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Clinical Data in the U.S. Department of Veterans Affairs: Ethnographic Engagements

By: Peter Taber, Nicholas Rattray, Lauren Penney, Megan McCullough and Samantha Gottlieb This post emerged from a 2018 Society for Applied Anthropology panel on anthropological engagements with health data in the U.S. Department of Veterans Affairs (VA). Serving over 9 million enrollees with a current federal budget of USD68 billion, the VA is an important testing site for digital healthcare infrastructure, as it has been for several decades. The panel brought our VA research and quality improvement (QI) efforts targeting the electronic health record (EHR) and other digital infrastructure into dialog with existing work on the social lives of data and algorithms, as well as the broader concerns of medical anthropology and STS in an era of the “datafication of health” (Ruckenstein and Schüll 2017). Extracts from our conversation, presented below, are taken from a follow-up video call exploring these issues. (read more...)

Listening to/with Technology: Meditation Apps as the New Voice of Mental Health

Shortly after giving birth to her son, Jessica[1] began to experience a health problem that she describes simply as “pain everywhere.” About one month after we initially met at Spirit Rock Meditation Center in Marin County, California, she elaborated on her symptoms: “Joint pain, muscle pain, stabbing pain, stinging pain, burning pain, tingling, numbness…chest pains, palpitations, dizzy spells, headaches. I feel like I’m going to have a seizure, or brain fog, fatigue.” (read more...)

White Fans, Liberal Ideologies, and the Erasure of Black Stories in Gaming

Last month, the highly anticipated video game Mortal Kombat 11 (MK11) was released to an excited yet wary fighting game community. Game studio NetherRealm’s newest incarnation received praise from both fans and critics for its simplistic yet entertaining combat system, its thrilling cinematic cutscenes, and the reintroduction of original and beloved characters. However, despite its success the game was given little time to rest on its laurels, as a subset of white male fans immediately began to criticize one particular choice in one character’s story. The game featured a compelling tale in which the two separate timelines of Mortal Kombat merged to finish an ongoing plot branching all the way back to MK’s 2006 game Mortal Kombat Armageddon. As a result of this temporal shift, fan favorite black “kombatant” Jackson Briggs (or “Jax”) was given a fascinating story ending, in which he gains the ability to rewrite time, a power he subsequently uses to create a history in which slavery does not exist. (read more...)

[Author Interview] Tom Gieryn and “Truth Spots”

Ilana Gershon interviews Tom Gieryn about his new book, Truth Spots: How Places Make People Believe (University of Chicago, 2018). Gieryn is Rudy Professor Emeritus of Sociology at Indiana University. Truth Spots began with a hunch that places matter in under-appreciated ways, and, in particular, with the question: In what ways does place matter for doing science? To understand this, however, one needs to understand the ways places become authoritative sites because they enable interactive orders that are locatable. Laboratories are counterpoised with sites seen as sparking political movements, sites that become the evidence for scientific classifications, sites that connect one to larger religious movements, and sites in which the future is predicted.​ (read more...)

Precarity, Exclusion, and Contract Work in the Tech Industry

At the satellite office of a Fortune 500 company, employees buzz around the main floor of the building. At first glance, they all seem similar. Dressed in business casual – jeans and a dress shirt— people wait in line for coffee at the coffee cart, stop and chat with coworkers, or zip past one another on the way to meetings. However, if you look at their badges, hanging from lanyards on their necks or trousers, a pattern appears. Some have dark green badges, while others have bright red ones. Those with the bright red badges, standing out in the crowd, are the contract workers. A 2018 NPR/Marista Poll reports that in the United States about 1 in 5 workers are employed under contract, and that number will only grow in the next decade. This number is especially high in the tech industry. In 2018, both Fortune and CNBC reported that (read more...)

At the Edge of Land and Water: Navigating sea level change in Chennai

It was 8am in Ennore, a coastal region at the northern-most tip of the city of Chennai and home to artisanal fishers who have traditionally lived along the shores of the Bay of Bengal.  I had recently started my fieldwork on property relations at coastal spaces around Chennai there. The sun was out, the fishers were busy sorting through the catch of the day, and the smoke from the factories around made everything look hazy. My neighbor and long-time Ennore resident, Kumar uncle, decided to introduce me to fishers he knew at Periyakuppam, a fishing village in the area. We met the fishers and as we stood facing the sea, I asked them about the history of the village and changes in the landscape over time. In response, they pointed at the sea and said, “Look! Do you see the sand there, the sea water extended till that point until last week, but it has receded further now…come again next month and see what we’re talking about!” Just a few minutes later, they shifted their gaze to the left and asked, “Can you see those ships in the distance? That is where the port is. They built it for the ships bringing coal to the power plant. They put in sea-walls around there…” and once again, shifting their gaze towards the shore and the sea they said, “Look there, half the land in that village is now under water; it’s because of those stones from the sea-walls over there.” (read more...)

Deep Thunder: The Rise of Big Meteorology

Today has been predicted 26 billion times. The same could be said for tomorrow and the foreseeable days to follow. This prodigious divination is the work of just one entity—IBM’s The Weather Company. These 26 billion daily forecasts of IBM likely represent only a small fraction of the models and projections to which any particular day is subjected (the financial and military sectors are equally ambitious prognosticators). Backed by IBM’s computational juggernaut, The Weather Company is burning through terabytes at a brow-furrowing velocity in its effort to fit the world into a forecast. (Listen Now...)

The FDA, Patient Empowerment, and the Type 1 Diabetes Communities in the Era of Digital Health

The day-long September 2018 workshop, “Medical Devices-Patient Engagement in Real World Evidence: Lessons Learned and Best Practices,” sponsored by the Food and Drug Administration (FDA) and University of Maryland (UM), met on the Baltimore campus, the city where I spent my graduate school years. In contrast to Baltimore’s palpable desperation, UMB’s health campus gleamed with newness, its brick walkways and tastefully planted vegetation viewable through floor-to-ceiling windows. In the well-appointed auditorium, Dr. Jeffrey Shuren, director of the Center for Devices and Radiological Health (CDRH, pronounced ‘cedar’), closed his introduction to the conference with the pronouncement that as the FDA moved toward real world evidence (RWE), “patient engagement” and the data patients may collect are invaluable for RWE. (read more...)