Each year in India more than two million people fall sick with tuberculosis (TB), an infectious, airborne, and potentially deadly lung disease. The country accounts for almost 30 percent of all TB cases worldwide and well above a third of global deaths from it. Because TB’s prevalence also indicates unfulfilled development promises, its control is an important issue of national concern, wrapped up in questions of postcolonial governance. Drawing on long-term ethnographic engagement with a village in North India and its TB epidemic, anthropologist Andrew McDowell tells the stories of socially marginalized Dalit (“ex-untouchable”) farming families afflicted by TB, and the nurses, doctors, quacks, mediums, and mystics who care for them. Each of the book’s chapters centers on a material or metaphorical substance - such as dust, clouds, and ghosts - to understand how breath and airborne illness entangle biological and social life in everyday acts of care for the self, for others, and for the environment.

From this raft of stories about the ways people make sense of and struggle with troubled breath, McDowell develops a philosophy and phenomenology of breathing that attends to medical systems, patient care, and health justice. He theorizes that breath - as an intersection between person and world - provides a unique perspective on public health and inequality. Breath is deeply intimate and personal, but also shared and distributed. Through it all, Breathless: Tuberculosis, Inequality, and Care in Rural India (Stanford UP, 2024) traces the multivalent relations that breath engenders between people, environments, social worlds, and microbes.

Andrew McDowell is Assistant Professor of Anthropology at Tulane University. He has a Ph.D. in socio-cultural anthropology from Harvard University. His research interests focus on care, contagion, pharmaceuticals, diagnosis, and inequality in North and Western Indian social worlds entangled with tuberculosis. His work has appeared in Medical Anthropology Quarterly, Ethos, and The Lancet among other venues.

Yadong Li is a PhD student in anthropology at Tulane University. His research interests lie at the intersection of the anthropology of state, the anthropology of time, hope studies, and post-structuralist philosophy. More details about his scholarship and research interests can be found here.

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Policing the Womb: Invisible Women and the Criminalization of Motherhood (Cambridge University Press, 2020) a brilliant but shocking account of the criminalization of all aspects of reproduction, pregnancy, abortion, birth, and motherhood in the United States. In her extensively researched monograph, Michele Goodwin recounts the horrific contemporary situation, which includes, for example, mothers giving birth shackled in leg irons, in solitary confinement, even in prison toilets, and in some states, women being coerced by the State into sterilization, in exchange for reduced sentences. She contextualises the modern day situation in America’s history of slavery and oppression, and also in relation to its place in the world. Goodwin shows how prosecutors abuse laws, and medical professionals are complicit in a system that disproportionally impacts the poor and women of color. However, Goodwin warns that these women are just the canaries in the coalmine. Not only is the United States the deadliest country in the developed world for pregnant women, but the severe lack of protections for reproductive rights and motherhood is compounding racial and indigent disparities.

Jane Richards is a doctoral candidate in Human Rights Law at the University of Hong Kong. Her research interests include disability, equality, criminal law and civil disobedience. You can find her on twitter @JaneRichardsHK where she avidly follows the Hong Kong’s protests and its politics.

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Students in twelfth-century Paris held slanging matches, branding the English drunkards, the Germans madmen and the French as arrogant. On Crusade, army recruits from different ethnic backgrounds taunted each other’s military skills. Men producing ethnography in monasteries and at court drafted derogatory descriptions of peoples dwelling in territories under colonization, questioning their work ethic, social organization, religious devotion and humanness. Monks listed and ruminated on the alleged traits of Jews, Saracens, Greeks, Saxons and Britons and their acceptance or rejection of Christianity.

Ethnicity in Medieval Europe 950-1250, Medicine, Power and Religion (Boydell and Brewer, 2021), provides a radical new approach to representations of nationhood in medieval western Europe, the author argues that ethnic stereotypes were constructed and wielded rhetorically to justify property claims, flaunt military strength, and assert moral and cultural ascendance over others. The gendered images of ethnicity in circulation reflect a negotiation over self-representations of discipline, rationality and strength, juxtaposed with the alleged chaos and weakness of racialized others. Interpreting nationhood through a religious lens, monks and schoolmen explained it as scientifically informed by environmental medicine, and ancient theory that held that location and climate influenced the physical and mental traits of peoples. Drawing on lists of ethnic character traits, school textbooks, medical treatises, proverbs, poetry and chronicles, this book shows that ethnic stereotypes served as rhetorical tools of power, crafting relationships within communities and towards others.

Claire Weeda is a cultural historian at the Institute for History at Leiden University, Netherlands. Her main fields of interest include ethnic stereotyping, the history of the body, Greco-Arabic medicine, and organic politics in Europe, 1100-1500.

Evan Zarkadas is a graduate student of European history at the University of Maine focusing on Medieval Europe, the Eastern Mediterranean, medieval identity, and ethnicity during the late Middle Ages.

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Dialysis is a medical miracle, a treatment that allows people with kidney failure to live when otherwise they would die. It also provides a captive customer for the dialysis industry, which values the steady revenues that come from critically required long-term care that is guaranteed by the government. 

Tom Mueller's six year deep dive into the dialysis industry has yielded his latest book, How to Make a Killing: Blood, Death, and Dollars in American Medicine (W. W. Norton, 2023). It's both an historical account of this lifesaving treatment and an indictment of the industry that is dominated by two for-profit companies that control ~80% of the market.  

There is a precarious balance between ethical care for patients and the prioritization of profits for the providers, a tension that has led to ethical, political, and legal debates about the rationing and exploitation of life-saving care and quality of life. 

Dialysis services are desperately needed by patients who require the dangerous, uncomfortable, and exhausting treatments multiple times per week, and pay for it through complex insurance procedures.

Tom Mueller’s book includes a vivid account of CEOs who lead their companies with messianic zeal to drive revenues continually up while simultaneously reducing the cost of care. He introduces us to the doctors charged with reducing those costs even at the expense of high-quality care and negative health outcomes. And we meet the patients themselves, who have little choice but to put their lives and well-being at the mercy of this system.

How did a lifesaving medical breakthrough become a for-profit enterprise that threatens many of the people it’s meant to save? And who are the brave people -patients, doctors, and employees of the system who are willing to tell their stories despite tremendous pressure to remain silent? And why do we as Americans accept worse outcomes at higher costs than the rest of the world?

Tom Mueller's highly readable yet devastating book illustrates the dialysis industry as a microcosm of American medicine. 

Mueller challenges us to find a solution for dialysis, an approach that could also provide the opportunity to begin fixing our country’s dysfunctional healthcare system and a fighting chance at restoring human health outcomes, rather than the extraction of profits, as its true purpose.

To contact Tom Mueller, visit www.tommueller.co

Suggested reading: 

Also mentioned: 

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In a broken world, in which even God Himself is in a state of deep crisis, what is required in order to mend the rupture? How can one heal God and His world? Moreover, what might allow our actions to be effective? These questions stand at the heart of the Lurianic Kabbalah, the apex of the Safedian intellectual and religious renaissance of the sixteenth century, and one of the constituting phenomena of Modern Jewish thought. 

God as Patient: The Medical Discourse of Lurianic Kabbalah (Magnes Press, 2023) presents medical discourse – the knowledge, language, and practice of medicine – as a significant key to our understanding of the Lurianic search for a way to mend reality, and first and foremost the Godhead. The book reads together the Lurianic texts alongside the medical writings of R. Hayyim Vital, R. Isaac Luria's chief disciple, and a medical practitioner. Consequently, the book analyzes how medicine becomes the model for the Lurianic language of action. In its final part, the book shows how God becomes in this Kabbalah the ultimate patient of the Lurianic Kabbalist, who in turn becomes the private court physician of the King of Kings, and needs, like every physician, the proper modes of healing to accomplish his task.

Dr. Assaf Tamari studies Jewish intellectual history in the early modern eastern Mediterranean, focusing on the affinities between theology, science and political thought, especially in the literature of the Kabbalah. He is currently the deputy head of the Ben Zvi Institute for the Study of Jewish Communities in the East, and teaches at Tel Aviv University, Shalem College and Alma - a Home for Hebrew Culture.

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Lucy Barnhouse of Arkansas State University talks with Jana Byars about her new book, Hospitals in Communities of the Late Medieval Rhineland: Houses of God, Places for the Sick, out 2023 with Amsterdam University Press. From the mid-twelfth century onwards, the development of European hospitals was shaped by their claim to the legal status of religious institutions, with its attendant privileges and responsibilities. The questions of whom hospitals should serve and why they should do so have recurred -- and been invested with moral weight -- in successive centuries, though similarities between medieval and modern debates on the subject have often been overlooked. Hospitals' legal status as religious institutions could be tendentious and therefore had to be vigorously defended in order to protect hospitals' resources. This status could also, however, be invoked to impose limits on who could serve in and be served by hospitals. As recent scholarship demonstrates, disputes over whom hospitals should serve, and how, find parallels in other periods of history and current debates.

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Rustam Alexander's Gay Lives and 'Aversion Therapy' in Brezhnev's Russia, 1964-1982 (Palgrave Macmillan, 2023) examines the autobiographies and diaries of Soviet homosexual men who underwent psychotherapy during the period from 1970 to 1980 under the guidance of Yan Goland, a psychiatrist-sexopathologist from Gorky. The examination of these unique and little-known documents contributes to our scant knowledge about the practices that many would call a Soviet proto-type of 'aversion therapy'. It also helps us understand the way homosexual people faced "queer dilemmas" of the self and how they sought to reconcile their queer desire with being Soviet.

Tatiana Klepikova is a Postdoctoral Fellow at the University of Regensburg, where she leads a research group on queer literatures and cultures under socialism.

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Decisions to go to war are often framed in cost-benefit terms, and typically such assessments do not factor in longer term costs. However, recent dramatic improvements in American military medicine have had an unanticipated effect: saving more soldiers' lives has vastly increased long-term, downstream costs of war with profound consequences for global politics in an era of heightened great power competition.

In Military Medicine and the Hidden Costs of War (Oxford UP, 2024), Tanisha Fazal traces the modern history of medical treatment and casualty rates in American conflicts from the Civil War to the more recent counterinsurgency wars. As she shows, wars became increasingly survivable for wounded troops, to the point now where a large majority of wounded soldiers survive. 

Yet the human and financial implications of this steep increase in the wounded-to-killed ratio are dramatic, and her powerful analysis of this shift provides a necessary corrective to how we understand the costs of war. For each major conflict, Fazal analyzes the weapons used, injuries sustained, and policies put in place for veterans' care and pensions. As she argues, these improvements have significant financial and deeply personal implications for the returned wounded and their families, as well as the US government and its citizenry. Fazal's analysis highlights the significance of policymakers underestimating the costs of war, which in turn makes it easier both to initiate and continue military action abroad, contributing to Americas' penchant for engaging in so-called "endless wars."

Tanisha Fazal is a Professor of Political Science at the University of Minnesota. Her scholarship focuses on sovereignty, international law, and armed conflict. In addition to her new book, she is the author of two award-winning books and numerous articles in academic and policy journals. From 2021-2023, she was an Andrew Carnegie Fellow

Lamis Abdelaaty is an associate professor of political science at the Maxwell School of Syracuse University. She is the author of Discrimination and Delegation: Explaining State Responses to Refugees (Oxford University Press, 2021). Email her comments at [email protected]

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Dr Pierce Salguero sits down with Justin B. Stein, a specialist in modern Japanese religion and the preeminent historian of Reiki. We discuss Justin’s new book, Alternate Currents: Reiki’s Circulation in the Twentieth-Century North Pacific (U Hawaii Press, 2023), about the transnational origins of Reiki, and also get into his perspective as a both a scholar and a Reiki practitioner. Along the way, we ask what Reiki has to do with Buddhism, what subtle energy feels like up close, and what kinds of extraordinary experiences might occur when you open up to energy of the universe.

Remember, if you want to hear from more experts on Buddhism, Asian medicine, and embodied spirituality, subscribe to Blue Beryl for monthly episodes. Please enjoy!

Resources mentioned in the episode:

Dr. Pierce Salguero is a transdisciplinary scholar of health humanities who is fascinated by historical and contemporary intersections between Buddhism, medicine, and crosscultural exchange. He has a Ph.D. in History of Medicine from the Johns Hopkins School of Medicine (2010), and teaches Asian history, medicine, and religion at Penn State University’s Abington College, located near Philadelphia. www.piercesalguero.com.

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After a storied career as a health policy expert, Stanford Medicine's Dr. Jay Bhattacharya's work became a political focal point during the COVID-19 pandemic, when he advocated against widespread lockdowns. He co-authored the Great Barrington Declaration, an open letter signed by infectious disease epidemiologists and public health scientists which advocated for a focused protection approach to COVID-19, and the Twitter Files revealed that his Twitter account had been placed on Twitter's "black list." In this conversation, he sits down to discuss how the history of American infectious disease affected our COVID response, the mimetic nature of lockdown policy, the importance of freedom of speech to the scientific endeavor, and more.

Dr. Jay Bhattacharya is a Professor of Medicine at Stanford University. He is also a research associate at the National Bureau of Economics Research, a senior fellow at the Stanford Institute for Economic Policy Research, a senior fellow at the Stanford Freeman Spogli Institute, and the Director of the Stanford Center on the Demography of Health and Aging. He holds an MD and a PhD in Economics, both from Stanford University.

Contributions to and/or sponsorship of any event does not constitute departmental or institutional endorsement of the specific program, speakers or views presented.

Annika Nordquist is the Communications Coordinator of Princeton University’s James Madison Program in American Ideals and Institutions and host of the Program’s podcast, Madison’s Notes.

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