Survival of the Sickest: A Medical Maverick Discovers Why We Need Disease


Sharon Moalem - 2007
    Sharon Moalem turns our current understanding of illness on its head and challenges us to fundamentally change the way we think about our bodies, our health, and our relationship to just about every other living thing on earth, from plants and animals to insects and bacteria.Through a fresh and engaging examination of our evolutionary history, Dr. Moalem reveals how many of the conditions that are diseases today actually gave our ancestors a leg up in the survival sweepstakes. When the option is a long life with a disease or a short one without it, evolution opts for disease almost every time.Everything from the climate our ancestors lived in to the crops they planted and ate to their beverage of choice can be seen in our genetic inheritance. But Survival of the Sickest doesn't stop there. It goes on to demonstrate just how little modern medicine really understands about human health, and offers a new way of thinking that can help all of us live longer, healthier lives..

In Pain: A Bioethicist's Personal Struggle with Opioids


Travis Rieder - 2019
    Enduring half a dozen surgeries, the drugs he received were both miraculous and essential to his recovery. But his most profound suffering came several months later when he went into acute opioid withdrawal while following his physician’s orders. Over the course of four excruciating weeks, Rieder learned what it means to be “dope sick”—the physical and mental agony caused by opioid dependence. Clueless how to manage his opioid taper, Travis’s doctors suggested he go back on the drugs and try again later. Yet returning to pills out of fear of withdrawal is one route to full-blown addiction. Instead, Rieder continued the painful process of weaning himself.Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system.In Pain in America is not only a gripping personal account of dependence, but a groundbreaking exploration of the intractable causes of America’s opioid problem and their implications for resolving the crisis. Rieder makes clear that the opioid crisis exists against a backdrop of real, debilitating pain—and that anyone can fall victim to this epidemic.

Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States


Seth Holmes - 2013
       An anthropologist and MD in the mold of Paul Farmer and Didier Fassin, Seth Holmes shows how market forces, anti-immigrant sentiment, and racism undermine health and healthcare. Holmes’s material is visceral and powerful. He trekked with his companions illegally through the desert into Arizona and was jailed with them before they were deported. He lived with indigenous families in the mountains of Oaxaca and in farm labor camps in the U.S., planted and harvested corn, picked strawberries, and accompanied sick workers to clinics and hospitals. This “embodied anthropology” deepens our theoretical understanding of how health equity is undermined by a normalization of migrant suffering, the natural endpoint of systemic dehumanization, exploitation, and oppression that clouds any sense of empathy for “invisible workers.”  Fresh Fruit, Broken Bodies is far more than an ethnography or supplementary labor studies text; Holmes tells the stories of food production workers from as close to the ground as possible, revealing often theoretically-discussed social inequalities as irreparable bodily damage done. This book substantiates the suffering of those facing the danger of crossing the border, threatened with deportation, or otherwise caught up in the structural violence of a system promising work but endangering or ignoring the human rights and health of its workers.All of the book award money and royalties from the sales of this book have been donated to farm worker unions, farm worker organizations and farm worker projects in consultation with farm workers who appear in the book.

Crazy Like Us: The Globalization of the American Psyche


Ethan Watters - 2009
    But is it possible America's most troubling impact on the globalizing world has yet to be accounted for? In "Crazy Like Us," Ethan Watters reveals that the most devastating consequence of the spread of American culture has not been our golden arches or our bomb craters but our bulldozing of the human psyche itself: We are in the process of homogenizing the way the world goes mad. America has been the world leader in generating new mental health treatments and modern theories of the human psyche. We export our psychopharmaceuticals packaged with the certainty that our biomedical knowledge will relieve the suffering and stigma of mental illness. We categorize disorders, thereby defining mental illness and health, and then parade these seemingly scientific certainties in front of the world. The blowback from these efforts is just now coming to light: It turns out that we have not only been changing the way the world talks about and treats mental illness -- we have been changing the mental illnesses themselves.For millennia, local beliefs in different cultures have shaped the experience of mental illness into endless varieties." Crazy Like Us" documents how American interventions have discounted and worked to change those indigenous beliefs, often at a dizzying rate. Over the last decades, mental illnesses popularized in America have been spreading across the globe with the speed of contagious diseases. Watters travels from China to Tanzania to bring home the unsettling conclusion that the virus is us: As we introduce Americanized ways of treating mental illnesses, we are in fact spreading the diseases.In post-tsunami Sri Lanka, Watters reports on the Western trauma counselors who, in their rush to help, inadvertently trampled local expressions of grief, suffering, and healing. In Hong Kong, he retraces the last steps of the teenager whose death sparked an epidemic of the American version of anorexia nervosa. Watters reveals the truth about a multi-million-dollar campaign by one of the world's biggest drug companies to change the Japanese experience of depression -- literally marketing the disease along with the drug.But this book is not just about the damage we've caused in faraway places. Looking at our impact on the psyches of people in other cultures is a gut check, a way of forcing ourselves to take a fresh look at our own beliefs about mental health and healing. When we examine our assumptions from a farther shore, we begin to understand how our own culture constantly shapes and sometimes creates the mental illnesses of our time. By setting aside our role as the world's therapist, we may come to accept that we have as much to learn from other cultures' beliefs about the mind as we have to teach.

One of Us: Conjoined Twins and the Future of Normal


Alice Domurat Dreger - 2004
    Anatomy matters, Alice Domurat Dreger tells us, because the senses we possess, the muscles we control, and the resources we require to keep our bodies alive limit and guide what we experience in any given context. Her deeply thought-provoking and compassionate work exposes the breadth and depth of that context--the extent of the social frame upon which we construct the normal. In doing so, the book calls into question assumptions about anatomy and normality, and transforms our understanding of how we are all intricately and inextricably joined.

Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear


Carl L. Hart - 2021
    . . when it comes to the legacy of this country's war on drugs, we should all share his outrage." --The New York Times Book Review From one of the world's foremost experts on the subject, a powerful argument that the greatest damage from drugs flows from their being illegal, and a hopeful reckoning with the possibility of their use as part of a responsible and happy lifeDr. Carl L. Hart, Ziff Professor at Columbia University and former chair of the Department of Psychology, is one of the world's preeminent experts on the effects of so-called recreational drugs on the human mind and body. Dr. Hart is open about the fact that he uses drugs himself, in a happy balance with the rest of his full and productive life as a colleague, husband, father, and friend. In Drug Use for Grown-Ups, he draws on decades of research and his own personal experience to argue definitively that the criminalization and demonization of drug use--not drugs themselves--have been a tremendous scourge on America, not least in reinforcing this country's enduring structural racism.Dr. Hart did not always have this view. He came of age in one of Miami's most troubled neighborhoods at a time when many ills were being laid at the door of crack cocaine. His initial work as a researcher was aimed at proving that drug use caused bad outcomes. But one problem kept cropping up: the evidence from his research did not support his hypothesis. From inside the massively well-funded research arm of the American war on drugs, he saw how the facts did not support the ideology. The truth was dismissed and distorted in order to keep fear and outrage stoked, the funds rolling in, and Black and brown bodies behind bars.Drug Use for Grown-Ups will be controversial, to be sure: the propaganda war, Dr. Hart argues, has been tremendously effective. Imagine if the only subject of any discussion about driving automobiles was fatal car crashes. Drug Use for Grown-Ups offers a radically different vision: when used responsibly, drugs can enrich and enhance our lives. We have a long way to go, but the vital conversation this book will generate is an extraordinarily important step.

Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic


Julie Livingston - 2012
    This affecting ethnography follows patients, their relatives, and ward staff as a cancer epidemic emerged in Botswana. The epidemic is part of an ongoing surge in cancers across the global south; the stories of Botswana's oncology ward dramatize the human stakes and intellectual and institutional challenges of an epidemic that will shape the future of global health. They convey the contingencies of high-tech medicine in a hospital where vital machines are often broken, drugs go in and out of stock, and bed-space is always at a premium. They also reveal cancer as something that happens between people. Serious illness, care, pain, disfigurement, and even death emerge as deeply social experiences. Livingston describes the cancer ward in terms of the bureaucracy, vulnerability, power, biomedical science, mortality, and hope that shape contemporary experience in southern Africa. Her ethnography is a profound reflection on the social orchestration of hope and futility in an African hospital, the politics and economics of healthcare in Africa, and palliation and disfigurement across the global south.Julie Livingston is Associate Professor of History at Rutgers University. She is the author of Debility and the Moral Imagination in Botswana and a coeditor of Three Shots at Prevention: The HPV Vaccine and the Politics of Medicine's Simple Solutions and A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship."Improvising Medicine is as good as it gets. It is a book that will be read for decades to come. I have always thought that great ethnography transcends the specificities of time and place, of the particular, to offer a glimpse of the universal. This gripping book does just that, and the subtle and grounded way that it speaks to global health and debates in medical anthropology makes it a major addition to both fields."—Vinh-Kim Nguyen, M.D., author of The Republic of Therapy: Triage and Sovereignty in West Africa's Time of AIDS“Improvising Medicine is a luminous book by a highly respected Africanist whose work creatively bridges anthropology and history. A product of intense listening and observation, deep care, and superb analytical work, it will become a canonical ethnography of medicine in the global south and will have a big impact across the social sciences and medical humanities.”—João Biehl, author of Will to Live: AIDS Therapies and the Politics of Survival and Vita: Life in a Zone of Social Abandonment

The Coming Plague: Newly Emerging Diseases in a World Out of Balance


Laurie Garrett - 1994
    Improper use of antibiotics. Local warfare. Massive refugee migration. Changing social and environmental conditions around the world have fostered the spread of new and potentially devastating viruses and diseases—HIV, Lassa, Ebola, and others. Laurie Garrett takes you on a fifty-year journey through the world's battles with microbes and examines the worldwide conditions that have culminated in recurrent outbreaks of newly discovered diseases, epidemics of diseases migrating to new areas, and mutated old diseases that are no longer curable. She argues that it is not too late to take action to prevent the further onslaught of viruses and microbes, and offers possible solutions for a healthier future.

My Own Country: A Doctor's Story


Abraham Verghese - 1994
    Nestled in the Smoky Mountains of eastern Tennessee, the town of Johnson City had always seemed exempt from the anxieties of modern American life. But when the local hospital treated its first AIDS patient, a crisis that had once seemed an urban problem had arrived in the town to stay. Working in Johnson City was Abraham Verghese, a young Indian doctor specializing in infectious diseases. Dr. Verghese became by necessity the local AIDS expert, soon besieged by a shocking number of male and female patients whose stories came to occupy his mind, and even take over his life. Verghese brought a singular perspective to Johnson City: as a doctor unique in his abilities; as an outsider who could talk to people suspicious of local practitioners; above all, as a writer of grace and compassion who saw that what was happening in this conservative community was both a medical and a spiritual emergency."

The Fever: How Malaria Has Ruled Humankind for 500,000 Years


Sonia Shah - 2010
    Bill Gates, Bono, and Laura Bush are only a few of the personalities who have lent their names--and opened their pocketbooks--in hopes of curing the disease. Still, in a time when every emergent disease inspires waves of panic, why aren't we doing more to eradicate one of our oldest foes? And how does a parasitic disease that we've known how to prevent for more than a century still infect 500 million people every year, killing nearly 1 million of them? In "The Fever," the journalist Sonia Shah sets out to answer these questions, delivering a timely, inquisitive chronicle of the illness and its influence on human lives. Through the centuries, she finds, we've invested our hopes in a panoply of drugs and technologies, and invariably those hopes have been dashed. From the settling of the New World to the construction of the Panama Canal, through wars and the advances of the Industrial Revolution, Shah tracks malaria's jagged ascent and the tragedies in its wake, revealing a parasite every bit as persistent as the insects that carry it. With distinguished prose and original reporting from Panama, Malawi, Cameroon, India, and elsewhere, "The Fever" captures the curiously fascinating, devastating history of this long-standing thorn in the side of humanity.

The Pastoral Clinic: Addiction and Dispossession along the Rio Grande


Ángela García - 2010
    In a luminous narrative, Angela Garcia chronicles the lives of several Hispanic addicts, introducing us to the intimate, physical, and institutional dependencies in which they are entangled. We discover how history pervades this region that has endured centuries of social inequality, drug and alcohol abuse, and material and cultural dispossession, and we come to see its experience of the opioid epidemic as a contemporary expression of these conditions, as well as a manifestation of the human desire to be released from them. With lyrical prose, evoking the Española Valley and its residents through conversations, encounters, and recollections, The Pastoral Clinic is at once a devastating portrait of immigration and addiction, a rich ethnography of place, and an eloquent call to political activists, politicians, and medical professionals for a new ethics of substance abuse treatment and care.

Vita: Life in a Zone of Social Abandonment


João Biehl - 2005
    This haunting, unforgettable story centers on a young woman named Catarina, increasingly paralyzed and said to be mad, living out her time at Vita. Anthropologist João Biehl leads a detective-like journey to know Catarina; to unravel the cryptic, poetic words that are part of the “dictionary” she is compiling; and to trace the complex network of family, medicine, state, and economy in which her abandonment and pathology took form.As Biehl painstakingly relates Catarina’s words to a vanished world and elucidates her condition, we learn of subjectivities unmade and remade under economic pressures, pharmaceuticals as moral technologies, a public common sense that lets the unsound and unproductive die, and anthropology’s unique power to work through these juxtaposed fields. Vita’s methodological innovations, bold fieldwork, and rigorous social theory make it an essential reading for anyone who is grappling with how to understand the conditions of life, thought and ethics in the contemporary world.

Brilliant Imperfection: Grappling with Cure


Eli Clare - 2017
    It saves lives, manipulates lives, and prioritizes some lives over others. It provides comfort, makes profits, justifies violence, and promises resolution to body-mind loss. Clare grapples with this knot of contradictions, maintaining that neither an anti-cure politics nor a pro-cure worldview can account for the messy, complex relationships we have with our body-minds.The stories he tells range widely, stretching from disability stereotypes to weight loss surgery, gender transition to skin lightening creams. At each turn, Clare weaves race, disability, sexuality, class, and gender together, insisting on the nonnegotiable value of body-mind difference. Into this mix, he adds environmental politics, thinking about ecosystem loss and restoration as a way of delving more deeply into cure.Ultimately Brilliant Imperfection reveals cure to be an ideology grounded in the twin notions of normal and natural, slippery and powerful, necessary and damaging all at the same time.

The Illness Narratives: Suffering, Healing, And The Human Condition


Arthur Kleinman - 1988
    But humans are not machines. When we are ill, we experience our illness: we become scared, distressed, tired, weary. Our illnesses are not just biological conditions, but human ones. It was Arthur Kleinman, a Harvard psychiatrist and anthropologist, who saw this truth when most of his fellow doctors did not. Based on decades of clinical experience studying and treating chronic illness, The Illness Narratives makes a case for interpreting the illness experience of patients as a core feature of doctoring.Before Being Mortal, there was The Illness Narratives. It remains today a prescient and passionate case for bridging the gap between patient and practitioner.

Medicine and Culture


Lynn Payer - 1996
    A classic comparative study of medicine and national culture, Medicine and Culture shows us that while doctors regard themselves as servants of science, they are often prisoners of custom.