Summary Of Improvizing Medicine By Julie Livingston

In the realm of medical anthropology, Julie Livingston’s Improvising Medicine stands as a poignant ethnography that examines the growing cancer crisis in Sub-Saharan Africa from the view of the oncology ward in Princess Marina Hospital (PMH) in Gaborone, Botswana. A professor at New York University, Julie Livingston is a medical historian who combines her training in anthropology and public health to evaluate medicine in Botswana with an emotional analysis, depicting a view of physical suffering in context of the social climate. Her previous work, Debility and the Moral Imagination in Botswana, analyzed the effect of economic and political development on traditional, medical care practices. This runs parallel with Improvising Medicine as the …show more content…
A large part of the book is dedicated towards highlighting the experiences of the patients at PMH and thus provides narratives of various people in the ward. Now, one side of the social experience is due to the compact size of the clinic. In a situation where families are washing dirty wounds, nurses are looking after the relatives in the ward, and beds are lined up close to one another, the setup makes it difficult for patients to ignore the rounds of vomiting after chemotherapy. This environment is made further unbearable with recurring amputations resulting from an inflow of patients with late-stage cancer. Although morphine and codeine are rather inexpensive, they are always in a short supply at PMH, leading Livingston to depict the overlooked issues of pain in Botswana and an overall invisibility of cancer in Africa as it trails the HIV/AIDS epidemic. In this manner, Livingston is continually able to revisit the cancer relation to hope and pain in the context of larger political and economic caveats of biomedicine as they relate to the North American model of cancer care. However, one aspect that separates Botswana’s culture from that of other nations is process of coping with pain. Suffering is an experience which brings people together, and with a lack of palliative care, Botswana culture expresses pain through laughter rather than screaming. A highlight of the book’s discussion of pain is thus the resilience of the patients at PMH and their ability to cooperate and account for each other amidst the inequity of their general treatment and care. Specifically, the nurses work, more than just to objectively treat the patients, to rehumanize those suffering through chemotherapy with profound care, both physical and emotional. This