Respossession Along The Rio Grande Analysis
Sociology is the study of social behavior or society, including its origins, development, organization, networks, and institutions. Since hospitals and medical institutions are significant institutions in our society, sociologists tend to focus on them extensively. In Conceiving Risk, Bearing Responsibility: Fetal Alcohol Syndrome and the Diagnosis of Moral Disorder by Elizabeth Armstrong and The Pastoral Clinic: Addiction and Dispossession Along the Rio Grande by Angela Garcia, theories about the social construction of illness and the impact of medicalization on a community have been exemplified. The purpose of Freidson’s article was to analyze the social organization of the medical profession and its members. In his study, he explored how the medical profession has gained a monopoly in its field, which grants it complete jurisdiction over determining what illness is therefore how people must act in order to be treated as ill (Freidson 1970:205). Because medicine has the ability to label one person’s grievance an illness and another one not, Freidson believes that medicine creates the social role of illness. Illness is thought of as a deviance from a set of norms that represent normal or healthy behavior. “Human, and therefore social evaluation of what is normal, proper, or
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desirable is as inherent in the notion of illness as it is in the notions of morality” (Freidson 1970:208). Freidson is drawing upon similarities between the standard definition of deviance associated with the law and deviance in illness, two instances that fall under the category of social deviance. Despite the biological experience of illness, Freidson notes how there is social interplay between the biology and the society. Illness is a biological disorder, but the idea of illness and how people respond to it is defined socially. In Elizabeth Armstrong’s book, Conceiving Risk, Bearing Responsibility: Fetal Alcohol Syndrome and the Diagnosis of Moral Disorder, she explores Freidson’s theory of how the medical profession holds a monopoly in the medical field, which grants them complete jurisdiction over determining what is or is not an illness. Armstrong uses fetal alcohol syndrome to show how social problems are individualized as well as the interplay of health and morality. Fetal alcohol syndrome is described as a set of birth defects that are associated with prenatal alcohol exposure, while fetal alcohol effect is used to denote a less severe form of the same symptoms (Armstrong 2003:3). In order to be diagnosed with fetal alcohol syndrome, four separate criteria needs to be met. The first is there has to be a confirmed maternal exposure to an excessive amount of alcohol. Second, the child must have some craniofacial anomalies. Third, the child must have prenatal or postnatal retarded growth. Fourth, the child must suffer nervous system anomalies (Armstrong 2003:4). Armstrong challenges our preconceived notions on fetal alcohol syndrome by providing facts about the occurrence of the disorder. Only five percent of pregnant woman who binge drink have children affected by fetal alcohol syndrome. By this small percentage, the layman would assume that there is no correlation between alcohol consumption and birth defects, but by honing onto social anxieties, the false ideas of fetal alcohol syndrome have been exaggerated, spread, and eventually transformed into public policy. The relationship between society and medicine is clearly exemplified in Armstrong’s work. Those in the medical field, including physician and scientists, helped to identify the symptoms of fetal alcohol syndrome, but society played a role in making it a social deviance by attaching stigma to woman who drank while pregnant. Armstrong opens her book with an antidote about a nine-month pregnant woman named Deborah Zimmerman who is admitted into the emergency room of St. Luke’s Hospital with a blood alcohol level well above the state’s legal limit. According to a nurse who was there that night, Zimmerman initially refused to deliver the baby because she wanted to go home and drink herself to death and kill the baby. Her child was eventually born with fetal alcohol effect and was then sent to foster care. Zimmerman was charged with attempted murder and reckless endangerment to her unborn child. The district attorney who pressed charges against her said, “I think its time for women to be held accountable when they inflict injuries on their unborn child” (Armstrong 2003:2). Zimmerman’s case shows how the stigma associated with drinking while pregnant or harming a fetus carries more power than other illnesses.
When Zimmerman was admitted into the hospital and explicitly stated her suicide intent, she was ignored and all the attention was focused on her baby. As a reader, it was not indicated in the text that she was admitted into the psychiatric ward or underwent any psychiatric evaluation. Women have a long history of trying to gain reproductive rights. Before Roe v. Wade, which legalized abortion, women were going to black market clinics and administrating abortions themselves. Many women were dying from the complications of at home abortions, but the value of an unborn child seemed more important than allowing women to receive safe abortions. It is impossible to study medical institutions without analyzing the impact of the society. If a pregnant woman went into a bar and decided to have a drink, she would be met with a societal response of dissent and anger. While medicine defines what an illness is, societal mechanisms enforce these illnesses and prevent the individual from straying from the norm.
Another theorist, Peter Conrad, examined the issue concerning medicalization and social control. Medicalization is the process by which nonmedical problems become defined and tested as medical problems, usually in the terms of illnesses and disorders (Conrad 1992:209). Medicalization can occur on three distinct levels: the conceptual, the institutional, and the interactional level. On the conceptual level, medical vocabulary is used to define the problem at hand. At the institutional level, an organization may adopt a medical approach to treating a particular disorder in which the organization specializes. The third level is the interaction level where physician and the idea of medicalization are in play. At the patient-doctor relationship, the doctor defines a problem as medical or treats a “social” problem with a medical form of treatment (Conrad 1992:211). Medicalization is often criticized for being socially constructed and a form of social control. The Books written by both Armstrong and Garcia support this critique.
The Pastoral Clinic: Addiction and Dispossession Along the Rio Grande is book by Angels Garcia that tells the story of several residents living in the Española valley of New Mexico and the struggles they face as heroin addicts in a impoverished environment.
Garcia is hired to work in the detoxification clinic. She has no formal training, but like the other attendants, neither do they. Despite her lack of training, she was still expected to distribute the proper dosage to all the patients in the clinic. During her return to New Mexico and her time in the clinic, Garcia became fascinated with the role of institutional structures and how they exacerbate an addict’s personal sense of
failure.
Addiction is a disorder that has become medicalized. Scientist and physicians have identified it as an illness and have developed the model of chronicity to help them to understand how to treat them. The model of chronicity likens addiction to a lifelong disease such as asthma, diabetes, or hypertension (Garcia 2010:13). By likening addiction to a disease, Garcia believes that it has distanced addiction from moral failure and stigma. I believe there has been tremendous growth in the medical field by acknowledging addiction as neurological disorder, but similar strides have not been made in society to legitimate this disease. Garcia complains about the turnover that exists in the clinics, but the nurses reinsured her that it was normal. By medicalizing addiction, I think sometimes the tie between society and medicine can be overlooked. The nurses in the clinic used the model of chronicity, which states that relapse is normal, to treat their patients. By doing this, the clinic fails to see the problems with their institution that is causing the patients to prematurely release themselves. Garcia recounts a moment where one patient had “everything to lose” if she did not get clean, but in one week she was gone from the clinic. The disconnection between society and medicine has exacerbated the addiction in Española Valley.
In Conrad’s article, he uses an example of post-traumatic war disorder to highlight the consequences of medicalization. “Post-traumatic war disorder is an instance where the cause of the disorder was shifted from the particularities of an individual's background to the nature of war itself; it is "normal" to be traumatized by the horrors of war” (Conrad 1992:224). This is example of what is occurring at the clinic in Española Valley. The nurses and physicians are focusing on the notion of addiction and how to use the standard medical procedure to treat it. This is problematic because it ignores all the underlying causes and problems in the community that keeps the people of Española Valley addicted to heroin. If a chronic skin rash represented the addiction in this community, an approach to healing the rash would not be to just apply ointment. Although that might be the first approach, the reoccurrence of the rash would make any physician look at other causes of the skin rash such as allergens. I think because addiction is closely tied with society, the medical field tends to only focus on their jurisdiction instead of collaborating with public health officials for a proper interventional program.
In both Garcia and Armstrong’s books, the social control is focused on marginalized, low socioeconomic communities. Armstrong focuses on women, a marginalized group compared to men, and points out that the incidence of fetal alcohol syndrome is higher among disadvantaged populations (Armstrong 2003:205). Garcia’s depiction of the Española Valley, and the lack of funding to the detox center shows the extent of how impoverished this community is. From this we can note that the removal of the stigma associated with addiction from medical vocabulary, does not necessarily mean that it has been removed from society. There is a biological aspect associated with addiction, such as pain and symptoms from withdrawal. However, social institutions such as prisons have failed to see that. Addiction is still seen as a moral deviance and that is very clear when the officers who Garcia speaks to say that they like to patrol graveyards to pick up drug users. The officers were seeing these drug users as criminals, while a physician might see this person in pain and I need of treatment. The biological experience of illness is only legitimized depending on society’s ideas of that particular illness; therefore the two go hand in hand.
The social construction of illness is a theme that is explored in both Garcia and Armstrong’s work. Through medicalization, a disorder becomes defined in medical terminology, but because of the dependence of society in the medical field, an illness is not legitimized unless society agrees too. This has been a problem in medicalization, but proves how important the study of medicine and society is.
desirable is as inherent in the notion of illness as it is in the notions of morality” (Freidson 1970:208). Freidson is drawing upon similarities between the standard definition of deviance associated with the law and deviance in illness, two instances that fall under the category of social deviance. Despite the biological experience of illness, Freidson notes how there is social interplay between the biology and the society. Illness is a biological disorder, but the idea of illness and how people respond to it is defined socially. In Elizabeth Armstrong’s book, Conceiving Risk, Bearing Responsibility: Fetal Alcohol Syndrome and the Diagnosis of Moral Disorder, she explores Freidson’s theory of how the medical profession holds a monopoly in the medical field, which grants them complete jurisdiction over determining what is or is not an illness. Armstrong uses fetal alcohol syndrome to show how social problems are individualized as well as the interplay of health and morality. Fetal alcohol syndrome is described as a set of birth defects that are associated with prenatal alcohol exposure, while fetal alcohol effect is used to denote a less severe form of the same symptoms (Armstrong 2003:3). In order to be diagnosed with fetal alcohol syndrome, four separate criteria needs to be met. The first is there has to be a confirmed maternal exposure to an excessive amount of alcohol. Second, the child must have some craniofacial anomalies. Third, the child must have prenatal or postnatal retarded growth. Fourth, the child must suffer nervous system anomalies (Armstrong 2003:4). Armstrong challenges our preconceived notions on fetal alcohol syndrome by providing facts about the occurrence of the disorder. Only five percent of pregnant woman who binge drink have children affected by fetal alcohol syndrome. By this small percentage, the layman would assume that there is no correlation between alcohol consumption and birth defects, but by honing onto social anxieties, the false ideas of fetal alcohol syndrome have been exaggerated, spread, and eventually transformed into public policy. The relationship between society and medicine is clearly exemplified in Armstrong’s work. Those in the medical field, including physician and scientists, helped to identify the symptoms of fetal alcohol syndrome, but society played a role in making it a social deviance by attaching stigma to woman who drank while pregnant. Armstrong opens her book with an antidote about a nine-month pregnant woman named Deborah Zimmerman who is admitted into the emergency room of St. Luke’s Hospital with a blood alcohol level well above the state’s legal limit. According to a nurse who was there that night, Zimmerman initially refused to deliver the baby because she wanted to go home and drink herself to death and kill the baby. Her child was eventually born with fetal alcohol effect and was then sent to foster care. Zimmerman was charged with attempted murder and reckless endangerment to her unborn child. The district attorney who pressed charges against her said, “I think its time for women to be held accountable when they inflict injuries on their unborn child” (Armstrong 2003:2). Zimmerman’s case shows how the stigma associated with drinking while pregnant or harming a fetus carries more power than other illnesses.
When Zimmerman was admitted into the hospital and explicitly stated her suicide intent, she was ignored and all the attention was focused on her baby. As a reader, it was not indicated in the text that she was admitted into the psychiatric ward or underwent any psychiatric evaluation. Women have a long history of trying to gain reproductive rights. Before Roe v. Wade, which legalized abortion, women were going to black market clinics and administrating abortions themselves. Many women were dying from the complications of at home abortions, but the value of an unborn child seemed more important than allowing women to receive safe abortions. It is impossible to study medical institutions without analyzing the impact of the society. If a pregnant woman went into a bar and decided to have a drink, she would be met with a societal response of dissent and anger. While medicine defines what an illness is, societal mechanisms enforce these illnesses and prevent the individual from straying from the norm.
Another theorist, Peter Conrad, examined the issue concerning medicalization and social control. Medicalization is the process by which nonmedical problems become defined and tested as medical problems, usually in the terms of illnesses and disorders (Conrad 1992:209). Medicalization can occur on three distinct levels: the conceptual, the institutional, and the interactional level. On the conceptual level, medical vocabulary is used to define the problem at hand. At the institutional level, an organization may adopt a medical approach to treating a particular disorder in which the organization specializes. The third level is the interaction level where physician and the idea of medicalization are in play. At the patient-doctor relationship, the doctor defines a problem as medical or treats a “social” problem with a medical form of treatment (Conrad 1992:211). Medicalization is often criticized for being socially constructed and a form of social control. The Books written by both Armstrong and Garcia support this critique.
The Pastoral Clinic: Addiction and Dispossession Along the Rio Grande is book by Angels Garcia that tells the story of several residents living in the Española valley of New Mexico and the struggles they face as heroin addicts in a impoverished environment.
Garcia is hired to work in the detoxification clinic. She has no formal training, but like the other attendants, neither do they. Despite her lack of training, she was still expected to distribute the proper dosage to all the patients in the clinic. During her return to New Mexico and her time in the clinic, Garcia became fascinated with the role of institutional structures and how they exacerbate an addict’s personal sense of
failure.
Addiction is a disorder that has become medicalized. Scientist and physicians have identified it as an illness and have developed the model of chronicity to help them to understand how to treat them. The model of chronicity likens addiction to a lifelong disease such as asthma, diabetes, or hypertension (Garcia 2010:13). By likening addiction to a disease, Garcia believes that it has distanced addiction from moral failure and stigma. I believe there has been tremendous growth in the medical field by acknowledging addiction as neurological disorder, but similar strides have not been made in society to legitimate this disease. Garcia complains about the turnover that exists in the clinics, but the nurses reinsured her that it was normal. By medicalizing addiction, I think sometimes the tie between society and medicine can be overlooked. The nurses in the clinic used the model of chronicity, which states that relapse is normal, to treat their patients. By doing this, the clinic fails to see the problems with their institution that is causing the patients to prematurely release themselves. Garcia recounts a moment where one patient had “everything to lose” if she did not get clean, but in one week she was gone from the clinic. The disconnection between society and medicine has exacerbated the addiction in Española Valley.
In Conrad’s article, he uses an example of post-traumatic war disorder to highlight the consequences of medicalization. “Post-traumatic war disorder is an instance where the cause of the disorder was shifted from the particularities of an individual's background to the nature of war itself; it is "normal" to be traumatized by the horrors of war” (Conrad 1992:224). This is example of what is occurring at the clinic in Española Valley. The nurses and physicians are focusing on the notion of addiction and how to use the standard medical procedure to treat it. This is problematic because it ignores all the underlying causes and problems in the community that keeps the people of Española Valley addicted to heroin. If a chronic skin rash represented the addiction in this community, an approach to healing the rash would not be to just apply ointment. Although that might be the first approach, the reoccurrence of the rash would make any physician look at other causes of the skin rash such as allergens. I think because addiction is closely tied with society, the medical field tends to only focus on their jurisdiction instead of collaborating with public health officials for a proper interventional program.
In both Garcia and Armstrong’s books, the social control is focused on marginalized, low socioeconomic communities. Armstrong focuses on women, a marginalized group compared to men, and points out that the incidence of fetal alcohol syndrome is higher among disadvantaged populations (Armstrong 2003:205). Garcia’s depiction of the Española Valley, and the lack of funding to the detox center shows the extent of how impoverished this community is. From this we can note that the removal of the stigma associated with addiction from medical vocabulary, does not necessarily mean that it has been removed from society. There is a biological aspect associated with addiction, such as pain and symptoms from withdrawal. However, social institutions such as prisons have failed to see that. Addiction is still seen as a moral deviance and that is very clear when the officers who Garcia speaks to say that they like to patrol graveyards to pick up drug users. The officers were seeing these drug users as criminals, while a physician might see this person in pain and I need of treatment. The biological experience of illness is only legitimized depending on society’s ideas of that particular illness; therefore the two go hand in hand.
The social construction of illness is a theme that is explored in both Garcia and Armstrong’s work. Through medicalization, a disorder becomes defined in medical terminology, but because of the dependence of society in the medical field, an illness is not legitimized unless society agrees too. This has been a problem in medicalization, but proves how important the study of medicine and society is.