Diagnosis and the Illness Experience

Maitra, Amrapali; Verghese, Abraham

doi:10.1001/jama.2021.19496

Cited by 13 publications

(8 citation statements)

References 9 publications

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“…Further, their pain did not typically respond to the treatments proffered. The strategy of responding to peter katha with testing and treatment eschews the moral significance of suffering (Maitra and Verghese, 2021), even becomes an “instrument of social control” (Taussig, 1980). Pregnancy tests or gas tablets neatly circumvented the most prevalent and distressing form of harm in the clinic: marriage itself (Pinto, 2011).…”

Section: Making Complaints Legiblementioning

confidence: 99%

The Belly's Word: Domestic Violence in a Bengali Clinic

Maitra

2023

Med Anthropol Q

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Unspeakability is a dominant analytic lens in scholarship on gendered violence in India, but women can and do speak out. This article examines how Bengali women complain about domestic violence through peter katha, the belly's word. The capacious pet (belly) is the seat of tension, where abuse dwells in the body. At a clinic in Kolkata, India, women describe sensations of abdominal pain, pressure, and hunger to convey patterns and temporalities of violence. Yet complaints of belly pain go unacknowledged by local clinicians. Hygiene discourses frame poor women's bodies, not structural violence, as the problem. Peter katha is more than an idiom of distress: it is a genre of embodied complaint that illuminates violence as the accrual of harm and, in its dynamic and layered quality, moves beyond a binary of disclosure or concealment. Anthropologists may use peter katha to extend the conceptual vocabulary of gender and silence. [domestic violence, kinship, complaint, hygiene, belly, India]

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Section: Making Complaints Legiblementioning

confidence: 99%

The Belly's Word: Domestic Violence in a Bengali Clinic

Maitra

2023

Med Anthropol Q

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“…In the initial Viewpoint of this series, Maitra and Verghese cautioned that no biomedical label can encompass the patient’s lived experience. Whether diagnostic excellence comes to depict a state and future course of health or to describe a current category of disease, physicians and other clinicians will always do well to focus on the lived experience.…”

Section: The Aims Of Diagnosismentioning

confidence: 99%

The Future of Diagnostic Excellence

Fineberg

Song

Wang

2022

JAMA

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“…In 1978, Kleinman coined the term 'explanatory models' to denote the cognitive and emotional frames through which individuals make sense of the illness experience [7]. Maitra and Verghese [8] describe this eloquently in their recent viewpoint article on 'diagnosis and the illness experience'. Using the example of depression, they highlight that, depending on the cultural and social context for the patient, depression could be viewed as the result of isolation, thinking too much or spirit possession.…”

Section: Patient Beliefsmentioning

confidence: 99%

“…They summarize that, in Western biomedicine, diagnosis means 'reducing multiplicity to singularity' (but as a result this can produce a dichotomy between disease as biology and illness as culture). This meaning of diagnosis is not universal through history and across cultures [8]. This is worthwhile to remember when practising medicine overseas, as usual cultural norms and beliefs may be vastly different and examples of this abound in urological practice.…”

Section: Patient Beliefsmentioning

confidence: 99%

Understanding cultural and logistical contexts for urologists in low‐income countries

et al. 2022

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The provision of effective urological management in low-and middle-income countries requires the delivery of appropriate and effective care adapted to the needs, capability and resources of the host country. However, a deeper cognisance of the culture, the religious practices and the logistics of healthcare in that environment determines the ability to effectively to 'twin', that is, to provide a long-term healthcare partnership. Patient beliefs can have profound effects on the understanding of the aetiology of illness, its relevance to their long-term health and the stigmatization of their family's social status. Consequently, individuals may have a greater willingness to seek help from practitioners of traditional medicine due to its availability as well as the lower costs of such medicine by comparison to those of medicine from highincome countries (HICs). This can influence the treatment of many urological conditions and lead to late-presenting states such as malignant ureteric obstruction. Social mores, such as cultural paternalism, can also influence many practices that are assumed by HICs to be part of normal healthcare provision, including the delivery of patient information and provision of informed consent to treatment. Doctor's status and dress have greater importance in many countries in sub-Saharan Africa (sSA) than in the UK and the modes of greeting and addressing colleagues and patients can affect the fluency and effectiveness of clinical interactions. A local cultural and religious knowledge is essential, therefore, to optimize the assimilation of external help. Logistics are perhaps the most important factor that needs to be grasped to provide a sustainable healthcare environment. Limitations in resource allocation are a major factor in planning effective urological treatment in many countries in sSA, whether this is the provision of trained personnel, basic infrastructure, a tenable workspace, equipment or drugs. This paper explores all of these factors, and looks at how their recognition assists urologists in providing a twinning process.

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Diagnosis and the Illness Experience

Abstract: This Viewpoint, part of a new JAMA series on diagnostic excellence, explores the meaning of diagnosis and the ultimate goal of using the diagnosis to provide individualized treatment and the art of caring to bring comfort to the patient experiencing illness.

Cited by 13 publications

References 9 publications

The Belly's Word: Domestic Violence in a Bengali Clinic

The Belly's Word: Domestic Violence in a Bengali Clinic

The Future of Diagnostic Excellence

Understanding cultural and logistical contexts for urologists in low‐income countries

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