medical anthropology

Medical Anthropology, UCI Illness narrative student sample

Union of Biomedicine and Religion: An Understanding of an Illness Experience

Phil is a young man who thrives off of physical activity. This has been the norm for him

ever since he was young. Throughout the years, he has avidly been involved in basketball, tennis,

hiking, and biking. His time spent exercising is an opportunity to de-stress, spend time with

friends, and re-balance his life. Unfortunately, this vital component of his character was taken

away from him at a very critical time in his life.

Phil was finishing the final year of his undergraduate career and was amidst the nerve-

wracking process of applying to medical school when he decided to take a quick break from

studying to play basketball. During a pick-up game, he was running down the court when he

decided to jump up for a layup. While in air, another player bumped him in an attempt to halt his

shot. As a result, his body weight was thrown off balance, and he did not land properly on his left

foot. He experienced a twisting motion in his left knee and heard a pop, after which he felt a

sharp pain for five minutes. Phil wasn't too concerned at the time; with a history of experiencing

a slew of minor ankle sprains and knee bumps over the years, he was no stranger to sports

injuries.

He limped home to his apartment and waited until the next morning, hoping his knee

would feel better as it had many times before. However, the next morning, the knee was bruised,

swollen, and more painful. He thought it could be serious so he called his father -- a doctor -- and

sent him pictures. His father suggested he may have torn a ligament. As result, Phil came home

from his college to be further assessed by one of his father's colleagues, who was an orthopedic

surgeon. The doctor drained excess fluid from his knee. The fluid showed a high amount of

blood, further suggesting a ligament may have been torn.

Medical Anthropology, UCI Illness narrative student sample

Phil then returned to his college, where he used his university health insurance to get an

MRI of his knee, which confirmed a tear of the anterior cruciate ligament (ACL). The moment

he learned of his ACL tear, Phil was disappointed and disheartened because he knew his mobility

would be limited for some time.

Phil scheduled his reconstructive surgery as soon as possible because he wanted to get

back on his feet. Following his surgery, he had to follow a strict regimen of physical therapy for

three days per week with physical therapists and three days on his own, with limited mobility

during this time. He was expected to do about two hours of physical therapy per day. The total

time for him to recover completely was nine months.

The Sick Role and Effect on Social Relationships

The injury was very difficult for Phil because when it happened, he was taking summer

classes to finish his degree and applying to medical school at the same time. He was expected to

continue to excel in his classes and finish his medical school applications, all while being limited

in mobility and spending extra time on physical therapy. He had to take a wheelchair to class for

some time, and the university staff helped him with this. However, he did not enjoy the attention

this brought towards him, which made it slightly embarrassing. It made it difficult to focus in

class and on his medical school applications.

People in situations like Phil's are often excused from their societal responsibilities for a

period of time to recover. Talcott Parsons, an American sociologist, termed the sick role to mean

a "sanctioned" form of deviance in which patients have the right to be exempt from social norms

until recovery. However, when Phil suffered his injury, he was actually denied the sick role, in

that he was not excused from his day-to-day duties as a college student and medical school

Medical Anthropology, UCI Illness narrative student sample

applicant. Even though he was brought to class in a wheelchair, he was still expected to finish his

courses in time to attain his degree and apply for medical school. Perhaps this denial of the sick

role highlights a larger problem within our competitive and sometimes unforgiving culture in

colleges and universities.

In addition to denial of the sick role, for Phil, the most significant consequence of the

injury was the lack of time to socialize and have fun through sports. His social relationships

were, therefore, significantly impacted by his ailment. Phil's situation shows the distinction

between illness and disease. A strictly Western biomedical disease perspective would consider

Phil's ailment only in terms of the observed conditions in the body -- a tear of the anterior

cruciate ligament. However, the illness perspective recognizes the lived experience of the

symptoms and suffering from the patient's viewpoint. For Phil, his illness was not simply a torn

ligament, but rather a lack of social relationships and relaxation time that helped him keep

balance in his life.

Healthcare Inequalities

During Phil's recovery after surgery, he had sessions with a professional physical

therapist in order to re-gain strength in his knee. This service was provided through his

undergraduate university's health insurance. However, after he graduated, Phil lost his university

health insurance and was not able to go see his physical therapist. This factor affected the quality

of his recovery. Phil's lack of health insurance was not an issue of biomedical pathogens, but

rather a product of his socio-cultural and economic context. Therefore, this shows that we must

understand disease in not only the biomedical, individualistic view, but rather we must also

consider the larger context within which the illness is being experienced. The biomedical tenet of

Medical Anthropology, UCI Illness narrative student sample

individualism says that disease is a condition that affects an individual and should be treated as

such. But rather, there are more factors to consider, such as an individual's access to healthcare in

his or her socio-economic position.

Encounters with Biomedicine

Although Phil's ACL injury is healed now, he does often sprain his ankle while playing

basketball, which gives him a nagging pain. Phil had done research on this problem and had

started doing particular exercises to strengthen his ankle. He went to see his doctor to ask if there

was anything else he could do to improve his ankle or if there was perhaps a more serious issue

underneath causing the problem. However, Phil felt that the doctor dismissed what he was asking

for, since the doctor simply repeated what he had already heard in the past. The doctor didn't take

a sincere interest in his illness experience, but rather followed a strictly biomedical model by

addressing the injury without understanding or acknowledging Phil's concerns and feelings as a

patient.

Explanatory Models

Coming from a family of doctors and healthcare professionals, Phil understands his

sports injuries largely through the lens of Western biomedicine, in that he believes in the

materialistic view that his injuries can be observed through signs in the body. But for his ACL

injury, a biomedical explanation wasn't enough, and he turned to his religious beliefs to help

explain why the injury happened to him. Phil comes from a conservative Hindu household and

believes in the 'Swaminarayan' sect of Hinduism. In this sect, they believe that one is constantly

reborn after death, and that each life's pain and suffering as well as material happiness is dictated

Medical Anthropology, UCI Illness narrative student sample

by the balance of sins and good deeds one did in previous lives, known as 'karma'. He believes

that major medical problems like his ACL tear are a result of 'karma.' While he firmly believes in

this religious outlook, he does not think about his day-to-day, mundane pains as products of

karma. But when a major event such as his ACL tear comes around, he finds it easier to

understand and explain it with his religious ideology. This helps him find a bright side to his

injury -- at least his pain and suffering happened for the noble reason that he was atoning for sins

he had done previously.

Biomedicine is based on an assumption of naturalism, which deems illness as amoral and

non-discriminatory. Phil's notion of 'karma' fills the gap left by the assumption of naturalism, in

explaining why and how his injury happened. Essentially, Phil's religious beliefs help him place

his experience with this medical event into a larger context and meaning in life.

Conclusion

After nine months of physical therapy, Phil was finally able to regain strength in his knee

to return to his normal physical activity and restore balance in his life. He is now a medical

student, and as an aspiring doctor, he does not believe that medicine/science and religion/faith

are mutually exclusive. For him, religion is simply the explanation of why science works.

Overall, his outlook on his ACL injury is a union between biomedicine and traditional Hindu

values.