Health and Medicine

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Gee whiz! And here I thought looking for meaningful cross-cultural
generalization was a time-honored tradition that still offered some
productive avenues for scholarship. Maybe we should burn all the intro
texts and 'armchair' classics that communicate a deceptive and mundane
"fatuous generality"? Gosh, ethnology died and nobody told me about it.
I had heard racist slurs went out of vogue in polite conversation, though,
even for the purposes of underlining one's point. I'm good and ornery
but I'll try and keep it civil.

OK, let's set aside the tag "non-western medical model" and assume that there
is a range of human strategies for dealing with illness and sickness which
may or may not have some organic basis being as we share concern regarding
the "impact for good or ill on the lives of billions of people." For the
sake of argument let's refer to those techniques and that subculture
characterizing the 'clinical gaze' in industrial/postindustrial (dare I say
western) societies as biomedicine [and let me note here that a trip to one's
local University or PresbyMethodoStMtWhatzits or HMO or Rural Health Center
may indicate that the "model" is far from on the way out].

Now assuming there is a patient, I recall some old sociological wisdom about
the patient giving up a certain amount of power, of abdicating in this sick
role and quite often these individuals let clinical and significant others
make decisions for them and even do procedures they may not fully understand
to them, whether this be diagnosis accomplished with a small rodent or magnetic
resonance imaging. I hope it would not be too bold to overgeneralize that
patients and others want to know "why me?" which could induce practicioners
to etiology: 'the child was frightened up on the windy hill,
the rainbow had touched down, the cold has effected her liver' ... 'hyper-
tension, hyperlipedemia, 30 pack years cigarettes'.

I'll take another stab: clinicians' approaches, whether depending on greater
or lesser holism, will require recourse to some understanding of anatomy and
involve some recourse to physical principles whether etiology is ascribed
to supernatural causation or not. In general, a particular organ or system
would be afflicted, right? Am I mistaken that humors relate to process as
well as substance: 'the cold is moving internally which is very dangerous'...
'the stenosis has reduced vascular flow'. The clinical moment implies
ambiguity, particularly regarding diagnosis and I imagine the words "I have
no idea, I don't know" are not in many healers' vocabularies: a moment of
of silence while s/he reads entrails or CT, scratches head and plunges in
to the scary business of solving human affliction. This may require greater
or lesser degrees of smoke and mirrors, greater or lesser specialization
and technical training, greater or lesser reliance on pills and injections
[just a little ethnographic reality check], greater or lesser organization
and systematization of the knowledge base (yes, nosology). Looking for
postulates is great... our humanity is common... go for it. Personally I
hesitate positing what some author somewhere called "a spurious equality"
between systems, but that might be a different argument.

Just one final thought, it strikes me that the health care debate is less
about the cultural logic of the model than about power and big bucks. Correct
me if I am mistaken he said naively.

Jim Stansbury

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