AAA 2015 & New Initiatives at the CMP Blog

To our readers:

This week, many of you are attending the American Anthropological Association (AAA) Meeting in Denver, Colorado. From all of us at Culture, Medicine & Psychiatry, we wish you safe travels to the conference and new knowledge and fresh insights upon your return.

Last year on the blog, the editorial staff took this week to thank our readers and to share with you the future directions of our social media in the coming year. We are grateful to all of our readers and followers for helping us foster an online community for medical anthropologists and our peers in allied disciplines, whether on our Facebook page, on our Twitter feed, or here at the blog. Thank you to all of our colleagues for sharing our posts, retweeting our links, and reading our features: from news updates, to conference postings, to book releases, and journal issue highlights.

In addition to these features, we are embarking upon two new initiatives on social media into 2016. The first is a new submission mechanism for book release updates on the blog. If you are an author of a new academic text in medical anthropology, social medicine, or medical humanities, let us know about your publication, and we will share it on the blog. We hope this new initiative allows us to showcase new and trending topics in the field, while it spreads the word about the research our readers and colleagues are carrying out across the globe.

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The second new initiative will include interviews with anthropologists, historians, and other scholars (including graduate students) about ongoing projects or newly published research. If you want to share your findings, introduce new theories or issues, or present new topics in the field, contact us to be interviewed. For both initiatives, please send requests and queries to our social media editor (Julia Knopes) at jcb193@case.edu. As always, books for review and academic articles can also be submitted to the journal proper. Please direct questions about journal submissions to managing editor Brandy Schillace at bls10@case.edu.

Lastly, we continue to accept guest blog submissions between 500-700 words in length on topics in medical anthropology, medical humanities, bioethics, and social medicine. Guest blog submissions may be submitted for review to our social media editor at the above listed address.

We look forward to sharing with you all of the changes and additions at CMP social media in the coming year.

Our best,

The Editorial Staff of Culture, Medicine & Psychiatry

Guest Blog: Reflections on Antibiotic Use in American Hospitals

This week, we are featuring a special guest blog written by Katharina Rynkiewich from Washington University in St. Louis. Today, she tells us about her experiences researching antibiotic use among infectious disease practitioners in Chicago, Illinois. If you would like to submit a guest blog entry on your research, please send a 500-700 word piece to social media editor Julia Balacko at jcb193@case.edu.


In the spring of 2013, I conducted research on hospital-based infectious disease specialists in Chicago. Although my participants had a lot to say about antibiotic resistance, I was most surprised at how they characterized and criticized fellow clinicians’ use of antibiotics in relation to resistant disease strains. In hospitals, they suggested, the regulation of antibiotics has changed drastically in the past half century. Some of the older infectious disease specialists I interviewed remembered a time when antibiotic overuse was rampant within the hospital setting. “Anyone could prescribe antibiotics,” my participants complained when describing that era. Clinicians and hospital officials at that time had little reason to expect that antibiotic resistance would become the expensive, lethal, and complicated problem that it is today.

In health care settings now, there is more regulation concerning the use of antibiotics. Clinicians are experiencing a lull in the production of antibiotics for infectious diseases, and practitioners must make do with the limited antibiotic supplies they have. Today, there are systematic hospital reviews of antibiotic use to monitor how often the drugs are used. However, most practitioners can still prescribe antibiotics with little oversight. Procedurally, the review of antibiotics in the hospital setting is an enormous task, and an adjustment of patient treatment plans may not occur until after the first few doses of an antibiotic have been given. There is room, therefore, for antibiotic-resistant diseases to generate as misuse and overuse of antibiotics still occurs.

One way to mitigate overuse employed was the notion of antibiotic stewardship: an idea that the infectious disease specialists I interviewed frequently emphasized. “Stewardship” here refers to the responsibility of certain clinicians to manage antibiotic prescription and usage. The infectious disease specialists expressed a desire to have more control over the distribution of antibiotics in hospital settings, leaving surgery to the surgeon and cancer to the oncologist. The infectious disease staff wished for this level of control over antibiotic use despite the fact that both surgeons and oncologists can prescribe antibiotics independently, meaning antibiotics are not managed by one clinical care specialty. When asked whether, in general, practitioners today realize the importance of antibiotic stewardship in light of the dangers of antibiotic resistant infections, one infectious disease practitioner joked, “Which doctors?” My data show that  many infectious disease specialists note that their management of antibiotic resistance is quite a challenge because most other physicians within and outside of hospitals may readily prescribe them.

This issue is especially pressing because illnesses themselves are rarely treated with one biomedical intervention, or by one clinician. Few patients can be treated for one disease with one corresponding treatment, meaning that patients’ cases are managed with a variety of therapies and by a number of doctors. Patients can also have multiple conditions, again meaning that multiple types of practitioners can prescribe antibiotics for these patients at different points in their hospital stay. In these complex networks of caregiving, who gets the power to give antibiotics might not always be clear, or there might be tension when deciding who gets to limit the drug’s use. Indeed, when an infectious disease specialist is added to a patient’s chart, they are often added as a consult, meaning their advice may not be adhered to by the primary physician.

Certainly, we can expect that infectious disease specialists want professional autonomy over the management of antibiotic drugs, which means limiting and surveying the drug’s accessibility to other clinicians. But to do so, this would mean that other practitioners would have to agree to the control of part of their treatment plans by an outside party. This relationship of competing interests and access to antibiotics leads to disagreements and struggles of bureaucratic power in the hospital. As it stands, the future of antibiotic resistance rests in the hands of all practitioners who must negotiate who gets to prescribe, and who gets to control, the use of antibiotics.


About the Author: Katharina Rynkiewich

I am a PhD student in Anthropology at Washington University in St. Louis. My current research involves studies of infectious disease practitioners and treatment of infectious disease in hospital settings, and will focus on hospital policy regarding infection and epistemic differences among specialty groups of physicians. In 2013, I completed a masters program (MAPSS) at the University of Chicago, and research for this post was done in partial fulfillment of this masters.

AAA 2014: Perspectives on the Bruno Latour Distinguished Lecture

This year at the American Anthropological Association 2014 Meeting, Bruno Latour was invited to deliver the distinguished lecture. Entitled “Anthropology at the Time of the Anthropocene,” Latour discusses the rise in the term anthropocene to describe our current stage of natural history. Although the term makes reference to how “human” (anthro) our current age may be, Latour jests that this term was introduced by geologists, not social scientists. In the anthropocene, it is humans that play the defining role in our geological historical moment.

The assumption, Latour notes, is that human agency is the prime source of action that shapes the physical world. Humans are responsible for climate change, for pollution, for altering the literal, natural fabric of our world. Yet we know that not all humans have the same impact on our environment. As Latour quips, there is not “One Human” who is responsible for the changes we see in our climate or environment. We are simultaneously assessing human power as a plural, collective entity, as well as using this concept to suggest that the blame for global change does not fall evenly across all humans. As anthropologists and cultural theorists, we know how fragile human agency can be when we divide it amongst many contending social and cultural groups.

Our blog editor at the Latour Distinguished Lecture

Our blog editor at the Latour Distinguished Lecture

Is there another way to think about human action that does not problematically configure humans as both collective and individual, acting but not universally accountable for all human actions? Latour posits that rather than focusing solely on agency, with a strong emphasis on human intention and purpose when committing action, we could think instead about animation, or what forces–human and non-human– are in motion in a given social space. To do so, we can no longer assume that the human agent is a colloquial be-all-end-all.

How does this assertion speak to medical anthropology, social medicine, and medical humanities? At first, we might raise our brows at the discussions of geography, environment, and most of all the suspicion surrounding the primacy of human agency. Decentralizing the human agent, we might say, is perhaps the least humanistic approach to the study of human experience. Indeed, medicine is the care of humans by humans!

However, our human ability to question our own power and position in the universe, amidst other natural and non-human forces, is a mark of our species. Whether through philosophy, religion, or social science, humans have a proclivity for ruminating about our place in the material, corporal world. We crave knowledge about what sets us apart from non-human things, and how we are sometimes reliant on them. For scholars of medicine, such inquiries about our relationships with the physical universe is key. We consider the place of non-human agents in disease and care. We ask: why do physicians rely on certain tools? Why do patients see stethoscopes, thermometers, and scalpels as making a clinician legitimate in his or her practice? How are medical traditions made unique by their tools and pharmaceutical formulas? Could the layout of a hospital or clinic itself alter the way care is given?

In an age where technology permeates developed and developing societies, Latour’s suggestion to destabilize human agency is productive when considering medicine as a cultural object. We must think not only of ourselves, but the physical environments we live in and the material objects and devices we cannot seem to live without.

Many scholars understandably resist Latour’s idea that non-humans could have some primitive agency. Yet even if we do not assign agency to non-human tools, things, and environments, thinking seriously about their role in sociocultural systems is informative. Medicine is a lively site of exchange between patients and physicians, as well as practitioners and devices, patients and new medical innovations, and the built environments which house them. As Latour invites us to do, we should pause to consider humans within the midst of a rich material world around us that– like humanity itself– is constantly in motion.

Julia Balacko is a second-year PhD student in medical anthropology at Case Western Reserve University. She holds an MA in Humanities from the University of Chicago. Her research focuses on the culture of human anatomy and dissection in Western medical traditions, as well as public access to anatomical and pathological specimens.


Note on the presenter:

Bruno Latour is professor at the Sciences Po Paris in Paris, France. A central theorist in STS (science and technology studies), he is the author of We Have Never Been Modern (1991), Science in Action (1987) and Laboratory Life (1979).

You can read the full text of Latour’s lecture here: http://www.bruno-latour.fr/sites/default/files/139-AAA-Washington.pdf

A Few Words from the AAA 2014 Meeting

This week, many of our readers (and staff members here in the office of Culture, Medicine, and Psychiatry) are attending the American Anthropological Association’s annual meeting in Washington, DC. For those of you presenting, we wish you the best of luck in delivering thoughtful and productive presentations. To all attendees, we hope you have pleasant travels to the nation’s capital, and return from the conference with new knowledge and fresh ideas.

via Wikimedia Commons

via Wikimedia Commons

Much like conferences in our field, CMP social media is a common space for intellectual inquiry about contemporary issues in anthropology. In the spirit of building this communal space electronically, we now invite our followers to submit approximately 500-word blog entries– ranging from brief commentaries on a research project, recent presentation, or reflections on topics in medical anthropology, medical humanities, and social medicine– to be considered for our blog.

We ask that submissions to the blog be widely accessible to readers across anthropology and the humanities: from advanced undergraduate students, graduate students, professors, as well as applied practitioners and interdisciplinary researchers. Accepted pieces will be posted here and shared via our Twitter account. This is an opportunity to showcase your work to new audiences and to gain valuable insight into producing widely accessible, digital scholarship. Please direct your submissions to Julia Balacko at jcb193@case.edu.

Thank you for following CMP social media. We look forward to receiving your guest blog submissions and hearing more from you about exciting new research from the AAA Annual Meeting.

Best Wishes,

The CMP Editorial Staff