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The Ethnographic Body, or the Ethnographic Bodies? Bodily Self, or Bodily Identity?

11/15/2015

1 Comment

 
Picture
Picture
by Elise Paradis
Assistant Professor
University of Toronto
Leslie Dan Faculty of Pharmacy
& Department of Anesthesia, Faculty of Medicine
Scientist, The Wilson Centre


I have recently crossed the street into a new job, leaving my office in the bustling core of the Toronto General Hospital for a new office on the 7th floor of the Leslie Dan Faculty of Pharmacy. As a sociologist, working in a hospital never felt “natural,” but landing in a Faculty of Pharmacy is no less strange: Who would ever have thought that a leftie feminist like me would end up here? It surprised me and my loved ones equally; but this is another story.
 
As a student of the body, who has conducted two ethnographies in apparently different but uncannily similar environments – the boxing gym (Paradis, 2012, 2014a) and the intensive care unit (Leslie et al., In Press; Paradis, Leslie, & Gropper, Under Review; Paradis et al., 2014) –, I have learned to pay close attention to what I used to call “my ethnographic
 body.” In the boxing gym, my inquiry into gender made my visibly female body an unavoidable object of study: comments by friends and gym members abounded, and the review process for my “Boxers, Briefs or Bras” paper (Paradis, 2012) made me emphasize this content to an extent that I did not foresee.
 
In our study of care team interactions in the ICU (Paradis, 2014), however, my body and how it was perceived seemed completely beside the point... until I realized that depending on what I was wearing, I was perceived differently. I was seen as a student when wearing jeans and sneakers; as an attending physician (staff physician in Canada; consultant in the UK and Australia) on Tuesdays when I tend to wear a tie; and as a physical therapist the rest of the time for my perceived athleticism and my civilian clothes (see Jenkins, 2014 on clothing and status in healthcare).
 
In a move parallel to the move from self to identity in sociological theory, these experiences have made me reconsider my relationship to my “ethnographic body.” I now see ethnography bodies. This reconsideration is reminiscent of Annemarie Mol’s “body multiple” (Mol, 2002), yet the shift here is not ontological: it is not when I take on a different perspective on what is real that my body changes. Rather, it is through its embeddedness into a context – or field, since I am very much a Bourdieusian – that my body crystallizes into one version of itself: the athletic body, the female body, the student body, the physiotherapist body. In fact, I have come to believe that I do not have a bodily self; rather, my body has an identity that shifts according to my location in social space, the actors I interact with, and how they read and value my body.1
 
In the hospital, I didn’t really “fit” in any of the main categories of hospital human resources. I was neither someone who cared for the ill nor an ill person myself. I was not part of the administration, nor part of the maintenance crew. Walking through the halls of the hospital, my discomfort was generally a low hum, muted until it was activated by a passerby who wanted guidance to find the red blood cell disorders clinic, or by someone in line at the coffee shop who shared the story of a surgeon in this hospital who, ten years ago, saved his life through a successful heart transplant. Those experiences made me feel slightly parasitic, aware as I am that my existence in this hospital context has been enabled by a Canadian (if not global!) health research enterprise that values interdisciplinarity and has placed several social scientists and humanities scholars like me into clinical faculties (especially medicine) around the country. Colleagues and I have written about the experiences of these scholars (Albert & Paradis, 2014; Albert, Paradis, & Kuper, 2015, Forthcoming), yet we haven’t covered this sense of being physically or bodily out of place, the sense of being neither here (in the hospital) nor there (in a social science department), of living in a liminal space.
 
Crossing the street into a more traditional academic setting three months ago made me reconsider my bodily identity once again. Strangers generally see me as someone who is in her mid 20s to mid 30s, and I thus stand in an imprecise relationship to the undergraduate students whom I cross in the hallways (and whom I will soon be teaching), and in an even more imprecise relationship to the graduate students, staff and other faculty members who have yet to “learn” that I am one of the new tenure track hires.
 
On Wednesdays, four different groups of 60 undergraduate pharmacy students in white coats wait for their pharmacy practice laboratories in the hall right in front of my office door, sitting and standing in small clusters, chatting. Every time I have to navigate the crowd, make my way through the white-clad bodies of students who haven’t yet met me, I wonder how they see me, how they “bin” me into one of the categories of people who have offices on that floor.2 About a month ago, I put my business card up behind the Plexiglas that holds my name (see Photo). “I might look young, and you might not know me, but I’m legit; here are my creds,” I felt defensively as I slid the card between paper and Plexiglas. I will not lie: writing this blog has made me ashamed of this silly, juvenile insecurity, and I took down the card after snapping the attached picture. My invisibility is something that in any other context I value: in the elevator, it allows me to listen to what students say while staying under the radar; for my upcoming ethnographic study of the Leslie Dan Faculty of Pharmacy, I wish I could at once earn students’ trust and spy on them freely, but as soon as I start teaching them, deception will become impossible.3 Yet in my new work context, where I am the new kid on the block ensconced in a body that often looks decidedly non-professorial, I felt the need to legitimate my existence.
 
In conclusion, it is a truism that at the core of contemporary ethnography is an understanding that the ethnographer is the instrument of data collection, and therefore the medium through which information must pass before being acknowledged as important, written up as fieldnotes and then being made part of ethnographic accounts. We show we care about the subjectivity of the ethnographer through emphasis on reflexivity on previous experiences and relationships to the people and topics we cover. Too often, however, the ethnographic bodies have no place in these accounts. What if we considered our bodily identities in our ethnographic research, documenting how they impact our perspectives? What if we troubled the idea of a single, lived experience of the body, and instead worked to document the many bodily identities of our research participants? What would an ethnography of bodily identities look like?

 
Notes 
1 Loïc Wacquant and I have been engaging in a conversation about the meaning of habitus and field in print in the context of boxing over the past few years; see Wacquant (2004); Paradis (2012); Paradis (2014b); Wacquant (2014); and Atkinson (2015).
2 Most of my colleagues on the 7th floor are pharmacists whom the Faculty calls “clinician scientists” because they teach undergraduates and conduct research on pharmacy practice. They have shared similar struggles with navigating the sea of white-coat-clad bodies on Wednesdays. On the 6th floor, below, faculty members have their names listed as “Dr. So Andso,” while I am “Elise Paradis.”
3 A colleague suggested that students do not always self-censor, even in front of faculty whom they know.
 
References 
Albert, M., & Paradis, E. (2014). Social scientists and humanists in the health research field: A clash of epistemic habitus. In D. L. Kleinman & K. Moore (Eds.), Handbook of science, technology, and society (pp. 369-387). New York, NY: Routledge.

Albert, M., Paradis, E., & Kuper, A. (2015). Interdisciplinary promises versus practices in medicine: The decoupled experiences of social sciences and humanities scholars. Social science & medicine, 126(1), 17-25.

Albert, M., Paradis, E., & Kuper, A. (Forthcoming). Interdisciplinary fantasy: Social scientists and humanities scholars working in faculties of medicine. In S. Frickel, M. Albert, & B. Prainsack (Eds.), Critical studies of interdisciplinary research. New Jersey: Rutgers University Press.

Atkinson, W. (2015). Putting Habitus Back in its Place? Reflections on the Homines in Extremis Debate. Body & Society, 1357034X15590486.

Jenkins, T. M. (2014). Clothing norms as markers of status in a hospital setting: A Bourdieusian analysis. Health:, 18(5), 526-541.  Retrieved from http://hea.sagepub.com/content/18/5/526.full.pdf

Leslie, M., Paradis, E., Gropper, M. A., Milic, M. M., Kitto, S., & Pronovost, P. J. (In Press). A Typology of ICU patients and families from the provider perspective: Towards patient centrism. Health Communications.

Mol, A. (2002). The body multiple: Ontology in medical practice: Duke University Press.

Paradis, E. (2012). Boxers, briefs or bras? Bodies, gender and change in the boxing gym. Body & Society, 18(2), 82-109.
Paradis, E. (2014a). Skirting the issue: Women boxers, liminality and change. In lisahunter, W. Smith, & e. emerald (Eds.), Pierre Bourdieu and physical culture. New York, NY: Routledge.

Paradis, E. (2014b). Sociology is a martial art: A commentary on Wacquant's Homines in Extremis. Body & Society, 20(2), 100-105.

Paradis, E., Leslie, M., & Gropper, M. (Under Review). Interprofessional Rhetoric and Operational Realities: An Ethnographic Study of Rounds in Four Intensive Care Units.

Paradis, E., Reeves, S., Leslie, M., Aboumatar, H., Chesluk, B., Clark, P., . . . Kitto, S. (2014). Exploring the nature of interprofessional collaboration and family member involvement in an intensive care context. Journal of Interprofessional Care, 28(1), 74-75. doi:10.3109/13561820.2013.781141

Wacquant, L. (2004). Body & Soul. New York: Oxford University Press.

Wacquant, L. (2014). Putting Habitus in its Place: rejoinder to the symposium. Body & Society, 20(2), 118-139.



1 Comment

Big Gay Men’s Critique of Weight-Loss Surgery

11/1/2015

10 Comments

 
Picture
Jason Whitesel, PhD
Assistant Professor of Women’s & Gender Studies
Pace University, NYC


In a paper I gave at the 2015 annual meeting of the American Sociological Association in Chicago, I presented on “discursive entanglements” in narratives on weight-loss surgery (WLS) by Girth & Mirthers, which both interact with, and disrupt, the dominant discourse on WLS.* In interviews with members of “Girth & Mirth” (G&M), a nationwide social club for big gay men, I explored the men’s perspectives on WLS. While G&M as a national social movement organization declares no official position on WLS, I gathered personal opinions on the topic from members in a local chapter. G&M was founded in the seventies to call attention to weight discrimination in the gay community. It provides life-affirming activities to assuage big gay men’s experiences of the shame of fat stigma, as they feel marginalized not only for their sexual orientation, but also for their size in gay society. G&M treats being big as “normal,” and offers a haven free of the usual hassle of weight-loss sermons (Whitesel 2014). Members are accepted as they are, without having to make drastic body alterations.

In doing a discourse analysis of the interview transcripts, I noted discursive knots where some arguments the men made about WLS were entangled. Karen Barad’s (2007) term, “discursive entanglements,” was useful for describing and unpacking the big men’s tenuous perspectives on WLS, which overlap and conflict, yet the men demonstrate a remarkable ability to creatively manage these entanglements. Their positions on WLS range from respect for others’ personal choices, to soft opposition to invasive surgery, comparison to sadomasochism, and to matters of attraction.

Most Girth & Mirthers personally opposed weight-loss surgery, but believed people should be free to choose for themselves. Members assumed a more-power-to-them attitude that seemed to be a recurring theme in many interviews, thereby creating a discursive entanglement between tolerance for personal choice and the club’s mission to be fat & happy. One member, a nurse, said: “I absolutely refused gastric bypass when my doctor asked me about it because I’ve cared for numerous patients over the years who’ve had the surgery, and were brought in for complications, and a number of them died of perforations. Besides, I don’t want a scar from my pelvis up to my sternum.” He went on to say: “If it worked for people, more power to them.” This speaker also could not help but reveal his deeper opposition to WLS. Adopting the dominant discourse he said, “My personal preference, not as a nurse, I think it’s the easy way out – I believe it’s a psychological thing. You have to retrain your stomach and let it shrink on its own.”

While this speaker scrutinized personal choice, he entangled it with issues of willpower and self-control. He asserted these surgeries are “the easy way out,” the unspoken being that fat people have not done the hard work of dieting and exercising. At the same time, he refused one dominant discourse, that of the medicalization of fat bodies that are in need of surgical intervention, but then fell back on another equally dominant discourse, that of psychologizing and individualizing fatness, and then blaming the “victim.” When those who are critical of weight-loss surgery individualize blame like this, they overlook the role that cultural stigmas play in the lives of fat people. They neglect to understand that one’s seemingly “personal and individual” choice to undergo major surgery is made under duress. Those who opt for WLS do so, from a set of options that are severely constrained by the extant system. One perhaps would not resort to WLS if the medical community were to make a practice of offering sustainable alternatives like the Health-at-Every-Size approach.

The Girth & Mirthers I interviewed also compared WLS to sadomasochism. This created a tricky discursive entanglement, because they also would not want to put down the kink community that engages in S&M. One Girth & Mirther made an analogy between WLS and being confined to a cage. He regarded it as constraining one’s pleasure of eating. Furthermore, like the nurse quoted above, he saw it as the easy way out: “It’s a cop-out. It’s like saying ‘I can’t do this on my own, but I’ll let you force me, so all I can drink is an ounce of fluid at a time and let my stomach process it.’ ” This big man likened undergoing the surgery to being forced into having one’s intake rationed. In creating a distinction between the willful, do-it-yourself weight-loss and the “cop-out,” coerced surgery, he rejects what he regards as total domination of the fat person by the medical industry, with its presumably “easy” solutions.

This big man went on to compare weight-loss surgery to being imprisoned in a cage, which is another illustration of a discursive entanglement. He said, “It’s basically the same as if somebody has put you in a cage. I knew someone who was gonna do it, and I said, ‘So, when did you get into S&M?’ I said, ‘Well, I’m not into that. But you’re getting into it.’ It’s the same principle as me putting you in a cage for a few months, and I ration you food, and whatever I don’t give you, you don’t eat.” 

With the S&M metaphor, the speaker shifted the discourse from the dominant medical one of fat being dangerous, to a counter-discourse of the surgery itself being far more dangerous. His comparison of WLS to a cage went beyond personal choice equaling control of one’s own body, to include ceding control of one’s body in S&M, recalling Weber’s “iron cage” of bureaucratic domination and destruction. The speaker regarded WLS as not corrective, but destructive. The position of the WLS candidate he articulated, of “I can’t do this on my own, but I’ll let you force me,” echoes Weber’s account of how the ascetic choice turned into a willingness to become part of a rational, mechanized culture, trading a “light cloak” for an “iron cage” (1953: 181). The speaker regarded those considering WLS as being unaware of inducing their own suffering and mocked them for getting pleasure out of literally punishing their bodies from within. His S&M comparison also relates to Freud’s moral masochist, who simultaneously occupies the roles of “both... victim and... victimizer,” both “pain-enduring” and “pain-inflicting” (Silverman 1992: 196). Similarly, those who undergo WLS as a last resort seem to be both punishing themselves and being punished by the external world.

Girth & Mirthers belong to a body-acceptance group: in theory, they aspire not to judge someone else’s body as imperfect; yet, for example, in the interviews the subject of sagging skin following WLS occasioned an entangled position of both opposing weight-loss surgery, and favoring cosmetic surgery down the line to tuck the loose skin. One big man said: “They should either finish the job, or put the weight back on.” This speaker’s opposition to WLS and support of body contouring surgery unwittingly placed him in a discursive bind. His words hearkened to the tragic irony that people have these weight-loss surgeries to be accepted and reinstated into society, but they may find that their bodies are still “unacceptable” and in need of cosmetic surgery, lest the excess skin make their bodies even more “undesirable.”

In recent years, Fat Studies has become a powerful, counter-hegemonic voice by not shying away from biomedical data on weight, but instead attending to it, to see what reconfigurations become possible. While the subject of this emerging field has often been women, I wanted to give voice to Girth & Mirthers regarding WLS. Weight-loss surgery is medically imposed and it contradicts the big gay men’s self-validation and acceptance of their fellow members’ size. But overall, the interview data reveal that despite facing stigma and so much rejection, the men extend their discourse of fat acceptance to a larger and crucial insistence of respect for people’s choices, even those less than palatable, which is consistent with “progressive” neo-liberal attitudes toward the body.


* For a longer treatment of this topic, see Whitesel, Jason and Amy Shuman. 2016. “Discursive Entanglements, Diffractive Readings: Weight-Loss-Surgery Narratives of Girth & Mirthers.” Fat Studies: An Interdisciplinary Journal of Body Weight and Society 5:1 (in press, January issue).

References
Barad, Karen. 2007. Meeting the Universe Halfway: Quantum Physics and the Entanglement of Matter and Meaning. Durham, NC: Duke University Press.

Butler, Judith. 2004. “Doing Justice to Someone: Sex Reassignment and Allegories of Transsexuality.” In Undoing Gender, 57-74. New York, NY: Routledge.

Silverman, Kaja. 1992. Male Subjectivity at the Margins. New York, NY: Routledge.

Weber, Max. 1953. The Protestant Ethic and the Spirit of Capitalism. New York, NY: Scribner.

Whitesel, Jason. 2014. Fat Gay Men: Girth, Mirth, and the Politics of Stigma. New York, NY: NYU Press.

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