Bhabha in the clinic

Abstract

Before professional diagnosis, the determination of whether one is ‘ill’ or ‘well’ rests within the patient. These moments, when sufferers (re)cognize their own bodily and phenomenological experience as abnormal or different, are critical to the positioning of healer and patient. So too are moments when diagnosed patients, struggling with a treatment regime, compromise and adjust to embrace, if only partially, disparate ideas of health. In this article, I apply Homi Bhabha’s framework of hybridity and difference to think about the perception of illness, self-diagnosis, and power in healing relationships. I consider how sufferers enact hybrid positions between their bodily perceptions and their professional diagnoses. To illustrate the utility of Bhabha’s colonial critique for health care, I examine narratives by patients with diabetes-related vision loss about: (1) first realizations that something was wrong, what Bhabha might call the ‘intervention of difference’; (2) expressed differences between self-knowledge and biomedical knowledge, corresponding to Bhabha’s ‘partial embrace’ of the colonial ideal; and (3) the self-colonizing epistemological work that compliant patients do as they re-orient their pre-diagnostic self to a post-diagnostic habitus of self-monitoring, timed medications, and other treatments. I conclude with a discussion of how Bhabha’s colonial hybridity supports a more productively contentious medical anthropology that envisions and pursues decolonized health care.

Decolonizing Care at Diagnosis: Culture, History, and Family at an Urban Inter‐tribal Clinic

“…Given these histories, the act of diagnosis remains an unwilling (e.g., Adelson 2000) or unwitting (Smith‐Morris 2020) process by which hegemonic medical paradigms reproduce the very structural disenfranchisement that was set in motion by colonialism. Efforts to decolonize health care therefore must take both colonial histories and continuing, postcolonial inequities into account.…”

“…11The term Native is problematic in light of colonial displacement as well as for reasons that contemporary economic and political disenfranchisement, and voluntary diasporic and migratory movements, shift colonized peoples away from their natal or traditional territories. Neither is the term Indigenous without controversy (Obrist and Van Eeuwijk 2020; Smith‐Morris 2020). We have used the term Native American for this article because the participants and authors used this term most often, second only to their tribal names.…”