Advancing Life, Dismissing Death

Throughout this quarter in “Culture, Medicine, and the Body”, we studied and compared perceptions of health and medicine by investigating the very social fabric that informs these notions. The pattern of biological commodification that Western medicine exemplifies became increasingly obvious through the weeks but in our final sweep of examining and questioning this trend, we focused on the recent and relatively uncharted field of bio-regenerative technology. The sophisticated experimentation currently underway that uses human embryonic stem cells (hES cells) to expand our understanding of life by regenerating it reflects the value that our society places on eliminating death and reversing ageing. The popularity of portrayals of immortality and supernatural abilities in the media confirm societal interest in the indefinite extension of life. As biotechnology improves, these once-fantastical plots in science fiction novels and movies represent a distinctly possible reality.

In the plot of any captivating story, a twist arises that complicates or thwarts the efforts of the characters that then slows the realization of their goal. Based on this simple analogy and on the hubris of Western biomedicine, I argue that the repercussions of our intentional and unscrupulous altering of the natural processes of life and death will incur consequences that future societies will be ill-equipped to handle. Who will benefit from technologically perpetuated life and what will this mean for unaffiliated populations? Additionally, in the purported “crisis of old age”, will the current trend of biotechnology eliminate health disparities or escalate them?

Both assigned articles acknowledge the crisis of old age and question the methods that fields like economics and science use to reverse it. Melinda Cooper writes extensively about the World Bank’s preoccupation with the globally growing elderly population since the extant resources and infrastructure cannot absorb the vast addition to society that result from the baby boom. Cooper explains that the crisis is even more extensive than this issue of population support because instead of addressing questions of infrastructure, we focus on research and “a much more malleable concept of biological limits, one that situates age as a movable threshold between surplus and waste, obsolescence and renewal”, or concepts like stem cells (Cooper 3). The effect that capitalism has on our understanding of life and death is well-documented as its tenets of productivity and reaching full potential influence the mindset that biotechnology’s use of regenerative medicine reduces the human waste that otherwise occurs in death. The commodification of life has been confirmed in our study of Western medicine this quarter to which Cooper responds that it resulted in “a profound legal reconfiguration of the value of human biological life” (Cooper 13). She further explains that, “the potential person will not be commodified – but the surplus life of the immortalized human stem cell will enter into the circuits of patentable intervention” (Cooper 13).



Courtesy of Mode Weekly



The cartoon above depicts Michael Jackson, a now deceased pop icon who famously underwent several plastic surgeries to alter the shape of his nose. Stem cells, according to Geron’s Annual Report from 2000, “can develop into any of the body’s cells, including heart, muscle, liver, neural and bone cells…due to this ability for self-renewal, hES cells are a potential source for the manufacture of all cells and tissues of the body”, which is why the depiction shows Michael Jackson with a regenerated nose (cited in Cooper  14). This comic relief regarding stem cell research and the future abilities that an individual may have in recreating organs and other cells may actually be a possibility soon. The optimization of body image and personality that individuals in Western culture already demonstrate through plastic surgery and age-reversal therapy could escalate to unforeseen levels if this technology allows the resuscitation of life and denial of death.

Several examples of immortality in pop culture exist like vampire legends and tales about hidden resources found in nature like special water that ensure immortality for its human users. Tuck Everlasting, a novel by Natalie Babbit that was published in 1975, explores immortality and the hardships that come with it. The main character befriends a family who drank from a spring of water that made them immortal and toils to guard their secret from a society that would surely capitalize on this resource. The plan that the family hatches goes awry and the unhappy ending implies that mortality is a necessary process that should be accepted. The image below shows the romanticized portrayal of life for the immortal boy, Jesse Tuck.

Courtesy of The Film Journal

Another example, the popular Twilight series, tells the story of another immortal family of vampires. The human main character lusts after the immortality that her transformation into a vampire would offer her, a notion that many in our society today seem to harbor through our emphasis on age-reversing and life-prolonging technology and medicine. The image shows a similar perception of immortality to Tuck Everlasting’s portrayal. The vampire family from the series are also characterized as beautiful, established, individuals who have the good fortune of living forever with optimal physical and mental qualities.



Courtesy of bloodrinako



Lafontaine’s “The Postmortal Condition” mirrors Cooper’s account in that she also discusses our dismissal of death and fixation on an ever-increasing lifespan. She brings up the same themes that these pop culture examples present. “The technoscientific desire to indefinitely prolong life is based on a particular conception of human perfectibility”, she writes of the true desires behind our “our quest for immortality” (Lafontaine 301). The patent laws that Cooper mentioned in “Resuscitations: Stem Cells and the Crisis of Old Age” pass because of science’s supposed mission to improve the quality of life for those with incurable conditions among other medicinal reasons. However, we clearly have other agendas too. Lafontaine speaks to this, “quoted by many researchers as the miracle solution to human weakness and death, nanotechnologies embody the technoscientific ideal of a world without mortality” (Lafontaine 304). Society values an increased quality of life for those that are privileged enough to access these technologies but the subsets of society that purchase exorbitant organs from other countries and invest in cryogenics represent a small portion of the global population. I wonder what the social landscape of the world will look like in the future if only the most powerful and affluent individuals preserve their existence while everyone else-those in developing countries especially- remain exposed to the same inequities that threaten their health today.  

Bibliography:

Cooper, Melinda. "Resuscitations: Stem Cells and the Crisis of Old Age." Body & Society. 1st ed. Vol. 12. London, Thousand Oaks and New Delhi: SAGE Publications, 2006. 1-23. Print.

Lafontaine, Celine. "The Postmortal Condition: From the Biomedical Deconstruction of Death to the Extension of Longevity." Science as Culture 18.3 (2009): 297-312. Print.



Revitalizing Death

 

Death, an inevitable phenomenon in life (so far), incites fear among individuals of varying cultures and beliefs all over the world. Those of agnostic identity freely admit to little confidence in the existence of an afterlife while atheists assert that no higher being or cerebral haven waits to welcome us when we quit the Earth. Meanwhile, individuals who subscribe to a religion usually belong to the camp that allows for some version of an after-life or preaches a divine purpose in existing. Despite religious convictions or the lack thereof, death still represents a feared enigma to many. I will provide arguments as to why I believe Americans encounter particular difficulty in accepting death as an inevitable outcome to our earthly journey. Another fascinating aspect of this topic is how sub-cultures in America and other cultures around the world perceive life and death. Why is it that Americans reduce death, a feared event, to a medicalized process instead of celebrating its merits, which for some include an end to physical suffering and to others an excuse for the deceased individual’s social network to gather? 

The video above from New Orleans’s The Times Picayune discusses the traditional Creole funeral rituals that frequently occur in Jackson Square and in other parts of the French Quarter. The “jazz funeral” or “funeral with music” involves a brass band of variable size, family members, friends, and miscellaneous community members who begin marching from the deceased individual’s home or church. They process through the streets of New Orleans toward the cemetery with the band playing sorrowful dirges or church hymns. The mourning ends after the burial in the cemetery. On the return trip, the brass band strikes up ragtime tunes like “When the Saints Go Marchin’ In”. I grew up near New Orleans and witnessed several funeral processions when visiting the French Quarter. African, French, and Caribbean cultures join together to create this beautiful community-wide reaction to death.

In Margaret Lock’s “Living Cadavers and the Calculation of Death”, she discusses the cultural constructions of life and death that predominate in Western medicine contrasted against the beliefs in Japan. She measures our distinctive value system against Japan’s by studying the criteria that both cultures use to determine when life ends. Understanding how brain death affects overall death is an increasingly sensitive matter as Western medicine prioritizes organ procurement and transplantation in its approach. Lock asserts, “knowledge, particularly from the Christian tradition, buttressed by Enlightenment philosophy, contributes to a tacit understanding that makes it appear rational to think of brain-dead bodies as objects that can be commodified” (Lock 144). To legally and ethically justify the extraction of organs from a technologically sustained- but still warm- body, Western medicine developed standards for determining the time of death.  

Courtesy of "Eternal Beauty", this image of a Scottish cemetery depicts a scene representative of death

The individualistic values promoted in America parallels to the commodification of brain-dead bodies in our ICUs. Our capitalist society values individuals who contribute to the economic system by remaining productive. The high probability that a brain-dead individual will not function again as a productive member of society leads to their quick commodification. Western medicine’s emphasis on organ procurement reflects this belief. Medical practitioners developed criteria so that brain-dead patients could qualify as an organ donor, in effect our way of ascertaining that we squeeze the last productive elements from their technologically sustained cadaver.  In Japan, doctors allow respectful space to families of brain-dead patients and never broach the subject of organ procurement unless families inquire about it. Japanese culture, much more community-based than that of American culture, emphasizes “family desires” as well as indigenous medical concepts like “the substance of ki”, and “kokoro as the centre” (Lock 148).

An article from National Geographic discusses another culture that regards death highly, that of the Torajan people in Sulawesi, Indonesia. “Funerals are really the cornerstone of Toraja's social fabric,” the author explains, “bringing together far-flung families and communities” (Hile). To properly honor the dead, Torajans go to great lengths in the planning and execution of lavish funerals that the author likens to American weddings. Ancestors are believed to allow good crops, fertility, and health if their funerals meet expectations. The author offers an astonishing portrayal of their funerals, “A typical ceremony for a farmer's family may have as many as 1,000 guests. Hosting them can saddle the descendants of the deceased with staggering debt that may take as long as 15 years to repay” (Hile). The celebration of life seems possible only through an acknowledgement that death actually occurred, which Americans avoid by fearing it and by increasing longevity through technology.

Eric Krakauer in “To Be Freed from the Infirmity of (the) Age” introduces the life-sustaining technologies of Western medicine like hemodialysis and mechanical ventilation and the ethical dilemmas that they cause. He mentions a concerning dichotomy, “The great gift of this technology brought with it the unforeseen danger of exacerbating suffering” (Krakaur 382). While the fear of death did not serve as the catalyst for innovative medical technology, the ethical dilemmas that are frequently associated with the technology relate back to our inability to process and to accept death as an outcome. Dr. Iva Byock speaks to this unpreparedness by mentioning the increased deaths in nursing homes where elderly are left to die and American ICUs that aggressively intervene until an individual only lives through wires and machine. He adds,

“This is not the way anybody really wants it, but we have never had a cultural conversation about what a healthy last chapter of life looks like, what that would actually look like to be taking the best care possible of one another professionally and socially in a way that is not always seeking to prolong life, and it corporates this notion that dying is going to happen at some point” (Byock).

American society would benefit from the emotional catharsis that the acceptance and welcoming of death allows. The Creole culture invites a wide range of emotion when acknowledging the phenomenon of life and death through a musical parade. The Japanese resist commodification of brain-dead individuals because of their respect for the social connections that keep their cadaver alive. Torajan culture honors the dead in a great show of respect as a matter of necessity for their community’s health and well-being. Mainstream America could learn from these examples.  

 

Bibliography:

Byock, Iva. "Why Are We so Afraid of Death?" Big Think. Big Think, Inc., 28 Mar. 2008. Web.

Hile, Jennifer. "Lavish Funerals on Indonesian Island Spur Tourism, Debate." National Geographic Today 23 Jan. 2002. National Geographic. National Geographic Society. Web.

Krakauer, Eric L. "To Be Freed from the Infirmity of (the) Age." Subjectivity: Ethnographic Investigations. Joao Biehl, Byron Good, and Arthur Kleinman, eds. Berkeley: University of California, 2007. 381-97. Print.

Lock, Margaret. "Living Cadavers and the Calculation of Death." Body and Society. 10 (2-3). 2004. 135-52. Print.

Societal Values and the Medicalization of Personality

To be successful in America, there are certain implicit characteristics an individual should exude to earn respect and riches. A farcical dichotomy exists in that individuals strive to present similar, valued characteristics while maintaining individuality when in reality, the mass personality adaptation causes the homogenization of society by filtering out a range of unique traits. In our capitalist, free-market economy, the mantra of the “American dream” purports that an individual from any socioeconomic class or race cannot only qualify as a competitive participant in the “rat race” towards success but can even receive the social status and recognition that accompanies the endorsement of being the best or at least, of beating the other participants. Thus, the emphasis on self-presentation clearly stems from our society’s structure. The self-awareness encouraged among children in their formative years begins the pattern of self-serving behavior that benefits one person’s advancement as opposed to community-oriented societies that function by collective efforts to better society.

In no particular order: What do the characteristics we value demonstrate about our value system as a whole? How does dominant society address the exceptions to the rule, the outliers who resist the social pressure to conform? And finally, how is America’s global standing as hegemon maintained through the narcissism that our society cultivates in individuals? Stephen Colbert of “The Colbert Report” in the video below addresses this last question. He parodies narcissistic American culture and the ethnocentricity that accompanies it.

Stephen Colbert's "Me Time: American Narcissism"

Colbert suggests that one of the obvious outcomes of our self-centered approach to life includes the self-importance we feel as a nation when measured against others, and more importantly, the influence that our attitude has on foreign diplomacy and how other nations perceive us. Individually, we act in ways that allow our self-advancement instead of working towards the betterment of our society and collectively, we hinge on our superiority as a country and seek to further our role as hegemon instead of aiming towards global improvement.

Carl Elliott in “The Face Behind the Mask” speaks to the characteristics that our society values by highlighting the ones that we dismiss through medicalization, a scientific basis that condones this societal rejection. He studies the sudden prevalence of social phobia among diagnosed mental disorders in the late 1980s. “In this case”, Elliot opines, “we are medicalizing a personality trait called shyness, which has been with us for a quite a well but has not previously been called a mental disorder” (Elliott 58). He cites the historical presence of self-help literature that suggests ways for us to optimize our qualities. While this literature potentially influences the attitudes and actions of readers, the medicalization and treatment of social anxiety or of excess energy (as discussed in Tuesday’s articles about A.D.H.D.) actually alters the chemical balance in our brains. The resulting alterations in personality and emotion prove harmful to individuals because they imply that changing one’s innate nature is necessary not only for societal acceptance, but also to attain a limited form of success. Elliott calls these tendencies, “partly a matter of American cultural style” but warns that it encourages Americans to “consider barriers to self-presentation, like shyness, to be social handicaps” (Elliott 70). Thus, dominant institutions reward valued characteristics like self-confidence and magnetism by casting a shadow over traits like sensitivity and introversion.

In a Washington Post article entitled “A Rush to Medicate Young Minds” by Elizabeth Roberts, she broaches similar concerns about the harmful effects that the medicalization of less socially desirable personality traits will have on children. Roberts argues that most entities supporting aggressive treatment have ulterior motives in doing so and that none of these involve the well-being of the individual. She writes,

“Unfortunately, when a child is diagnosed with a mental illness, almost everyone benefits. The schools get more state funding for the education of a mentally handicapped student. Teachers have more subdued students in their already overcrowded classrooms. Finally, parents are not forced to examine their poor parenting practices, because they have the perfect excuse: Their child has a chemical imbalance.”

I wonder, what will this generation of over-medicated children look like once they reach adulthood? Will an individual who would have been considered healthy 50 years ago not produce a groundbreaking novel or an emotionally-charged piece of art because medication stripped that person of his or her ability to feel deeply and to experience a wide range of emotions? That will be hard to measure. However, I attempted to gain insight into how medicated individuals feel now, as we are riding the first wave of subjective diagnosing and aggressive drug-prescribing. I came across the thread excerpts posted below entitled “inadequacy..poor me” (Courtesy of VBulletin's addforums).

Elduderino writes: "I recently received an 80% disability rating from VA. Major depressive disorder, ADHD, OCD, GAD, social phobia, and alcohol dependence-in remission. I have moved back in with my mom, due to being unable to function independently. I have no friends, I underachieve quite severely, and I am generally a 24 year old loser. I spend a lot of time thinking about how my life is slipping by and I have nothing to show for it. No success. I'm not even following a normal developmental path. I see women in my peer group who are strong, independent, accomplished, etc. And they terrify me. What I go for the intelligent, science-y, literati girls. But what the **** could I offer a woman like that? For all my above average intelligence, I'm still a low performing student, and grossly uneducated. I feel like a boy in a fat bearded guy's body. **** sucks man. Anyone else feel inadequate, or like a loser whose wasted a huge chunk of life?"

Nova2012 responds: "Yes, and same disorders here (except alcohol dependence). It's pretty awful. The depression keeps me from enjoying life. The social phobia keeps me from enjoying others. The OCD keeps me from enjoying my own thoughts. The GAD keeps me from enjoying my own company. What is left? No one can tell me. They just issue platitudes like "it will get better" or "you'll look back on this and laugh." Yeah, right."

The anguish of feeling inadequate that these bloggers write about exposes another possible motive of dominant institutions for medicalizing individuals: disorders sanction the societal dismissal of these nonconformist members. No wonder they feel inadequate. Society in the form of medical professionals told them that their true selves needed personality alterations and if this failed to produce them into an active participant of our capitalist empire, society views them deviants, holding their diagnoses against them and continuing to treat them with drugs and with disregard.

Elliott introduces a twist to this flawed system in “Amputees by Choice”. He discusses apotemnophilia, a condition likened to gender-identity disorder in which individuals crave amputation. Society ostracizes this group similarly to the individuals with social anxiety disorder.  Except in an apotemnophiliac’s case, he or she must convince society that the condition is legitimate instead of society pushing diagnoses on patients with questionable symptoms.

The increasing medicalization of common personality traits compounded with American self-consciousness and the desire to “get ahead” results in overdiagnosing, overmedicating, and the loss of our individuality that we tweak to fit society’s mold.

Bibliography:

Carl, Elliott. "The Face Behind the Mask" and "Amputees by Choice." Better Than Well: American Medicine Meets the American Dream. New York: Norton and, 2003. 54-76, 208-236. Print.

Roberts, Elizabeth J. "A Rush to Medicate Young Minds." Washington Post. 08 Oct. 2006. Web.

Changing Lifestyles and Health Inequities

Unnatural Causes, an acclaimed video series, identifies practices and mindsets that perpetuate racism and inequities in health. The episodes portray the widened gap between affluent and impoverished populations in the U.S., specifically exposing the trends in society that allow the health of undervalued communities to decline like the strategic placement of fast food joints and liquor stores in inner-city areas. In a video clip entitled “Impact of Poverty and Stress on Diabetes among Native Americans”, Dr. Donald Warne explains that impoverished conditions and high levels of stress contribute to an unhealthy lifestyle that almost guarantees chronic health conditions like diabetes and hypertension (Impact).

Courtesy of Unnatural Causes

A tally of the suffering Native Americans endured could stretch miles long. The forced removal off their land and the resulting loss of culture and identity that it spurred still damages the physical and emotional health of their communities nationwide. As industrialization and urban migration become increasingly common, which lifestyle features indicate unhealthiness? Why does the highest rate of chronic conditions like diabetes and heart disease continue to occur in the most marginalized of communities in the U.S.?

Dennis Wiedman in “Globalizing the Chronicities of Modernity” delves into the questions I posed above by studying the adapted cultures and lifestyles of communities, particularly indigenous, that have experienced declined health due to the rise of industrialization and globalization. He names the recent emergence of MetS, metabolic syndrome, as directly related to lifestyle change. Most individuals are not predisposed to these disorders, he argues. “No particular foods, genes, socioeconomic class, ethnicity, or other inequality can consistently explain the initiation of metabolic disorders in modernizing populations worldwide”, Wiedman opines of the enigmatic nature of MetS (Wiedman 38). This quote contradicts the remaining content of his article where he develops the theory that Native Americans suffer from a disproportionally high amount of stress due to the forced adaptation of a modern lifestyle.

Several studies exist today that prove the correlation between stress and health conditions. Wiedman cites studies specific to Native American health and their findings that “multiple generations of stressful events are associated with continued loss of identity, demoralization, and ongoing emotional suffering, key elements that maintain the chronic stresses resulting in metabolic disorders” (Wiedman 50). Clearly, he supports the conclusion that the historic oppression of these indigenous communities factor into their accumulation of stress, a scientifically proven causal agent of MetS. While I do agree that the genetic basis for these disorders remains less notable, I feel that undervalued groups in society are victims to social constructs and structural violence that predispose them to poor health and Wiedman’s so-called “chronicities of modern disease”. What are the main mediums that modern diseases use to reach populations? One way is through food.

Consumerism and capitalism are intertwined with the American food industry. In “On the Ideology of Nutritionism” by Gyorgy Scrinis, she cites Marion Nestle’s findings that that the constantly changing food politics obscure the message of recommended nutrition and healthy diet. Methods of coercion include lobbyists ascertaining the agendas of the food industry get passed by the U.S. government so that they can “shape the official dietary guidelines in ways that undermine criticism of processed foods and of high meat and dairy consumption” (Scrinis 39). The reductionism of nutrition Scrinis discusses involves the categorization and manipulation of various foods without context so that they serve to support theories about bodily health or “nutri-biochemical level” (Scrinis 41).

Courtesy of "The Tyanny of Choice" from The Economist

The abundant choices and ambiguity that shape modern-day food marketing further add to the confusion that consumers experience when trying to make health-conscious decisions about diet. The image above depicts the large quantity of items we must sift through, each with respective labels announcing the unique mix of nutrients they offer.  For individuals that already feel overwhelmed by society and their designated status in it, like Native Americans, the unreasonably difficult path they must navigate down to eat healthily proves daunting.

A well-known study by Dr. Dean Ornish entitled “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease” investigates the effects of a complete lifestyle change on patients’ health who suffer from coronary atherosclerosis. The treatment involved a “10% fat whole foods vegetarian diet, aerobic exercise, stress management training, smoking cessation, group psychosocial support” with the research team tracking their progress after the first 5 years then after the next 4 years (Ornish). The results shocked the medical and scientific communities. The treatment proved far more effective than medication as the patients’ atherosclerosis actually reversed its course. The findings proved so significant because they linked MetS (the conditions Wiedman discussed in his article) with lifestyle factors like stress and diet.

Devalued communities like Native Americans in the U.S. who have historically endured stress due to forced migration and a shift in culture like subsisting on processed foods instead of traditional meals causes their rates in chronic diseases to spike above most groups. Wiedman specifically addresses this point when he introduces the Cultural Consonance model that links “social status inconsistencies with chronic diseases such as hypertension and circulating levels of stress hormones, the catecholamines” (Wiedman 50).

How can society progress forward in a way that identifies marginalized communities and addresses the societal forces that perpetuate health inequity? “Chronic Conditions, Health, and Well-Being in Global Contexts” by Frank, Baum, and Law suggests that the merging of medical anthropology and occupational therapy could help initiate the process of addressing and improving the quality of life for communities effected by health disparities. The authors consider, “in calling for deeper conversations and more active institutional linkages we perhaps tread a pioneer path for other health professions that are inherently more interested in health and well-being than in elimination of disease”, which seems to me a perfect place to start (Frank 246). 

Bibliography:

Frank, Gelya and Carolyn Baum and Mary Law. "Chronic Conditions, Health, and Well-Being in Global Contexts: Occupational Therapy in Conversation with Critical Medical Anthropology." Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. 2010. 230-246. Print.

"Impact of Poverty and Stress on Diabetes Among Native Americans." Unnatural Causes. California Newsreel, 2007. Web. 15 Feb. 2011.

Ornish, Dean. "Intensive Lifestyle Changes for Reversal of Coronary Heart Disease, December 16, 1998, Ornish Et Al. 280 (23): 2001 — JAMA." JAMA, the Journal of the American Medical Association, a Weekly Peer-reviewed Medical Journal Published by AMA — JAMA. American Medical Association, 21 Apr. 1999. Web. 15 Feb. 2011. <http://jama.ama-assn.org/content/280/23/2001>.

Scrinis, Gyorgy. "On the Ideology of Nutritionism." Gastronomica 8.1 (2008): 39-48. Print.

Wiedman, Dennis. "Globalizing the Chronicities of Modernity." Chronic Conditions, Fluid States: Chronicity and the Anthropology of Illness. Lenore Manderson and Carolyn Smith-Morris, eds. New Brunswick, NJ: Rutgers University Press. 2010. 38-53. Print.

Overanalyzing Sexual Behavior

In this 2007 news clip from CNN, the host investigates the binary of “Nature vs. Nurture” as it relates to the development of homosexuals in American society. Paula Zahn introduces research studies that attempt to answer the controversial question of how homosexually identified people “become” that way- whether it happens at birth or is a result of learned behavior. The first research study shown involves the observation of children’s behavior in home videos and the subjective estimation by the researchers of the subjects’ present sexual orientation, years after the studied footage. Another more scientifically based study examines the sexual orientation of young adults who qualify as fraternal twins, identical twins, or adopted siblings. The historic and present search for scientific solutions to pertinent issues relating to sex and gender is a theme in both the assigned articles for this week and CNN’s broadcast.

The apt title “Fluid Sexes” by Jennifer Terry corresponds to the enlightened idea that “sex anatomy, gender roles, and sexual practice” deserve reconceptualization (Terry 161).  Predominant views in Western society tend to stigmatize certain groups that fall outside of the strict dichotomy of heteronormative organization with a derogative label like “cultural deviants” (Terry 166). Terry cites the work of scholars from multiple disciplines. Each examined homosexuality in an attempt to either discredit it as a genetic abnormality or to find indisputable evidence that legitimized the behavior of undervalued members of society.

Like the scientists on CNN’s news segment who searched for genetic markers, endocrinologists in the early 20^th century used hormone research to clearly differentiate between males and females. This incited the creation of a continuum with “normal males concentrated on one side and normal females on the other”, which translated to the accepted heterosexual members of society (Terry 162). Structural violence against homosexuals ensued when scientists carried out experiments to normalize them by injecting hormones of the opposite sex into each subject in an effort to cure them of their socially misguided sexual orientation.

Not surprisingly, the discrimination does not stop at the homosexual population. Killing two undervalued birds with one prejudiced stone, the same dominant sector in society also oppresses women. In trying to determine how women’s reproductive anatomy contributes to conception, male scholars clumsily stumbled over concepts like the frequency of ovulation and the purported absence of female sexual desire in “Discovery of Sexes” by Thomas Lacqueur. He continues themes from the previously assigned article “New Science, One Flesh” by providing copious examples of anatomical sketches and chauvinistic quotations that express the woman’s primary role as the inferior-to-male child bearer.

While so many controversial quotes abound in Lacqueur’s article, Victor Joze’s opening passage describes a woman as “neither equal nor inferior nor superior to a man, that she is a being apart, another thing, endowed with other functions by nature than the man with whom she has no business competing in public life… A woman exists only through her ovaries” (Lacqueur 149). In Joze’s opinion the woman deserves due credit for her reproductive capabilities but any additional demands for social status or equality will fall on deaf ears. Lacqueur provides a fascinating juxtaposition to Joze’s initial statement. The only role that women fulfill and Renaissance scholars appreciate seems to be the very trait that lessens their status next to men. “What matters is the superior strength of men or, more important, the frequent incapacity of women because of their reproductive functions”, Hobbes opines about the weak biological function females serve (Lacqueur 157).

Those in power historically maintain it by the continued oppression of vulnerable groups. Attempts to medicalize female sexual desire and conception resulted in scientific experiments with harmful implications, both physically and socially. Surgeons removed thousands of ovaries before their physiological function was even understood. Lacqueur likens the women subjects to “humans worked like that ubiquitous experimental creature of the nineteenth century, the rabbit” (Lacqueur 187). Even as women endured pain to help science progress, males perpetuated their lowly social status, “many women are apt to imagine, out of hope or fear, that they have conceived- their reports on this matter are not to be trusted and can be of no practical concern” (Lacqueur 185).

Science can serve to legitimize homosexuality such as the study in CNN that identifies heritable traits that a homosexual person may possess like left-handedness or “hair that whirls in a counter-clockwise direction” (Nature). Terry summarizes Margaret Meads’ findings from her research in the South Pacific, “since there was no natural dictate as to how the sexes should be organized, there should be greater tolerance of variations”, an eloquent appeal for tolerance (Terry 165). However, the endocrinologists used scientific means to create a heteronormative scale that excluded homosexuals as dysfunctional and sexually aberrant.

The medicalization of homosexuality could potentially pave the way for its constitutional acceptance but alternatively, could allow power-preserving groups to use “science” to discredit it.  

Bibliography:

Lacqueur, Thomas. "Discovery of the Sexes." Making Sex: Body and Gender from the Greeks to Freud. Cambridge: Harvard UP, 1990. 149-92. Print.

"Nature vs. Nurture." Paula Zahn Now. CNN. June-July 2007. Veoh. Veoh Networks Inc. Web.

Terry, Jennifer. "Fluid Sexes." An American Obsession: Science, Medicine, and Homosexuality in Modern Society. Chicago: University of Chicago, 1999. 159-77. Print.

Timeless Domination of Feminity

One of my favorite television shows, NBC’s The Office, provides a satirical view of an average American workplace. Some background: The award-winning television series portrays an eclectic group of employees at a small branch of a paper manufacturing company. Steve Carrell plays Michael, the regional manager, an incredibly inappropriate boss whose sexist and tactless behavior regularly creates controversy in the office. Each character represents a stereotype in American media and culture, but the two characters that particularly exemplify stereotypical gender roles in a romantic relationship are the regional manager (Michael) and Jan, the boss he reports to at the corporate office, played by Melora Hardin.

Click the link for clip from the last episode of Season 3 entitled “The Job”, courtesy of NBC via Youtube.

Courtesy of "Working in an Office Wonderland"

 In earlier seasons, Jan represented an independent, strong-willed woman who succeeded in reaching corporate level and contending with the male-dominated business world. However, this scene serves as the catalyst in which Jan reverts to the stereotypically female role in media: dependent on a male figure and prone to emotional outbursts. In “New Science, One Flesh” by Thomas Lacqueur, he also examines the stereotypical gender roles that were prevalent in an earlier time period. He references scholars, scientists, and artists, all of which exuded a male-dominated perspective on physiological traits.

Lacqueur emphasizes with several drawn depictions “the new anatomy displayed, at many levels and with unprecedented vigor, the ‘fact’ that the vagina really is a penis, and the uterus a scrotum” (79). Renaissance writers exclaimed with male-centric language that female reproductive anatomy merely resembles “a female penis” (64) or “an interior version of the male’s” (86). Ironically, Lacqueur concedes that the likening of female genitalia to male actually holds weight. He asserts that the proportions in the depictions were mostly correct and that the homologies suggested by the drawings seem quite plausible. “In fact, if they were more accurate, they would make their point even more powerfully”, Lacquer opines of the artistic comparisons (83). I disagree with this assertion because a woman’s anatomy is uniquely feminine and can exist as such without needing the support of female-male homologies. What cultural values did Renaissance writings portray by its male-dominated language on anatomy and why do these values persist today?

When examining these past depictions and words regarding male-reliant female genitalia, the context of the culture, society, and time period must be taken into consideration. Advanced scientific and medical knowledge lacked during the Renaissance so the structures and language developed mainly because of rudimentary conclusions from existing ideologies. Lacqueur supports this by stating, “Ideology, not accuracy of observation, determined how they were seen and which differences would matter”, “they” being physiological traits of women (88). The predominant view during the Renaissance era that females owed the existence and functionality of their reproductive anatomy to men perpetuates today but in dissimilar ways, as thousands of years have passed.

In The Office episode, Jan’s character takes a turn for the worse when she dramatically protests her termination by storming into her boss’s office in the middle of an interview. She pulls back her sweater, exposing recently implanted breasts through her revealing shirt. She points to her artificial breasts and asks, “Is it because of these? Is it? If it is, then I will see you in court… Because he likes them and that, that is all I care about!” Jan refers to Michael, her partner, who positively reinforced the merits of her plastic surgery by proudly bragging about her “boob job” to all of his employees. Previously, Michael had intentions of breaking up with Jan but when she returned flaunting her cosmetic addition, Michael immediately dismissed thoughts of ending the relationship. The episode, ironically titled “The Job”, could mean both the loss of her job as well as the boob job she experienced to lure Michael’s attention.

Lacqueur’s article also focuses on female anatomy, although his reports on Renaissance medicine and scientific thought clearly predate elective plastic surgery like breast implants. Regardless of the difference in time period, both examples further the values on women’s role in society, especially in contrast to men’s. In “New Science, One Flesh”, Lacqueur includes a 16^th century depiction by Vesalius of a crowd gathering around a dissected woman. He states, “The picture may seem to be, more narrowly, an assertion of male power to know the female body and hence to know and control feminine Nature”, an insight that provides possible motives for why men wish to dominate and define the gender role of females (73).

In the 15^th and 16^th centuries, domination in the rustic medical world meant declarations like “all parts that are in men are present in women” and “indeed if they were not, women might not be human” (97). The one-sex mindset that pervaded Renaissance thought alluded to the male-dominated and frankly, sexist, thought that women owed their physiology to their male counterparts. In modern time, The Office portrays similar gender roles. The American male population generally celebrates the physiological altering of women to enhance their appearance with the help of large breasts or full lips. Even now, with scientific advancements about anatomy and newfound agency that women experience with the right to vote and to undergo abortions, women still surrender their bodies to male-dominated views on the ideal female physique. 


Bibliography:

Laqueur, Thomas. "New Science, One Flesh." Making Sex: Body and Gender from the Greeks to Freud. Cambridge: Harvard UP, 1990. 63-113. Print.

Cultural Appropriation vs. Quackery

Christian Lander, a white American male, freely admits to his enjoyment of the very fads he identifies in his humorous and satirical blog “Stuff White People Like”. In posts #2 and #15, Lander highlights religions- mostly Eastern- to which Americans subscribe for the exoticism they offer, as well as the American appropriation of yoga, a meditative form of healing from India. These posts, albeit light-hearted, suggest that Americans collectively endorse certain activities or ideas and alter them so that they lose enough of their ethnicity to satisfy American tastes. His self-aware mockery of culturally sensitive themes contrasts to the articles this week that question the authenticity of both Ayurvedic and Tibetan medicine pitting them against the Western standard of biomedicine. 

Labels pervade American culture- especially when determining if an entity earns the title of legitimate (“legit” in colloquial American English) or fails to meet that esoteric standard, thus condemned to quackery. In Jean Langford’s article “Medical Mimesis”, she investigates the Ayurvedic medicine practice of Dr. Mistry, a self-proclaimed specialist in pulse reading, from her perspective as a medical anthropologist based here at University of Washington. Langford embarks on her mission to conduct ethnographic field work in India with a clear understanding of the criticism that Baudrillard and Taussig, well-published anthropologists, issue for those suspected of medical mimesis.

“…mimesis involved in any act of signification, suggest, on the contrary, that simulation is integral to medical practice, troubling the binary of truth and falsehood that is the foundation of scientific knowledge”, Langford reports of the analyses by Baudrillard and Taussig (Langford 24). While not entirely unbiased, she does attempt to thoroughly examine Dr. Mistry by exploring several perspectives of him and of his practice; in spite of his controversial approach, he still sees over 400 patients daily and employs a handful of assistants (Langford 28). She interviews a fellow practitioner, Dr. Upadhyay, who decries Dr. Mistry’s practice as“mimicry of both professional Ayurvedic doctors and bona fide folk practitioners” (Langford 35). In response, Dr. Mistry finds his critic’s practice too dependent on allopathic, or bio, medicine. This ironic string of judgements reflects the subjective standards that we are all guilty of applying to dissimilar practices or beliefs.

Ayurvedic pulse reading
Courtesy of Ayurveda Intro

An important aspect of the analysis on Dr. Mistry’s medical methods remains: his effectiveness in healing patients. He claims that psychological effects of illnesses produce more than half of the symptoms patients feel.  Langford allows, “Pulse reading sparks the faith that fires the healing process”, naming the faith that Dr. Mistry inspires as his treatment plan (Langford 40). The biomedicine on which Westerners rely even permeates the practices of Ayurvedic practitioners, as evidenced by Dr. Upadhyay’s strong objection to the lack of physiological knowledge Dr. Mistry displays (Langford 34).

Vincanne Adams’s “The Sacred in the Scientific” discusses the spiritual emphasis grounded in Tibetan medicine. In attempts to modernize, the Tibetan government insists that medicine turn to science instead of religion. Adams relates of Tibetan medicine, “Medical truth became visible as a set of relationships between mental perception, emotional responses, the five elements, and finally the physician’s own capacities for clear insight,” underscoring the mixture of old 12th century tradition and newly adopted concepts like the physician (Adams 560). However, the task of modernization proves difficult as spirituality and religion remain deeply ingrained and inseparable within Tibetan medicine.

Why do we need labels to decide which medical practice is legitimately Ayurvedic because it contains the perfect balance of Hindu and Western elements and which is “quackery”?  How can Tibetan medicine modernize to ease political tension but also retain its spiritual values so that it remains uniquely Tibetan instead of a Western progeny? Finally, why is it acceptable for Westerners to appropriate practices of other cultures until they resemble forms of quackery while we selectively judge dissimilar entities out of context and label them as fraudulent?

Martha Stewart and Trudie Styler (wife of Sting) on Martha Stewart Show
Courtesy of Chicago Now

Returning to the blog, post #15 reads, “Yoga is also an expensive activity. It gives white people the chance to showcase their $80 pants,” alluding to the yoga fashion industry that Americans inspired. Although this post makes several statements without supporting evidence like, “One can find more yoga studios in white neighbourhoods such as Kitsilano or Orange County than in Kolkata”, its purpose is to describe not only the extent of the fervor but also to highlight the entirely different interpretation of yoga in the states. In India yoga represents a meditative, spiritual practice that began in ancient civilization while in America, the stereotypes for yoga enthusiasts include affluent white women and celebrities. Can we deem American yoga as quackery?

I do believe American yoga appropriates from Indian culture but refrain from calling it quackery. As long as yoga enthusiasts here acknowledge they practice an interpretation and not mimicry, the highly negative connotation that quackery holds does not apply. This follows for Dr. Mistry and Dr. Upadhyay. They each practice different versions of Ayurvedic medicine and satisfy their respective patients. Neither practitioner deserves the title of quack.

Bibliography:
Adams, Vincanne. "The Sacred in the Scientific: Ambiguous Practices of Science in Tibetan Medicine." Cultural Anthropology 16.4 (2001): 542-75.

Lander, Christian. "Yoga." Web log post. Stuff White People Like. 22 Jan. 2008. Web.

Langford, Jean M. "Medical Mimesis: Healing Signs of a Cosmopolitan "Quack"" American Ethnologist 26.1 (1999): 24-46. Print.

Global Health and Human Experiments

Image from Doctors Without Borders

 Excerpt from "A Bitter Pill: Exporting Drug Trials to the Developing World"

By David Concar

"When a deadly epidemic of bacterial meningitis swept through northern Nigeria in 1996, Samaila Musa's parents did the obvious thing. They took their stricken 7-year-old to the infectious disease hospital in the nearby city of Kano.

Amidst an anguished dispute over what happened next, one thing is clear: The world's richest pharmaceutical company enrolled Samaila, and hundreds of infected children like him, as test subjects in a now-notorious drug trial.

A team from Pfizer Inc. had learned of the outbreak on the internet and flown to Kano armed with a promising new antibiotic called Trovan (trovafloxacin). With meningitis rare in the West, it was a golden opportunity to put the drug through its paces, compare it to a rival company's approved treatment, and gather the data needed for a license to market the potentially lucrative drug.

Trovan, alas, was no miracle cure. Several (the exact number is disputed) of the sick children given the experimental drug died. Many more suffered lasting injuries from their infections. Samaila, now a teenager, was struck deaf and dumb.

Pfizer says that Trovan worked better than any other treatment administered in Kano. But lawyers representing outraged Nigerian families dispute that view and claim that the trial violated international agreements, including the Nuremberg Code. These international guidelines were drawn up in 1949 to protect human subjects from the kind of appalling experiments Nazi doctors performed on concentration camp inmates.

"The Kano patients didn't know they were being enrolled into a for-profit study. It is absolutely abhorrent that you can use sick children as guinea pigs without informed consent," says Elaine Kusel, the legal partner handling the case at Milberg Weiss in New York.

Pfizer spokesperson Kate Robins disagrees. "The study was conducted in accordance with standard international legislation on clinical trials and the verbal consent of family members of all treated patients," she wrote in a statement sent to Amnesty International Magazine.

Whoever triumphs in the lawsuit, the Trovan affair is just one of several cases from the past decade that have begun to expose the secretive, ethically fraught nature of the pharmaceutical business and the globalization of human experimentation.

Shoe and clothing companies were among the first to seek out the cheap labor, tax breaks, and looser regulations of developing countries in the recent wave of globalization. Pharmaceutical companies discovered that they, too, could save money and time by moving the costliest part of their business — clinical trials — overseas.

It's easy to see why. While pharmaceutical companies face complex regulations and wary patients in the West, the developing world is filled with patients whose only hope of treatment is enrollment in a clinical trial. Add improving infrastructure to the mix and the attraction gets stronger. Chile, Argentina, and Thailand, while poor, have aspiring doctors, hospitals, and health ministers eager for the prestige, money, and access to medicines and equipment that accompany major drugs trials.

The pharmaceutical industry denies using the developing world as the medical equivalent of a sweatshop. "No matter where clinical trials are held, they're held to the same ethical standards," says Mark Grayson of Washington-based Pharmaceutical Research and Manufacturers of America.

Grayson points out that Western-sponsored clinical trials often spur access to better treatments and help countries develop medical expertise and understanding. "A medicine must at some point be tested where a disease exists, and this is why Pfizer sent its doctors to Nigeria," adds Pfizer's Kate Robins in her statement. It is "simply not the case" that the pharmaceutical industry is "conducting more and more trials in less developed countries to avoid regulations."

But that's not the perception of some experts and human rights activists in poorer countries. "The companies don't want to apply the U.S. regulations because they are too tight," says Miguel Kottow Lang, an ethicist at the University of Chile in Santiago. "So they come here and say 'We will use your regulations, or the regulations we are going to teach you.' " 

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The clinicians, public health advocates, and a myriad of groups in the healthcare industry who entangle themselves in the complex web of global health encounter ethical dilemmas when they commit to health promotion in the developing world. That being said, the image above from a press release on Doctors Without Borders’ website represents an illegal drug trial that occurred in Nigeria. The Amnesty International article “A Bitter Pill” explains that Pfizer, the most affluent pharmaceutical company worldwide, entered Nigeria in 1996 with a drug recently developed to cure bacterial meningitis, a deadly infectious disease. However, the drug remained untested and its side effects on humans unknown. Anxious to beat competing pharmaceutical companies with a rival drug, Pfizer neglected to include this caveat. A human rights catastrophe ensued as the untested drug led to physical deformity, loss of physiological functions, neurological defects, and even death. 

The moneymaking intentions of Pfizer in this example seem irrefutable but statistics cited in “A Bitter Pill” point to an increasing number of situations in which companies take advantage of vulnerable populations. The article cites a 2000 report from U.S. Health and Human Services Department's Inspector General's Office about experimentation in the third world, “From 1990 to 1999, the number of foreign clinical scientists seeking FDA approval to market new drugs increased six fold…which raised concerns about "aggressive recruiting" of human subjects”.

Vincanne Adams in “Against Global Health?” acknowledges this shortfall in the global health system when she alludes to varying perspectives of each actor involved. Adams investigates “how the commitment to health- the singular goal of global health programs- often becomes the means by which such programs authorize subtle shifts between epistemological frames”, a phenomenon evidenced by the drug trial in Nigeria (Adams 41). Under the pretext of providing health services and resources to developing regions, actors in global health can reach their objective- whether that is developing a cheaper alternative drug like Pfizer or truly attempting to address health issues relevant to the community of interest; historically, the latter paved the way for ethnocentrism in regards to non-Western beliefs about medicine and perhaps, even set the precedent for the structural violence that meningitis-afflicted Nigerians experienced.

From the epistemological frame of science, the interconnectedness of polities under global health permits scientists and researchers to uncover the hidden secrets of pathogens and to develop treatment plans. Vulnerable populations receive this scientific probing in the hopes of health betterment and increased resources while Western providers get insight into their beliefs and cultures that sharply contrast the scientific method and medical knowledge. “…Traditional beliefs were not merely non-scientific in the colonial medical mind-set; they seemed to be “nonsense” as empirical explanations of medical facts”, Adams relates from her study of the scientific perspective on global health (Adams 43).  

Are health care providers and scientists, specifically physicians, to be blamed for the disconnect between viewing the patient as a fellow human being versus a patient whose body, or machinery, needs repair? The vicious cycle of ethnocentrism and structural violence perpetuates when global health actors fail to consider not only the significance of cultural beliefs but also the interest of the individuals in the community. Focusing again on the physicians’ role, how does a perspective of the human body as a machine develop?

“Learning Medicine” by Byron and Mary-Jo Good provides ethnographies of a class of Harvard medical students. The authors follow them as they internally transform and their perspectives of “the dual discourse” and the body change (Good 91). In the initial interviews, first-year medical students express this discourse as the importance of being a competent health provider while leaving intact the humanistic demeanor that allows for empathy. A common critique, that Western physicians omit the “caring” component of healthcare, points back to the statistics listed earlier about increased medical experimentation in the developing world. If physicians forget the “language of relationships, of attitudes and emotions, and of innate qualities of persons” and reduce patients to a body in which scientific reactions merely occur, human beings may become commodities to entities like pharmaceutical companies (Good 93).

However, physicians do not collectively deserve the position of global health scapegoat. Products of a system that Western academicians designed, physicians labor for several years to essentially learn a new medical vocabulary “as large as most foreign languages” and then dissect, dissect, dissect (Good 97). After year two of medical school, Harvard students recalled that anatomy lab marked the beginning of an alternate reality when their perception of the body reconstructed to become “machinelike” and “a thing of compartments” (Good 96). This reduction of a human being to organs and appendages reminds me of the Nigerians who served as study subjects for the experimental drug.

Nigerians enrolled in Pfizer’s 1996 study experienced commodification in that they represented an abstract variable with no agency in an experiment that put their lives in danger. Global health interventions service many deprived populations but also open up the same communities to possible exploitation. While physicians and members of the healthcare field claim to promote global health, perspectives among them form along the way that can lead to structural violence and in effect, do more harm than good.

Birthing: Amniocentesis and Hard Decisions

Background: This video, extracted from YouTube, originally aired on Showtime's "This American Life" on Season 2 Episode 1. Chicago Public Radio sponsors this highly acclaimed weekly radio broadcast that gained enough popularity to prompt its adaptation to television. Anthropological in many ways, “This American Life” identifies both obscure and ordinary phenomenon in American culture and compiles social ethnographies through interviews, images, and music that almost invariably challenge stereotypes. 

The episode “Escape” features Mike Phillips, a 27-year-old young man with a genetic disorder called spinal muscular atrophy. In effect, he cannot move his limbs. The only movements his muscles allow includes a weak tapping of his thumb that transmits letters, and eventually words, onto a screen as well as the blinking of his eyes in response to questions. Ira Glass, the host of TAL, describes Mike’s life as “tenuous”, hanging by a thread. Each meal represents a struggle with feeding tubes and every time he attempts mobilization- to the car or just to go outside- he risks death.

Mike’s steadfast mother, Karen, never mentions an experience with amniocentesis or a conscious decision to conceive a child prenatally diagnosed with such a rare and severe genetic disorder. However, in our readings this week, we explored amniocentesis as it related to women interested in determining prenatally whether or not their children had genetic abnormalities. Rayna Rapp in “Accounting for Amniocentesis” seeks to portray the multiple meanings of amniocentesis through the lenses of both women and other figures, each with their own association to the scientific process. 

The genetic technicians Rapp follows in the New York lab view amniocentesis as research, a means to uncover obscure genetic conditions, as well as a scientific process that for the time being pays their bills. Amniocentesis reduced to a perfunctory task, a lab tech likens a fetus to a wimp by stating, “It’s got a wimpy Y and the bikini on the X is pretty gross”, underscoring the detached emotions of the technician. Like many other things in life that vary in value depending on the beholder, the results of a “needle test” had huge implications to the pregnant clients but amounted to a toilsome task for the lab techs. 

Rapp remarks on the differing perspectives of mother vs. provider on a prenatally diagnosed, disabled baby. She asserts, “As the geneticists pathologized the mother ‘genealogized’”, a significant statement in that it summarizes the distinction between the two parties. The geneticists observed the child with the keenness of scientists gazing upon a study subject. While they hastily scribbled down notes on the baby’s condition, the mother fondly noted her child’s likenesses to family members. 

Two women from Rapp’s account closely align with Karen’s representation in Mike’s story: Veronique, who conceived a baby prenatally diagnosed with Trisomy 9, and Pat, who conceived a baby prenatally diagnosed with Downs syndrome. Their unwavering decisions to raise disabled children in spite of medical suggestions sparks questions. Why did the somber predictions made by the genetic technicians fail to deter Veronique and Pat from conceiving their children? And how is Karen able to so selflessly tend to her severely disabled son, both day and night without help? 

Veronique and Pat each created human beings who share their genes, even if that means unlucky ones that carried traits for abnormalities. Modern technology offered them a chance to throw back their creations, imperfect to the scientific eye, but they clung to them instead. Rapp uses metaphor for the uncharted amniocentesis process by dubbing it “the DNA research frontier”, “information for consumers without guideposts”, and “a play whose acts are as yet unwritten.” As an anthropologist, she halts judgment for the mothers’ choices and the geneticists’ attitudes, and continues to evaluate amniocentesis. 

Mike Phillips surely suffers from a condition unimaginable to most in its scope of pain and physical restrictions. However, he fights with vigor against his limitations and remains in solidarity with Karen, his mother who fights alongside him to increase his odds of surviving, each day at a time. Fortunately, Mike’s access to health care resources and Karen’s ability to serve as his full-time nurse allow him to exercise occasional autonomy, which helps his quality of life. 

In contrast to Mike’s relative privilege, at least socioeconomically, Rapp introduces amniocentesis as a public health measure in New York City used to curb seemingly extraneous funding for the disabled poor populations. Through the lenses of politicians, the costly “needle test” pales in financial comparison to the money necessary for social services to support disabled people in poverty. Similar to the geneticists’ emotionally removed interest in the findings from amniocentesis, the Health Department betrayed the population by blurring the lines between “eugenic and choice-enhancing aspects of prenatal diagnosis.” 

The complex array of perspective serves as essential tools in evaluating amniocentesis anthropologically. Rapp meets this task by introducing varying viewpoints and examining them critically but comprehensively. I highlighted Mike Phillips’ story because it provides duality to the conflict of determining the worth of allowing or refusing disabled lives before birth. On the extreme end of disabled, his obvious struggles require constant attention and interfere with his quality of life... In contrast, his attempts to actively study the human condition and to function in society mirror those of almost everyone I know.