives but it will in time come back and connect to the ‘smal-

6 This also allowed me to reflect on previous ideas from the accounting literature concerning accounting’s implication in spaceand time (e.g. Boland 2001; Carmona, Ezzamel, & Gutirrez 2002; Czarniawska 2004; Czarniawska & Sevón, 1996; Ezzamel &Hoskin, 2002; Frandsen 2002b; Frandsen & Hoskin 2006; Hoskin 1998, 2004; Jones et al. 2004; Kirk & Mouritsen, 1996; Loft 1990;Miller & O’Leary 1994; Mouritsen 2001; Mouritsen & Bekke, 1999; Quattrone & Hopper, 2001; Schultze & Boland, 2000).

Fig. 1. From psoriasis to a number and back: Left-psoriasis on a persons skin, right the income statement from the ward unitPSO treating psoriasis.


ler’ again to define what there ‘is’ there, and what is going on there. This circle can be seen as the ex-panded chain of translations.7

3. Travel report: following a chain of translations

3.1. Initial translations in a house – a ‘small’ circuit

3.1.1. A house for care?The chain of translations (as Fig. 1 tires to illustrates) necessary to reduce a medical treatment to a

named number in an accounting document and then to expand the named number back into a treat-ment was long. I began with the number standing for the rent and with the ward sister Maria askingme questions concerning maintenance and cleaning supposedly specified in a rental contract whichshe had not ever seen. Instructed by Maria I made some phone calls to Medic House and later was ableto obtain a copy of the contract from them. At this point the link between PSO and Medic House8

where they kept the contract was not clear. However, it was a start and it referred to the house in ques-tion and its use in the treatment for psoriasis since 1979 (before which it had been a bath house).

To situate myself in this house I have to move. I take a tram and arrive at the corner of DjurgårdStreet and Karl Johan Street. To be sure I am in the right location, I look above the door where itsays, ‘‘number 12”. There is also a sign which says: ‘‘Health Care Administration PSO” and an olderclay plaque which says ‘‘Bath house”.9 The number on the house is a reference to a coordinate systemof numbers and the words making up the text on the two signs signifying through the use of the uni-versal (alphabetic) technology. Together they help me and Kim [a person who comes for treatment]and 13,000 other visitors to get here every year. I open a door located in one of the corners of thehouse and enter.

From this moment, and still strange to me – a space as Tuan (2001) puts it – the house begins itstransformation, perhaps not into a place for me as it becomes for the visitors for treatment of psoriasisbut at least I now start to share it with them. I also see how this location has come to be associatedwith other locations through a system of alphabetic and numeric labels. One of the first relations thatI can establish with the house is between the door and myself, which creates the contrast betweeninside and outside. The door is stopping me from going in the house at first, but it can be opened.

7 Fig. 1 and its dotted lines is a way to illustrate the ‘black boxed’ translations I traced.8 This is the entity that coordinates Medical premises and accommodations.9 Where appropriate I translate Swedish names into English.


It is not locked, and it hangs on hinges that make it movable. Ready to act as an upright body, I canopen it and enter, thus creating a spatial ordering.

From the corridor passing a veranda to the right, I enter a room with two desks in the middle hav-ing terminals, keyboards and telephones on them. On the walls there are shelves filled with filesand books. I continue to the right and find myself inside the veranda I saw from the outside. I noticethat the ‘‘window” can only be opened from the inside by pushing it to one side. In here I find twoprinters, telephones and monitors connected to a terminal. I do not have to return to the corridor togo to the next room. There is an open door connecting this room with the next. Here, most of thefloor space is occupied by two tall metal cabins. They have wheels but no base or top. To enter eachcabin there is a handle. I open one of them and see a low stool and long vertical light bulbs alongthe sides. Outside the cabin there are some buttons to be pressed. I leave and enter the next roomby moving aside a curtain. This room is small and also contains two cabins. They look older than theprevious ones. I open the door of one of them and find bulbs all around except for the door. Thesecabins do not have wheels.

My sense of this area and my relations to it grow as does my affinity with the others who comehere. Entering these cabins means that my body experiences significant restrictions in its movements.This is a contrast to the rooms I have been walking through earlier, where my body could move freely.In everyday life the relations of restriction and freedom matter, especially when they are translatedinto a diagnosis or accounting named numbers, which then circulate.

Past the cabins I find some showers and small lockers. Now I cannot walk any farther without re-entering the corridor, where I pass some big green plants. Further down, the corridor ends with adoor. I open it and enter. To my left there are two rooms. One is filled with dirty laundry, and theother with clean laundry, toilet paper and towels. To my right, there is a room that looks quite largebut has very little furniture. At one end of it there is a mirror stretching from one wall to the next,with a shelf underneath. There is a table with plastic bottles with pumps and a couple of chairs. Theroom feels cold and big, perhaps because it is almost empty. Next, the corridor is now covered withsmall boxes hanging on the walls. In some of them I can see slippers and shampoo bottles. Furtherdown the corridor to the right there is a large room with big lockers. To the left, which is the onlyway to go, there are cabins like the previous, but more old-fashioned. There is also a cabin whichlooks like a bed and a door with the sign WC on it. To the right are instructions and an intercomphone. A few steps away I find showers and to the right a sauna. The last room to the left is largewith a high ceiling and tile walls and it contains two bathtubs. So far there is no activity in thishouse (except for my walking) and it is hard to know whether this is a medical space or not. Whatactions and actants can define what kind of place this is? What makes someone enter here? Whatmakes them leave?

3.1.2. Movements in the house

Maria (the nurse) and Agneta (a physician) meet me and we sit down in the room with kitchenequipment. I am served coffee and notice that the people present are dressed in white. I realise thatthis room functions as a canteen for the staff. We start talking about many things but mainly aboutwhat they do here: they treat skin problems such as psoriasis.
Since 1841 (Mailbach & Roenigk, 1990), psoriasis has been a diagnosis that is found in the medicalliterature and commonly used by physicians. Psoriasis is defined as areas of skin cells that neverreach the age of 30 days. Usually such cells live only for 10 days and never get all the qualitiesof full-grown cells. Instead, they become wax-like and their capacity to isolate the body is dimin-ished. The psoriasis-affected body produces a lot of such ‘‘unfinished” cells. The affliction is chronic,often starting around the age of 16. The treatment attempts to eliminate the symptoms, which tendto appear randomly. The treatment, often UVB radiation, usually continues for about 10–12 weeks.A specific translation of this general description of psoriasis which will permit connection to a per-son like Kim requires a dermatologist using her eyes and hands.


An important link connecting a person to these premises where care is produced is a diagnosis ofpsoriasis. A diagnosis might produce a feeling of closeness as well as distance. Touching the skin tosense the psoriasis gives the experience of closeness: using the eyes is a way of creating distance. Adermatologist carries both these experiences within her as part of her expertise and translates themto other people’s skin. Both Agneta and Maria say they know how psoriasis feels: their bodiesremember.

When a diagnosis has been established, the physician translates it into a letter of introduction. Thisnew piece of paper has Kim’s name and diagnosis on it. It sets both Kim and the PSO-unit in motion.Kim makes a phone call to make an appointment for the first visit and gets in contact with Maria.The letter and telephone call are subsequent links connecting Kim and the care provided by thePSO-unit. Maria’s room is the one next to the canteen to the left. She writes down the name andappointment time and then shifts attention to the latest PSO profit/loss statement in front ofher. She confides that it is easier to understand external invoices than internal ones for example:numbers concerning ointments look suspicious. A price list could be useful. She starts to makesome phone calls and the accounting references into which Kim’s care will be translated beginto emerge.

Maria has been a nurse for many years and knows the ‘‘ins and outs” of being a nurse. She cananswer any question about nursing. The law protects both the definition of a ‘‘nurse” and nursingas an occupation. Her responsibility is defined in a range of documents and includes accountabilityfor the work done in her unit. For example, ‘‘Health care personnel must engage and be madeaccountable for systematic, continuous quality documentation of the work performed toward sta-ted objectives” (SOSFS, 1996). Maria is now also responsible for the PSO-unit as a profit centre.10

This means that only she can sign a certain piece of paper and a series of her actions become public.Some of these actions are labelled ‘‘responsibility”. This concept is like an umbrella for a set of activ-ities. Recently this set of activities has been expanded to include a direct engagement by Maria withaccounting in various ways. For example ‘‘Employees in this position are responsible for the economyand administration of their unit and for reporting the scale of operations and results.” But also ‘‘YouMUST NOT: Buy equipment for more than SEK 10,000 apiece (depreciation 3 years or more), or allowdays off work for personal reasons prior longer than one month” etc.

With these instructions in mind, and with the financial reports Maria gets every month, she tries tointerpret and manage the PSO-unit, even if she can not answer all questions in this area yet. Account-ing, being an unfamiliar practice, is for her as yet a ‘‘space” in Tuan’s sense, but it seems to have a lot tooffer, e.g. in relation to responsibility and novel ways of talking about care, providing a common lan-guage. By imitating (Tarde, 1888/1969) how other colleagues are using and producing accountingnumbers that seem to be always connected to a name/heading, she can get to know PSO in new ways.Having mastered the links already in place to produce care, that is, knowing how they feel, Maria mustacquire the same feel for the accounting references into which they are being translated.

3.1.3. Psoriasis is connected to a person, and the person is sent to PSO

Agneta visits PSO on Tuesdays to meet people with defined or undefined skin problems. She givesthem a diagnosis and shows them a brochure, which they browse through together. Then thenurses show the diagnosed person around so he or she can get to know the place, and they givethem more information about their treatment in a way similar to that which I am experiencing.

For Kalle and Kim (another person who receives treatment) the house on 12 Karl Johan Street isthe place where they can get rid of psoriasis for a while, which makes it easier to live their lives

10 Here the profit centre means a unit which is allocated all relevant costs (wages, training, rent, interest etc.) and relevantpatient fees and subsidies from the health authority.


(Frandsen, 2002a). At the outset, it was an unknown space for them, even if they knew that it was ahouse for health care. They were then guided round the house, and different objects helped themfind their way round – signs, doors, plants, UVB boxes. In similar ways, symptoms translated intoa diagnosis guide Maria’s movements in the house. Now, the accounting named numbers also offerguidance to Maria, relating her past and future movements. Accounting named numbers representthings, situations and people as clear-cut events, countable objects to evaluate. The numbers intowhich the links producing care have been translated can be expressed and ‘‘seen” and perhaps even‘‘felt.”

Ultraviolet light (UVA, UVB and UVC) with different wavelengths and different effects on thehuman body is used for treatment. The UVB also gives a suntan. The TL01 box has a UVB lightbut it is made a little bit differently from the old-fashioned boxes. A so-called Wolff box uses acombination of UVB and UVA. UVC is not used for treatment. Four old inbuilt UVB boxes are placedin what the personnel call the big ward and two in the small ward. These labels are used to deter-mine where and when men and women are supposed to have treatment. Two of the boxes in thebig ward are not in use anymore because the new TL01 is used for that treatment. Many peoplewho come for treatment have been prescribed the TL01 treatment, and with only one box available,the time schedule is tight. Maria’s request to invest in a further box has not been granted in thelatest budget: however the treatment queue is now so long that Agneta has had to start prescribingthe old UVB treatment.

The above example highlights the importance of accounting named numbers; they act as undispu-table facts which draw boundaries on care and its possibilities rather than simply accounting for it. Therefusal to fulfil the request for a further TL01 box frames what is possible. If she can walk the namednumbers walk it also offers Maria a sense of ordering of the PSO in relation to other spaces. It is clearthat the PSO-unit is not first on the list.

Maria is in her room preparing current appointments by collecting journals, prescription papersand a list of visitors. It is easy for Maria to get an overview after Agneta’s visit is over, becauseher room is next to Agneta’s. Berit, another nurse, shows Kim around PSO.

Simple observation reveals who is here for treatment, not only when they have no clothes, but alsobecause they move around in different areas. Berit’s guided tour shows Kim where to undress, whereto go for treatment, and where to meet the doctor. In this way, space defines movements, but move-ment also defines space. To put it another way, this is how the relationship between everyday move-ments and the body is established. This, it is argued, also applies for other movements such astranslations into diagnosis/treatment or into accounting named numbers. The former are taken morefor granted than then the latter. However because my movements are different, this location is differ-ent for me than it is for Kim and Maria.

The guided tour for Kim starts at the veranda which also functions as the reception. Behind the ver-anda’s sliding window sits Lotta, who takes care of the administration. Everyone who gets treat-ment here – Martin, Lesley, Lei, Manuela, Kalle, John, Ulla, Enrico, Abdul and Kim – pays the feefor the treatment and announces their arrival to Lotta. They receive their treatment journal anda clean towel.

When Kim pays, he gets access to PSO. Inside the sliding door Lotta sits and receives money andhands out treatment journals to Kim and Kalle. To get inside PSO for treatment one has to have theright diagnosis, a doctor’s letter of introduction and a means to pay. To get inside PSO for work, onehas to be registered as an employee and will be paid for it. Among the links which produce care (diag-nosis, letter of introduction, registration as an employee) appear the accounting references (money).Named numbers and money are in use to confirm the relations between objects, situations and people.Lotta, who receives the money, will translate it into other numbers but all with names related to them,in the computer throughout the day. With just one click, the numbers will be off to the hospital’s com-mon database and to the municipal computer office. However, in time they will be back. These placesare all connected to each other through a medium of accounting referencing so it seems, which namesand counts.


After each treatment Maria writes down her latest action, i.e. what kind of treatment was given andhow many seconds of it, in the personal diary, signing with her initials. This paper is a journal or awalking reference. With this paper in circulation, it is possible to learn what has been done and todecide how to go on. It is possible to know who did what and on which day it was done. The per-sons coming here for treatment will return year after year, and both Maria and Agneta know manyof the visitors well by now. Years of practice have taught them that psoriasis turns up randomly,and it then makes Kalle or Kim return to PSO, which takes a lot of their energy and time. Peoplewho come here for treatment appreciate if they can meet the same doctor each time. The doctor,and especially the nurses who see them more frequently, know the most important things aboutthem so the person with the diagnosis of psoriasis does not have to repeat her or his story everytime.

As mentioned above, different areas of the building confirm and stabilise identities, separatingthose who come here for treatment and those who work at PSO. Space separates different movementsand actions, but movements and actions separate spaces. Objects – doors, walls, TL01 boxes – give sta-bility to experiences. When a space becomes a place, various things anchor the physical paths and theexperiences. The repeating of movements and encounters with people and objects stabilise the paths,and translate the space into a place – something known and familiar. Maria used to enter PSO as anurse but now she also enters it as a profit centre manager. People in everyday work create associa-tions with space and translate it into a place – something familiar and known – which will frame fu-ture experiences. The chain of translation that binds psoriasis treatment to accounting produces aplace for care but also a place for profit.

When the place becomes stable or is taken for granted, time become visible, as Tuan (2001) alsopointed out. At PSO time is visible through the people who repeatedly come here for treatment overmany years. It is also visible through the income statement that arrives, after many translations, with amonthly rhythm. But time is also visible in the dynamic between pause and movement, between mis-trust and trust, between chaos and continuity, between non-acceptance and acceptance, between pso-riasis and non-psoriasis skin and between income statements for one month and another.

One other important issue is opening hours and appointment times. The personnel translate eachvisit into lines on paper, which are organised under headings like time, date, week, female or male. Thelines are summed each month, in a way that removes every sign of each specific person and visit. Theresult is an abstract representation of total visits and persons treated. Also the movements of the PSO’spersonnel along the corridor towards the treatment room can be represented as clear-cut events, aslines on paper, organised with the help of the objective clock time and calendar.

Based on these lines, Maria decides the opening hours for PSO, and a work schedule is created.Maria, Berit, Katarina, Susanne and Inger represent 4.14 full-time jobs in working hours. Maria isalso the one who keeps a record of the hours worked and sends them via her terminal to a placewhere they calculate their wages. The named numbers come back expressed in the profit and lossstatement. Such routes between places become clearer and clearer to me, and I see how Maria,Berit, Katarina, Susanne, and Inger are translated back and known as ‘‘employees” in accordancewith the definition of a ‘‘money-valued full-time job.”

All movements at PSO – conversations, stroking hands for comfort, going in and out of rooms, putt-ing on ointments – are abstracted into or as the time of calendars and clocks, and reported as namednumbers and distinct events to Maria. Care has been translated step by step into accounting referenceswhich Maria tried to follow too. Maria’s ‘‘predefined place of responsibility” has been presented to heras a proof of increased decentralization, with accounting numbers as a common language. When shesends her translations of PSO movements to the Automatic Computer Processing Office (ACPO), shehelps to stabilise and expand the association of numbers, linguistic signs and money to PSO’s everydaywork, because they become elements of translations in other places too, as I will later show. Later, thenamed numbers will return in an income report with the internal mail. With these numbers, she canlearn to see the local as being something more general and by doing so be able to compare movementsand situations over time. More importantly she can in time turn this frozen local around too and startto value and to prioritize, deciding what to do next or what to do in a different way than before. PSO as


a place for care, as a node of associations, gives the impression of being relatively solid. It is not a bathhouse anymore; it is a house for care connected to people with a specific diagnosis, connected to theACPO but also a centre for profit, a space for valuing.

The point being made here is that accounting practice helps to produce of a special kind of spatial-izing (and timing). With numbers and linguistic signs working together they are the media used toseparate and create boundaries, which then can be judged and analysed (Ezzamel & Hoskin, 2002).The naming and counting simultaneously will play a part in various situations where space is createdor eliminated and where interactions change. Continuing the journey along the traces of the rentalcontract, obtained after some phone calls, was progressing away from the PSO house to an extendedcircle of translations to other places in search of those references which produce accounting facts.

3.2. The road to numbers and back – translations leaving a house – a ‘larger’ circuit

The contract has no reference to the area to be rented but here I find new names and new counting.They refer to a loan and mortgage represented by numbers. However, they end with two signa-tures, one representing Family Residence Inc. and one The Municipal Health department. At thispoint I was little aware of where the translations would take me and what other relations the ref-erences would reveal along the way. This was not obvious the first time I read and saw the contract.The reference number on the contract says 723:7, not PSO. At the real estate department in the CityHall I receive a map of the PSO’s building. On the map, there are two kinds of numbers in placewhere the PSO house stands. To eliminate possible confusion about the location of the property,the paper refers to a specific map (5045D) of the Gothenburg area, and it gives the coordinatesX 27204, Y 37309. PSO could now be located without doubt. These systems replace the PSO housewith a new combination of linguistic codes and number. There were now three identifications, thePSO house, the plot number 723:7 and the coordinates. Further connections were discoveredbetween PSO, Family Residence Inc., The Municipal Health Department, and City Hall mediatedby numbers and money in the continuous chain of translations of accounting.Files referring to specific properties explain who owns the property, how big it is etc. and that theowner in 1979 was the City of Gothenburg. The municipal government wanted to start a new typeof PSO treatment and was looking for a place. The bath house was found, and the municipalityinstructed Family Residence (a company owned by the municipality) to rebuild it and to run thehouse. The costs of the reconstruction appeared many years later in PSO’s income statement.

The idea behind new treatments for psoriasis was embedded in arguments like ‘‘poor economy” and‘‘lack of resources” (Lärkö & Swanbeck 1982). This ‘‘lack of resources” was translated into the idea of aday care centre instead of hospitalisation, a change that would make the treatments cheaper. The newform of treatment existed already in Stockholm where according to dermatologists it worked well. In1974 a Gothenburg dermatologist contacted politicians and managed to convince them. This mayhave been where the translation of this type of psoriasis care into accounting references originated.

With a proper house of 748.2 m2, Family Residence demanded money – about SEK 5 million – forthe project of turning it into a care unit. The Gothenburg municipality acted as a guarantor for anSEK 3 million loan. This could only be done with permission from the Swedish government. Theloan of SEK 3 million was split in two: SEK 1 million was connected to the mortgage deed of thehouse: the other SEK 2 million was related to the guarantee given by the City of Gothenburg. Whenthe PSO centre opened, ‘‘the lack of resources” rhetoric was replaced by a more positive ‘‘openhouse for treatment” and ‘‘relief for people with psoriasis”. Thus, yet another reference, the Swed-ish government in Stockholm, has become part of the network.The loan – with interest – was to be repaid as a rent by PSO. Above, it was shown how the PSOhouse was transformed into number 723:7 by a reference to a standardised cartographic system.The object 723:7 has now become linked to money, a kind of standardised measurement, whichthen became the bridge between the thingness of the object and its token. The associationorganised round the money needed for the rebuilding was thus rendered strong and wellestablished. These numbers would then be linked through time and space to a paper called an

11


‘‘invoice”. The first time these links were visualised on an income statement referring to PSO was in1993.

3.2.1. Tracing an invoice11

At this point in time when I hold a relatively recent invoice in my hand the relation between thecontract and the number on the income statement referring to PSO is expressed through the addressand contract number. However, the relation to PSO is not obvious, because as is usually the case whenblack boxes are open, they tend to become a bit messy. In retrospect, the links became clear: First, theMunicipal Health department which signed the contract in 1979 does not have the same role today.Second, there are two ‘new’ elements drawn into the chain of translations: Medic House, which sentthe invoice to me, and Gothenburg Premises. This is the sequence of events to create an invoice: Fam-ily Residence produces an invoice and asks for permission for it to be sent off by Gothenburg Premises(its parent company, to be described below) to Medic House. A month later Medic House pays FamilyResidence. Medic House sends another invoice to the economic department of the hospital of whichPSO is part, which then pays it.

However, in order to understand these links from which PSO can be known as a profit centre, I mustfollow the translations further and reflect on the character of the associations they seem to establish.One further translation is related to ‘‘economy not in balance”. Documents found in the city adminis-tration archives revealed changes that had taken place in the local health care sector. In 1991, the Cityof Gothenburg had economic problems; ‘‘not in balance” was the verdict. This message was repeatedseveral times in the documents. An imbalance could not be tolerated, a reform ensued. To balance theeconomy, the text argued, a decentralised system of work organisation and decision-making was re-quired. Everybody had to have a meaningful and clear-cut role so that it would be possible to produce‘‘receipts” of what had been done. All departments, hospitals and other units in the municipality ofGothenburg had to introduce this system of controls. These ideas were similar to the control modelscirculating in Europe at that time such as ‘‘management by objectives” (Olson, Guthrie, & Humphrey,1998). The aim was to increase responsibility and increase influence and decentralisation (Brorström& Solli, 1990; Grimlund, Gustafsson, & Zanderin, 1993). These concepts and arguments abounded inthe municipal budget and documents I found.

Gothenburg’s main hospital started the reform in the 1990s by introducing an ‘‘efficiency program”which contained many characteristics mentioned above. This meant a lot of construction and reallo-cation of premises – to become more ‘core focused’ but also to create a better basis for calculations andpricing. It opted for the so-called ‘‘Purchaser–Provider model”, which was supposed to achieve decen-tralisation, clear-cut roles, responsibilities, more influence and so on. It replaced the old system, inwhich a sum of money was handed out to people responsible for production of a given service. Thismodel also defined and constructed new entities known as ‘‘purchasers” and ‘‘providers.”

It also re-defined and re-constructed departments and units, which needed to be classified differ-ently than before and evaluated in terms of costs and profits. At the same time, the number of areaswas reduced from 52 to 11, invoking the same argument of ‘‘bad economy”. The borders betweenthese areas cannot be seen in something like lines drawn on the floor, but they are materialised insigns and documents containing small squares with texts inside which say: Area 1, Area 2 etc. Theyare also materialised in various kinds of reports from each area. Area 6 is where the PSO ward is lo-cated and this number is a further form of identity for the ward. The fact that it is physically located5 km from the main hospital does not matter. It is still ‘‘in” Area 6. This kind of area system makes itpossible to grasp the whole hospital in terms of numbers connecting places.

Money, named numbers and diagnoses also impose boundaries when they are accepted or forcedupon, integrated and used, just like walls in a house. Walls and money can be obstacles or reliefs. ThePSO house contains beautiful things, which produce a nice feeling. But movements in it can also betranslated into an experience of volume, size, and front or back, near or far. Experiences can function

Please use Fig. 2 in Appendix 1 which illustrates the invoice journey and its relations to PSO.


as images of hierarchies or levels, of what is central and what is peripheral. Also income statements,charts of accounts, budgets and calculations can produce such images every so often. Distance can beexperienced in relation to the big hospital which cannot be seen from PSO: to get there one needs takea car, a tram, or to walk. Distance to another ward that is just next door can also be experiencedthrough the named numbers. The relation to the hospital can nevertheless still be experienced asone of ‘‘belonging together” – through the media of cables that can carry signals identical to binarynumbers to and from PSO, doctors from the main hospital visiting, internal phone calls and internalmail. Belonging together is also experienced through the income statement which makes it visibleto Maria every month that PSO belongs to the hospital. They belong together – connected and heldtogether by money and named numbers.

In the name of the ‘‘economy not in balance”, several new associations that are relevant for the in-voice were created and stabilised. The municipality centralised, redefined, reconstructed, and rear-ranged the organisation that took care of real estate. In 1991 Medic House was created with thepurpose of providing the health care sector in Gothenburg with premises suitable for their operations.The same year, internal rent appeared and premises were no longer a ‘‘free interdivisional service”.Three years later, the buildings of the hospital were put under supervision of Medic House, includinghouse 723:7. Also in 1991, PSO was transformed into a profit centre. It was then that the number761220 and the PSO profit centre became connected to one another as elements in the hospital’s ‘‘Pur-chaser–Provider model”.

In 1993 there was talk of a recession in the Swedish economy, which affected the financial system,and made the real estate market chaotic. A real estate bank for the municipality was created under thename Future Administration Inc., with the purpose of making the use of premises more efficient. Fu-ture Administration is a holding company that encompasses Gothenburg Premises, one division ofwhich is Family Residence, which had owned the PSO house since 1988. So in researching this, twomore places were revealed to me to be connected via a chain of translations that continued outsidethe building of PSO and the network I was already aware of.

Kim, Kalle and Maria began to move differently in the PSO house after 1993. Earlier, women andmen could move around one whole floor each, and personnel moved up and down between two floors.But the movements between two floors turned out to be inefficient, and PSO was reduced to one floor.With this reduction of floors, the women were allocated to a smaller area because they do not come asoften as men. Berit and her colleagues made 16,327 lines representing numbers of visits in 1992 and12,130 lines in 1994. Persons had been translated into ‘‘lines,” which were used to reconfigure thearea.

Money numbers in their income statement also started to change. According to the rental contract,the municipal health department is required to send rent to Family Residence every third month.Every month Martina, who works for Family Residence, calls those who are in charge of administrationof their own property, for instance Barbro at Gothenburg Premises, to inform them of the current sta-tus of their loans based on the rental contract. This translation of a contract will end up as a namednumber on an invoice that will be produced and sent by Gothenburg Premises to Medic House, butwith the name of Family Residence on it. This invoice is a piece of paper, a medium which servesas the evidence that something has happened and become framed. In this case, the event refers tothe reconstruction of a building which made it possible to deliver psoriasis treatments. The moneytransaction takes place between Medic House and Family Residence. Medic House will in turn producean invoice that covers not only PSO but the whole hospital. These numbers on the invoice will also betransferred through another medium – a computer link – and then be pre-coded into the hospital’saccounting department by Medic House. However, on a closer look, the invoice between Family Res-idence and Medic House reveals a smaller number than that sent between Medic House and the Hos-pital (and included in PSO’s report). This is a ‘‘discrepancy”.

3.2.2. The genesis of the invoice

Knowing the route of the invoice it is possible to see when the number is changing and where on itsway between Medic House and Sahlgrenska Hospital/PSO. The next journey took me to Medic


House to ask some questions. However, by the time the journey was carried out, the unit in chargeof the hospital premises has changed. Now it is West Properties Inc., because a huge reorganisationin the health care organisation of West Sweden has taken place. It seems as if the circulation ofaccounting references keeps moving and expanding the number of interconnected places fasterthan I can physically visit them. Also, without knowing for sure how these links will be interpretedor used it gives further material to reflect upon accounting practice such as; who can read andwrite this practice as experts and give the translations a further push.West Properties is located exactly at the same spot as Medic House – two actors in the same areadistinguished only by accounting? I meet Johan who provides me with copies of the invoices for1999. He calculates the difference between invoices – the one received by Medic House and theother sent by them to the Hospital – to be SEK 280,000. How is this possible? Johan tells me thatI do not see the whole picture. This is a zero-sum game: some will pay more and others less, but thetotal payment will cover all the costs for the premises. West Properties calculates a cost per m2

based on invoices for all premises in their custody plus their own operating costs �880 kronor.With the use of a spread sheet, this number is translated into a new one for each set of hospitalpremises via a set of indices to reflect operating cost (ranging from 0.5 to 1.5), type of premises(e.g. childbirth wards, special care wards or garage), and how modern they are. PSO is translatedby West Properties into a special ward or 1.5, except for the basement which is used as storage,and as a 1.1 modern house because of improved facilities. This new number will, according toJohan, include everything like electricity, water, sewage, maintenance and so forth. For PSO thismeans 1200 kronor per m2.

The translations made by people working at West Properties are an example of how PSO now trans-lated and reduced into new numbers and linguistic signs now enters other places and is taken care ofand amplified, in the course of everyday work. It is also an example of how the PSO building was trans-lated further, re-defined and re-constructed in terms of new and different combinations that name andcount. The numbers received from PSO and other places and translated by West Properties producerelations to their own everyday work, to where they came from and to where they will be sent, andas such cannot easily be removed.

When the invoice from Medic House arrives at the hospital, it will be translated by people from thecentral office. The guide for further translations is an accounting classification, a system always inbalance because of its arithmetical construction of debit and credit (Corvellec, 1999). This balancedform will visualise the recorded events – identified as trans-action – by the central office. To clas-sify an event and translation properly, one has to use standardised accounting rules. The first ruleis: it must concern money. On this basis the invoice qualifies. Money is a relation between some-thing and something else unifying them into one which also will be ready for counting. The nameson the invoice need to be checked. The next task is to classify, that is name, the transaction. It is arent; number 5301. Together with 5301, someone in front of the computer will press number761220 – PSO’s identification. This makes the last important transformation possible the one whichwill produce reports to PSO and express psoriasis treatment as part of a profit number. The routeI’ve been following finally points back to the place where I started.

This kind of classification work happens all the time, practically every day, and Maria too makesthis happen. Through different kinds of numerical/linguistic systems, associations can be produced be-tween things in such a way that it seems natural and can be taken for granted. It is as if each numberhad a hook so that numbers can hook on to other numbers quite easily at each node. In small, steadyand aligned steps movements in a house are translated to numbers that are (re)named, and the com-plex and ambiguous ‘‘here and now” becomes plain and simple profit numbers. These associations arestabilised by technology and therefore are easily repeated. Before the accounting rent number reachesMaria, it will travel through wires and chips as 1’s and 0’s, not only in the hospital computers but alsoin other places, until it finally will change form again becoming Arabic numerals on paper.

The Hospital uses numbers for different areas: 760000 is the whole Area 6. Area 6 covers centraladministration, dermatology, plastic surgery and hearing problems. 760010 is the administration.Dermatology where PSO belongs is given number 761010 and PSO ‘‘is” 761220.


But what do 761220, 5301, 280.000 or 723:7 mean? What do they do? They are numbers based ona place–value system, known as ‘‘Arabic numerals” (Crump, 1990; Robson, 1992). Crump says that thevisual representation of numbers and spatial location of the constitutive elements makes them subjectto possible rearrangement, an important quality if there is demand for arithmetical computation.Numbers can be divided into ordinal and cardinal. Ordinal numbers are used as adjectives and haveno function outside where they were created. For example, first, second, third. . . up to twelfth canbe used to count the months, which makes November the eleventh month. In contrast, a cardinal num-ber is used as a substantive, which can stand alone. Ordinal numerals can also be translated into car-dinal Crump says: ‘‘Once the number of a set is divorced from the order of its members, the individualidentity of each number is lost. This is inherent in the transformation from ordinal to cardinal num-bers, which is only significant if it qualifies something.” (Crump, 1990, p. 9).

761220 is an ordinal number, since it does not stand alone but only in relation to other place–des-ignating numbers in this system. Taken with the other designators listed above, this set of numbersand characters organises and reflects the organisation chart of a hospital clinic where psoriasis is trea-ted. When the classification containing names, ordinal numbers and cardinal numbers representingmoney is done, all numbers enter the big computer. All these identification numbers are then inter-twined with the computer and accounting software so that a profit–loss statement can be produced.The software just waits to be filled with numbers, so it can start to produce reports of profits or losses.From now on when I passed the gate to PSO house at the corner of Karl Johan Street and DjurgårdStreet, it was not just a door to PSO, but also the gate to 761220 as a sort of naming number. Whenall the reports are produced and printed out, they will be sent to all units, including PSO. All numberscome from the municipal ACPO.

3.2.3. Journey to the centre of the earth

At the Centre – appropriately named given its role in this network of accounting-mediated inter-connected places – appointment with Krister is organised. He has the card necessary to enter everyclosed door we have to pass, which turns out to be many. At the end of the corridor, there are barsreaching from floor to ceiling. This is where the safety zone starts. People work here 24 h a day.Behind the bars there are stairs going down, which we take. It is not very bright in here but alsocold, and sounds are different because of the big fans. The computers are sensitive to heat, saysKrister. The wall on the other side is made of glass, behind which big metallic boxes are placed.Here everything is computers, hard discs and servers that hold the numbers ‘‘in custody”.

Spatial experiences are built on contrasts and tend to be ambiguous, complex and paradoxical. Thedifference between the place where computers live at the ACPO and PSO is striking. It is a contrastbetween how to produce care in action and how the same care can be put together and visualisedas signs that name and count at the ACPO after having been translated into accounting references.At ACPO one does not need a diagnosis to get in, but a special card as there are many locked doors,some even with bars. Not many people have access to this important place in the chain of translations.It is the place where the numbers are brought together and arranged to become profit and loss state-ments. These statements will be ‘pictures’ of what is going on, and when brought back to places likePSO, they will be translated back into everyday work and movements.

To enter where the computers are, another door made of bars and a room needs to be passed fur-nitured with many big tables and post boxes. To the left before the computer room there is hugeprinter, several meters long. This printer has a capacity of printing 229 pages in one minute. The bigpaper roll attached to it contains 70,000 pages. It is this printer that produces the numbers – notonly for PSO but also for the Hospital as a whole and the City of Gothenburg with its companiesand administrative offices. The tables on the right are where the papers are sorted before theyare transported by cars to make the return trip back for new translations, amplified into everydaywork.Past the printer boxes with invoices with various company names on them are stored. Family Res-idence is one organisation they usually print invoices for, says Krister, but at the moment he can


not find a box with their name on it. We enter the computer room, or as Krister prefer to call it, the‘‘server hotel”. The room is clean and cold. There are not as many cables as I expected, but that isonly because most of them are hidden under the floor. Krister lifts one of the tiles covering thefloor, and reveals all the cables that transport the named numbers as 1’s and 0’s not only betweencomputers here, but also in and out through fibre optics and firewalls. The last thing to see is thecars used for transportation. They stand in a garage close to the place where the printed numbersare sorted into boxes.

3.2.4. And back: towards amplifying named numbers in everyday workThe mail arrives for Maria. She notices that some numbers have changed to her advantage. She is

not charged any longer for cleaning done for another tenant as it was before. My travel helped. But hertrust in the accounting department did not increase. ‘‘Where have those numbers gone? On whose in-come statement will they now emerge?” That I do not know any more than Maria. Maria explains tome how she reads the report: some of the numbers she recognises, some not. When she has doubts,she sometimes calls the accounting department, but often they will not give any answers. Sometimesthey say they will call her back later, but then they do not. To make many phone calls takes energy,and she feels neglected. Her ‘‘feel” for and knowledge about psoriasis is still more familiar and moreimmediate than her ‘‘feel” for and knowledge about accounting. However, in time, if she repeatedlykeeps producing and using these texts, her familiarity with them and their relations with PSO andwhat is going on there will change, and as Tuan discusses how experiences integrated in everydaymovements change, moving from space to place.

Maria also revealed that she tried to change one of the numbers printed on a coming report con-cerning ointment. She contacted the supplier and asked for a price list. She wanted to compare thesame kinds of ointments and their prices. However she did not receive any list and so she asks meto help her. After some research and phone calls, I manage to speak with a man who is a member ofthe Drugs Committee – the location where prices are decided I hadn’t encountered before. He isthen informed what Maria wants, and he offers to send a Drugs Dictionary. This would not helpas they have one already and it does not include prices. They are in the middle of negotiationsand therefore cannot send any list, but he could talk to Maria. When I speak to Maria the next time,she says that he called, but no price list was ever sent to PSO. Also an income statement for Sep-tember and October arrives in December, which is too late to do anything, Maria feels. It is verydifficult to follow up operations and make annual comparisons. And some months later, the newcoding system will arrive, again with no explanation.

As Tuan (2001) points out, when we are alone, thoughts can fly freely, but together with others ourideas will be projected on the same arena and can therefore be disrupted by various arguments. Todisrupt someone’s thoughts can sometimes be good, for instance when it will ease life for people withpsoriasis. Other ideas and procedures can also be firmly imposed and change our way of knowing,such as the relations to named numbers and money that are imposed on Maria and change her wayof knowing health care. This can be seen when she tries to follow the named numbers step by stepmoving in the space/time of accounting, learn how to eventalise her ‘here and now’ movements intoa series of frozen valued moments and to learn how to ‘cut’ them back again or turn the space/timearound into ‘here and now’ again. ‘Imposing’ translations also comes from when the PSO numbersare amplified elsewhere too: PSO becomes part of other people’s everyday work, understanding andmovements, in an interlocking whole. Another idea is that of accountability, which in Swedish is calledresponsibility. Interesting translations ensue.

Maria says she wants a job with responsibility, but in her job more could be wished for. For her,responsibility is a way to develop as a human being and deal with life.

Maria: It is said I am responsible for this and that. But in reality I am not. Suddenly someoneelse just takes it from me when it suits them. This is awful. In reality I have only a part of thisresponsibility, maybe only to check if the numbers are right. But it would be fun to watch thetrends sometimes, to see how we are doing perhaps find some room for something enjoyable.


It is not only I who experienced how difficult is to trace translations or to enter such places as theACPO office. Maria often discovers that some numbers are out of reach for her, as were the cases withthe prices of ointment, or what was included in the rent. Numbers and money are supposed to havemany relations to objects and situations, but they cannot be changed by just anyone; there is an orderfor changing numbers. This order has been established when PSO, first as space, became a place inTuan’s sense, not only for psoriasis treatment but also as a profit centre. Objects in rooms are also rep-resented in the accounting records as money and numbers. Movements that make objects into markshelping to order paths and movements, changing what is unknown into something known, from spaceinto place, teach Maria to understand their monetary value.

4. Accounting practice as a space/time/value machine

The journey in which I traced and stayed in the accounting until I returned back to PSO was long. Itmade me move not only in time, such as seeing back to economic recession and other times, but alsobeyond the house to Medic House, to the Finance Headquarters, the City and National Archives fordocuments and the City of Gothenburg’s Computer Centre. It revealed not only many interconnectednodes and an idea of the ‘size’ of the network, but also a long list of elements that were needed tomake the circulation of references possible. Along the way several questions served as guide (Section2.2): What does accounting organise, what is circulating, how is this done and how can ‘it’, this objectaccounting, speak with one voice – as an actor? Finding answers to these questions was integral to theresearch process and to the theorising of accounting practice as a space/time/value machine. As alsonoted in Section 2.2, categories emerged and developed from these empirical journeys, which was re-vealed along the last section in order to describe and explain the dynamics of this machine.

The answer developed to the question of what is circulating took shape as an explanatory category,call the ‘‘character of the associations”. This is what holds the ‘‘Net Work” together. The category refersto the way that the particular accounting practices observed translated and reduced medical practicesinto signs which had a particular associative character of dividing things and holding them together atthe same time, through the action of what I have called named numbers. The practice of ‘doingaccounting’ observed was precisely one of assembling named numbers in texts and so generatingstreams of ‘named numbers’ which could circulate through successive series of texts. It was this tex-tual assembling of named numbers that constructed a distinctive relation between space, time and va-lue, including durable associations between the named numbers and money. Money here intensifiedthe associative character, since it can eliminate the differences between different things, but also splitthings in ways that would not be possible otherwise. Money combined with accounting’s named num-bers is translated into profit and loss accounts, where objects, people and movements are summed upin a ‘‘lifeless and neutral” profit number. What has been homogenised through the use of money is alsoat the same time differentiated. Money and named numbers are used to differentiate, constructwedges and split things that are not otherwise possible to divide, even as they can work to hold thingstogether at the same time. Still it is important not to reduce the named numbers to a status secondaryto money, for then we would miss the point of how the named numbers continue to circulate evenwhen money is not involved.

This flexible differentiating character of doing valuing creates a dynamic of how the ‘‘Net Work”operates and is able to redefine itself. One form this take is as new accounting based control instru-ments such as the Balanced Score Card as discussed by Andon et al. (2007). By contrast, the case pre-sented here shows how the practice of circulating named numbers is able continually to generate re-namings and re-valuings into new composite accounting numbers, which can then produce new pos-sibilities and new spaces.

But then how does ‘it’ (i.e. the accounting reference) circulate? The answer to this is expressed in asecond category the integration of associations and the delimitation of movement. This tries to describewhat makes it possible to translate and circulate the treatment of psoriasis as accounting named num-bers. This integration and delimitation is achieved by both ‘‘offering” and ‘‘enforcing” the (re) produc-tion of named numbers as a reciprocal relation between the people and non humans involved. The factthat accounting named numbers promise the possibility (or illusion) of a common language, accessible


to everyone, is what enables them to get inside PSO and Maria in the first place, as a new practice inher daily work acquiring familiarity and meaning as it is practised. Inside PSO, it turns out that theSwedish linguistic artefact ‘‘responsibility” has special importance as an intermediary which helpsthe integration of associations to keep moving in a continuous process of reduction/amplification, thusenabling the work of equivalence between action and named numbers to take place. ‘‘Responsibility”is invoked to promote a smoother accounting translating practice as the means to enabling people atwork to be professional at the same time as they are being answerable for what they have beencharged with doing as expressed through different composite accounting named numbers, some pre-scribed in advance and others reviewing performance ex post. Putting people (as actants) ‘‘in place”,where they can be part of translating accounting practices, helps to stabilise the emerging space thataccounting produces as its associations come to work inside and outside the self. Here technologiessuch as maps, computers, post, fax and telephones play an important part in the integration of suchassociations. With their help, accounting named numbers can move across locations and be producedand consumed more easily.

An ordering and its changing started to emerge when these practices were accepted and learned,such as when Maria moved within the accounting space–time translations and then learned to turnthem around again. When translating practices of reduction and amplification became part of everydaymovements as associations working inside the self, and when movements began to be seen as distinctseries of events expressed as named numbers, circulating outside the self and PSO, then PSO’s relationsto other spaces could also be assembled together into a larger space, a macro-actor, the Hospital. Suchproduction and consumption of named numbers is necessary to produce and maintain an order. Whatwas noted during the tracing (and emphasised in the previous section) was the way in which throughthis production and consumption experiences were integrated into everyday life and work.

In this way, it was possible to observe how accounting practice had effects not only in spaces whereit was not taken for granted but where it was familiar, as the translations kept moving both inside andoutside PSO in an extended circulation. Across the space of accounting these references could beshared and become known by others in similar way. With the character of the associations observedhere, the associations could be added to each other and expand the accounting space to a larger orga-nisation which was sometimes far away in a physical sense but close in an accounting sense. Observ-ing the character of the associations and how they could travel light and be ‘picked up’ in differentplaces was a way to get insights into how and what space was produced and how it became known,(amplified, turned around). In short to theorize about ‘spaces’ where elements are defined by and de-fine space simultaneously, it is important to ask what kind of character of the relations is produced,how the links are integrated, what ‘order-ing’ seems to be established when repeated and what kindof knowing subject this requires. What is suggested in the next paragraph is that this practice is notonly one of maintaining boundaries (Llewellyn, 1994) – it is a very active element in producing themtoo.

What does this practice organise? To answer this question, a third category was developed callOrder and its relation to change. As already mentioned the associations are a key issue here, an impor-tant element in how the boundaries of an ‘organisation’ emerge. For accounting has the ability throughcontinuous repetition of the associations to interlock resources and activities into a whole. It cannotdo this, however, without changing every body/thing which engages with it. In Maria’s interplay withthe two circles, the nurse tries to ‘be in accounting’ – and move in the same time and space. Simulta-neously and reciprocally she also learns how to move the space–time around again into her everydaymovements which extends the accounting practice and possibilities for actions at a distance. Beforethis can happen or be possible each person has to go the distance of space–time so to speak.

Still, action at a distance is not that simple, or a one way street. As Czarniawska (2004) noted a cen-tre of calculation is not centre of even a site: it moves around (see e.g. Frandsen & Mouritsen, 2008). Aso-called centre does not necessarily means that a nurse is controlled from a distance. First distance asit is often expressed is problematic: it does not have to be distance in a physical sense but can be nextdoor or a distance in time in the same place. Second, the centre does not have to be a single centre or asite where the principles of naming and counting get inside people in new ways. Taking into accountthat this ‘‘Net Work” is made up of named numbers circulating then this change should not come as asurprise. This Actor is capable of reshaping itself. Accounting working inside humans is a way to inten-


sify the time/space/value machine with the centres of calculations moving around. It is the acceptanceand use of these links that matters, as is well expressed in Kirk and Mouritsen (1996). What is impor-tant too is that the associations emphasize the establishment of a space as ‘‘place” before objectivetime is employed as an explicit motivating device to encourage further speeding up in the circulationof the flexible named numbers.

A dynamic is produced where moving from space to place implicates accounting practice as part ofeveryday experience. When accepted and translated, the circulating references establish their ownspace working inside people who now engage with accounting translations. The machine begins toeliminate other ways of seeing and knowing, other ways of producing space/time, because of howit also defines what is not valued. So it is not about a new knowledge parallel to other ways of know-ing, it infiltrates and changes what is already known. To change an order, named numbers must beenrolled on the side of the change, but change itself has to follow the order of the hierarchy it ex-presses. The production of ‘equivalence’ and ‘differences’ characteristic of the associations betweennamed numbers and events means that a new value can always be produced and that an order witha different space can be produced. But not everyone or everything can change. When named numbersget better known and become a place in Tuan’s (2001) sense, this place is only as flexible as the namednumbers in the temporal ‘stable order’ at hand. Named numbers therefore delimit people’s move-ments between spaces and places by putting boundaries on what is seen as possible.

Finally, putting this together and asking the overall question that holds the other questions to-gether – how does accounting speak with one voice? It is when it can operate as a time/space/valuemachine as part of the work ‘‘place” i.e. when the valuing (flexible named numbers) can circulatethrough everyday life/work as taken for granted fact. At this point accounting practice, as text-objectat work both inside and outside actants (non humans and humans), shapes what and how things canbe seen and known.

But what about other experiences and places? This is my final category, which I have called the pro-duction of other spaces. It is important to articulate such a final category, in order to acknowledge thataccounting space/place (and time and value) was not the only space/place (or time and value) pro-duced at PSO. There remain many ways to produce space and time and value, and some of these couldbe seen as I followed the object. Because of the specificity of the treatment delivered at PSO, whichwas here based on a face-to-face interaction between the staff and people in need, trust had to beestablished as a key value shared between them. As there is no cure for psoriasis, these interactionscan become life-long relationships, and therefore they produce a sense of emotional ‘‘place” persistingacross time. Such relationships have diffuse boundaries, and they are established differently thanthose which form accounting in practice. This category is therefore a way to take into account theother, distinct from the translating practices of accounting, which even if seemingly an absent otherstill persists when accounting’s translations become integrated and when accounting becomes takenfor granted.

5. Conclusion

Accounting as this machine generates specific references which name and count features of a spe-cific space (here PSO) at specified times and so render that space stable and known, as those featuresget defined as significant through being named and counted. These references then become a taken forgranted part of everyday work, as they circulate inside and outside that particular space, moving thenamed numbers as simply and speedily as possible across networks of circulation via a whole range oftechnologies.12 Every move of the named numbers to a new location in a particular network then creates

12 An important strand of accounting research work is in the medical sector not at least in the light of New Public Management(Chua, 1995; Llewellyn, 1998; Llewellyn & Northcott, 2005; Samuel, Dirsmith, & McElroy, 2005). It is still not about accounting in aspecific setting even if the particular setting of Health Care is of huge interest in it self to show some of its effects as seen in Berg(1997), Pinch, Mulkay, and Ashmore (1989),1992), Pinch (1993). It is to focus on what and how accounting organises. But thehealth care sector is interesting because of how accounting-driven innovations are commonplace today in the health care sector(Diagnosis Related Groups (DRG) being one example) moving in scope and scale where it has not been before (such as the PSOclinic) and therefore offer further insights into accounting.


links or associations which keep the character of the particular named numbers stable and constant ateach particular moment in space and time while also allowing flexibility in their use and interpretationas they enter new spaces and times along the way. Thus the named numbers continue to correspond, inkey respects, to those defined in that first space but may take different specific forms to serve differentpurposes in other locations at other moments.

Understanding and accepting (and so using and producing) this framework of links and circulationsis to be ‘inside’ accounting. The argument here is that the everyday work of medical sites, exemplifiedhere in PSO, increasingly becomes ‘inside’ accounting in this way, as its references circulate throughand within such sites repetitively, and as there is a machine-like requirement, now established in-side/outside each humans and non humans, when the references arrive, and then to send it againon its circulating way in conformity with set deadlines. In this way an accounting space/time to whichvalue is intrinsically related itself becomes stabilised.

This study has attempted, by following and subsequently portraying the chain of translations con-stituting accounting practice, to open the black box of accounting named numbers. The ‘picture’ re-vealed here hopefully shows how this practice infiltrates everyday working life in subtle ways,forming the nexus where space, time and value (including monetary value) are first linked and thenheld together. Starting from accounting practice in this way, arguably then permits further connec-tions to be made to other significant associations, ranging from organisational associations to bodilymovements and ways of thinking. Accounting presents itself as a way of approaching the world in anapparently neutral manner, yet it shapes that which can be thought, said and done, delimiting or re-limiting experiences and functioning as a knowledge device.

Arguably the most important insight from following theses references is the notion of howaccounting practice, in practice, operates as a form of actor which can be designated as a space/time/value machine. It operates as a machine in the way in which it constitutes valuing through flex-ible named numbers that circulate, moving inside/outside humans and non humans in everyday worklife, and thus offers, describes and prescribes a particular spacing and timing through which value canbe conveyed. As my journey showed, the machine is not just having these effects within PSO butacross all the sites visited, right up to the Finance Office which was trying to handle anomalies gen-erated from the circulation of the named numbers.

But additionally the space/time/value relation created by accounting proves to be a powerful basefor the construction of personal and professional identities. In this respect accounting is not simply adisciplinary force in the sense of constraining or repressing identity; it positively enables certain expe-riences, perceptions and identities to emerge while it excludes others. It gives people identities andthus exerts a doubly disciplinary force in which certain experiences, through getting translated intothe disciplinary expert knowledge that is accounting, emerge as a disciplined and disciplining wayof living in the world. Accounting is thus subtly shaping the world.

Furthermore, something has arguably been added to the existing ANT-based accounting researchand to research focussing on space/time relations related literature, in that I have demonstrated thestrength of the argument that this translating referencing practice provides a form of knowledgeand has a greater potential for ‘power than or action at an instance than many others’ (Ezzamelet al., 2004; Quattrone & Hopper, 2005; Robson, 1992, etc). Here I have sought to acknowledge theimportant role played by particular forms of textual layout in shaping the way that the named num-bers circulate, following the argument of Hoskin and Macve (1986) and Quattrone (2009). Hopefullythis way of framing the research activity undertaken here of ‘‘following the references” helps to pro-mote a recognition that studying ‘‘accounting practice” can not just be a study of acts or inscriptionsbut also of interactions with specific textual forms.

Finally, this paper hopefully underlines how accounting is not just a secondary practice (or ‘‘just atechnology”) which simply reflects on what is going on. Accounting is a central practice that promotesspecific actions in space and time, and excludes others. As a means of expressing and keeping track ofnamed numbers, and money, accounting helps keep right and proper associations between accuracy,economy, efficiency and effectiveness. Accounting as an Actor therefore cannot just be approached bytracing how it acts when already embedded in a given entity, but must instead be approached also interms of how it may shape, re-shape, coordinate and interlock resources and activities into a newwhole. Arguably this kind of approach can then lead to tracing still further ‘nodes’ where this actor


acts, where entities/organisations can be seen just as ‘points’ where certain sets of valuing practicesare undertaken, and so as actants in a much ‘wider’ value net work.

I would just make one final observation about accounting as space/time/value machine as pre-sented here. I hope it is clear that, even though this study has traced its actions in a particular present,the machine as such is not just an invention of the present. Viewing accounting with a historical ordiachronic focus such as that used by Ezzamel and Hoskin (2002) shows accounting as generating sim-ilar associations between space and time and valuing from before the invention of writing, or ofmoney. In that respect, what is observed here is arguably a version of the machine that is just moreextensive and more powerful than ever before in human experience. But its power and scope areundeniable, as can be seen here from the way in which certain experiences get established for andinternalised by a wide range of people through the associations the machine constructs and producesbetween named numbers, operating across external and internal space and time. At the same time, itspower is not omnipotent, nor its scope universal. For it remains the case that accounting in practice isoften, as is also shown here, an ambiguous and fragile practice that is never wholly under control.

Acknowledgements

This article could not been researched and written without the help of colleagues and the people Imet during my field work. I especially wish to thank Barbara Czarniawska, Keith Hoskin, Jan Mouritsenand Thomas Polesie who always providing me with challenging questions and discussions aboutaccounting, space/time and ANT/STS approaches. I would also like to thank the two anonymous refer-ees and the journal editor for their helpful and constructive comments. The usual disclaimers apply.

Appendix 1

The concept ‘translation’ enables understanding of how things become other things, in this instancehow psoriasis treatment becomes accounting numbers. Translation is predicated on the idea thatevery movement contains or entails change, a form of transformation which can involve both linguis-tic and physical objects. At the same time in every translation something is lost while something isalso kept constant. More specifically translations can take different paths, and produce differentmeanings in different situations. However, things are kept constant either by recognising what is al-ready known, or/and by technological interventions designed to help maintain stability of meanings.

Family Residence Gothenburg Premises Medic House

PSO SU Accounting department

An invoice is sent to Medic Housebased on reported numbers from Family Residence

Martina calls Barbroat Gothenburg Premises about the latest numbers concerning mortgage and interest for PSO house

Rent numbers including PSO are sent via computer cables to the SU AccountingDepartment.

The owner of PSO house is Family Residenceaccording to the documents

Medic Housepay Family Residence

Gunillasorts PSO rent out and connects it to 761220, which signifies PSO

Invoices from all premises in the Medic House portfolio are placed in a spread sheet and recalculated with different indices

Fig. 2. An invoices’ journey.


Association then comes in since translation creates associations between things, people, and ideas.Such associations acquire a stable character when they are reproduced, and again technologies help tostabilise them by facilitating their reproduction. At the same time, stability of associations can neverbe taken for granted, not least since repetition can also induce change and questioning. The very at-tempt at stabilisation gives rise to other translations and transformations, sometimes far from the ori-ginal point of departure. So associations may be ‘leaking’, even where they appear most stable.However, one particular way in which the stability of associations is maintained is through makingthem so regular that they become taken for granted and so insulated from destabilisation.

Black box then comes into play as the metaphor used in STS work to describe those associations thatare taken for granted and sealed. Where associations are ‘black boxed’, then under normal conditionspeople take them for granted, accepting the norms that keep the associations closed and unexplored.At the same time, once again black boxes do not necessarily remain sealed for ever. They can be reo-pened through questioning, for instance in a crisis situation. In everyday organising, however, theassociations ‘‘hidden” in black boxes become a ‘‘natural” way of defining things, and so of understand-ing the world.13

Finally accounting in and as practice can be seen in terms of the fourth STS category, from a ‘per-formative perspective’, that is, as an active mode where certain associations are picked up, used andcirculated further, rather than as an object-like structure that is seen as already being there, unques-tionable and predefined.

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