“Five years out, I utilize the praxis of medical anthropology daily.”
UNC Chapel Hill Alumni Sarah Stoneking, MD discusses how medical anthropology helped her find her place in the medical world.
by Cameron Catherine, Will Grine, Sierra Reid, Jinah Han, and Yasmin Amini
Part I: Considering Life’s Trajectory
As I sit down to consider my life’s trajectory since the conclusion of my formal medical anthropology education—now five years past—I am having a hard time knowing where to start. The snow-ball effect that an education in medical anthropology initiated has touched almost every facet of my life: from the personal to the professional. At first I thought that I would write on the lens I felt I carried into hospitals as a new medical trainee—or on my experience of witnessing death first hand for the first time, both gruesome and quiet— or how hard it was to pull myself out of the world of prestige in medicine, a place I never imagined I would find myself entangled. I have found the teachings of medical anthropology wildly and widely applicable. Five years out, I utilize the praxis of medical anthropology daily.
In my anthropology courses, I learned from writers, professors, and classmates reflecting on where we as members of our particular culture place emphasis and praise power. I recall being fascinated by the many ways the authorities we commonly and reflexively accept, in turn, shape our experiences of the world around us, particularly in the most vulnerable and universal of moments: death, birth, illness, and pain, and in perpetuating injustices for vulnerable populations, particularly in the minute details. Beyond the classroom, I have found that those reflections helped me in advocating and fighting for the rights of my patients and community on individual and larger scales, but they also now implicate me, soon to be a functioning member of the medical authority’s “upper” class.
It’s a Skype interview, but the hustle and bustle of the café Felipe Dest has settled down in reflects the fast track his life is currently on.
After graduating from UNC with an Anthropology degree, Dest spent time in AmeriCorps, leading to his interest in patient care after working in a community health center in Berkley, California. “It was a 10 month program and after I finished, I got hired on and worked my way up into the quality improvement department there, at the community health center. I was doing a lot of stuff related to patient experience. I worked with the patient advisory council within the community health center and I did a lot of data analytics.” Right from the start, it’s clear that unique experiences have shaped Dest’s career path, from his Anthropology interests at UNC (Professor Rivkin-Fish’s classes are one of his top recommendations) to a study abroad program in Brazil, his subsequent work in AmeriCorps, and now at Johns Hopkins pursuing a masters in Health Administration.
Like many students at UNC, Felipe Dest arrived to college with an interest in pursuing a career in medicine . He was aware of his interests in public health, sociology, and environmental impacts on health, but struggled to find a program of study that truly reflected and encompassed all of these areas. After some friends recommended that he take a class with Professor Rivkin-Fish, he realized that medical anthropology was this program that he had been looking for. Dest noted that “it seemed to culminate all those things I was interested in,” and he enjoyed the way the classes challenged him to think about health and systems of care from different perspectives.
As I placed my feet onto the red-eye flight to Lima, Peru I instantly felt a rush of emotions that had been building up in my stubborn self for several months. From the discussions of packing to the safety concerns from my family, it was not until my long flight that I started to consider what I had gotten myself into. The next 24 hours of travel that involved several plane transfers, unsafe cars, donkeys, and wagons proved to become a microcosm of the adventures I had voluntarily placed myself in for the next few months.
As a health education coordinator working for Sacred Valley Health in Ollantaytambo, Peru, it was my responsibility to develop and train community health workers (promotoras) in 7 surrounding communities. With little knowledge about the communities, I found my first day hiking 8 hours with a Peruvian nurse to quickly learn about my main areas of focus. Let me say that hiking over 14,000 ft. passes and extreme conversation barriers leaves a lot of time to think, and a lot of time to complain about your aching legs. In fact, the majority of my time in Peru was spent in solitude trekking across the mountains, riding donkeys across the passes, or more commonly hitchhiking in the back of an animal truck just praying to get back to my village. Everyday I left my home in Ollantaytambo, never knowing what danger I may face, or if I would make it down the mountain alone. If I wasn’t hiking or up working in one of my communities, my time was spent in my own village. This often included hour-long meals eating guinea pig, being chased by rabid dogs, or more simply just living out underneath the beauty of the stars. With zero electricity, I didn’t have any modern conveniences such as a hot shower, running toilet, or even a normal sleeping arrangement for several months. Despite the hardships that I faced, these were the three best months of my life, and I am yearning for the moment that I can return.
I believe that my personal discovery of the field of medical anthropology, though occurring relatively late in my time at university, has nonetheless been one of the most influential aspects of the liberal arts education that I attained at UNC. And though the readings from my med anth classes reached far and wide in content, one text in particular from a class with Professor Rivkin-Fish continues to stand out with rippling effects in my life: …And a Time to Die. How American Hospitals Shape the End of Life by Sharon Kaufman.
Kaufman’s book grapples with a topic that is by its very nature innumerable shades of grey in every respect. How do we think about death? How do we think about others’, our own, as a concept, or as an acute reality? How are specific ways of dying created and promoted in the American hospital setting? What sociocultural, political, and economic factors play into creating these paths and guiding (or forcing) people along them? How much of the decision process do you want responsibility for, or do you think you should be responsible for, in another’s death? In your own? How do you want to die? When? Where? Why do people think they can ultimately have a real choice when it comes to these questions? I hadn’t honestly thought in depth about many of these ideas before coming in contact with Kaufman’s book. My major take away from the text: death is an invaluable discussion to have with friends and family during life and any time is the right time. In respect to life and death, I personally believe that ignoring the inevitability of the later can truly detriment one’s experience of the former.