Tag: medical anthropology

What Makes An Egg Collapse?: Infrastructures of Egg Freezing

“I am not really emotionally ready for children, but this is on my mind on repeat: Biologically speaking, your eggs are collapsing, your eggs are collapsing.” I heard this from Dicle, a migrant lawyer in her late twenties, during our in-depth interview in central Frankfurt. I understood two years later what was puzzling me about her exact wording. What did it mean, exactly, for an egg to collapse? The way she expressed it in our native language, Turkish, was yumurtaların çöküyor. Collapsing eggs was the fitting translation, but it still seemed strange. The Turkish verb çökmek is rather literal. A building could collapse; a bridge could collapse. But how does an egg collapse? (read more...)

Microbiome Monitoring: Smart Toilets, Precision Medicine, and the Post-Genomic Bowel

Imagine that every time you poop, your hygiene routine involves depositing your used toilet paper into a toilet-side receptacle. As you wash your hands, the device mixes, processes, and extracts microbial DNA from your stool. It sequences the microbial DNA for a real-time readout of your microbiome (the microbial genomes from within your gut, or at least the ones that made it to your stool), automatically sending the information to a large-scale microbiome database that integrates it into its data, algorithms, and analytic programs. The program connects to an app on your phone, telling you that based on your personal version of a healthy microbiome, today your microbiome is looking a little low in the bacterial species Akkermansia municiphila and high in some risky metabolites (the molecular outputs of some of your gut microbes). It recommends that you eat extra polyphenol- and fiber-rich foods today, and asks if you want a recipe for a berry- and seed-laden oatmeal for breakfast. The vision I describe here is a technoscientific imaginary: a shared vision of a future, mediated by science and technology (Marcus 1995). Technoscientific imaginaries are always embedded in historic and cultural contexts and narratives, which shape what future visions we find possible, desirable, and relevant. In this post, I examine how this technoscientific imaginary draws on narratives about promise and precision medicine inherited from genomics, as well as newer ones based in new understandings of the human microbiome and its powerful associations with many aspects of human health. (read more...)

Outbreak Mitigation at the Crossroads: Technical Expertise, Political Imperatives, and the Myth of John Snow

Outbreak mitigation always operates within a tension between technical expertise (lo técnico) and political imperatives (lo político). My conversations with epidemiologists in Guatemala over the past twenty-eight years have taught me that this dichotomy places a strain in their daily work that reaches its highest intensity during an outbreak. The essence of this challenge lies in what one seeks to mitigate. The technical prioritizes disease and its effects on population health while the political, in contrast, prioritizes certain social, economic, or political consequences of the epidemic’s spread. In their accounts of outbreaks, several of these epidemiologists have invoked the figure of John Snow, the English physician who in the nineteenth century investigated the causes of several cholera epidemics in London. I argue that Snow functions here not simply as a historical reference, but as a modern myth, one that offers clues for understanding how epidemiologists make sense of the persistent tension between technical expertise and political authority, especially when performing the work of mitigating outbreaks. Below I present examples of this dichotomy and references to Snow, whom I then analyze as a modern myth that offers clues for understanding the place of epidemiology in contemporary society. (read more...)

Seeing, Acting, Believing: The CyberKnife and the Transformation of Medical Imaging

Dr. Sinha is the anti-Benjamin of our times. He asks his patients to believe in the aura of the machine. When I meet him in the treatment room at the corner of the Radiation Oncology wing on a Thursday afternoon—its ceiling painted blue with drifting, improbable clouds—he speaks in paragraphs, waxing lyrical about the CyberKnife’s precision. The CyberKnife’s industrial robotic arm, he tells me, is a direct import from the automobile assembly line. At his cue, the technologists in the control room set it in motion. The arm whirrs as it moves along three linear and rotational axes; it is designed to track the movements of the patient’s body in real time. Dr. Sinha walks me through each piece of the ensemble: the ceiling-mounted x-ray machines that track the tumour’s position, the large linear accelerator that charges the radiation beam, a phantom skull laid on the table for setting delivery coordinates. “High dose and minimal margins,” he insists, “is the future of radiation therapy.” (read more...)

Microbes and the Permeable Body: Rethinking Health Through the Holobiont

Donna Haraway opens When Species Meet with the proclamation that “human genomes can be found in only about 10 percent of all the cells that occupy the mundane space I call my body” (Haraway, 2007). The rest of the human body is comprised of bacteria, viruses, archaea and other microorganisms – largely invisible to the human eye, but nonetheless living on and within us. In recent years we have seen a proliferation of research and attention towards these microorganisms, particularly in the gut, skin, lungs, and mouth, with each comprising their own microbiome. Although this research is still developing, it is increasingly clear that these microorganisms may actually be fundamental to the development and functioning of human bodies. (read more...)

From Hotspots to Outbreaks: Keywords for (Un)Grounding Space, Temporality, and the Boundaries of Infection

This special series examines the spatial, temporal, and conceptual boundaries of infection. As a primarily analytic approach, the authors in this series unpack epidemiologic keywords such as outbreak, hotspot and epidemic, to assess their uptake, uses and meanings amongst scientists, public health and healthcare practitioners, experts and broader publics. As disruptions to public health ripple through the healthcare landscape in the United States, and whilst the global COVID-19 pandemic continues to haunt our collective present, the fundamental terms or “keywords” through which we understand disease transmission demand ethnographically-grounded inquiry, critique, and theorization. The posts in this series look at how infectious diseases and their conceptualizations spread through space and time, as well as how ethnography can articulate the expansive, lived realities of infection. (read more...)

The Human Cost of Precision

In 2022, Microsoft CEO Satya Nadella’s son died at the age of twenty-six from a lifelong battle with cerebral palsy, a neurological disorder caused by birth-related brain damage. When in 2017, Nadella delivered a talk about the use of assistive artificial intelligence for people suffering from disabilities like CP, he was contacted by one his colleagues in Spain. Julián Isla, a software engineer at Microsoft, emailed Nadella out of a sense of resonance, because his own son suffered from a rare genetic epilepsy making him a parent of a child living with disability as well. Like Nadella, Isla was also motivated to think of the role of artificial intelligence in the assistance of other parents who, as he described, were on the “odyssey of diagnosis”. (read more...)

Laughter and Dreaming of Wins in Recovery

“Hannah, roll a six!,” Mahad, Alliance Wellness recovery program resident, pleaded as the game of Ludo intensified. Ludo, a strategic and competitive board game, was popular among Somali American men, such as Mahad, who were in the process of renegotiating their dependency on substance use. These men also held vivid memories of playing Ludo in Somalia and neighboring countries that they moved through as they sought asylum from Somalia’s civil war. I first heard about Ludo when I began fieldwork at Alliance Wellness, a recovery program for an East African communities that was developed out of community need in Bloomington, Minnesota. With increasing rates of opioid related addiction and deaths among Somali Americans, Yussuf Shafie recognized a need for culturally appropriate therapy and recovery programs for Somali Americans in Minnesota (Feshir 2019). (read more...)