Young Forever?

The new goal of existence is immortality. Whether it’s fear of the unknown or an inability to conceptualize what aging is like, we’re socialized to want to maintain our youth at all costs. Even pop songs are reflecting this general desire, specifically Katy Perry’s “Teenage Dream” and Jay-Z’s “Young Forever”: 

Let's go all the way tonight
No regrets, just love
We can dance until we die
You and I
We'll be young forever

Let us die young or let us live forever

We don’t have the power, but we never say never

Sitting in a sandpit, life is a short trip
The music’s for the sad man

Forever young, I wanna be forever young
Do you really want to live forever, forever and ever?
Forever young, I wanna be forever young
Do you really want to live forever, forever, forever?

Katy Perry’s “Teenage Dream” exemplifies just how death-obsessed our culture truly is. Not only the line “We can dance until we die,” but also her reference to cardiac arrest (“My heart stops/When you look at me”) are representative of how often we think and talk about death in everyday life. Additionally, the line “We’ll be young forever” indirectly reinforces the stigma attached to old-age by placing value on the status of youth.

Though at first glance Jay-Z’s “Young Forever” seems to be presenting a simplistic, ageist approach to this heavy topic (and for the most part he is), Jay-Z also questions this new-age desire to live forever in posing the question “Do you really want to live forever, forever and ever?” Unfortunately, the medical profession, unlike Jay-Z, does not seem to be asking this question at all. Biomedicine is quickly forging ahead with new technology and assumptions without considering the ethical or social implications of their practices.

These ageist portrayals of desirability and age contribute to post-mortality and the devaluation of the elderly, as discussed in Lafontaine’s article “The Postmortal Condition: From the Biomedical Deconstruction of Death to the Extension of Longevity”. “If old age is a state against which one must fight, people who are ‘suffering’ from it are not only excluded from society, they become an element of biopower via an increasingly far-reaching medicalization” (308). Thus, ageing, in a sense, is becoming pathology as the line between disease and ageing is increasingly blurred by medicine.

Furthermore, “feeding the fantasy of infinite longevity, the biomedical deconstruction of death and anti-age medicine threaten to shake even more fundamentally the anthropological reference points on which human existence and experience is based” (309). Therefore, in a sense, the lack of questioning of scientific evaluations of ageing or songs such as “Young Forever” and “Teenage Dream” may have greater implications for society. If we do indeed view life “as linear and extensible,” we will continue to encourage the technological advancements that are fueling this problematic thinking to begin with. Without death, our lives would cease to form the vital cycle of our ancestors. The attempt to escape death or defer it comes with a cost: not only devaluation of old age, but also meaninglessness of life itself.

In short, “the devaluing of old age, the desocialization of death, its loss of meaning and the feeling of absurdity that accompanies it are the negative sides of the postmortal condition,” and of pop songs that over-value youth (309).

In the article “Resuscitations: Stem Cells and the Crisis of Old Age,” Cooper explores stem cell research and the meaning of old age in our society. Specifically, she discusses age in terms of biological limits, and “as a moveable threshold between surplus and waste, obsolescence and renewal” (3). This market-driven approach to ageing proves to be extremely problematic, especially when considering how “the life sciences and their cutting-edge biotechnologies are becoming ever more integrated into the circuits of capital accumulation” (16). She goes on to state that “…it is clear that no appeal to the lost sanctity of human life will protect us from the incursions of the market” (16). Therefore, almost all attempts to change the future path of biomedicine and biotechnology will be impossible. “Increasingly we are being confronted with the problem of thinking about and resisting forms of property that claim to own life in its futurity, before it has emerged into morphological form” (16).

In order to solve these societal problems that will only worsen with technological advancements in the area of biomedicine, we must first seek to reverse the devaluation of old age. Ageist social commentaries, such as pop songs that glorify youth, must be seriously considered. We, like Jay-Z, must continue to ask ourselves, our friends, and the institution of medicine “Do you really want to live forever, forever and ever?” And, if we do want to live forever, what would that mean? What are implications of reinforcing these ideals? How can we address these issues realistically, from a social or technological/biomedical perspective?

Though just merely asking questions does not seem to amount to much, we must begin to raise these concerns in order to commence a reconsideration of bio-power and current assumptions regarding social status and value.

Bibliography

http://www.youtube.com/watch?v=E1nbvplgElw

http://www.youtube.com/watch?v=c3-yr4jv32s

Cooper, Melinda. 2006. “Resuscitations: Stem Cells and the Crisis of Old Age.” Body and Society 12(1): 1-23.

Lafontaine, Celine. 2009. The Postmortal Condition: From the Biomedical Deconstruction of Death to the Extension of Longevity. Science as Culture 18(3): 297-312.

Not Dead… Yet

Kaufman blurs the distinction between life and death in her article “Dementia-Near-Dear and ‘Life Itself,’” claiming dementia to be “a condition both of death-in-life and of life-in-death” (Kaufman, 23). Conditions like dementia serve to dismantle society’s perception of two discrete entities: life and death. But are these two phenomena actually so distinct?

Though there is indeed some sort of difference between life and death, particularly between youth and old age, the distinction between these two categories can be murky. Does one cross over at 40, with a black cake and an “Over the Hill” banner? Or at the first strand of gray hair?  Where can we begin to draw the line? Some would argue that the cross over from younger to older via mid-life can be defined by a chronology of medical events, such as menopause in women. In the article “The Politics of Mid-Life and Menopause,” Margaret Lock critiques the medical construction of the female body and aging processes such as menopause as largely informed by a hegemonic social and medical discourse. This becomes even more apparent when she compares perceptions of menopause and aging in the United States with those in Japan. However, in both discourses “the subjective experience of aging is ignored; it is assumed to be irrelevant and inaccurate knowledge in political arenas where reality is above all quantitatively constructed” (357).  Thus, what could be the natural progression of life is ultimately dictated and defined by medicine, which continues through the process of dying and death.

If we distinguish dying from death, perhaps we can differentiate between dying as a process and death as a discrete point in time. However, even this distinction proves to be increasingly difficult due to increased technology and varying definitions of death, including the category of “brain death.” Highly contingent on the location of “personhood,” brain death proves to be a controversial concept that varies between cultures. Margaret Lock explores the gray area between life and death in the United States and Japan, claiming “Brain-dead patients remain betwixt and between, both alive and dead, breathing with technological assistance but irreversibly unconscious” (136). She concludes that while brain-dead patients are largely dead to American society, brain-dead patients in Japan live on through their relationships and family ties. “In North America a brain-dead body is biologically alive in the minds of those who work closely with it, but it is no longer a person, whereas in Japan, for the majority, including a good number of physicians, such an entity is both living and remains a person, at least for several days after brain death has been diagnosed” (150).

Not only the status of “brain-dead” as lingering between life and death, but also the determination of the condition seems to be in turmoil. The USA Today article When is someone brain dead? Experts revise guidelines by Jenifer Goodwin presents the conflict over definitions of “brain-dead” and their real life consequences in hospitals. The U.S. Uniform Determination of Death Act defines brain death as occurring “when a person permanently stops breathing, the heart stops beating and "all functions of the entire brain, including the brain stem" cease.” Though there is little debate over this definition, the American Academy of Neurology has issued new guidelines for determining brain death due to large discrepancies over determinations of brain death in America’s top hospitals. Now there is a step-by-step checklist of approximately 25 tests and criteria to rightly and consistently identify brain death.

The equation of brain-death with death itself can largely be attributed to the Cartesian idea that personhood is to be located within the mind. Eric Krakauer explores the realm of Cartesian thinking in regards to medicine and end-of-life issues. Central to the Cartesian approach is the thinking subject, which is thought to be able to “’master’ the chaos of the world” (385). Thus, it logically follows that personhood ends when the thinking, subjective self ceases to master the world with his brain power. This reasoning fits perfectly with concepts of medical mastery, especially the mastery of death. But has medicine actually mastered death? Is this medical definition of death as lack of brain functioning universally accepted in our society?  

The answer is no. Varying definitions of death (and where personhood is located) result in controversy around when it is acceptable to officially end a life. One example of a group that rejects the simplistic medical definition of death as “brain death” is a radical disability rights advocacy group called Not Dead Yet. Though the line between life and death is often unclear, the legalized medical killing of people in the gray area (between these categories) is often met with protest from the disability community. The following is a description of the group and their work:

Since 1983, many people with disabilities have opposed the assisted suicide and euthanasia movement. Though often described as compassionate, legalized medical killing is really about a deadly double standard for people with severe disabilities, including both conditions that are labeled terminal and those that are not.

This resistance problematizes the simplistic Cartesian distinction being thinking and non-thinking subjects and resulting existence (or lack thereof) of personhood. Many people living with severe disabilities, or who are in a “vegetative” state, are often deprived of personhood and human rights. These instances raise questions about what constitutes a full person and who should have authority in making decisions about people’s lives that cannot exercise their own autonomy. Also, when doctors deem someone as “brain-dead” are they really dead? Or are they just “disabled” in some capacity? And if they are just “disabled,” shouldn’t they enjoy the right to life like the rest of us?

Bibliography

Goodwin, Jenifer. 2010. “When is someone brain dead? Experts revise guidelines.” USA Today online. http://www.usatoday.com/news/health/2010-06-12-brain-dead_N.htm

Kaufman, Sharon R. 2006. “Dementia-Near-Death and ‘Life Itself.’” In Thinking about Dementia: Culture, Loss, and the Anthropology of Senility. Annette Leibing and Lawrence Cohen, eds. New Brunswick, NJ: Rutgers University Press. Pp. 23-42.

Krakauer, Eric. 2007. “‘To Be Freed from the Informity of (the) Age’: Subjectivity, Life-Sustaining Treatment, and Palliative Medicine.” In Sebjectivity: Ethnographic Investigations. Joao Biehl, Byron Good, and Arthur Kleinman, eds. Berkeley: University of California Press. Pp. 381-397.

Lock, Margaret. 2004. “Living Cadavers and the Calculation of Death.” Body and Society 10(2-3): 135-152.

Lock, Margaret. 1993. “The Politics of Mid-Life and Menopause: Ideologies for the Second Sex in North America and Japan.” In Knowledge, Power, and Practice: The Anthropology of Medicine in Everyday Life. Shirley Lindenbaum and Margaret Lock, eds. Pp. 330-363. Berkeley: University of California Press.

http://www.notdeadyet.org/docs/about.html

http://www.google.com/imgres?imgurl=http://torahmusings.com/wp-content/uploads/2010/12/brain-death.jpg&imgrefurl=http://torahmusings.com/2010/12/brain-death-in-the-news/&usg=__wkkpIS0Q1Xsg8ytdUAine-A7ic4=&h=201&w=200&sz=20&hl=en&start=0&sig2=UFoaPpUUmvNG8-84fWGySA&zoom=1&tbnid=JbV5uQRDMOdpqM:&tbnh=137&tbnw=136&ei=l29xTZOkK4qisAPq3NWdCw&prev=/images%3Fq%3Dbrain%2Bdeath%26um%3D1%26hl%3Den%26sa%3DN%26biw%3D1280%26bih%3D620%26tbs%3Disch:1&um=1&itbs=1&iact=hc&vpx=160&vpy=147&dur=3093&hovh=160&hovw=160&tx=93&ty=72&oei=l29xTZOkK4qisAPq3NWdCw&page=1&ndsp=20&ved=1t:429,r:0,s:0

http://www.google.com/imgres?imgurl=http://graphics8.nytimes.com/images/2005/03/27/national/schiavo_protest1.jpg&imgrefurl=http://www.nytimes.com/imagepages/2005/03/27/national/28schiavo_slide03.html&usg=__BE2_0wB5EUBP-dTQFuWt4ENY7So=&h=450&w=650&sz=84&hl=en&start=0&sig2=fDUR3LE5yRCSpHe63RjU7A&zoom=1&tbnid=JRk85GGe-3KCEM:&tbnh=161&tbnw=191&ei=H4FxTbu2IYL0tgOWluzHCw&prev=/images%3Fq%3DNot%2BDead%2BYet%2Bprotest%26um%3D1%26hl%3Den%26biw%3D1280%26bih%3D620%26tbs%3Disch:1&um=1&itbs=1&iact=hc&vpx=540&vpy=109&dur=950&hovh=187&hovw=270&tx=188&ty=76&oei=H4FxTbu2IYL0tgOWluzHCw&page=1&ndsp=19&ved=1t:429,r:3,s:0

Difference & Variation: A Disability Studies Perspective

Difference – though, arguably, always a social construction – can be identified and responded to in myriad ways. In reading the Rose, Talbot and Elliot pieces, my mind continuously wandered to frustration as the result of the oversimplification of various desires, moods, behaviors, etc. I was also consistently framing my frustrations in terms of disability studies and the predominant theoretical models of disability.

According to Simi Linton, disability studies serves as “a location and a means to think critically about disability, a juncture that can serve both academic discourse and social change” (1). She also emphasizes the necessity of a sociopolitical analysis of disability, claiming the disability rights movement has “resulted in new paradigms used to understand disability as a social, political, and cultural phenomenon” (2).

While the medical/individual model of disability locates the problem within the individual and focuses on “treating the problem” or finding a cure, the social models locates the problem within society and focuses on eliminating structural or attitudinal barriers (Barnes and Mercer, 11). The social model differentiates between impairment – the individual’s mental, physical, cognitive difference – and disability – the social, attitudinal and physical barriers that prevent an individual from successfully integrating into society (Barnes and Mercer, 12).

This distinction complicates the disorders and conditions presented in the Rose, Talbot and Elliot articles. The social model of disability not only claims disability/disorder/dysfunction to be a social construction, but also criticizes the medicalization of disability and the very act of locating the issue within the individual. What could this mean for the various instances of over-medicalization presented in the articles?

The manifesto of Nikolas Rose’s “Neurochemical Selves” reads: “While our desires, moods, and discontents might previously have been mapped onto a psychological space, they are now mapped upon the body itself, or one particular organ of the body—the brain. And this brain is itself understood in a particular register. In significant ways, I suggest, we have become “neurochemical selves” (188). Thus, human “problems” or “disorders” will increasingly be physically located in the brain, reinforcing the medical model and further discounting the social aspects of difference. Additionally, this movement from abstract DSM categories to physical brain phenomena will facilitate drug marketing and sales. Prescribing rates rose eight-fold in the decade from 1990 to 2000 alone (210). Rose argues “such drugs do not so much seek to normalize a deviant but to correct anomalies, to adjust the individual and restore his or her capacity to enter the circuits of everyday life” (210). I, however, argue that this very ideology only serves to reinforce medicalization and does not succeed to locating the problem outside of the individual. “Correcting anomalies” indicates there is something to correct – to fix – which is the epitome of medical model thinking.

The “Brain Gain” phenomenon (as presented in Margaret Talbot’s piece) is in a sense the consequence of the over-medicalization of “disorders” and the over-distribution of drugs to treat them. I argue this over-medicalization is pushing the standard distribution of the bell curve to the right, raising standards of performance for everyone, and ultimately forcing people to perform even better than typical in order to be “normal.” Enter neuro-enhancing drugs and a competitive society, and it logically follows that everyone feels they need to be popping pills in order to compete. Talbot’s article also addresses the cyclical nature of the identification of disorders, writing “New Psychiatric drugs have a way of creating markets for themselves. Disorders often become widely diagnosed after drugs come along that can alter a set of suboptimal behaviors” (5). Thus, the very creation of ADHD as a disorder legitimizes the alleged “symptoms” and promotes the prescription of drugs to treat it. The ease of acquiring these drugs then fuels the “Brain Gain” issue, which then raises the standard of human performance, and the cycle begins again.

Similarly, the medicalization of shyness as a “social phobia” (as articulated in Carl Elliots’s work) also functions to reinforce the medicalization of conditions and to legitimate stereotypes and stigma. Thanks to its 1987 debut in the DSM III, “social phobia” is now a bona fide disorder that can be diagnosed and treated. Diagnosis implicitly blames the individual, locating the problem within his deficits. Without acknowledging cultural problems and societal attitudes we will not truly treat “problems” such as social phobia as much as legitimize them and fuel the pharmaceutical industry.

In the article “Amputees by Choice,” Carl Elliot discusses what John Money terms “apotemnophilia,” or the attraction to the idea of becoming an amputee (209). From a disability studies perspective, common attitudes towards “apotemnophiliacs” also relate to the medical v. social model debate. If someone without legs would not experience discrimination and difficulty integrating into society, would it be so absurd that someone would autonomously join them? Since society tends to employ the medical model to evaluate the experience disability, we tend to focus on people’s deficits or inabilities as opposed to viewing them as a person like anyone else. If disability were not viewed as a problem to be fixed, society would be les judgmental and critical of those with differences, impairments, and disabilities.

When will a drug be invented to cure societal problems such as physical and attitudinal barriers or stigmatization of difference? Until this occurs, we, as a society, must continue to think critically about human variation and strive to be inclusive as opposed to exclusive and to search for sustainable cures to societal issues. Medicalizing and treating disorders/problems/disabilities with drugs only serves to reinforce the medical/individual model of difference, discounting the real, problematic effects of social attitudes and barriers that probably create these “problems” in the first place.

Bibliography

Barnes, Colin and Geof, Mercer. 2003. “Disability: A Choice of Models” and “Disabling Societies: Domination and Oppression.” In Disability. Cambridge: Polity Press. Pp. 1-41.

Elliot, Carl. 2003. “The Face Behind the Mask” and “Amputees by Choice.” In Better Than Well: American Medicine Meets the American Dream. New York: W.W. Norton and Company. Pp. 54-76, 208-236.

Linton, Simi. 1998. “Reclamation.” In Claiming Disability: Knowledge and Identity. New York: New York University Press. Pp. 1-7.

Rose, Nikolas. 2007. “Neurochemical Selves.” In The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century. Princeton: Princeton University Press. Pp. 187-223.

Talbot, Margaret, “Brain Gain: The Underground World of ‘Neuroenhancing’ Drugs.” The New Yorker, April 27, 2009.

We Are... What?! Food, Health, Body

“Nutritionism involves not only a nutritionally reductive approach to food but also a reductive approach to understanding the body and bodily health” (Scrinis, 42).

“American culture’s treasured doctrine of the perfectible body is deeply indebted to Christian currents that have perceived the body as central for pushing the soul along the path to progress” (Griffith, 38).

“We aren’t growing quality. We’re growing crap.” (King Corn)

How have we become so disconnected from the food we eat? We spend a large portion of our incomes on it. We put it in our mouths. It travels through our intestines, giving us the fuel we need for our high-energy lives. And, perhaps most importantly, most would, at least to some extent, agree with the age-old cliché “You are what you eat.”

So, if we are indeed what we eat, what are we eating? How do we think about food? How do we conceptualize the relationship between food, health, our sense of self, and our bodies?

First of all, according to visualeconomics.com, this is what we’re eating.

This depiction of the average, 36.6-year-old American is undoubtedly disturbing. How could it be possible to consume 29 pounds of french fries, 53 gallons of soda, and 24 pounds of artificial sweeteners? Perhaps even more disturbing is the incredible corn consumption. The average American eats 56 pounds of corn and 42 pounds of corn syrup each year. How is this possible?

King Corn, a food documentary, follows two young men on their journey from Boston to rural Iowa to plant an acre of corn. Consequentially, the film explains how corn sneaks its way into our diets:

 Food documentaries such as King Corn are working to expose the atrocities of our food system by providing consumers with information that is not as readily available as one would think. As such an intimate part of our lives, food needs to be reevaluated and thought about more holistically, taking into consideration not only the consequences of food at the individual level, but also the agricultural system, the environment, and sustainability. 

 Food, Inc., another documentary, exposes problems with the food system and encourages people to rethink food: 

Though rather thorough in scope, these documentaries only begin to get at the American food complex. In a society obsessed with the notion of health, how can it make sense to unknowingly consume so much high fructose corn syrup? Shouldn’t we know what we’re eating?

Gyorgy Scrinis’ article addresses the ideology or paradigm of nutritionism as a reductive approach to food. “This focus on nutrients has come to dominate, to undermine, and to replace other ways of engaging with food and of contextualizing the relationship between food and the body” (39). She critiques the modern conceptualization of nutrients and diets, claiming that “nutritionism promotes the idea that the perceived problems with contemporary diets can be tackled by the more or less precise quantitative tinkering of the nutrient profile of foods and diets – by nutritional tinkering – rather than by means of more far-reaching qualitative changes in diets and the types of foods eaten” (43). Indeed, this superficial approach to food makes more holistic approaches (such as the ideology of Food, Inc.) seem shocking. Scrinis also argues that “nutri-qualification” manipulates the categorization of foods, blurring distinctions between various kinds of foods, such as processed and unprocessed, plant-based or animal-based.

Furthermore, Scrinis discusses issues around focusing on nutrients as opposed to food as a whole. “The more extensively a food is processed, the more opportunities there are for its nutrient profile to be engineered according to the latest nutritional fetish” (43). Therefore, over-processing of foods fuels the nutritional fetish, creating a toxic cycle. This cycle leaves less room for the autonomy of the consumer in making decisions about food. Additionally, Scrinis presents the idea of “wonder foods” as necessary to attain health and how this phenomenon “overrides the preference for local and seasonal foods, as well as the need to reduce meat consumption to minimize the environmental impacts of animal production” (44). This occurrence is also addressed in Food, Inc., which emphasizes the importance of eating locally grown foods.

In the article “Don’t Eat That: The Erotics of Abstinence in American Christianity,” Marie Griffith explores the role of Christianity in forming opinions about food. In linking food and religion, she claims that few authors “question the belief that following God means taking a deeply suspicious stance toward food” (42). She continues by stating that

“like the lifeless body that no longer hungers, so should living Christians adopt indifference toward food” (43). According to this logic, the stomach turns into a God if food is given too much importance (43). Thus, good Christians must distance themselves from the appeal of food.

Griffith also discusses Shamblin’s image of “food as a seductive lover who entices the overeater away from the true husband, God” (45). This claim portrays the Christian idea of food as something to distrust and loathe (45). Though Christian authors may adhere more closely to the body standards of American pop culture than they would like to admit, their writings “provide biblical justification for their reader’s desire to be lean and appealing” (46). This phenomenon suggests a moral component of food, and an integral connection between body image, health, and food.

Though the relationship between food, health, and self is extremely complicated, I feel this relationship is too often oversimplified and pushed to the sideline in a society that is simultaneously obsessed with (yet overwhelmingly ignorant about) food. We must continue to question not only how our food is produced, but also how our perceptions of food are informed by the very people who try to poison us with corn by-products.

Bibliography

http://www.visualeconomics.com/food-consumption-in-america_2010-07-12/

http://www.fancast.com/movies/Food%2C-Inc./148348/1098855281/-Food%2C-Inc.-%3A-Trailer/videos?cmpid=syn_rss

http://www.fancast.com/movies/King-Corn/139869/561667151/-King-Corn--Trailer/videos?cmpid=syn_rss

Griffith, Marie R. 2001. “’Don’t Eat That’: The Erotics of Abstinence in American Christianity.” Gastronomica 1(4): 36-47.

Scrinis, Gyorgy. 2008. “The Ideology of Nutritionism.” Gastronomica 8(1): 39-48. 

Norms, Medicalization, & Deviance

Despite the inevitability of human variation, people seem to have a tendency to categorize and discriminate, label and ostracize. Though there are many ways to create and explain difference, historically people have looked to a variety of sources (religion, morality, authoritative figures, law, etc.) for guidelines on how to interpret human variation. The articles for this week focus on the medicalization of sex, gender, sexuality, and sexual desire. In an attempt to define deviations from a (probably nonexistent) norm, medicalization seems to serve as a means to further enforce already existent cultural intolerance for groups that do not fit perfectly into the mainstream. 

In “Discovery of the Sexes,” Laqueur articulates how “in the late seventeenth and eighteenth centuries, science fleshed out, in terms acceptable to the new epistemology, the categories ‘male’ and ‘female’ as opposite and incommensurable biological sexes” (154). He goes on to point out the terminology with which science defined these new sexes. “It claimed that the body provided a solid foundation, a causal locus, of the meaning of male or female” (163). These inherent (and biological) differences between the sexes set the stage for the construction of gender roles, which are illustrated in the following cartoons:

The first cartoon, which depicts an angry caveman grunting about how his son prefers female work and how his daughter is aggressive, demonstrates how engrained gender roles are in society, past and present. The caveman clearly is struggling to accept the abnormal characteristics of his children, further enforcing the gender binary. The cartoon also expresses how gender roles are completely contingent on time and place, suggesting their arbitrary (and socially constructed) nature.

The second cartoon, which depicts two figures (male and female) disassembling the (literally) constructed framework of gender, demonstrates how ultimately (behind the guise of gender, and beyond the limits of sex) we are all individuals. The structural representation of the sex symbols shows how pervasive the gender binary is in our culture, and how difficult it is to break through it (according to the cartoon, it requires a hammer!). Additionally, the physical separation of the two symbols reinforces Laqueur’s idea of two “opposite and incommensurable biological sexes” (154). This biological distinction serves to legitimize and reinforce this cultural gender binary. Men and women are not the same, nor are they equal.

Since considering homosexuality as an “other” category stems from the normative view that people ought to be attracted to members of the opposite sex and fit neatly into their respective gender roles, the medicalization of homosexuality further exemplifies the desire to precisely map any deviations from a sexual or sex-related norm. Terry outlines the perspectives of many groups and individuals on homosexuality, explaining how the psychoanalysts’ “theories reflected preconceived notions that the individual’s healthy adjustment to normative gender roles and monogamous reproductive heterosexuality were favorable” (57). Though the psychoanalysts did not view homosexuality as some sort of hereditary defect that could be cured, they were worried about its prevalence and its threat to cultural progress (62). Thus, the Freud camp, while resisting the medicalization of homosexuality, still upheld the heteronormative values of gender roles, related sexual preference, and monogamy.

The Irvine article entitled “Regulated Passions: The Invention of Inhibited Sexual Desire and Sexual Addiction” addresses the phenomenon of medicalizing and normalizing sexual desire. Irvine discusses the invention of the diagnostic constructs, their arbitrariness, and how they reflect “cultural traditions and anxieties” (315). She also draws a connection between the field of addictionology and professional expansion (318). She identifies the issues with how “the assertion of exact definitional and diagnostic criteria poses an enormous challenge when ‘disease’ is a generalized set of signifiers of cultural chaos and social control” (319). This concern reflects the inter-dependency of science and culture and exposes the abuse of expertise and medicine in dictating cultural interpretations of natural variation, whether it be “levels of desire,” homosexuality, gender, or sex.

It seems that the medicalization of various conditions and ways of life serves to reinforce dichotomies and cultural norms. Therefore, medical expertise and medicalizing conditions strengthen the walls of normalcy and expectation, as represented in cartoon 2. Though the constructed binary depicted in the cartoon is gender and/or sex, the symbolic value extends to normalizing heterosexuality or sexual desire. Medicalizing these conditions makes it more difficult to break out of these structural restraints and to be accepted in society as an individual -- not a precisely mapped deviation from a correct, valued norm. 

Bibliography

http://www.cartoonstock.com/directory/g/gender_roles.asp

Irvine, Janice M. 1995. “Regulated Passions: The Invention of Inhibited Sexual Desire and Sexual Addiction.” In Deviant Bodies: Critical Perspectives on Difference in Science and Popular Culture. Edited by Jennifer Terry and Jacqueline Urla. Pp. 314-337. Bloomington and Indianapolis: Indiana University Press.   

Laqueur, Thomas. 1990. “Discovery of the Sexes.” In Making Sex: Body and Gender from the Greeks to Freud. Cambridge: Harvard University Press. Pp. 149-192.

Terry, Jennifer. 1999. “Medicalizing Homosexuality.” In American Obsession: Science, Medicine, and Homosexuality in Modern Society. Chicago: University of Chicago Press. Pp. 40-73.

(fe)Male Anatomical Representations (Past and Present)

 

“The history of the representation of the anatomical differences between man and woman is thus extraordinarily independent of the actual structures of these organs or of what was known about them. Ideology, not accuracy of observation, determined how they were seen and which differences would matter” (88).

“…But all anatomical illustrations, historical and contemporary, are abstractions; they are maps to a bewildering and infinitely varied reality. Representations of features that pertain especially to male or female, because of the enormous social consequences of these distinctions, are most obviously dictated by art and culture” (164).

In his book Making Sex: Body and Gender from the Greeks to Freud, Thomas Laqueur reveals the history and evolution of (fe)male anatomical representations. Specifically, he focuses on how the interpretations of the sexes have been more informed by culture than by scientific discoveries. Furthermore, he acknowledges how anatomical illustrations are merely abstractions, influenced by art and culture to create social distinctions between the sexes. To serve as a complement to the multitude of representations of the human genitalia presented in Laqueur’s chapters, I will compare and contrast historical anatomical illustrations with an AIDS advertisement video entitled “Penis after Vagina” that portrays modern representations of male and female sex organs.

Laqueur’s Chapter Three, New Science, One Flesh, presents Renaissance reproductive anatomy. Laqueur argues that these historical beliefs “suggest that the anatomical representation of male and female is dependent on the cultural politics of representation and illusion, not on evidence about organs, ducts, or blood vessels” (66). Notions of sexuality were dictated by the one-sex model, which claimed that there was only one “canonical body and that body was male” (63). Women, therefore, were viewed merely as the inverted, inferior versions of men. The medical profession explained this with “an assertion of male power to know the female body and hence to know and control a feminine Nature” (73). Thus, anatomy explicated nature, creating a sense of understanding in the medical and social worlds.

Laqueur’s Chapter Five, Discovery of the Sexes, outlines the rise of the distinction between sex and gender. He argues that “there are two explanations for how the two modern sexes as we imagine them were, and continue to be, invented: one is epistemological and the other is, broadly speaking, political” (151). Thus, anatomical distinctions are largely the result of forces outside those of anatomy, namely culture and politics. Therefore, “no discovery or group of discoveries dictated the rise of a two-sex model, for precisely the same reasons that the anatomical discoveries of the Renaissance did not unseat the one-sex model: the nature of sexual difference is not susceptible to empirical testing” (153). Gender distinctions defy the simple, quantitative assessments of the scientific method and expand into the murky realm of assumptions and beliefs.

Laqueur also address the idealism of scientific representations of the body. “Anatomical illustrations that claim canonical status, that announce themselves to represent the human eye or the female skeleton, are more directly implicated in the culture producing them. Idealist anatomy, like idealism generally, must postulate a transcendent norm’ (166). Thus it logically follows that Laqueur also asserts that the ideal body is male, and thus that “it is simply assumed that the human body is male. The female body is presented only to show how it differs from the male” (167). This male-centric approach to the body demonstrates how ideal structures reflect culturally constructed beliefs about gender.

The AIDS advertisement video presents modern day (gendered) representations of the male and female genitalia. Though they are neither textbook illustrations nor scientific in any regard, I feel they reflect the rise of the sex/gender distinction and two-sex model that Laqueur discusses in his book. Clearly, the penis and vagina are separate, unrelated entities, not just the inversion, one-sex model of the Renaissance. The cartooned penis and vaginas also present gender stereotypes. For example, in the opening scene, the penis (or man) is portrayed as being confident, aggressive and domineering, and the vagina (or woman) reacts by acting weak and frightened. While the penis just has prickly hair on its testicles, the vaginas sport eyelashes, heels, sexy outfits and breasts, further perpetuating the gender binary. However, the various shapes and sizes of vaginas help break the idealist model of anatomical representations, demonstrating the diversity of human bodies.

The final scene (after the woman draws the condom on the penis) could be interpreted in a number of ways. Of course, the purpose of the video is to encourage people to use protection to prevent STDs such as AIDS. However, I feel that the video may also reinforce the stereotype of the lustful woman in a male-dominated world that Laqueur describes in Chapter 3 (113). The key to wanting sex cannot be as simple as using a condom.

Ultimately, this video demonstrates the ever-evolving representations of anatomical differences between men and women, and resulting interpretations of sexual difference. Completely contingent on culture, politics, time and place, the cartooned penis and vagina of the 21^st century vary greatly from the illustrations of the Renaissance or those of the 18^th century. Art, science, and culture continue to work together to construct ideas about gender in an ever-changing world.

Bibliography

http://www.youtube.com/watch?v=_8D3Q2hxWX0&oref=http%3A%2F%2Fwww.youtube.com%2Fresults%3Fsearch_query%3Daids%2Badvertisement%2B%26aq%3Df&has_verified=1

Laqueur, Thomas, New Science, One Flesh, IN Making Sex: Body and Gender from the Greeks to Freud. Cambridge: Harvard University Press, 1990. Pp. 63-113.

(Re)Constructions of Mental Illness

The DSM as symbolizing the dominance of discourse in the creation of mental illness, definitions of mental disorders as prior to and separate from culture and personal experience, and American imperialism in regards to the construction of mental disorders

The Americanization of Mental Illness (New York Times)

“…We’ve been changing not only treatments but also the expression of mental illness in other cultures. Indeed, a handful of mental-health disorders – depression, post-traumatic stress disorder and anorexia among them – now appear to be spreading across cultures with the speed of contagious diseases. These symptom clusters are becoming the lingua franca of human suffering, replacing indigenous forms of mental illness” (2).

“Western mental-health practitioners often prefer to believe that the 844 pages of the DSM-IV prior to the inclusion of culture-bound syndromes describe real disorders of the mind, illnesses with symptomatology and outcomes relatively unaffected by shifting cultural beliefs. And, it logically follows, if these disorders are unaffected by culture, then they are surely universal to humans everywhere. In this view, the DSM is a field guide to the world’s psyche, and applying it around the world represents simply the brave march of scientific knowledge” (4).

“This current view (intersection without ideology), like the earlier one (ideology without intersection), is premised on the positivist idea, shared by the patients and nearly all of the staff, that science uncovers its objects and does not construct them” (Young, 119).

“Critics have been concerned that with the rapid increase in brain imaging techniques, the traditional basis of psychiatric diagnosis will be overtaken by crude biological reductionism” (Cohn, 81).

Both the Young and Cohn articles demonstrate how mental illnesses are constructed in certain contexts. In conjunction with the medical definition of the disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM), both seem to focus on the importance of scientific knowledge in the construction of the illness. However, the examples of posttraumatic stress disorder (PTSD) and the mental disorders indicated by brain scans complicate a simplistic scientific construction of illness by introducing the role of ideology and technology in the patient’s construction of the disorder.

Young claims scientific knowledge to be the result of scholarly discourse and institutional ideologies (118). He uses the example of how PTSD is constructed and treated at an Institute that was created by the Veterans Administration (VA) to provide “specialized treatment” for PTSD (110). He discusses the interplay of discourse (scholarly work that provides a rubric for diagnosis) and ideology (local systems of knowledge that provide an arena for the materiality of PTSD) in creating scientific knowledge. Though historically the perceptions of the relationship between discourse and ideology have varied at the Institute, currently the notion of ideology has been abandoned for a sole focus on discourse, confirming “that science uncovers its objects and does not construct them” (119).

However, ideology continues to dominate the construction of PTSD at the Institute because of its authority and efficacy (126). The power of the Institute’s ideology persists because it is “sanctioned by the administrative authority” and because therapists must not only adhere, but also believe the legitimacy of the ideology (126). Meanwhile, patients use ideology as a means of “throw(ing) meaning around the unbounded and incoherent misfortunes of (their) postwar lives” (127). The patients are also able to avoid moral responsibility for their present state by medicalizing the past. This “sickness without psychosis” provides the men with comfort and a sense of self-efficacy (127).

Cohn address the claim that brain imaging technology will succeed at locating diseases –such as depression and schizophrenia – fully within the brain (68). In evaluating this possibility, he discusses the virtual impossibility of creating a stable and distinctive object of illness because of its contingency on the establishment of a “normal” brain (71). However, the use of brain imaging technology in the form of brain scans seems to provide patients with the illusions of objectivity and fact. Though many professionals are uncertain of the ability of the scans to define illness, an air of certainty still surrounds these images. “This imbued sense of certainty emanates from the illusion, largely colluded with by the researchers themselves who are anxious to demonstrate their expertise to the volunteers, that somehow the images are divorced from the many people and technical decisions involved in their construction” (76).

Though this new technology seeks to locate disease within the brain to further scientific knowledge of mental illness, patients attempt to use the scans not only to make their illness external, but also to provide an explanation of their condition for their social relationships (74, 79). Technology masks the uncertainty surrounding the meaning of the scan, so patients appropriate the images as extensions of themselves in their social lives, assigning personal (and perhaps scientifically unjustifiable) meaning to the images (67, 78). This, however, reveals a paradox: while patients “wanted to use the images to find ways of divorcing themselves from the illness, the illness itself refuses to be redefined because in the end it emerges not from the internal body but the nature of the person’s social relationships” (80).

Therefore, in these examples, both ideology and technology serve as a means of providing patients with a false sense of security regarding the stability or meaning of their disorder. Mental illnesses defy concrete definition, as they are a reflection of social relationships and culture. Ethan Watter’s article entitled “The Americanization of Mental Illness” addresses this issue in confronting the problems surrounding the globalization of American definitions of mental disorders (the DSM). Though “scientific leaps in understanding the brain haven’t yet created the sorts of cultural stories from which humans take comfort and meaning,” these definitions and technologies are presented as fact not only in the United States, but also globally (8).

Without the existence of a “stable, distinctive object of illness,” how could we possibly expect to apply the DSM in other countries (Cohn, 71)? Though the DSM blatantly ignores culture (until the “culture-bound syndromes” section on pages 845-849 of the DSM-IV), the role of culture cannot be ignored in the construction of a mental disorder (Watters, 4). Since “mental illnesses are not discrete entities,” nor will they ever be, we should use caution while introducing our ideas of mental disorders into other cultures (1).

Bibliography

http://www.google.com/imgres?imgurl=http://www.addictmedicine.com/images/DSM_IV_2.jpg&imgrefurl=http://www.addictmedicine.com/dsm_iv_%28tr%29.htm&usg=__CIZ4id4Y1rpwSt6mrNXdd_XOhmc=&h=737&w=509&sz=28&hl=en&start=0&sig2=oEVtJxnDaKGw9_PsT_9x3w&zoom=1&tbnid=Oc0eusFqnp15gM:&tbnh=155&tbnw=107&ei=CkU_TfiVPIyWsgOH1IT7BA&prev=/images%3Fq%3Ddsm%2Biv%26um%3D1%26hl%3Den%26sa%3DN%26biw%3D1280%26bih%3D647%26tbs%3Disch:1&um=1&itbs=1&iact=hc&vpx=129&vpy=86&dur=1361&hovh=270&hovw=186&tx=121&ty=172&oei=CkU_TfiVPIyWsgOH1IT7BA&esq=1&page=1&ndsp=24&ved=1t:429,r:0,s:0

Cohn, Simon. 2010. “Picturing the Brain Inside, Revealing the Illness Outside: A Comparison of the Different Meaning Attributed to Brain Scans by Scientists and Patients.” Pp. 65-84. IN Technologized Images Technologized Bodies. Edited by Jeanette Edwards, Penny Harvey and Peter Wade. New York: Berghahn Books.

Watters, Ethan. 10 January, 2010. “The Americanization of Mental Illness.” The New York Times. http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?_r=1

Young, Allan. 1993. “A Description of How Ideology Shapes Knowledge of a Mental Disorder (Posttraumatic Stress Disorder).” Pp. 108-128. IN Knowledge, Power and Practice: The Anthropology of Medicine and Everyday Life. Edited by Shirley Lindenbaum and Margaret Lock. Berkeley: University of California Press.

 

 

Risks, Control, and Public Health

“…The ‘web’ of causation that is often constructed to show why individuals may choose to smoke draws attention to such factors as stress, lack of knowledge about side-effects of smoking, addiction to nicotine, low self-esteem, and low self-efficacy. While the sociocultural context is clearly important here, it is generally reduced to the individual level: a person feels stress and smokes to alleviate it, lacking the self-esteem and self-efficacy she or he requires to give it up. The questions of how ‘stress’ is generated, why that particular individual should be suffering from ‘stress’ in comparison to others, and the sources of that individual’s lack of self-esteem and self-efficacy are often glossed over for a focus upon ‘improving’ self-esteem and self-efficacy and alleviating stress, so that the individual may then give up smoking. Such individualistic understandings of smoking behavior tend to ignore or at the very least play down the whole panoply of broader sociocultural phenomena around smoking, including the cultural and symbolic meanings of smoking, the use of cigarettes as commodities to define the self, and the economics and politics of the production and marketing practices to do with cigarettes” (48).

The above news clip entitled “E-Cigarettes: Healthy Habit or New Hazard” from The Associated Press presents the phenomenon of the “e-cigarette.” These electronic pipes, manufactured by a Chinese company, serve as a possibly “healthy” alternative to the normal cigarette. Instead of smoke, they produce a fine nicotine spray that is quickly absorbed by the lungs. Therefore, one can have an e-cigarette around others without the concern of second-hand smoke. However, these facts do not prove to be universally accepted. While the product designer claims the e-cigarette to be a safe alternative to regular cigarettes and a way to kick the habit, the World Health Organization (WHO) remains concerned about the content of e-cigarettes and of long-term medical effects. Additionally, since they contain nicotine, e-cigarettes are still addictive, which seems to be in contrast with the overall goal of the product.

The mere existence of a cigarette alternative indicates an issue with normal cigarettes, with which Peterson and Lupton would surely agree. Classified as a “risky behavior,” cigarette smoking joins a wealth of other activities and life-style choices that public health labels as “risks” (23). Other “risk factors” include, but are not limited to, smoking, alcohol, diet, exercise, reproductive behavior, driving behavior, social relationships, the occupational environment, pollution, and the built environment (19).  The authors claim that “one of the key tasks of this expanding system of expert knowledge (public health) is to track down, calculate and eliminate the ‘risks’ that are seen to pervade all aspects of human life” (18). They acknowledge the social, cultural and political processes that shape risks and recognize that morality influences the interpretation of risk factors (18). Ultimately, the “calculation of risks” legitimates interventions based on an “expert assessment that an undesirable event may occur,” which helps them advance their goal of achieving health through intervention (19).

Later in Chapter 2, Peterson and Lupton discuss the epidemiology of risk. Though the term “risk” usually designates “something that can be given a numerical value,” in the case of public health the term mostly denotes danger (48). They also acknowledge that, in the realm of risk, epidemiology manipulates which outcomes and risk factors to focus on (47). These decisions are “surrounded by culturally defined moral problems in which power relations always have a central position” (47). Therefore, risk is a “sociocultural construct” informed by moralism with an emphasis on personal responsibility (48). Smoking cigarettes is no exception. The introductory block quote illustrates the framing of cigarette smoking in a complex socio-cultural and political context. The “web of causation” includes not only individualistic understandings of the behavior, but also the “broader sociocultural phenomena around smoking” (48).

Among these “sociocultural phenomena” lies the “use of cigarettes as commodities to define the self” (48). Therefore, cigarette smoking may constitute a part of a person’s identity, helping them form their sense of self. Relatedly, Peterson and Lupton discuss the constructions of “self” and “other” in epidemiological discourses, which tend to focus on the categorization of social groups as “normal” or “abnormal” (55). “As part of this process of drawing a dichotomy between ‘high risk’ or ‘unhealthy’ groups and ‘low risk’ or ‘healthy’ groups, fears about social order, death and disease may be projected by the latter onto the former” (55). Therefore, in trying to construct their identities, non-smokers may use commonly held moral assumptions about smokers to bolster their sense of self, while smokers may just be using smoking to help form their identity. Therefore, smoking and non-smoking and moral judgments regarding the habit all serve individuals in the fabrication of their identities.

Ultimately, the demand for e-cigarettes demonstrates Peterson and Lupton’s assertions that society is obsessed with notions of health to the point where they comply almost voluntarily with the principles and guidelines of public health. The authors stress the remarkable extent of “health-related concerns” in contemporary Western societies (1). Therefore, it logically follows that “by providing norms by which individuals are monitored and classified, and against which individuals may be measured, the emphasis of the new public health is upon persuading people to conform voluntarily to the goals of the state and other agencies,” including public health (12). Thus, in identifying smoking as a “risk factor,” public health attempts to dissuade people from smoking, and the demand for e-cigarettes proves their attempts to be successful and provides evidence for the control of public health on society. People conform voluntarily to public health standards because of their desire to achieve “health,” which may be a reason for them to transition from normal to e-cigarettes. 

Bibliography

http://www.youtube.com/watch?v=fIUWXwIfyFc

Alan Peterson and Deborah Lupton. 1996. “The New Public Health: A New Morality?” and “Epidemiology: Governing by Numbers.” Pp. 1-60. IN The New Public Health: Health and Self in the Age of Risk. London: Sage Publications.

The Black and White of Biomedicine

“It is a mistake to underestimate the force of Cartesian dualism in medicine today. In spite of a growing disaffection of a section of the populace with traditional approaches to health, the dualist philosophy is alive and well, the guiding light of almost all theoretical and clinical efforts of Western medicine” Dossey, (1984:15), Gordon (20)

“Biology leaves unexplored an aspect of the mind-body problem that is essentially ethical. This residual mind-body problem occurs because mind and body symbolize contrasting poles in human experience: the voluntary or intentional and the involuntary or accidental. It is because the contrast between willful action and impersonal accident is central to both the private sense of self and the public concept of the person that mind-body dualism persists in Western thinking about morally significant events like sickness and disability” Kirmayer (57)

The dichotomies upon which modern biomedicine is constructed are as stark and rigid as the hues in the above images. The primary dichotomous relationships found in biomedicine include not only classic Cartesian dualism of body and mind, but also ideas of irrationality and rationality, patient and physician, and illness and disease. I argue that this scientific tendency to “rationally” classify and polarize results in the precarious construction of Western biomedicine, and ultimately perpetuates (the perhaps otherwise unfounded) authority of the institution of medicine.

Kirmayer outlines how biomedicine was founded on a “Cartesian division of man into a soulless mortal machine capable of mechanistic explanation and manipulation, and a bodyless soul” (59). Gordon furthers this notion in asserting a distinction between “naturalism,” “individualism,” and biomedicine, claiming that they thrive on mutual support. He ultimately draws several key parallels between naturalism and individualism. Both use the atom as the fundamental building block, and neither acknowledges the importance of society, culture, or the body in the construction of the atom. Thus, the individual body is alienated from exterior factors and robbed of its ability to define itself.

Although the mind/body split exemplifies a primary dualism in modern biomedicine, Kirmayer uses the metaphor of the body as a biochemical machine to illustrate how dualistic values in Western biomedicine also fixate on a rational mastery of the body. This metaphor elicits ideas of biomedical control and the value of rationality. Under this model, patients, if rational, adhere to particular guidelines given by medical professionals. Only when patients fail to behave rationally do they experience medical problems, which, according to this model, represent individual failure.

Kirmayer also describes the dualism between the “physician as active knower and the patient as passive known” (59). This dichotomy is manifested in the medical distinction between disease and illness. While disease represents the physician’s biomedical interpretation of disorder, illness merely refers to the patient’s “personal experience of distress” (59). Biomedicine deals with this divide by applying “rational techniques to sickness,” viewing the body as a machine by “distancing from the emotional significance of illness” (60). Kirmayer discusses the various ways medical practice distances from the body as a person. First, the architecture of hospitals provides concrete barriers between sick bodies and social persons. Second, physicians manipulate language (mostly in the form of “codes”) to reduce the “affectivity” of the discourse (61). This distancing further removes the patient from not only the outside world, but also from the possibility of relating to the institution on a personal or emotional level. Ultimately, medicine trumps the “bodily-felt” reality of the patient, posing sickness as a threat to rationality (Kirmayer, 61).

Gordon illuminates this distinction between disease and illness by considering the separation between the objectivity of nature and the subjectivity of the individual’s experience of the world (25). This separation can be applied to distinguishing “signs,” objective indications of the patient’s body, from “symptoms,” the patient’s complaints (25). Using this model, “disease” is defined as biological abnormality while “illness” is merely the patient’s experience. This distinction is problematic for several reasons. First, it assumes that the physician is rational and unconditionally correct, identifying and evaluating infallible “signs” of disease. Meanwhile, the irrational patient determines her illness by evaluating her subjective distress. This interpretation leaves no room for a more holistic, cultural or emotional understanding of illness.

After considering the relationship between naturalism, individualism, and biomedicine, Gordon questions whether a “holistic” approach to medicine is possible in a society so focused on atomism and the individual as separate from culture and society (42). However, she also claims that “sickness expounds a truth about the order of the world as much as the body of the sick person” (42). In stating this, she exposes her belief that the patient’s interpretation of her illness is imperative to the overall understanding of the condition.

Ultimately, in considering these various dichotomies and power structures as a whole, we see that they work together to promote the (mostly) unquestioned authority of biomedicine in our culture. The patients’ desire for answers leads to the reinforcement of the legitimacy of the answers given by medical professionals, which indirectly affirms the dominance of biomedicine and the way in which it operates. Therefore, the dichotomies and distinctions remain unquestioned, not providing an arena for change. Patients must be aware of the power dynamic and assumptions of biomedicine in order to claim their contribution to the meaning of their “disease.”