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Lecture 2

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th Making Meaning of Illness Lecture 2 May 18 2011 refer to lecture notes as well • Culture, Explanatory Models and Narrative • Cultural aspects of illness and disease…” I am so grateful for my daughter’s cancer”- direct quote and say one thing your grateful for why? Her and her daughter has been estranged and when she heard from her daughter in 10 years.. and from mom’s perspective is healing perspecitive… got opportunity to help daughter and patched themselves up… healing vs cure… at the time of the sotry… cure was not certain but she was so impacted by healing…healing was not individual.. healing was familial family…. Not just the girl with cancer… can fit into rebirth literature because mother Is re-newed…. Narratives is that it can be repeated, passed on and that way it re-creates its meanings • Look at the process of meaning making in this lecture… • On culture: perspect of culture in this course…. Ideational system ( ideas, symbols, concepts, rules, meanings)… meanings and rules that govern how people live…assumptions on which behavior/life is based.. there are rules of how we think of ourselves • Culture- distorting lens that we forget that we are wearing and taking them for granted. Assume that we are seeing reality directly but not really.. Features of this lens.. assume that everyone else sees the world the same way we do… and this is where it gets interesting… we try to learn about prescription of own lens.. how is my perception different from anothers.. • Culture is : not homogenous … it is changeable and develops ; the underlying basis for having a conversation…. This concept helps us to avoid being ethnocentric( meaning) culture is underlying basis for conversation or disagreeing… ( do not connect) • Culture encoding is often hidden, implicit in what people say and do… some culture is more dominant hence power is issue • Notion of culture was strongly promoted like Franz Boas to counter racism…. Boas conducted multi generation studies …immigrant children did better if had enough time to socialize… introduced culture to … race…culture is what race is not. ( no real foundation as concept) but has a social reality and there it has some kind of impact. Culture is learnt behavior. • Culture definition is hermeneutic (meaning: biblical interpretation started in 1800s and to come to some agreement to how to interpret bible … what is involved in interpreting…. * hermeneutic circle upon..its about a dialogical relationship because we talk to people… define and read upon it. ) • Culture is not same as behavior but how we interpret behavior • Methods we use to study culture is not same as natural sciences. Culture is not an object to be analyzed.. culture emerges in dialogical conversation • We try to learn to communicate in a better way. A whole lot of cultural conditioning is not explicit… ( more implicit).. as an observer (anthropologist- we have to bring it out) • Disease: a biological or biochemical malfunction ( bacteria..virus) • Illness- impaired functioning as perceived by the patient within a given cultural context • Disease –describes the perspective of medical specialist and patient condition is framed as a technical issue • Illness refers to how a person perceived and responds to symptoms and how disease is shaped into experience ( how are bodily changes organized, given meaning, how does it get is it interpreted) • Illness model shapes ones experience of disease (might be individual or more social… a fairly elaborated idea ( this symptom this illness and this is what we have to do ) or can be individual here in the west… a whole a lot of information altering particular viewpoints.. • Illness model – not everyone that gets a disease will not respond the same way. May not help individual help resolve disease but help morally situate it. Can help decide if your fault (eating too much fatty foods or give ancestor food) or someone else’s. IE; Breast cancer: for a doctor it’s a tumor in the breast… can be well classified in stages and each stage can have ideal treatment and prognosis. What is breast cancer for a patient? .. it’s a lump… it might be dread or fearful emotion, surgery, death, chemotherapy…changed bodily terrain or self image.. hair lost, breast removed.--> change in change is social role or stigma ( this is all the illness side of a illness diagnosis) • Disease model.. is path physiological model.. • Disease/Illness = Epistemological Frameworks ( How do we know * get meaning) • Different frameworks in which we can construct model… • any model that tells a culturally meaningful story of a illness= illness model • “ Biomedicine is one such cultural system of healing…”- when it operates with a disease model…it becomes a illness model..disease is the illness model in biomedicine… symptoms as signs of disease • Disease and Illness came up ( formal and informal) via biomedicine.. looked at traditional medicine where did not have biological understanding.. but they had beliefs and practices. Biomedicine treat disease and illness model fixes illness.. • The spirit catchs you falls: sacrifice pigs + shamans... does a lot for illness not disease ( from doctors POV) • Toronto: how you are feeling about illness and your family…. Not useful for diagnosis… no one really cares how you feel about it. However going to a doctor and not feelings like you were heard usually sends people to alternative forms of medicine ( being heard helps person) • Disease and Illness : dichotomies… the disease/illness dichotomy has a affinity for other dichotomies that are prominent features of western knowledge practices…. Anthropologists aim to be aware of when such dichotomies are invoked.. and to recognize the work that they do and to use them reflexively.. ( nature vs culture; mind vs body …) what is dichotomies? • Illness (mind – more about feelings and usual traditional medicine…ritual healing.. managing peoples perception, generating belief that people are well… placebo effect sort … cancer can sometimes remit…) and disease ( body.. what you can see ina lab, identifying the change bacteria virus ) • Curing and Healing Curing: treatment of a specific biological condition/ removal of disease Healing: treatment of illness, addressing beliefs, emotions, social relations ( whole person) • Illness mind healing ( traditional medicine) Disease Body curing ( biomedicine) • Question is about emphasis because some doctors do care. • What is specific to biomedicine? no traditional medicine in the world that has biomedicine ( sequencing…) • Biomedicine is a part of culture… becomes to naturalized… • Look at characteristics of biomedicine…. Look as system of certain assumption…. Rationality ( knowledge production..hypothesis and assumptions should be verified opposed to Chinese medicine looks at the past Manuel…); objectivity ( phenomenon is real if they are observable in controlled circumstances… and if we cant repeat them then they are not real ) ; Quantification: emphasizes of measurements and ideal arrangements.. numerical data.. ; Mind body dualism * really strong component of biomedicine… body is site of measuring ( divisi
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