Medicine Anthropology Theory
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An uncritical encounter between anthropology and psychiatry: AIIMS psychiatrists reading \u27Affliction\u27
No full textIn what ways do two bodies of knowledge meet? Anthropology and psychiatry most often meet in a mood of mutual suspicion, the danger of which is that each confronts (or avoids) the other as a straw man. In this introduction I describe a refreshingly different encounter in which a group of psychiatrists from the All India Institute of Medical Sciences in Delhi respond to an anthropological text, Veena Das’s \u27Affliction: Health, Disease, Poverty\u27, which engages with lives and issues quite similar to those encountered by these psychiatrists in their clinical practice. Rather than rehearsing relatively predictable debates (for instance on the importance, or lack thereof, of ‘culture’, often assumed to be the sole meeting ground between anthropology and psychiatry), what is instead surprising in the psychiatrists’ engagement with Affliction is their recognition of a shared terrain of uncertainty and complexity that moves across the realms of the spiritual, the ‘vernacular’ uses of biomedical terms, and the political economy of health. I outline three domains of inquiry that this interdisciplinary discussion opens up as regards the study of mental health and illness: 1) ecologies, circuits, and tempos rather than institutions and subjectivity; 2) not-yet ontologies and etiologies; and 3) methodological consequences, beyond quantitative/qualitative divides and towards patterns, singularities, and modes of attunement
Companionable thinking
No full textThe paper takes up three themes that emerge from the commentaries on the book, \u27Affliction: Health, Disease, Poverty\u27: (a) the relevance of neighborhood as the right scale at which to render the relation between health, disease, and poverty; b) the ordinary as an interrogation of the normal; and c) the relation between subjectivation and subjectivity. Knitting together the qualitative and the quantitative as well as advocacy and research, this essay comments on Georges Canguilhem’s notions of the normal and the pathological, and of disease as an experiment with life. It also provides a commentary on the default position often assumed in the literature on subjectivity that treats it as the residue, as that which subjectivation cannot encompass. These different themes are joined within an overarching question: how do we learn to see ethnographically what is before our eyes
Promises and perils of Guan: Mental healthcare and the rise of biopolitical paternalism in contemporary China
Get PDFThis article examines families’ involvement in the care and management of people with serious mental illnesses in China, and focuses on how that involvement is shaped by changing psychiatric institutions and law. Drawing on 32 months of fieldwork, I show that familial involvement is primarily characterised by guan [管], which can mean ‘care’ and/or ‘control’, and which commonly invokes a particular cultural ideal of parenting. Tracing how the language and practice of guan circulate between different realms, I argue that a ‘biopolitical paternalism’ has emerged in contemporary China. It reduces patients to carriers and manifestations of biomedical/security risk and legitimises the state’s policy of population management as a form of paternalistic intervention, while displacing certain paternalistic responsibilities, such as hospitalisation and ensuring medication compliance, onto patients’ families. This biopolitical paternalism produces vulnerabilities and unease within families and aggravates health disparities between patients. The analytic of biopolitical paternalism has conceptual efficacy and practical implications beyond mental health
Cubical ethnography: Another kind of fieldwork
Get PDFStudying the contemporary clinic necessitates rethinking what it means to both enter and access ‘the field’. In these Field Notes, I reflect on the beginnings of fieldwork and the processes of crafting research protocols which can stand up to formal ethics reviews. Rather than treating the process as a barrier to ‘real’ ethnographic research, I suggest that the mundane institutional realities of inserting oneself into a bureaucratic atmosphere form a particular—but no less valid—kind of ethnographic experience. I call this experience ‘cubicle ethnography’, after how the structures of the office—keys, badges, desktop computers—reflected negotiations of access and my own legitimacy as a visiting ethnographer.  
Collaborative intimacies: How research pigs in Danish organ transplantation facilitate medical training, moral reflection, and social networking
Get PDFPigs and pig organs are frequently used prior to human trials in experimental transplant research into how to optimise human transplantation. But what exactly happens when transplant professionals perform experimental research on pigs? Similarly, what happens when a pig is on the surgical table? Based on ethnographic fieldwork in Danish transplant research laboratories, we investigate how pig experiments facilitate ‘collaborative intimacies’ among medical professionals. Collaborative intimacies are used here as an empirical and theoretical framework for conceptualising and re-imagining the social relationships between species and the medical disciplines that emerge in laboratory work. Collaborative intimacies in the lab provide medical training and facilitate moral reflection and social networking among transplant professionals. As such, we argue that research utilising animal models is not only about technological progress and ethical dilemmas; rather, collaborative intimacies make us understand how intimate relations among medical professionals in translational research unfold and how such relations matter for professional and technological futures
‘Silent mentors’: Donation, education, and bodies in Taiwan
No full textUnlike cadaver donation in the West, which has to a large degree maintained the anonymity of the body used to teach medical students, the Taiwanese Tzu Chi Buddhist Silent Mentor programme at the centre of this article foregrounds the identity of the tra
Crafting an Amish biomedical landscape
No full textWithin their pluralistic system of health care, the Amish make medical decisions influenced by cultural practice: a call for adherents to separate themselves from the outside world and to yield to the group. Using ethnographic research, this article discusses one aspect of the relationship between Amish communities near Lancaster, Pennsylvania, and a pediatric genetics clinic that has reformed the ways it mobilizes biomedicine in order to engage this community. Despite local Amish reticence to participate in biomedical systems, three elements discussed here are among those that help shape successful relationships between Amish families and the clinic: a carefully crafted physical space, a conceptualization of genetic medicine as skilled work, and a consideration for culturally appropriate use of time. Amish spaces of practice open to incorporate the clinic as biomedical spaces labor to incorporate Amish practice. The result is an emergent therapeutic landscape developing as a response to group social practice