7.02.2008

Reflections on love

This is a totally un-fieldwork related post, but forgive the momentary lapse in single-mindedness. I seem to be lacking single-mindedness in general. (My father seems to think I'm hopelessly peripatetic and unfocused...it's just that I'm enthusiastic for variety and newness.) In my half-hearted defense, I did once try to teach a class on love, though it was a total failure, since I was inadequately versed in the scope of literatures. I did have a phase where I was very interested in emotions-theory, and I wanted to remove love from the "emotions" literatures....but that's for another post...or not.

There's an interesting post on Jewcy.com (which I read really really rarely) about monogamy and monotheism, and though I could do without the religious overtones, the part I found most interesting about this article was the dangers of becoming overly dependent on whomever you love for the full sustenance of your well-being. The idea that any one person can provide all the support you need seems to mirror the American attachment to the nuclear family: the loss of community that I think we've suffered both from our (ahem, I am guilty guilty guilty) peripatic ways (we spread out across the country, and don't seem to value or prioritize staying close to our families, usually) and our valuing of self-determination (sometimes called "individualism"), which allows us to disconnect or claim we are "choosing" our new lives. It's always seemed unwise to me that one could expect one's romantic partner to provide the full-scope of support, but it does seem to be a slippery slope.

One of my dearest friends is so very good at maintaining our friendship in spite of the ebbs and flows of our love lives. In some ways, this reflection is as much about the way in which one imagines and values friends as it is about navigating emotional monogamy with partners. Really, one would never expect any one friend to be the full bearer of one's emotional needs, so why would we expect it of our spouses/partners/lovers/whatevers? What I'm trying to say...badly...is that this is more of a post on friendship and the priorities we make for our friends. Over a pitcher of good African reinterpretation of a caipiranhas, a friend and I discussed the perversity of the expectations we place on sexual partners versus the expectations that we expect of our friends. And that we expect of our partners to reciprocate -- perhaps a far more damning phenomenon, to expect sexual partners to treasure us as the primary support. There is a logic to it, it's just not clear to me that the logic is constructive or productive.

I've long been a skeptic of the nuclear family structure, though as my friends marry and have children, it starts to seem more appealling since everyone else is busy with babies' and husbands' demands, it's almost a default choice -- or a choice by virtue of a lack of other options. The analogy of monotheism and monogamy was an interesting way to frame the analysis, though, even if it's not quite the angle I'd have chosen. I do think that this has some relevance to thinking about my own research subjects, and the ways in which Americans imagine and expect their homelife to be structured, given that I work with parents and families.

I'm just currently operating on a lazyperson's research schedule. I am getting a bit itchy, however, not working as much as I am used to. It's about time, really, to get back to thinking beyond these superficial (half-edited) posts.

7.01.2008

More on others' brilliance

I was reading someone else's website, thanks to Google reader, which allows me to half-heartedly follow blogs I find interesting, and got deeply annoyed at her celebration of the idiotic Bonk. It made me wonder whether I should stop reading this woman's blog altogether.

However, my snarky dislike for poorly written "popular" press is not going to keep the 3 people who read this coming back for more. Instead, I'd like to send you to read an article about James Trussell's call for a shift in contraceptive methods. He argued (and I haven't found the original speech, if such a thing actually exists) that the birth control pill is an "outdated" method, advocating for longer-acting contraceptive methods. Trussell has written some very excellent academic articles on women's bodies and contraceptive methods, and I like it when someone challenges standardized practices when it is clear that the methods we depend on are simply out of habit. So much of medical practice comes from "habit," or "that is what we have done for years," rather than actual benefit/efficacy/efficiency.

A number of women I know have gotten an Intrauterine Device (IUD) -- a method which has been improved (purportedly) in the last ten years or so. One by one, friends have told me about their decision (not all of whom have given birth, which used to be the case, you had to have already had a kid to be allowed to have an IUD). The fascinating thing about the IUD is that they don't entirely understand how/why it works. Another example in medical technology in which lack of frequency of use has probably driven the lack of research surrounding it. It's easy to claim that failure to understand technology is due to the impenetrability of the task at hand, but it seems to me that often the failure is due to lack of motivation (such as economic...we do live in a capitalist-driven health world).

6.30.2008

I love Alison Bechdel

In another, unrelated, or tangential, post, I will send you to Alison Bechdel's comic about not reading enough, or the right things. She has a wonderful graphic novel called Fun Home about her father's closeted homosexuality, its effects on their family, and general autobiographical tales. Now I have to go back to half-attentionedly reading the New Yorker, for which I feel guilty if I don't read cover to cover.

6.27.2008

Refraining from saying what I really think

I've been scrambling to finalize the project I'm consulting on. As with all projects, I suppose, there's all sorts of 25th hour requests, or changes in expectations at the very last minute. The medical director keeps trying to check in with me, to make sure that the design of the study is "useful" to me for my own work. I obviously can't tell her that it's not going to be useful at all, except in the financial gains department. I really want to say, as I'm designing the interview guide (somewhat lazily, I admit), that I don't think providers are actually all that interesting. Yes, they're important from the implementation side of vaccinations -- they're the medium through which kids get their shots -- but from an anthropological perspective, they tend to be a bit dull. It's gotten old to write about instituational medical practices, and interventions are usually quite old school, steeped in hundreds of years of attitudes about the human body and medical authority (cf...duh, Foucault...Donzelot...Canguillhem...etc.).

I had initially interviewed providers for my own dissertation fieldwork, but it just wasn't compelling. Providers generally tell you that they follow guidelines and criteria. It takes a long time to get to know them and to really follow them around in order to capture the humanness of their practice, and this is just not something that public health methods usually makes time for. Further, most of the people who are overseeing the project I'm working on are trained as doctors, and a few of them even continue to practice. I have to tread awfully lightly in the kinds of comments and observations I am making about providers, given that the head researchers (or should I call them the committee of dissent?) are all members of the very community we're trying to study!

Hmmm, I hadn't thought, before, about how important that piece of information actually is to my own criticisms of the experience of designing this project...there's a little meta here, where my fieldwork is as much the execution of the project as watching the process of trying to execute the project in the first place. In fact, the reason I turned to writing on the blog is that I was getting frustrated with the interview guide and the criticisms I've received. I wanted to try to note the ways in which I feel extremely constrained in being critical of the way the project is going -- since I am dependent on it as a financial support mechanism, but my own intellectual interest has totally been killed by the process of designing this. Sad, but true.

6.25.2008

Modernizing the stalker

Sociological Images is a blog that explores media images and advertising very deftly that has posted the YouTube video for a cell phone ad. It's so deeply disturbing, yet worth watching to think about what's considered acceptable behavior with current technology.

Clearly I'm neither posting about fieldwork nor doing any fieldwork. So you'll have to forgive the sending you to some other blog.

6.20.2008

For example, repro health 101, thanks FDA!

Witness one of the important questions one has to fill out if taking Sotret...do men get these questions about their female partners? Do men have to announce the forms of birth control they and their partners are using? Do men have to proclaim abstinence? Or do their sperm remain uncorrupted? These are important questions.

Birth Defects and Pregnancy
Which of the following are signs you might be pregnant?

My own research subject

A number of times in the last few years, I've found myself in the position of experiencing some of the very things I've set out to study. In a way, it's comforting that there's a very generalizable set of experiences that my friends and I have had, as women who have semi-regular contact with the medical system for preventive care. But it's also unnerving to theorize about something and to also experience it firsthand.

In the last week, I've been a bit of a guinea pig, as I've seen 3 doctors, for three different conditions/concerns, as well as taken more prescription and over-the-counter drugs than I've taken in years. I've also developed hives -- perhaps a secondary research effect, from working with so many holistic believers, I have started to feel uneasy about filling my body with pharma's best. In addition, I purchased an over-the-counter (pharmacist controlled) medication that I'd never taken before, and one that I've read an amazing theoretical article about. It's strange to find myself part of that very political struggle and to think about the significance and power of having access to certain drugs in certain contexts. This is perhaps a point that I'm uneasy writing about -- when do I reveal and discuss the personal in my own research? Does my own experience strengthen or diminish the power of the argument?

At one of the doctor's offices, a sports medicine practice, within a teaching hospital, I had to sign a waiver, giving up my right to claim any financial benefits should they discover anything commercializable with my tissues or genes (as I like to send you to The New York Times for good examples of these sorts of things, of course, I have an article to point to, about the "tissue industrial complex"), allowing the physicians to have student doctors accompany them, and a whole other slew of apparently waivable rights. What choice does one have? You can choose not to receive care there, but many of the other physicians have some version of these waivers. I did, in fact, get a couple of residents who accompanied my physician, as they watched him rotate my hips and my legs and expressed amazement at my range of motion. They each got to move my leg around and tried to re-capture the spot where it hurt me. All three were men, and I could tell the residents were uncomfortable. I kept thinking of Terri Kapsalis's really phenomenal book, Public Privates: Performing Gynecology from Both Ends of the Speculum, which is one my favorite social analyses of medical practice and culturally inflected experiences of the body. (The first few chapters, in particular, address gynecological practice and history like no other book or article I've read.)

At the ambulatory care center that I went to, two days after the sports medicine experience, I listened as a man couldn't get his insurance to admit that he had coverage under his wife's plan, and then for the offices to have closed before he could get approval for a much needed scan. The administrators decided to go ahead without pre-approval, since they said it was important. God knows how much that's going to cost this man. And then, I went in and found a lovely old doctor, who spent an amazing amount of time with me, wrote me extensive prescriptions for my bronchitis and any possible pain I might be in as a result, and he even gave me his card with his pager on it. What doctor allows you to contact him without an appointment these days?

Then, there was the dermatologist. The medication I'm on has (over the years, as I have taken it a couple of times in the past) grown increasingly strict about women not getting pregnant while on it. There are now many hurdles to getting access to the medication (also due to people committing suicide while on it), and all sorts of pre-approvals and blood tests. Because my pregnancy test was more than a week old, I had to go back and get a urine test. One of my favorite parts of the new "iPledge" system is that I have to announce my birth control methods. My dermatologist had wanted me to take the pill, but I refused. I have to have two birth control methods, and apparently it is totally within the realm of the system's logic for my first method to be "abstinence" and my second method to be the "diaphragm". Like with federal documents for identification, there is a hierarchy for birth control methods. The first method can only be a few things -- for example, one can't choose a barrier method as the "primary method" -- no condoms or diaphragms. Though I can choose abstinence, if I promise to also use a barrier method. The inanity is hilarious to me.

Anyway, it's strange as I swallow the various pills, take advantage of social advances, political gains, and my incredible wealth of knowledge and education around this topic, to have had this condensed week of medical adventures. None of them terribly serious or traumatic, but still revealing. It's not so bad being my own research subject.

6.18.2008

Anthropology effaced

As I sit on a two-hour conference call, listening to them re-working the survey, it's amazing to me how much depth and attention surveys garner, and how little anyone actually cares about my methods. I know some of this is because few understand my research methods, but it's sort of like being the belle of the ball and then being usurped as quickly as I rose to attention. That's a bit melodramatic, but it is strange to realize that we've not yet given my methods the depth of attention that the survey has merited. I suppose it's ok, it's a way in which I get to be left alone to do what I need to do. But it's also incredibly discouraging.

Similarly, I was reading the CDC grant that I want to apply for, that's due in less than two months, and I feel a bit hopeless about it. I mean, what's the point of their gazillion page protocol when I probably won't get it anyway. Public health is purportedly multidisciplinary, but I've always felt that it has an ugly stepchild syndrome, feeling like it needs to prove its mettle to both medicine and science...I don't know where on the kinship map Anthropology would fall, maybe little matchstick girl begging for alms? (This metaphor is going to incur the wrath of HL, as she never lets me draw insane analogies, but they're so much fun. Someday, my dear, you will get to make an example out of me to your future students, and then, you'll be grateful.)

I was talking to another dear friend (why must these wonderful people be so far away from where I am?) -- and she was confronting the frustrations of fieldwork with people whose lives are quite messy and often get caught in the horrible web of incarceration and racism and poverty. There's an inexorability to their lives that can be very sad and painful to watch. I compared it to my work with men and women in a drug rehab center, and when you hear and follow these people's stories, it's very hard to feel that the work we are doing is meaningful. As fellow "qualitative" researcher extraordinaire (FQRE) put it, it's difficult to work with individuals with the goal of helping larger populations. The work you do with any individual and the theoretical and practical challenges that you're hoping to achieve won't actually line up. We are not helping any specific individuals in our work -- it's all abstracted with longer-term goals. That can be hard to accept. And, as FQRE also expressed, it's incredibly hard to find oneself losing the empathy and emotional reactions to some very upsetting circumstances. After 9 months talking to recovering addicts and drug dealers, I really wanted to say, yes, yes, yes, why wouldn't you turn to dope when life is so insurmountable and the problems keep piling up. Those very limited interviews that I conducted would drive me and my research partner to drink on a regular basis. And when you live in the same city and have to confront the huge social disparities by virtue of your own privilege, it can be extremely jarring and intense. It's not just abstract theorizing, rather, it's simultaneous lives in the same space, with vastly different experiences of the place.

And yet, in order to continue the work, you can't let yourself be distracted too much by the problems of people's lives. You can help as best you are able (and I think FQRE does an excellent job of following and helping people maneuver the systems as best she can), but it can only go so far. Of course, this is also why we're not in direct service work, as that approach to social problems has its own huge limitations. Really, what it comes down to, and as I pointed out to FQRE, is that no matter what tack we might have chosen, we would be limited by our methods. We cannot (sadly) rule the world and fix all the interconnected social problems. But that doesn't mean we should give up, either.

I attribute this brief glimpse of Pollyannaism to the fact that I no longer feel like Camille on her deathbed, and that I suspect it's not deadly tuberculosis after all. Amazing what Nyquil will accomplish.

6.17.2008

More public health-anthropology face-offs

For those who inexplicably continue to read this blog, you may have well noticed I am doing little fieldwork at all. It's a bit shameful, as I believe I am a superhero and can move, get horribly sick, and start new research all simultaneously. In addition, I have started to look at a CDC grant for funding the next year of my life (which is proving daunting in its labyrinthian criteria and guidelines). It's all very exciting in its perilousness.

In the work that I've been contracted to do with the LA health department, there have been a number of frustrations in which the CDC people simply fail to have any interest or faith in the kind of work I do. As I've spent a good amount of time in the public health world, it isn't a huge shock, but it never fails to depress me. In spite of being hired to do "qualitative" research, there was a proposal to include an exit survey at the end of some of our research. Anthropologists don't really enjoy being reduced to the "qualitative" category, as it is usually used derogatively and implies a lesser research method than the more robust "quantitative" methods.

Surveys are usually quantitative. You take conceptual questions and you make them fit into binary responses. I hate this. Rarely do we have binary reactions to social phenomena. If you don't want to make it binary, you can use likert scales, which allow for a range of responses. I have never felt either option on surveys matched my feelings about anything. I'm always choosing the least bad choice. Further, the public healthians constantly ask me if my research methods will "bias" those we're observing, as though a survey with slotted answers don't intriniscally bias the respondent -- since one is given predetermined responses, rather than answering with your own terms. Clearly, such methods have utility, but I simply don't believe that any research method is fully sufficient, and thus, it's acceptable to choose a method that is different than the more standard one. Not because my method is superior (depending on what you value -- is it efficiency or nuance? Statistics or depth of information?), but because none is flawless, why assume that there is an actual hierarchy or value attached to the data collected?

Fortunately, on the LA side, my supervisor brought in an epidemiologist to consult on the survey, since I had no interest in it, have no skills to develop it, and think it's kind of a bullshit measure. Suffice it to say, meeting with the epidemiologist, I immediately hated her. Her way of framing questions and understanding the problems offended me and struck me as completely naive about the actual population with whom we will be working. She simply couldn't understand the nuances of the project that the project director and I had been trying to access through the qualitative methods. Not all epidemiologists are dense, and some do some fascinating and wonderful work. But it was kind of depressing to be confronted (again, for the millionth time) with the limitations of the public health methodology. I've very much wanted to bridge disciplines, but these few months working with the public health side of things makes me want to run in the other direction.

6.16.2008

A mini-zeitgeist predictor

I have a knack for thinking about or being interested in stuff right before it becomes of more popular interest. Example -- babydoll dresses in the early 90s. In spite of terrible sewing skills, I kept searching for patterns for a high waisted short dress, and then a few months later, they were all the rage in the stores. My intellectual interests seem to follow similar patterns, and while I'd like to pretend that I'm a weather vane, or have some amazing predictive skills, I suspect I'm simply susceptible to marketing and priming and perhaps overly-aware of the early signs of new trends. That makes me feel like a vessel for corporate schemes and potential mind control experiments.

Regardless of this seeming unmarketable skill, I thought I'd point out that the Sunday NYT has an article about equal parenting efforts...see two posts ago and my concerns about mother-father responsibilities in raising children. Sigh. It can be so boring to be a know-it-all. If only I were better at predicting my own life. Then I really could take the dinghy out to the middle of the ocean and be done with it, as I proposed to a friend.