Modernity and Indigenization: A Study into Biomedical Discourses in India
The figures of pain are not conjured away by means of a body of neutralizedknowledge; they have been redistributed in the space in which bodies and eyes meet. What haschanged is the silent configuration in which language finds support: the relation of situationand attitude to what is speaking and what is spoken about.– Michel Foucault,
The Birth of the Clinic: An Archaeology of Medical Perception
There is a story about the physicist Enrico Fermi (1901-1954). Thanking a guestspeaker for a lecture he had just given, Fermi told him that before the lecture he had beenconfused about the subject. Now, having heard him, he was still confused – but at a higherlevel. I am afraid talking about biomedical discourses in India may have caught us into asimilar confusing situation. But, confusion – or at least, a lack of certainty – is, I believe, a veryimportant thing for investigation. There is not a single frame through which we can view theentirety of nuances in these discourses. Search for the meanings of health and disease ishaunted by two originary questions which have not yet been answered satisfactorily – Whyme? Why now? So, let us fall into the maze of confusion – at least, for the time being.R. M. Hare, the philosopher of medicine, asks, “Why do attacks of viruses count asillness, but not the attacks of larger animals or of motor vehicles? Is it just a question of size?Or of invisibility?…Does a disease have to be something
me? And in what sense of ‘in’?”
To reconcile opposing concepts and confusion, may be to lesser extent, the concept of diseasebecomes normative – where, what counts as the ‘norm’ is prescribed rather than statisticallyderived. In effect, we decide what constitutes a disease. What do we mean when we use theword ‘disease’ and when we use the word ‘health’?
Sometimes the debate seems to be merelyabout our use of words. Sometimes little consideration is given to the underlying biology.Arthur Kleinman offers an example from the front page of the
New York Times
of Tuesday,March 10, 1998, to show “the immense disjunction between the claims for what is supposedlyknown about the biological bases of human nature and what is actually known about humanconditions.” He concludes, “Viewed from the decidedly ordinary practices of everydayexperience, human conditions certainly have a biology, but they have a history, a politics, aneconomics, and they reflect cultural and subjective differences.”
I may now ask what ishealing? “Clearly, it is a somewhat different thing for patient (and perhaps family),practitioners, and researcher.”
Most Western-style doctors communicate in a technical,
R. M. Hare, “Health” in
Journal of Medical Ethics
1986; 12: 172-181.
For a brilliant discussion about normativity of the normal, pathological, health, and disease see, GeorgesCanguilhem,
On the Normal and the Pathological
(Holland, Boston, London: Doerdrecht, 1978).
Experience and Its Moral Modes: Culture, Human Conditions, and Disorder
(TheTanner Lectures on Human Values), delivered at Stanford University, April 13-16, 1998.
Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry
(Berkley, London: University California Press, 1981), 354.