It has been argued that the new technologies of medicine privilege the image over the actual body and its experience, so that the patients themselves may 'vanish' behind the images. A case study is used to explore this from the patient's point of view. What evidence is there that alienation or other dysfunctional effects can actually happen? In this example of the high-tech medicine of lung cancer treatment, it was demonstrable that the process of diagnosis was not only dependent on, but also in some ways distorted by, the reliance on technologies. It was not necessarily true, however, that the machines and the images themselves proved alienating to the patient, or produced a feeling of disembodiment. It was the system in which they were used, their translation into records and decisions, which was deeply alienating, with only lip-service paid to the principles of patient-centredness or the inclusion of the patient as a partner in decision making. Features of the contemporary British health service which seem to foster this are discussed.