Medicine Anthropology Theory
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Haunting Biology : Book Forum
No full textEmma Kowal’s Haunting Biology: Science and Indigeneity (2023) investigates the history of biological and medical research about Indigenous peoples in Australia. This book forum invited contributors to provide nuanced insights that engage the book’s central contributions to debates in medical anthropology about decoloniality and racial science. Bringing together medical historians, anthropologists, and scholars of science and technology Trevor Engel, Beth Greenhough, Frederic Keck, and Ros Williams, the forum’s contributors highlight the profound utility of Kowal’s insights and the necessity of attending to the spectral presence of the colonial-era ghosts that haunt the ground on which contemporary biological science, including genetics and epigenetics, is practised. The forum contributors draw out the multivalent affects that ghosts provoke, brought to presence through Kowal’s ethnographic observations and rich archival research. They engage ghostly characters like British scientist Baldwin Spencer, who sits out of sight but not out of mind in a museum storeroom, and surgeon and Australian anatomist Sir William Colin Mackenzie, who haunts the dreams of Goenpul Indigenous filmmaker Romaine Moreton. Each contributor shows the productive tension gained by following Kowal’s directive to listen to these and other ghosts around us, and gesture towards the possibilities of decolonial scientific practices.
The Role of Affective Labour in Expertise: Bringing Emotions Back into Expert Practices
No full textIn recent years, a lot of scholarly attention has been devoted to how practices of digitalisation and datafication require medical professionals to work together with different stakeholders, and to how such collaborations shape expertise (Stevens, Wehrens, and de Bont 2020; Carboni et al. 2024). STS scholars have generally approached expertise as an epistemic and social endeavor, but they have tended to neglect the role affects and emotions play in its development and performance. In this paper, we provide a theoretical reflection on the relation between affective labour and expertise building upon Egher’s (2023) conceptualisation of expertise as a practical achievement realised through coordination and affective labour. Based on ethnographic fieldwork conducted in various medical settings, including digital pathology, psychiatry, and datafication in intensive care, we explore what types of affective labour are conducted in digital healthcare, by whom, and with what consequences. We show how affective labour mediates both epistemic and relational practices. We argue that different affects and emotions are mobilised in these practices, which impacts the development and effective performance of expertise.
Reckless Local and Ill-Fated Stranger: Reimagining Vietnamese National Sentiment during COVID-19
No full textSince the beginning of the COVID-19 pandemic in Vietnam, the media has meticulously covered disease prevention and reported on infection cases. This article will explore the current and shifting gender relations of Vietnam’s state and societal expectations by comparing Patient 17, a female Vietnamese citizen, and Patient 91, a British male pilot. While Patient 91 has received sympathy and international acclaim, Patient 17 has been heavily criticised and shunned from Vietnamese society. Through these case studies, I seek to understand how individual patient cases reflect the nuances of nationalism in Vietnam and how online citizens interpret the quintessential traits of Vietnamese character. Drawing on media analyses from an online news outlet, I delve into themes of media representation, gender, class, and race. By exploring how media coverage and online commentators shape perceptions of these patients, I aim to shed light on how patient stories can transcend individual experiences and become emblematic of broader societal ideals
Recast(e)ing Medicine in India: Contested Hierarchies of Expertise in Digital Primary Care
No full textIn this article, I examine a public-private partnership project in West Bengal, India, that trains and deploys people from marginalised castes as digital health workers in rural areas. Although digital technologies offer new opportunities for access to the medical sector, caste hierarchies inherent to the field persist, reinforcing and perpetuating caste-based inequities. This is evident in the division of labour, shaped by caste dynamics and justified through the distinction between professional knowledge and technical skill. The widely-used metaphors of the doctor—and by extension the software—as the mind, and the health workers as foot soldiers, rely on and further entrench long-standing hierarchies of expertise where privileged castes do knowledge work while marginalised castes literally do the footwork. Nevertheless, health workers actively challenge these hierarchies and foreground their creative contributions. While caste lives on in projects of ‘empowerment’, particularly through the limited and limiting imaginations of health workers’ structural position, health workers find ways to visibilise and value their labour and expertise. I argue that their assertions and aspirations may open up new possibilities for thinking about ‘empowerment’. Overall, recast(e)ing medicine implies that caste in the health sector is being simultaneously perpetuated and reimagined in ambivalent and partly contradictory ways
Mending Little Hearts ‘For Life’? Promises of a Cure and Experiences of Chronicity in a Context of Unequal Access to Paediatric Heart Surgery
No full textCongenital heart defects (CHDs) are the most common type of major birth defects worldwide. Yet globally, access to high quality treatment is very limited and uneven with most patients living in places without adequate diagnostic or treatment. Based on ethnographic engagement with Beninese and Togolese children undergoing surgical treatment in Switzerland through a humanitarian medicine programme, this paper explores the multiple temporalities and experiences of chronicity at play in the lived experiences of families with children with CHDs in a context of profound health inequalities. These temporal experiences encompass the various promises of a cure made to them, ensuring continued investment in their child’s health, experiencing a sense of rebirth, and navigating the potential risks of future complications. The article highlights how families facing CHDs in underserved regions encounter distinct forms of chronicity compared to those in more privileged areas. It identifies four kinds of chronicity in the families’ lived experiences: symptom-related, procedural, follow-up, and emotions-related
Fixing Unfixable Bodies: Expectations and Metaphors of the Body Among Patients and Surgeons in Elective Orthopaedic Surgery in Denmark
No full textIn this article we examine how patients of elective orthopaedic surgery might transform the understanding of their body’s fixability over time. The article builds on an ethnographic fieldwork at an elective orthopaedic unit in Denmark and follow-up interviews with two patients eighteen months after their surgery. Through the affective theoretical framework of Lauren Berlant’s Cruel Optimism, we discuss how the patients experience the part-loss of functionality. We trace the transformations in their expectations of their body through their use of metaphors. Drawing on Alan Bleakley’s division of the metaphors of the body into ‘body-as-machine’ and ‘body-as-ecology’, we argue that patients end up describing their bodies through both these metaphors, and come to understand their bodies as not being fixable, but as being in ongoing process.
Making Visible the Expertise of Data Workers in AI-Driven Healthcare: A Call to Action
No full textData constitute a crucial resource in healthcare systems increasingly reliant on digital technologies powered by artificial intelligence (AI). However, before these technologies can be used, they need to be ‘trained’ on large datasets assembled by individuals often working from home utilising their expertise to ensure that technologies work as they are designed to. Amidst recent enthusiasm for the adoption of AI in healthcare, little attention has been paid to the expertise and plight of these data workers. As I argue in this position piece, researchers have an important role to play in analysing and bringing to public attention the expertise possessed by those who curate content needed to power AI in healthcare and the affective demands and potential harms they face in undertaking this work. I discuss recent efforts to address the working conditions of data workers in general and suggest that the International Labour Organization could help develop standards, policies and programs to protect these individuals. As I conclude, making visible the expertise of data workers in healthcare will assist to both improve their lives and increase public awareness of the fact that AI would not exist without their contributions
Doing Health in the Clinical Research Centre: Care Work in Choreographies of Data Production
No full textHealth examinations are an essential part of cohort studies: questionnaires are filled in, biological samples drawn, bodies weighed and measured, their capacities and functions tested. Drawing on an ethnography of these clinical encounters, in the context of a population-based environmental health cohort in Switzerland, I describe the choreography of data production and how it blurs the boundary between healthcare and scientific research. In contrast to the notion of clinical labour, which describes logics of objectification and extraction, this Field Note paints a more nuanced and sensitive picture, in which care work performed by nurses, the active role played by participants, and the materialities around them, come together and move apart. These fragile choreographies point to the importance of care work as a form of expertise necessary for data production.
The Loss of a Cyclical Self: Exploring Perspectives on Menstruation and Menopause
No full textThis article explores the profound impact of menstruation and menopause on people’s sense of self, as shaped by the lenses of medical experts and advocates of the cyclical living movement. Drawing from personal experience of premature menopause, it reflects on the narratives surrounding reproductive health and the cultural significance attached to these bodily transitions. The article moves beyond a discussion of the complex emotions associated with the loss of reproductive potential and highlights a less often discussed topic in this age of fem-tech: the perceived missed opportunity for self-exploration through the menstrual cycle, for people who do not menstruate (any longer)