[lit-ideas] Re: Diabetes (paging David Ritchie)
- From: "John McCreery" <john.mccreery@xxxxxxxxx>
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Wed, 19 Nov 2008 10:10:39 +0900
Point of information: A Google search for "culture bound syndromes" produces
2,490,000 hits. The field of medical anthropology is mostly about the
questions you have raised. Someone whose work is particularly worth looking
at is Arthur Kleinman at Harvard. The wiki entry about him is not a bad
place to start.
John
On Wed, Nov 19, 2008 at 3:11 AM, David Ritchie <ritchierd@xxxxxxxxxxxxx>wrote:
>
> On Nov 18, 2008, at 5:39 AM, Teemu Pyyluoma wrote:
>
> David, thanks for reply.
>>
>> The link didn't open, but I think I found it on youtube. I'd like to
>> expand a bit on "a cultural element at play in the defining of some
>> ailments." If the cultural element at play in early 20th century Britain was
>> class, what is it now? Invidualization?
>>
> I may have given the impression that only class was in play. This is not
> what I wrote in my thesis. Then, as now, there are/were many cultural
> elements to notice. Among these:
>
> *That regular folk and doctors define disease differently
> *That doctors are trained within cultures and though they have
> international meetings where they hash out agreements, they continue to be
> influenced by personal and cultural biases
> *That people claim ownership of disease, "my rheumatism," "my diabetes"
> *That diseases have economic value, both costs and benefits
> *That diseases are not evenly distributed; some kinds of people get more of
> one disease, others, another
> *That popular definitions of disease persist and vary from culture to
> culture--the British feel "under the weather," the French have "mal au
> foie," Californians suffer from "hypoglycemia."
> *That individual doctors assessing diseases look for a visual, numerical or
> other pattern of symptoms and try to interpret a story, taking a patient's
> narrative and re-arranging it into one with a different form.
> Epidemiologists work differently, looking for patterns in numbers and case
> reports. Information is bulky and balky; sometimes it goes nicely into the
> cage and sometimes it resists all attempts at definition
>
>
>
>> The idea that some diseases are caused by life style, such as lack of
>> exercise, obesity, etc. is not problematic in the sense that it is untrue,
>> but I do find it problematic because it is too vague. And I am guessing that
>> approval of such vague diagnosis is linked to the general social ranking of
>> life styles of the patients, that is for example the pathologies of lower
>> classes are more easily assumed be caused by their lifestyles.
>>
>> There is an economical side to this. To the extent pathologies are common,
>> economies of scale can be used to develop relatively affordable standardized
>> treatmens to the illnesses. Most people can not afford invidual pathologies.
>> But this urge to generalize may in turn lead to worse diagnosis, and
>> parodoxically to more expensive, in terms of time, money and suffering,
>> standard treatments instead.
>>
>>
>>
> That the arguments about diet and exercise have a moral overlay will get no
> disagreement from me. "Natural" is confused with morally sound, red meat,
> fat, sugar and both too little and too much alcohol with evil. We are
> supposed to live on fruits and vegetables, also chicken sausages and slivers
> of fish. My wife gets a newsletter on the latest findings about connections
> between nutrition and health. It reminds me of Victorian tracts against
> sin.
>
> David Ritchie,
> Portland,
> Oregon------------------------------------------------------------------
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--
John McCreery
The Word Works, Ltd., Yokohama, JAPAN
Tel. +81-45-314-9324
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