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Under the Medical Gaze

Facts and Fictions of Chronic Pain

Susan Greenhalgh (Author)

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ISBN: 9780520925090
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This compelling account of the author's experience with a chronic pain disorder and subsequent interaction with the American health care system goes to the heart of the workings of power and culture in the biomedical domain. It is a medical whodunit full of mysterious misdiagnosis, subtle power plays, and shrewd detective work. Setting a new standard for the practice of autoethnography, Susan Greenhalgh presents a case study of her intense encounter with an enthusiastic young specialist who, through creative interpretation of the diagnostic criteria for a newly emerging chronic disease, became convinced she had a painful, essentially untreatable, lifelong muscle condition called fibromyalgia. Greenhalgh traces the ruinous effects of this diagnosis on her inner world, bodily health, and overall well-being. Under the Medical Gaze serves as a powerful illustration of medicine's power to create and inflict suffering, to define disease and the self, and to manage relationships and lives.

Greenhalgh ultimately learns that she had been misdiagnosed and begins the long process of undoing the physical and emotional damage brought about by her nearly catastrophic treatment. In considering how things could go so awry, she embarks on a cogent and powerful analysis of the sociopolitical sources of pain through feminist, cultural, and political understandings of the nature of medical discourse and practice in the United States. She develops fresh arguments about the power of medicine to medicalize our selves and lives, the seductions of medical science, and the deep, psychologically rooted difficulties women patients face in interactions with male physicians. In the end, Under the Medical Gaze goes beyond the critique of biomedicine to probe the social roots of chronic pain and therapeutic alternatives that rely on neither the body-cure of conventional medicine nor the mind-cure of some alternative medicines, but rather a broader set of strategies that address the sociopolitical sources of pain.
List of Tables and Figures

PART ONE: Understanding Chronic Pain
Prologue: Finding Dr. Right

PART TWO: Doing Biomedicine
1 The Initial Consultation: The Making of a “Fibromyalgic”
2 Medicating the “Fibromyalgic”-Arthritic Body
3 Producing the Good Patient

PART THREE: Doing Gender
4 A Most Pleasant Patient
5 Silent Rebellion and Rage
6 A Depression Worse Than the Disease

PART FOUR: A Losing Battle to Get Better
7 Struggling To Make the Treatment Work
8 “Accept It!” Alternative Medicines Offer Medicine for the Mind
9 A Life Shrunk, a Mind Gone Nearly Mad

PART FIVE: Rebellion and Self-Renewal
1 A Second Opinion: The Unmaking of a “Fibromyalgic”
11 The Final Meeting: A Tale of Decline and a Denial
12 Out from under the Medical Gaze

PART SIX: Narrating Illness, Politicizing Pain

Conclusion: Re-viewing the Medicine of Chronic Pain
Epilogue: Speaking of Pain -- On Stories, Cultural Recuperations, and Political Interventions
Susan Greenhalgh is Associate Professor in the Department of Anthropology at the University of California, Irvine.
"This is an extraordinary book—riveting story, concise scholarship, experimental ethnography—and it is beautifully told. Greenhalgh makes a cogent and powerful analysis of the sociopolitical sources of pain through feminist, cultural, and political understandings of the nature of medical science and medical practice in the United States."—Sharon Kaufman, author of The Healer's Tale

"Far above a simple telling of an illness, Greenhalgh takes the experience as a way to view gendered relations in medical care, the seduction of science for the physician and the patient, and the creation of facts and selves in the treatment of pain. She sets a new standard for the practice of autoethnography."—Virginia Olesen, Professor Emerita of Sociology, Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco

"A compellingly told story that advances our understanding of the meaning of chronic illness, particularly for women. This work adds a new dimension to the genre of illness narratives."—Susan DiGiacomo, Series Editor, Theory and Practice in Medical Anthropology and International Health

"A very useful and very well written book. . . . It states the issues in the culture of biomedicine field effectively and makes them relevant."—Arthur Kleinman, author of Writing at the Margin: Discourse between Anthropology and Medicine

"A deeply troubling, meticulous account about the chasm between medical orthodoxy and the subjective experience of chronic illness. This courageous book is essential reading for physicians and the public at large."—Margaret Lock, author of Encounters with Aging: Mythologies of Menopause in Japan and North America

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