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Immobility and
Medicine
Exploring Stillness, Waiting
and the In-Between
Edited by
Cecilia Vindrola-Padros
Bruno Vindrola-Padros
Kyle Lee-Crossett
Immobility and Medicine
Cecilia Vindrola-Padros ·
Bruno Vindrola-Padros · Kyle Lee-Crossett
Editors
Immobility
and Medicine
Exploring Stillness, Waiting
and the In-Between
Editors
Cecilia Vindrola-Padros Bruno Vindrola-Padros
University College London University College London
London, UK London, UK
Kyle Lee-Crossett
University College London
London, UK
ISBN 978-981-15-4975-5 ISBN 978-981-15-4976-2 (eBook)

https://doi.org/10.1007/978-981-15-4976-2
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Contents
1 Immobility and Medicine: An Introduction 1

Cecilia Vindrola-Padros, Bruno Vindrola-Padros,
and Kyle Lee-Crossett
Part I Immobile Infrastructures and Enforced Waiting
2 Lists in Flux, Lives on Hold? Technologies of Waiting

in Liver Transplant Medicine 15
Julia Rehsmann
3 ‘Being Stuck’: Refugees’ Experiences of Enforced

Waiting in Greece 39
Pia Juul Bjertrup, Jihane Ben Farhat, Malika Bouhenia,
Michaël Neuman, Philippe Mayaud, and Karl Blanchet
v
vi Contents
4 ‘An (Im)Patient Population’: Waiting Experiences

of Transgender Patients at Healthcare Services
in Buenos Aires 61
María Victoria Tiseyra, Santiago Morcillo, Julián Ortega,
Mario Martín Pecheny, and Marine Gálvez
5 Living in ‘Limbo’: Immobility and Uncertainty

in Childhood Cancer Medical Care in Argentina 85
Eugenia Brage
Part II Embodied Stillness and Fixity
6 Embodying Immobility: Dysphoric Geographies

of Labour Migration and Their Transformations
in the Therapeutic Context of ‘Venda’ Ancestor
Possession in Post-apartheid South Africa 113
Vendula Rezacova
7 Liminality and the SCI Body: How Medicine

Reproduces Stuckedness 135
Colleen McMillan
8 Embodied Perceptions of Immobility After Stroke 155

Hannah Stott
9 “When You Do Nothing You Die a Little Bit”: On

Stillness and Honing Responsive Existence Among
Community-Dwelling People with Dementia 185
Laura H. Vermeulen
10 Stories of (Im)Mobility: People Affected by Dementia

on an Acute Medical Unit 207
Pippa Collins
Contents vii
Part III Motility and (Im)Mobile Possibilities
11 Migratory Labour and the Politics of Prevention:

Motility and HPV Vaccination Among Florida
Farmworkers 231
Nolan Kline, Cheryl Vamos, Coralia Vázquez-Otero,
Elizabeth Lockhart, Sara K. Proctor, Kristen J. Wells,
and Ellen Daley
12 Living Suspended: Anticipation and Resistance

in Brain Cancer 251
Henry Llewellyn and Paul Higgs
Index 273
Notes on Contributors
Jihane Ben Farhat is an epidemiologist and biostatistician at Epicentre

and Médecins Sans Frontières since 2010. In recent years, Jihane has
mainly worked on pediatric themes, in particular in infectious diseases
(Uganda, Kenya, and Malawi), mental health (Greece and Iraq), and
malnutrition (Democratic Republic of Congo and Mali).
Pia Juul Bjertrup is a Medical Anthropologist with fieldwork experi-
ence from Burkina Faso, Eswatini, and Greece. In recent years, she has
worked as a Qualitative Researcher at Epicentre on a study of refugee
mental health in Greece and with Médecins sans Frontières in Eswa-
tini on HIV and Tuberculosis. Currently, Pia is a Ph.D. fellow at the
Department of Anthropology, University of Copenhagen, studying care,
bereavement, and death in relation to infectious and potential epidemic
disease in Burkina Faso.
Professor Karl Blanchet is the Director of the Geneva Centre of
Humanitarian Studies, and professor at the Faculty of Medicine, Univer-
sity of Geneva. Professor Blanchet has been working in health systems
research at the London School of Hygiene and Tropical Medicine since
ix
x Notes on Contributors
2010 and was appointed as co-director of the Health in Humani-

tarian Crises Centre in 2016. He has a management and public health
background and brings to extensive us experience in humanitarian
contexts as a relief worker and a researcher. Professor Blanchet’s research
focuses on resilience issues in global health, specifically in post-conflict
and conflict-affected countries. He has developed innovative research
approaches based on complexity science and system thinking, and is
currently focused on developing and testing people-centered method-
ological approaches for refugee populations in the Middle East.
Malika Bouhenia is an epidemiologist with thirteen years’ experience
in international health. She began her career as a Program Coordinator
with Médecins sans Frontières in Ivory Coast, Chad, and Yemen. Over
the past seven years, she has worked in a diverse range of epidemiologist
positions with Epicentre and conducted several surveys in refugee camps,
South Sudan, Chad, France, and Greece. Her areas of expertise include
epidemiology of infectious diseases, surveillance, and management of
outbreaks.
Eugenia Brage is a postdoctoral researcher at Universidade de São
Paulo, Centro de Estudos da Metrópole-Cebrap, Brazil. She has a Ph.D.
in Anthropology from the Universidad de Buenos Aires, Argentina.
Dr. Pippa Collins is a Clinical Academic with an interest in older
people living with physical and cognitive frailty. She received both her
Masters in Clinical Research and her Ph.D. from the University of
Southampton. Her background is in physiotherapy and she has a clinical
and academic interest in mobility, both as a way of moving in the world
and as a means of communication. She works clinically as an Advanced
Clinical Practitioner in Bournemouth, UK, treating people in their own
homes who have become clinically unwell or who are in social crisis.
Dr. Ellen Daley, the Associate Dean for Translational Research and
Practice, is a Professor at the College of Public Health. Dr. Daley is a
behavioral researcher with interests in women’s health, health literacy,
reproductive health, Human Papillomavirus (HPV) prevention, adoles-
cent health, and health risk-taking behaviors.
Notes on Contributors xi
Marine Gálvez, B.A. in Gender Studies and Political Science from

Barnard College of Columbia University. Fulbright Scholar.
Paul Higgs is Professor of Sociology of Ageing at UCL where he teaches
medical sociology. He has co-authored with Chris Gilleard Cultures of
Ageing: Self, Citizen, and the Body (2000) and Contexts of Ageing: Class,
Cohort and Community (2005). He is the co-author of Medical Sociology
and Old Age: Towards a Sociology of Health in Later Life (2008) with Ian
Jones. Professor Higgs edits the journal Social Theory and Health and
has published widely in social gerontology and medical sociology. He is
a Fellow of the UK Academy of Social Sciences and the Gerontological
Society of America.
Dr. Nolan Kline is Assistant Professor of Anthropology and Co-
Coordinator of the Global Health program at Rollins College. His
book, Pathogenic Policing: Immigration Enforcement and Health in the
US South (Rutgers), traces the multiple health-related consequences of
immigration legislation and police practices in Atlanta, Georgia. His
work has been funded by the National Science Foundation, and he has
published several peer-reviewed articles and book chapters on im/migrant
and farmworker health and human papillomavirus interventions. As an
applied, medical anthropologist who uses community-based methodolo-
gies to examine the social and political determinants of health, Kline’s
work intersects with policy and activism.
Kyle Lee-Crossett is based in the Institute of Archaeology, UCL. He
specializes in heritage studies and currently investigates institutional
(im)mobilities in the context of collecting contemporary bio- and
cultural diversity in public archives and museums. He is interested in
how people and materials associated with diversity run into barriers in
collections practice, despite diversity being seen as a mobile and inclusive
force. His work explores how pathways into collections are experienced
and narrated, who and what becomes stuck, and goals and aspirations
for collections diversity. This book extends his work on institutional and
material culture (im)mobilities to the healthcare field.
Henry Llewellyn is a medical anthropologist and research fellow in the
UCL Division of Psychiatry. His work explores relationships between
xii Notes on Contributors
scientific knowledge production, medical diagnosis, treatment decision-

making, clinical trials, and subjectivity. His current project examines the
social and ethical implications of new medical technologies in cancer
with an ethnographic focus on changing diagnostic classification and
personalized medicine in brain tumors in the UK.
Dr. Elizabeth Lockhart is a postdoctoral fellow at the University of
South Florida (USF). She received her Ph.D. from USF College of
Public Health and her MPH from the University of Michigan. Her main
research areas of interest include sexual and reproductive health preven-
tion and care (HIV and HPV), as well as increasing access to care via
community health workers and technologies. Dr. Lockhart has worked
in community-engaged research for over 10 years in Michigan and in
Florida.
Philippe Mayaud is a Professor of Infectious Diseases and Reproduc-
tive Health at the London School of Hygiene and Tropical Medicine.
Philippe’s research and teaching interests are in HIV/AIDS and sexually
transmitted infections (STI) and more recently emerging infections. He
has worked in many parts of Western, Eastern, and Southern Africa, but
also in the Caribbean, China, and Brazil, where he has additional research
projects on arbovirus epidemiology.
Colleen McMillan is Associate Professor at Renison University College,
University of Waterloo. Her research interests include: the genderization
of health, photovoice as a methodology in the context of illness, interpro-
fessional education, and participatory action research with marginalized
populations. Her research and teaching methods are framed by Rela-
tional Cultural Theory which emphasizes the value of connection and
reciprocity.
Santiago Morcillo is Ph.D. in Social Sciences from the University of
Buenos Aires (UBA). He is a researcher at the National Council on
Science and Technology (CONICET), Argentina, and Professor of Social
Psychology at the Sociology department (UBA). His research focuses on
the intersection between sexuality, gender, masculinity, sex industry, and
health, has directed the project: “Gender and sexuality in the gaze of men
Notes on Contributors xiii
who pays for sex in Argentina,” and co-directs “Anti-trafficking campaign

in Argentina: sexual politics and discourses on prostitution.”
Michaël Neuman Director of studies at Crash/Médecins sans Fron-
tières, Michaël Neuman graduated in Contemporary History and Inter-
national Relations (University Paris-I). He joined Médecins sans Fron-
tières in 1999 and has worked both on the ground (Balkans, Sudan,
Caucasus, West Africa) and in headquarters (New York, Paris as deputy
director responsible for programs). He has also carried out research
on issues of immigration and geopolitics. He is co-editor of Humani-
tarian Negotiations Revealed, the MSF Experience (London: Hurst and Co,
2011). He is also the co-editor of Saving Lives and Staying Alive. Human-
itarian Security in the Age of Risk Management (London: Hurst and Co,
2016).
Julián Ortega, Ph.D in Psychology (University of Buenos Aires),
Master in Labor Studies (University of Buenos Aires).
Mario Martín Pecheny is Full Professor of Political Science and Soci-
ology of Health, University of Buenos Aires and principal researcher
at the National Council on Science and Technology (CONICET),
Argentina. He has extensively published on rights and politics in health,
gender, and sexuality in Latin America.
Sister Sara K. Proctor is the program coordinator of the Catholic
Charities, Diocese of St. Petersburg, Mobile Medical Clinic that serves
migrant farmworker populations. She is a member of American Academy
of Physician Assistants and has collaborated on a number of funded
research studies. She has also provided trainings related to migrant health
to health providers in the Tampa Bay area. In 2013, she received the
Pontifical Award Pro Ecclesia et Pontifice, and in 2003, she was named
Humanitarian of the year by the Florida Academy of Physician Assistants.
Julia Rehsmann is an anthropologist and postdoctoral fellow at the
University of Bern and Bern University of Applied Science. As part of
the research project “Intimate Uncertainties” (SNSF project 149368), she
conducted research on liver transplants in Germany and examined how
this field of high-tech medicine is interwoven with moral and intimate
xiv Notes on Contributors
questions about “lives worth saving.” In her book, she deals with the exis-
tential, technological and political dimensions of waiting in transplant
medicine. Currently, she is currently working on the interdisciplinary
research project “Things of Dying” (SNSF project 188869) on inpatient
palliative care in Switzerland.
Vendula Rezacova is a lecturer in social anthropology at the Institute
of Sociological Studies, Faculty of Social Sciences, Charles University in
Prague. Toward her Ph.D. degree in sociology and social anthropology
earned in 2011 from Charles University, she has conducted fieldwork in
the Venda region, South Africa. Focusing on the articulation of symbolic
and social transformations within traditional medicine, this research has
combined the author´s interests in anthropology of medicine, religion,
mobility, and gender. The author is working on a book manuscript
dealing with spatio-temporal relations orienting social action as these can
be worked out from constituents of “Venda” personhood.
Hannah Stott is a Chartered Psychologist and Research Fellow at
University of the West of England, where she was awarded her Doctorate
for her thesis exploring “Embodiment, Altered Perception and Comfort
After Stroke.” She has a special interest in qualitative, visual, and realist
research methods and is currently working on a large realist evalua-
tion of physiotherapy services within primary care. Prior to working in
academia, she has worked supporting stroke survivors and others with
long-term physical and psychological conditions and is passionate about
supporting individuals to improve their well-being.
María Victoria Tiseyra is a sociologist (University of Buenos Aires)
and Ph.D. scholar in Sociology at the National Council on Science
and Technology (CONICET), Argentina. Her interdisciplinary training
combines studies into Social Politics (UBA) and a Master´s degree in
Women´s, Gender and Citizenship studies (University of Barcelona),
Spain. Her research focuses on the intersection between gender, sexuality,
disability/crip/decolonial studies. Also she has done research in sexual
and reproductive health.
Dr. Cheryl Vamos is an Associate Professor and a Fellow with the Chiles
Center for Women, Children, and Families. She is also a Core Faculty
Notes on Contributors xv
member of the Collaborative for Research Understanding Sexual Health

(CRUSH). The overall goal of Dr. Vamos’ research is to facilitate the
translation of maternal and child health (MCH) evidence into practice
for patients, providers, and women at-large.
Coralia Vázquez-Otero is an NCI Postdoctoral Fellow in the Depart-
ment of Social and Behavioral Sciences at the Harvard T. H. Chan
School of Public Health and Dana-Farber Cancer Institute. She is inter-
ested in the prevention of HPV-related cancers via educating about
and promoting the HPV vaccine, and the use of evidence-based and
population-based interventions (policy) to prevent and improve cancer-
related outcomes and eliminate health inequities. Dr. Vázquez-Otero is
originally from Puerto Rico and completed her Ph.D. at the University
of South Florida College of Public Health.
Laura H. Vermeulen is a senior researcher based at the University of
Amsterdam, department of Anthropology. Her Ph.D. dissertation chron-
icles the world-making of people with dementia living on their own
in the community in The Netherlands. Her research interests include
phenomenology, philosophical anthropology, responsiveness, collabora-
tive methods, politics of learning. Her current project focuses on how
social networks are being done by people with dementia, their family,
friends, neighbors, and care workers in long-term care. It studies how
these attempts at networking care open up a space for broadening a focus
on dyadic care relations toward networked forms of support in long-term
care.
Bruno Vindrola-Padros is based in the Institute of Archaeology, UCL.
He specializes in material culture studies and is currently exploring mani-
festations of (im)mobilities in the Neolithic period. His interest lies in
understanding how objects have unintended consequences on human
social life when they (are) break(ing). Some of these consequences relate
to social re-categorizations of space, modifications of social practices
through the incorporation of broken objects, and/or the development
of a social care or maintenance of certain objects. He has published arti-
cles in Antiquity and has recently expanded his work into the healthcare
field by publishing in BMJ Quality and Safety.
xvi Notes on Contributors
Cecilia Vindrola-Padros is a medical anthropologist working in the

Department of Targeted Intervention, UCL. One of her research inter-
ests is the exploration of (im)mobilities in healthcare. She has carried out
research on medical travel and has now started to explore microforms
of movement involved in the delivery of care. She is the lead editor of
Healthcare in Motion: (Im)mobilities in Health Service Delivery and Access
(co-edited with Johnson and Pfister, Berghahn Books; 2018).
Dr. Kristen J. Wells is an Associate Professor of Psychology at San
Diego State University. She directs the Cancer Disparities and Cancer
Communication Lab and is Co-Director of the SDSU HealthLINK
Center. Her graduate training was in clinical psychology and public
health, followed by post-doctoral training in behavioral oncology. Her
research focuses on improving the quality of healthcare delivered to
underserved populations. She has led or contributed to multiple studies
that developed and evaluated patient navigation interventions to improve
cancer care, HIV-related care, and mental health. She also develops tech-
nological solutions to improve adherence to recommended cancer care
and oral cancer medications.
List of Figures
Fig. 4.1 Urology Division 69

Fig. 4.2 Patients with appointments to be hospitalized, form a
line here 70
Fig. 4.3 Waiting room 72
Fig. 8.1 Relationship between the body, motility and performed
action 160
Fig. 8.2 Multifaceted experiences of immobility after stroke 176
xvii
1
Immobility and Medicine: An Introduction
Cecilia Vindrola-Padros, Bruno Vindrola-Padros,
and Kyle Lee-Crossett
The social sciences have experienced a “mobilities turn” in the last

two decades, which critiqued fixed and sedentary notions of social
life and drew attention to the constant flows of people, ideas and
objects that permeate our daily lives. This emerging field of thought
proposed to study mobilities “in their own singularity, centrality and
contingent determination” (D’Andrea et al. 2011, 150), creating a new,
dynamic, lens through which to (re)examine social thought and practice
(Soderstrom et al. 2013, vi).
Mobility forms were considered as acting in dialectical relationship
with the immobile, where flows of people, information or objects might
C. Vindrola-Padros (B) · B. Vindrola-Padros · K. Lee-Crossett

University College London, London, UK
e-mail: [email protected]
B. Vindrola-Padros
K. Lee-Crossett
© The Author(s) 2021 1

C. Vindrola-Padros et al. (eds.), Immobility and Medicine,
https://doi.org/10.1007/978-981-15-4976-2_1
2 C. Vindrola-Padros et al.
be interrupted, fixed or suspended at specific time points (Hannam

et al. 2006; Urry 2007). Recent work has highlighted the importance
of thinking about the relation between mobility and immobility, where
movement intersects with processes that might entail episodes of transi-
tion, waiting, emptiness, uncertainty and fixity (Adey 2006; Khan 2016;
Leivestad 2016; Szakolczai 2009). These moments when motion seems
to be frozen in time and space (Adey 2006), when things are stuck,
incomplete or in a state of transition can point to new theoretical,
methodological and practical dimensions in social studies of medicine.
Social studies of health, illness and medicine have drawn from the
mobilities literature to explore the flows of people, patients, medical
technologies and healthcare workers through concepts such as health-
scapes (Llewellyn et al. 2017), biotech pilgrimage (Song 2010), medical
travel (Inhorn 2015; Sobo 2009; Holliday et al. 2019) and mobilities
of wellness (Masuda et al. 2017). Considerable work has been carried
out on mobile technologies in healthcare delivery, mainly in the form of
mhealth or virtual care, such as telemedicine (Lupton 2018). A signifi-
cant amount of attention has been placed on the study of mobility, but
not always in relation to immobility (Vindrola-Padros et al. 2018). This
represents a significant gap in knowledge, as episodes of standing still
or “doing nothing” are critical in shaping daily life routines. As Ehn and
Lofgren (2010) have argued, these mundane activities allow us to explore
how habits, thoughts and feelings are culturally shaped and might even
provide insight into larger and existential social issues.
In this edited volume, we bring the concept of immobility to the
forefront of social studies of medicine to answer the following questions:
• How does immobility shape processes of medical care?

• How does the medical context develop forms of movement and stasis?
• What are the theoretical and methodological challenges of studying
immobility in medical contexts?
• How can we change the ways in which we conceptualise and study
immobility to address these challenges?
We believe that the study of immobility can make contributions to our

understanding of health, illness and medicine by highlighting previ-
ously invisible processes concerning movement and inaction in health
and medicine, particularly in relation to the nature of immobility, that
is, how inaction can lead to the (re)constitution of people, places and
things (Khan 2016). It can illustrate the unequal distribution of mobility
as a resource, mainly when movement is required to maintain health
(Vindrola-Padros et al. 2018), shedding light on how immobility imagi-
naries enable or limit certain kinds of movement and action (Salazar and
Smart 2011). Finally, a study of immobility can foster methodological
innovation by experimenting with new ways to capture movement and
stasis, but also by using stillness or remaining in a fixed place as a method
in itself (Coates 2017). All of these contributions have implications not
only for our current understanding of health, illness and medicine, but
also for the analysis of mobility and immobility in other areas.
“Thinking with” Immobility

The tension between mobility and immobility is made explicit in several
scenarios or cases throughout the book. As we were developing the
content, we encouraged contributors to think about some concepts that
might help frame different manifestations of immobility such as: (1)
liminality, (2) stillness, (3) emptiness, and (4) motility. The chapters
are organised in relation to these different manifestations, alluding to
material culture and materialities, practices, imaginaries and emotions.
Liminality has been widely used in anthropology and other disci-
plines to explore conditions and practices of uncertainty, in-betweenness,
never-ending transition and waiting (Szakolczai 2009) and how these are
(re)produced. As Horvath et al. (2015) have argued, liminality captures
situations where established structures might be dislocated and hierar-
chies reversed, where outcomes are uncertain. These spaces of ambiva-
lence are, nonetheless, central to sustaining social reality (Horvath et al.
2015). In medicine, the concept of liminality has been used to explore
topics such as clinical staff and parents’ experiences of dealing with
uncertain new-born screening results (Timmermans and Buchbinder
2010), liminality and breastfeeding (Mahon-Daly and Andrews 2002),

or waiting for care (Day 2015). The concept of liminality represents a
useful heuristic tool to move beyond binary oppositions (as the liminal
often relates to states of in-betweenness) and focus on incompleteness
and processes of becoming.
The concept of stillness considers physical and imagined restrictions of
movement and a sense of “stuckedness”, fixity or “going nowhere” (Hage
2009). In medicine, stillness is often understood as the state of remaining
motionless or stuck, which can be desired or undesired. For instance,
Gask et al. (2011) have explored the relationship between depression,
isolation and feeling “stuck”, while the gradual loss of motion and slow
succumbing into a “fixed” state has been studied in patients’ experiences
of disrupted motor coordination (McMillan, this volume). An inter-
esting dimension of the concept of stillness is its potential for uncovering
different mobility empowerments (or capacities for movement), where
not all who desire to move will be able to do so.
Emptiness has been associated with processes where markers of
certainty are eroded, leading to a sense of vacuum, where everything
seems to melt into a void. According to Khan (2016), the concept
of emptiness sheds light on the affective dimension of immobility, by
pointing to states or emotions that might be unavailable (Deleuze and
Guattari 2004). Political anthropologists have theorised emptiness in
relation to empty places of power, instances of “authority vacuum, where
the place of power is empty and can only be appropriated temporarily”
(Wydra 2015). In medicine, feelings of emptiness have been analysed in
the context of women’s experiences of miscarriage (Adolfsson et al. 2004)
and couple’s experiences with infertility (Phipps 1993).
Motility refers to the potential for movement, aspirations for move-
ment that are never materialised, movement imaginaries, ideas of incom-
pleteness and never-arriving (Leivestad 2016). It allows us to explore
more symbolic dimensions of immobility in the sense that movement
might only rest in the imaginaries of individuals and never enacted in
practice. In medicine, dimensions of motility are present in the concept
of disnarration proposed by Vindrola-Padros and Brage (2017) to analyse
parents’ stories of their child’s illness, where parents reflect on past and
future scenarios that did not occur, yet are deemed important enough
to be included in the story. The authors reflect on the power of these

hypothetical scenarios for uncovering instances of anxiety and regret in
parents’ stories (Vindrola-Padros and Brage 2017).
Throughout the book, these four concepts are not developed in isola-
tion, but interlace to formulate complex instances of waiting, restraint
and the negotiation of imagined scenarios. The contributors bring these
concepts to life in their rich descriptions of clinical scenarios, individuals’
search for services and their struggles with ill health. The book brings
together contributors from a wide range of disciplines (anthropology,
sociology, social work, medicine, psychology and public health) working
in countries such as Argentina, Canada, Czech Republic, Germany,
Greece, South Africa, Netherlands, Switzerland, the US and the UK.
These contributions highlight the importance of integrating concepts of
immobility to explore experiences of enforced waiting and their effect
on mental and physical health, patients’ search and access to medical
services for cancer treatment and transplants, and embodied experiences
of spinal cord injury, stroke, cancer and dementia.
Immobile Infrastructures and Enforced

Waiting
The chapters in this section of the book highlight the need to consider
the invisible infrastructures of immobility, the processes, structures and
actors that both enable and hinder immobile states. In doing so, however,
they move beyond representations of these immobile states as passive
and, instead, underscore the dynamic role of actors in maintaining and
transgressing them. Bjertrup and colleagues, in their chapter on the
lived experiences of refugees in Greece, argue that the act of waiting has
varying degrees of activity. The authors analyse the disciplining practices
of refugee camps, exploring how these create different emotions and reac-
tions in refugees, with some choosing to leave the indefinite waiting state
and others deciding to “endure the wait”.
The variability of waiting experiences is also explored in the chapter
by Tiseyra and colleagues, documenting the experiences of transgender
patients seeking care in Argentina. According to these authors, the stigma
associated with transgender in this country shapes the waiting experi-

ences of patients who suffer continuous discrimination and humiliation.
The waiting room embodies a history of exclusion and the power rela-
tions inherent to the medical gaze. Through the act of waiting, patients
become disciplined into the ideal concept of the “good patient”.
Processes of waiting are further unpacked in the chapter by Rehsman
on patients’ experiences of being on a transplant waiting list. Rehsman’s
analysis is granular as she considers the waiting list as “bureaucratic tech-
nology, marker of eligibility and symbol for patients’ chances to receive
life-saving treatment”. She presents a detailed account of the material
culture of waiting, the algorithm used to create the list or the telephone
patients will not leave out of their sight, as this is how they will know
if an organ is available for them. These tools and objects act as symbols
of both mobility and immobility and are imbued with emotions such as
fear and hope.
Brage centres her analysis on the concept of liminality, reflecting
on the experiences of families who had to leave their place of origin
to access cancer treatment. According to her, the geographic displace-
ment as well as the uncertainty produced by the disease and treatment
combine to generate a transitional state characterised by ambiguity, lack
of belonging, loss of social ties, isolation and the feeling of “being out of
time”. The liminal states included in the narratives of the parents in her
study demonstrate the central role of immobility in patient and family
therapeutic itineraries.
Embodied Stillness and Fixity

This section focuses on the performative aspects of immobility, the
different ways in which the body becomes still, stuck or fixed. The
authors contributing to this section theorise the body in different ways,
including the “object body” (Stott), the “denying body” (Řezáčová), the
“undeserving body” (Kline, et al.) and the “damaged body” (Llewellyn
and Higgs). These different depictions of bodily experience visualise
embodiment as an active process reconfigured by the individual, which
entails different stages of both movement and stasis.
When analysing the experiences of patients with spinal cord injury,

McMillan asks if medicine reproduces feelings of “stuckedness”. The
SCI body is viewed as “problematic” in the sense that it questions the
central purpose of medicine: cure a disease or fix an injury. The immo-
bility of the injured body is a constant reminder to medicine of its
failure to fulfil its main purpose, leading to negative configurations of
this body that does not comply with its normative role. It signals the
limitations of medical knowledge, as it fails to provide alternative ways of
understanding the SCI body. In this sense, an interesting finding made
by McMillan is the nuanced signs of resistance towards this dominant
discourse, offering alternative conceptualisations of the SCI body where
stuckedness and in-betweenness are recognised and made sense of.
The relationship between injury and disrupted mobility is further
explored in the chapter by Stott on embodied perceptions of immo-
bility after stroke. The unexpected and uncomfortable nature of the
immobile body leads to, what the author has identified as, a psycho-
logical separation between body and self, which ultimately impacted on
patients’ identity. This separation creates intermediate bodily states that
call into question dualistic notions of mind and body and, instead, repre-
sent a multi-modal definition of the body as “heavy”, “unresponsive” or
“untrustworthy”.
The book explores immobility from the point of view of another body,
one suffering from dementia. In their analysis of the lived experiences
of patients with dementia, Collins and Vermeulen (in their respective
chapters) argue that mobility and immobility shape the person’s mental
condition as well as the delivery of care. Two different states of movement
interlace throughout care delivery: the immobile patient with dementia
who must remain still or fixed and the mobile healthcare professional
who must move to carry out their work. The movement of the person
with dementia is always controlled and when this is not so, as in cases of
wandering, the patient is labelled as risky or dangerous. Collins’ chapter
urges us to be sensitive to the different rhythms of movement, variable
gradients of moving and staying still, that coincide in the same clinical
environment. Vermeulen considers the benefits of focusing on instances
of stillness her research participants highlighted as essential components
of their lives, and visualises these as “phenomena that trigger creativity”
and are capable of helping others to make sense of vulnerable moments

in life.
Motility and (Im)Mobile Possibilities

This section focuses on the ways in which imagined possibilities for the
future shape current processes of movement and stillness and potential
strategies for accessing care. The chapters in this section generate inter-
esting discussions on the important role of imagination in (im)mobility
studies, in the form of both anticipation and alternative scenarios
(Stephan and Flaherty 2019). Kline and colleagues use the concept of
motility to examine the efforts of migrant farmworkers to vaccinate their
children against HPV that might never materialise. While the benefits of
vaccination were acknowledged by the participants in Kline et al.’s study,
the structural barriers preventing their (and their children’s) access to
medical services meant that vaccination remained only in the imaginary,
as a distant possibility.
Llewellyn and Higgs also explore the power of the imagination, but
the imagined state is one of the potential immobility that might affect
patients with brain tumours. The patients in their study were “living
suspended”, waiting for the progressive mental and physical debility
generated by their disease. The authors argue that these patients go
through an anticipatory loss of self, that is, “a subjectivity and an inter-
pretation of oneself—mind and brain—produced in the intersubjective
encounters between people with a brain tumour, their families, clini-
cians, biomedical technologies and the physical sensations that emerge
as tumours develop and patients undergo intensive monitoring, surgery
and therapies”. In other words, patients’ projected image of themselves
being mentally lost and deprived of any agency in turn immobilises
patients’ actual daily life. This powerful interpretation of oneself repre-
sents a useful lens through which to understand the experiences of those
living with disease.
Conclusion: Moving the Field of Immobility

and Medicine
The motivation behind the book was to show how mobility cannot
be understood under its own gaze but requires its contraposition
with immobility. The perpetual pull or tension that lies between
these two dimensions frames the medical treatment/healthcare prac-
tices/experiences presented in this book. While we decided to understand
this tension by unpacking immobility into four different domains in
the first instance (i.e. liminality, stillness, emptiness and motility), the
chapter contributors have gone to great lengths to move this emerging
field of thought to different, unplanned, directions.
The evident “take home” messages from these chapters relate to the
need to consider the invisible infrastructures of immobility, exempli-
fied in the waiting list that dictates movement and access to medical
treatment, the refugee camp that facilitates and constrains movement.
Stasis and permanence bring their own sets of challenges and can shift
social practices in any direction. Immobility might seem initially framed
around ideas of impotence or constraint, but being unable to move does
not need to be seen as a disempowering condition. Power can be used to
move others around you, and being “chosen” might mean not having to
move. The “highly-mobile” might also experience barriers to care.
While there are some outstanding contributions drawing from the
concept of liminality (Turner 1992), we feel there is some caution
required with this elusive concept. In many of the experiences described
as liminal in healthcare studies, many social relations appear to be rein-
forced, rather than dissolved or mitigated as the term originally suggests.
Similarly, previously existing conditions of inequality often pervade and
are even accentuated in so-called “transitional” contexts. The concept
does seem to work rather well with highlighting certain aspects of
the experiences described, such as the transformation of social roles,
moments of deep reflection and critique, helping to blur the line between
fixed categories and move away from binary dualisms. Nonetheless, it
certainly should not be regarded as an absolute, as it runs the risk of
obscuring crucial elements of social practice, as well as power relations.
The ethnographic approaches used in many of the chapters of the

volume also highlight the importance of taking into consideration
the interaction of gradients of mobility and immobility in the same
space/bodies. This requires examining the practices of immobility at a
granular level and exploring their reconfiguration in everyday life. A key
aspect of this exploration of practice will be its analysis in conjunction
with the affective dimensions of mobility and immobility: subjective
experiences and feelings of emptiness, fear, hope and stuckedness that
shape the many lives described in this book. These emotional states
underscore aspects of humanity in our study of health and illness and
our understanding of the diseased body and the healthcare establish-
ment, often shaped by our experiences of waiting, exclusion, agency and
everything in-between.
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Part I
Immobile Infrastructures and Enforced
Waiting
2
Lists in Flux, Lives on Hold? Technologies
of Waiting in Liver Transplant Medicine
Julia Rehsmann
Introduction: On Top of a Mountain

Getting comfortable in his armchair, Arthur took another quick glance at
the mobile phone on the coffee table next to him. While I was familiar
with this glance from other social contexts—just quickly checking the
phone before, or even during, a conversation—this look of his carried
an existential urgency and uncertain expectation that shed light on the
particularities of liver transplants. ‘It wasn’t that long ago’, Arthur sighed,
‘I had this terrible nightmare; I was on top of a mountain, enjoying the
fresh air and the amazing view when my phone suddenly rang’. It was his
transplant clinic calling him, telling him that he had to come in imme-
diately because they finally had a donor liver for him. ‘But standing on
the mountain top, it was impossible for me to make it in time to the
J. Rehsmann (B)
Institute of Social Anthropology, University of Bern, Bern, Switzerland
Department of Health Professions, Bern University of Applied Science, Bern,
Switzerland
© The Author(s) 2021 15

C. Vindrola-Padros et al. (eds.), Immobility and Medicine,
https://doi.org/10.1007/978-981-15-4976-2_2
16 J. Rehsmann
hospital’, Arthur said and shook his head in disbelief. It was there on
this mountain top that he missed his chance for a transplant.
In this chapter, I want to use Arthur’s relation to his mobile phone
in his dreams and his everyday life to unpack the ambivalent relation-
ship between mobility and immobility when waiting for a transplant.
Based on ethnographic research in Germany, I focus on the time before
transplantation to discuss the role technologies play in the field of liver
transplants—a field that is characterized by uncertainties, urgency and
delay. In this particular temporality of transplant medicine, such tech-
nologies as mobile phones become a critical feature that shapes the
waiting experiences of patients like Arthur Berger1 by mediating hope
for a life-saving donor liver. Understanding waiting as a temporal experi-
ence that is shaped by hope, uncertainties and expectations, I scrutinize
how the high-tech medical treatment of liver transplants works as a
‘hope-generating machine’ (Nuijten 2003, 16).
In what follows, I take a closer look at the crucial technological
features of this hope-generating machine: how they are constituted, how
they relate to each other, and how they affect patients. Inspired by Geof-
frey C. Bowker and Susan Leigh Star’s (2000) work on information
infrastructures and classificatory practices, I discuss the waiting list as an
invisible infrastructure and classifying technology of this hope-generating
machine. Addressing the issue of visibility brings the materiality of lists
to mind, and I delineate how waiting lists for transplants differ from
common understandings of lists as a fixed, stable order, documented on
paper. Furthermore, I show how these specially configured lists are based
on the invisible workings of a complex computer algorithm. Handing
decisions over to allocation algorithms makes it difficult to understand
the workings of the waiting list and its conclusions. I contend that by
being passed on to a computer program, decisions that have life and
death consequences remain opaque for those affected by algorithms’
calculations and assessments.
After discussing the particularities of lists in flux and the allocating
algorithms they are based upon, I contend that the mobile phone
becomes a critical feature in this invisible infrastructure. I argue that
1 All names have been anonymized by the author.

2 Lists in Flux, Lives on Hold? … 17
in the context of liver transplants, the mobile phone is more than a

mere communication device: it becomes an extension of the invisible
and intangible waiting list. Discussing Arthur’s experience of waiting
for a transplant, I demonstrate how, during waiting, the mobile phone
becomes a tangible manifestation of the ephemeral waiting list, a medi-
ator of hope for a life-saving treatment, as well as a reminder of one’s
dependency on medical care. I show how the mobile phone transforms in
this context from a mere technological communication tool used to reach
people at any time and which increases mobility for those carrying it into
an ambivalent marker of people’s simultaneous mobility and immobility.
Methods
This chapter is informed by 13 months of in-depth ethnographic liver
transplant medicine in Germany that was conducted in 2014 and 2015
and supplemented by several short field trips in 2015–2017. I explored
liver transplant medicine in a variety of locations, from transplant clinics
to people’s home, medical conferences to patient support group meet-
ings. This allowed me to include a wide range of perspectives, from
nurses, hepatologists and transplant surgeons, through administrative
personnel and journalists to patients and their relatives, while focusing
particularly on patients’ experiences before as well as after transplant.
Ethics approval was awarded by the University of Leipzig. Informed by
multiple problem-centred, narrative interviews with 29 patients and 13
medical professionals and other experts, in this chapter, I present one
exemplary patient case to discuss in detail how waiting for a liver trans-
plant is bound up with very intimate considerations concerning life and
death that are contingent on such technologies as algorithms, lists and
mobile phones.
18 J. Rehsmann
Transplant Medicine as a ‘Hope-Generating

Machine’
With his liver failing due to cancer and cirrhosis, Arthur’s fate was bound
up with the medical possibilities transplant medicine in Germany had
to offer. As his failing and tumorous liver would inevitably lead to his
death, Arthur had placed all his hope on a donor liver—as a trans-
plant remains the only long-term treatment available for end-stage liver
failure. It is currently impossible to save everyone who needs a trans-
plant; in Germany, every third person on the wait list for an organ
dies while waiting. Part of public health care, transplant medicine in
Germany is covered by the national statutory health insurance and is
exclusively practised in university hospitals with specialized transplant
clinics. Commissioned by the government, such national institutions as
the German Medical Association (Bundesärztekammer) are crucial in
defining criteria and formulating regulations regarding how organ dona-
tion and transplantation are to be practised at the national level. While
the task of establishing criteria for allocating organs may seem merely
a bureaucratic matter, it is these criteria that decide who in Germany
should be eligible for a transplant and who should not—and thus are
decisive for patients’ treatment and chance of survival.
At the same time, transplant clinics and their organization, special-
ization and means differ significantly across the country, giving rise to a
medical field shaped by particular local practices. While being a nation-
ally regulated and locally shaped practice, German transplant medicine
is also part of transnational flows of expertise and donor organs, espe-
cially as Germany is part of Eurotransplant—the non-profit organization
responsible for the allocation of deceased donor organs in 8 European
countries and across these countries’ boundaries. With multiple organi-
zations and institutions involved in shaping how organs in Germany are
donated as well as transplanted, Arthur’s desire for a liver transplant drew
him into a complex web of legal, political and medical infrastructures and
bureaucracies.
Bureaucracy is so ubiquitous in our lives that, as David Graeber stated,
it ‘has become the water in which we swim’ (2015, 4). Dreaded by most,
bureaucracies affect people differently, and while boredom or annoyance
might ostensibly seem to be the more obvious associations with bureau-

cratic institutions and procedures, Monique Nuijten (2003) discusses
their hope-generating characteristics. In her work on state power and its
relationships with local communities in Mexico, Nuijten examines how
state bureaucracies create expectations by fuelling hopes that ‘everything
is possible’ (ibid., 16) and that ‘things will be different from now on’,
while many of these promises remain unfulfilled. I see the features of
fuelling hopes, and leaving promises unfulfilled, as constitutive elements
in transplant medicine (Crowley-Matoka 2016; Kaufman and Fjord
2011; Sharp 2014) as well. With its promise to save and prolong lives,
transplant medicine fuels the hopes of patients like Arthur that treat-
ment, improvement or survival are possible. While these promises often
turn out ‘to be elusive’ (Crowley-Matoka 2016, 150), it is the desire for
more time and a better quality of life that drives people to commit to the
uncertainties of this medical procedure as well as the uncertain waiting
time for a transplant.
Transplant medicine in Germany relies on deceased donor organs as
the main resource for liver transplants. As the death of potential organ
donors is as unknown as it is unplannable and the suitability of their
organs is equally uncertain, patients like Arthur wait for an indetermi-
nate time for their hoped-for donor organ, never sure whether they will
live long enough that a potential ‘match’ becomes available. Hope and
waiting are closely related, and, as recent anthropological explorations
have demonstrated, both phenomena are defined by a sense of uncer-
tainty (Auyero 2012; Bandak and Janeja 2018; Ehn and Löfgren 2010;
Elliot 2016; Hage 2009; Reed 2011). In their book on different ways of
‘doing nothing’ like daydreaming, routines and waiting, Billy Ehn and
Orvar Löfgren (2010) point to the closely connected characteristics of
hope, uncertainty, liminality and waiting. ‘Above all, it is the liminality
of waiting that makes it a special kind of doing nothing. In-between
events can make people feel stuck, but such events can also generate new
possibilities’ (ibid., 67). In the context of liver transplants, the new possi-
bility people wait for is nothing less than surviving their life-threatening
disease and prolonging their lives. Nonetheless, due to the many uncer-
tainties involved and the particular requirements people on the waiting
list have to meet, patients on the wait list often feel stuck too, trapped
20 J. Rehsmann
in a limbo, not knowing how to live between pending death or potential

survival.
Ghassan Hage (2009) has explored ‘stuckedness’ and ‘immobility’ in
detail by emphasizing the powerful normative discourse about people’s
ability to endure and ‘wait out’ an undesired situation. Being able to
‘properly’ or ‘best’ wait out is also of critical importance to patients
waiting-in-uncertainty for a donor liver—normative discourses that
become most audible and visible in transplant clinics and at patient
support group meetings. Hospital and bureaucratic spaces are saturated
with power relations that shape people’s waiting time, issues that Sophie
Day (2016) and Javier Auyero (2012) have analysed in their respective
work on bureaucratic waiting for healthcare or welfare benefits. Both
authors draw attention to the arbitrariness and indeterminacy of people’s
wait when they need either medical care (Day 2016) or welfare benefits
(Auyero 2012).
The ‘hope-generating machine’ (Nuijten 2003) of liver transplant
medicine offers patients like Arthur, who would otherwise die of organ
failure, a chance of survival, fuelling the hope that they may live for
a couple more years or even decades. This hope unfolds in relation to
an uncertain outcome in future. Receiving a transplant remains a mere
possibility throughout the patients’ wait, with no guarantee that the hope
for treatment will be fulfilled. Because liver transplantation is a form of
life-saving treatment, the uncertainty around whether it can be actual-
ized in time prevails throughout waiting. In other words, death is always
a possibility while hopefully waiting for a liver transplant. I contend that
when livers fail, the resulting existential urgencies and intimate uncer-
tainties (Strasser and Piart 2018) shape the particularities of this form of
‘expectant waiting’ (Elliot 2016).
In her analysis of waiting for migration in North Africa, Alice Elliot
discusses ‘expectant waiting’ and draws attention to the ‘distinctive juxta-
position of certainty and indeterminacy’ (ibid., 110) in spouses’ waiting
to follow their migrated partners. This expectant waiting is character-
ized by the waiting spouses’ sense of certainty about their migration to
come, while it nonetheless remains unclear when this migration will be
actualized, mirroring patients’ experiences of waiting for a liver trans-
plant. Migration, or in the case of my research, a donor liver, turns into
a constant possibility that shapes people’s everyday lives, relations and

subjectivities, causing ‘expectant waiting’ over an indeterminate period of
time. While waiting for migration and for a transplant constitutes very
different forms of waiting, Elliot’s notion of ‘expectant waiting’ draws
attention to the ways in which hope and expectations shape waiting expe-
riences and how a temporal orientation to the future affects how people
live in the present.
In the context of waiting for a transplant, the outcome that people
hope for is to survive their life-threatening liver failure by receiving a
donor organ. A crucial step towards fulfilling this hope is getting access
to the waiting list, because only those on the list are considered eligible
for this high-tech and high-end medical treatment. Thus, carrying the
opportunities for life-saving treatment and the hope of survival, the
waiting list serves as a pivotal marker of eligibility for a liver transplant—
unfolding in a space where the hopeful promises of transplant medicine
meet healthcare infrastructures, legal frameworks and questions of triage.
Lists in Flux
Due to its centrality in allocating potentially life-saving donor livers, the
waiting list requires closer consideration when thinking about technolo-
gies of waiting. Waiting lists are a central feature in German transplant
medicine. They are omnipresent in patients’ and physicians’ narrations;
they are central to medico-legal frameworks; they are mentioned in news-
paper articles about the decreasing numbers of organ donations; and
they played a critical role in the German transplant scandal.2 There
are multiple lists and lists that overlap. Each of the 50 transplant
centres in Germany manages its own waiting list, while these individual
lists are also combined in an international data pool administered by
2The so-called German transplant scandal refers to physicians’ wrongful tampering with patients’
medical files to increase their chances of a transplant (Connolly 2013; Shaw 2013). By doing
so, physicians manipulated the waiting list and interfered with patients’ chance of survival.
A wide-ranging matter across several clinics and transplant programmes, the scandal has led
to changes in the legal regulations and structural requirements of transplant programmes in
Germany.
22 J. Rehsmann
Eurotransplant in Leiden, the Netherlands. Only people registered in

Eurotransplant’s data pool are considered eligible for transplantation, and
it is only among them that the scarce but vital resource of donor livers is
allocated.
The allocation of donor livers does not operate on a ‘first come, first
served’ principle but is based on a complex algorithm that generates
‘match lists’ for each donated organ that becomes available. To get into
this data pool, or to ‘get listed’, is a crucial step towards receiving a trans-
plant—without it, receiving a transplant in a German clinic is legally
impossible. Although the notion of ‘getting on the list’ concerns first and
foremost the inclusion of patients’ data in Eurotransplant’s data pool, no
patient or doctor I encountered ever talked about data pools and algo-
rithms. Patients and medical professionals talked about the waiting list,
mostly how to get on the list and how to stay on it. Exactly how this list
worked was of no interest to those facing a life-threatening liver disease;
what they cared about was getting on the list. ‘Getting on the list’ was
communicated by medics as the defining step on the patients’ way to a
transplant. While it did not mean that patients would get a transplant,
getting on the list gave them a chance of a transplant.
Thus, the moment Arthur Berger had passed all necessary medical
examinations and tests for a liver transplant and was considered eligible
for this form of treatment, his data was forwarded to Eurotransplant
and added to the international data pool administered by the non-profit
organization. From that day onwards, whenever a donor liver in the
Eurotransplant region became available, his data was assessed alongside
that of numerous other patients’ in that region to find the ‘perfect match’
for the available donor liver. At the same time, Arthur’s clinic admin-
istered their own waiting list, of which he was part. The main reason
for such local lists is that clinics are sometimes ‘offered’ a donor organ
directly and have the opportunity to choose a suitable ‘match’ from
among those on their own wait list. This is the case when an organ is
either repeatedly declined by patients, transplant surgeons consider it
unsuitable for their patients, or the organ does not meet the highest
criteria and is designated as a so-called marginal organ. Patients like
Arthur, whose chance of a match is limited by their age and progressive
cancer are often asked whether they would also be willing to accept a
‘marginal organ’ as it significantly increases their chance for a transplant.
To make the process even more complex, the allocation of donor livers
is not only based on medical criteria, but also based on ethical prin-
ciples (who has the best chance of survival vs. who needs a liver most
urgently), patients’ body dimensions (a liver of a certain size will not
fit in just any body or abdomen, but donor and recipient have to be
of similar size) as well as spatial and temporal distances between clinics
(to allow a quick transfer of the donor liver to its recipient). To keep
the organ as healthy as possible for transplantation, this process takes
place under immense time pressure, necessitating quick decisions and
immediate responses. Furthermore, because of the inevitable multiple
back-and-forth telephone calls between countries, clinics, medical profes-
sionals and waiting patients, those on the waiting list for a transplant
have to be reachable day and night 24/7. Thus, telephones, and partic-
ularly mobile phones, become critical technologies for the unfolding of
transplant trajectories, particularly so for patients on the waiting list.
Unlike the digital infrastructures that these lists are now part of,
lists per se are nothing new: they are among the oldest written human
documents (Goody 1977, 74–111). In his investigation of literacy, Jack
Goody considers lists predominantly as a tool of cataloguing, encom-
passing such household inventories as cattle, as well as lists of deities, kin
and servants. In a general sense, generating a list creates order and reduces
complexities, and sometimes the created order is hierarchical, prioritizing
some things over others. Lists are a ‘mode of classifying’ (Goody 1977,
103) and thus intrinsically linked to processes of inclusion and exclusion.
Lists make decisions visible about whom or what should or should not be
put on the list. The reasoning behind what gets on a list and what does
not is not always entirely clear; nevertheless, lists strive to produce the
illusion that everything can be easily classified. As waiting lists for trans-
plants are also the result of classifying practices, giving some the chance
of treatment and excluding others based on medico-legal regulations,
they furthermore have to be understood as a triaging tool.
These cataloguing lists that Goody is writing about are defined by their
materiality and visibility and the boundaries that come with their mate-
rial features. They have clear beginnings and ends; they can be read ‘both
24 J. Rehsmann
sideways and downwards, up and down, as well as left and right’ (Goody
1977, 81). Waiting lists for transplants lack this visibility and materi-
ality, although they present these features as snapshots in the form of
temporary match lists. But these lists remain fleeting and in constant
flux. Moreover, visibility is difficult to define in the context of transplant
medicine with its short-lived match lists and digital data pools. Patients
listed for a transplant are indeed visible to the allocating system as well
as to the people administering these data sets and temporary lists. But it
is only the bureaucratic, administrative aspect of this high-tech medical
treatment that has an overview of all those ‘on the list’ and waiting for an
organ. What becomes visible to the public are a wide range of numbers as
well as medical conditions published in the annual reports of Eurotrans-
plant, the German Association for Organ Donation (DSO) and local
clinics. However, those who are actually waiting do not know who is
waiting along with them.3
Waiting lists for a liver transplant are not worked through from the
top-down, by crossing off one name after another. A clearly defined list
with an obvious order does not exist in this field. What do exist are
digital data sets and organ-specific algorithms of allocation that create
temporary waiting lists (Amelang 2014, 21). While there is a pool of
patients waiting for this form of treatment, concrete ‘match lists’ are
formatted only if an organ becomes available and just for that one organ.
The next donor liver most probably prompts the generation of a very
different list. Patients’ imaginings of ‘getting on’ the waiting list differ
from the reality of accessing liver transplants by means of being added
to an international data pool. Patients as well as physicians describe this
stage as ‘getting on the list’, despite there being no actual list—at least in
Goody’s (1977) terms. Thus, the issue of clear readability and ordering
that Goody (1977) discusses appears to be far from the waiting lists in
liver transplant medicine, whose formation remains opaque for those
whose name might appear under very particular circumstances on such
a list.
3This is the case unless patients on the waiting list get in touch with patient associations or local
support groups, which offer a platform for information and emotional support. Nonetheless,
there tend to be very few patients who are waiting for a transplant at these meetings, as
attendees are usually people who already received a transplant.
In a strict sense, waiting lists are the result of an algorithm cross-

referencing a particular donor organ with all the relevant information
available about patients in Eurotransplant’s data pool. When a donor
organ becomes available, algorithms generate a match list and the organ
is placed with a recipient in accordance with that organ-specific match
list of potential organ recipients. Thus, while patients tend to think that
the transplant system works to find an organ for them, it is rather that the
allocating system looks for the best possible match for each organ that
becomes available. Forming anew with every organ that becomes avail-
able, these ‘match lists’ do not hold their shape for long. Unlike a clearly
defined document listing names, they are fleeting and in constant flux.
Allocating Algorithms
Due to its centrality in creating ‘match lists’ and thus deciding the fate
of patients like Arthur, I want to take a closer look at the algorithm that
is so decisive in the allocation of donor livers as well as the numbers and
scores it generates. With the aim of making the allocation as fair and
impartial as possible, the decision of which donor liver should be offered
to whom is delegated to an algorithm that cross-references such varied
data as blood type, age, height and body weight of donor and recipient
to a make a match. ‘Making a match is ultimately no more than pressing
a button’, the voice-over explains in Eurotransplant’s (2015) company
film, with ‘advanced computer systems’ behind that ‘button’. After all,
who or what else could make the allocation of livers—and triaging of
lives—fairer and more impartial then algorithms calculating numbers?
Highlighting the moral and political features of classifications, Bowker
and Star argue that classifying schemes are ‘ordinarily invisible’ (2000, 2)
and so ubiquitous in our everyday lives that they tend to get overlooked
and taken for granted. Moreover, they point out how an increasing
amount of data is organized in such highly technological and complex
ways that it has become ever more challenging to trace how classifications
and categories are defined, configured and employed. This is relevant to
the system of transplant medicine as well, as it is a field that merges
medical, political and technological terrains (Kierans and Cooper 2011).
26 J. Rehsmann
This invisibility becomes especially problematic when the complexities

of ‘decision making are hidden away inside a piece of technology or in
a complex representation’ (Bowker and Star 2000, 135)—like allocation
algorithms.
As medical anthropologist Katrin Amelang (2014, 23–24) has pointed
out, algorithms in this context represent a political compromise rather
than a purely objective tool for allocation. Decisions about what kind of
factors should be considered relevant in this algorithm are the product
of negotiations and discussion. This is particularly so in the context of a
non-profit organization that allocates organs nationally and internation-
ally and whose member states contribute to the pool of available donor
organs very differently in terms of numbers. Germany, for example,
receives more donor organs from the shared pool than it contributes—in
contrast to other Eurotransplant member states.4
Numbers are decisive in this field, and they are ‘trusted’ (Porter 1996);
they decide whether a patient is too old or sick to be considered a poten-
tial transplant recipient or organ donor. They determine whether a liver
is too fat, too sick, tumours too big or too numerous. Numbers form
the basis on which to establish whether someone meets crucial criteria
and gets included in the pool of those waiting for transplantation or not.
Among all these numbers, the pivotal one for a liver transplant, though,
has been the MELD (Model of End-Stage Liver Disease) score since its
adoption from the United States in 2006. This score, a number between
six and forty that almost every patient I met knew by heart, functions as
the crucial number in liver transplant medicine. It serves as a signpost for
one’s chances of a transplant, as the higher the number the better one’s
chances. This score has real-life consequences for patients like Arthur
whose data is being calculated. After being registered in Eurotransplant’s
4This variation in relative numbers can be explained due to the different legal frameworks for
organ donation in these countries. Unlike other member states, Germany follows an opt-in
system, requiring people’s active consent for organ donations. As numbers have remained low
despite major campaigns promoting organ donation, a change to an opt-out system is currently
being promoted by the German health minister and is causing heated debates. As transplant
medicine relies on the use of human body parts and tissues, the question of organ donation
remains a contested and ethically charged issue. Especially so in a country that has a history
of bodies being misused for experiments under National Socialism, or bodies being considered
state property in the East German socialist state (Hogle 1999, 3).
data pool, and thus ‘listed’ for a transplant, patients’ engagement with
the ways in which their livers, and lives, are assessed, evaluated and classi-
fied becomes more refined and their focus on ‘getting on the waiting list’
is replaced by concerns about their MELD score. What patients rarely
talked about was the fact that the score actually assessed their mortality
risk, calculating the probability of death without a liver transplant over
the next 3 months.
The so-called lab MELD score is the result of a calculation that takes
three laboratory variables into account, combining serum creatinine,
serum bilirubin and the international normalized ratio for prothrombin
time (INR) to calculate people’s mortality risk. ‘The original mathemat-
ical formula for MELD is: MELD = 9.57 × loge(creatinine) + 3.78 ×
Loge(total bilirubin) + 11.2 × Loge(INR) + 6.43’ (Kamath and Kim
2007‚ 797). But not all end-stage liver diseases are considered with these
clearly defined laboratory values. So, for instance, in the case of liver
cancer patients like Arthur, the responsible transplant committee ascribes
a patient a MELD that is supposed to ‘match’ their mortality risk as long
as their cancer stays within clearly defined criteria regarding number and
size of tumours, a so-called matchMELD (Bundesärztekammer 2017).
The matchMELD is intended to make the comparison between patients
possible in order to assess who is most urgently in need of a transplant—
despite the wide range of ways in which liver diseases present themselves,
as well as the singularity of each patient’s experience. These calculations
are driven by the effort to assess mortality risk and control probable
futures, to make the unknown predictable and manageable (Rose 2001).
Like waiting lists that are in constant flux, the MELD score is also a
temporary snapshot, a number that increases and decreases with patients’
fluctuating physical conditions and changing medical values. A patient’s
MELD score, their calculated mortality risk, not only increases with
their deteriorating health, also has the potential to drop when, due to
the liver’s capacity to regenerate healthy tissue, a person’s physical condi-
tion improves. Because the score is grounded in medical values assessed
in laboratories by scientifically proven biomedical methods, it repre-
sents the dominant ideal of evidence-based medicine and is surrounded
by a sense of objectivity and impartiality. Information infrastructures
and technologies like scores, lists and algorithms clarify such aspects as
28 J. Rehsmann
patients’ health, mortality risk or chance of a transplant. But while they

create the impression that the decision-making processes involved are
conducted fairly and objectively, these medical information technologies
obscure how these are shaped by political and moral economies, inti-
mate considerations and individual decisions (Amelang 2014; Rehsmann
2018).
The MELD score is in line with the dominant trend of the increasing
standardization of medical care. Most physicians I encountered in trans-
plant clinics would have favoured a more individualized approach to
medical care and criticized this trend as well as the emphasis on evidence-
based medicine. Simultaneously, many of them also felt ambivalent
about more individualized medical practice. Bureaucratic paperwork
was already a big part of their daily work, and while standardized
forms like checklists do have their limitations (Kocman et al. 2018),
they also reduce the amount of documentation required from medics.
Decisions about medical treatment derived from a less standardized
approach would require much more detailed documentation of all deci-
sions involved. What is more, they would also require more time—one
of the most valuable resources in healthcare institutions and a critical one
when treating people with failing livers.
Waiting-in-Uncertainty, Mobile Phones

and Immobilities
Arthur Berger was one of many patients I came to know in the space
of the transplant clinic who was looking for treatment for their liver
diseases, getting assessed for a transplant or who were already on the
wait list and, thus, in the very midst of the unknowns and uncertain-
ties of waiting for a liver transplant. Slightly older than most other
patients, who were usually in their 50s or early 60s, the 70-year-old was
affected by irreversible liver cirrhosis as well as nonmetastatic liver cancer
and without a transplant his prognosis was grim. Because no long-term
substitute treatments are available for failing livers, like dialysis for kidney
failure, receiving a donor liver becomes a highly urgent matter for those
with irreversible liver failure. In the context of failing livers, time becomes
an extremely limited resource—and waiting for a transplant a particularly

trying experience. While Arthur was listed for a transplant, his eligibility
for a donor liver was continuously reassessed by medical tests and the
clinics’ transplant board. For patients with liver cancer, the number as
well as the size of tumours in the liver have to fit certain criteria. If their
cancerous liver tumours exceed these strict limits, patients are no longer
considered eligible for the treatment that they so urgently need, as they
are assessed to have less chance of surviving the transplantation.
Thus, getting on the waiting list is not a unilinear process that cannot
be revoked. Because of their fluctuating medical condition, patients are
kept under continuous observation to assess their MELD score, to check
their compliance regarding alcohol consumption or to ascertain whether
their liver tumours fit the eligibility criteria. In other words, Arthur’s
eligibility for treatment and with it his chance of survival were not the
result of a one-off assessment. Getting access to the waiting list was not
the end of medical tests, treatments and assessments. What followed was
a continual process of evaluation that lasted for years, with the constant
threat of losing his eligibility.
In addition to the same process that all patients must go through,
regardless of their age or condition, Arthur‘s eligibility was further scru-
tinized due to his advanced age—despite the fact that there is no official
age limit for transplant recipients. It was his treating physician who told
me that he had argued in Arthur’s favour based on his biological age,
because his physical constitution was that of a 60-year-old. Providing
that the growth of his tumours was kept at bay, Arthur’s eligibility for
a liver transplant, i.e. his access to the waiting list, was granted for one
more year. His doctor told me that if he did not receive a donor organ
in that set timeframe, he would be considered too old and no longer
eligible. So, without knowing how much time he had left without a
transplant and how long he would have to wait for a donor liver, Arthur’s
chances got slimmer and slimmer with every month that passed by and
he became increasingly impatient due to his medical emergency. His
eligibility was as fragile as his health and while Arthur was glad that he
was on the waiting list for a transplant, he was concerned whether he
would outlive his wait.
30 J. Rehsmann
When I visited Arthur at home, his mobile phone was omnipresent.

It was always by his side—he took it with him when he went into the
kitchen, into the bathroom—and he could not bear not having it next
to him. He told me that since he had got on the waiting list, he always
kept his phone within reach and made sure that it was charged all the
time and indeed switched on because missing a call, the call, could mean
missing out on his chance of survival. As a tangible manifestation of
the invisible waiting list, the phone seemed to have become his constant
companion—in his daily life and in his dreams. The desire to hear his
phone ring had become so strong for Arthur that he repeatedly ‘heard’
it ringing—mistakenly, as it turned out, again and again—and that the
wished-for ringing sound even followed him into his dreams.
The mobile phone not only symbolized Arthur’s hope for a transplant
was also a continual reminder of his dependency on medical expertise
and technologies. His imaginings of the transplant surgery followed him
into the recurrent nightmares that he suffered from. Again and again, he
was lying conscious and cut open on the operating table, with surgeons
removing flesh and surreal objects such as a children’s bicycle from his
open abdomen. Again and again, he woke up in a cold sweat in the
middle of the night from nightmares so unsettling that he became afraid
of falling asleep. While Arthur’s dream about the transplant clinic calling
him on top of a mountain with his chance of a transplant was signifi-
cantly less violent than these surgical nightmares, it also exemplified his
unease with his life depending on a donor liver, and the sense of ‘exis-
tential immobility’ and ‘stuckedness’ he experienced while ‘waiting out’
(Hage 2009) his wait. With his survival being dependent on a trans-
plant and his lack of control over the duration and outcome of his wait,
Arthur felt like he had no choice but to endure this wait. Unable to live
life the way he wanted, he felt stuck and suffered from the uncertain-
ties this waiting period entailed. Nonetheless, he kept on waiting, as ‘the
more one waits and invests in waiting, the more reluctant one is to stop
waiting’ (ibid., 104), and Arthur did not want to miss out on his chance
of a liver.
Glancing again and again at the phone, lying silent on the table,
Arthur told me that he was bothered by the fact that he could not travel
at the moment. After all, more travelling was one of the main reasons
Another random document with
no related content on Scribd:
212.3 Thureau-Dangin, Les cylindres de Goudéa, p. 57: Les héros
morts leur bouche auprès d’une fontaine il plaça.
212.4 Winckler, op. cit., p. 41.
212.5 Jeremias, op. cit., p. 15.
213.1 E.g. Peiser, Sketch of Babylonian Society, in the Smithsonian
Institute, 1898, p. 586, speaks as if it was ancestor-worship that held

the Babylonian family together.
213.2 Vide my article on “Hero-worship” in Hibbert Journal, 1909, p.
417.
214.1 V. Landau, Phönizische Inschr., p. 15.
214.2 Jeremias, Hölle u. Paradies, p. 37.
215.1 It would be idle for my purpose to distinguish between the so-
called “Achaean” and “Pelasgian” elements in the Homeric Νέκυια;
even if the latter ethnic term was of any present value for Greek
religion.
215.2 Hesiod, Ἔργ. 110-170 (the men of the golden and the silver
ages and the heroes).
216.1 Vide Zimmern in K.A.T.3, pp. 636-639; Jeremias, Hölle u.
Paradies, p. 25; cf. his Die Babyl. Assyr. Vorstellungen rom. Leben
nach dem Tode.
216.2 Vide supra, p. 160.
216.3 Zimmern, op. cit., p. 520; King, op. cit., p. 188.
217.1 King, op. cit., p. 138.
217.2 Lagrange, Études sur les religions sémitiques, p. 493.
218.1 Cf. Keil. Bibl., ii. 109; Jeremias, Hölle u. Paradies, pp. 13-14.
219.1 Jastrow, op. cit., pp. 472-473.
219.2 Ib., p. 473.
219.3 Ib., p. 472.
219.4 Zimmern in Sitzungsber. d. Kön. Sächs. Gesell. Wiss. 1907,
“Sumerisch-Babylonische Tanzlieder,” p. 220.

219.5 Vide Jeremias in his article on “Nergal” in Roscher’s Lexikon,
iii. p. 251.
219.6 It is doubtful if any argument can be based on the name
Ningzu, occasionally found as the name of the consort of Ereshkigal
(Zimmern, K.A.T.3, p. 637) and said to mean “Lord of Healing,” in
reference, probably, to the waters of life.
219.7 Only in the story of Adapa he appears as one of the warders
of the gates of heaven (Zimmern, K.A.T.3, p. 521).

220.1 The story of Aphrodite descending into Hades to seek Adonis
is much later than the period with which we are dealing. Nergal’s
descent to satisfy the wrath of Allatu and his subsequent marriage
with her (Jeremias, Hölle und Paradies, p. 22) is a story of entirely
different motive to the Rape of Kore.
CHAPTER XIII NOTES
223.1 Cook, The Religion of Ancient Palestine, p. 17.
223.2 Researches in Sinai, p. 72, etc., 186: he would carry back the
foundation to the fourth millennium B.C.
223.3 Vide Arch. Anzeig., 1909, p. 498.
223.4 Vide Cults, iii. p. 299.
224.1 Vide Hogarth’s evidence for the date of the earliest
Artemision, Excavations at Ephesus, p. 244.

224.2 Il., i. 38.
224.3 Ib., vi. 269, 299-300.
224.4 Ib., ii. 550.
224.5 Ib., ix. 405.
224.6 Vide Stengel, Griechische Sacral-Altertümer, p. 17.
224.7 Vide Athen. Mittheil., 1911, pp. 27, 192.
225.1 Vide Jeremias in Roscher, Lexikon, ii. p. 2347, s.v. “Marduk.”
225.2 Something near to it would be found in the cult-phrase Ζεὺς
Νᾶος of Dodona, which is a form commoner in the inscriptions than
Ζεὺς Νάϊος, if, with M. Reinach (Rev. Archéol., 1905, p. 97), we
regarded this as the original title and interpreted it as “Zeus-Temple.”
But the interpretation is hazardous.
225.3 A disk on the top of a pole, vide Jastrow, Rel. Bab. Assyr.,
vol. i. p. 203.
226.1 Cook, op. cit., p. 28.
226.2 Religion of the Semites, pp. 185-195; “Mycenaean Tree and
Pillar Cult,” Hell. Journ., 1901. It is interesting to note that Baitylos, a
name derived from the Semitic description of the sacred stone as the
“House of God,” is given as the name of a divine king in the
cosmogony of Philo Byblius, Müller, Frag. Hist. Graec., iii. p. 567; cf.
the baitylos with human head found at Tegea inscribed Διὸς
Στορπάω (fifth century B.C.), “Zeus of the lightning” (Eph. Arch.,
1906, p. 64).
227.1 Vide Evans, op. cit., and Annual of British School, 1908,
1909.
227.2 Vide my Cults, i. pp. 13-18, 102; ii. pp. 520, 670; iv. pp. 4,
149, 307; v. pp. 7, 240, 444.
227.3 For the evidence of a pillar-cult of Apollo Agyieus and
Karneios coming from the north, vide Cults, vol. iv. pp. 307-308.
227.4 The pillars known as “Kudurru,” with emblems of the various
divinities upon them, served merely as boundary-stones (vide
Jastrow, op. cit., i. p. 191; Hilprecht in Babylonian Expedition of
University of Pennsylvania, vol. iv.).
228.1 6, 269.
228.2 Cults, ii. 445.
228.3 Op. cit., vol. v. p. 8.
229.1 Arnob. Adv. Gent., 5, 19 (in the mysteries of the Cyprian
Venus), “referunt phallos propitii numinis signa donatos.”
229.2 Cook, Religion of Ancient Palestine, p. 28; cf. Corp. Inscr.
Sem., i. 11. 6, inscription found in cave, dedicated perhaps by the
hierodulai, “pudenda muliebria” carved on the wall.
229.3 Rel. of Sem., pp. 437-438.
229.4 De Dea Syria, c. 16 and c. 28.
229.5 Histoire de l’Art, iv. pl. viii, D.
230.1 Jeremias, in his articles on “Izdubar” and “Nebo” in Roscher’s
Lexikon, ii. p. 792 and iii. p. 65, concludes that a phallic emblem was
employed in the ritual of Ishtar; but he bases his view on the
translation of the word ibattu in the Gilgamesh Epic, which is
differently rendered by King, Babylonian Religion, p. 163, and
Zimmern, K.A.T.3, p. 572.
230.2 Thureau-Dangin, Les Cylindres de Goudéa, p. 69.
231.1 This may explain the double phrase, used concerning the
institution and endowment of temple-rites in an inscription of the time
of Tiglath-Pileser III., which Zimmern translates by “Opfer-
Mahlzeiten,” Keil. Bibl., iv. p. 103; cf. especially K.B., iii. p. 179 (inscr.
of ninth century); Zimmern, Beiträge zur Kenntniss der Babyl. Relig.,
ii. p. 99 (sacred loaves offered before consultation of divinity).
231.2 Vide Robertson Smith, op. cit., p. 200.
231.3 Vide Cults, i. p. 88; v. p. 199.
232.1 Judges ix. 13; cf. Robertson Smith, op. cit., p. 203.
232.2 Lagrange, Études sur les religions sémitiques, p. 506. This
seems to agree with the statement in Diodorus (19, 94) that the
Nabataeans tabooed wine; yet Dusares, the Arabian counterpart of
Dionysos, was a Nabataean god.
232.3 Gray, Shamash Religious Texts, p. 21.
232.4 Dhorme, Choix, etc., p. 41, l. 136.
232.5 Vide Cults, iii. p. 390, R. 57h.
232.6 Ib., ii. p. 646.
234.1 Robertson Smith, op. cit., pp. 272-273.
234.2 Athenae. 376a (Cults, i. p. 141).
234.3 Cults, ii. pp. 646-647.
234.4 O. Weber, Dämonenbeschwörung, p. 29; his note on the
passage “that the unclean beast is offered as a substitute for an
unclean man” is not supported by any evidence.
234.5 Zimmern, K.A.T.3, pp. 409-410.
235.1 Robertson Smith’s theory that the gift-sacrifice was a later
degeneracy from the communion-type is unconvincing; vide specially
an article by Ada Thomsen, “Der Trug von Prometheus,” Arch. Relig.
Wissensch., 1909, p. 460.
236.1 “Sacrificial Communion in Greek Religion,” in Hibbert Journal,
1904.
236.2 E.g. Il., 1, 457-474; Od., 3, 1-41; 14, 426.
236.3 Cf. Schol. Od., 3, 441 (who defines οὐλοχύται as barley and
salt mixed with water or wine… καὶ ἔθυον αὐτὰ πρὸ τοῦ ἱερείου…
κριθὰς δὲ ἐνέβαλον τοῖς θύμασι χάριν εὐφορίας); Schol. Arist. Equ.,
1167, τοῖς θύμασιν ἐπιβαλλόμεναι [κριφαί]. Vide Fritz. Hermes, 32,
235; for another theory, vide Stoll, “Alte Taufgebraüche,” in Arch.
Relig. Wissensch., 1905, Beiheft, p. 33.
237.1 Vide Evans, “Mycenaean Tree and Pillar Cult,” Hell. Journ.,
1901, pp. 114-115.
237.2 Od., 14, 426; cf. the custom reported from Arabia of mingling
hair from the head of a worshipper with the paste from which an idol
is made.
237.3 Aristoph. Pax., 956.
237.4 Athenae, p. 419, B.
237.5 Vide Arch. Rel. Wiss., 1909, p. 467; Thomsen there explains
it wholly from the idea of tabu.
237.6 The common meal of the thiasotaï is often represented on
later reliefs, vide Perdriyet, “Reliefs Mysiens,” Bull. Corr. Hell., 1899,
p. 592.
238.1 Vide Cults, i. pp. 56-58, 88-92.
239.1 In my article on “Sacrificial Communion in Greek Religion,”
Hibbert Journal, 1904, p. 320, I have been myself guilty of this, in
quoting the story told by Polynaenus (Strategem. 8, 43), about the
devouring of the mad bull with golden horns by the Erythraean host,
as containing an example of a true sacrament.
239.2 Vide Cults, vol. i. p. 145.
239.3 See Crusius’ article in Roscher’s Lexikon, s.v. “Harpalyke.”
240.1 Vide Cults, v. pp. 161-172.
240.2 Ib., v. p. 165.
241.1 K.A.T.3, p. 596.
241.2 Jeremias, Die Cultus-Tafel von Sippar, p. 26.
241.3 Zimmern, Beiträge zur Kennt. Bab. Rel., p. 15.
242.1 Vide Frazer, Adonis-Attis-Osiris, p. 189; cf. “Communion in
Greek Religion,” Hibbert Journ., 1904, p. 317.
242.2 Jeremias, Die Cultus-Tafel von Sippar, p. 28.
243.1 Weber, Dämonenbeschwörung, etc., p. 29.
243.2 iv. R2, pl. 26, No. 6; this is the inscription quoted by Prof.
Sayce (vide infra, p. 182, n.) as a document proving human sacrifice.

I owe the above translation to the kindness of Dr. Langdon; it differs
very slightly from Zimmern’s in K.A.T.3, p. 597.
243.3 Jeremias, op. cit., p. 29.
243.4 Renan’s thesis (C. I. Sem., i. p. 229) that the idea of sin, so
dominant in the Hebrew and Phoenician sacrifice, was entirely
lacking in the Hellenic, cannot be maintained; he quotes Porph. De
Abstin., 1, 2, 24, a passage which contains an incomplete theory of
Greek sacrifice. The sin-offering is indicated by Homer, and is
recognised frequently in Greek literature and legend; only no
technical term was invented to distinguish it from the ordinary
cheerful sacrifice.
244.1 Cults, ii. p. 441.
244.2 Vide K.A.T.3, pp. 434, 599, where Zimmern refers to the
monuments published by Ménant, Pierres gravées, i. figs. 94, 95, 97,
as possibly showing a scene of human sacrifice. But Ménant’s
interpretation of them is wrong; vide Langdon, Babyloniaca, Tome iii.
p. 236, “two Babylonian seals”; the kneeling figure is the owner of
the seal; the personage behind him is no executioner, but Ramman
or Teschub holding, not a knife, but his usual club. The inscriptions
published by Prof. Sayce (Trans. Soc. Bibl. Arch., iv. pp. 25-29) are
translated differently by Dr. Langdon, so that the first one (iv. R2, pl.
26, No. 6) refers to the sacrifice of a kid, not of an infant. The
misinterpretation of the inscription has misled Trumbull (Blood
Covenant, p. 166). The statement in 2 Kings xvii. 31 about the
Sepharvites in Samaria does not necessarily point to a genuine
Babylonian ritual, even if we are sure that the Sepharvites were
Babylonians.
245.1 Babylonian and Assyrian Laws, p. 95.
245.2 The excavations at Gezer have revealed almost certain
evidence of the early practice of human sacrifice; a number of
skeletons, one of a girl sawn in half, were found buried under the
foundation of houses (vide Cook, op. cit., pp. 38-39).
246.1 Stengel, Die griechischen Kultusaltertümer, p. 89.
246.2 K.A.T.3, p. 599.
246.3 Jastrow, op. cit., i. p. 500.
246.4 Might this be the meaning of a line in a hymn translated by
Jastrow, op. cit., p. 549, “I turn myself to thee (O Goddess Gula), I
have grasped thy cord as the cord of my god and goddess” (vide
King, Babyl. Magic, No. 6, No. 71-94); or of the phrase in the
Apocrypha (Epist. Jerem., 43), “The women also with cords about
them sit in the ways”?
246.5 Zimmern’s Beiträge, etc., p. 99.
247.1 On the famous bronze plaque of the Louvre (Jeremias, Hölle
und Paradies, p. 28, Abb. 6) we see two representatives of Ea in the
fish-skin of the god; and on a frieze of Assur-nasir-pal in the British
Museum (Hell. Journ., 1894, p. 115, fig. 10; Layard, Monuments of
Nineveh, 1, pl. 30), two men in lions’ skins; but these are not skins of
animals of sacrifice.
247.2 Vide my Evolution of Religion, pp. 118-120.
248.1 K.A.T.3, p. 49.
248.2 3, 300; 19, 265-267.
248.3 Polybius, 3, 25, ἐγὼ μόνος ἐκπέσοιμι οὕτως ὡς ὅδε λίθος
νῦν.
248.4 Op. cit., ii. p. 217.
250.1 According to Dr. Langdon (op. cit., p. xvi.), the wailing for
Tammuz was developed in the early Sumerian period of the fourth
millennium.
251.1 Langdon, op. cit., 300-341; cf. Zimmern, “Sumerisch-
Babylonische Tamuzlieder,” in Sitzungsber. König. Sächs. Gesell.
Wissen., 1907, pp. 201-252, and his discussion, “Der Babylonische
Gott Tamuz,” in Abhandl. König. Sächs. Gesell. Wissen., 1909.
251.3 Vide Langdon, op. cit., p. 501.
251.4 Antiqu., 8, 5, 3; cf. Clem. Recogn., 10, 24; Baudissin in his
Eschmun-Asklepios (Oriental. Stud. zu Nöldeke gewidmet, p. 752)
thinks that the Healer-god, Marduk Asclepios Eschmun, is himself
one who died and rose again in Assyrian and Phoenician theology.
For Asklepios of Berytos we have the almost useless story of
Damascius in Phot. Bibl., 573 H.; the uncritical legend in Ktesias (c.
21) and Ael. Var. Hist., 13, 3, about the grave of Belitana at Babylon
(to which Strabo also alludes, p. 740), does not justify the view that
the death of Marduk was ever a Babylonian dogma.
252.1 Perrot-Chipiez, Histoire de l’Art, iv. pl. viii.
253.1 Rev. de Philol., 1893, p. 195.
253.2 Vide Frazer, op. cit., pp. 98-99.
253.3 K. O. Müller, Kleine Schriften, vol. ii. pp. 102-103.
253.4 Journ. Roy. Asiat. Soc., 1909, pp. 966, 971; the information
about the true meaning of the ideogram I owe to Dr. Langdon.
254.1 Vide supra, p. 91; cf. Cults, ii. pp. 644-649; iii. pp. 300-305.
254.2 The Babylonian myths of Etana and Adapa, and their ascent
to heaven, may have given the cue to the Phrygian stories of
Ganymede and Tantalos.
256.1 Dr. Frazer, in Magic Art and the Evolution of Kings (G. B., vol.
ii. p. 45), quotes from N. Tsackni (La Russie Sectaire, p. 74) an
example of a fanatic Christian sect in modern Russia practising
castration. I have not been able to find this treatise.
257.1 Vide Cults, iii. pp. 300-301. Dr. Frazer’s theory is that the act
of castration was performed in order to maintain the fruitfulness of
the earth (op. cit., pp. 224-237). But this is against the countless
examples which he himself has adduced of the character and
function of the priest or priest-king as one whose virile strength
maintains the strength of the earth; the sexual act performed in the
field by the owner increases the fruitfulness of the field (Frazer, GB2,
ii. p. 205). Why should the priest make himself impotent so as to
improve the crops? The only grounds of his belief appear to be that
the priest’s testicles were committed to the earth or to an
underground shrine of Kybele (Arnob. Adv. Gent., v. 14, and Schol.
Nikand. Alexipharm., 7; vide Cults, 3; Kybele Ref. 54a); but such
consecration of them to Kybele would be natural on any hypothesis,
and Arnobius’ words do not prove that they were buried in the bare
earth.
259.1 Vide Cults, i. pp. 36-38.
259.2 Vide Evolution of Religion, p. 62.
260.1 Porph. Vit. Pyth., 17; cf. Callim. H. ad. Jov., 8; Diod. Sic., 3,
61; vide Cults, i. pp. 36-37.
260.2 Vide A. Evans in Hell. Journ., xvii. 350.
261.1 Vide Cults, vol. ii. p. 651; cf. Clem. Recogn., 10, 24,
“sepulcrum Cypriae Veneris apud Cyprum.”

261.2 Ib., pp. 651-652.
261.3 Vide Cults, vol. ii. pp. 447, n. c., 478, 638, n. a.
261.4 Aristot. Rhet., 2, 23.
262.1 Athenae, p. 620 A (ζητεῖν αὐτὸν τοὺς ἀπὸ τῆς χώρας μετά
τινος μεμελῳδημένου θρήνου καὶ ἀνακλήσεως); Pollux., 4, 54.

262.2 Frazer, GB2, vol. ii. p. 106.
263.1 Vide Thureau-Dangin, Vorderasiatische Bibliothek, i. p. 77.
263.2 Weber, Arabien vor dem Islam, p. 19.
264.1 Vide Evans in Hell. Journ., 1901, p. 176.
264.2 Cults, i. pp. 184-191.
264.3 Ib., iii. pp. 123-124.
264.4 Ib., iii. p. 176; cf. vol. iv. p. 34 n. b.
264.5 Ib., i. pp. 189-190.
265.1 1, 181.
265.2 Vide, for instance, Dr. Langdon in the Expositor, 1909, p. 143.
265.3 Winckler, Die Gesetze Hammurabi, p. 182.
266.1 Vide Dieterich, Mithras-Liturgie, pp. 126-127; Reizenstein,
Die hellenistischen Mysterien-religionen.

266.2 Vide Herzog’s Real-Encyclop., s.v. “Montanismus.”
266.3 Jourdanet et Siméon transl. of Sahagun, pp. 147-148.
266.4 Golther, Handbuch der Germanischen Mythologie, p. 229; cf.
Mannhardt, Baumkultus, p. 589.
267.1 Pausan., 2, 33, 3; 9, 27, 6; cf. my article in Archiv. für
Religionswiss., 1904, p. 74; E. Fehrle, Die Kultische Keuschheit im
Alterthum, p. 223, gives other examples which appear to me more
doubtful.
267.2 Paus., 3, 16, 1.
267.3 Cults, v. pp. 217-219.
268.1 Vide Cults, v. p. 109.
268.2 Winckler, op. cit., p. 110; Johns, op. cit., p. 54.
269.1 Code, § 182.
269.2 Jastrow, op. cit., ii. 157.
269.3 Vide Winckler’s interpretation of §§ 178, 180, 181; cf. also
Zimmern in K.A.T.3, 423.

269.4 1, 199.
270.1 E.g. Zimmern in K.A.T.3, p. 423.
270.2 Verse 43.
271.1 The first to insist emphatically on the necessity of their
distinction was Mr. Hartland, in Anthropological Essays presented to
E. B. Tylor, pp. 190-191; but he has there, I think, wrongly classified
—through a misunderstanding of a phrase in Aelian—the Lydian
custom that Herodotus (1, 93) and Aelian (Var. Hist., iv. 1) refer to;
both these writers mention the custom of the women of Lydia
practising prostitution before marriage. Aelian does not mention the
motive that Herodotus assigns, the collection of a dowry; neither
associates it with religion. Aelian merely adds that when once
married the Lydian women were virtuous; this need have nothing to
do with the Mylitta-rite.
272.1 E.g. Hosea iv. 13; Deut. xxiii. 18; 1 Kings xiv. 24.
272.2 Weber, Arabien vor dem Islam, p. 18.
272.3 C. I. Sem., 1, 263.
272.4 Strab., 272.
272.5 Strab., 559.
272.6 Pind. Frag., 87; Strab., 378; (Cults, ii. p. 746, R. 99g).
273.1 Cities and Bishoprics, i. 94. In his comment he rightly points
out that the woman is Lydian, as her name is not genuine Roman;
but he is wrong in speaking of her service as performed to a god
(Frazer, Adonis, etc., p. 34, follows him). This would be a unique
fact, for the service in Asia Minor is always to a goddess; but the
inscription neither mentions nor implies a god. The bride of Zeus at
Egyptian Thebes was also a temple-harlot, if we could believe
Strabo, p. 816; but on this point he contradicts Herodotus, 1, 182.
273.2 Et. Mag., s.v. Ἱκόνιον.
274.1 De Dea Syr., 6; cf. Aug. De Civ. Dei, 4, 10: “cui (Veneri) etiam
Phoenices donum dabant de prostitutione filiarum, antequam eas
jungerent viris”: religious prostitution before marriage prevailed
among the Carthaginians in the worship of Astarte (Valer. Max., 2,
ch. 1, sub. fin.: these vague statements may refer either to
defloration of virgins or prolonged service in the temple).
274.2 See Frazer, op. cit., p. 33, n. 1, quoting Sozomen. Hist.
Eccles., 5, 10, 7; Sokrates, Hist. Eccles., 1, 18, 7-9; Euseb. Vita
Constantin., 3, 58. Eusebius only vaguely alludes to it. Sokrates
merely says that the wives were in common, and that the people had
the habit of giving over the virgins to strangers to violate.
Sozomenos is the only voucher for the religious aspect of the
practice; from Sokrates we gather that the rule about strangers was
observed in the rite.
274.3 18, 5.
274.4 This is confirmed by the legend given by Apollodoros (Bibl., 3,
14, 3) that the daughters of Kinyras, owing to the wrath of Aphrodite,
had sexual intercourse with strangers.
275.1 Justin, 21, 3; Athenaeus, 516 A, speaks vaguely, as if the
women of the Lokri Epizephyrii were promiscuous prostitutes.
275.2 Pp. 532-533.
275.3 The lovers, Melanippos and Komaitho, sin in the temple of
Artemis Triklaria of the Ionians in Achaia; the whole community is
visited with the divine wrath, and the sinners are offered up as a
piacular sacrifice (Paus., 7, 19, 3); according to Euphorion,
Laokoon’s fate was due to a similar trespass committed with his wife
before the statue of Apollo (Serv. Aen., 2, 201). It may be that such
legends faintly reflect a very early ἱερὸς γάμος once performed in
temples by the priest and priestess: if so, they also express the
repugnance of the later Hellene to the idea of it; and in any case this
is not the institution that is being discussed.
276.1 Antike Wald u. Feld Kulte, p. 285, etc.
277.1 Why should not the priestess rather play the part of the
goddess, and why, if we trust Plutarch (Vit. Artaxerx., 27), was the
priestess of Anaitis at Ekbatana, to whose temple harlots were
attached, obliged to observe chastity after election?
277.2 Vol. i. pp. 94-96.
277.3 Op. cit., p. 35, etc.
277.4 Op. cit., p. 44.
278.1 I pointed out this objection in an article in the Archiv. f. Relig.
Wissensch., 1904, p. 81; Mr. S. Hartland has also, independently,
developed it (op. cit., p. 191).
278.2 Vol. ii. p. 446.
278.3 Origin of Civilisation, pp. 535-537.
279.1 Vide Westermarck, History of Human Marriage, p. 76.
279.2 Mr. Hartland objects (loc. cit., p. 200) to this explanation on
the ground that the stranger would dislike the danger as much as
any one else; but the rite may have arisen among a Semitic tribe
who were peculiarly sensitive to that feeling of peril, while they found
that the usual stranger was sceptical and more venturesome: when
once the rule was established, it could become a stereotyped
convention. His own suggestion (p. 201) that a stranger was alone
privileged, lest the solemn act should become a mere love-affair with
a native lover, does not seem to me so reasonable; to prevent that,
the act might as well have been performed by a priest. Dr. Frazer in
his new edition of Adonis, etc. (pp. 50-54), criticises my explanation,
which I first put forth—but with insufficient clearness—in the Archiv.
für Religionswissenschaft (1904, p. 88), mainly on the ground that it
does not naturally apply to general temple-prostitution nor to the
prostitution of married women. But it was never meant to apply to
these, but only to the defloration of virgins before marriage. Dr.
Frazer also argues that the account of Herodotus does not show that
the Babylonian rite was limited to virgins. Explicitly it does not, but
implicitly it does; for Herodotus declares that it was an isolated act,
and therefore to be distinguished from temple-prostitution of
indefinite duration; and he adds that the same rite was performed in
Cyprus, which, as the other record clearly attests, was the
defloration of virgins by strangers. Sozomenos and Sokrates attest
the same of the Baalbec rite, and Eusebius’s vague words are not
sufficient to contradict them. One rite might easily pass into the
other; but our theories as to the original meaning of different rites
should observe the difference.
280.1 But vide Gennep, Les Rites de passage, p. 100.
280.2 Cf. Arnob. Adv. Gent., 5, 19, with Firmic. Matern. De Error.,
10, and Clemens, Protrept., c. 2, p. 12, Pott.
281.1 1, 199.
281.2 The lady who there boasts of her prostitute-ancestresses
describes them also as “of unwashed feet”; and this is a point of
asceticism and holiness.
282.1 Op. cit., p. 199.
282.2 K.A.T.3, p. 423.
283.1 Vide supra, p. 163. The writer of the late apocryphal
document, “The Epistle of Jeremy,” makes it a reproach to the
Babylonian cult that “women set meat before the gods” (v. 30), and
“the menstruous woman and the woman in child-bed touch their
sacrifices” (v. 29), meaning, perhaps, that there was nothing to
prevent the Babylonian priestess being in that condition. But we
cannot trust him for exact knowledge of these matters. Being a Jew,
he objects to the ministration of women. The Babylonian and Hellene
were wiser, and admitted them to the higher functions of religion.
283.2 Vide Cults, iv. p. 301.
283.3 Vide Inscription of Sippar in British Museum, concerning the
re-establishment of cult of Shamash by King Nabupaladdin, 884-860
B.C. (Jeremias, Die Cultus-Tafel von Sippar).
284.1 Sumerian and Babylonian Psalms, p. 75.
284.2 Vide Langdon in Transactions of Congress for the History of
Religions (1908), vol. i. p. 250.
284.3 Vide Zeitung für Assyriologie, 1910, p. 157.
284.4 Formula for driving out the demon of sickness, “Bread at his
head place, rain-water at his feet place” (Langdon, ib. p. 252).

284.5 Delitsch, Wörterbuch, i. 79-80.
284.6 Zeit. für Assyr., 1910, p. 157.
284.7 Vide Hippocrates (Littré), vi. 362; Stengel, Griechischer
Kultusaltertümer (Iwan Müller’s Handbuch, p. 110).
285.1 Referred to in the comedy of Eupolis called the “Baptai.”
285.2 Jastrow, op. cit., p. 500.
285.3 Op. cit., p. 297, 487; the priest-exorciser, the Ashipu, uses a
brazier in the expulsion of demons.
285.4 Vide Golther, Handbuch der Germanischen Mythologie, p.
580; cf. my Cults, v. p. 196.
285.5 Cults, vol. v. pp. 383-384; cf. iv. p. 301.
286.1 Cults, v. p. 356; cf. p. 363 (the purifying animal carried round
the hearth).
286.2 Eur. Herc. Fur., 928.
286.3 Dio Chrys. Or., 48 (Dind., vol. ii. p. 144), περικαθήραντες τὴν
πόλιν μὴ σκίλλῃ μηδὲ δαδί, πολὺ δὲ καθαρωτέρῳ χρήματι τῷ λόγῳ
(cf. Lucian, Menipp., c. 7, use of squills and torches in “katharsis,” (?)
Babylonian or Hellenic); Serv. ad Aen., 6, 741, “in sacris omnibus
tres sunt istae purgationes, nam aut taeda purgant aut sulphure aut
aqua abluunt aut aere ventilant.”
286.4 “To take fire and swear by God” is a formula that occurs in the
third tablet of Surpu; vide Zimmern, Beiträge zur Kenntniss Babyl.
Relig., p. 13; cf. Soph. Antig., 264.
286.5 Salt used as a means of exorcism in Babylonia as early as
the third millennium (vide Langdon, Transactions of Congress Hist.
Relig., 1908, vol. i. p. 251); the fell “of the great ox” used to purify the
palace of the king (vide Zimmern, Beiträge, p. 123; compare the Διὸς
κῴδιον in Greek ritual).
287.1 Vide Thureau-Dangin, Cylindres de Goudéa, pp. 29, 93.
287.2 Vide Evolution of Religion, pp. 113, 114, 117; Cults, v. p. 322
(Schol. Demosth., 22, p. 68).
287.3 5, 13, 6.
287.4 Vide Cults, iii. pp. 303-304; Evolution of Religion, p. 121.
288.2 Vide Cults, iii. p. 167.
288.3 Published in Zimmern’s Beiträge, p. 123; cf. Weber,
Dämonenbeschwörung, pp. 17-19.
289.1 Il., xvi. 228.
289.2 Od., ii. 261.
289.3 Il., i. 313.
290.1 Od., xxii. 481: In the passage referred to above, Achilles uses
sulphur to purify the cups.
290.2 Od., xiii. 256-281: This is rightly pointed out by Stengel in his
Griechische Kultusaltertümer, p. 107.
290.3 Evolution of Religion, pp. 139-152; Cults, iv. pp. 295-306.
291.1 Vide Cults, iv. pp. 144-147, 300: To suppose that Hellas learnt
its cathartic rites from Lydia, because Herodotus (i. 35) tells us that
in his time the Lydians had the Hellenic system of purification from
homicide, is less natural. Lydia may well have learnt it from Delphi in
the time of Alyattes or Croesus. Or it may have survived in Lydia as
a tradition of the early “Minoan” period; and, similarly, it may have
survived in Crete.
291.2 Vide supra, pp. 176-178.
292.1 Vide Cults, iv. pp. 268-284.
292.2 For similar practices, vide Cults, pp. 415-417.
292.3 Clem. Alex. Strom., p. 755, Pott.
293.1 Paus., 9, 33, 4.
293.2 For the facts vide Zimmern, K.A.T.3, p. 592.
294.1 Works and Days, l. 824.
294.2 Ib., l. 804.
294.3 Expositor, 1909, p. 156.
294.4 Vide Photius and Hesych., s.v. Μιαραὶ ἡμέραι.
295.1 Hell., 1, 4, 12.
295.2 Vide Cults, v. pp. 215-216.
295.3 Cults, iv. p. 259.
295.4 Vide supra, pp. 176-177.
296.1 Sumerian and Babylonian Psalms, p. 196.
296.2 King, Babylonian Religion, p. 196.
296.3 Vide Fossey, La Magie Assyrienne, p. 96.
297.1 Knudtzon, Assyrische Gebete an den Sonnengott, p. 78
(texts belonging to period of Asarhaddon, circ. 681).
297.2 Zimmern, Beiträge, etc., p. 161.
298.1 Zimmern, Beiträge, etc., p. 163.
298.2 Fossey, op. cit., p. 399.
298.3 iv. R. 56, 12; Fossey, op. cit., p. 401.
298.4 Expositor, 1909, p. 150, giving text from iv. R. 40.
299.1 Fossey, op. cit., p. 209.
299.2 Zimmern, Beiträge, p. 173.
299.3 Supra, p. 176.
299.4 Zimmern, op. cit., p. 169.
300.1 Zimmern, Beiträge, pp. 30-31; he mentions also the similar
practice of tying up a sheepskin or a fillet of wool and throwing it into
the fire.
300.2 Zimmern, op. cit., p. 33: note magic use of knots in general,
vide Frazer, G.B.2, vol. i. pp. 392-403; Archiv. für Religionsw., 1908,
pp. 128, 383, 405. The superstition may have prevailed in Minoan
Crete (see A. Evans, Annual British School, 1902-1903, pp. 7-9) and
was in vogue in ancient Greece.
300.3 W. Warde Fowler, The Religious Experiences of the Roman
People, Gifford Lectures, p. 49.
301.1 Vide supra, pp. 248-249; Cults, iv. p. 191.
301.2 For the main facts relating to the Babylonian system and the
“baru”-priests, vide Zimmern, Beiträge, etc., pp. 82-92; for the

Hellenic, vide Cults, iv. 190-192, 224-231; also vol. iii. 9-12.
301.3 The documentary evidence, from a very early period, is given
by Zimmern, Beiträge, etc., pp. 85-97.
301.4 L. 322: Clytemnestra speaks of pouring oil and vinegar into
the same vessel and reproaching them for their unsociable
behaviour.
302.1 We have also one example of an oracle of Ishtar (in plain
prose), Keil. Bibl., ii. p. 179.
303.1 Zimmern, op. cit., p. 89.
303.2 Cults, iii. p. 297.
303.3 Lucian, De Dea Syr., 43.
303.4 Cults, iii. p. 297.
303.5 Vide Cults, iv. pp. 191-192; iii. p. 11.
TRANSCRIBER’S NOTES.
Page numbers are given in {curly} brackets.
Plain text version only: endnote markers are given in [square]
brackets.
Minor spelling inconsistencies (e.g. coexist/co-exist, temple-
ritual/temple ritual, etc.) have been preserved.
Add title, subtitle, and author’s name to cover image.
Alterations to the text:
Convert footnotes to endnotes, relabel note markers (append the
original note number to the page number), and add a corresponding
entry to the TOC.
[Title page]
Add commas to author’s bibliography.
[Chapter I]
Change “from the tyranny of a morbid ascetism” to asceticism.
[Chapter III]
“In his Historie des anciennes Religions, Tiele classifies” to
Histoire.
“and their aboriginal god was Possidon” to Poseidon.
[Chapter IV]
“and expecially the powers of the lower world” to especially.
“Even Allat, the goddess of Hell, she who” to Allatu.
“the great Assyrian god Ahshur is quaintly expressed” to Asshur.
“the idea that Istar is the compeer in power” to Ishtar.
“between the Hittites and the Assyrian Babylonian kingdom” to
Assyrian-Babylonian.
“no clear trace of theriomophism either in the” to theriomorphism.
“how far the Minaon religion was purely anthropomorphic” to
Minoan.
[Chapter V]
“I formerly developed in the second volume of my cults” capitalize
and italicize cults.
[Chapter VI]
“Still less is Allalu, the monstrous and grim Queen” to Allatu.
[Chapter VII]
(Alalkomenai, “the places of Athena Alalkomene; Nemea, “the…)
add right double quotation mark after Alalkomene.
[Chapter VII]
“about whom he is particulurly thoughtful” to particularly.
[Chapter IX]
“and regards this Hititte goddess as the ancestress” to Hittite.
[Chapter XIII]
“modern savagery and the history of ascetism” to asceticism.
(and bewail her”: “If you regard her as a deity, do) delete right
double quotation mark.
[Index]
“Hell, Babylonian conception of, 205-206” add period at end of
line.
[Endnotes]
(Page 17, note 1) “Archiv fur Religionswissenschaft, 1904.” to für.
(Page 42, note 1) “that the idiogram of Enlil, the god of” to
ideogram.
(Page 84, note 3) “last of the Babylonian kings, Nabuna ’id, who
prays” to Nabuna’id.
(Page 124, note 1) “Die Phoenizischen Imschriften,” to
Phönizischen Inschriften.
(Page 148, note 1) “Weber, Dämonenbeschworung bei den
Babyloniern…” to Dämonenbeschwörung.
(Page 183, note 3) “pp. 502 503, n. 2” add comma after 502.
(Page 232, note 2) “Lagranges, Études sur les religions
sémitiques” to Lagrange.
(Page 246, note 1) “Stengel, Die griechischen Kultusalterthümer,
p. 89” to Kultusaltertümer.
(Page 286, note 5) “vide Zimmern, Beitrage, p. 123;” to Beiträge.
[End of text]
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Immobility and Medicine: Exploring

Stillness, Waiting and the In-Between

ISBN 978-981-15-4975-5 ISBN 978-981-15-4976-2 (eBook)

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1 Immobility and Medicine: An Introduction 1

Part I Immobile Infrastructures and Enforced Waiting

2 Lists in Flux, Lives on Hold? Technologies of Waiting

3 ‘Being Stuck’: Refugees’ Experiences of Enforced

4 ‘An (Im)Patient Population’: Waiting Experiences

5 Living in ‘Limbo’: Immobility and Uncertainty

Part II Embodied Stillness and Fixity

6 Embodying Immobility: Dysphoric Geographies

7 Liminality and the SCI Body: How Medicine

8 Embodied Perceptions of Immobility After Stroke 155

9 “When You Do Nothing You Die a Little Bit”: On

10 Stories of (Im)Mobility: People Affected by Dementia

Part III Motility and (Im)Mobile Possibilities

11 Migratory Labour and the Politics of Prevention:

12 Living Suspended: Anticipation and Resistance

Jihane Ben Farhat is an epidemiologist and biostatistician at Epicentre

2010 and was appointed as co-director of the Health in Humani-

Marine Gálvez, B.A. in Gender Studies and Political Science from

scientific knowledge production, medical diagnosis, treatment decision-

who pays for sex in Argentina,” and co-directs “Anti-trafficking campaign

member of the Collaborative for Research Understanding Sexual Health

Cecilia Vindrola-Padros is a medical anthropologist working in the

Fig. 4.1 Urology Division 69

The social sciences have experienced a “mobilities turn” in the last

C. Vindrola-Padros (B) · B. Vindrola-Padros · K. Lee-Crossett

© The Author(s) 2021 1

be interrupted, fixed or suspended at specific time points (Hannam

• How does immobility shape processes of medical care?

We believe that the study of immobility can make contributions to our

“Thinking with” Immobility

2010), liminality and breastfeeding (Mahon-Daly and Andrews 2002),

to be included in the story. The authors reflect on the power of these

Immobile Infrastructures and Enforced

associated with transgender in this country shapes the waiting experi-

Embodied Stillness and Fixity

When analysing the experiences of patients with spinal cord injury,

and are capable of helping others to make sense of vulnerable moments

Motility and (Im)Mobile Possibilities

Conclusion: Moving the Field of Immobility

The ethnographic approaches used in many of the chapters of the

Stephan, C., and D. Flaherty. 2019. “Introduction Experiencing Anticipation:

Introduction: On Top of a Mountain

© The Author(s) 2021 15

1 All names have been anonymized by the author.

in the context of liver transplants, the mobile phone is more than a

Transplant Medicine as a ‘Hope-Generating

might ostensibly seem to be the more obvious associations with bureau-

in a limbo, not knowing how to live between pending death or potential

a constant possibility that shapes people’s everyday lives, relations and

Eurotransplant in Leiden, the Netherlands. Only people registered in

In a strict sense, waiting lists are the result of an algorithm cross-

This invisibility becomes especially problematic when the complexities

patients’ health, mortality risk or chance of a transplant. But while they

Waiting-in-Uncertainty, Mobile Phones

an extremely limited resource—and waiting for a transplant a particularly