Mobile Health in Context

Mobile Health in Context: How Information is Woven Into Our Lives  

@SusannahFox @PewResearch

Susannah Fox from Pew Review Research put together an excellent presentation of the latest health and digital technology related statistics.  The slides are concise, accessible, and thought provoking.  Can we put cell phones to use improve health and health information seeking strategies?   

I came across this presentation of data at exactly the right time thanks to Carol Torgan.  The information will be incredibly insightful to my future dissertation research and will go along way in demonstrating the significance of my proposed research.

Performance Enhancing Drugs – College Edition

Passing with Pills: Redefining Performance in the Pharmaceuticalized University”  is a very thoughtful and thought provoking ethnographic look in the mirror.  Tazin Karim of Michigan State University did an excellent job applying a critical, medical anthropological lens to academia and the pressures of the rite of passage in America referred to as college.  
When discussing the exportation/globalization of mental illness and Western pharmaceuticals, undergrads in both my Intro to Anthropology discussion sections admitted to knowing a ‘friends’ who used Academic Performance enhancing drugs …  I have to admit my own caffeine dependence could fall in the same category.  American culture in general gives preference to substances which promote productivity and the University is no exception.  A few of my students discussed being prescribed Ritalin and Adderall long before they entered a college campus.  One girl described for us how ease it had been for her best friend to get a prescription, which she used primarily to write papers and make it through finals week.  

I think this is a very serious issue which is largely ignored because it gets the desired results and is socially linked to productivity and achievement.  For my part, some might argue that I am part of the problem, as a graduate student and teaching assistant who was aware of these thinly veiled “confessions.”   But I am 25 years old which makes me only a few years older than most of my students and this time four years ago I was the undergrad who had close friends doing the same thing.  However, it also raises an important ethical issue.  This was information I gained from a semester of building rapport with my students and a safe environment for discussion in my classroom.  In that moment, I saw my responsibility in guiding my students to think critically about the social and structural pressures that make the need for academic performance drugs and in interrogating the problematic dichotomy between legal prescription drugs and illegal drugs.  I pushed them to critically think about any substance they put in their body and I urged them to be accountable for researching these medicines, their purpose and their side effects.  In that classroom, I felt that was the extent of my ability to influence the matter.

But as a medical anthropologist, I think this is definitely an issue which merits further investigation and careful attention to potential solutions that address this “inconvenient truth.”  Karim’s narratives demonstrate the hidden reality on our campuses.  I hope to see more work along these lines in the future.

 

Gunman Suicide – A Social Illness

The media storm follow the Newton school shooting has left our nation with heavy hearts and that unanswerable question “but why…?”  The shooting occurred the day left Dallas heading home for Arkansas to spend my Christmas break with my family.  These incidents which have become all too frequent always leave me initially dumbfounded, but as the social scientist in the family people expect me to have a more educated response than a look of horror on my face.  Within hours of the shooting Facebook and Twitter was aflame with arguments for gun control and explanations of mental illness.  I found myself driving home in the dark and trying to explain to my father on the cell phone that it was “more complicated than that”.

Do we blame guns?  Do we blame mental illness? Do we blame the media or video games?  Do we blame American culture itself?

Part of the reason it is “more complicated than that” for me to explain to my father or most of the people I grew up with for that matter, is that Living Anthropologically’s simple answer “measures to reduce and restrict the weaponry” would begin a debate met by deaf ears.  Saying the word “gun control” to a hunter is the equivalent of saying “Internet censorship” to a member of anonymous.  Certain topics trigger a panicked emotional response that jumps to the worst case scenario first.  I know that restrictions on semi-automatics and hand guns is not the equivalent of a universal gun ban, but both the audience and the bigger picture need to be kept in mind.  The weapon of choice is definitely one way to tackle the problem, especially if you see no use for the device,  but it doesn’t fix the “why” which can always find a new outlet.

In his Neuroanthropology blog Daniel Lende reminds us that “Mentally ill patients are not more violent than anyone else.” and “Guns don’t shoot themselves.”  in his response to the two easy answers which have been put forth by the media and the public following the Newton shootings.

Follow the Aurora shooting, David Dobbs argued that “Culture shapes the expression of behavioral traits. The traits don’t rise inherent as an urge to play basketball or a plan to shoot up a Batman movie. A long conversation between the trait and the surrounding culture shape those expressions. Culture gives the impulse form and direction.”

In talking to my father who is very anti-gun control, I realized that there is a very big difference between a hunter and a gunman.  Friend and follow Arkansan, Justin Snook makes a similar connection in his blog post Guns and Games, when he says “I learned to treat a gun sensitively and reverently whether it was in my own hand or someone else’s.”  Growing up in rural Arkansas my first experience with guns did not come from video games or even TV.  I remember being between 2 and 3 years old and my dad letting me pull the trigger on his .22 while he held the gun.  As I got older both of my parents always re-enforced strict rules and behaviors relating to guns.  Guns were always present in my household, but they were also always serious.  The first rule I remember my mother telling me was to never go near the place my dad kept his guns unless he was with me.  The first rule I remember my father telling me about guns was to never point one at anything or anyone I didn’t want to kill, whether I thought the gun was loaded or not.   Guns were to be respected and were only used to hunt.  My brother, sister, and I were taught that what we did with a gun was our responsibility.  But this is not part of how most Americans are raised.  While hunters-ed is required for hunting licenses it is not required to own a gun.  You have to take two exams to drive a car but all you need is a background check to own a gun.  This means that unlike me, many Americans are taught about guns by TV, movies, and video games.  These media are artistic expressions of our culture so it is hard to blame them in and of themselves.  Films no longer warn that “you’ll shoot your eye out” and instead depict firearm novices becoming epic heroes by picking up a gun.  People who have never witnessed anything larger than a spider die are allowed to own hand guns designed for shooting people and even semi-automatic weapons designed to shoot everything insight.

If the people using them and how they are used, not the guns themselves are at the center of the “but why …?” question, then we that we are to blame.  A cultural dialogue which allows people to assign the blame to others instead of accepting responsibility makes it possible for the gunman suicide phenomenon to become an accepted cultural script.

A young man (statistically most are males) has bad relationships with his family.  He becomes/feels disenfranchised.  He is alienated from his community and he begins to blame all the people in his life for how terrible his life is.  That blame turns to hate and when he cannot take it anymore and is ready to end it all by killing himself he turns to the pre-existing techniques his culture has provided.  Going out in a blaze of glory, maximizing his ability to hurt those who he blames for his state, and regaining control of his life in a hyper-masculine villainous act.   Gunman suicide becomes the last desperate attempt at significance.

Lende argues that “If we’re going to think of violence as a sickness, then it is its own type of sickness, different in kind and in expression from the mental and physical ailments that also possess us. Violence is red in tooth and claw, seemingly primordial, until we recognize how socially regulated it is.”

My best explanation is that the gunman suicide phenomenon is a social illness rather than a mental or physical one.  These gunmen which have become all too common are suffering from a lack of the social components necessary to be healthy in body and mind.  It is a social illness in that these gunmen are men who society has failed and in that the illness harms society itself.  It takes the lives of the incident’s victims, it wrecks havoc on the lives of the victims families and the community, but it also traumatized us as a nation, as a globally connected world.  The gunman is ground zone of the social illness, proving to us that in this hyper-connected and highly visible age a ticking time bomb can still remain in plain sight.

Insights from UCD

(I am still a bit behind on posting updates–this is from June 12-14)

Insights from University College Dublin

We took a bus to UCD and made a friend of a Canadian en route to the Folklore Library as the three of us wondered the campus lost.

Meeting with Dr. Moore

Even though he had a pretty busy day, Dr. Moore met with me for an hour before I went to the Folklore Library and about an hour afterwards.  He was extremely helpful and very interested in my project.  He recommends I focus my research on patients and their experiences with  using folk cures.  He sees the performance of the healing act itself and the role of the healer as periphery.  More over, the secretive nature of my subject suggest that the bulk of my data will be coming from patient’s stories of healing (their illness narratives) and that I may have very little opportunity to observe a cure take place.  Following his direction, I have altered my research site location avoiding the overly tourist locations in Western Ireland (possible).  Dr. Moore assures me that knowledge and use of folk cures is incredibly common throughout Ireland, the only complication is getting people to talk about it.  When people’s health is well, it seems people do not normally discuss charms and cures, which could prove problematic.  I hope this doesn’t mean that I will only be able to interview people once.  Our conversation provided me with great insight into folk cures which could never come for the words on a page alone.

Touring the Folklore Collection Library

UCD has an amazing folklore collection including transcriptions of folklore interviews dating back to the 1930s!  http://www.ucd.ie/irishfolklore/en/  This amazing collection of Irish oral traditions, family life, and folk arts includes a quite a sizable amount of entries on folk cures and charms as well as herbal remedies.  The staff was incredibly helpful and friendly.  I plan to spend some time doing a bit of research there again when I return to Dublin before I leave to come back to the States.

Plan Going Forward from Here                                                                             (Subject to Change as New Information come to Light)

  • Find a New Research Site
Find a small quite community with few or no tourist attractions.  Check out homestays, B&Bs, and self-catering and compare prices and locations.  Look for a smaller community in the County Galway and County Mayo area.
  • Who I am Interviewing
Primarily Patients –try to equally cover all demographics.  Collect stories of illness experiences, stories about cures used, and the person’s own explanatory model for the illness, cure and recovery.  Pay special attention to who refers the patient; what the cure itself requires: actions, ingredients, actors, time; patient’s specific experience and outcome.  Who is directing people to cures?  How are health decisions being made.
Also try to interview Bio-medical professional.  Determine the attitude of bio-medical professionals toward folk cure.
If the opportunity presents itself, interview any/all people I can find that have a cure or charm.
  • Determine what my research questions and what interview questions to ask to address them.
  • Conduct Ethnographic Analysis of the Community

 

Ireland Week 1

Week 1 Ireland – Dublin

Highlights from my first week in Ireland.

First, I think I left out one tiny detail in explaining my plans for Ireland.  I guess I should mention that assisting me in doing all that stuff I mentioned in previous posts, is my travel companion Greg Wright: part-time research assistant, part-time body guard (my mom thinks I need one?), part-time 2 am sounding board, and full-time boyfriend.

We arrived in Dublin around 8 am on Thursday June 7.   While I was still smiling then, I definitely would not advise arriving in a new country in the morning hours if it can be helped.  Unfortunately for me, the cheapest airfare didn’t really give me any options on timing.  If you do arrive in the morning, make sure you’ve worked it out in advance so that you have bed upon arrival.  Everyone may not need a place to crash after a 13 plus hour flight, but honestly it is a good safety precaution either way because even if you don’t pass out you need a safe place for your luggage.  No one wants to be dragging a suitcase any further than necessary.

That said, we got a great deal on a hostel in Dublin and were able to rest up and try to coop with the jet lag.  It was situated in the older part of the city which had lots of interesting things to see while getting adjusted to the country.

We stayed in Dublin near the River Liffey, while I met with a professor at the University College Dublin and explored the UCD’s Folklore Collection as a potential resource for my research.

I spoke with Dr. Ronnie Moore and got clear direction about the possibilities of my research.  These meetings were immensely informative for my research.  Perhaps, the biggest take away for me from our talks was a realization that focusing on “healers” per-say is not really the way to go.  In regard to Irish folk cures, the people who “have a cure” for the most part possess it because of unusual characteristic or circumstance or as a birth right of sorts.  Instead, I think I will give my attention to the knowledge of folk medicine and the use of folk healing by the average person.  More on the contemplation of this talk later.

Ireland 2012

Preliminary Fieldwork/Pilot Study in Western Ireland 

As I mentioned in an earlier blog post, this summer I am going to be in Ireland conducting an 8 week preliminary investigation of Irish Folk Medicine (a subject which is far more complex than that description might led you to think).  Irish folk healing insects my two academic areas of specialization medical anthropology and the anthropology of religion.   I am particularly interested in the impact of belief (as an action/neurophysiological process) and beliefs (body of knowledge) on wellness- health maintenance and illness recovery.  I hope to investigate this in the context of Irish folk medicine.  So in short, this 8 week long trip to Ireland will hopefully let me meet and discuss my topic with Irish anthropologists and folklorists; interview Irish people about their experiences and knowledge of Irish folk medicine; determine an appropriate location/locations for me to conduct my research; and establish the significance of my research within the local context.  Here’s hoping!