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Sociology of Health and Illness Book Prize
Winner 2004The BSA Medical Sociology Group is pleased to announce the winner of the sociology of health and illness book of the year prize, 2004 which was awarded at the Medical Sociology Group Annual conference.
- Annemarie Mol (2002) ´The Body Multiple: Ontology in Medical Practice´. Duke University Press. Durham NC and London.
I became a graduate student of anthropology in Manchester in the 1950´s because of Max Gluckman´s article analysing a bridge opening ceremony in Zululand in which he argued that the one ceremony was is in fact a multiplicity of ceremonies. Zulu warriors, the governor, church ladies, the choir, the military band, the anthropologist, the bridge, his car were all in Mol´s terms enacting their own ceremonies but they were also enacting the ceremony as a whole. I noticed only after reading Mol, last week that Gluckman had written in another much later paper:
This is but one example of why I insist that, in defining a social system, independent value must be given to environment and tools and weapons; and a social system cannot be defined, as is sometimes done, as consisting of the interactions of persons, with technology, and so on, treated as contents of interaction, and not as autonomous elements.
The ceremony, like the objects of Mol´s study, bodies and atherosclerosis to name the two principal one, was in Strathern´s words cited by Mol, "more than one… but less than many.".
I have spent the rest of my life trying to understand, and prematurely, without quite myself knowing the explanation, to explain, the importance of that original paper. In recent years during the course of this I have met, listened to and read AnneMarie and usually criticised, cavilled and complained to her and about her; Mea MaximaCulpa. Now that her work is complete (not quite of course, whose is but more so than most published work) I am converted and convinced.
As Arthur W. Frank says in his review "The Body Multiple is my nominee for defining medical sociology in the 21st century-unless it defines sociological theory, but effacing that distinction is part of what is so engaging about Annemarie Mol´s Work." (p.532) and later "She follows objects, details enactments, reviews the literature, and her compelling, original view of society seems like it has been there all along, as it has. Awards committees should take notice of this major contribution´´ (p 534) For the first time in my life I got there ahead of A.W Frank. (For his full review and followed Trevor Pinch on her joint book with John Law see American Journal of Sociology 109,2 2003 pp 532-4.
She talks about Praxiography which she defines as studying how objects are enacted rather than performed (cf Goffman. We´ve all been there with her ). She will perhaps not be pleased that her method reminds me of Gramsci´s theory of Praxis. Since he devised it in the prison in which he died, it never became practice for him.
Her book is arranged partly as a detailed account (not a fictional fashionably fashioned narrative about) her ethnographic practice in a Dutch hospital, where over a very long period she looked at how doctors, patients, laboratory workers etc and she herself "did" atherosclerosis which produced a set of answers as to what it is (hence and thence ontology), which sometimes overlapped but which were never identical. One couldn´t just add them up. Nor could one say that any one of them encompassed any of the others or was itself encompassed.
One could not know a single whole living body by reference to the knowledge of populations nor would the knowledge of populations enable you to know what was going on in a single body. (Cochrane copiers, please read carefully, people who knew the great man including anthropologists, canny GPs and leading epidemiologists knew at the time (names can be provided in a sealed envelope) But these knowledges often influenced what someone looked for, this interference in turn led doctors, scientists and surgeons to concentrate on particular kinds of populations, old or young, male or female which tended to produce action or inaction on particular kinds of individual, body part or process.
She concluded that she was doing the ethnography of a disease and how it enacted itself or was enacted by others. All these different ways of enacting related to bodies or bits of bodies, alive or dead, as a whole or in part (arteries, legs, consciousness) so that the body was multiple. You could (and she does) suggest a relevance for this in considering diabetes (eg) and she could, of course, have suggested the elderly.
She writes very clearly and concisely and instead of footnotes has, literally, a subtext which relates her arguments reciprocally to those of others. (If only Sociology of Health and Illness would have the courage to take up this brilliant invention instead of the pointless, usually contentless literature review, copied, with minor tweaks, from one paper to the other giving an illusion of voluntary scholarship to what might as well be web and journal crawling or even perish the thought, involuntarily enforced crawling to bosses, editors and supervisors.) For example, anthropological but with general influence on ethic medical sociology and sociogenetics, Marilyn Strathern (subtext pp18-23) on English vs New Guinea Kinship; (subtext pp 78-82) on fragmentation so that a person is ´more than one and less than many´ and (subtext pp 147-149) on how she mobilises her own thoughts on how she has internalised and transformed Melanesian thought and her own thinking.
If you have not time to read the whole book just reading the subtext, enables you to see David Armstrong, Jim Clifford, Erving Goffman, Foucault, Haraway, Hahn, Robert Pool, Allan Young and of course, Strathern in a new light. Once you´ve done that you won´t be able to resist the main text anyway and so on; once is not enough for either. It stands beside, derives strength from and transforms the significance of works like Goffman´s, Armstrong´s, Foucault´s, Irving Zola´ Freidson´s and Anselm Strauss´s.
Ronald Frankenberg, Keele and Brunel
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