Reflections on Ethnography in Medicine
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Abstract
After conducting many years of ‘classical’ ethnographic fieldwork among refugees in Cyprus, I started field research in hospitals, community settings, and medical schools in Belgium, England, and Cyprus. My collaborations with clinical and biomedical scientists have led to an ongoing dialogue about ethnographic fieldwork and ethnographic writing. I discuss, through some ethnographic vignettes from my own research journey, some challenges that academics who work in medical research units may face in their engagements with ethnography. Stefan Beck’s work speaks to researchers from different social, biomedical and clinical disciplines. I show that ethnographic work, such as that by Beck, raises the profile of social scientific work in medicine and demonstrates the potential of ethnography in medicine.
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Keywords
Anthropology, Stefan Beck, medicine, ethnography, social sciences, biomedical sciences, interdisciplinarity
References
Ahmed, F., Dikomitis, L., Zafar H.W., Goadsby, P. and Paemeleire, K. (2014) ‘Perceptions and experiences of cluster headache among patients, general practitioners and neurologists in the north of England: a qualitative study’, The Journal of Headache and Pain, 15 (Suppl 1): J1.
Albert, M., and Paradis, E. (2014) ‘Social Scientists and Humanists in the Health Research Field: a Clash of Epistemic Habitus’, in Kleinman, D.L. and Moore, K. (Eds.), Routledge Handbook of Science, Technology, and Society. London:Routledge, pp. 369-387.
Amelang, K., Anastasiadou-Christophidou, V., Constantinou, C., Johansson, S.L. and Beck, S. (2011) ‘Learning to Eat Strawberries in a Disciplined Way: Normalization Practices Following Organ Transplantation’, Ethnologia Europaea, Vol. 41, No. 2, pp. 54-70.
Atkinson, P., and Pugsley, L. (2005) ‘Making sense of ethnography and medical education’, Medical education, Vol. 39, No. 2, pp. 228-234.
Atkinson, P. (2015) For Ethnography. London: Sage. Ball, L. J., and Ormerod, T. C. (2000) ‘Applying ethnography in the analysis and support of expertise in engineering design’, Design Studies, Vol. 21, No. 4, pp. 403-421.
Beck, S. (2005) ‘Putting Genetics to Use’, The Cyprus Review, Vol. 17 No. 1, pp. 59-78.
Beck, S. (2008) ‘Medicalizing culture(s) or culturalizing medicine(s)’, in Burri, R. and Dumit, J. (eds.) Biomedicine as Culture: Instrumental Practices, Technoscientific Knowledge, and New Modes of Life. London: Routledge, pp. 17-33.
Beck, S. (2011) ‘Staging Bone Marrow Donation as a Ballot: Reconfiguring the Social and the Political Using Biomedicine in Cyprus’, Body & Society, Vol. 17, No. 2&3, pp. 93-119.
Becker, H. S., Geer, B., Hughes, E. C. and Strauss, A.L. (1961) Boys in White: Student Culture in Medical School. Chicago: University of Chicago Press.
Béhague, D., Victora, C., and Barros, F. (2002) ‘Consumer Demand for Caesarean Sections in Brazil: Population Based Birth Cohort Study Linking Ethnographic and Epidemiological Methods’, BMJ: British Medical Journal, Vol. 324, No. 7343, pp. 942-945.
Behar, R. (1995) ‘Introduction: Out of Exile’, in Behar, R. and Gordon, D. (eds.) Women Writing Culture. Berkeley: University of California Press.
BeSST. (2016) A Core Curriculum for Sociology in UK Undergraduate Medical Education, Cardiff: Cardiff University. Available at http://www.besst.info, last accessed on 18 May 2016.
Blommaert, J., and Dong, J. (2010) Ethnographic fieldwork: A Beginner’s Guide. Bristol: Multilingual Matters.
Clarke, A. (2001) The Sociology of Health Care. New York: Prentice.
Clarke, A., Shim, J. K., Mamo,L., Fosket, J. R., and Fishman, J. R. (2003) ‘Biomedicalization: technoscientific transformations of health, Illness, and U.S. biomedicine’, American
Sociological Review, Vol. 68, pp. 161-194.
Davis, E. A. (2012) Bad souls: Madness and responsibility in modern Greece. Durham: Duke University Press.
Dikomitis, L. (2012) Cyprus and Its Places of Desire: Cultures of Displacement Among Greek and Turkish Cypriot Refugees. London: IB Tauris.
Dikomitis, L., Bonte, M., Willems, S. and Paemeleire, K., (2013) ‘Patients’ Perceptions of the Causes of Migraine in Flanders (Belgium): A Qualitative Study’, Cephalalgia, Vol. 33, No. S 8, pp. 144-145.
Dikomitis, L. Birks, Y., Oliver, S. and Macleod, U. (2014) ‘Embedding public health in primary care: the example of health inequalities’, SEDA Research Summaries No. 1, Hull York Medical School, University of Hull.
Dikomitis, L., Green, T. and Macleod, M. (2015) ‘Embedding electronic decision-support tools for suspected cancer in primary care: a qualitative study of GPs’ experiences’, Primary Health Care Research & Development, Vol. 16, No. 6, pp. 548-555.
Dikomitis, L., Quarshie, V., Paemeleire, K., Goadsby, P.J. and Ahmed, F. (2015) ‘Perceptions, understandings and experiences of cluster headache patients in the north of England: a qualitative study’, Cephalalgia, Vol. 35, p 79.
Dixon-Woods, M. (2003) ‘What can ethnography do for quality and safety in health care?’, Quality and Safety in Health Care, Vol. 12, No. 5, pp. 326-327.
Farmer, P. (2001). Infections and inequalities: The modern plagues. Berkeley: University of California Press.
Farmer, P. (2004) Pathologies of power: Health, human rights, and the new war on the poor. Berkeley: University of California Press.
Hafferty, F.W. (1998) ‘Beyond curriculum reform: Confronting medicine’s hidden curriculum’, Academic Medicine, Vol. 73, No. 4, pp. 403-407.
Ghodsee, K. (2016) From Notes to Narrative: Writing Ethnographies That Everyone Can Read. Chicago: University of Chicago Press.
Goodson, L., and Vassar, M. (2011) ‘An overview of ethnography in healthcare and medical education research’, Journal of Educational Evaluation for Health Professions, Vol. 8, pp. 4-8.
Gottlieb, A. (ed.) (2012) The Restless Anthropologist: New Fieldsites, New Visions. Chicago: The University of Chicago Press.
Greenhalgh, T. and Swinglehurst, D. (2011) ‘Studying technology use as social practice: the untapped potential of ethnography, BMC Medicine, Vol. 9, No. 1, pp. 45-51.
Greenhalgh, T., Annandale, E., Ashcroft, R., et al. (2016) ‘An open letter to the BMJ editors on qualitative research’, British Medical Journal, Vol. 352, pp. i563.
Ivry, T. (2009) Embodying culture: pregnancy in Japan and Israel. Rutgers, NJ: Rutgers University Press.
Johanson, R., Newburn, M. and Macfarlane, A. (2002) ‘Has the medicalisation of childbirth gone too far?’, British Medical Journal, Vol. 324, No. 7342, pp. 892-895.
Keating, P. and Cambrosio, A. (2003) Biomedical Platforms: Realigning the Normal and the Pathological in Late Twentieth-century Medicine. Cambridge, MA: MIT Press.
Kleinman, A. (1980) Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: University of California Press.
Kleinman, A. (1988) The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.
Kleinman, A. (2008) What really matters: Living a moral life amidst uncertainty and danger. Oxford: Oxford University Press.
Loder, E., Groves, T., Schroter, S., Merino, J. G., and Weber, W. (2016) ‘Qualitative research and the BMJ’, British Medical Journal, Vol. 352, pp. i641.
Long, D., Hunter, C., and Van der Geest, S. (2008) ‘When the field is a ward or a clinic: Hospital ethnography’, Anthropology and Medicine, Vol. 15, No. 2, pp. 71-78.
Maginn, P. J. (2007) ‘Towards more effective community participation in urban regeneration: The potential of collaborative planning and applied ethnography’, Qualitative Research, Vol. 7, No. 1, pp. 25-43.
Nakamura, K. (2013) A disability of the soul: An ethnography of schizophrenia and mental illness in contemporary Japan. Ithaca: Cornell University Press.
Pelto, P. J. (2013) Applied ethnography: Guidelines for field research. Walnut Creek, CA: Left Coast Press.
Pope, C. (2005) ‘Conducting ethnography in medical settings’, Medical Education, Vol. 39, No. 12, pp. 1180-1187.
Prentice, R. (2013) Bodies in formation: An ethnography of anatomy and surgery education. Durham, NC: Duke University Press.
Reeves, S., Kuper, A. and Hodges, B.D. (2008) ‘Qualitative research methodologies: ethnography’, British Medical Journal, Vol. 337, No. 7-3), pp. a1020-a1020.
Sargent, C. and Bascope, G. (1996) ‘Ways of knowing about birth in three cultures’, Medical Anthropology Quarterly, Vol. 10, No. 2, pp.213-236.
Sinclair, S. (1997) Making Doctors: An Institutional Apprenticeship. Oxford: Berg Publishers.
Street, A. (2014) Biomedicine in an unstable place: Infrastructure and personhood in a Papua New Guinean hospital. Durham: Duke University Press.
Tsouroufli, M. (2012) ‘Breaking in and breaking out a Medical School: Feminist Academic Interrupted’, Equality, Diversity and Inclusion, Vol. 13, No. 5. pp. 467-483.
Unnamed author (1980) ‘More anthropology and less sleep for medical students’, British Medical Journal, Vol. 281, pp. 1662.
Van der Geest, Sjaak, and Kaja Finkler. (2004) ‘Hospital ethnography: introduction’, Social science & Medicine, Vol. 59, No. 10, pp. 1995-2001.
Walsh, D. (2006). ‘Subverting the assembly-line: childbirth in a free-standing birth centre’, Social Science & Medicine, Vol. 62, No. 6, pp. 1330-1340.
Wendland, C. L. (2010) A Heart for the Work: journeys through an African medical school. Chicago: University of Chicago Press.
Wulff, H. (ed.). (2016) The Anthropologist as Writer: Genres and Contexts in the Twenty-First Century. Oxford: Berghahn Books.
Albert, M., and Paradis, E. (2014) ‘Social Scientists and Humanists in the Health Research Field: a Clash of Epistemic Habitus’, in Kleinman, D.L. and Moore, K. (Eds.), Routledge Handbook of Science, Technology, and Society. London:Routledge, pp. 369-387.
Amelang, K., Anastasiadou-Christophidou, V., Constantinou, C., Johansson, S.L. and Beck, S. (2011) ‘Learning to Eat Strawberries in a Disciplined Way: Normalization Practices Following Organ Transplantation’, Ethnologia Europaea, Vol. 41, No. 2, pp. 54-70.
Atkinson, P., and Pugsley, L. (2005) ‘Making sense of ethnography and medical education’, Medical education, Vol. 39, No. 2, pp. 228-234.
Atkinson, P. (2015) For Ethnography. London: Sage. Ball, L. J., and Ormerod, T. C. (2000) ‘Applying ethnography in the analysis and support of expertise in engineering design’, Design Studies, Vol. 21, No. 4, pp. 403-421.
Beck, S. (2005) ‘Putting Genetics to Use’, The Cyprus Review, Vol. 17 No. 1, pp. 59-78.
Beck, S. (2008) ‘Medicalizing culture(s) or culturalizing medicine(s)’, in Burri, R. and Dumit, J. (eds.) Biomedicine as Culture: Instrumental Practices, Technoscientific Knowledge, and New Modes of Life. London: Routledge, pp. 17-33.
Beck, S. (2011) ‘Staging Bone Marrow Donation as a Ballot: Reconfiguring the Social and the Political Using Biomedicine in Cyprus’, Body & Society, Vol. 17, No. 2&3, pp. 93-119.
Becker, H. S., Geer, B., Hughes, E. C. and Strauss, A.L. (1961) Boys in White: Student Culture in Medical School. Chicago: University of Chicago Press.
Béhague, D., Victora, C., and Barros, F. (2002) ‘Consumer Demand for Caesarean Sections in Brazil: Population Based Birth Cohort Study Linking Ethnographic and Epidemiological Methods’, BMJ: British Medical Journal, Vol. 324, No. 7343, pp. 942-945.
Behar, R. (1995) ‘Introduction: Out of Exile’, in Behar, R. and Gordon, D. (eds.) Women Writing Culture. Berkeley: University of California Press.
BeSST. (2016) A Core Curriculum for Sociology in UK Undergraduate Medical Education, Cardiff: Cardiff University. Available at http://www.besst.info, last accessed on 18 May 2016.
Blommaert, J., and Dong, J. (2010) Ethnographic fieldwork: A Beginner’s Guide. Bristol: Multilingual Matters.
Clarke, A. (2001) The Sociology of Health Care. New York: Prentice.
Clarke, A., Shim, J. K., Mamo,L., Fosket, J. R., and Fishman, J. R. (2003) ‘Biomedicalization: technoscientific transformations of health, Illness, and U.S. biomedicine’, American
Sociological Review, Vol. 68, pp. 161-194.
Davis, E. A. (2012) Bad souls: Madness and responsibility in modern Greece. Durham: Duke University Press.
Dikomitis, L. (2012) Cyprus and Its Places of Desire: Cultures of Displacement Among Greek and Turkish Cypriot Refugees. London: IB Tauris.
Dikomitis, L., Bonte, M., Willems, S. and Paemeleire, K., (2013) ‘Patients’ Perceptions of the Causes of Migraine in Flanders (Belgium): A Qualitative Study’, Cephalalgia, Vol. 33, No. S 8, pp. 144-145.
Dikomitis, L. Birks, Y., Oliver, S. and Macleod, U. (2014) ‘Embedding public health in primary care: the example of health inequalities’, SEDA Research Summaries No. 1, Hull York Medical School, University of Hull.
Dikomitis, L., Green, T. and Macleod, M. (2015) ‘Embedding electronic decision-support tools for suspected cancer in primary care: a qualitative study of GPs’ experiences’, Primary Health Care Research & Development, Vol. 16, No. 6, pp. 548-555.
Dikomitis, L., Quarshie, V., Paemeleire, K., Goadsby, P.J. and Ahmed, F. (2015) ‘Perceptions, understandings and experiences of cluster headache patients in the north of England: a qualitative study’, Cephalalgia, Vol. 35, p 79.
Dixon-Woods, M. (2003) ‘What can ethnography do for quality and safety in health care?’, Quality and Safety in Health Care, Vol. 12, No. 5, pp. 326-327.
Farmer, P. (2001). Infections and inequalities: The modern plagues. Berkeley: University of California Press.
Farmer, P. (2004) Pathologies of power: Health, human rights, and the new war on the poor. Berkeley: University of California Press.
Hafferty, F.W. (1998) ‘Beyond curriculum reform: Confronting medicine’s hidden curriculum’, Academic Medicine, Vol. 73, No. 4, pp. 403-407.
Ghodsee, K. (2016) From Notes to Narrative: Writing Ethnographies That Everyone Can Read. Chicago: University of Chicago Press.
Goodson, L., and Vassar, M. (2011) ‘An overview of ethnography in healthcare and medical education research’, Journal of Educational Evaluation for Health Professions, Vol. 8, pp. 4-8.
Gottlieb, A. (ed.) (2012) The Restless Anthropologist: New Fieldsites, New Visions. Chicago: The University of Chicago Press.
Greenhalgh, T. and Swinglehurst, D. (2011) ‘Studying technology use as social practice: the untapped potential of ethnography, BMC Medicine, Vol. 9, No. 1, pp. 45-51.
Greenhalgh, T., Annandale, E., Ashcroft, R., et al. (2016) ‘An open letter to the BMJ editors on qualitative research’, British Medical Journal, Vol. 352, pp. i563.
Ivry, T. (2009) Embodying culture: pregnancy in Japan and Israel. Rutgers, NJ: Rutgers University Press.
Johanson, R., Newburn, M. and Macfarlane, A. (2002) ‘Has the medicalisation of childbirth gone too far?’, British Medical Journal, Vol. 324, No. 7342, pp. 892-895.
Keating, P. and Cambrosio, A. (2003) Biomedical Platforms: Realigning the Normal and the Pathological in Late Twentieth-century Medicine. Cambridge, MA: MIT Press.
Kleinman, A. (1980) Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: University of California Press.
Kleinman, A. (1988) The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.
Kleinman, A. (2008) What really matters: Living a moral life amidst uncertainty and danger. Oxford: Oxford University Press.
Loder, E., Groves, T., Schroter, S., Merino, J. G., and Weber, W. (2016) ‘Qualitative research and the BMJ’, British Medical Journal, Vol. 352, pp. i641.
Long, D., Hunter, C., and Van der Geest, S. (2008) ‘When the field is a ward or a clinic: Hospital ethnography’, Anthropology and Medicine, Vol. 15, No. 2, pp. 71-78.
Maginn, P. J. (2007) ‘Towards more effective community participation in urban regeneration: The potential of collaborative planning and applied ethnography’, Qualitative Research, Vol. 7, No. 1, pp. 25-43.
Nakamura, K. (2013) A disability of the soul: An ethnography of schizophrenia and mental illness in contemporary Japan. Ithaca: Cornell University Press.
Pelto, P. J. (2013) Applied ethnography: Guidelines for field research. Walnut Creek, CA: Left Coast Press.
Pope, C. (2005) ‘Conducting ethnography in medical settings’, Medical Education, Vol. 39, No. 12, pp. 1180-1187.
Prentice, R. (2013) Bodies in formation: An ethnography of anatomy and surgery education. Durham, NC: Duke University Press.
Reeves, S., Kuper, A. and Hodges, B.D. (2008) ‘Qualitative research methodologies: ethnography’, British Medical Journal, Vol. 337, No. 7-3), pp. a1020-a1020.
Sargent, C. and Bascope, G. (1996) ‘Ways of knowing about birth in three cultures’, Medical Anthropology Quarterly, Vol. 10, No. 2, pp.213-236.
Sinclair, S. (1997) Making Doctors: An Institutional Apprenticeship. Oxford: Berg Publishers.
Street, A. (2014) Biomedicine in an unstable place: Infrastructure and personhood in a Papua New Guinean hospital. Durham: Duke University Press.
Tsouroufli, M. (2012) ‘Breaking in and breaking out a Medical School: Feminist Academic Interrupted’, Equality, Diversity and Inclusion, Vol. 13, No. 5. pp. 467-483.
Unnamed author (1980) ‘More anthropology and less sleep for medical students’, British Medical Journal, Vol. 281, pp. 1662.
Van der Geest, Sjaak, and Kaja Finkler. (2004) ‘Hospital ethnography: introduction’, Social science & Medicine, Vol. 59, No. 10, pp. 1995-2001.
Walsh, D. (2006). ‘Subverting the assembly-line: childbirth in a free-standing birth centre’, Social Science & Medicine, Vol. 62, No. 6, pp. 1330-1340.
Wendland, C. L. (2010) A Heart for the Work: journeys through an African medical school. Chicago: University of Chicago Press.
Wulff, H. (ed.). (2016) The Anthropologist as Writer: Genres and Contexts in the Twenty-First Century. Oxford: Berghahn Books.
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“Reflections on Ethnography in Medicine”. 2017. Cyprus Review 28 (1): 85-97. https://cyprusreview.org/index.php/cr/article/view/36.