00:00:00
yeah a lot of people maybe some people
00:00:03
get scared when they see the words
00:00:05
medical anthropology it sounds a little
00:00:07
bit
00:00:09
a little bit frightening out there maybe
00:00:12
like biological anthropology like it's
00:00:14
going to be scary in science or
00:00:17
something like that but in fact we find
00:00:22
out that medical anthropology is about
00:00:25
uh different kinds of people and of
00:00:28
course their relationship to things like
00:00:30
health and illness and I put these
00:00:33
little flames in there because medical
00:00:35
anthropology has been like this hot
00:00:37
lit sub-discipline of anthropology
00:00:40
recently even before the whole
00:00:42
coronavirus thing it's been a little bit
00:00:46
uh a little bit trendy a little bit on
00:00:48
the move my wife teaches a medical
00:00:51
anthropology class uh here has anybody
00:00:54
taken the medical anthropology class
00:00:56
from Professor Anderson Taylor how was
00:00:58
that
00:01:01
pretty good he liked it yeah and so if
00:01:04
you haven't taken it there's still some
00:01:06
spots open for next semester if you want
00:01:08
to take it uh so you know this has been
00:01:11
a popular class and then in our in
00:01:15
textbooks I've noticed that um I used to
00:01:17
teach this one textbook they didn't have
00:01:19
a chapter on it and then all of a sudden
00:01:21
they had a chapter on and then they made
00:01:22
it their big last concluding chapter
00:01:25
so I think although this is not the end
00:01:29
chapter the end chapter in this textbook
00:01:31
would have been sustainability I think
00:01:33
this worked works pretty well for us as
00:01:36
a way to end the book and to think about
00:01:40
or
00:01:42
perhaps our final topics and things like
00:01:46
that uh in the the hot new field or not
00:01:49
the new field the burgeoning subfield of
00:01:53
medical anthropology
00:01:55
the first thing I want to talk about is
00:01:57
why medical anthropology has been uh has
00:02:01
been coming to the fore recently I think
00:02:04
one obvious answer to this is that
00:02:07
issues of health and health care and
00:02:11
especially at a place like here we are
00:02:14
at Hartwick College where we have a
00:02:16
nursing program and uh a
00:02:20
Health oriented Health Sciences program
00:02:23
and people studying biology and of
00:02:26
course people are
00:02:28
as Cyrus once told us we're all dying uh
00:02:32
but uh you know there's issues that our
00:02:35
population is generally aging has is is
00:02:39
more dying than it was before I
00:02:42
shouldn't laugh but it is and so we have
00:02:46
uh issues of aging and how to handle
00:02:49
issues of death and we talked about this
00:02:51
again a good pairing with what we were
00:02:53
talking about uh in the last class on
00:02:56
supernaturalism because when people come
00:02:59
on to the issue of of death it kind of
00:03:03
crystallizes some of these ideas about
00:03:05
why things happen and meaning of life
00:03:09
and all of these things
00:03:10
of course we probably don't want to
00:03:12
forget that people still have to be born
00:03:14
and there's reproduction and there's
00:03:16
lots of uh
00:03:18
and this is something that that uh
00:03:21
my my wife has studied a lot is the
00:03:24
anthropology of reproduction uh and how
00:03:26
people uh
00:03:28
how women and men and uh reap and all
00:03:32
and others reproduce uh society and and
00:03:36
how that is seen in different places and
00:03:39
in uh in our own society as well
00:03:44
uh at the end of this chapter uh issues
00:03:48
around uh being differently abled
00:03:52
diagnosis and treatment of things that
00:03:56
are classified as disability and various
00:03:58
movements around those issues
00:04:03
um also that the
00:04:06
uh the fact that that Health Care is not
00:04:09
equally divided provided that there are
00:04:12
many inequities and imbalances in our
00:04:16
Health Care system and so uh Public
00:04:19
Health the eye that that you need to
00:04:23
think about not just pills and shots but
00:04:27
they don't automatically solve the
00:04:29
issues you need to think about how
00:04:30
people receive uh interventions what
00:04:34
kinds of things will help with People's
00:04:36
Health in general so anthropology has
00:04:39
long had a a bridge to Public Health and
00:04:44
before there was a public health program
00:04:45
at Harvard College uh Professor Anderson
00:04:49
and others were kind of patching this
00:04:51
together with medical anthropology and
00:04:54
other courses and that was instrumental
00:04:57
in actually getting to people to a
00:05:01
public health program which came about a
00:05:03
few years ago and now you can take that
00:05:05
and take Anthony apology as part of your
00:05:08
public health major but we've known
00:05:12
people that have gone from anthropology
00:05:13
into public health before even there was
00:05:16
such a major
00:05:18
and uh as you know the
00:05:22
navigating Health Care
00:05:25
and the ways in which people are moving
00:05:28
about uh
00:05:30
anthropology I think is is
00:05:32
provides a crucial way to be sensitive
00:05:36
to both the ideas that other people
00:05:39
might have about treatments
00:05:41
and also about the effectiveness and how
00:05:45
people uh are able to interact across uh
00:05:49
a complicated Terrain in which uh people
00:05:54
are uh Even in our own Society or are
00:05:57
rejecting uh different biomedical
00:06:00
interventions for various reasons uh and
00:06:03
in other societies might be embracing
00:06:05
them perhaps even more than the United
00:06:07
States so these issues are are aren't
00:06:10
going to go away very soon in fact
00:06:12
they're probably increasing prominence
00:06:14
and there's perhaps an opportunity for
00:06:16
anthropology to to say something about
00:06:18
that
00:06:19
one other reason or I mean another
00:06:21
reason why I think uh medical
00:06:24
anthropology is uh
00:06:28
I know
00:06:29
exciting these days
00:06:31
is because of what uh
00:06:34
it's always refers to this is a
00:06:36
biocultural perspective
00:06:39
well
00:06:41
kind of a big word
00:06:43
South what do you get out of
00:06:46
out of this okay what kind of
00:06:48
perspective does does medical or
00:06:51
anthropology take on health
00:06:56
foreign
00:07:19
yeah great so the holistic view now we
00:07:24
can take holism in a couple of different
00:07:26
ways I mean one is I think that since
00:07:29
we're reading about illness and health
00:07:31
we're drawn to the ideas of holistic
00:07:33
medicine but in anthropology that means
00:07:36
kind of taking a view in which things
00:07:37
are interconnected to each other so our
00:07:40
economic situation our political
00:07:42
situation our religious beliefs are all
00:07:45
interconnected with our beliefs about
00:07:47
health and illness and how we will uh
00:07:50
how we will treat these things so as a
00:07:53
sub-discipline I think what's what one
00:07:56
of the things that's nice about medical
00:07:57
anthropology is it brings together this
00:08:00
stuff that we learned in biological
00:08:01
anthropology and health and human
00:08:04
evolution together with the ideas about
00:08:07
culture belief ideas about the world and
00:08:11
also of course language so how people
00:08:13
talk about uh health and illness how
00:08:17
people understand those things so so uh
00:08:20
I think it is a new way forward in
00:08:24
trying to think about how uh how
00:08:26
anthropology both combines things like
00:08:29
uh material culture together with uh
00:08:33
with cultural and biological approaches
00:08:36
so
00:08:37
um
00:08:39
this is a good Frontier for us to be on
00:08:44
it's always talks about the distinction
00:08:46
between disease
00:08:49
and illness
00:08:51
which we might be tempted to think of
00:08:54
the same thing
00:08:55
but basically what the distinction here
00:08:58
is is that disease is what you're trying
00:09:01
to sort of biomedically diagnose
00:09:05
virus or the bacteria or whatever it is
00:09:08
that that your that you're diagnosing
00:09:11
and illness is is this the personal and
00:09:15
social experience of disease
00:09:18
and how the same thing might be
00:09:20
experienced in somewhat different ways
00:09:23
or perhaps not even validated at all in
00:09:27
some societies
00:09:28
and so I'm reminded of
00:09:30
not too long ago when we talked about
00:09:33
the difference between biological Saxon
00:09:35
social ideas about gender and this is a
00:09:38
kind of a similar distinction between
00:09:40
what's going on
00:09:42
you might say biologically or
00:09:44
scientifically the disease part and our
00:09:47
ideas and our expectations of what
00:09:49
happens when we get such a thing so
00:09:55
uh one uh thing that is mentioned are
00:09:59
what are called illness narratives or
00:10:01
stories about
00:10:05
about illness
00:10:07
um different ways in which we
00:10:10
conceptualize that
00:10:13
Taylor you talked a little bit about the
00:10:15
different
00:10:16
theories of illness
00:10:18
why do people
00:10:28
think that yeah
00:10:32
but then there was
00:10:34
foreign
00:10:48
okay so this is on page 238 and it has a
00:10:51
good yeah I mean a good summary of
00:10:54
different ideas about the natural
00:10:56
causation and the supernatural or or
00:11:00
outside of natural causation good links
00:11:03
back to the last chapter as well and I
00:11:06
guess one of the points that I would
00:11:08
make when I'm thinking about this is
00:11:10
that even if if we might technically
00:11:15
dismiss somebody's belief and say well
00:11:18
that's that's not going to work there's
00:11:21
no such thing as
00:11:24
witchcraft
00:11:26
or you didn't see that there's no such
00:11:29
thing as Soul loss
00:11:32
what you believe
00:11:35
can affect your health so even if we
00:11:39
might scientifically say well that
00:11:41
doesn't make any sense if you believe
00:11:43
something is happening in your body or
00:11:46
around you it may end up affecting your
00:11:48
health
00:11:50
so uh
00:11:53
the other thing I will say about this is
00:11:55
we often combine these ideas so we
00:11:59
talked about in the last class the the
00:12:02
idea that okay The Termites Ate out the
00:12:08
sticks supporting The Granary but what
00:12:11
was the reason for it what was the
00:12:13
ultimate cause and that's where some of
00:12:16
these other causes come in and it has to
00:12:18
do with something that's very of course
00:12:20
deeply rooted in what we need to know as
00:12:22
human beings we need to know Juliana
00:12:25
when we get sick
00:12:27
or something happens to us what do we
00:12:29
want to know
00:12:35
yeah we want to know why the why why did
00:12:38
this happen to me so again
00:12:42
the ideas of Supernatural causation are
00:12:46
often as I said they're combined with
00:12:49
biomedical so people might say yes I
00:12:51
know that this virus is making me ill
00:12:55
but why did I catch this virus why is
00:12:58
this happening to me why is this
00:13:00
happening to me and not that other guy
00:13:02
because he deserves it more than I do so
00:13:05
those kinds of ideas and and as I said
00:13:08
sometimes the scientific or the
00:13:11
biomedical explanation is not very
00:13:13
comforting as to telling us why things
00:13:17
happen and in fact it's it deliberately
00:13:22
avoids the idea of why because that's
00:13:25
more of a a belief or
00:13:27
belongs to the the field of religion so
00:13:32
again these things are are often
00:13:34
combined
00:13:37
Gonzalez discusses the air uh
00:13:40
at that point discusses the the idea of
00:13:43
modern Western biomedicine which is what
00:13:47
we know and love using chemicals and
00:13:50
pills and shots to treat us make sure
00:13:54
everything's working but one important
00:13:57
point is that
00:14:00
our belief that something will work
00:14:04
is an important
00:14:06
part of why it works
00:14:08
and uh
00:14:11
you can look on YouTube and other places
00:14:14
for some interesting Placebo and what
00:14:17
are called nocebo studies where people
00:14:19
are given pills and told they are going
00:14:22
to do something if they really believe
00:14:24
that
00:14:25
sometimes amazing how much uh placebos
00:14:28
and even people have even done Placebo
00:14:31
operations where they tell you that
00:14:33
they've operated on your knee and then
00:14:35
just put it back together and sometimes
00:14:39
it's surprising how much just believing
00:14:41
that something has happened to you can
00:14:42
work eyes you know I know that it's a
00:14:45
little bit out there sometimes what
00:14:47
people will do and how much our belief
00:14:49
does does influence us but it certainly
00:14:53
can influence us as well
00:14:56
I think in our own society as well as in
00:14:59
other societies most people practice
00:15:02
what is called medical plural pluralism
00:15:06
so yes people might believe in
00:15:10
biomedicine and take the
00:15:14
take the shot take the Tylenol but
00:15:17
they'll also be lighting a little candle
00:15:19
and eating some special bread and
00:15:22
getting some
00:15:24
chicken soup which really does work but
00:15:27
uh so most people are combining various
00:15:30
forms of
00:15:32
trying to deal with with what they have
00:15:35
because as Cyrus told us he's hoping for
00:15:38
health not to get sick and so you have
00:15:41
to
00:15:42
grow everything you got at it you know
00:15:44
you've got to put everything in there
00:15:46
you can't just count on the biomedicine
00:15:48
you have to put in a pull in some what
00:15:50
is called
00:15:51
ethno medicine
00:15:54
so ethno medicine
00:15:55
is the ideas of things that are perhaps
00:15:59
outside the Western biomedical approach
00:16:03
different approaches to doing uh doing
00:16:07
medicine
00:16:10
I guess I'm probably repeating myself a
00:16:12
lot but people often combine the
00:16:15
ethnic or the specific cultural
00:16:18
approaches with biomedical approaches
00:16:21
and so they'll go to the go to the
00:16:23
shaman and get a remedy but the shaman
00:16:25
will dispense them
00:16:27
some
00:16:29
Sprinter
00:16:31
or Advil too
00:16:34
there are also uh some pretty
00:16:37
established uh
00:16:40
um a large scale ideas that have
00:16:46
become in some ways popular like
00:16:50
traditional Chinese medicine
00:16:55
which great
00:16:58
I'm calling Francis for that but she's
00:17:00
disappeared oh my gosh all right
00:17:03
get her back in a second
00:17:06
I'm gonna have to call on Brady instead
00:17:08
Brady what else do we see here in ethno
00:17:12
medicine
00:17:14
um there's something called Theory
00:17:25
okay you like that
00:17:32
yeah
00:17:34
it makes sense I think that the I the
00:17:37
idea of balance is something that often
00:17:40
comes up with ideas about food too so
00:17:43
balancing out what our type just hot and
00:17:46
cold foods or hot and cold environments
00:17:49
and trying to to establish balance it
00:17:51
can be used in to balance kinds of ideas
00:17:56
about the individual but it is also seen
00:17:59
sometimes that a person might believe
00:18:01
that their society or their social
00:18:03
relationships are not in balance and so
00:18:06
many of the ethno medical approaches
00:18:08
take that sort of wider uh lens and look
00:18:12
not just of what is physically
00:18:15
afflicting you as disease but try to
00:18:18
bring your whole body into alignment
00:18:20
with uh with the world and that's
00:18:24
probably why it's become uh appealing to
00:18:27
people various forms of ethno medicine
00:18:29
so traditional Chinese medicine although
00:18:32
it is seen as a form of traditional
00:18:35
medicine is now very much all over the
00:18:38
world that you can almost go anywhere
00:18:40
and find someone who will sell you uh
00:18:43
herbs and supplements in different
00:18:46
places and there's a Global Network of
00:18:49
practitioners probably all over the
00:18:51
place sorry as you're looking to be very
00:18:53
skeptically you don't think you can get
00:18:55
this almost anywhere
00:18:58
is
00:19:05
like a lot of stuff they give you are
00:19:09
visuals
00:19:13
I mean
00:19:15
they're fishy
00:19:24
please interview
00:19:28
these bad kids
00:19:30
I'm not making yourself
00:19:37
what am I going to say about that no
00:19:40
no I don't know I've been working out
00:19:42
that I don't want a driver I'll take a
00:19:45
chemical crack you'll take a chemical
00:19:47
you'll take a distilled chemical that
00:19:50
was once bat but you'll take that
00:19:53
as opposed to just the regular old stuff
00:19:56
I'm giving you a hard time I think that
00:20:00
you know I mean there's there's often
00:20:01
been an interaction between those
00:20:04
substances that are found in the natural
00:20:07
world and a biomedical person will go
00:20:10
and try to extract whatever it is
00:20:12
they're using in ethno medicine and then
00:20:14
bottle it up and sell it to you in a
00:20:17
pill form
00:20:18
and the traditional form now it is
00:20:22
though also true wait where does uh
00:20:29
I think uh Gonzalez says that here that
00:20:34
uh
00:20:35
let's see
00:20:37
this is on page 233 of course every
00:20:42
society has its share of false Healers
00:20:46
all right so every society has a Dr Oz
00:20:49
out there
00:20:51
a false healer who knowingly manipulate
00:20:54
people for profit this happens in our
00:20:58
society and happens in other societies
00:21:00
as well so you know we we do want to be
00:21:03
careful of people who are manipulating
00:21:06
others for profit and telling us that
00:21:09
this is going to work better than
00:21:10
that but you know there's sometimes
00:21:15
there's sometimes ideas that we can take
00:21:17
from things like traditional Chinese
00:21:20
medicine and as Brady told us ideas
00:21:23
about balance or trying to balance out
00:21:26
things in the world so this can be an
00:21:29
interesting idea for you to
00:21:32
to pursue
00:21:37
in the uh
00:21:40
toward the end of the chapter
00:21:42
maybe middle uh just after that
00:21:46
ethno medicine equilibrium traditional
00:21:49
child there we go Health inequity on
00:21:51
page 247.
00:21:54
um from Pages 247 to 249
00:21:58
um
00:21:58
Gonzalez discusses something that is is
00:22:01
now called critical medical anthropology
00:22:04
which uh focuses not just on this
00:22:07
cultural difference but between the
00:22:09
inequalities and societies and basically
00:22:12
I my kind of shorthand for that is that
00:22:15
it combines the kind of ideas about
00:22:18
economics and wealth inequalities
00:22:20
together with political inequalities and
00:22:24
different kinds of things to come up
00:22:26
with the what Paul Farmer or what is
00:22:29
most as famously associated with Paul
00:22:31
Farmer has described as structural
00:22:34
violence
00:22:35
and so the idea of structural violence
00:22:37
which is discussed on page 248
00:22:41
is that there are forms of violence
00:22:43
which we know like you know
00:22:46
uh people hurting each other and
00:22:49
gunshots and War and those kinds of
00:22:52
things but there are also forms of
00:22:54
violence which come to us as
00:22:57
differentials in health outcomes in a
00:22:59
society so these might be linked with
00:23:03
poverty they may be linked with racism
00:23:06
they may be linked with uh gender
00:23:10
inequalities so that what happens is
00:23:12
that over time certain populations get
00:23:15
more exposed to illness and and disease
00:23:20
and thus experience uh a form of what is
00:23:25
called what he calls structural violence
00:23:28
and uh Paul Farmer is a fairly
00:23:31
inspirational uh person as an
00:23:33
anthropologist and as a as a doctor as
00:23:37
well so he combines both being a doctor
00:23:39
and uh being an anthropologist uh sadly
00:23:44
passed away uh last year
00:23:48
um but was a a crucial person in forming
00:23:52
what is called Partners in Health
00:23:54
and um he has a little video I'd like to
00:23:59
show you
