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Anthropology 205 B: Introduction to Medical Anthropology Ian Whitmarsh whitmarshi@dahsm.ucsf.

edu Medical Governance, Culture, and Subjectivities This course looks at current trajectories in medical anthropology theory. By reading texts that have informed these trajectories, both within anthropology and in related fields, we will attempt a rich approach to where theory in medical anthropology has been and where it might be going. This will entail moving outside of the clinic and the lab to the formation of subjectivities and the way governance takes shape, where institutions makes violence and health inextricable. We will attend to key moments in structuralist and poststructualist approaches—e.g., Foucault and Agamben on disciplinarity and life; Freud and Zizek on subject formations; Derrida and Nancy on representation—that have helped shape contemporary approaches. We will look to the ways anthropologists have played with, interrogated, or opened up these intellectual currents through ethnographic work in ‘the field.’ How is truth constituted: what configurations are needed to give authority to particular conceptualizations of life, ethics, personhood? In what ways do categorizations of disease, treatment, and health include and produce political, economic, social associations? Can we see ways that institutions enact discipline, violence, care, and nurturance in the same moment? What might we call “compliance” (biomedical, anthropological…). This exploration will include examining current critical moves in medical anthropology, including the critique of humanitarianism, analyses of the “nonhuman,” and the law as site of subjectivity. In the course as a whole, we follow trajectories in medical anthropology that offer new insights into institutional configurations, cultural meaning, and subject positions in today’s ethnographic moment. Requirements: In addition to regular attendance and participation every week, students will rotate leading a discussion about the week’s readings. A weekly précis on the readings will be due before each class. One paper on the readings will be required, no more than 15 pgs.

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Week 1 Medical Totems and Taboos: Law, Populations, and Nosologies What goes into taxonomies of illness? How do categorizations of disease, treatment, and health include political, economic, social associations? And what politics do they produce? In contrast to a depiction of disease categorization as a linear, logical process, these readings explore the contingency of such classifications: they look for the moral and cultural meanings that get associated with disease classification. If science and medicine are “callings” in Weber’s sense, what demons do they evoke? How might we see the prescriptions and proscriptions of medicine as taboos in Levi-Strauss’s sense? And so see the classification of disease populations as totems. Foucault, Michel 1970 [1964]. Preface. The Order of Things: An Archaeology of the Human Sciences. New York:Vintage. (XV-XXIV). Levi-Strauss, Claude 1966 (Engl. trans.). The Savage Mind. Chicago: University of Chicago Press. (75-108) Weber, Max 1946 “Science as a Vocation.” In From Max Weber: Essays in Sociology, H. H. Gerth and C. Wright Mills, eds. New York: Oxford University Press (129-156). Sarah Horton and Judith C. Barker. 2009. Stains on their self-discipline. public health, hygiene, and the disciplining of undocumented immigrant parents in the nation’s internal borderlands. AE 36, 4, 784-798. Recommended: Fleck, Ludwik. How the Modern Concept of Syphilis Originated. (1-19). Genesis and Development of a Scientific Fact. Chicago: University of Chicago Press. Campbell, Mary B. 1992 Carnal Knowledge: Fracastero’s De Syphillis and the Discovery of the New World. Crossing Cultures: Essays in the Displacement of Western Civilization. Daniel Segal, ed. (3-32). Tuscon, AZ: University of Arizona Press. Latour, Bruno 1999 “Give Me a Laboratory and I Will Raise the World.” In The Science Studies Reader. Mario Biagioli (ed.) New York: Routledge. (258-275) Foucault, Michel 1994 “Truth and Power.” In Power. Michel Foucault, James D. Faubion, ed. New York: The New Press 111-133.

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Week 2 The Medical Exchange This week we look at how, as James Boon writes, “commodities go crazy, or already are so foundationally.” They are made, used, hoarded, rejected in ways that have multiple meanings. Following Nancy (and Boon), look at how all commodities, or any object, is always symbolic, spectral- there is no really real object underneath that escapes this association. Perhaps pick a technology or treatment to explore this idea. Nancy, Jean Luc 2001. “The Two Secrets of the Fetish.” Diacritics 31(2): 3-8 Lovell, Anne M. Addiction Markets: The Case of High-Dose Buprenorphine in France. . Global Pharmaceuticals: Ethics, Markets, Practices, ed. Adriana Petryna, Andrew Lakoff, and Arthur Kleinman, 136-170. Durham: Duke University Press. Bateson, Gregory 2000 “The Cybernetics of ‘Self’: A Theory of Alcoholism.” In Steps to an Ecology of Mind. Chicago: University of Chicago Press. (309-337) Schull, Natasha Dow. 2006. Machines, Medication, Modulation: Circuits of Dependency and Self-Care in Las Vegas. Culture Medicine and Psychiatry 30: 223-247. Recommended: Martin, Emily. 2006 “Pharmaceutical Virtue.” Culture, Medicine, and Psychiatry 30: 157-174. Elyachar, Julia 2006 “Best Practices: Research, Finance, and NGOs in Cairo.” American Ethnologist 33(3): 413-426. Taussig, Michael. History as Commodity in Some Recent (Anthropological) Literature. Critique of Anthropology 9(1): 7-23. And Mintz and Wolf’s response 25-31. Spyer, Patricia. 1997. “The Eroticism of Debt: Pearl Divers, Traders, and Sea Wives in the Aru Islands, Eastern Indonesia.” American Ethnologist 24(3): 515-538. Week 3 Religion and the Modern Flesh (or The Politics of Bodies) How might we extend the anthropological insights about pharmaceuticals to bodies, pain, and something like physicality. Following Alan Klima, we will question any discourse that posits some actual body behind the figural one (any discourse that is “nostalgic for the whole body”). With Foucault and Garcia, we will try to see the ways a medical techniques comes to define and inscribe social norms around corporeality.

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Klima, Alan 2001 “The Telegraphic Abject: Buddhist Meditation and the Redemption of Mechanical Reproduction.” Comparative Studies in Society and History 43(3): 552-582. Asad, Talal Notes on Body Pain and Truth Garcia, Angela “The Elegiac Addict.” Cultural Anthropology 2009 Foucault, Michel. 1994 “The Politics of Health in the 18th Century.” in Power. Michel Foucault, James D. Faubion, ed. New York: The New Press. 90-105. Week 4 The State of Health This week we look for how the state presides over health, illness, and death. As the state determines who gets care, what kind of medicine, and who will die, what meanings of life or citizenship are made? How do we define the state? How does it take on symbolic power, becoming spectral, The State. What do we mean by “life” as the object of governance? How might the state be said to run on desires and anxieties? Das, Veena and Deborah Poole 2004 “State and Its Margins: Comparative Ethnographies.” In Anthropology in the Margins of the State, Veena Das and Deborah Poole, eds. Santa Fe: School of American Research Press. (3-34) Taussig, Michael 1993 “Maleficium: State Fetishism.” In Fetishism as Cultural Discourse, William Pietz and Emily Apter, eds. Ithaca, NY: Cornell University Press. (217-250) Agamben, Giorgio. 1998. “Life that Does Not Deserve to Live” and “Politicizing Death.” Homo Sacer: Sovereign Power and Bare Life. Stanford University Press, pp. 136-143, 160-165 Redfield, Peter 2005 “Doctors, Borders, and Life in Crisis.” Cultural Anthropology 20(3): 328-361. Aretxaga, Begona, Maddening States. Annual Review of Anthropology Recommended: Rhodes, Lorna 2005 “Changing the Subject: Conversation in Supermax.” Cultural Anthropology 20(3): 388-411. Das, Veena and Ranendra K. Das. 2007. “How the Body Speaks: Illness and the Lifeworld among the Urban Poor.” In Subjectivity: Ethnographic Investigations, ed. João

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Biehl, Arthur Kleinman, and Byron Good, 66–97. Berkeley, CA: University of California Press. Stoler, Ann Laura. 1995. Race and the Education of Desire: Foucault’s History of Sexuality and the Colonial Order of Things. Durham: Duke University Press. Caldeira, Teresa F. 2001. City of Walls: Crime, Segregation, and Citizenship in Sao Paulo. Berkeley: University of California Press Week 5 Violence and Meaning We continue our reading of institutions as things of power and contradiction to explore violence. How is violence brought into language and meaning. How have anthropologists explored the other as object of desire and horror, as fetishized, to interrogate violence. What spaces do anthropologists posit as outside meaning. To what ends? Nelson, Diane. Reckoning. Durham: Duke University Press (selections) 1-30, 87-114 Derrida, Jacques 1978 “Structure, Sign, and Play in the Discourse of the Human Sciences.” In Writing and Difference. Alan Bass, trans. Chicago: University of Chicago Press. (278-294) Das, Veena 1997. Life and Words (selections) Week 6 Institutions of Love, Care, Nurturance: Humanitarianism Can we make sense of humanitarian institutions as loving institutions: attempts to offer care, benevolence, aid. We will try to explore what gets erased or overlooked in a discourse of suffering and care. This will include exploring the violence of caring institutions. At the same time, we will try to trouble any critique that would reduce caring to a pure violence. We will also look to the ways institutions always enact and respond to desires, rather than simple “needs.” Feldman, Ilana and Miriam Ticktin eds. In the Name of Humanity. Durham: Duke University Press. 2010. (selections) (Feldman and Ticktin: Government and Humanity. Malkki: Children, Humanity, and the Infantilizatoin of Peace. Fassin: Inequality of Life Boon, James 1999 Literytoor n Anthropolygee. Chapter 5 of Verging on ExtgraVagance. Princeton University Press Ticktin, Miriam Where ethics and politics meet: The violence of humanitarianism in France. American Ethnologist 206

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Recommended: Borneman, John. Caring and Being Cared For. Povinelli, Elizabeth. 2006. The Empire of Love. Duke University Press. Week 7 The Self in the Other, the Other in the Self: Intimacy, violence, care How have anthropologists used the idea the uncanny to interpret subjectivity. How are sexuality, gender, family, ethnicity, caught up in the use of expert knowledge to understand ‘the other.’ How might medical anthropology explore the idea that this “other” is intimately tied to the ‘self’? Freud, Sigmund 1997 “The Uncanny.” In Writings on Art and Literature. Stanford: Stanford University Press. (193-233) Biehl, Joao. 2008. The Mucker War: A History of Violence and Silence. Postcolonial Disorders. Mary-Jo Delvecchio Good, Sandra Teresa Hyde, Sarah Pinto, Byron J. Good. Berkeley: University of California Press. (279-308) Weismantel, Mary 2001 Chapter 1 Cholas and Pishtacos: Stories of Race and Sex in the Andes. Chicago: University of Chicago Press. (3-44) Povinelli, Elizabeth A. 2002 “Notes on Gridlock: Genealogy, Intimacy, Sexuality.” Public Culture 14(1): 215-238. Recommended: Lacan, Jaques 2002 “The Function and Field of Speech and Language in Psychoanalysis.” In Ecrits. Bruce Fink, trans. New York: W.W. Norton. (31-106) Pinto, Sarah. 2008. Where There is no Midwife: Birth and Loss in Rural India. Berghan Books. Week 8 Current Subjectivities: Ambivalent Selves What are the ways populations, communities, individuals take up the expertise that classifies them. How can we talk about the subject without reifying a universal character. What is the role of ambivalence and ambiguity in how people make sense of themselves as they draw on cultural, political, economic discourses. Zizek, Slavoj 2003 “Introduction and Cogito: The Void Called Subject.” In Tarrying with the Negative: Kant, Hegel, and the Critique of Ideology. Durham: Duke University Press. (1-45) 6

Foucault, Michel. 1994 “Technologies of the Self.” Ethics: Subjectivity and Truth. Michel Foucault. Paul Rabinow, ed. New York: The New Press. 223-252. Deleuze, Gilles 1992 “Post-Script on Control Societies,” in October 59: 3-7. Recommended: Martin, Emily Bipolar Expeditions 2007. Princeton, NJ: Princeton University Press. 150173 Benedict, Ruth. 1959. “Anthropology and the Abnormal.” An Anthropologiist at Work: Writings of Ruth Benedict. Boston: Houghlin Mifflin, pp. 262-283. Lakoff, Andrew 2003 “The Lacan Ward: Pharmacology and Subjectivity in Buenos Aires.” Social Analysis 47(2): 82-101 Corin, Ellen 2007 “The “Other” of Culture in Psychosis: The Ex-Centricity of the Subject.” In Subjectivity: Ethnographic Investigations. Joao Biehl, Byron Good, Arthur Kleinman, eds. Berkeley: University of California Press (273-314). Week 9 “Compliance” and Culture in Contemporary Medicine This week we use the analytic tools we’ve discussed throughout the course to examine where we find the discourse of “compliance” acting, in any of its guises: what kinds of subjectivity are posited by a metric of properly listening to authority, or properly transgressing it. We also examine what an emphasis on culture might do in medicine and in medical anthropology. Whitmarsh, Ian Medical Schismogenics: Compliance and “Culture” in Caribbean Biomedicine. Anthropology Quarterly. Giordano, Cristiana Practices of translation and the making of migrant subjectivities in contemporary Italy American Ethnologist 2008 Pouillon, Jean 1982 “Remarks on the Verb ‘To Believe.’” In Between Belief and Transgression: Structuralist Essays in Religion, History, and Myth. Michel Izard and Pierre Smith, eds. John Leavitt, trans. Chicago: University of Chicago Press. (1-9) Molé, Noelle. Living it on the skin: Italian States, Working Illness. American Ethnologist. Recommended:

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Lambek, Michael and Paul Antze, eds. 2004 Illness and Irony: On the Ambiguity of Suffering in Culture. New York: Bergham. Zizek, Slavoj. From Politics to Biopolitics…and Back. Week 10 The (In)human This week we investigate the “human/non-human divide.” What might older anthropological works tell us amid the contemporary focus on the non-human, (e.g., in the concept of “multi-species ethnography” or networks of human and non-human hybrids). How can we see nature/culture as a relational distinction. Bulmer, Ralph. 1970 [1967]. “Why the Cassowary Is Not a Bird.” In Rules and Meanings: The Anthropology of Everyday Knowledge, ed. Mary Douglas, 167–93. Hammondsworth, England: Penguin Education. Douglas, Mary. 1966. Pangolin. In Purity and Danger. New York: Praeger. Feldman, Alan. Inhumanitas. In In the Name of Humanity: The Government of Threat and Care. Strathern, Marilyn 1980 “No Nature, No Culture: The Hagen Case” in Nature, Culture and Gender. Carol P. McCormack and Marilyn Strathern, eds. New York: Cambridge University Press. (174-222). Recommended: Latour, Bruno introduction to The Public of Things Cultural Anthropology Nov, 2010, special issue

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