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Janelle Taylor on teaching "Perspectives in Medical Anthropology"

ANTH 475 Syllabus 2009

In Tristes Tropiques, Claude Lévi-Strauss explained that it was his dread of teaching the same course over and over again that impelled him to travel to Brazil and pursue anthropology:

“After spending a happy year at the Mont de Marsan lycée, teaching and preparing my course of lessons as I went along, I was dismayed to discover at the beginning of the next school year… that I would have to repeat the same course for the rest of my life…” (p. 53)

For my part, I have taught the same upper-level undergraduate medical anthropology class (ANTH 475, “Perspectives in Medical Anthropology”) every year since I came to the University of Washington more than a decade ago now.

How is it that repeating the same course leaves me feeling not “dismayed,” but actually pretty jazzed?  I can’t help thinking that perhaps if Lévi-Strauss had stuck with his lycée job a bit longer, he might have been able to discover through teaching some version of the same insight he arrived at in the Amazon: that a really good structure contains within itself endless creative possibilities. I think that the reason my “Perspectives in Medical Anthropology” class works well, and remains interesting and fun to teach over and over again, is because it has a robust and flexible structure.

The big idea for this course is that it is possible to create understanding about health, illness, and medicine not by looking inside the individual body, but by using ethnographic research to situate individual lives within broader contexts.  (This is a very new idea to many of my students, the majority of whom are upper-level undergraduates hoping to pursue careers in medicine, nursing, public health, pharmacy, and other health-related professions). Since the world obviously does not present itself in pre-packaged chunks of context, ethnographers must make choices – at once theoretical and methodological — about what and whom to include, what and whom to leave out, and why. Following from this, the course is structured in a manner intended to highlight conceptual differences among ethnographic studies, such that students may get a sense of how it matters whether, for example, one begins with questions about meaning, or questions about power, or questions about technology, etc.

The course thus does not “cover” any set list of specific illness conditions, nor any particular world area. Topic headings for each day and for each week are meant to help students situate specific ethnographic studies assigned for the day, as examples of how particular theoretical & methodological approaches may be applied. The specific articles assigned often change from one year to the next; the weekly topics also shift and change a bit over the years, reflecting developments in the field.  I select articles that I want to read, and ones I love — because they are written clearly and well, and exemplify the best potential of ethnographic research, to yield surprising and challenging insights.

Key to the success of this structure are the writing assignments, especially the “reflection paper.” This is something I dreamed up the first year I taught the course, that has proven to work wonderfully well. On the first day of class I tell students that for the next class meeting they must write a short (2-3 page) account of an episode of illness and healing that they know about at first hand. An open-ended assignment such as this, at the very start of the quarter, inevitably creates some anxiety, and they always want to know more specifically what I am looking for; I tell them, “Just write an honest account.” (I reassure them that these will not be graded; I also advise them to bear that in mind when deciding what to write about, that that these will be read and commented on by their classmates as well as by me.)

On the second day of class, I ask the students to tell me about some of the choices they found themselves making when they wrote their accounts, and I list these on the board. Referring to this list, I talk about how the choices that each of them had to make are similar to some of the choices faced by ethnographers, and segue from there into a discussion of what ethnographic research is.

At the end of the quarter, after exploring many different approaches and topics, reading some very compelling articles, watching documentary film clips, and writing two analytical papers, the students are asked to look back at their firsthand account, and write a paper that reflects on it in light of what they have learned. I leave this very open-ended, and encourage them to draw connections with whatever articles seem most relevant and helpful. I advise them that they can treat their firsthand account as “data” and reflect on how they told that story (what they left out, what voice they chose to adopt, etc), or they can consider the specific health problem about which they wrote in light of what they may have learned about it through the class readings, or they can write about what sort of research they might want to pursue on the topic about which they wrote, if they were to go on to become an ethnographer.

For the final class session, small groups of students are assigned to read each other’s firsthand accounts and reflection papers, and discuss them. The course is thus structured to end by positioning the students as authors who create new understanding, informed by scholarly research, about matters they know at first hand, and also colleagues who respond respectfully and thoughtfully to the work of others. And when that is what one repeats, teaching the same course every year can be not a grind, but a positive joy.

Janelle S. Taylor is Associate Professor of Anthropology at the University of Washington, and author, most recently, of The Public Life of the Fetal Sonogram: Technology, Consumption, and the Politics of Reproduction (Rutgers University Press, 2008).

By Janelle Taylor

I am a medical anthropologist, trained as an ethnographer, and am on faculty in, and currently serving as chair of, the Department of Anthropology at the University of Washington (in Seattle). I am the author of one book, The Public Life of the Fetal Sonogram: Technology, Consumption, and the Politics of Reproduction (Rutgers U Press 2008), and co-editor of one volume, Consuming Motherhood (Rutgers U Press 2004). I have also published a number of articles in medical as well as social-science journals, on a variety of topics, including fetal ultrasound imaging, cultural competency, end of life decisionmaking, dementia care, and standardized patient simulations in health professions education.

4 replies on “Janelle Taylor on teaching "Perspectives in Medical Anthropology"”

Thanks, Janelle for such a thoughtful and interesting post! I really appreciate your reflections on the structure and organization of the course.

I have also found that organizing the course around topics really encourages students to think openly and comparatively about health, illness, and the ways people (including anthropologists in their research and writing) attribute meaning to, experience, and respond to these in relation to knowledge and power. Last time I taught the course (during a 15 week semester) I divided the material according to four thematic units: Cultural Perspectives on Illness, Knowledge and Belief; Body and Mind; Medicalizing and Claiming Difference; and, Illness, Causality and Morality. Within each unit we engaged books, articles and films that encouraged us to discuss how illness, health, and technologies of diagnosis and healing are culturally constituted and established as anthropological subjects of inquiry in different social, political and economic contexts. For their final paper, students reflected on some of the broader issues in an illness narrative that they wrote based on an interview with a friend or relative (for class purposes only).

Overall the course was successful. In the end, however, I still felt slightly constrained by some of the sub-topics such as aging, disabilities, genetics and environment, and infectious disease. My concern was that students were walking away with a sort of check list of topics they do and do not expect medical anthropologists to cover, rather than an appreciation of the range of methodological and theoretical approaches that the authors used to raise questions and stake their claims. Their final papers eased my mind. Nonetheless, I think your approach of using conceptual differences to ask questions about how and why questions of power, meaning and technologies matter in different ways can offer a powerful antidote to the risks of checklist thinking/course structure that, at least for me personally, have not been very successful in the past. I also love the idea of having students write reflectively at the outset, and returning to this account as “data” for a final reflective paper at the end of the quarter.

I’m curious about the absence of book-length ethnographies on your syllabus. I know that in an academic quarter it can be difficult to set aside enough time to really engage a book- length ethnography. But I’m wondering if there are any other factors contributing to that decision. For example, do you find that articles and essays teach better in an (upper division) undergraduate course, and if so, why? I’m interested in what you and others think are the strengths and weaknesses of teaching with both article/essay and book-length texts for medical anthropology (and perhaps more generally).

Hi Erin,

On books versus articles, I tend to prefer articles in undergraduate classes, for a couple of reasons:

1) In a class such as this, where my goal is to highlight different theoretical & methodological approaches, I find it easier to create comparative & critical discussions when what the students have read for a given day is work by more than one author;

2) Two substantial articles per class session (i.e., four per week) seems to be about the maximum amount that my undergraduates can realistically read carefully enough to absorb and discuss. If I assign more (and most books are substantially longer), I may feel better about having "covered" more material, left out fewer vitally important things. But in my experience, assigning too much reading simply sets us all up for failure in terms of classroom discussion dynamics, as the students can't keep up, and/or come to class feeling exhausted, stressed, and resentful.

Considerations of substance and rigor weigh on the side of more reading, always. Yet I sometimes think that what my students (and maybe all of us) really need most is just a little bit more leisure, more time, more freedom to think and to discuss ideas together — to experience anthropology as a collective and *creative* activity, of "making" sense. It's a matter of trying to hold on to the joy in the work.

Thank you so much, Janelle, for so generously sharing your course vision and the recent syllabus! I share your philosophy and approach to teaching medical anthropology to undergraduates, and am eager to try some of your ideas this spring.

I am a huge fan of your work! I am a professor of nursing, global health, and social medicine , practicing nurse practitioner in primary care for 32 years, and am currently working on a degree in med anthro- because I needed to be able to situate my patient’s lives within a broader context. Any advice for how I could bring in some of these ideas into my teaching nurses despite the fact that I do not have a PhD in anthropology and my students do not know anything about the subject? In my opinion, nursing has a huge context problem.

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