Crossing Bodily, Social, and Intimate Boundaries: How Class, Ethnic, and Gender Differences Are Reproduced in Medical Training in Mexico

• Published in: American anthropologist 2019-02, Vol.121 (1), p.113-125
• Main Authors: Smith‐Oka, Vania, Marshalla, Megan K.
• Format: Article
• Language: English
• Subjects: Anthropology; Boundaries; Class differences; Ears; Embodiment; Ethnic differences; Ethnic studies; Ethnicity; Ethnographic research; Ethnography; Gender differences; Health care; Health services; Human body; Intimacy; Learning; Medical education; Medical schools; Medicine; Physicians; Political economy; Politics; Racial differences; Social classes; Social inequality; Touch; Training; Translation
• ISSN: 0002-7294; 1548-1433
• DOI: 10.1111/aman.13174

ABSTRACT Bodies are useful instruments for understanding the reproduction of inequalities. In this article, we investigate why and how bodily, social, intimate, and physical boundaries are crossed and what this can tell us about individual and social bodies. We unpack how seeing and being seen, touching and being touched, or feeling and being felt are conditioned in very particular ways by the broader political economy. Participants in this ethnographic research in Mexico used the term manitas to describe how they trained their senses (hands, ears, eyes) during medical practice; how they learned through practice on the bodies of less‐agentive populations (female, raced, or impoverished); and how they crossed intimacy, structural, and physical boundaries through what we term somatic translation: seeing others’ bodies with their own. Manitas was developed unconsciously by doctors, never explicitly taught or learned in practice, reproducing social difference. These forms of learning highlight a friction between the violence of knowing and the importance of touch as a legitimate mode of care. This form of tactile and sensorial learning entails not only a form of boundary crossing that is medically useful, but it is also a form of boundary crossing that surfaces social inequalities by taking advantage of them. [hospital ethnography, anthropology of reproduction, embodiment, social boundaries, Mexico] RESUMEN Los cuerpos son instrumentos útiles para entender la reproducción de las desigualdades. En este artículo, investigamos por qué y cómo los límites corporales, sociales, íntimos y físicos son cruzados y qué nos puede decir este proceso acerca de los cuerpos individuales y sociales. Analizamos en detalle cómo los procesos de ver y ser visto, tocar y ser tocado, o sentir y ser sentido están condicionados en modos muy particulares por la economía política más amplia. Los participantes en esta investigación etnográfica en México utilizaron el término manitas para describir cómo ellos entrenaron sus sentidos (manos, oídos, ojos) durante la práctica médica, cómo aprendieron a través de la práctica sobre los cuerpos de poblaciones con menos agencia (mujeres, racializadas, o empobrecidas), y cómo cruzaron varios límites (intimidad, estructurales y físicos) a través de lo que llamamos traducción somática: ver los cuerpos de otros con el de uno mismo. Manitas fue desarrollado inconscientemente por doctores, nunca explícitamente enseñado o aprendido en la práctica, repr