2. Biomedicine as a Cultural Worldview Wednesday, September 13, 2000

3. What is “biomedicine”? A system of healing that “took off” in 17th century Europe claiming basis in empirical science and is now among the most socially powerful healing systems in the world, taught at universities in US and throughout the world

4. Images of the body Ancient Egypt –Body as microcosm of irrigation system Classical India –Body as microcosm of caste system Tantric Buddhism –Body as microcosm of the world/cosmos

5. Traditional Hmong image of the body Body as home, house or village Each spirit within is unique and irreplaceable the spirits must be in harmony reflects centrality of tight-knit group in Hmong society

6. The biomedical image: body is a machine Model of the clock –A shell enclosing a complex set of impersonal mechanisms Clock was crucial technological breakthrough in 17th century Europe The more recent model: the automobile

7. Implications of the machine image, 1 Encourages impersonal, invasive manipulation to get at the internal gears and mechanisms (open case, look under the hood)

8. Implications of the machine image, 2 Encourages inter-body transfers of blood and organs –all parts are replaceable, –as are the parts of a machine

9. Implications of the machine image, 3 Encourages proliferation of sub- specializations Currently over 100 biomedical specialties

10. Implications of machine image, 4 Encourages emphasis on the tangible and mechanical –the social and psychological are suspiciously intangible –physician as technician, seeing many patients What remains un- analyzed?

11. Implications of the machine image, 5 Encourages depersonalization –the focus is often on the disease, not person –technical language renders pain abstract –hospital gown turns individual into a body –Anatomy 101 ritual

12. From mechanic to hero Aggressive, decisive action Dramatic, life-saving heroism The mystique of emergency and surgery Overlap with Hmong shamanism?