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Tales about organ transplants appear in mythology and folk stories,
and surface in documents from medieval times, but only during the
past twenty years has medical knowledge and technology been
sufficiently advanced for surgeons to perform thousands of
transplants each year. In the majority of cases individuals
diagnosed as "brain dead" are the source of the organs without
which transplants could not take place. In this compelling and
provocative examination, Margaret Lock traces the discourse over
the past thirty years that contributed to the locating of a new
criterion of death in the brain, and its routinization in clinical
practice in North America. She compares this situation with that in
Japan where, despite the availability of the necessary technology
and expertise, brain death was legally recognized only in 1997, and
then under limited and contested circumstances. "Twice Dead"
explores the cultural, historical, political, and clinical reasons
for the ready acceptance of the new criterion of death in North
America and its rejection, until recently, in Japan, with the
result that organ transplantation has been severely restricted in
that country. This incisive and timely discussion demonstrates that
death is not self-evident, that the space between life and death is
historically and culturally constructed, fluid, multiple, and open
to dispute.
In addition to an analysis of that professional literature on and
popular representations of the subject, Lock draws on extensive
interviews conducted over ten years with physicians working in
intensive care units, transplant surgeons, organ recipients, donor
families, members of the general public in both Japan and North
America, and political activists in Japan opposed to the
recognition of brain death. By showing that death can never be
understood merely as a biological event, and that cultural,
medical, legal, and political dimensions are inevitably implicated
in the invention of brain death, "Twice Dead" confronts one of the
most troubling questions of our era.
"An excellent description and analysis of East Asian medicine
...Based on fieldwork conducted in Japan during 1973 and 1974,
which involved the use of a variecy of participant-observer
techniques, as well as extensive reading in primary and secondary
sources in Japanese and English, Lock's study makes a significant
contribution to our understanding of an important dimension of life
in Japan...In well-written chapters dealing with the philosophical
foundations and historical development of East Asian medicine,
Japanese attitudes regarding health, illness, and the human body,
detailed description of kanpo clinics, herbal pharmacies,
acupuncture and moxibustion clinics, shiatsu and anma clinics, East
Asian medical schools as well as the interactions between various
providers and patients (customers), Lock develops the cultural
thesis ...In the process, she provides information on things most
visitors to Japan have seen, heard, felt, and smelled but rarely
understood." (Journal of Asian Studies). "Breaks important new
ground . Lock discusses concrete medical practice and its cultural
significance in general...rich in comparisons, engrossing to read,
and analytically penetrating ...an important and absorbing book. It
is an engaging account of how at least some Japanese people respond
to universal problems. Most readers will obtain from it their first
clear impression of what East Asian medicine actually is and does."
(Journal of Japanese Studies). "Of considerable significance for
comparative cross-cultural studies of medicine, of which this is
the best account for a Japanese setting that we now possess."
(Monumenta Nipponica). "Both Japan specialists and medical
anthropologists will be stimulated, challenged, and engaged by this
book." (Medical Anthropology Newsletter).
"Remaking a World "completes a triptych of volumes on social
suffering, violence, and recovery. "Social Suffering, "the first
volume, deals with sources and major forms of social adversity,
with an emphasis on political violence. The second, "Violence and
Subjectivity, "contains graphic accounts of how collective
experience of violence can alter individual subjectivity. This
third volume explores the ways communities "cope" with--endure,
work through, break apart under, transcend--traumatic and other
more insidious forms of violence, addressing the effects of
violence at the level of local worlds, interpersonal relations, and
individual lives. The authors highlight the complex relationship
between recognition of suffering in the public sphere and
experienced suffering in people's everyday lives. Rich in local
detail, the book's comparative ethnographies bring out both the
recalcitrance of tragedy and the meaning of healing in attempts to
remake the world.
These original essays, which combine theoretical argument with
empirical observation, constitute a state-of-the-art platform for
future research in medical anthropology. Ranging in time and
locale, the essays are based on research in historical and cultural
settings. The contributors accept the notion that all knowledge is
socially and culturally constructed and examine the contexts in
which that knowledge is produced and practiced in medicine,
psychiatry, epidemiology, and anthropology. Professionals in
behavioral medicine, public health, and epidemiology as well as
medical anthropologists will find their insights significant.
Margaret Lock explicitly compares Japanese and North American
medical and political accounts of female middle age to challenge
Western assumptions about menopause. She uses ethnography,
interviews, statistics, historical and popular culture materials,
and medical publications to produce a richly detailed account of
Japanese women's lives. The result offers irrefutable evidence that
the experience and meanings--even the endocrinological
changes--associated with female midlife are far from universal.
Rather, Lock argues, they are the product of an ongoing dialectic
between culture and local biologies.
Japanese focus on middle-aged women as family members, and
particularly as caretakers of elderly relatives. They attach
relatively little importance to the end of menstruation, seeing it
as a natural part of the aging process and not a diseaselike state
heralding physical decline and emotional instability. Even the
symptoms of midlife are different: Japanese women report few hot
flashes, for example, but complain frequently of stiff shoulders.
Articulate, passionate, and carefully documented, Lock's study
systematically undoes the many preconceptions about aging women in
two distinct cultural settings. Because it is rooted in the
everyday lives of Japanese women, it also provides an excellent
entree to Japanese society as a whole.
Aging and menopause are subjects that have been closeted behind our
myths, fears, and misconceptions. Margaret Lock's cross-cultural
perspective gives us a critical new lens through which to examine
our assumptions.
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