Med Anthro Key Terms

culture

-a cumulative deposit of knowledge, experience, beliefs, values, attitudes, meanings, hierarchies [etc.] acquired by a group of people in the course of generations through individual and group striving

-a ‘cultivated behaviour’ that is a person’s learned, accumulated experience which is socially transmitted, or more briefly, behaviour through social learning”

-a “common sense,” necessary for adaptation and survival—cultural is “a system of inherited conceptions expressed in symbolic forms by means of which men communicate, perpetuate, and develop their knowledge about an attitudes towards life”

EX: climate change (flooding), swimming

health

-”a state of complete physical, mental, and social well-being”

-more than just the absence of disease

-includes both freedoms and entitlements

anthropological method

biomedicine I

moern western scientific medicine is called biomedical because it explains health in terms of biology; a biomedical account is one which gives a physical or biological explanation for health and offers physical/biological methods for ‘repairing’ bodies when they are not working correctly

medical anthropology

an anthropological subfield that uses interdisciplinary perspectuves and field research methods to study health, well-being, and disease within and across cultures; allow us to examine ideas about the body and healing practices and how they are shaped by cultural, political, and economic forces that influence or restrict access to well-being or health

medical system

“the organization of people, institutions, and resources that deliver healyh care services to meet the health needs to target populations… may include hospitals, clinics, home care, long-term care facilities, assisted living, health plans, and other services”

biomedicine II

a cultural system in that its practitioners must maintain a set of internal beliefs, rules, and practices around a view that health is a biologicl reality; the system is largely predicated on an understanding that illnesses can be reduced to their physiologic causes

normal vs. abnormal

-normal = moral, abnormal = immoral

-how ideas of health, illness, and pathology are shaped by culture

EX 1: Margaret Mead’s “Trance and Dance in Bali” (thorazine) → the colonial gaze

~an attempt to demonstrate cultural variation in the kinds of relationships people from with healing, with trance, with voices; role of trance in societies in which mediumship and possession; a prominent part of religion life

~human plasticity = a response to the “molding force of society in which [people] are born”

EX 2: “Differences in voice-hearing experiences of people with psychosis in the USA, India and Ghana: interview-based study”

cultural relativism and reflexity

interpreting practices on their own terms, reflecting on our own assumptions

ethnography and ‘experience-near’ perspectives

deep engagement with people’s lived realities and practices

cultural relativism

-means that there are no absolute distinctions between what is considered normal or abnormal; there are simply different ways of being human

-the notion that an individual’s beliefs, and activities should be interpreted in terms of their own culture and society rather than one’s own (ethnocentrism)

-a capacity to put yourself “in someone else’s shoes”

ethnography

-a logistic study of a people, with detailed contextual information and information about kinship, religious, medical and political practices

~etic vs. emic perspectives (emic: ‘experience-near’)

Etic vs Emic Perspectives

-emic perspectives come from being deeply immersed in everyday life of a cultural group

-anthropologists spend extended, informal time with people and communities

-close participation often reveals the most powerful and meaningful insights

-participant-observation, interviews (key informants, focus group); forms of collaboration

Illness is a story

-stories of caregiving

-stories of pain, feelings of alienation, despair

-stories of struggle/protest

-stories of contradiction, resistance, joy, humor

illness is a ‘truth’

-illness, arguably, is not just an isolated event, nor an unfortunate brush with nature

-it is a form of communication—a language through which nature and society speak simultaneously

Disease

-the biomedical view of symptoms as rooted in biology or pathology

-focuses on biological cause and diagnosis

-emphasizes technical control of symptoms

-less attentive to lived and cultural meanings

Illness

-the lived experience of symptoms, bodily processes

-how affected persons/families perceive and respond to symptoms

-goes beyond the ‘technical quest for symptom control’

illness narratives capture cultural scripts and personal biographies

illness narratives

show how local cultural orientations and individual life histories shape the experience of illness

idioms of distress

-popular expressions of emotional or physical tension, fatigue, weakness, and chronic pain

-can act as coping mechanisms; often arise in cultural, family, or intimate relationships

-sometimes seen as ‘culture-bound syndromes’—ways groups recognize ‘somatize’ stress, conflict, pain

-idioms express illness experience

EX: back-breaking labor, tongue-tied

idioms of resilience

-socially meaningful and culturally resonant means of experiencing and expressing positive adaptation

EX: ‘don’t take things to heart,’ ‘tough as nails’

medicalization

social course of disease

-stresses an interactive relationship between body and society

-a 2-part characteristic:

~symptoms can wax and wane in response to the nature of the social environment, social environments can ‘trigger’ symptoms or make them more/less severe

~regarding symptom identification, help-seeking, treatment, outcome

EX: smoking rates, mortality trends, connection between covid-19 deaths and vaccinations

explanatory models of disease (Kleinman, illness narratives)

-afford patients the opportunity to explain how they see their illness, as individuals and groups can have different explanations or notions of cause

-Kleinman proposes that, instead of simply asking patients, "“where does it hurt?”, physicians should do some work on eliciting patients’ explanatory models

self-reflexivity

-the awareness on the part of the researcher of the effect they may be having on the research process

-the constant practice of stepping back from one’s biases and assumptions in order to create dialogue

-in reflecting on one’s own assumptions—and becoming more in touch with them—your research questions probably will change or at least get clearer, and more exciting

-about creating space for others/the interviews, which can help you better engage them as people in the world rather than as subjects

iatrogenesis

harm or disease caused by medical treatment or intervention (from professionals)

mindful body

-somatization: bodily susceptibility to societal pressures

-managing expectation: is there a physiology of expectation? (fight-or-flight response, placebo response)

embodiment

-a little more agency than somatization

body technique

-Marcel Mauss (1872-1950)

-”The body is [at] first a natural instrument}

-two senses:

1) natural instruments (EX: swimming, giving birth)

2) symbolic uses (in rituals + protests)

three-body concept

-personal body

-social-symbolic body

-political-economic body

EX: Delirio de Fome

body as machine

“reductionism",” a paradigm of reducing a body to component parts; the bpdy is objective → independent of social force (biology is the governing factor)

body as symbol

-forgoing reductionism; forgoing mind-body distinctions → EX: objects with powerful spirits are thought to objectively alter life course/some dimension of individuals/groups

-rituals + protests

EX: Vodou Death → linked to traumatic shock, fight-or-flight response, and placebo response

traumatic/shell shock

soldiers were afflicted with this during WWII; it confounded physicians and was considered to be a forerunner to PTSD

-treatments often focused on rest and/or disciplinary methods; saline solution; improving circulation (lifting legs)

-symptoms: diarrhea, unrelenting anxiety, facial tics, stomach cramps, loss of sight, nightmares, day dreams, inability to eat or sleep, inability to function physically (faults in walking, taking, etc.)

fight-or-flight response

-through sympathetic nervous system, muscles are prepared for action by production of large amounts of adrenalin and contraction of certain blood vessels (the fight or flight response)

-when the emergency is not met by action, or is prolonged, a state of shock may results

-the blood pressure is reduced, heart deteriorates and blood plasma escapes into the tissues

-‘anatomy of fear”

placebo effect

-the body distinguishes between hopeful and fearful beliefs and expectations

-the body knows to respond therapeutically or pathologically to those expectations

-the ‘wisdom of bodies’ must be understoof i light of the cultural wisdom of societies

personal body

immediately grasped and intuitively true; at times hard to translate or communicate

social-symbolic body

-projected outwardly—through classifications, symbols, and labels; we may or may not present our bodies in ways that follow cultural codes, whether to fit in, avoid conflict, challenge stereotypes, etc.

-that which is made normalized/made routine

political-economic body

where social categories like class, race, and gender are inscribed (and sometimes resisted); where broader political and economic forces can shape health outcomes

panopticon

-factors include uniformity, conformity, obedience, and acquiescence

-openly coercive, force/repression, ideology, and punishment

-origins in the history of public health and contagion control strategies

-links to prison architecture and ideas of reform of society’s deviants

-resonates with various practices linked to policing, health, and forms of social control

-staying in place/being watched (surveillance of bodies) → keeping records and following rules → instills a compulish to self-monitor/patrol

-touted as an ‘innovation’ in efficiency → but this further entrenches social containment and discrimination

-in the actual prison, the goal was not explicitly punitive → it was about reform and rehabilitation

reductionism

en-casement

sick role

stigma

M. Foucault’s View of Power

-power works through ‘decentralized’ techniques to shape behaviors seen as desirable or productive

according to Foucault, how is health a value in context of state formation/power?

-to preserve the ‘life of the state’

-to maintain armies

-to maintain a class of educated ‘technocrats’ that reinforce certain notions of health/normality

how does the panopticon ‘automate’ state projects of health?

it links bodily self-discipline/morality to broader projects of social and political reproduction