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The Body Silent

Article in Contemporary Sociology · March 1989

DOI: 10.2307/2074129

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Lawrence A. Hirschfeld
The New School for Social Research
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276 REVIEWS
nearlyall respondents used theabove in con- ing this state of ill healthmightseem to
junctionwithalternative healing. society at large, disabilityis hardly a
A majorhypothesis of thisstudyis that"a homogeneous category:One can be disabled
new mode of self-in-relation-to-the-world" as a resultofcountlessdisorders andtraumas.
(p. 238) has developedwithina newgenreof By the same token,the disabledstateis
suburbanites.McGuire speculatesthat this itselfdifficult to specifyabstractly: Profes-
group,promptedby exposureto alternative sional footballplayers, for instance,fre-
therapies,could affectthe largersocietyby quentlyperform whileexperiencing levelsof
demandingthat social institutions become pain thatin othercontextsone would find,
morecompatiblewiththeirholisticselves- well, disabling.Yet as athletestheyare the
thisconstituting a challengeto thepervasive
polaroppositesof thedisabled.In short,the
rationalizationof contemporary society.
disabled'sconditionis "social, forno matter
Researchersinvestigating what McGuire
termsthemind-body-society will who we are or how we got into our
relationship
regardthisbookas a pioneering empiricalstudy unenviable situation, theable-bodiedtreatthe
givingsounddirection forfuture research.The physicallyhandicappedin much the same
highqualityof researchand conceptualizationway. Disabilityis definedby societyand
andthemeticulous documentation of therele- given meaningby culture;it is a social
vantliterature makeRitualHealingin Subur- malady"(p. 4). Regardlessof how corporeal
ban Americaessentialreadingforthoseinter- a physicalhandicapmightat firstblushseem,
ested in the sociologyand anthropology of it is as importantly "an aspect of social
religionand of medicine,and in thestudyof identity-a process set in motionby somatic
healthandillnessin contemporary America. causes but given definition and meaningby
society"(p. 195). The Body Silentis not,
however,an interpretive anthropological ef-
The Body Silent, by ROBERT F. MURPHY.
fort at unpacking the cultural categories of
New York:HenryHolt,1987. 242 pp. $17.95 disability in our society. For example, the
cloth. healthcaresystem-which playsan instrumen-
talrolein categorizing thedisabled-although
LAWRENCE A. HIRSCHFELD clearlyfeltin thebook,is hardlyheardfrom.
University of Wisconsin, Madison TheBodySilentis insteadthepersonaland
fragmentary accountof a continuing experi-
TheBodySilentis theaccountofanthropol- ence of physical disability and a struggle
ogistRobertMurphy'sineluctable transforma-againstsocialdisability. Murphyremarks that
tion from an active, apparentlyhealthy the collaborativeprojecton disabilitywhich
individualwith "a littlemuscle spasm" in he headswillreport elsewhere,presumably in
1972 to a quadriplegicin 1986. It is a very a more sociological manner. Here he is
personal chronicle, detailing the conse- concernedto conveyhis own journeyfrom
quencesof "a tumorinsidemyspinalcolumn "normalcy"and "health"to "disability"and
thatis growingslowlybut steadilyand will "illness." Whilehis accountis frank,reveal-
eventuallyreduce my body to total quies- ing, and oftenmoving,Murphydoes not
cence" (p. 3). Murphy,knownin anthropol- seeminterested in simplyproviding testimony
ogyforbothhisiconoclasmandclearwriting, to a personal catastrophe. Rather, he has cast
notsurprisingly has crafteda fine,and often his narrative in what is both a rare and
quietlyand disturbingly detached,storyof essentialethnological light:
whatformanypeople is one of life's worst This book was conceivedin therealization
scenarios-theprotracted devastation ofone's thatmy long illness . . . has been a kind of
physicalcapacitiesaccompaniedby undimin- extended anthropologicalfield trip. . . . It
ishedpowersof observation and reflection. has been writtenwithmanypurposesin
As Murphyremarks, disordersof thissort mind,butthemostimportant is to relateto
are frequently viewedby thehealthypopula- thegeneralpublic,and to disabledpeople
tion as so degrading,so undermining of everywhere, thesocialcircumstances ofthe
essentialself,thatone is betteroffdead than physically impairedandthemeaningofthis
thusstricken. Yet he also notesthatno matter conditionas an allegoryof all life in
howgloballydisturbing anduniformly affect- society.(p. ix)

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 REVIEWS
Murphy'sprimaryinspiration forthis work
was itselfa unique anthropological report,
ClaudeLevi-Strauss'sTristeTropique,which
used a "journeyacrossgeographicspace as a
backdropand sourceforan inquiryintothe
structureofhumanthought. In muchthesame
way, I have used my own odysseyin inner
space to explorethestructure of selfhoodand
sentiment" (p. x).
To be sure,Murphyis a singulardisabled,
and his explorationis thus to some extent
unique.He enjoysa profession flex-
sufficiently
ibleto (moreorless) adaptto hishandicap:he
has continued, as thisbook is witness,to re-
searchandwritein thefaceof his illness.Co-
lumbiaUniversity, hisemployer, appearstohave
beenmoreaccommodating thanmany.Butper-
hapsmostimportant, Murphyis singularin a
wayindependent of hishandicap:He is an ex-
ceptionalcommentator, who, in earlierwork,
has usedthelivesof lowlandSouthAmerican
tribesmen, sub-Saharan nomads,andAmerican
undergraduate to inform withgraceandhumor
ourunderstanding of society.Remarkably, he
hasdonemuchthesamewithhisownphysical
disintegration.
The Politicsof Health in India, by ROGER
JEFFERY. Berkeley:University of California
Press,1988. 348 pp. $39.95 cloth.
LINDAA. BERGTHOLD
of California,San Francisco
University
DuringthetimeI was writing thisreview,I
was invitedto a receptionfor a groupof
Indiandoctorsat theIndianconsulatein San
Francisco.I decidedto testsome of Roger
Jeffery'spointsabouttheeffectofBritishrule
and independenceon health care, health
politics, and health policy in India. The
doctorslistenedpolitelyas I explainedthe
framework of thebook. The firstpartof the
book examinestheeffectsof Britishmedical
policyon thehealthof theIndianpopulation,
indigenousways of copingwithillness,and
medical systemsand practitioners before
Independence in 1947. The secondpartofthe
book describeshealthpolicyand politicsin
Independent Indiaafter1947.
Expectingan attackon colonialrulefrom
the book, the doctorswere surprisedat my
accountofJeffery'sconclusions:Whilehealth
policies underBritishcolonial rule did not
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277
substantially affectmorbidity and mortality,
theydid establisha framework of institutions
and providers thatfacilitatedpositiveimpacts
in the post-Independence period. Jeffery
concludes that post-1947effortsat health
planningin independent Indiaachievedsome
real gains: resourceshave been allocatedto
preventive medicine, ruralareas,andparamed-
ical workers.Campaignsagainstmalariaand
smallpoxhave been surprisingly successful,
and thepoor have notbeen totallyexcluded
fromparticipation in andthebenefits of these
programs.
The Politicsof Health in India trulyis a
uniquecontribution to the literature. It is a
tributeto RogerJeffery thatit is difficult to
place thisbook withina singlesociological
category.It is at the same timea studyof
politicalinstitutionsand thestate,an analysis
ofhealthpolicyandplanning, anda history of
medical politics in India. Comprehensive
studiesofhealthcarepoliticsin thedeveloped
worldare relatively scarce;studiesof devel-
opingcountriesare almostnonexistent. Jef-
feryprovidesus witha multilevel analysisof
patternsof healthservicesin India,based on
severalyearsoffieldstudyinIndia,as wellas
a thorough reviewof archivalsourcesin both
India and theUnitedKingdom.The bibliog-
raphyis excellent.While Jeffery's world-
view is a Marxistone, his unitof analysisis
organizational: Indianhealthcareinstitutions.
Insteadof leavinghis framework at thedoor
of his introduction, as so oftenoccurs in
books such as this, he applies it evenly
throughout the book, deftlyavoiding the
dogmatismof so manyapplicationsof class
theory.His analysisis complexand even-
handed,and otherthanhis ideologicalbias
againstfamilyplanningand populationpro-
grams,he is morethanfairin his presenta-
tion,even whentheevidencecontradicts his
own hypotheses.
While the book will appeal to a wide
audience,includingstudentsof international
healthpolicyas well as politicalinstitutions
and the state, its scope is so large that
coverageof some issues is too superficial,
while the historicaldetail is sometimes
overwhelming. Jeffery's analysisof thepoli-
ticsofprofessional medicinein Indiais notas
strongas it could be, because Jeffery takes
the participation of the professionin policy
makingas the majorindicatorof its power,
disregardingsuch other indicatorsas the