Morbid mixtures: Hybridity, pain and transnational dying

Abstract

Three stories about diseased and dying migrants in the United Kingdom are at the heart of this paper. Working with these narratives, I investigate the neurobiological, subjective and sociocultural entanglements of disease, pain and dying and the challenges these hybridisations present for attempts to recognise and alleviate suffering. My aim is to show the differential workings of hybridising forces with regard to assumed correspondences and time, as well as the indeterminate and liminal states of subjective experience that disease can amplify. The paper engages with the growing literature on 'social pain' and suggests that social pain is the mortar rather than merely a reflection of the affects and neurology of transnational migrations, loss and social violation. Keywords:Bodies, care, ethics, migrants, neurology, temporality.In the early stages of an on-going project, I sent out a call through palliative care networks in the UK, for stories about transnational dying and care. The first story that I received came from Errol, a music therapist, who described his work with Tony, a Rastafarian and migrant from Jamaica. Tony was in his late sixties and was nearing the end of his life in an urban hospice (all names are pseudonyms). Errol explained how Tony 'on the basis of his beliefs, had refused conventional cancer treatment such as chemotherapy and radiotherapy' and 'was adamant that he did not wish any opiates or western medical painkillers'. When Errol met him for the first time -taking a tambourine, a guitar and a small hand drum to the single-bedded room -Tony was writhing in 'silent agony' in his bed. Errol continued I immediately began playing the guitar trying to match the intensity of his movements and mood with the intention of providing a musical focus that called his attention to the music and away from the pain. Upon hearing this, Tony responded by indicating he wanted the hand drum. For the next hour the sound of improvised rhythmic grooves, Reggae rhythms and various Bob Marley songs could be heard to the delight of staff, floating down the ward as Tony, who proved to be a consummate drummer, played himself into a state of musical transcendence -music, used therapeutically had helped him tap into his own resources of pain management. The session ended and Tony asked for the drum to be left. As I exited, promising to return the following day, he thanked me and smiled saying he felt better…"more like me old self". There was a similar event of shared musical improvisation the next day with Tony's release from pain through music. Because it was a Friday, Errol left the instruments with Tony for the weekend. On his return to the hospice on Monday, a nurse told him that Tony had died on Sunday morning, peacefully and without pain. He had spent much of the previous day singing and playing the drums with his family and friends.Errol's story opens up three crucial matters for my discussion of hybridity at the migrant deathbed in the UK. First, there is the underlying mixing that characterises transna...

“If I had stayed back home, I would not be alive any more…” – Exploring end-of-life preferences in patients with migration background

“…Being stuck between their German home (e.g. for medical reasons) and their home elsewhere, the meaning of ‘being at home’ and ‘dying at home’ may cause distress, ‘social pain’[31], and homesickness. Physical, family, financial, or legal restraints may keep patients from returning to their home country.…”

“…In a diverse population, culture-based presumptions need to be challenged in order to deliver high quality care to all patients regardless of their background. It is therefore essential to understand the patient’s individual experience and address aspects of ‘social pain’[31]. The American Academy of Family Physicians has issued clinical guidelines that also acknowledge communication patterns deviating from common practice, e.g.…”

Kultuuritundlikkusest ja rändetausta tähendusest palliatiivravis ja hospiitsitöös patsiendinarratiivide näitel

“…Isegi kui tegemist on suurte inimmassidega, kes ühekorraga saabuvad teatud regioonist, on iga indiviidi rändepõhjused ja -lugu erinevad. Ka siis kui ränne toimub ühe maa piirides, külast linna, põhjast lõunasse, võivad sellel olla tagajärjed, mis võivad tekitada koduigatsuse (Gunaratnam 2014;Paal 2018). Ränne on alati ja igal pool oluline eluetapp, murrang, mis toob kaasa nii positiivseid kui ka negatiivseid muudatusi elukorralduses aga ka maailmavaates.…”

老年人移动构成的时空——老龄化地理学中非表征理论的引入①

“…Body and care dynamics are understood to take place across levels of practice (Dean et al, 1999) and across traditional boundaries. Indeed'relationality'of the body and care is experienced across transnational settings (Zhou, 2012), producing not only complicated power relations within and across families in space-time, but also dimensions and types of social pain (Gunaratnam, 2014). More generally, in both non-representational theory and critical gerontology, actor-network-theory presents an approach that can explain the networking, relationality and equal importance of humans and non-humans in life' s events (Tatnall et al, 2003;Cutchin, 2005).…”

“…Analysis of the trans-personal or shared sensations are only beginning (as illustrated in the above example of trans-national care (Gunaratnam, 2014)). Instead, the main body of work on'affective dimensions'or feeling states, is articulated from within the psychological tradition.…”