James Meza - Diagnosis Narratives and the Healing Ritual in Western Medicine

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Diagnosis Narratives and the Healing Ritual in Western Medicine

The dominance of illness narratives in narrative healing studies has tended to mean that the focus centers around the healing of the individual. Meza proposes that this emphasis is misplaced and the true focus of cultural healing should lie in managing the disruption of disease and death (cultural or biological) to the individuals relationship with society. By explicating narrative theory through the lens of cognitive anthropology, Meza reframes the epistemology of narrative and healing, moving it from relativism to a philosophical perspective of pragmatic realism. Using a novel combination of narrative theory and cognitive anthropology to represent the ethnographic data, Mezas ethnography is a valuable contribution in a field where ethnographic records related to medical clinical encounters are scarce. The book will be of interest to scholars of medical anthropology and those interested in narrative history and narrative medicine.

James P. Meza is Assistant Professor in the Department of Family Medicine and Public Health Science at Wayne State University School of Medicine, USA. He holds a PhD in Cultural Anthropology and is a practicing doctor of medicine (MD).

Routledge Studies in Health and Medical Anthropology

Depression in Kerala

Ayurveda and mental health care in 21st century India

Claudia Lang

Diagnosis Narratives and the Healing Ritual in Western Medicine

James P. Meza

www.routledge.com/Routledge-Studies-in-Health-and-Medical-Anthropology/book-series/RSHMA

Diagnosis Narratives and the Healing Ritual in Western Medicine

James P. Meza

First published 2019

by Routledge

2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

and by Routledge

711 Third Avenue, New York, NY 10017

Routledge is an imprint of the Taylor & Francis Group, an informa business

2019 James P. Meza

The right of James P. Meza to be identified as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

British Library Cataloguing-in-Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Cataloging-in-Publication Data

A catalog record for this book has been requested

ISBN: 978-1-138-63142-7 (hbk)

ISBN: 978-1-315-20888-6 (ebk)

Typeset in Sabon

by Apex CoVantage, LLC

Healing is the ritual process where a self facing annihilation by an existential threat navigates the liminal social space of alienation from the cultural body and reconnects with a new cultural role by forming a healing relationship with the socially authorized healer the doctor.

Dedicated to K.A.C., who was there at the beginning of my journey of understanding and K.C.S., who encouraged me to write.

Contents

1. i
2. ii
3. v
4. vi

I always enjoy reading ethnographies. They are typically easy to read and help me understand what it is like to be in a different time or place to understand how people live their lives differently than anything I had known before. The best ethnographies also have an important truth to reveal.

I am mindful of my reading audience. I wrote this book in the genre of ethnography capable of withstanding critique by any anthropologist. With the increasing awareness of the social determinants of health, I believe more doctors need to read ethnographies. A medical student who looked at an early draft manuscript told me he struggled with the theory but enjoyed the rest of the book. For medical readers, do not worry too much about theory and simply enjoy the book. Ethnography has helped me understand the social context of my own clinical practice in a way that nothing else can.

I also know that there are many doctors quite interested in narrative medicine (Brody 1994; Charon 2006; Elwyn and Gwyn 1999; Engel et al. 2008; Launer 2002). This book presents a unique perspective on narrative medicine. I hope physicians interested in narrative medicine can find a previously unrecognized description of their daily clinical practice.

For medical anthropologists interested in narrative healing, I recognize that this ethnography presents an iconoclastic perspective. Because anthropologists are more interested in theory than doctors are, I hope this book opens new theoretical perspectives. I hope to have pushed the field of narrative healing just a bit forward. I also think my synthetic theoretical discussion at the end of the book provides an opportunity to go back and question solidified attitudes while inviting further study.

By reaching a broad audience, I hope to have impact on medical education and health policy unless we understand the core function of a doctor in society, we will continue to repeat our mistakes. American medicine is in turmoil and I hope getting back to basics has a clarifying effect. This is the gift anthropology offers. More than anything, I hope to instill how medicine and anthropology enhance each other by breaking down disciplinary barriers.

References

Brody, Howard. 1994. My Story Is Broken; Can You Help Me Fix It? Medical Ethics and the Joint Construction of Narrative. Literature and Medicine 33(1):7992.

Charon, Rita. 2006. Narrative Medicine Honoring the Stories of Illness. Oxford: Oxford University Press.

Elwyn, Glyn, and Richard Gwyn. 1999. Narrative Based Medicine: Stories We Hear and Stories We Tell: Analysing Talk in Clinical Practice. BMJ 318(7177):186188.

Engel, John D., et al. 2008. Narrative in Health Care: Healing Patients, Practitioners, Profession, and Community. Oxford: Radcliffe.

Launer, John. 2002. Narrative-Based Primary Care. Abingdon: Radcliffe Medical Press.

The American Academy of Family Physicians Foundation Joint Grant Awards Program provided partial funding during data acquisition (G0907).

The Arnold P. Gold Foundation provided partial funding for data analysis (RS-15005).

Science is asking important questions; research is answering those questions. Anthropologists are scientists who explore, discover, understand, and describe culture. In this chapter, I report the intellectual and pragmatic components of how I accomplished those tasks for this research project.

Epistemology matters

Narrative theory is ubiquitous and informs many disciplines; it means different things to different people. The self is a highly contested construct. Living in a post-modern world, an in-depth reading of narrative and healing reveals a cacophony of opinions. To critically appraise this body of literature, I was advised to study philosophy because it will help you think. I took the advice to heart (Cahoone 2010; Goldman 2006; Kasser 2006; Robinson 2004).

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