Medical Anthropology Quarterly (MAQ)
International Journal for the Analysis of Health
Vol. 22, No. 3: September 2008
articles
Coded Talk, Scripted Omissions: The Micropolitics of AIDS Talk in South Africa
Kate Wood, Helen Lambert
- In this ethnographic article, we explore the character of local discourse about AIDS in an affected township community in South Africa, describing the “indirection” that characterized communication about suspected cases of AIDS. Through a case study of one affected family, the article first explores the diverse ways in which people came to “know” that specific cases of illness were AIDS related, and how this “knowledge” was communicated. We consider why communication was indirect and coded, arguing that this reflected not a “denial” of its presence in this community but, rather, a complex group of overlapping concerns far from unique to AIDS: first, a normative injunction on naming potentially fatal conditions; second, an interest in pursuing different therapeutic options and the need to maintain hope of recovery; and third, a wish to avoid the “disrespect” entailed in referring directly to the nature of the problem in a context where, discursively, stigma was still present. The coded and indirect character of HIV/AIDS-related talk underlines the importance of ethnographic inquiry in understanding community responses to this epidemic, demonstrating that the subtleties entailed by verbal silence and elision should not be interpreted naively as collective “denial” but rather be grounded within existing patterns of responses to dangerous sickness.
Making Scenes: Imaginative Practices of a Child with Autism in a Therapy Session
Melissa Park
- A tension in medical anthropology, as an interdisciplinary field, exists between those polar territories of the logic—and therefore grammars—of a positivist–scientific stance of biomedicine and a literary–philosophical one used to represent experience. Taking up literary-philosophical and existential perspectives from anthropology proper, I draw on an ethnographic study of a sensory-integration–based clinic to propose that imaginative practices are one arena where such tension can be worked out. Enacted narratives, as a method, reveal how imaginative practices foreground the ways in which desire and hope are integral to healing. Kenneth Burke's (1969[1945]) theory of dramatism, particularly his scene: act ratio, provides an analytic lens to examine the imaginary play of a singular session between a child with autism and an occupational therapist. Further, an interpretive frame that tacks between the positivist–biomedical and literary–philosophical discourses excavates how making scenes is integral to a healing of belonging and its embodiment.
Neoliberal Reform and Health Dilemmas: Social Hierarchy and Therapeutic Decision Making in Senegal
Ellen E Foley
- In this article, I trace the links among neoliberalism, regional ecological decline, and the dynamics of therapeutic processes in rural Senegal. By focusing on illness management in a small rural community, the article explores how economic reform is mediated by existing social structures, and how household social organization in turn influences therapeutic decision making. The illness episodes relayed here demonstrate how the acute economic and social crisis facing the Ganjool region becomes written on the bodies of young men, and how the fault lines of gender and generation shape illness experiences. These narratives also illuminate the tremendous discrepancy between the lived realities of sickness and death, and the idealized models of health participation and empowerment envisioned by the state. Rather than “neoliberal subjects” who behave as rational economic actors, men and women coping with illness are social beings embedded in fields of power characterized by highly stratified household social relations.
Being Anorexic: Hunger, Subjectivity, and Embodied Morality
Sigal Gooldin
- This article explores the embodied process of being anorexic and the moral repertoires within which this process is entangled. The point of departure for this discussion is that, while critical feminist epistemology plays an important role in politicizing anorexia as a symbolic cluster of meanings, it has provided us with limited analytical tools for an in-depth understanding of an anorexic's lived experiences and of the embodied realities involved in being anorexic. At the same time, autobiographical accounts of anorexia provide insightful emic perspectives on being anorexic but are not engaged with symbolic and theoretical etic perspectives on anorexia. This article attempts to bridge this gap through an anthropological exploration of anorexia from within; that is, as a situated embodied knowledge of anorexic women anchored in concrete lived experiences. Findings from an ethnographic study of young women who were diagnosed with anorexia and admitted to an outpatient hospital unit in Israel suggest that anorexic women actively construct a “heroic moral subjectivity,” in which the experience of hunger plays a crucial role, and in which everyday (mundane) practices gain “out-of-the-ordinary” meanings. While these findings partially accord with feminist philosophical explorations of anorexia, I argue that it is only via a detailed ethnographic account that we can follow the ongoing phenomenological and semiotic process through which such heroic subjectivity actually develops. Using an anthropological perspective to bear on the phenomenology of anorexia as an embodied experience contributes toward extending our understanding of the concrete ways in which “culture” becomes present in anorexia. The concluding section discusses gaps between feminist and anorexic narratives of anorexia in terms of therapeutic encounters.
book reviews
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On the Game: Women and Sex Work. by Sophie Day London: Pluto Press, 2007, ix + 277
Review by Yasmina Katsulis
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Pharmaceutical Reason: Knowledge and Value in Global Psychiatry. by Andrew Lakoff Cambridge: Cambridge University Press, 2005, x + 206
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Review by Michael Oldani
Multiple Medical Realities: Patients and Healers in Biomedical, Alternative and Traditional Medicine. -
Helle Johannessen and Lázár Imreeds. New York: Berghahn Books, 2005 xiii + 202
Review by Kaja Finkler
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Transforming Emotions with Chinese Medicine: An Ethnographic Account from Contemporary China. Yanhua Zhang Albany: State University of New York Press, 2007, xiv + 191 pp.
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Review by Judith Farquhar
Gender, Race, Class, and Health: Intersectional Approaches. Amy J Schulz and Leith Mullings San -
Francisco: Jossey-Bass, 2007. xx + 423 pp.
Review by Janis Faye Hutchinson
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Introducing Medical Anthropology: A Discipline in Action. Merrill Singer and Hans Lanham Baer, MD: AltaMira Press, 2007, v + 246 pp.
Review by Priscilla Song
