Kleinman- The Personal and Social Meanings of Illness – Page 2

Reading Response 1 Sakari Law

One thing I believe Kleinman wants the reader to reflect on is that, in our capitalist society, technology has been the focal point of medical treatment and progress. His argument considers a diverse range of cultural perspectives, feelings, and beliefs, and terms it as the “soft” concerns of medicine (9). Half of his reading provides the reader with examples of different culture systems across the world, which shows how much this understanding fills in “the space” between the practitioner and the patient. He provides multiple perspectives to give us multiple things to consider. It is a lesson that is needed in order to understand how a patient might view themselves as being a sick person and for doctors to provide the best treatment. In addition, several of his passages are titled “the meaning” of, whether that be of illness, sickness or disease. His intentions are to communicate with the reader that these are often times misunderstood and usually are not directly expressed.

Technology as being innovative medicine, however, is limiting and does not leave room for any of these meanings. It takes away that narrating experience, leaving the patient with “closed-ended practical issues,” because technology is used to simply control symptoms (20). This is the “radically materialist pursuit of the biological mechanism of disease.” He describes this quest as being “hard” and overvalued in medicine (9). As a result, medical workers become stiffened and unable to operate under pressures of moral perspective. It is as if we have completely forgotten that we are operating on humans, not robots.

And this is the product of a capitalist society, the current social circumstances of Kleinman’s reading and the “hot spot” that we are in.

Works Cited

Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books, 1988. Print.

Reading Response 1 – Arthur Kleinman from Katy Meier

Utilizing his knowledge as both a psychiatrist and anthropologist, Arthur Kleinman details distinct definitions for the following terms: “illness”, “disease” and “sickness”. These definitions are specific yet overlapping at the same time. “Illness” involves the unique and personal experience of an individual suffering. An example of “illness” as the subjective lived experience of a disorder include the incomprehensible pain of losing an arm and being unable to express oneself through art ever again. Kleiman states that, “Illness problems are the principal difficulties that symptoms and disability create in our lives”. He continues by giving a multitude of examples, “We may become demoralized and lose our hope of getting better, or we may be depressed by our fear of death, or of becoming an invalid. We grieve over lost health, altered body image, and dangerously declining self-esteem” (4). Kleiman’s examples involve the non-standardized aspects of a disorder that are rarely addressed publicly. I find it interesting that as Kleinman lists these examples, he uses the plural pronoun “we”, including both himself and the reader. I think his intentions for doing this were to emphasize that illness problems are experienced by all yet no one experiences them in the same way.

The distinct definitions between, “illness”, “disease” and “sickness” are important because recognizing these differences allows us to better understand the meanings behind disorders both in our own culture and cross-culturally. Furthermore, it enables us to better address and relieve suffering. By confining the term “disease” to biomedical usage and using “illness” to address the condition holistically, instead of the two synonymously, empowers the individual suffering. Kleiman refers to disease as “radically materialist” meaning that it focuses solely on the testable and irrefutable science of a pathogen. As Kleinman specifies later in the chapter, he says that disease refers to the “technical quest for the control of symptoms” (9). Using this specific language, Kleiman gives a narrow definition to disease.

Work Cited

Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human

Condition. Basic Books, Inc, 1998.

The Doctor’s Failure

Passage taken from A Fortunate Man: The Story of a Country Doctor

“Her asthma continued and caused structural deterioration of the lungs. She now survives on steroids. Her face is moon shaped. The expression of her large eyes is placid. But her brows and eyelids and the skin pulled tight over her cheek bones twitch at every moment and sound which might constitute a warning of the unexpected. She looks after her mother, but very seldom leaves the cottage. When she sees the doctor, she smiles at him now as she would probably smile at the solider of the Salvation Army.”

Before, the water was deep. Then the torrent of God and the man. And afterwards the shallows, clear but constantly disturbed, endlessly irritated by their very shallowness as though by an allergy. There is a bend in the river which often reminds the doctor of his failure” (Berger and Mohr 23).

In A Fortunate Man: The Story of a Country Doctor, John Berger and Jean Mohr create a story detailing the relationship between a doctor and a young girl in a village in rural England. At the beginning of the passage, words such as “structural deterioration” and “steroids” which are associated with disease, “an alteration in biological structure or functioning,” are used to describe the girl’s condition (Kleinman 5). In the middle of the passage, words that describe the patient’s specific features such as her “placid” eyes and “cheekbones” twitching signify the doctor’s transition into also recognizing her symptoms of illness, or “the innately human experience of symptoms and suffering” which he realizes two years later (Kleinman 3).

Towards the end of the passage, Berger describes a body of water which is likened to the girl’s personality. Prior to the assault, the girl is characterized as “deep” where she is willing to put a deep trust in those around her. Then, there is a “torrent” when her trust is shattered by her sexual assault and the doctor’s inability to understand her anxiousness. Given her trust has been diminished, her personality is likened to the “shallows” in her maintenance of a superficial relationship to those around her.

Through word choice and metaphor, Berger and Mohr ultimately reveal the deterioration and destruction of the doctor-patient relationship that can arise when doctors only consider symptoms of disease and are unable to earn their patients’ trust. The doctor has failed to recognize symptoms of illness in the girl’s facial expressions and nonverbal actions by merely questioning her instead of trying to recognize her actions, thereby losing her trust. The doctor’s failure is clearly seen in her smile towards him as how “she would probably smile at the soldier of the Salvation Army,” a superficial smile signifying a lack of trust which he cannot earn back.

Works Cited

Kleinman, Arthur. The Illness Narratives: Suffering, Healing, and the Human Condition. Basic Books, A Member of the Perseus Books Group, 2007.

Berger, John, and Jean Mohr. A Fortunate Man: The Story of a Country Doctor. Canongate, 2016.