Category Archives: health

about health related matters, whether mental or physical (e.g. autism, medical interventions and practices

An actor-network of consequential consociates: applying anthropology to one’s personal case

In this post, I am doing something somewhat different from the usual.  I am maintaining the order I think I have established (at least as I look at it, retrospectively): this is an experiment in anthropological theorizing and teaching.  But I am delving further into parts of my life that I have not brought out.

So here it goes: applied medical anthropology

A few years ago, my wife, Susan, was diagnosed with a form of cancer known as “myelofibrosis” (who may not know it under that name might be a topic for another post as the exact name can be consequential—see below).  The “official” diagnosis was made, not surprisingly by an oncologist, the acknowledged, state approved, expert who can transform speech (this is myelofibrosis) into not simply an act, but a sequence of new moves a particular set of others, from the patient, to her family, to insurance companies, must now make. [This would be easy to model as a special case of entry into a particular kind of polity of practice.]

The oncologist told us, as I remember it four years later, something like: “People live with this for 15 years or more … You are likely to die of something else … It will change your everyday life as you will now have to schedule regular medical visits.”  I remember she was altogether good at telling us something that we knew, and much that we did not know: we had certainly never heard of this cancer or of its treatment.  Of course we went to the Internet and learned what we could, talked to her further, and settled into what I am experimenting in calling, for various theoretical reasons, a “new normal.”  Actually, what we learned was not extremely bad news for people entering in their 70s.  The oncologist then (and I will keep emphasizing conversational and interactional temporality) tried a drug that would alleviate the symptoms of a cancer that affects the production by the bone marrow of red blood cells: profound anemia and the attendants limits on mobility.

Susan’s body, in its thinginess and peculiarities, was leading us to various particular disabilities that can be mitigated or expanded depending (de Wolfe 2014).

So, this was actually a good time for us to adopt the car culture of suburbia.  The long walks in Manhattan to which we were accustomed would not have been possible anymore.  We escaped one disability.

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on taming the ignorant powerful …

In an earlier post, I asked a question, with a tongue in my cheek: “how could we tame Oprah?” I did not specifying who ‘we’ are, on what grounds ‘we” should try to tame her, and whether taming Oprah (and others like her) is something that could be done.  After all, they are wonderfully extra-Vagant (as Boon, 1999, might put it) and likely to escape most forms of social control.

I leave the questions open for the moment in order to expand the puzzle triggered by a critique of the advice Oprah dispenses on matters like vaccination.  There is every evidence that, from the ‘official’ public health point of view, her shows can be dangerous, particularly when she discusses vaccination.  She may endanger the health of individual children not getting vaccinated, as well as the health of the public as these children get sick and may sicken others.  At least this is what us, sober headed experts in public health as driven by medical research, might say (and have said).  As a highly schooled expert myself, and someone who generally accepts what other experts tell me, I am uncomfortable at any challenge to my expertise, particularly when it comes from someone as powerful as Oprah.  But I am not writing her to complain.  I continue here to puzzle.

In the earlier post, I marveled at Oprah’s pedagogy (the way she formats the discussions) and at her use of a classic American formula where highly schooled experts are pitted against the common sense of the non-expert.  As a cultural anthropologist, I cheer at a particularly striking improvisation on an old theme.

But I am also an anthropologist interested in education.  As such I am puzzled and need to figure out how the new skepticism about medical authority is actually performed, by whom and when.  So I was fascinated by an editorial by Joel Stein of Time Magazine about “The Vaccination War” and how it played out in a “liberal, wealthy [couple] of L.A.” and their immediate network.  He assumed his new-born would be vaccinated, his wife said ‘No’.  So:

To try to be open-minded and stop our fighting, I went to a seminar about inoculation at Cassandra’s yoga center.  Along with about 50 other people, we paid $30 each to listen to Dr. Lauren Feder.

This Dr. Feder explained why inoculation is not necessary, and how not immunizing might possibly be healthier for the child.  I am tempted to write about this as a case of deliberate mis-education and induced ignorance among the prosperous and powerful.  I could also write it as a case of resistance among some of the powerful (the people who might appear in Larry David’s Curb your enthusiasm) against some other powerful people (health experts).  Unless of course it is just a case of mass hysteria.

Again, I do not want to complain, but the problem remains: “how are we to tame the mis-guided powerful?” (if we decided to do so).

“Educational research” has produced much that has documented the apparent ignorance of the poor and powerless, particularly as compared to the apparent knowledge of the prosperous and powerful.  This literature assumes that the latter know (more) and that they pass this knowledge on to their children (“cultural capital”).  But what if the prosperous also mis-educate their children, if not on matters relating to schooling at school-relevant moments (e.g. high stake exams), at least on a lot of other matters, and at other times?  And what if the prosperous’ success in school tests is not quite a reflection of what they end up “knowing”?  What if the prosperous, often, just pass (pretend, lie) at passing (school tests)?  There is some evidence that the children of the poor sometimes fail at tests because they refuse to do what it takes to pass.  We need to see if, in some case and for certain purposes, the children of the powerful succeed at the same tests because all they have done is do what it takes to pass, without learning in the sense of understanding or accepting the answers they gave on the tests.  When test-taking is done, then what they actually learned over the course of their schooling, or what they continue to educate themselves about as they grow older, may reveal itself as something else altogether than school-people might have expected.

Joel Stein, in the same column, says something very interesting and challenging to us school people about the source of his adult knowledge:

Even in the age of Google and Wikipedia, we still receive almost all of our information through our peers.  I believe in evolution not because I’ve read Darwin but because everyone I know things it’s true.

Now, that is a challenge for all educators, and for all researchers on education.

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on being educated about cancer, death rates, and their statistical interpretation

Last week, I completed the first draft of what is to be the postface of the third volume of the Perspectives on Comprehensive Education Series I am co-editing with Ed Gordon.  It includes a few lines about the responsibility for journalists to build on their educative role.  They educate, whether they are aware of it or not, simply by providing information about the world we all inhabit.  I use the word ‘educate’ rather than ‘teach’ to distinguish between activities where one can check what those who read (watch, or whatever) might learn, and activities where there is no way to check.  Journalists make something available that is much more than “information” or even “opinion.”  Journalists make us discover what we might not know, and they organize a curriculum, as well as a pedagogy.  How might we get them to take this activity even more seriously than some of them already may do?

There is much evidence that journalists know about their educative role.  One example is a sub-story that accompanied a New York Times story about the difficulty of curing cancer, “Advances Elusive in the Drive to Cure Cancer” (NYT, April 23, 2009).  The handle supposed to get our attention (I think) is the fact that modern medicine has been much more successful at dealing with heart disease than with cancer.  The basic “data” is a comparison of death rates and a spectacular table summarizing “Deaths from cancer, adjusted for the size and age of the population [compared] to death rates from heart disease and stroke.”

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an education into Ritalin for college success

I am an altogether avid reader of Discover, a magazine about “Science, Technology, and The Future.” I find something interesting in almost every issue. Sometimes it is a bit of new knowledge interesting for its own sake. Often it is because it provides a brief glimpse of the actual doing of science, and thus help think further about the anthropology of science, and also anthropology as a science. Quite regularly, in recent years, it gives me a sense of a journalistic discourse about matters at the edge of science and politics–particularly, on the one hand in the common articles about ecology, global warming, etc., and, on the other hand, on human evolution and sociobiology,

In the April 2009 issue I found in passing a little of Americana directly related to my arguments about the uncontrolled education of the officially ignorant. In an article on “Building a better brain” (the title is not ironic, and gives a sense of the editorial attitude towards the story) that discusses about the great things “mind-altering drugs” might do for humanity, they write:

In a study published last year in Pharmacotherapy, researchers at the University of Maryland found that of 1,208 college students, 18 percent took ADHD medications like Ritalin and Adderall even though the drugs had not been prescribed. You might think the college students were taking stimulants mostly to party, but that is not what the researchers found. The students were taking the stimulants mainly to help with studying. (Baker, 2009)

The story is written in the “brave new world” discourse of enhanced possibilities (“Think of millions of workers in India or China cognitively enhanced with neuropharmaceuticals. Will the United States be able to compete?”). The original study took the opposite tack. The paper ended with warnings to physicians and parents about “overuse and/or diversion of stimulant drug” (Arria, Caldeira, O’Grady, Johnson, & Wish, 2008, p. 266).

Neither wondered about is my perennial question (Varenne 2008, 2009): where do the students find out about these drugs? What sort of conversations do they have about them? To whom do they talk about it? That is, how do they educate themselves about these drugs? What is the place of the race for school of success in these discussions?

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