 |
 |
 |
3rd Global Conference
Making Sense of: Health, Illness and Disease
Monday 5th July - Friday 9th July 2004
St Catherine's College, Oxford
Conference Programme, Abstract & Papers
Session 3: Bodies, Minds and
Devices
Chair: Peter Twohig
Insulin Pumps Incorporated in Young People’s Bodies and Lives:
Existential Dynamics of a Medical Device
Griet Scheldeman
Department of Social Anthropology, University of St Andrews, Scotland
Insulin pumps have become an option to treat insulin
dependent diabetes over the last years in the UK. Multiple daily insulin
injections, by syringe or pen, are replaced by a pager-sized pump, which
pumps a programmed dose of insulin into the body every three minutes.
As this continuous insulin flow imitates more closely the workings of
a pancreas, the pump has significant health benefits (more stable
blood sugar level). By freeing the wearer from injections at set times
(where the administered dose of insulin dictates the next four hours
of food and activity) the pump is also claimed to greatly improve quality
of life. Young
pump wearers report they have regained freedom and live a normal life
again, able to do what they want when they want.
In recent fieldwork in
Scotland I followed 5 young people (age 11-17) starting pump therapy.
These youngsters actively engaged with their pumps, not to search better health but
to pursue better quality
of life. I take an existential approach to explore how young people
incorporate the pump into their daily lives. A focus on how they DO diabetes,
from an agent perspective, allows us to ethnographically consider the
theoretical aspects of embodiment and intersubjectivity, and puts to
the fore practical issues such as freedom and control. Does the pump
remain an external device or does it become part of them? Do the young
people hand over the intense routine of diabetes management to a machine?
Do they have to renegotiate control over their body? Are these topics
even issues to them? The paper offers an account of scientific intervention
experienced as the visible and tangible replacement of an invisible and
intangible organ.
Negotiating the Boundaries between Physical
and Mental Health Problems: Patient and Practitioner Perspectives on
Upper Limb Pain
Michael Calnan
Professor of Medical Sociology, Department of Social Medicine, University
of Bristol, Bristol, United Kingdom
Upper limb disorders (ULDs) are soft tissue rheumatic
disorders that fall into two broad clinical categories: specific disorders
and non-specific (often chronic and troublesome) pain. However, these
conditions are heterogeneous by nature and thus have sewed the seeds
of confusion and controversy. Labels such as ‘repetitive strain
injury’ and ‘cumulative
trauma disorder’ are seen to be unsatisfactory not least because
clinically indistinguishable disorders may arise for other (non-occupational)
reasons. This uncertainty about the status of ULDs, most notably the
non-specific conditions, has consequences for understanding causation
and for management and treatment and presents a challenge to the patient
and their sense of identity.
This paper explores how patients and their
health care practitioners manage and treat upper limb disorders. It draws
on evidence from a study that primarily used qualitative methods (informal
face-to-face interviews) to explore the pathways through health care,
followed by ULD sufferers (n=47) and identify explanations for variations
in their experiences. These accounts were complemented by those from
face-to-face interviews with their health care practitioners (orthodox/non-orthodox).
Using data from these different sources it was possible to construct
case studies of pathways through health care. The paper specifically
examines lay and practitioner models of causation and the circumstances
under which physical explanations for upper limb pain are replaced by
psychological explanations. It provides a prime example of how patients
and practitioners negotiate ‘problematic’ mental health and
psychological problems.
Download Full Conference Paper - 
When the Diagnosed Talk: Ethnographic Narratives on Mental
Illness
Bindhulakshmi
Department of Humanities and Social Sciences,
Indian Institute of Technology Bombay,
India
This paper tries to analyze the case histories and narratives of women undergoing psychiatric treatments and understands the experiential realm of mental illness within a particular cultural paradigm of Kerala, the South West costal state of India. The observations are drawn from an ethnographic field study among the diagnosed women who are undergoing psychiatric treatment. This paper gives primacy to the voices of diagnosed women and their experiences. But at the same time it also looks at other (dominant) institutional narratives to understand the engagements and negotiations happening in the process of identification, diagnosis, treatment and aftercare. Ones being diagnosed there is a tendency to call a woman as ‘irrational’ ‘abnormal’ and ‘dysfunctional’. But many times she negotiates with various other institutions in the society as a ‘rational’, ‘normal’ and ‘functional’ individual. Through case histories it examines how these women understand the illness and its effects in their identities and also how it shapes their relationship with their bodies. It also explores the experiences of diagnosed women in the everyday life especially when they engage with various institutions not only as diagnosed individuals but also as ‘normal’ women with multiple engagements and responsibilities. It is observed that being a diagnosed person is not the only identity these women have. They also have various other identities in their available cultural context. Through this exercise of analyzing the narratives and also by critically looking at the institutions involved in the making of diagnosed women, this paper tries to understand the construction of mentally ill women and also to understand how they negotiate and deal with these institutions in their every day lives. Analyzing the view points of psychiatrists, family members and other persons engage with them, this paper tries to draw the trajectories and differences of illness experience for different individuals.