“Remodelling a medical brain: Thinking Anthropologically”…

Paulina Pérez-Duarte Mendiola

MSc Medical Anthropology & Pediatrician

DR KELEKIAN: This treatment is the strongest thing we have to offer you. And, as research, it will make a significant contribution to our knowledge.

VIVIAN: Knowledge, yes.

W;t A Play by Margaret Edson

I entered the room a paediatrician and left ninety minutes later… as someone else. 

A couple of Thursdays ago, in a Medical Anthropology seminar, Dr. Caroline Ackley discussed ‘Post-mortem tissue sampling in children under-5 in Kersa District, Ethiopia’.In doing so, she mentionedCHAMPS (Child Health and Mortality Prevention Surveillance), an effort funded by the Bill Gates Foundation, who are investigating the causes and reason(s) behind high mortality rates in this region of Africa.

Their methodology, explained somewhat crudely, is based mainly on taking tissue samples from cadavers. They are analysing the microbiology, pathology and more. Sampling from brains, lungs, bone marrow, livers, hearts, kidneys, placentas, stools, urine, cerebral spine fluid, etc. This is known as MITS (Minimally Invasive Tissue Sampling).

As the seminar unfolded, my paediatric and science-focused mind was questioning and analysing their methodology and approach: the way they were taking the samples, the number of cadavers they had tested so far, etc. But then, suddenly, Dr. Ackley changed, it was like she turned into someone else. She went into, what I like to call, ‘anthropologist mode’. An interesting sub-species somewhere between adventurer and storyteller.

She shared narratives related to her field work: the suffering of the affected families; their reactions when the research team asked for consent; the long journey from home to the research facility; the unnerving echoes made by the needle that takes each of those one hundred samples… in my mind the image was real. I totally understood why people in the village called them ‘deadly sucking vampires ’.

Suddenly, my train of thought and mind-set switched… Unfortunately, I have a lot of experience when it comes to deathand children literally dying in my arms, but I started to wonder how those around me, my (non-medical) colleagues, were picturing this terrifying narrative. What images were flashing through their own personal imaginarium.

Dr. Ackley’s words threw me into a spiral. She was sharing with us the human side of this experience, the suffering and the thoughts of the families that were ‘making a significant contribution to knowledge’.

Mini tangent… Many years ago, I came across a play by Margaret Edson, titled Wit (W;t). It is the heartwrenching story of Vivian Bearing, a fifty-year old university professor of seventh-century poetry, who was diagnosed with advanced metastatic ovarian cancer. The play narrates her excruciating experience while going through an experimental (and strong) chemotherapy treatment. A path she agreed to take as, according to her oncologist, there were no other options and ‘it will make a significant contribution to our knowledge’.

I don’t want to ruin the play for you, but in the end, she dies. She reveals as much on the first page of the script. But you can see, hear and feel her pain and suffering  throughout the play… until the suffering is finally over. All because of this ‘it will make a significant contribution to our knowledge’.

So why the theatrical detour? Well, at the beginning of the seminar, my mind was thinking only about the methodology. From a medical or scientific perspective. Naturally lots of question swam through my mind. But suddenly all those questions vanished; they became completely stupid (and irrelevant). This happened when I opened my eyes and ears to the anthropological side of the story.

The thoughts of the people in the village, the tears and suffering of the parents, their complaints about the lack of medical attention BEFORE it was too late… it all made me wonder. What’s the point of this study? Is it really going to change their lives and soothe their struggles? Is it really going to stop so many other kids from dying? Or is just another play trying to ‘make a significant contribution to our knowledge’? 1

It seems that my pediatric/medical ‘rectangular’ brain is receiving the beating of its life. The more I delve into this ‘Medical Anthropology’ field, the more I feel like my brain is changing its own shape and form. Maybe, at the end of this year of intellectual struggle, I will leave UCL with a pentagonalshaped brain? And… hopefully, some day, I will learn how to ‘remodel’ other clinicians’ brains. 

References:

  1. Edson, Margaret. Wit / Margaret Edson. London: Nick Hern, 2000. Print.
  2. https://champshealth.org/where-we-work/ethiopia-site/

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