Short Questions

1. What are the difference between “illness” and “disease?” Illustrate with an example.

My answer:

According to Arthur Kleinman, illness is different from the disease. Illness includes how the patient feels about the discomfort, how the patient subjectively perceives, how the discomfort affects the patient’s life, family, social network, and how the patient responds to the discomfort. Illness may directly or indirectly cause illness problems such as losing the job or partner. These problems will always make the patient uncomfortable to live, but these problems are not primarily biological issues.

Patients who feel the illness may bring illness problems to practitioners, who will then translate and turn it into the disease problem. Disease describes how practitioners are trained to diagnose and treat the alternation in the biological body regarding the “normal state.” The disease involves biomedical and technical models that describe the physiological mechanism of a typical human body narrowly.

That said, illness is more subjective that describes what happens on the person, whereas disease always has a standard and is more objective that describes what happens on specific body parts.

For example, if a man’s penis is unable to become hard during sexual intercourse, this will result in the discomfort in his sexual life and may lead to divorce because his wife is not satisfied. Because of this significant change in his family, this man may perform poorly during work and lose his job. So he becomes low self-esteem and loses his partner and job. These are all about the man’s feelings and changes in his life, which describes the illness. When he sees a doctor, the doctor will define his problem as Erectile Dysfunction, which may be caused by a limited amount of blood flowing to the penis. This biological problem described by the doctor has a diagnosis standard, which is the disease.

2. Why did caesarian section surgery replace the use of tongs in childbirth?

My answer:

According to Atul Gawande, the use of tongs in childbirth could perform well. However, successful cases are shown from highly experienced obstetricians from large hospitals. Besides, the use of tongs is complicated to teach. The use of tongs differs when facing different situations. Not all children would be in the same position at birth. The use of tongs is primarily taught through experiences and depends on individual cases rather than standardized procedures. The use of tongs considers medicine as an art, obstetricians are trained to acquire the craft skills, but not everyone can utilize the skills through their hands when facing different situations.

While not all obstetricians can master the artistic tong technique, caesarian section surgery (C-section) provides a more straightforward?and?more predictable way to intervene in problems that happen in childbirth. Though C-section is not perfect and maybe fetal in extreme situations, the technical revolution in obstetrics makes C-sections consistently safer than the use of tongs. Furthermore, some studies show that scheduled C-sections could prevent some deaths. Obstetricians also suggest that scheduled C-sections are even less risky, less time-consuming, and more predictable. C-section considers medicine as an industry; it allows practitioners to follow standardized processes so that every obstetrician can perform C-section surgery. C-section is also easier for obstetricians to schedule, and they are paid more for C-sections.

Atul Gawande argues that obstetrics has become more standardized and industrialized over time. With the aim of medicine to provide the safest possible care to a variety of people, practitioners are seeking reliability in childbirth rather than the possibility of occasional perfection. That said, consider medicine as a standardized industry allows more trained practitioners to provide more reliable treatment for more people. C-section surgery indeed allows this so that it replaces the use of tongs in childbirth.

3. What are the three principal stages of a rite of passage? What effect do rituals of obstetric training have on medical students?

My answer:

Rite of passage refers to an individual who leaves its original group and enters a new group. It always involves a significant change in social status. There are three principal stages of a rite of passage:

(1) Separation stage: the participant leaves its preceding social group;

(2) Liminality stage: transition in between;?the participant has neither one status nor the other social identity;?the participant is in the ambiguous status;

(3) Reintegration stage: the participant is absorbed into the new social state through various rituals of incorporation.

According to Robbie Davis-Floyd in "Obstetric Training as a Rite of Passage," the first two years of medical education is narrowly focusing on natural sciences. Many students bring humanitarian ideals to medical schools, but their level of cognitive functioning is lowered by medical training. This type of training separates medical students from the people they were before entering the medical school, to train them as distinct as physicians who consider sciences?and?depend on technology. Medical students are also encouraged to consider patients as individual cases that they may label patients as numbers. This idea in medical schools separates medical students from the patients who as real humans, so that medical students are trained to consider people as a type of mechanism, and it is technological models of birth to allow childbirth to be safe.

Davis-Floyd argues that medical students learn the core cultural values of biomedicine through the rite of passage. Medical students are separated as technology-users and machine-fixers, then they may learn significant lessons from extreme cases in practice. Through these rituals of obstetric training, medical students consider human bodies as mechanistic and depersonalized objects, and they would consider childbirth to require technology.

4 What is the object-body and how does it differ from the lived body?

My answer:

According to Drew Leder, object-body and lived-body are different models for thinking about the body. Object-body refers to Cartesian Dualism. The object-body considers the body as a passive, material, and unthinking object that is distinct from ?the mind, whereas the mind makes what the meaning, the person is. The idea of object-body considers that the body is separate from the mind or self, but the mind or self owns the body and makes the body to operate.

Lived-body considers both the body and the mind or self as a united, active unit operating together in the world, so the body is inseparable from the mind or self. Lived-body argues that experiences make what the person is, and it is the body that allows the person to get experiences through senses or perception. Lived-body refers to being-in-the-world; it is through sensing or perceiving that the person could first acquire and understand the environment surrounding to develop the mind further. It is the body that makes intersubjective communication and meaning possible through senses, perceptions, and interactions with each other. Referring to embodiment, the lived-body can interact and be shaped by different social and cultural experiences so that the body can orient toward the world in particular ways, whereas the object would not. For example, men in the US and in Vietnam have different postures to walk.

To contrast, object-body considers the body as an unthinking machine, so the meaning is only made through the mind; but lived-body considers that the body can be shaped by the environment, and the body is also intentionally sensing, perceiving, and thinking so that the body allows the mind to have meaning and to communicate.

Drew Leder also states that patients talk to the doctor about feelings by presenting lived-body, but doctors examine object-body by fixed standards.

Prompt:

Produce a symbolic analysis of Susan G. Komen for the Cure. What is symbolic healing and do events like breast cancer marches contribute to it? Does this also contribute to undesirable metaphors around breast cancer?

My Prompt:

Susan G, Komen for the Cure is the largest breast cancer organization in the United States (Sulik 2010). With the rising awareness in breast cancer, the pink ribbon has become a symbol of breast cancer awareness. The color pink is considered feminism in Western countries, and the pink ribbon is a signifier that represents signified young women. The use of the pink ribbon is the connotation that it implies caring for young women so that they are being beautiful, being good, and being cooperative (Sulik 2010).

The pink ribbon gives the power of symbolic healing. Symbolic healing utilizes the manipulation of symbols or acts, such as the pink ribbons or marches, that represent disease, health, and the body to achieve the purpose of healing. Symbolic healing already exists in modern medical systems. According to Linda-Miller (1995), there were clown doctors in New York City hospitals. Clown doctors made uncanny antics so that children patients felt happy about funny actions, and these clown doctors reduced children's anxiety about their diseases. Through the collaboration with medical doctors, clown doctors increased patients' satisfaction and gave positive clinical outcomes.

The breast cancer march is one of the most dominant events of breast cancer awareness. These events show that people around the country march and raise money to support breast cancer research and treatments. Through these events, breast cancer patients would feel the population largely supports them. Although these events do not contribute to the biological mechanism change for breast cancer, patients would be positive with cancer because of the population's attention. These events are also symbols that connect breast cancer patients together. In the community of breast cancer patients, such as Susan G, Komen for the Cure, they can support each other, share personal stories, and look into the future. More and more women are educated about breast cancer, and these events make more and more resources for breast cancer research and treatments. That said, breast cancer awareness events such as marches contribute to the form of healing that promotes a positive attitude among patients to treat cancer, which would give better outcomes clinically.

However, over-awareness is problematic. Though breast cancer awareness events contribute to symbolic healing, it has also caused increased public anxiety. According to Ave (2006), women are more afraid of dying from breast cancers than from heart diseases, though there were eleven times more women died from the latter. Breast cancer has become an undesired metaphor. A pink ribbon is romantic, but considering breast cancer as such, "great-in-scale" events like marches make ill people feel doomed. These "great-in-scale" events make women take breast cancer as a great deal that "this super killer" gives them fate leading to death. Sontag (1990) argues that the sense of destiny prevents patients from maximizing their effort against diseases, and it also prevents doctors from being honest with the patients. That said, breast cancer awareness events cause undesirable metaphors that increase the anxiety about breast cancer in women, though breast cancer is not as fatal as heart diseases, for example.

Over-awareness may also lead to other problems. Educated women would consider their breast cancer due to their own behavior, such as poor diet or lack of exercise. These awareness events emphasize how to prevent cancer through daily actions and sometimes disregard non-controllable factors such as genetics or social and natural environments. This causes patients to feel guilty about breast cancer; they may feel it is because of themselves that they get breast cancer, which prevents the positive attitude to treat cancer and further impacts the clinical outcome.

The use of the pink ribbon as a symbol for women also contains problems. Though the majority of breast cancer patients may identify themselves as women, some patients are biological men or them may not identify themselves as women. These "minor" patients may not be considered through awareness events such as the pink ribbon marches. The "minor" group is further harmed, in addition to the disease itself (while biological men are more deadly from breast cancer, 2015), by the awareness events because they would feel excluded and unsupported. The use of the symbol is always problematic, as not any single symbol would fit all targeting populations.

To conclude, Susan G, Komen for the Cure is a great organization that provides more resources about breast cancer, builds connections between patients through events such as marches, and raises funding and public awareness about breast cancer. Though these events may not directly heal cancer, it contributes to symbolic healing that gives patients power. However, the use of symbols may also contribute to increased anxiety, unnecessary guilt, and minor-group exclusion.

Reference List (Citation Format not used due to technical issues)

Gayle A. Sulik (2010). Pink Ribbon Blues: How Breast Cancer Culture Undermines?Women's Health. USA: Oxford University Press.

Van Blerkom, L. (1995). Clown Doctors: Shaman Healers of Western?Medicine.Medical Anthropology Quarterly, 9(4), new series, 462-475.

Ave, Melanie (2006). "All May Not Be in the Pink". The St. Petersburg Times.

Sontag, S., & Sontag, S. (1990). Illness as metaphor;and,AIDS and its metaphors.?New York:?Doubleday.

Men Have Lower Breast Cancer Survival Rate Than Women. (2015). Retrieved September 30, 2020, from https://www.breastcancer.org/research-news/20120517