Sunday, July 5, 2009

Just someone else's normal

I often find myself wishing everyone could take an anthropology class with my college anthro professor. I took three courses with her, all variations on medical anthropology, and they were amazing, and probably life-changing. I grew up very scientifically-minded. There was one way of knowing how to do things - western science/medicine - and if it didn't work, then you were out of luck. Other cultural beliefs were sweet and quaint, but they all needed to get busy catching up to us.

Studying medical anthro cracked my world open and let a lot of other possibilities in. My professor used to say, "Culture is to people as water is to fish." It's very hard to notice and analyze because you're already living in it. She once explained that she taught her classes in a careful sequence - she started by having us look at cultures very different from our own, and then slowly brought us closer and closer throughout the semester until we were able to start seeing the water we were swimming in.

Since then I've found it so useful, when I am accepting something as fact or "how it has to be done", to think of other parts of the world. Do they have an alternate system of thinking, and how does it work for them? This is well-illustrated in the birth world by the contrast between the British RCOG's support for homebirth and the American ACOG's condemnation. These are two developed countries that have strong historical ties, have similar populations and standards of living, and share a common language and can read the exact same evidence - yet they reach opposite conclusions (and in the UK's cause their way seems to work just as well as, if not better than, ours).

I also end up using cross-cultural comparisons for a lot of breastfeeding discussions. I feel pretty strongly about speaking up when I hear people making negative comments about things like extended breastfeeding or nursing in public. With extended breastfeeding, I talk about Kathy Dettweiler's research on age of weaning in non-human primates, to show that there is little biological evidence for early weaning, and discuss the variability of age at weaning around the world. For public breastfeeding, I point to the many cultures that do not sexualize breasts and where nursing your baby in public is as normal as giving your child a handful of crackers. (This mother calls out our ideas of being "the most liberated": "I imagined the women of West African villages looking at the enlightened mama cloaked in a Hooter Hider or nursing in the bathroom with that same mix of sympathy and bewilderment and condescension I catch myself using on a Muslim woman trudging through the summer heat in a black burqa.")

I really hope this technique does work. I do think it's helpful, in that it's the kind of thing I can say in a calm, offhand kind of way: "Oh sure, that's what we've gotten used to, but actually in other countries they do it this way and it's actually got some really great benefits". (As opposed to the other arguments like "Why is it any of your business and if you don't like it stop looking" which tend to involve a little more righteousness and spittle.) Especially with people who are already schooled in multiculturalism and open-mindedness, they just need a little nudge to see this as something that's not beyond the pale of all human experience - it's just someone else's normal.

Anyway, if you're interested in learning more about culture and health/medicine, I highly recommend the book The Spirit Catches You and You Fall Down by Anne Fadiman. It's filled with those "aha!" moments where you get to see your own culture/water. The only drawback is that it may be hard to get enough sleep because the story is so compelling, it keeps you up late reading.


Jill--Unnecesarean said...

Good lord. I spent all day (well, off and on) reading anthropology text and thinking about how my definition of normal is wider than most people's because I think of culture as something of an arbitrary construct, like gender.

That's weird.

publichealthdoula said...

Ooh, that is weird synergy.

I agree that understanding the many ways culture constructs our lives starts broadening your ideas of normal. I don't ever want to slip into total relativism - "there's no good or bad, just different" - there IS good and bad - but it has been generally so helpful.

Jill--Unnecesarean said...

Agreed. There are some universals. And a need for laws.

I've heard some really interesting discussions over the years. It seems as though people with very rigid views are terribly afraid that humans are inherently evil and cannot be trusted to make sound judgments without invoking mass chaos and widespread depravity (as they define it). I am endlessly fascinated by listening to how people define their world and reality.

Emily said...

I LOVE your blog! I just stumbled across it while blog-hopping doula blogs. I am an aspiring medical anthropologist who is just looking into doula training workshops. I also looked into going for an MCH, but do not just yet have any medical background. I'm working on it! Any tips/advice?

I think my interest all started with a Cross-Cultural Healing medical Anth course I took as an undergrad. We read The Spirit Catches You, as well as Birth in Four Cultures, among others. LOVED it.

publichealthdoula said...

@Emily: Thank you so much!!

Going further with medical anthropology was a huge temptation for me, I think it's great you're doing that! I even looked at programs that have the joint MPH/MA in med anthro, although I ended up just going to a straight MPH program.

A few MPH programs require a medical background but some do not (like mine) so don't let that stop you if you're interested! The best thing to do is get experience in MCH/public health, very broadly defined. People in my program did teaching, foster care, international development, and medical research (among others) before they came to school. Becoming a doula is a great way to get that background.

And of course I encourage everyone to do doula training :-) So I hope you get a chance to do it!!