History of Science 170 Blog Post #6
Improving Medical Care for People with Complex Health Conditions: Support for Medical Anthropology
By Nathan Grant
People with chronic illnesses and developmental disabilities need doctors who are skilled in more than just medical science. They need doctors who understand and practice methods of medical anthropology.
Medical anthropology is a subfield of anthropology that explores how biological, social, and cultural factors affect health and well-being. Through interviews and fieldwork, medical anthropologists directly ask patients and their caregivers what it is like to live with illness. By asking these questions, medical anthropologists can identify the full experiences, perceptions, and support needs of patients and their families.
Oliver Sacks is a perfect example of a physician who used anthropological methods to help patients with neurologic conditions. While Sacks received training as a neurologist, he did more than just examine the biological nature of his patients’ symptoms. As G. Thomas Couser, former Director of Disability Studies at Hofstra University, explains in his article “The Cases of Oliver Sacks,” Sacks aspired to understand “the ‘I’ or the ‘who’ (the patient’s subjectivity) from the ‘it’ or the ‘what’ (the physiological condition)” (2001, 1). Sacks wanted to understand his patients’ full experiences with illness, which culminated in many famous articles and books.
Sacks is particularly known for his 1993 article about Temple Grandin, an autistic woman who is a professor of animal science at Colorado State University. By observing Grandin outside the clinic and by asking about her experiences, Sacks discovered that Grandin did not fit the common perception of autism (Sacks 1993). While people in the late 1900s primarily thought that autism was a “disorder of affect and empathy,” Sacks proved this perception wrong by showing that Grandin is “capable of joy, whimsy, tenderness, [and] passion about her work. [She] had a deep sense of kinship with other disabled people and with animals” (Silberman 2015). Sacks adopted anthropological methods to observe and interview Grandin about her full experiences with autism. By doing so, Sacks was able to determine what it was really like for Grandin to live with autism and ultimately helped change society’s understanding of autism.
Doctors who take an anthropological approach to illness would benefit families like mine. My twin brother Nik has a rare genetic condition called Mucopolysaccharidosis (MPS) II, also known as Hunter syndrome. Due to his condition, Nik has recurrent ear infections, seizures, heart disease, gastrointestinal issues, and musculoskeletal pain, among other complicated symptoms. He is also nonverbal and has a severe developmental disability. Since MPS II affects multiple organ systems, Nik needs help from many doctors including geneticists, neurologists, psychiatrists, and orthopedic surgeons. However, the high degree of specialization in medicine makes it difficult to find effective treatments for Nik.
My brother experiences a lot of pain and discomfort. This year, he started to limp and it has been very uncomfortable for him to walk. He has also had several ear and tooth infections. While Nik cannot verbally tell us that he is in discomfort, he often becomes physically aggressive when he is very sick. My family believes that Nik’s aggression is his way to express that he is in pain and something is wrong. Plus, whenever we treat his infections or provide medications like Tylenol and Motrin, Nik becomes much happier. It is almost like he is a different person.
This past summer, however, my brother was extremely aggressive and we could not find a way to calm him at home. He was hospitalized for 20 days and saw many specialists. Due to Nik’s aggressive behavior, the psychiatrists at the hospital asserted that Nik had a psychiatric illness and should be treated with antipsychotics. However, Nik has been on antipsychotics for years and they have never provided the same relief as Tylenol and Motrin have. My family told Nik’s doctors that we believe there is some bigger underlying medical problem behind his behavior. We asked for tests to determine if Nik had a skeletal issue, hydrocephalus, or any other sign that could indicate discomfort. We also asked for stronger pain medications. However, Nik’s doctors were adamant in prescribing him antipsychotics.
We followed the doctor’s recommendations and gave Nik antipsychotics, but they did not help. Nik remained aggressive. My parents demanded more tests and after a thorough dental checkup, we discovered that Nik had a severe tooth infection! After we treated Nik’s infection, Nik became much happier and we enjoyed many good days for several weeks.
While aggressive behavior may be indicative of a psychiatric illness, Nik’s doctors focused predominantly on one aspect of his overall condition. By overemphasizing psychiatric treatment, the doctor’s almost missed Nik’s tooth infection – and there may be other underlying sources of pain that we have not yet discovered. The specialization of medicine today affects doctors’ ability to understand the entire patient, which is incredibly important for people like my brother who have progressive multisystem disease.
While we know doctors do all they can to help my brother, we need doctors to take a more holistic approach to treatment. Doctors need to inquire about their patients’ entire experiences with illness. People like my brother need doctors to ask: What are all of the symptoms of your illness? What is it like to live with your illness? What do you need to feel better? These anthropological questions can help doctors identify the full impact of their patients’ illness. If patients are nonverbal, like my brother, doctors can ask these questions to caregivers. Conversing with caregivers can also help identify caregivers’ experiences, which can help caregivers feel more supported.
Anthropological methods can help doctors better understand their patients’ needs and provide treatments that are effective. However, in order for more doctors to adopt anthropological approaches to care, medical education needs to fully include training in the medical humanities (which should include not only medical anthropology, but also history of medicine, medical ethics, and medical sociology). As Couser explains in his article about Oliver Sacks, “Sacks has pointed the way, but postcolonial neuroanthropology still awaits its exemplary theorist and practitioner” (2001, 12). Patients like my brother need doctors to take an anthropological approach to care. By integrating medicine with medical anthropology, doctors can help enhance medical services and improve outcomes for patients and their families.
Improving Medical Care for People with Complex Health Conditions: Support for Medical Anthropology
By Nathan Grant
People with chronic illnesses and developmental disabilities need doctors who are skilled in more than just medical science. They need doctors who understand and practice methods of medical anthropology.
Medical anthropology is a subfield of anthropology that explores how biological, social, and cultural factors affect health and well-being. Through interviews and fieldwork, medical anthropologists directly ask patients and their caregivers what it is like to live with illness. By asking these questions, medical anthropologists can identify the full experiences, perceptions, and support needs of patients and their families.
Oliver Sacks is a perfect example of a physician who used anthropological methods to help patients with neurologic conditions. While Sacks received training as a neurologist, he did more than just examine the biological nature of his patients’ symptoms. As G. Thomas Couser, former Director of Disability Studies at Hofstra University, explains in his article “The Cases of Oliver Sacks,” Sacks aspired to understand “the ‘I’ or the ‘who’ (the patient’s subjectivity) from the ‘it’ or the ‘what’ (the physiological condition)” (2001, 1). Sacks wanted to understand his patients’ full experiences with illness, which culminated in many famous articles and books.
Sacks is particularly known for his 1993 article about Temple Grandin, an autistic woman who is a professor of animal science at Colorado State University. By observing Grandin outside the clinic and by asking about her experiences, Sacks discovered that Grandin did not fit the common perception of autism (Sacks 1993). While people in the late 1900s primarily thought that autism was a “disorder of affect and empathy,” Sacks proved this perception wrong by showing that Grandin is “capable of joy, whimsy, tenderness, [and] passion about her work. [She] had a deep sense of kinship with other disabled people and with animals” (Silberman 2015). Sacks adopted anthropological methods to observe and interview Grandin about her full experiences with autism. By doing so, Sacks was able to determine what it was really like for Grandin to live with autism and ultimately helped change society’s understanding of autism.
Doctors who take an anthropological approach to illness would benefit families like mine. My twin brother Nik has a rare genetic condition called Mucopolysaccharidosis (MPS) II, also known as Hunter syndrome. Due to his condition, Nik has recurrent ear infections, seizures, heart disease, gastrointestinal issues, and musculoskeletal pain, among other complicated symptoms. He is also nonverbal and has a severe developmental disability. Since MPS II affects multiple organ systems, Nik needs help from many doctors including geneticists, neurologists, psychiatrists, and orthopedic surgeons. However, the high degree of specialization in medicine makes it difficult to find effective treatments for Nik.
My brother experiences a lot of pain and discomfort. This year, he started to limp and it has been very uncomfortable for him to walk. He has also had several ear and tooth infections. While Nik cannot verbally tell us that he is in discomfort, he often becomes physically aggressive when he is very sick. My family believes that Nik’s aggression is his way to express that he is in pain and something is wrong. Plus, whenever we treat his infections or provide medications like Tylenol and Motrin, Nik becomes much happier. It is almost like he is a different person.
This past summer, however, my brother was extremely aggressive and we could not find a way to calm him at home. He was hospitalized for 20 days and saw many specialists. Due to Nik’s aggressive behavior, the psychiatrists at the hospital asserted that Nik had a psychiatric illness and should be treated with antipsychotics. However, Nik has been on antipsychotics for years and they have never provided the same relief as Tylenol and Motrin have. My family told Nik’s doctors that we believe there is some bigger underlying medical problem behind his behavior. We asked for tests to determine if Nik had a skeletal issue, hydrocephalus, or any other sign that could indicate discomfort. We also asked for stronger pain medications. However, Nik’s doctors were adamant in prescribing him antipsychotics.
We followed the doctor’s recommendations and gave Nik antipsychotics, but they did not help. Nik remained aggressive. My parents demanded more tests and after a thorough dental checkup, we discovered that Nik had a severe tooth infection! After we treated Nik’s infection, Nik became much happier and we enjoyed many good days for several weeks.
While aggressive behavior may be indicative of a psychiatric illness, Nik’s doctors focused predominantly on one aspect of his overall condition. By overemphasizing psychiatric treatment, the doctor’s almost missed Nik’s tooth infection – and there may be other underlying sources of pain that we have not yet discovered. The specialization of medicine today affects doctors’ ability to understand the entire patient, which is incredibly important for people like my brother who have progressive multisystem disease.
While we know doctors do all they can to help my brother, we need doctors to take a more holistic approach to treatment. Doctors need to inquire about their patients’ entire experiences with illness. People like my brother need doctors to ask: What are all of the symptoms of your illness? What is it like to live with your illness? What do you need to feel better? These anthropological questions can help doctors identify the full impact of their patients’ illness. If patients are nonverbal, like my brother, doctors can ask these questions to caregivers. Conversing with caregivers can also help identify caregivers’ experiences, which can help caregivers feel more supported.
Anthropological methods can help doctors better understand their patients’ needs and provide treatments that are effective. However, in order for more doctors to adopt anthropological approaches to care, medical education needs to fully include training in the medical humanities (which should include not only medical anthropology, but also history of medicine, medical ethics, and medical sociology). As Couser explains in his article about Oliver Sacks, “Sacks has pointed the way, but postcolonial neuroanthropology still awaits its exemplary theorist and practitioner” (2001, 12). Patients like my brother need doctors to take an anthropological approach to care. By integrating medicine with medical anthropology, doctors can help enhance medical services and improve outcomes for patients and their families.
References
Couser, G. Thomas. “The Cases of Oliver Sacks: The Ethics of Neuroanthropology,” in Vulnerable Subjects: Ethics and Life Writing. Cornell University Press, 2001.
Sacks, Oliver. “An Anthropologist on Mars.” December 27, 1993. https://www.newyorker.com/magazine/1993/12/27/anthropologist-mars.
Silberman, Steve. “How Oliver Sacks Helped Introduce The World To Autism.” Last modified August 30, 2015, https://www.buzzfeed.com/ssilberman/how-oliver-sacks-introduced-the-world-to-autism.
Couser, G. Thomas. “The Cases of Oliver Sacks: The Ethics of Neuroanthropology,” in Vulnerable Subjects: Ethics and Life Writing. Cornell University Press, 2001.
Sacks, Oliver. “An Anthropologist on Mars.” December 27, 1993. https://www.newyorker.com/magazine/1993/12/27/anthropologist-mars.
Silberman, Steve. “How Oliver Sacks Helped Introduce The World To Autism.” Last modified August 30, 2015, https://www.buzzfeed.com/ssilberman/how-oliver-sacks-introduced-the-world-to-autism.
Click here to return back to the History of Science 170 Blog home page
Siblings with a Mission is a non-profit, international organization established to serve and support siblings of individuals with complex health conditions and developmental disabilities. All images are found on Google images and are solely used for educational purposes. The stories and advice provided by Siblings with a Mission are not to be replaced by professional advice and counseling but to be considered as an additional source of support.
Siblings with a Mission is a non-profit, international organization established to serve and support siblings of individuals with complex health conditions and developmental disabilities. All images are found on Google images and are solely used for educational purposes. The stories and advice provided by Siblings with a Mission are not to be replaced by professional advice and counseling but to be considered as an additional source of support.
