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This book provides a history of the American natural and health foods industry and its leadership in the social movement oriented to spreading a natural foods way of life. The natural foods case is used to consider the broader question of what possibilities open up and what limits emerge when private enterprise is involved in movements advocating for broad-based social and cultural change. Beginning with the first American natural foods advocates in the early nineteenth century, and continuing to the early twenty-first century, this history shows how the leadership of the natural foods industry was central to transforming natural foods consumption from a culturally marginal activity associated with religious minorities, immigrants, the elderly, and the infirm, to a hip lifestyle associated with the young, the fit, and the affluent. In the process, industry helped lead the natural foods movement away from an emphasis on asceticism and simple living, and towards a valuation of indulgence and material comforts. The book argues that instead of acting as a singularly eradicalizing force, the natural and health foods industry reinforced the natural foods movement's often radical rejection of medical expertise. The natural foods case demonstrates that business interests promote a flexible approach to cultural meanings and symbols, which undermines cultural authority and catalyzes cultural change.

For a generation, an intense debate has been waged over the expanding number of people who are diagnosed with a mental disorder and treated with prescription drugs such as Prozac and Adderall. One side, the psychiatric, sees progress. People suffering from mental illness are finally getting the treatment they need. The other side challenges the psychiatric perspective and the medicalization and treatment of common personality traits and forms of distress as mental disorders. Neither side has much to say about how people themselves explain their suffering and or envision a resolution. Chemically Imbalanced, based on interviews, explores this sense-making among people dealing with experiences of loss, disappointment, and underachievement. At the heart of distress is a gap between experience and valued standards and ideals of selfhood, and confusion over why things are not going as they should. People are in a predicament, and the book explores how many take up diagnostic categories, biological explanations, and pharmaceuticals as social objects and narratives to make sense of their situation and ameliorate it. These efforts reveal that a quiet but profound revolution in consciousness is underway. Ways of conceiving of suffering in terms of the mind, interpersonal experience, and social circumstances are being replaced with a thin and mechanistic language of the body/brain. The appeal of this “neurobiological imaginary,” the book argues, is not its explanatory power but in what it promises people they can be in our fluid and depthless culture. Despite the vaunted freedom, the imaginary has troubling and entrapping consequences.

Research physicians face intractable dilemmas when they consider introducing new medical procedures. Innovations carry the promise of preventing or curing life-threatening diseases, but they can also lead to injury or even death. How have clinical scientists made high-stakes decisions about undertaking human tests of new medical treatments? This book explores this issue as it examines vaccine trials in America during the early and mid-twentieth century. Today's scientists follow federal guidelines for research on human subjects developed during the 1960s and 1970s. But long before these government regulations, medical investigators observed informal rules when conducting human research. They insisted that the dangers of natural disease should outweigh the risks of a medical intervention, and they struggled to assess accurately the relative hazards. The book explores this logic of risk in immunization controversies extending as far back as the eighteenth century. Then, focusing on the period between 1930 and 1960, it shows how research physicians and their sponsors debated the moral quandaries involved in moving vaccine use from the laboratory to the clinic. This work describes the efforts of clinical investigators to balance the benefits and dangers of untested vaccines, to respond to popular sentiment about medical hazards, and to present strategically risk-laden research to sponsors and the public.

Headache disorders are often dismissed. Yet migraine is a serious problem for millions of people. Epidemiologists estimate that as many as 37 million adult Americans (or 12% of the adult population) have migraine. How is it that a disorder can disrupt so many lives, yet seem so banal, unimportant and, ultimately, difficult to believe? This book addresses the complex relationship between this legitimacy deficit and the cultural organization of pain, describing the multiple and often contradictory symbols, images, metaphors, patterns, and meanings that the word “headache” evokes and explaining how these social meanings circulate and contribute to rules and conventions about pain. How have developments in medicine shaped the cultural meaning of migraine and, conversely, how has the cultural meaning of migraine shaped what medicines are made, how medicine is practiced and what knowledge about head pain is and is not produced? Drawing on ethnography, interview, and archival data, this book examines the political economy of pain, taking a close look at how the politics of gender and health affect three distinct, but tightly interconnected groups of stakeholders-physicians who specialize in headache treatment, patient advocates, and the pharmaceutical industry. Each plays a central role in motivating a paradigm shift in understanding headache from a psychological imaginary to the neurobiological real. The conclusion describes the constituent components of legitimacy, with special emphasis on how the gendering of migraine may prevent it from being taken seriously as a disorder.

Now that we have sequenced the human genome, what does it mean? In The Postgenomic Condition, Jenny Reardon critically examines the decade after the Human Genome Project, and the fundamental questions about meaning, value and justice this landmark achievement left in its wake. Drawing on more than a decade of research—in molecular biology labs, commercial startups, governmental agencies, and civic spaces—Reardon demonstrates how the extensive efforts to transform genomics from high tech informatics practiced by a few to meaningful knowledge beneficial to all exposed the limits of long-cherished liberal modes of knowing and governing life. Those in the American South challenged the value of being included in genomics when no hospital served their community. Ethicists and lawyers charged with overseeing Scottish DNA and data questioned how to develop a system of ownership for these resources when their capacity to create things of value—new personalized treatments—remained largely unrealized. Molecular biologists who pioneered genomics asked whether their practices of thinking could survive the deluge of data produced by sequencing machines. While the media is filled with grand visions of precision medicine, The Postgenomic Condition shares these actual challenges of those who sought to leverage liberal democratic practices to render genomic data a valuable resource for interpreting and caring for life. It brings into rich empirical focus the resulting hard on-the-ground questions about how to know and live on a depleted but data-rich, interconnected yet fractured planet, where technoscience garners significant resources, but deeper questions of knowledge and justice urgently demand attention.

As elected coroners came to be replaced by medical examiners with scientific training, the American public became fascinated with their work. From the grisly investigations showcased on highly rated television shows like C.S.I. to the bestselling mysteries that revolve around forensic science, medical examiners have never been so visible—or compelling. They, and they alone, solve the riddle of suspicious death and the existential questions that come with it. Why did someone die? Could it have been prevented? Should someone be held accountable? What are the implications of ruling a death a suicide, a homicide, or an accident? Can medical examiners unmask the perfect crime? This book goes deep inside the world of medical examiners to uncover the intricate web of pathological, social, legal, and moral issues in which they operate. The author of this book spent years in a medical examiner's office, following cases, interviewing examiners, and watching autopsies. While he relates cases here, he is also more broadly interested in the cultural authority and responsibilities that come with being a medical examiner. Although these professionals attempt to remain objective, medical examiners are nonetheless responsible for evaluating subtle human intentions. Consequently, they may end—or start—criminal investigations, issue public health alerts, and even cause financial gain or harm to survivors. How medical examiners speak to the living on behalf of the dead, is the book's subject, revealed here in the day-to-day lives of the examiners themselves.

Contemporary health care often lacks generosity of spirit, even when treatment is most efficient. Too many patients are left unhappy with how they are treated, and too many medical professionals feel estranged from the calling that drew them to medicine. The book tells the stories of ill people, doctors, and nurses who are restoring generosity to medicine—generosity toward others and to themselves. It evokes medicine as the face-to-face encounter that comes before and after diagnostics, pharmaceuticals, and surgeries. The book calls upon the Roman emperor Marcus Aurelius, philosopher Emmanuel Levinas, and literary critic Mikhail Bakhtin to reflect on stories of ill people, doctors, and nurses who transform demoralized medicine into caring relationships. It presents their stories as a source of consolation for both ill and professional alike and as an impetus to changing medical systems. It shows how generosity is being renewed through dialogue that is more than the exchange of information. Dialogue is an ethic and an ideal for people on both sides of the medical encounter who want to offer more to those they meet and who want their own lives enriched in the process.

It has been close to six decades since Watson and Crick discovered the structure of DNA and more than ten years since the human genome was decoded. Today, through the collection and analysis of a small blood sample, every baby born in the United States is screened for more than fifty genetic disorders. Though the early detection of these abnormalities can potentially save lives, the test also has a high percentage of false positives—inaccurate results that can take a brutal emotional toll on parents before they are corrected. Now some doctors are questioning whether the benefits of these screenings outweigh the stress and pain they sometimes produce. This book evaluates the consequences and benefits of state-mandated newborn screening and the larger policy questions they raise about the inherent inequalities in American medical care that limit the effectiveness of this potentially lifesaving technology. Drawing on observations and interviews with families, doctors, and policy actors, the book provides an ethnographic study of how parents and geneticists resolve the many uncertainties in screening newborns.