ATH 291

Medicine & Culture

Fall 2021, Muhlenberg College
Soc/Anth 25, MW 12:30–1:45 p.m.

Instructor: Casey James Miller, Ph.D. E-mail: [email protected]

Office Hours: By appointment in person and on Zoom (ID: 972 0834 1229, passcode: 935576)

Course Description:

In this course, students will be encouraged to develop a broad understanding of medical

anthropology, one of the newest, largest, and fastest growing subfields of cultural anthropology.
Drawing from theoretical and ethnographic material and from detailed case studies from the U.S.,
Haiti, Peru, and Guatemala, we will examine a number of topics in medical anthropology,
including applied, interpretive, and critical medical anthropological approaches and practices.
Through reading and evaluating a wide range of both classical and contemporary publications in
medical anthropology, we will explore the different kinds of questions that medical anthropologists
ask, the research methods they use to answer those questions, and the insights (theoretical, moral,
and practical) that these insights provide.

Throughout the course, our discussions will focus on how people from different societies and
cultures understand health, illness, and healing, including studying different cultural healing
practices and beliefs as well as the social origins and consequences of illness and disease.
Questions we will investigate together include: How do cultures and societies interact with
people’s physical environments to cause health problems and/or influence the spread of illness
and disease? How do economic and political structures and inequalities help shape people’s
health, their access to quality health care, and the distribution of illness and disease within and
across different societies? How do people in different cultures and societies label, describe, and
experience illness and offer meaningful responses to individual and communal distress?

Course Goals:

• To guide students in developing a strong and broad foundation in the subfield of medical
anthropology, including the study of biocultural adaptations to disease, ethnomedical
systems, and cultural factors in health and access to healthcare.

• To emphasize how beliefs about health, illness, and medicine are culturally created, and
how understanding the cultural dimensions of health and illness can help make healing
more effective.

• To examine how people’s health status and their access to quality health care as well as
the distribution of illness and disease are always intimately connected to larger issues of
politics and socio-economic inequalities.

• To understand how healing systems can help provide meaning to people who are
suffering from illness and disease, which can itself be a powerful form of healing.

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 • To give students an opportunity to apply the theoretical and methodological concepts
learned in class by developing and carrying out an original ethnographic or archival final
research project on a topic of their own choosing.

Required Texts (in the order assigned):

Anne Fadiman. 2012. The Spirit Catches You and You Fall Down: A Hmong Child, Her
American Doctors, and the Collision of Two Cultures. New York, NY: Farrar, Strauss and
Giroux. [NB: earlier editions of this book are OK but page numbers might shift slightly.]

Emily Yates-Doerr. 2015. The Weight of Obesity: Hunger and Global Health in Postwar
Guatemala. Berkeley, CA: University of California Press.

Sharon R. Kaufman. 2015. Ordinary Medicine: Extraordinary Treatments, Longer Lives, and
Where to Draw the Line. Durham, NC: Duke University Press.

All required texts are available for purchase at the college bookstore and/or any major online
bookseller. Books will also be made available at Trexler Library on reserve and/or online.
Additional required readings will be posted on the course Canvas site. Please bring copies of all
assigned readings with you to the appropriate class.

Course Requirements and Evaluation:

Class Participation and Attendance: 20%

Online Reading Responses: 20%
Two-Page Essays (3 @ 10% each): 30%
Final Project: 30%

Course Unit Instruction:

This class is scheduled to meet for 3 hours per week of classroom instruction. Additional
instructional activities for this course may include required attendance at lectures and film
screenings; online discussions; and individual ethnographic and/or archival research projects.

Course Policies and Expectations:

Online Reading Responses: Reading responses are an informal way for you to organize your
thoughts about the readings, make connections, and ask questions, and will also serve as the basis
for our class discussions. Each student will be responsible for composing approximately one short
online reading response per week over the duration of the semester. (A sign-up sheet will be
distributed on the first day of class; students will sign up for Monday or Wednesday reading
response groups.) Reading responses should be 250–300 words each, discuss what you found
interesting, questionable and/or confusing about the assigned readings, and raise 1–2 questions for
class discussion. Online reading responses are due on Canvas at least one hour before class.

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Two-Page Essays: For this class you will write three Two-Page Essays over the course of the
semester. Each essay will be based on one or more of the assigned readings for Sections II–V of
the course. You may choose which of the sections you wish to write about, although you must turn
in your first Two-Page Essay no later than the end of Section III. Two-Page Essays are due by the
first class of the following section (for example, if you choose to write on a reading in Section 1
your essay will be due no later than the first class of Section 2). Each essay must have an original
thesis and make use of evidence (data, quotes, examples, etc.) drawn from the readings. Each essay
must fit onto one standard letter-sized sheet of paper (front and back sides), but you may use any
size font or line spacing you wish. You may revise two of your three Two-Page Essays and
receive the average of the two grades. Themes or questions you explore in your Two-Page Essays
may be used as inspiration for your Final Project.

Final Project: In lieu of a final exam, this course will require all students to complete a Final
Project. You have two options for this assignment:

1) An illness narrative based on either A) an interview with a family member or a friend who
has experienced a severe and/or chronic illness or serious injury, or B) an interview with a
family member or friend who has been a caregiver for someone suffering from a severe
and/or chronic illness or serious injury (ethnographic method).

2) A research paper exploring a topic related to medical anthropology of your own choosing.
(archival method).

The Final Project consists of three components:

I) 1–page Final Project Proposal due on 10/13. Students will receive feedback from the
instructor at the outset of the project.
II) 2–page Final Project Annotated Bibliography due on 11/3. All Final Projects must make
use of at least one assigned course reading.
III) Completed Final Projects will be due on 12/13.

Detailed instructions for the Final Project can be found on Canvas.

Class Attendance and Participation: Consistent attendance will be crucial to doing well in this
course, as we will be learning content in class lectures that will not necessarily be covered in
assigned readings. While I will not be keeping track of attendance in class, I will be keeping
track of attendance at required events and lectures. Students will be required to attend specific
events as part of the Fall 2021 Center for Ethics and 40 Years of HIV/AIDS Activism speaker
series. If you miss class for whatever reason, you are responsible for making up the missed material
as it will not be covered again in class. Please complete all assigned readings before class and be
prepared to make a thoughtful contribution to in-class discussions. I want to create and maintain a
classroom learning environment that is inclusive and welcoming to people from all backgrounds.
Please be respectful of your classmates’ viewpoints and feelings during class discussions. The use
of mobile phones is not permitted in class; laptops may only be used for note-taking. If you
anticipate needing to miss multiple classes over the semester for any reason, please discuss this
with me in advance so that we can make appropriate arrangements. Thank you!

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Late and/or Missing Work: All assignments are due on Canvas before class on the day they are
listed on the syllabus, unless otherwise noted. Assignments will generally not be accepted over e-
mail. I am happy to grant students extensions on their assignments if they have a legitimate need;
however, except for cases of emergency, all extension requests must be made at least 24 hours
before an assignment is due. Papers will be marked down a grade for each day they are late (i.e. a
B+ paper turned in a day late will receive a B).

The Writing Center: Students are encouraged to utilize the services of the Muhlenberg College
Writing Center, where a staff of trained tutors offer individual sessions to help students with their
writing assignments. Students can set up an appointment with a writing tutor, either in person or
online, to discuss any and all aspects of their writing. Drop-in hours are also available Sunday
through Wednesday from 3:30 to 5:30 and 7:00 to 11:00 p.m. and on Thursdays
from 3:30 to 5:30 and 7:00 to 9:00 p.m. For more information please visit
https://www.muhlenberg.edu/academics/writingcenter/.

Academic Resource Center: The Academic Resource Center (ARC) offers individual and small-
group tutoring, course-specific workshops, peer mentoring, and professional academic coaching
for all currently enrolled Muhlenberg students. Students may request to be assigned to work on a
weekly basis with a tutor for the duration of the fall semester starting on Wednesday, September
8, 2021. A link to the online tutor request form is available on the ARC website:
www.muhlenberg.edu/arc. Questions regarding the ARC or any of their services may be directed
to [email protected].

Academic Integrity Code: Maintaining one’s individual academic integrity is a crucial component
of Muhlenberg College’s Academic Integrity Code, which is found online at
www.muhlenberg.edu/main/aboutus/dean-academic/integrity. As specified in the Code, “As an
academic community devoted to the discovery and dissemination of truth, Muhlenberg College
insists that its students will conduct themselves honestly in all academic activities.” Every student
bears the primary responsibility for understanding the nature and importance of academic honesty;
any instances of plagiarism will not be tolerated and will be dealt with on an ad hoc basis. In
accordance with the Code, “on all forms of work submitted for a grade, students shall write
and [initial] the following pledge: ‘I pledge that I have complied with the Academic Integrity
Code in this work.’” If you have any questions or concerns about the AIC, please ask.

Students with Disabilities or Special Needs: Students with disabilities requesting classroom or
course accommodations must complete a multi-faceted determination process through the Office
of Disability Services prior to the development and implementation of accommodations,
auxiliary aids, and services. Each Accommodation Plan is individually and collaboratively
developed between the student and the Office of Disability Services. If you have not already
done so, please contact the Office of Disability Services to have a dialogue regarding your
academic needs and the recommended accommodations, auxiliary aides, and services.

Students Experiencing Financial Hardship: If you are experiencing financial hardship, have
difficulty affording groceries or accessing sufficient food to eat every day or do not have a safe
and stable place to live, and believe this may affect your performance in this course, I would

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urge you to contact our CARE Team through the Dean of Students Office for support. The
webpage is: www.muhlenberg.edu/main/aboutus/deanst/careteam/. You may also discuss your
concerns with me if you are comfortable doing so.

Class Recording Policy: By enrolling and attending Muhlenberg College courses, students
consent to the recording of classes within the scope of college policies. The purpose of recording
a class is to facilitate the achievement of learning outcomes and/or educational access, with the
recording serving as a teaching/learning tool. In all cases where a recording will occur, the
instructor must be notified in advance of the recording of a class session. An instructor may give
students in the class access to a recording as part of the course curriculum or, alternatively, grant
permission to select individuals (including proxy recordings). The instructor may rescind
previously granted permission to record at any point during the course, provided that doing so
does not compromise an approved accommodation. Any permitted class recordings made by
students must be destroyed one week after the final grade is posted for the course, unless the
student has received permission from the instructor to retain them or is entitled to retain them as
an approved accommodation. Instructors may retain a class recording for other purposes on the
condition that all identifying student audio and images are edited out of the recording unless
permission has been granted. No instructor will be required to permit recording except under
requirements of law.

Class recordings may not be reproduced, transferred, distributed, or displayed in any manner.
Students may not share authorized recordings from class in any way with anyone. This includes,
but is not limited to:
• Sharing recordings with other students;
• Sharing recordings with other students;
• Sharing recordings with parents or guardians;
• Sharing recordings with friends;
• Sharing recordings through social media;
• Posting recordings online;
• E-mailing recordings to anyone; and
• Retaining downloaded recordings.

Permission to allow class recording is not a transfer of any copyrights in the recording or related
course materials. Materials contained within the class recordings, including but not limited to
videos and other web-based media, may also have their own copyright protection for which there
may be separate prohibitions under the law against dissemination.

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Class schedule: Subject to change based on course pace and inclement weather

Section I. Introduction to medical anthropology.

Monday, August 30
Course overview and introductions.
Horace Miner. 1956. “Body Ritual Among the Nacirema.” American Anthropologist
58(3):503–507.

Wednesday, September 1 (GROUP A)

Merrill Singer and Hans Baer. 2012. “What Medical Anthropologist Do.” In Introducing
Medical Anthropology. Pp: 38–61.

Section II. Ethnomedicine and biomedicine. Case study: medical misunderstandings among
a Hmong refugee community in California.

Monday, September 6 (GROUP B)

Robert Hahn. 1995. “The Universe of Sickness.” In Sickness and Healing: An
Anthropological Perspective. Pp: 13–39.
E. E. Evans-Pritchard. 1937. “The Notion of Witchcraft Explains Unfortunate Events.” In
Witchcraft, Oracles, and Magic Among the Azande. Pp. 63–83.

Wednesday, September 8 (GROUP A)

Claude Levi-Strauss. 1963. “The Sorcerer and His Magic.” In Structural Anthropology. Pp:
167–185.
Arthur Kleinman. 1998. “The Meanings of Symptoms and Disorders.” In The Illness
Narratives: Suffering, Healing and the Human Condition. Pp. 1–30.

Monday, September 13 (GROUP B)

Lorna A. Rhodes, 1996. “Studying Biomedicine as a Cultural System.” In Medical
Anthropology: Contemporary Theory and Method. Pp: 165–180.
Anne Fadiman. 2012. The Spirit Catches You and You Fall Down. Preface and Chs. 1–5, pp.
vii–59.

Tuesday, September 14
Justin Perez, “When Projects End: The Afterlives of HIV Prevention in Peru,” 40
Years of HIV/AIDS Activism, 6 p.m. on Zoom

Wednesday, September 15 (GROUP A)

Arthur Rubel. 1964. “The Epidemiology of a Folk Illness: Susto in Hispanic America.”
Ethnology 3(3):268–283.
Anne Fadiman. 2012. The Spirit Catches You and You Fall Down. Chs. 6–8, pp. 60–105.

Monday, September 20 (GROUP B)

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 Gananath Obeyesekere, 1985. “Depression, Buddhism, and the Work of Culture in Sri
Lanka.” In Culture and Depression: Studies in the Anthropology and Cross-Cultural
Psychiatry of Affect and Disorder. Pp:134–152.
Anne Fadiman. 2012. The Spirit Catches You and You Fall Down. Chs. 9–12, pp. 106–170.

Wednesday, September 22 (GROUP A)

Anne Fadiman. 2012. The Spirit Catches You and You Fall Down. Chs. 13–15, pp. 171–224.
Watch film, The Split Horn: Life of a Shaman in America (58 min.)
Sonia Shah lecture, title TBA, Center for Ethics, 7:00 p.m. Miller Forum, Moyer Hall

Monday, September 27 (GROUP B)

Stacy Leigh Pigg, 1996. The Credible and the Credulous: The Question of Villager’s ‘Belief’
in Nepal. Cultural Anthropology 11(2):160–201.
Anne Fadiman. 2012. The Spirit Catches You and You Fall Down. Chs. 16–17, pp. 225–261.

Wednesday, September 29 (GROUP A)

Anne Fadiman. 2012. The Spirit Catches You and You Fall Down. Chs. 18–19, pp. 262–288.
Janelle Taylor. 2003. “The Story Catches You and You Fall Down.” Medical Anthropology
Quarterly 17(2):159–181.

Section III. Health and inequality: Critical medical anthropology. Case study: the life and
work of Paul Farmer.

Monday, October 4 (GROUP B)

Merrill Singer. 1990. “Reinventing Medical Anthropology: Toward a Critical Realignment.”
Social Science & Medicine 30(2):179–187.
Paul Farmer. 1990. “Sending Sickness: Sorcery, Politics, and Changing Concepts of AIDS in
Rural Haiti.” Medical Anthropology Quarterly 4(1):6–27.
Begin film: Bending the Arc (102 min)

Wednesday, October 6 (GROUP A)

Nancy Scheper-Hughes. 1992. “Nervoso.” In Death Without Weeping: The Violence of
Everyday Life in Brazil. Pp. 167–215.
Paul Farmer. 2006. “Rethinking Emerging Infectious Diseases.” In Partner to the Poor: A
Paul Farmer Reader. Pp. 155–173.
Finish film: Bending the Arc (102 min)

FALL BREAK

Wednesday, October 13 (GROUP B)

Paul Farmer. 2006. “From Haiti to Rwanda: AIDS and Accusations.” In Partner to the Poor:
A Paul Farmer Reader. Pp. 136–147.
Sonia Shaw. 2016. Blame. In Pandemic: Tracking Contagions from Cholera to Ebola and
Beyond. Pp. 121–140.
Frantz Fanon. 1965. “Medicine and Colonialism.” In A Dying Colonialism. Pp. 121–145.

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Section IV. Health systems and the body. Case study: Hunger, obesity, and global health in
Guatemala.

Monday, October 18 (GROUP A)

Nancy Scheper-Hughes and Margaret M. Lock, 1987. The Mindful Body: A Prolegomenon
to Future Work in Medical Anthropology. Medical Anthropology Quarterly 1(1):6–41.
Emily Yates-Doerr. 2015. The Weight of Obesity. Introduction and Ch. 1, pp. 1–52.
Final Project Proposals Due
First 2-Page Essay Due

Wednesday, October 20 (GROUP B)

Emily Martin, 1994. “The Body at War: Media Views of the Immune System.” In Flexible
Bodies: Tracking Immunity in American Culture from the Days of Polio to the Age of
AIDS. Pp: 49–81.
Ieva Jusionyte. 2018. “Called to ‘Ankle Alley’: Tactical Infrastructure, Migrant Injuries, and
Emergency Medical Services on the US–Mexico Border.” American Anthropologist
120(1):89–101.

Thursday, October 21
Dan Royles, “Don’t We Die Too? Rice and Sexuality in the Early AIDS Crisis,” Center
for Ethics/40 Years of HIV/AIDS Activism, 7 p.m., Miller Forum, Moyer Hall

Monday, October 25
Library research session

Wednesday, October 27 (GROUP A)

Emily Yates-Doerr. 2015. The Weight of Obesity. Chs. 2–3, pp. 55–109.
Michael Foucault, 1995 [1977]. “Docile Bodies.” In Discipline and Punish: The Birth of the
Prison. Pp. 135–169

Friday, October 29
Mandisa Mbali, title TBA, 40 Years of HIV/AIDS Activism, 2:00 p.m. on Zoom

Monday, November 1 (GROUP B)

Emily Yates-Doerr. 2015. The Weight of Obesity. Chs. 4–5, pp. 111–153.
Jason Whitesel and Amy Schuman. 2013. “Normalizing Desire: Stigma and the
Carnivalesque in Gay Bigmen’s Cultural Practices.” Men and Masculinities 16(4):478–
496.

Wednesday, November 3 (GROUP A)

Emily Yates-Doerr. 2015. The Weight of Obesity. Ch. 6 and Conclusion, pp. 155–185.
Irving Kenneth Zola, 1972. Medicine as an Institution of Social Control. The Sociological
Review 20(4):487–504.

Section V. The politics of care. Case study: Aging and end-of-life of care in the U.S.

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Monday, November 8 (GROUP B)
John Borneman. 1997. “Caring and Being Cared For: Displacing Marriage, Kinship, Gender,
and Sexuality.” International Social Science Journal 49:573–584.
Felicity Aulino. 2016. “Rituals of Care for the Elderly in Northern Thailand: Merit, Morality,
and the Everyday of Long-term Care. American Ethnologist 43:91–102.
Casey James Miller. 2016. “We Can Only Be Healthy if We Love Ourselves: Queer AIDS
NGOs, Kinship, and Alternative Families of Care in China.” AIDS Care 28(sup4):51–60.
Final Project Annotated Bibliography Due

Wednesday, November 10 (GROUP A)

Byron J. Good and Mary-Jo DelVecchio Good. 1993. “‘Learning Medicine:’ The
Construction of Medical Knowledge at Harvard Medical School.” In Knowledge, Power,
and Practice: The Anthropology of Medicine and Everyday Life. Pp: 81–107.
Janelle Taylor. 2003. “Confronting ‘Culture’ in Medicine’s ‘Culture of No Culture.’”
Academic Medicine 78(6):555–559.

Monday, November 15 (GROUP B)

Sharon R. Kaufman. 2015. Ordinary Medicine. Introduction and Ch. 1, pp. 1–50.
Margaret Lock. 1996. “Death in Technological Time: Locating the End of Meaningful Life.”
Medical Anthropology Quarterly 10(4):575–600.

AMERICAN ANTHROPOLOGICAL ASSOCIATION MEETING

Continue reading Ordinary Medicine.

Monday, November 22 (GROUP A)

Sharon R. Kaufman. 2015. Ordinary Medicine. Chs. 2–4, pp. 53–124.
Malcolm Johnson. 2005. “The Social Construction of Old Age as a Problem.” In The
Cambridge Handbook of Age and Ageing. Malcolm L. Johnson, ed. Pp. 563–571.

THANKSGIVING BREAK
Continue reading Ordinary Medicine and catch up if you are behind!

Monday, November 29 (GROUP B)

Sharon R. Kaufman. 2015. Ordinary Medicine. Chs. 5–7, pp. 127–216.

Wednesday December 1
Watch film: Pensioners Inc. (52 min)

Monday, December 6 (GROUP A)

Sharon R. Kaufman. 2015. Ordinary Medicine. Ch. 8 and Conclusion, pp. 217–247.
Luisa Margolies. 2004. “Lesson Five: Enough is Enough: Prolonging Living or Prolonging
Dying?” In My Mother’s Hip. Pp. 225–236.

Wednesday, December 8 (GROUP B)

Final reading TBD
Course Wrap-up

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Final Projects Due: Monday, December 13

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