In the majority of cases individuals diagnosed as "brain dead" are the source of the organs without which transplants could not take place. In this compelling and provocative examination, Margaret Lock traces the discourse over the past thirty years that contributed to the locating of a new criterion of death in the brain, and its routinization in clinical practice in North America. She compares this situation with that in Japan where, despite the availability of the necessary technology and expertise, brain death was legally recognized only in 1997, and then under limited and contested circumstances. Twice Dead explores the cultural, historical, political, and clinical reasons for the ready acceptance of the new criterion of death in North America and its rejection, until recently, in Japan, with the result that organ transplantation has been severely restricted in that country. This incisive and timely discussion demonstrates that death is not self-evident, that the space between life and death is historically and culturally constructed, fluid, multiple, and open to dispute. In addition to an analysis of that professional literature on and popular representations of the subject, Lock draws on extensive interviews conducted over ten years with physicians working in intensive care units, transplant surgeons, organ recipients, donor families, members of the general public in both Japan and North America, and political activists in Japan opposed to the recognition of brain death. By showing that death can never be understood merely as a biological event, and that cultural, medical, legal, and political dimensions are inevitably implicated in the invention of brain death, Twice Dead confronts one of the most troubling questions of our era.

    By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, over-medication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance." The Spirit Catches You and You Fall Down is a tragedy of Shakespearean dimensions, written with the deepest of human feeling. Sherwin Nuland said of the account, "There are no villains in Fadiman's tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty—and their nobility.

    For the first time, medical knowledge took on a precision that had formerly belonged only to mathematics. The body became something that could be mapped. Disease became subject to new rules of classification. And doctors begin to describe phenomena that for centuries had remained below the threshold of the visible and expressible.In The Birth of the Clinic the philosopher and intellectual historian who may be the true heir to Nietzsche charts this dramatic transformation of medical knowledge. As in his classic Madness and Civilization, Michel Foucault shows how much what we think of as pure science owes to social and cultural attitudes — in this case, to the climate of the French Revolution. Brilliant, provocative, and omnivorously learned, his book sheds new light on the origins of our current notions of health and sickness, life and death.

    Steven Epstein's astute and readable investigation focuses on the critical question of "how certainty is constructed or deconstructed," leading us through the views of medical researchers, activists, policy makers, and others to discover how knowledge about AIDS emerges out of what he calls "credibility struggles."Epstein shows the extent to which AIDS research has been a social and political phenomenon and how the AIDS movement has transformed biomedical research practices through its capacity to garner credibility by novel strategies. Epstein finds that nonscientist AIDS activists have gained enough of a voice in the scientific world to shape NIH–sponsored research to a remarkable extent. Because of the blurring of roles and responsibilities, the production of biomedical knowledge about AIDS does not, he says, follow the pathways common to science; indeed, AIDS research can only be understood as a field that is unusually broad, public, and contested. He concludes by analyzing recent moves to democratize biomedicine, arguing that although AIDS activists have set the stage for new challenges to scientific authority, all social movements that seek to democratize expertise face unusual difficulties.Avoiding polemics and accusations, Epstein provides a benchmark account of the AIDS epidemic to date, one that will be as useful to activists, policy makers, and general readers as to sociologists, physicians, and scientists.

    Does the scientific "theory" that HIV came to North America from Haiti stem from underlying attitudes of racism and ethnocentrism in the United States rather than from hard evidence? Anthropologist-physician Paul Farmer answers in the affirmative with this, the first full-length ethnographic study of AIDS in a poor society.

    Contrasting the views of medical science with those of ordinary women from diverse social and economic backgrounds, anthropologist Emily Martin presents unique fieldwork on American culture and uncovers the metaphors of economy and alienation that pervade women's imaging of themselves and their bodies. A new preface examines some of the latest medical ideas about women's reproductive cycles.

    This elegant, humane, and engaging book "captures what we know of the development of what makes us human" (Nature).Visit Armand Marie Leroi on the web: http: //armandleroi.com/index.htmlStepping effortlessly from myth to cutting-edge science,

    By demystifying the fantasies surrounding cancer, Sontag shows cancer for what it is--just a disease. Cancer, she argues, is not a curse, not a punishment, certainly not an embarrassment and, it is highly curable, if good treatment is followed.Almost a decade later, with the outbreak of a new, stigmatized disease replete with mystifications and punitive metaphors, Sontag wrote a sequel to Illness as Metaphor, extending the argument of the earlier book to the AIDS pandemic.These two essays now published together, Illness as Metaphor and AIDS and Its Metaphors, have been translated into many languages and continue to have an enormous influence on the thinking of medical professionals and, above all, on the lives of many thousands of patients and caregivers.

    Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations.The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice.Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine.

    With swashbuckling wit and fierce honesty, she dishes on herself and her colleagues as they try to prod reluctant governments to fund HIV prevention for the people who need it most—drug injectors, gay men, sex workers, and johns.Pisani chats with flamboyant Indonesian transsexuals about their boob jobs and watches Chinese streetwalkers turn away clients because their SUVs aren't nice enough. With verve and clarity, she shows the general reader how her profession really works; how easy it is to draw wrong conclusions from "objective" data; and, shockingly, how much money is spent so very badly. "Exhibit A": the 45 billion taxpayer dollars the Bush administration is committing to international AIDS programs.

     It is a remarkable portrait, too, of the life of a psychiatric asylum--the sort of community in which, for better and for worse, hundreds of thousands of people lived out their lives.More than four hundred abandoned suitcases filled with patients’ belongings were found when Willard Psychiatric Center closed in 1995 after 125 years of operation. They are skillfully examined here and compared to the written record to create a moving—and devastating—group portrait of twentieth-century American psychiatric care.

    But, as A Heart for the Work makes clear, Malawian medical students learn to confront poverty creatively, experiencing fatigue and frustration but also joy and commitment on their way to becoming physicians. The first ethnography of medical training in the global South, Claire L. Wendland’s book is a moving and perceptive look at medicine in a world where the transnational movement of people and ideas creates both devastation and possibility.Wendland, a physician anthropologist, conducted extensive interviews and worked in wards, clinics, and operating theaters alongside the student doctors whose stories she relates. From the relative calm of Malawi’s College of Medicine to the turbulence of training at hospitals with gravely ill patients and dramatically inadequate supplies, staff, and technology, Wendland’s work reveals the way these young doctors engage the contradictions of their circumstances, shedding new light on debates about the effects of medical training, the impact of traditional healing, and the purposes of medicine.

    What he discovered is a revolution under way—an explosion of new ideas about what cancer really is and where it comes from. In a provocative and intellectually vibrant exploration, he takes us on an adventure through the history and recent advances of cancer research that will challenge everything you thought you knew about the disease. Deftly excavating and illuminating decades of investigation and analysis, he reveals what we know and don’t know about cancer, showing why a cure remains such a slippery concept. We follow him as he combs through the realms of epidemiology, clinical trials, laboratory experiments, and scientific hypotheses—rooted in every discipline from evolutionary biology to game theory and physics. Cogently extracting fact from a towering canon of myth and hype, he describes tumors that evolve like alien creatures inside the body, paleo-oncologists who uncover petrified tumors clinging to the skeletons of dinosaurs and ancient human ancestors, and the surprising reversals in science’s comprehension of the causes of cancer, with the foods we eat and environmental toxins playing a lesser role. Perhaps most fascinating of all is how cancer borrows natural processes involved in the healing of a wound or the unfolding of a human embryo and turns them, jujitsu-like, against the body. Throughout his pursuit, Johnson clarifies the human experience of cancer with elegiac grace, bearing witness to the punishing gauntlet of consultations, surgeries, targeted therapies, and other treatments. He finds compassion, solace, and community among a vast network of patients and professionals committed to the fight and wrestles to comprehend the cruel randomness cancer metes out in his own family. For anyone whose life has been affected by cancer and has found themselves asking why?, this book provides a new understanding. In good company with the works of Atul Gawande, Siddhartha Mukherjee, and Abraham Verghese, The Cancer Chronicles is endlessly surprising and as radiant in its prose as it is authoritative in its eye-opening science.

    Aspirin, the world's most widely used drug, is based on compounds originally extracted from the bark of a willow tree, and more than a quarter of medicines found on pharmacy shelves contain plant compounds. Now Western medicine, faced with health crises such as AIDS, Alzheimer's disease, and cancer, has begun to look to the healing plants used by indigenous peoples to develop powerful new medicines. Nowhere is the search more promising than in the Amazon, the world's largest tropical forest, home to a quarter of all botanical species on this planet—as well as hundreds of Indian tribes whose medicinal plants have never been studied by Western scientists. In Tales of a Shaman's Apprentice, ethnobotanist Mark J. Plotkin recounts his travels and studies with some of the most powerful Amazonian shamans, who taught him the plant lore their tribes have spent thousands of years gleaning from the rain forest.For more than a decade, Dr. Plotkin has raced against time to harvest and record new plants before the rain forests' fragile ecosystems succumb to overdevelopment—and before the Indians abandon their own culture and learning for the seductive appeal of Western material culture. Tales of a Shaman's Apprentice relates nine of the author's quests, taking the reader along on a wild odyssey as he participates in healing rituals; discovers the secret of curare, the lethal arrow poison that kills in minutes; tries the hallucinogenic snuff epena that enables the Indians to speak with their spirit world; and earns the respect and fellowship of the mysterious shamans as he proves that he shares both their endurance and their reverence for the rain forest. Mark Plotkin combines the Darwinian spirit of the great writer-explorers of the nineteenth century—curious, discursive, and rigorously scientific—with a very modern concern for the erosion of our environment and the vanishing culture of native peoples.

    The book is an analysis of physical suffering and its relation to the numerous vocabularies and cultural forces--literary, political, philosophical, medical, religious--that confront it. Elaine Scarry bases her study on a wide range of sources: literature and art, medical case histories, documents on torture compiled by Amnesty International, legal transcripts of personal injury trials, and military and strategic writings by such figures as Clausewitz, Churchill, Liddell Hart, and Kissinger, She weaves these into her discussion with an eloquence, humanity, and insight that recall the writings of Hannah Arendt and Jean-Paul Sartre. Scarry begins with the fact of pain's inexpressibility. Not only is physical pain enormously difficult to describe in words--confronted with it, Virginia Woolf once noted, "language runs dry"--it also actively destroys language, reducing sufferers in the most extreme instances to an inarticulate state of cries and moans. Scarry analyzes the political ramifications of deliberately inflicted pain, specifically in the cases of torture and warfare, and shows how to be fictive. From these actions of "unmaking" Scarry turns finally to the actions of "making"--the examples of artistic and cultural creation that work against pain and the debased uses that are made of it. Challenging and inventive, The Body in Pain is landmark work that promises to spark widespread debate.