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ANTH 227
Dan Small

Anthropology 227 – Medical Anthropology January 15 , 2013 Healers and Medical Culture Filde’s painting - sick little girl on Christmas eve - doctor who is struggling with being powerless but stays with her all night long = compassion - in the background there is death looming over, in the morning she died Narratives - everyone has a different narratives, they may intermix with zones of friction - are a social action, not a “thing” - one of the most powerful ways of knowing, we respect it the most ex. When you take a class you look for someone who’s been there - going beyond the science – this is what medical anthropology adds to the picture of medicine and science - ways of thinking, speaking and organizing with a plot like structure - purpose embedding in them - give shape to illness experience , establish meaning to the meaning of our experience - gives shape to clinical practice Professional vs. Patient narratives – medical anthropology in concerned with the complex interaction between individuals, their bodies, interruption with their health care situations and institutions. Disease - the biological manifestation of a health case interruption, not an entity but a way of explaining something Illness – the way a disease is brought into individual consciousness, experience - this doesn’t exist in clinics, in families Sickness – the way that disease and illness are socially constructed Meaning centered Anthropology - Medical anthropology looks at the meaning of illness experience or the meaningfulness of the disease to the physician. The very same disease may have a completely different meaningfulness from physician to physician. - Interpreted Anthropology - because something is constructed doesn’t mean that it is imaginary – interpreted differently depending on the individual - Everything has a critical social aspect - Trying to get a plausible interpretation Social relations between individuals involved - Ethnography: description and analysis of a particular aspect of society/piece of culture, the collection of data that describes a culture (both a product and a process) Ex. Participant observation - Interviewing 700 people for 7 minutes vs. interviewing 7 people for 700 minutes Looking for narratives Arthur Kleinmann – “Father of Medical Anthropology” Medicine is a culture - Has its own language - Changing all the time – values change, culture changes Analysis – Qualitative Research - Data = interviews 1. Interview take taped interview and type it exactly how it is (including silences, pauses etc. - tell you just as much) 2. Reflect on material gathered – look for key themes, values, narratives, implicit and explicit values Cancer - The majority of studies that analyze the psychological aspects of illness reply upon instruments that yield quantitative data such as structured interviews, standard scales etc. rather than qualitative approaches that might be able to shed light on the issue of validity - “has a silence around it”, has a certain culture value around it - Some place, your diagnosis is not given to you Patient vs. Clinicians – Clinicians resist answering to the narrative of the patient as they have a different. - Clinicians focus on the treatment, patients want to know their chances Later on, patients will be transferred to clinicians who will Final Narrative - When treatment is over, the therapeutic narrative comes to an end Therapeutic Narratives - Therapeutic emplotment: Medical anthropology that focuses on the process by which practitioners and patients activity make use of a narrative framework, with a plot like structure, helps them guide and interpret therapies - This shapes the reality for both patient and physician - This may be completely different than the patient illness narrative Therapeutic narrative: outline what will take place (from start of treatment to the end of treatment) vs. Illness narratives: worrying about things, how did this happen. These two narratives interact Friction between the two – ex. Clinicians refuse to talk about prognosis Professional Narratives - Resist answerin
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