News: WHO Release on Worldwide Hearing Loss

Posted by jknopes

When medical anthropologists consider the impacts of technology on human health, we envision life-saving drugs, surgeries, or diagnostic tools to detect disease. Technology in these ways can prove instrumental– quite literally — in improving patients’ health outcomes. However, it is equally important to think about the ways in which technology can diminish health, particularly in an age where the global spread of technology deserves the attention of clinicians and anthropologists alike.

This is the nature of the concern posed by the latest World Health Organization (WHO) report, released on February 27th 2015. After studying noise exposure in middle and high income countries and among participants ages 14-35, WHO officials stated that an estimated 1.1 billion people are at risk for hearing loss due to “recreational noise.” This includes music piped through headphones and noise experienced at entertainment venues. Exposure to high decibels of sound is not itself harmful: for instance, hearing a heavy pot fall from the counter and crash onto the floor would not cause hearing damager. Rather, the extended length of exposure to such loud noises is what proves detrimental. The WHO defines dangerous levels of noise exposure as 85 decibels for eight hours or 100 decibels for 15 minutes. The report notes that a rock concert that lasts for two hours may cause temporary hearing loss or lead to other symptoms such as a ringing sensation in the ears, and regular extended exposure may lead to more permanent damage.

The WHO flag, via Wikimedia Commons

What does the WHO recommend to address this global health concern? The report singles out teenagers and implores them to take noise management into their own hands: purchasing noise-canceling headphones, taking “sound breaks” if extended exposure to loud sounds is unavoidable, or wearing ear plugs to loud music venues. This places the responsibility to manage noise exposure on young people rather than on their families and caregivers. Likewise, the report suggests that patrons of entertainment venues like clubs and bars that feature loud music and sounds should limit their time spent in such environments. There are no extensive recommendations listed in the report for those who work in loud venues, other than limiting shifts to eight hours to shorten exposure.

From a medical anthropological standpoint, many of the factors in sound environments are tangled with social life. For instance, in many developed countries, concerts are an important social gathering place for young people. Teens may not avoid these events, but if they follow the WHO recommendations and wear earplugs to the venue, they may be ostracized by their peers for looking out of place. Likewise, neighborhood bars and clubs are important hubs of activity for locals, and avoiding them may come at the cost of social isolation. As technologies spread both to developing and developed countries, the ways that people integrate audio technologies, new entertainment venues, and popular music into their lives is worth considering given the impacts of these tools, sounds, and social spaces on hearing health.

To read the WHO’s news release, click here: http://www.who.int/mediacentre/news/releases/2015/ear-care/en/

March 2015: Preview of Books Received

Posted by jknopes

This week, we are featuring previews of five books received for review at Culture, Medicine, and Psychiatry. Be sure to check out more articles, reviews, commentaries, and case studies published in the first issue of volume 39 (2015) here: http://link.springer.com/journal/volumesAndIssues/11013

via Westview Press

Language, Culture, and Society: An Introduction to Linguistic Anthropology

Zdenek Salzmann, James Stanlaw, and Nobuko Adachi, eds.

This textbook was first published in 1993, and this is the book’s sixth edition. The new incarnation of Language, Culture, and Society features has been revised and expanded with further explanation of the sociocultural context of language. It is also complete with class exercises, discussion questions, and other student resources. The book pays special attention to multilingual and transnational linguistic anthropology.

More details from Westview Press here: http://westviewpress.com/books/language-culture-and-society/

Via UC Press

Haunting Images: A Cultural Account of Selective Reproduction in Vietnam

Tine M. Gammeltoft

This ethnographic account explores the lives of pregnant women in Hanoi, Vietnam whose fetuses were deemed biologically abnormal after ultrasound examinations. Gammeltoft considers the moral dilemmas these women face against the backdrop of their everyday lives and the roles of their family members in reproductive decision-making.

More details from UC Press here: http://www.ucpress.edu/book.php?isbn=9780520278431

Via UC Press

Can’t Catch a Break: Gender, Jail, and the Limits of Personal Responsibility

Susan Starr Sered and Maureen Norton-Hawk

This ethnographic work traces Boston women’s experiences of sexual abuse, violence, inadequate social and therapeutic programs, and the impacts of local and federal policies on incarceration and criminal punishment. The authors consider how these women’s struggles are cast aside as the consequences of “bad choices” and “personal flaws,” and how marginalized women make their way in this “unforgiving world.”

More details from UC Press here: http://www.ucpress.edu/book.php?isbn=9780520282797

Via Duke UP

Given to the Goddess: South Indian Devadasis and the Sexuality of Religion

Lucinda Ramberg

Ramberg’s account addresses a unique cultural tradition in South India, where girls and sometimes boys are married to a goddess. They have sex with partner outside of traditional marriage and conduct holy rites outside of the goddess’ temple, and complicate the boundaries between what is male and female. The author argues that goddess marriages challenge existing notions of gender, marriage, and religious practice.

More details from Duke UP here: https://www.dukeupress.edu/Given-to-the-Goddess/index-viewby=subject&categoryid=27&sort=newest.html

Via Johns Hopkins UP

Generic: The Unbranding of Modern Medicine

Jeremy Greene

This text is a social, political, and cultural history of the rise in generic pharmaceuticals. It tracks the development of modern generic drugs from early 20th century hacks who counterfeited popular medications through the growth in powerful corporations who first produced un-branded drugs. Greene describes generic drugs as a seminal movement towards more equitable, affordable medical care by giving patients quality medicines at a reduced price.

More details from Johns Hopkins UP here: https://jhupbooks.press.jhu.edu/content/generic

From the Archive: Biotechnology and the Culture of Medicine

Posted by jknopes

In the “From the Archive” series, we highlight articles published throughout the journal’s history. We look forward to sharing with our readers these samples of the innovative research that CMP has published on the cultural life of medicine across the globe.

In this installment of From the Archive, we turn to Mary-Jo Delvecchio Good’s article The Biotechnical Embrace (Vol 25 Issue 4, December 2001.) In this piece, Delvecchio Good frames three concepts in the cultural study of biomedicine: medical imaginaries, biotechnical embraces, and clinical narratives. Here, we will briefly outline these notions.

The medical imaginary, we learn, is the envisioned potential of the new technologies and treatments that medicine could produce in the future. The power of possibility in this sense impacts both clinicians, who are always working to stay ahead of new scientific knowledge, and patients: often those afflicted with diseases for which no current remedy exists. The medical imaginary situates medical progress in a position of hope and opportunity. Stories of medical failure, malpractice, or dearths of medical knowledge, although evidence contrary to establishing an “optimistic” view of the field, are framed in an overarching positive narrative of scientific progress.

Delvecchio Good next describes the biotechnical embrace: the embracing of, and the “being embraced” by technical innovations. This refers to the public “enthusiasm” for biotechnical therapies, as well as the engagement of biotechnologies with the patient’s body. Like the medical imaginary, the biotechnical embrace concept recalls a biomedical commitment to scientific progress and possibility. Even whenever a treatment is highly experimental, not yet approved as effective, or so new that its pitfalls are not fully known, patients will ’embrace’ and request it– and the public will hastily invest in it.

Lastly, we parse the concept of the clinical narrative, or ethnographic frame. This qualitative data is what evidences popular and clinical enthusiasm for bioscientific innovation and the use of the latest technological treatments.

Put simply, narratives can demonstrate that patients and clinicians alike are able to frame care in terms of the gap between what is presently the case, and what might be. For instance, a cancer patient might note the gaps between their condition, current treatments they have used, future therapeutic options, and subsequent clinical outcomes for his or her illness. Clinical narratives remind us that patients (and caregivers) do not view medicine as a static database of information, but instead a dynamic and progressive body of knowledge that exists in relation to illness experiences.

Click here for a link to the abstract and further details about the paper: http://link.springer.com/article/10.1023/A%3A1013097002487

Preview of Books Received: Vol. 38 Issue 4, Dec 2014

Posted by jknopes

The following are previews of two books received for review at Culture, Medicine, and Psychiatry. These previews provide a snapshot of recent publications in medical anthropology, cultural studies, and the history of medicine. For a full list of books received in December 2014, click here: http://link.springer.com/article/10.1007/s11013-014-9395-6

Image via Berghahn Books

Culture, Suicide, and the Human Condition

Edited by Marja-Liisa Honkasalo and Miira Tuominen / Afterword by Arthur Kleinman

This collection of research on suicide argues that suicide is not “a separate realm of pathological behavior,” but instead a human action contextualized by a suicidal person’s cultural, historical, and ethnic roots. However, “the context never completely determines the decision,” allowing the authors to focus on suicide as both cultural and psychological phenomena. The authors emphasize individual action and choice regarding the decision to commit suicide. Similarly, the collection presents a complicated puzzle: suicidal narratives make sense of self-killing to a community, and depict suicide as a “solution to common human problems.”

Culture, Suicide, and the Human Condition was released in March 2014 by Berghahn Books. More details on the book here: https://www.berghahnbooks.com/extras/docs/flyer/HonkasaloCulture_9781782382348.html

Image via MIT Press

A Metaphysics of Psychopathology

Peter Zachar

Zachar’s book asks what constitutes the “real” in psychopathology. He states that in psychiatry, pathologies are assumed to be “real,” while in psychology, the “realness” of a pathology is debated in terms of its roots in personality, superego, or in “general intelligence.” Neither discipline, however, aims to pin down what “real” entails for mental illness and conditions. Some pathologies move from being cast off as imaginary to being embraced as legitimate, such as PTSD, and others, like multiple personality disorder, are classified as real only to be later considered imaginary. Zachar takes a philosophical approach to considering what “real” means in terms of psychiatric and psychological classification, proposing a new classificatory system that the summary asserts “avoids both relativism and essentialism.” He then uses this model to interpret recent “controversies” in the inclusion of certain mental disorders within existing classificatory systems.

A Metaphysics of Psychopathology was released in March 2014 by MIT Press: http://mitpress.mit.edu/books/metaphysics-psychopathology

AAA 2014: Perspectives on the Bruno Latour Distinguished Lecture

Posted by jknopes

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

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

Current Issue Highlight: Vol. 38 Issue 4, December 2014

Posted by jknopes

In our “Current Issue Highlight” series, we provide brief synopses of some of the original articles and commentaries published in our latest issue of Culture, Medicine, and Psychiatry. We hope these glimpses into our recent publications serve as a taste of the research we publish, as well as offer fresh insights on the intersections of culture, disease, health, and healing.

“The Ethics of Ambivalence and the Practice of Constraint in US Psychiatry”

Paul Brodwin

“This article,” the abstract begins, “investigates the ambivalence of front-line mental health clinicians toward their power to impose treatment against people’s will.” Ambivalence is itself a psychological construct that describes the tensions between love and hate, or multiple perspectives, within both individual subjects as well as the collective social group: here, psychiatric health workers. Central to this article is the friction generated between the clinicians’ self-concept as caregivers and their professional drive to control patients. Such ambivalence about clinical work in psychiatry is evident in the ethnographic research presented here.

Brodwin’s piece reminds us that anthropology is perfectly situated to draw meaning from these problematic and conflicted perspectives within a social group. Rather than reconciling the participants’ feelings and drawing one universal message from them, Brodwin presents us with an authentic picture of the complicated world of clinical psychiatric practice. He concludes, “To understand the paradox, fieldwork should focus especially on the moments when people’s sense of unease erupts into collective life.”

Link to article: http://link.springer.com/article/10.1007/s11013-014-9401-z

“A Village Possessed by ‘Witches’: A Mixed-Methods Case–Control Study of Possession and Common Mental Disorders in Rural Nepal”

Ram P. Sapkota, et al.

In this article, the authors probe an important question: if we consider spirit possession and psychopathology as separate categories, rather than assume possession as a form of mental illness, how might we describe mental illness within a population who has experienced spirit possession? For societies in which spirit encounters are frequent and socially normative, reading mental illness as distinct from possession is particularly critical when exploring local psychic events.

Nepal provided fertile intellectual grounds for exploring this question because spiritual possession occurs regularly. When the researchers delivered educational sessions on psychosomatic and psychosocial illnesses, suggesting that spirit possession might be a type of mental distress, villagers in the study resisted this notion. They argued that possession was rooted in cosmological and supernatural disturbances, making them altogether different psychological phenomena.

Instead of casting possession as a brand of psychiatric illness, the authors suggest that we might view possession as a coping mechanism against other mental duress. In another way, we could conceive of possession as a cultural idiom of distress: reframing illness in terms of a socially acceptable category of experience that is widely shared.

Link to article: http://link.springer.com/article/10.1007/s11013-014-9393-8

“Confinement and Psychiatric Care: A Comparison Between High-Security Units for Prisoners and for Difficult Patients in France”

Livia Velpry & Benoît Eyraud

Focusing on French mental health care, this article explores the evolving use of confinement as part of the treatment of mentally ill individuals who exhibit violent behavior. The authors parallel the nature of confinement in French psychiatric wards to the security practices of high-security prison units.

In their research, Velpry and Eyraud discovered that the public appeal to heightened security in psychiatric institutions, as well as executive action from the president, led to a “turn” towards new confinement measures. Second, psychiatrists used this new narrative of control to justify control techniques that they argued gave patients “psychic structure.” Rather than standing as its own therapeutic measure, physicians employed confinement as a means of managing “difficult” patients.

As an object of inquiry, this recent trend in French psychiatry recalls the complementary trajectories of care and justice, power and control, as well as reflects on the changing landscape of what we define as therapy.

Link to article: http://link.springer.com/article/10.1007/s11013-014-9400-0

“Psychiatry with Teeth: Notes on Coercion and Control in France and the United States”

Anne M. Lovell & Lorna A. Rhodes

This commentary piece on the articles published in the current issue highlights the “rough edge” of the use of constraint and coercion to subdue “difficult” psychiatric patients. Lovell and Rhodes note that many of the articles demonstrate how these forms of discipline and control are enacted at the local scale, and remind us that the exchange between psychiatric patient and the care institution is the site of the strongest conflict when we look at systems of control. What is the border between “care and custody,” the issue asks? How do we as anthropologists contribute to the knowledge about these complex social interactions?

Furthermore, the authors observe that the geographic emphasis on psychiatric care in France and the United States is hardly accidental. Although care practices for the mentally ill differ widely between the two countries, the focus on constraint and control is similarly present in the scholarly literature produced on psychiatry in each place. Likewise, in French and American research, there is a mutual tendency to study mental health care in terms of autonomy, freedom, humanism, and democracy.

Link to commentary: http://link.springer.com/article/10.1007/s11013-014-9420-9

Want to see a preview and abstracts of all the articles in the current issue? Find details on the full issue here: http://link.springer.com/journal/11013/38/4/page/1

A Few Words from the AAA 2014 Meeting

Posted by jknopes

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

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

AAA 2014: Sessions on Biotechnology and Medical Practice

Posted by jknopes

For our readers attending the American Anthropological Association annual meeting this year, we’ve put together a second selected list of sessions on anthropological approaches to biotechnology and forms of medical practice. The following selection of sessions was drawn from this year’s AAA online presentation schedule for the 2014 annual meeting, to be held this year in Washington, DC from December 3-7th (for more information, click here: http://www.aaanet.org/meetings).

Wednesday, December 3rd

Reproductive Potentialities: Assisted Reproductive Technologies and the Imagination of Possible Futures

8:00pm-9:45pm

https://aaa.confex.com/aaa/2014/webprogram/Session11643.html

Thursday, December 4th

Techniques and Technologies of Global Health

9:00am-10:15am

https://aaa.confex.com/aaa/2014/webprogram/Session11699.html

What Constitutes Medical Knowledge?: Part 2 of a Discussion of Affliction by Veena Das

11:00am-12:45pm

https://aaa.confex.com/aaa/2014/webprogram/Session10870.html

Saturday, December 6th

Producing Intercultural Discourse in the Clinical Encounter, Part 2

2:30pm-4:15pm

https://aaa.confex.com/aaa/2014/webprogram/Session12505.html

Revisiting Midwifery: New Approaches to an Old Profession

6:30pm-8:15pm

https://aaa.confex.com/aaa/2014/webprogram/Session11410.html

Ordering, Morality, and Triage: Producing Medical Anthropology Beyond the Suffering Subject – Part 1: Biomedical Interventions and Failings

6:30pm-8:15pm

https://aaa.confex.com/aaa/2014/webprogram/Session11357.html

Sunday, December 7th

Doctors: Influencing and Being Influenced by Their Work and Subject

10:00am-11:45am

https://aaa.confex.com/aaa/2014/webprogram/Session12929.html

AAA 2014: Sessions on Psychiatry, Mental Illness, and Drugs

Posted by jknopes

For our readers attending the American Anthropological Association annual meeting this year, we’re featuring a list of sessions sure to pique your interest in various aspects of mental illness, health, drugs, and psychiatric care. The following selection of sessions was drawn from this year’s AAA online presentation schedule for the 2014 annual meeting, to be held this year in Washington, DC from December 3-7th (for more information, click here: http://www.aaanet.org/meetings). Sessions in the list are organized by chronological date and time.

If you would like your session to be added to this list, please email a link to the session description on the AAA website to: jcb193@case.edu.

Global Mental Healthcare: Challenges, Controversies and Innovations

Wednesday, December 3rd 2pm-3:45pm

http://aaa.confex.com/aaa/2014/webprogram/Session12926.html

“Global” Knowledge, “Local” Care, and Subjectivity: Producing an Anthropology of Psychosis

Wednesday, December 3rd 2pm-3:45pm

http://aaa.confex.com/aaa/2014/webprogram/Session11392.html

Psyche and the Brain in the 21st Century

Wednesday, December 3rd 4pm-5:45pm

http://aaa.confex.com/aaa/2014/webprogram/Session11636.html

Transcendance and the Everyday in Responses to Trauma

Thursday, December 4th 2:30-4:15pm

http://aaa.confex.com/aaa/2014/webprogram/Session11838.html

What Drugs Produce

Saturday, December 6th 9am-10:45am

http://aaa.confex.com/aaa/2014/webprogram/Session11124.html

Psychological Disorder and Subjectivity in Socio-Political Context

Saturday, December 6th 11am-12:45pm

http://aaa.confex.com/aaa/2014/webprogram/Session12768.html

Ordering, Morality and Triage: Producing Medical Anthropology Beyond the Suffering Subject Part 2: Mental Health and Illness

Saturday, December 6th 2:30pm-4:15pm

http://aaa.confex.com/aaa/2014/webprogram/Session11809.html

Professional Perspectives in the Anthropology of Drugs

Saturday, December 6th 6:30pm-8:15pm

http://aaa.confex.com/aaa/2014/webprogram/Session11263.html

Book Release: Paul Stoller’s “Yaya’s Story: The Quest for Well-Being in the World”

Posted by jknopes

Image from UC Press website

Out this month from the University of Chicago Press is Paul Stoller’s book Yaya’s Story: The Quest for Well-Being in the World. The text traces the author’s friendship with a Songhay trader from Niger named Yaya Harouna: a man who moved to the United States as Stoller, an anthropologist, had likewise made a journey from the USA to Africa as a Peace Corps volunteer. Their story begins whenever Stoller meets Yaya selling artwork in an African market in New York City’s Harlem neighborhood, where Stoller carried out research.

Although the men’s histories are markedly different, they become close after the two are each diagnosed with cancer: this serves as the heart of Yaya’s Story, and the experience upon which the two men’s culturally divergent, yet not entirely dissimilar, narratives cross paths. With extensive publications in the genres of both ethnography and memoir, Stoller is certain to blend keen anthropological insight with deeply personal accounts of human suffering, endurance, and resilience in the face of illness across cultures in his latest book.

Stoller, Professor of Anthropology at West Chester University, is a 1994 winner of a Guggenheim Fellowship and the 2013 recipient of the prestigious Anders Retzius Gold Medal in Anthropology from the King of Sweden.

You can find out more about the book here, at the UC Press website:

http://www.press.uchicago.edu/ucp/books/book/chicago/Y/bo18882897.html