In Arc of Interference: Medical Anthropology for Worlds on Edge, João Biehl and Vincanne Adams assemble reflections on the role of anthropology in understanding healthcare in today’s world of rapid change. Taking a cue from renowned medical anthropologist Arthur Kleinman, the authors in this volume write sensitively and critically to disrupt the uncomfortable norms and assumptions embedded in the discipline, writes Evelyn Hoon.
Arc of Interference: Medical Anthropology for Worlds on Edge. João Biehl and Vincanne Adams (eds.). Duke University Press. 2023.
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As our world reckons with the perils of climate change, inequality, and health crises, the discipline of anthropology too finds itself in a time of reckoning. What role does anthropology have to play in our increasingly unequal and unsettled worlds? Enter Arc of Interference: Medical Anthropology of Worlds on Edge, a valuable collection responding to these upheavals with attention, care, and solidarity. The twelve chapters, written by influential US-based anthropologists, extend and challenge ethical and practical questions facing the discipline.
What role does anthropology have to play in our increasingly unequal and unsettled worlds?
The chapters address a combination of philosophical questions and ethnographic puzzles and respond with care and “interference”. A few theoretical concepts guide the volume, all derived from or inspired by the celebrated medical anthropologist Arthur Kleinman. The first concept, and namesake of the collection, is “interference”: the act of interrupting norms and assumptions. Refreshingly, the concept is taken honestly, with many contributors concluding that “interference” is easier said than done. Also central to the volume is the idea of care – both how families and loved ones care for their own, and how anthropologists can conduct their work “care-fully”. Contributors adopt a variety of approaches, including ethnographies, reflections on the history of medicine, and explorations of philosophical concepts. These explorations take place in a variety of settings, including Tibet, the US, Mexico, India, the UAE, Japan, and Brazil.
Also central to the volume is the idea of care – both how families and loved ones care for their own, and how anthropologists can conduct their work “care-fully”
This volume is not intended for a wide audience, and nor is it directed to the faint of heart. As Paul Farmer wrote in the preface, it is “both easy and difficult to read”– most chapters focus on heavy content, including suicide, migrant deaths, a worsening climate and unequal access to medicine. Not only is the content heavy, but many chapters employ theory-heavy language. Unsurprisingly, for a volume centred on Kleinman’s academic arc, some terms and concepts will be inaccessible for non-academics.
The collection is divided into four sections, each section (of three chapters each) detailing a “mode of interference”. The first section of the volume explores Kleinman’s concept of “local moral worlds” to inquire where, when, and what it means to “interfere”. The contributors to this section make the uncertainty of the Anthropocene apparent; not only are moral certainties dislodged, but so too are enduring dogmas. Section two asks how medical anthropology can challenge hegemonic certainties in biomedicine to advance care and justice. These chapters reflect on medicine in the “postcolonial” world, providing provocative anthropological and ethnographic insights. Section three “interferes” in our thinking about new technological advancements by highlighting how technologies complicate the concept and implementation of care. From biometric identities to assisted conception, the authors reveal the complex ways that technologies change our worlds and ourselves. Fittingly, the final section deals with the end: death. Its contributors question the “aftermaths” of care, ethnographic relationships, and intervention, and how the discipline can learn from death.
From biometric identities to assisted conception, the authors reveal the complex ways that technologies change our worlds and ourselves.
Traced throughout the volume runs an attractive theme of humility. In their chapters, Adams, Carrasco, Cohen, and Biehl meditate sensitively on the purpose and place of their work. For instance, reflecting on his position in a dichotomous controversy over the biometric inclusion of transgender women in India, Cohen asks himself, “can one even write… about interference if one is uncertain as to the place of critique?” (178). The contributor’s humble responses to ambiguities in their work are certainly a highlight of the collection.
In this vein, Biehl offers a standout chapter creatively displaying the humanity, artistry, and uniqueness of the ethnographic method. Reflecting on his relationship with a deceased subject and her descendants, Biehl writes that the work of ethnography is always “rife with myriad entanglements” and “ethnographic opens”– but that its products are all the more valuable for this ambiguity (270). In his 2005 book Vita, Biehl articulated the complex life and social context of a woman named Catarina, confined to an asylum in rural Brazil as her neurogenerative disease progressed. In his chapter in Arc of Interference, Biehl reflects on Catarina’s dreams of her estranged children, and how he was contacted by Catarina’s long-lost daughter after her death. This chapter is proof of the sensitivity, humanity, and open-endedness of the method.
While contributors are unapologetic in their critiques of external dogmas– in medicine, technology, and politics– the volume does little to radically examine itself.
The stated intention of the volume is to answer what the role of anthropology is in our changing world, and how practitioners are proving the discipline’s value by “radically” interfering (xiii). Although eloquently written and true to Kleinman’s concepts, the collection falls slightly short on this. While contributors are unapologetic in their critiques of external dogmas– in medicine, technology, and politics– the volume does little to radically examine itself.
Case in point, Comaroff’s chapter offhandedly dismisses internal challenges to anthropology. Mentioning Ryan Cecil Jobson’s controversial “The Case for Letting Anthropology Burn: Sociocultural Anthropology in 2019”, a challenging article that calls for a renewed, self-critical discipline, Comaroff unfortunately misses an opportunity to reflect on the volume’s positionality. Instead, Comaroff uses the chapter to affirm the importance of the anthropological archive, listing past sources of wisdom, such as temporality, that can inform new challenges. Yet, valuing conceptual insights from past work need not be at odds with calls for reflexivity. As Jobson and colleagues explore in a 2020 panel discussion, those pushing for reflection within the discipline are still students of, and inspired by, concepts from the anthropological archive. While Comaroff’s meditation on existing sources of wisdom, and the volume overall, are instructive and valuable, they do not chart a new path towards a “radical” anthropology.
The myriad lessons, reflections, and sensitive ambiguities contained in the chapters are a touching ode to both Kleinman, and to his late student and colleague Paul Farmer
Despite these limitations, Biehl, Adams, and their contributors have nevertheless penned a classic in Arc of Interference. The myriad lessons, reflections, and sensitive ambiguities contained in the chapters are a touching ode to both Kleinman, and to his late student and colleague Paul Farmer, who wrote the volume’s preface shortly before his untimely death in 2022. Academics and students of medical anthropology, sociology, history, and ethics will find it a refined rendering of the discipline. In our current times of reckoning – both global and disciplinary – contributions like Arc of Interference are a good place to start.
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