The Full Monty: Cultures, Margins and Meanings

Leaving Church at Wounded Knee:

“I hear you are a doctor now”….

Working in Old Age Home

“It’s nice they let you out once in awhile”

Premature Entitlement—first the title then the lecture (Fogelson method)

what I want to do today (in an hour—trap door opens and I’m ejected back to arts

and sciences)

apologia for title (in classical sense) explanation

Anthropological Approach to Margination

The Full Monty

Holistic Approach

Anthropologists study everything—the ultimate parasitic science

“Tapestry” an apt metaphor for culture

Jesuit Education – Holistic Approach – Christian Humanism of the Renaissance

Jesuits scientists, linguists, playwrights, artists, architects, theologians,

Explorers

Holism in medicine – you deal with a patient in a context (not just a liver –

Reader’s Digest: “I am Joe’s Liver” “I am Joe’s Pancreas”

Cultures

Multiculturalism the buzzword

19^th century—belief there was but one culture

difference accounted for by evolutionary progress

savage – barbarian – civilized

Anthropology—the study of culture

Anthropologist – someone who rejects his culture shortly before his

Culture rejects him

Definitions of culture:

"A society's culture consists of whatever it is one has to know or believe in order to operate in a manner acceptable to its members" (Ward Goodenough).

Culture is "an historically transmitted pattern of meanings embodied in symbols, a system of inherited conceptions expressed in symbolic form by means of which men communicate, perpetuate, and develop their knowledge about and attitudes towards life" (Clifford Geertz).

Meanings

Culture is about meaning:

meaning is created in a social and historical context

key to symbolic anthropology

3 out of work academics become umpires

empiricist – I call them the way I see them

realist – I call them the way they are

symbolic anthropologist – they ain’t nothing until I call them

signs and symbols

sign – one meaning “Stop sign” “highway salute”

symbol – multiplicity of meanings

bottle of pills – label – sign (one every 4 hours)

symbol – healing ~~ so take more

placebo effect ~~ the power of symbols

Margins

Historical roots in maps

Anthropologically: Anthony F C Wallace “Mazeways” –

cultural/mental maps of cosmos

12^th Century Psalter Map (from prayer books):

Small version of Psalter Map: Click on image to enlarge

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Christocentric Universe

Biblical Universe

Center – Jerusalem

Center of the world (from larger map above)

Click on image to enlarge

Incorporated Fact and Fancy

Look at the margins (home of Blemmies, Cyclopses, and Monopods):

Those placed in the margins (part of larger map above)

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Margin- The marginal “out there”

Different from the “cutting edge” – positive valuation of

Marginal

Negative valuation – we literally put people “out” at edge

Prisons (2.1 million), asylums, other institutions

Complex issue BUT…..

Sociological Definitions of Margination

inability to participate equitably in the social goods of a group

may be by choice or by imposition

self-exclusion or imposed social/economic/religious

exclusion

The world changes:

Copernican Revolution

De revolutionibus – 1540s

Click Image To Enlarge

Earth no longer the center of the universe –

Heliocentrism vs Geocentrism vs Relativism (physics trumps

Astronomy – thought astronomy course would look at stars!)….

Anthropological equivalents:

Cultural Relativism vs Ethnocentrism

Anthropological Definition of Margination

inability to fit into the symbolic mazeway of the specific group –

mental or institutional - economic, social, -- across categories

(Goodenough and Wallace)

Astronomers give us a relational view of the world—

depends on where you stand when you are looking

Anthropology does the same by studying a culture “from within” Cultural Relativism

learn the local perspective

cultural definition of the universe

center and periphery shift

for example poverty:

Western definition – Economic

under a certain earning level

Micronesia – US Trusteeship

send out commodity foods

people self-sufficient but not a money economy

Lakota definition – kinship

you are poor if you lack family and relationships

above economic considerations—Wihpeya – give away

Thus at times YOU will be marginal

to ethnic, social, sexual and economic groups

But you will also be central – Very Central to US Health Care System

health care provider -- revered and reviled

You need to be able to balance positions and perspectives and still hold your stethoscopes:

Shalom Alechem “Fiddler on the Roof”

Village Arbiter: one man says it’s a horse another it’s a mule.

Arbiter agrees with them both

Someone in the crowd says they can’t be both right

Arbiter says “And you’re right too!”

Why Jesuit Anthropology?

Anthropology

Key to discipline – participant observation

Dialogue – interaction with patients and their contexts

Tough in the whirlwind of care

But key to quality of care and dignity of persons

learn to see (albeit imperfectly) from another perspective

respect and value that perspective – don’t necessarily adopt it

learn to observe -- see the value in that….

early ethnographers of Lakota were all doctors

James Walker— 1890s alleviate tuberculosis

Charles Eastman (Dakota Indian) – 1890s general practitioner

Robert Ruby – 1955 General Health

Thomas Lewis – 1960s Mental Health

disease is disease but interpreted through cultural lenses

as much a matter of religion in most cultures as science

remember TAPESTRY – interconnected threads

your patients will have these perspectives

Jesuit

preferential option for the poor:

perspective of Hebrew, Islamic and Christian scriptures

Ignatius’ perspective

work in hospitals – Aloysius Gonzaga (patron of AIDS

victims) dies while caring for plague victims in Rome

Who are the marginated?

Perspective but not simply relative (avoid the Red Queen approach – things mean

anything I want them to mean

or avoid the postmodern approach == epistemological hypochondria

cross a postmodernist with a mafioso?

Your task is to gain the perspective—one of dignity and respect for these “others” – solidarity (option means embracing love in Jesuit mind—not intellectual choice)

Ethnic margination: Native Americans, Hispanics, African American

Economic margination: the poor, homeless

Physical margination: deaf, mentally retarded, physically disabled, mentally ill

Biological margination: hiv/aids

Cultural margination: homosexuals, drug users, elderly, dying

Talking with a friend about being out of place in graduate school—grew up in blue color industrial town – parents were hairdressers

he reminded me that Ph D academics were less than 1% of the

United States’ population

center and margin…..

The challenge:

Use the power you have as part of the center – education, skill, training

Remember that at the same times you are in solidarity with these people –

you are on the margins also in one way or the other

Lakota – be respectful

Bedside manner

Not as simple as may seem in our diverse country

Cultural manner

Recognize that you are in the center “Jerusalem”

Respect the center in which your patients stand – even though different

From your own!

Ignatius: Desire to be a "Help of souls" -- not simply spiritualized

Ignatius: Preferential Option for the poor-- radically counter-cultural !

Ignatius: Women and men for others.