Books Received for Review: February 2017

This week we are featuring previews of four books received for review at Culture, Medicine, and Psychiatry (available here). These previews provide a snapshot of recent publications in medical anthropology, global health, and the history of medicine that we’re excited to discuss in our journal and with our followers on social media.


9780520282841

via UC Press

Blind Spot: How Neoliberalism Infiltrated Global Health

Salmaan Keshavjee

From the University of California Press, Blind Spot is a historical and anthropological case study of how market-based ideologies and neoliberal health policies impact global health and development programs. “A vivid illustration of the infiltration of neoliberal ideology into the design and implementation of development programs, this case study, set in post-Soviet Tajikistan’s remote eastern province of Badakhshan, draws on extensive ethnographic and historical material to examine a ‘revolving drug fund’ program — used by numerous nongovernmental organizations globally to address shortages of high-quality pharmaceuticals in poor communities.” The books discusses how the privatization of health care can impact outcomes for some of the world’s most vulnerable populations.

For more information, visit the University of California Press website here.


via Berghahn Books

via Berghahn Books

Cosmos, Gods, and Madmen: Frameworks in the Anthropologies of Medicine

Roland Littlewood and Rebecca Lynch, eds.

“The social anthropology of sickness and health has always been concerned with religious cosmologies: how societies make sense of such issues as prediction and control of misfortune and fate; the malevolence of others; the benevolence (or otherwise) of the mystical world; local understanding and explanations of the natural and ultra-human worlds. This volume presents differing categorizations and conflicts that occur as people seek to make sense of suffering and their experiences. Cosmologies, whether incorporating the divine or as purely secular, lead us to interpret human action and the human constitution, its ills and its healing and, in particular, ways which determine and limit our very possibilities.”

For more information, visit the Berghahn Books website here.


via UC Press

via UC Press

A Passion for Society: How We Think about Human Suffering

 Iain Wilkinson and Arthur Kleinman

“What does human suffering mean for society? And how has this meaning changed from the past to the present? In what ways does “the problem of suffering” serve to inspire us to care for others? How does our response to suffering reveal our moral and social conditions?” This highly anticipated book investigates how social science has been shaped by problems of social suffering. The authors discuss how social action, through caring for others, is reshaping the discipline of social science and offers a hopeful, intellectual basis for a fundamentally moral stance against indifference, cynicism, and inaction. They argue for an engaged social science that bridges critical thought with social action, seeking to learn through caregiving, and achieving greater understanding that operates with a commitment to establish and sustain compassionate forms of society.

For more information, visit the University of California Press website here.


via UC Press

via UC Press

It’s Madness: The Politics of Mental Health in Colonial Korea

Theodore Jun Yoo

“This book examines Korea’s years under Japanese colonialism, when mental health first became defined as a medical and social problem. As in most Asian countries, severe social ostracism, shame, and fear of jeopardizing marriage prospects compelled most Korean families to conceal the mentally ill behind closed doors. This book explores the impact of Chinese traditional medicine and its holistic approach to treating mental disorders, the resilience of folk illnesses as explanations for inappropriate and dangerous behaviors, the emergence of clinical psychiatry as a discipline, and the competing models of care under the Japanese colonial authorities and Western missionary doctors. Drawing upon printed and unpublished archival sources, this is the first study to examine the ways in which “madness” was understood, classified, and treated in traditional Korea and the role of science in pathologizing and redefining mental illness under Japanese colonial rule.”

For more information, visit the University of California Press website here.

In the News: Telemedicine in the United States

cropped-2009cover-copy

The intersections between technology, medicine, and health are a frequent site of discussion at Culture, Medicine & Psychiatry. In our last issue of 2015, for instance, Yael Hashiloni-Dolev[1] examined the role of new medical technologies that enable posthumous reproduction, while Petersen and Traulsen[2] shed light on the nuanced social uses of psychoactive medications amongst university students. These articles underscore the centrality of technology in everyday human health behaviors, and on the cultural meaning of these new tools in local medical landscapes.

Another technological innovation altering the social world of medicine—one making headlines in recent months—is telemedicine. In the Journal of the American Medical Association[3] (JAMA), telemedicine has been described as “the use of telecommunications technologies to provide medical information and services,” often a shorthand “for remote electronic clinical consultation” via phones and internet applications.

In the December 2015 AARP Bulletin, author Charlotte Huff[4] remarked that over 1 million patients will use telemedicine services this year, and remote access to physicians by phone, video chat, and email is more and more commonly covered by American employers’ health insurance packages. A Reuters article[5] adds that in Texas, a telemedicine company is working to block a state law that would require physicians to see a patient in-person before consulting with them via phone, email, or other means. And in the New York Times[6], a physician observed that telemedicine may prove a useful tool for children and adolescents: many of whom have grown up in a digital culture of “oversharing” and would not balk at texting their physicians images of strange rashes or lesions on their bodies. As this new tool of health care delivery is negotiated in different societal arenas, so too are its implications increasingly worthy of anthropological attention.

Telemedicine is altering the social fabric of medicine in a number of significant ways. Here, we will outline two potential outcomes of telemedicine on medical exchanges facilitated by technology. First, telemedicine extends the professional reach of biomedical clinicians. Areas where biomedical care is inaccessible, or where only indigenous medical systems exist, may now fall under the electronic eye of a faraway practitioner. This has extraordinary consequences for the ubiquity of biomedicine and the consolidation of biomedical power. Second, and rather conversely, telemedicine empowers the patient in the clinical encounter. Because the physician or clinician is not physically present to examine the patient’s body, the patient themself is the one who touches a swollen throat, or flexes a stiff joint, and relays their response through phone or web camera. In sum, the patient gains greater control over bodily (and verbal) narratives that, unlike an in-person exam, the clinician does not have total access to.

The rise of telemedicine speaks to medical anthropologists, certainly, but it also presents a fascinating case more broadly for science and technology theorists and scholars in health communication. As the topic of telemedicine continues to capture the interest of medicine and the media, so too will it fall under the consideration of researchers piecing together the networks that bring patients and their caregivers together in novel ways.

[1] http://link.springer.com/article/10.1007/s11013-015-9447-6

[2] http://link.springer.com/article/10.1007/s11013-015-9457-4

[3] http://jama.jamanetwork.com/article.aspx?articleid=386892

[4] http://www.aarp.org/health/conditions-treatments/info-2015/telemedicine-health-symptoms-diagnosis.html#slide1

[5] http://www.reuters.com/article/health-case-to-watch-teladoc-idUSL1N14H0CT20151228

[6] http://well.blogs.nytimes.com/2016/01/18/using-phones-to-connect-children-to-health-care/?ref=health

 

Issue Highlight: Vol 39 Issue 4, Incarceration & Medical Anthropology

This blog post is the second installment of our three-part issue highlight on the new December 2015 issue of Culture, Medicine & Psychiatry (the full issue is accessible here.) In this week’s blog, we examine Carolyn Sufrin’s article on the shared roles of clinicians and anthropologists working with incarcerated women in the United States.


cropped-cards.jpg

Clinician-anthropologists are in a unique position to lend voice to their participants and to care for their medical needs. For Carolyn Sufrin, who served both as a physician and an ethnographic researcher for incarcerated women in the United States, the clinical and anthropological roles intersected in deeply meaningful ways. Sufrin notes that in these dual roles, she observed with female prisoners and analyzed their experiences, and provided reproductive health care and delivering the same women’s babies in a county hospital, where imprisoned women gave birth. The women were alternately enrolled in Sufrin’s study upon ceasing to officially be her patients, or were individuals that Sufrin cared for during her tenure as their OB/GYN.

Sufrin uses her case as an example of how to interpret the ethical consequences of working as a clinician-anthropologist. Part of the challenge she faced as both a physician and anthropologist to the women was that IRB and HIPAA regulations divided the types of data she could use in her anthropological research. Though some details of her participants’ lives, such as past trauma or childhood abuse, were essential to their experiences as mothers and as incarcerated women, she could not use this data inasmuch as it had been shared with her in the context of a patient-practitioner interaction: in other words, it was considered classified personal health information that could not be subsequently utilized in her ethnographic research. These methodological hurdles, Sufrin explains, shed light on the complexities of what constitutes “sacrosanct” data. It also suggests how the safeguarding of medical data does not necessarily translate to the “protective” collection of ethnographic data which is not isolated to the case of individual patients, and which relies on knowledge of participants and their connections to other people (in this instance, to individuals in the participant’s life who had caused past psychological harm.)

Likewise, as stated earlier, relationships between the participant/patient and the clinician/anthropologist are another form of interpersonal connection which must be reconfigured depending on the nature of the exchange taking place. In Sufrin’s case, this meant being clear with her participants that– upon entry into her anthropological study– she was no longer their physician, and that the nature of their exchanges and their professional relationship would take a new form. She could share their information (albeit de-identified), unlike information drawn solely from their medical records or from an examination.

Yet here, Sufrin notes that the anthropologist– like the clinician– is still engaged in an ethic of care. For example, one of Sufrin’s former patients in the prison was charged with child endangerment after giving birth in an alley and handing her child to a stranger, unable to afford treatment at a hospital following her release from prison. The story made news headlines, and as public knowledge, was within the realm of information that Sufrin employed in her ethnographic analysis of reproductive health in the American prison system. However, Sufrin knew an added piece of information that was not already publicized from her interaction with the woman in prison: a clinical detail that she understood as a physician, but was shared during her time as an ethnographic researcher. This detail would have enhanced her analysis of the situation, but she chose to omit it out of concern that to publicize the detail would be to betray the woman’s trust in her as a researcher and as someone who served in the prison as a physician.

In other instances that Sufrin discusses, her role as both an anthropologist and clinician led the women she worked with in each capacity to feel as if she was especially attentive and caring. Rather than always relying on her medical authority, Sufrin underscores her decision to remain non-judgmental and supportive even when the women in her study had made potentially harmful choices; for example, she chose not to openly admonish a woman who was continuing to use crack upon release from jail, despite being thirty-two weeks pregnant. Sufrin notes that her silence hid her own frustration with this choice, but it strengthened the woman’s trust in her as an anthropologist and “as a doctor.”

In sum, these dual roles ultimately bolstered her relationships to the incarcerated and formerly incarcerated women that she served. Thus, the author argues that both anthropologists and clinicians share an “ethic of care” in their relationships with research subjects or patients. This ethic involves a careful fostering of the professional, interpersonal connections that ethnographers make with research participants, or that physicians make with their patients. This care entails the protection of private information and the researcher/clinician’s conscious attendance to interpersonal exchanges that bolster the patient/participant’s trust in the clinician/anthropologist. Likewise, an analysis of the clinician role alongside the anthropological one demonstrates both the delineations between multiple forms of care and social connection, as well as the shared commitment in medicine and anthropology to the sensitive attendance to patient and participant experiences.