Medicine Anthropology Theory
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Crowds and COVID-19: An Introduction
No full textIntroduction to the Special Section \u27Crowds and COVID-19\u27, guest edited by Vaibhav Saria and Pooja Satyogi
Seeing Green: Plants, Pests, Pathogens, People and Pharmaceuticalisation in Thai Mandarin Orchards
No full textMedical professionals’ and policymakers’ fear of antimicrobial resistance (AMR) has largely been directed toward antibiotic use in medicine and animal agriculture. In Thailand, however, the use of antibiotics in citrus orchards has raised some concern over their ‘appropriateness’ and there have been calls for reduction—if not complete cessation—of their usage. We explore the emergence of antibiotic use for citrus greening disease (CGD) as part of shifting assemblages of plants, pests, pathogens, and people, as well as of varying climates, technologies, and farming practices. We suggest that rather than being a threat coming from outside orchards, CGD pathogenicity repeatedly emerges from within, and in Thailand appears to have increased alongside, the intensification of agricultural practices. We document how, when antibiotics emerged in the mid-20th century, their ‘pharmaceutical efficacy’ was insufficient to trigger their widespread adoption. Rather, the pharmaceuticalisation of orchards continues to be entangled with the expansion and intensification of mandarin agriculture, and also with the affordability of antibiotics, dissemination of relevant knowledge, and availability of equipment for their injection. Current proposals to reduce antibiotic use risk not taking sufficiently seriously the importance of their role in sustaining intensive orchard practices—and profits
Eyes in Sight: Embodiment, Affect, and Learning to See in Ophthalmology
No full textVision is central to the apprenticeship of ophthalmology residency training. As clinicians who diagnose and treat diseases of the eye, ophthalmologists build their professional identities around the mission of safeguarding their patients’ sight. At the same time, ophthalmologists rely on their own vision as they peer into the eye to detect subtle signs of disease. Based on an extended ethnography of an ophthalmology residency programme, as well as autoethnographic analysis of ophthalmology training, this article explores how novice trainees learn to view the eye by considering two fundamental examination techniques. The first is slit lamp biomicroscopy, where a table-mounted microscope is used to view ocular structures in fine detail. The second is binocular indirect ophthalmoscopy, where examiners view the retina using a head-mounted instrument in conjunction with handheld lenses. Rather than framing visual interpretation as a cognitive exercise in identifying pathology, I instead consider these techniques as embodied practices where trainees must discipline their movement, attention, and use of instrumentation to make the eye visible. This process of embodiment, in turn, unfolds within a broader terrain of affects as trainees marvel at what they behold, yearn to see more, and fear the limitations of their own vision while they learn to perform challenging examination manoeuvres. Situating the ophthalmic examination in its embodied and affective contexts illustrates the sensibilities that ophthalmology residents come to inhabit during their apprenticeship and which undergird the visual expertise of ophthalmologists
Sticking with the Fat: Excess and Insignificance of Fat Tissue in Cadaver Dissection
No full textFat, in the context of dissection, is a nuisance, an obstruction to anatomical order and orientation. Yet it makes up a large part of the human body, and in the practice of dissection becomes one of the most prominent materials in the room, as it sticks to gloves and spreads through the dissection hall, making chairs greasy and instruments slippery. In this article I explore the role and significance of fat tissue in anatomical dissection for medical students. In anatomy, fat remains largely an excess material; something superfluous, insignificant, left-over when the body is turned into an anatomical body consisting of muscles, nerves, blood vessels, and bones, cleaned and displayable. But fat is also something which appears in experience as excessive, omnipresent, proliferating, and resistant to attempts to keep it in order. Much anthropological work within dissection practices has described the process of ‘cleaning’ the bodies, but often—mirroring medicine—these accounts follow the becoming of the anatomical body and leave the fat behind. In this article, I try to ‘stick with’ the fat and suggest that fat tissue, as an embodiment or material manifestation of the more-than-anatomical-body, may tell us something about bodies, subjectivity, scientific order, and dissection
Behind the Scenes at MAT: Labour at an open access journal
No full textEditorial to the September issue of 2022
In the Shadows of COVID-19: From January 2020 to October 2021
No full textIn this Field Note piece, I use my clinical and research experiences in the UK and Uganda during the COVID-19 pandemic to explore the contrasting ways it unravelled in each setting during the period between January 2020 and October 2021. In the UK, working as a clinician while also studying at a leading public health institution, my life became monopolised by COVID-19, particularly in relation to concerns around direct transmission of the virus and the illness it causes. Whilst conducting fieldwork and working in a health centre in Uganda, however, I was reminded to pay greater attention to the effects of COVID-19 restrictions and the burden of other causes of ill health. Bringing together these experiences, this piece explores how priorities and preparedness for fieldwork developed in one setting do not necessarily translate to another location, thereby underlining the challenges of planning adequately for fieldwork
Ethics in Practice and Ethnography: Faux pas During Fieldwork with Structurally Vulnerable Groups
No full textEthical issues are an essential part of research and need to be considered throughout the process and in its aftermath, especially when including vulnerable groups. This Field Notes revisits some ethical tensions that emerged during fieldwork with a ‘vulnerable population’—a group of waste-pickers and their families—and links these to specific avenues for further thinking within ethical frameworks. I reflect on mistakes, omissions, and blunders committed over 5 years working with this social group affected by many different forms of injustices, part of my 25 years of wider research into social inequalities and health disparities within marginalised communities. I remark upon three emerging ethical tensions relating to: the exclusion of certain narratives; the layers of vulnerabilities and danger of harm; and the risk of stereotyping vulnerable groups. I conclude that, more than just considering ethical issues within the context of our own work as researchers on moral solipsism, decisions in applied ethics must be integrated into broader models that offer a connected rationale for the infinite situations that can emerge from research. Alternative ethical models—such as anti-racist, feminist, communitarian, and transformative approaches—provide chances for collective decision making and promote social justice, equity, and democracy. 
Giving Care a Platform: The Use of Instagram by Mothers of Children with Chronic Illness
No full textIn this article, we explore the ways that the social media platform Instagram shapes the intersubjective experience of caring for children with chronic illnesses. Based on long-term immersive social media research and in-depth interviews with women maintaining popular Instagram accounts dedicated to caring for children with chronic illnesses, we approach Instagram as a ‘moral laboratory’ (Mattingly 2010) in which caregivers negotiate the meaning of their present experiences and experiment with potential futures for themselves, their children, and their relationships together. Through a consideration of the role played by Instagram in mediating the forms of affective labour these mothers engaged in, we consider how the very features that make Instagram a resource—its ability to foster a sense of social connectedness, validate their invisible labour, and provide practical knowledge—both create new and intensify longstanding forms of pressure and anxiety in their lives. We regard these Instagram feeds as complex social settings that are playing an increasingly important role in the trajectory of lives of people with chronic illness and their caregivers
The Essential Crowd: Service Workers and Social Death in Pandemic Times
No full textDuring the spring of 2020, public messaging in the United States regarding COVID-19 conveyed the idea that pandemics and viral infections strike people from ‘all walks of life’ and that ‘diseases know no borders’. Corporations and media outlets disseminated the message that ‘we are all in this together’. While there might be some truth in these messages, they have also been challenged as existing social inequalities have been exposed by the impacts of COVID-19. The slogan ‘we are all in this together’—which apportions risk equally—is undermined when we consider the ‘social apparatus’ that informs people’s everyday lives. While people from some walks of life have been afforded the opportunity to telework, for instance, others have been required to report physically to workplaces. Given the tag ‘essential workers’, these people often work in places that carry greater risk of infection, partly because these spaces are some of the few remaining in which crowds continue to gather during the global pandemic. We use Lisa Marie Cacho’s (2012) formulation of the concept of ‘social death’ to offer a working theoretical model of essential workers during the COVID-19 pandemic. We engage with Cacho’s model of ‘social death’ to highlight the blurred lines, in times of crisis, between those rendered valuable and valueless (or disposable)
Shelter Vision: Compassion, Fear, and Learning to (Not) See Trauma along the Migrant Trail through Mexico
No full textWithin a context of shifting affective economies of racialised fear and reluctant humanitarianism that surround Central American migration through Mexico, this article draws on ethnographic fieldwork as a volunteer at a humanitarian migrant shelter in Central Mexico to describe how aid workers negotiated concerns expressed by visiting volunteers about compassion fatigue and vicarious traumatisation. Building on the work of scholars who examine intersubjective and relational dynamics of looking and being looked at beyond a lens of either surveillance or performance, I describe how shelter workers learned to (not) see trauma by negotiating the affective expectations of visitors. I argue that what visitors took to be indifference and insensitivity reflects what I refer to as ‘shelter vision’, a tacit and embodied form of competent looking developed through apprenticeship and enskilment. Such vision refuses racialised discourses that position undocumented migrants as either passive victims deserving of compassion or as a toxic threat to the body politic, both in the United States and Mexico