Exploring the Unknown

Exploring the Unknown
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Wednesday, March 29, 2017

A Review of Deborah Lupton's Medicine as Culture: Illness, Disease and the Body (2012)

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I had the privilege to teach SOC 307 Sociology of Health last semester at Bishop's University. This course seeks to examine the place of health and illness in society, the relationship between bio-medical problems and the social, political and economic realities that help shape them. Topics included poverty and health, mental illness, aging, death and dying, professionalism, health service organization, inequalities in health service access and use, recent policies and difficulties with health care reform. Whilst choosing a textbook for a class is never a straightforward task, I personally enjoyed Deborah Lupton's book and found her insights particularly interesting as she draws from various disciplines including social and cultural anthropology, world geography and sociology to analyse the aforementioned topics. However, allow my students to share with you their impressions of the textbook instead. 😊

Student Reviews

In sociology it is often difficult to learn about theoretical perspectives that can be used to analyse different social phenomena and apply the knowledge to new situations and problems in a variety of sociology courses, especially when the theories discussed have seemingly particular and complex ways they relate to specific phenomena. The most helpful chapter in Deborah Lupton’s Medicine as Culture: Illness, Disease and The Body, was chapter 1 that focussed on theoretical perspectives on medicine and the body. As a third year sociology student I’ve read enough textbooks that summarize the main theories in sociology and think that suffices to understand how the numerous theories apply to social problems, the healthcare system, the job force, education, or other social phenomena and institutions that can be analysed. What was different and helpful with Lupton’s book is that she explained the theoretical perspectives and further elaborated to apply the different theories to a number of instances in the medical industry and in societal institutions that perpetuate ideologies created by medical professionals. For example, functionalism is applied to most social issues and societal phenomena but can be understood in very different ways. Lupton was quick to explain how functionalism sees society as a number of parts working towards the successful functioning of the whole, but instead of leaving it at that elaborated to show how not only the medical industry is a series of parts that works towards a functioning whole, but how attitudes lead to discrimination and inequalities when members of society that are sick or ‘weak’ are seen as malingering and excluding themselves from being functioning members of society. Through understanding functionalism it can be understood how illnesses are seen as creating social dysfunction, which is a conclusion that may not have been drawn with just a classic textbook definition of functionalism without any context in the medical field. Furthermore, Lupton discussed and defined a number of the main sociological theories, but also introduced theories like the political economy perspective and studies of science, technologies, place, and space that are rarely used in sociology classes to develop a further understanding of numerous concepts. Lupton utilised these theories to further reinforce her points on the capabilities of the medical industry to exert control over individuals’ bodies, and through applying theories with Marxist roots to areas of society outside the mode of production and the economy it can be understood how relevant the theory is and how many aspects of society, including medical institutions, contribute towards class inequalities and conflict. By applying the more common sociological theories to the medical industry and medical perspectives on female bodies in particular, Lupton takes her textbook outside of the realm of average information and makes it more comprehensible and allows for a deeper understanding of theoretical perspectives that shape medical discourse, which has been valuable in understanding this course. The other sections and information in the textbook are more similar to the normal textbooks I would expect in other sociology classes, and the chapters deal with similar issues, discussions, and themes that apply to most sociological phenomena. The beginning chapter however did a much better job than most sociology textbooks of not only explaining the theoretical perspectives, but applying them to the subject in question. Learning how to apply specific theories to the class at hand is valuable in beginning to comprehend the ways medical sociology affects societies and cultures globally. 
- Lauren Nelis

Using the book of Deborah Lupton for this class, I found it quite useful. Using chapter 2 as a critical analysis of the book context. The book is well reflected to the course. Giving more details of what we have elaborated in class. With the aid of critical thinking in class helped better understand the book. The only issue of this book is that it is small. Having discussed multiples contexts, it seemed that there are a lot to say for a little book and chapter. It was very heavy reading the book. I had to split the chapters in sections, and would breakdown subjects. There were to much information being given in little text. I have found it hard to read but by taking the time to break it down it became clear. By doing so also aided me to better understand what the author was elaborating on. Examples of why it is difficult to understand is that it is a medical study book. Multiple people are mentioned doing cases or experiments in various of years. Having multiple definitions and terms in short chapters. My first language being French didn’t help the case. But overall, it was a great book to read and was helpful for the course. 
- Philippe Despars

I will discuss chapter four of the book. The reason I have chosen this chapter is because it discusses an aspect of medicine that is not often regarded, the social aspect. This chapter gave accounts of people’s personal experience with illness and how it changed their lives. It also brings up a lot of issues that people tend to try and ignore. The main issue is that of how we as a people treat the sick. I believe we have all been in a situation at one point in time where we have felt uncomfortable around someone who was sick. It is hard for us to be around these people because it reminds us of the inevitability of death and makes us consider our own health and mortality. The chapter discusses the hospital experience, something that no one enjoys. It brings anxiety, fear and despair, the reason being because we are awaiting the answer. We wait to see if we are healthy, moderately sick, or in worst cases deeply sick. This chapter made me think about all the things that I try to avoid thinking of, but it enlightened me on the subject. 
- Michael Usher-Jones

I decided to critic the Lupton’s first chapter. The chapter put more the emphasis on the theories in a way to understand health in different perspective. Thus, there are three main perspectives linked to health, which are social constructionism, functionalism and political economy. (Lupton, 2012) The last perspective is the Social Constructionism. That perspective claims the existence of essential truths. Truths that should be considered as the product of power relations. Also, Social Constructionism focus on the social aspects of biomedicine. Functionalism could be understood as social relations in the health-care setting as products of a consensualist society. (Lupton, 2012) Lupton also view illness, in the Classic Functionalism, as state of deviance; in other words, as a failure to conform social expectations and norms as well as to perform their social obligations. Thus, for functionalism, sick people are perceived deviant because they can’t go to work and rather stay at home, so they are not able to perform their daily basis routine due to illness so they are considered as deviant. The second perspective, the Political Economy, is a critical response to functionalism. In this perspective, ill, aging or physical disabled people are marginalized by society, because they do not contribute to the production (economy). (Lupton, 2012) So institutions of medicine exist to attempt to ensure that people could contribute to the economic system (medicalization). Lupton also describe that political economists see medicine as a moral exercise used to define normality. Furthermore, this normality is associated to two factors; 1) Accepts that biomedicine is a politically neutral and 2) critique has questioned the value of biomedicine. Personally, I did not really like the book. The subject of the book, as what we saw in class, was interesting, but I found the book difficult to read or to understand what the author wanted to explain. In all honestly, I did not read all chapters, so maybe I did not read the chapter that could caught my eyes. Anyway, I decided to review the first chapter because I think it is really important to define the different perspectives to understand not only one way of something but also open our mind to knowledge something that could be in a perspective that we do not attached ourselves but that is the best way to do. 
- Vincent Dubé

The book Medicine as Culture by Deborah Lupton is very informative. I like this book, the sections I’ve read taught me so many things and gave me new perspectives on how we as humans think and act. The structure of the book helps you organize thoughts and it makes it easy to connect to the chapters and relevant themes.  Its very easy to understand and gives you lots of connectable experiences to the real world. For example, I reread the “commodified body” and “food and the body” sections in chapter 2 and it instantly connects me to todays world, and how western societies are so obsessed about the body and how it should look. Social media has a direct influence on people. It shows that for you to be “popular” and have “likes/followers” you have to be fit/skinny, as well as be posting the foods your eating ‘healthy foods’ and things you are doing like working out. I find it fascinating because it makes you think differently about how the world works and why people do what they do. I also like the book because it touches on so many different topics, but briefly and this allows you to think for yourself and ask questions. I have never read a book like this before so I think you should continue with it when teaching Sociology of Health again. Thank you so much for all your help and knowledge during the semester, your honestly one of my favourite teachers I’ve ever had. 
- Mehana Heins

I will be focusing my review on one specific section of the textbook that has been assigned to this course.  The section I will be focusing on is in chapter one (entitled “Theoretical Perspectives on Medicine and Society”).  The section is called “Studies of Science, Technologies, Place and Space”.  In my review, I will be talking about my general opinions of the book, and then I will give my review and opinions of the specific section of the book I have mentioned previously. In my opinion, the book entitled “Medicine as Culture: Illness, Disease and the Body” Id a book that is highly relevant to the course of Sociology of Health.  I think the course of Sociology of Health can be taught from the book, summarizing the different parts in the book, or the course can use the book as a solid foundation to back up what is being taught in the course.  In my opinion, the book is heavy and dense with information, which is good.  The author, Deborah Lupton, integrates many outcomes of the impact that health has on a population, society and/or culture.  Lupton correlates many aspects of the influence health has on a society that not many people may have expected or have thought of before.  The information the book has was well-research and integrates many different published works, making Lupton’s book almost like compilation of information and inserting her own opinions and knowledge into the book.  Despite being heavy on information, Lupton makes the content rather easy to understand because Lupton explains the concepts that have been brought up in the book.  Unfortunately, I personally find that on occasion, Lupton can explain more on certain concepts.  I say this because while working in-class on excerpts with classmates, I spent a lot of time explaining the material because Lupton did not spend very much time explaining it in the book.  The section “Studies of Science, Technologies, Place and Space” in chapter one, I feel, had explained what ANT meant, but did not link or correlate much of the information.  I feel like Lupton states the different factors that are brought up, but it seems like Lupton assumes that readers can make the links themselves in their heads, instead of Lupton explaining it clearly.  An aspect of the book that I think is lacking in severely is the use of examples.  I do not think that Lupton uses many examples when explaining new concepts in the book.  The reason why I think using examples in the book is important, is because it can help readers (especially students who are using the book as a course textbook) understand a concept, and apply the concept to real life.  By applying newly learned concepts, the concepts can be understood much better than without the use of an example or examples. 
- Laetitia Felix

Deborah Lutpon’s book Medicine as Culture: Illness, Disease and the Body is a very well written and well informed scholarly work. However, in my opinion it is always important to understand that any person has a bias when writing. While I am not saying she showed specific bias towards anything, having additional authors help write works like this give better insight to different views of one subject. Lupton provides very good in depth analysis’ of different topics of the medical world and its implications on society and our bodies. Though I have noticed she is always going through the history of every single topic. History of course is important but it does not always address contemporary issues. Specifically looking at chapter six Feminism and Medicine Lupton goes so in depth into the history of the female body in the medical world but does not often refer back to contemporary issues. While the history of the female medical body has a lot to say about how we see female bodies today she does not really elaborate on contemporary issues that are the ramifications of the history she goes so in depth into. While I understand our current world is filled with high tech medical advances Lutpon refers very little to societies that do not use medical technologies and instead revert to more primitive forms of health. She does mention it a little bit in Chapter One Theoretical Perspectives on Medicine and Society in the section on medical Anthropology, but it could be very insightful for students to learn about other medical techniques not common in our own Western culture because Medicine as culture suggests that there should be different forms of Medicine to adapt to different cultures, but she only really elaborates on our Western culture.  However, only so much can fit in one book and Deborah Lupton’s writing style is very clear and easily understandable. In terms of reading it as a student, it was not always the most interesting read because as I mentioned she refers so much to history it can sometimes take a while to figure out its current relevance; but for the parts written for present day it was very interesting. 
- Michelle Slawich

Deborah Lupton’s book is very interesting because it allows for people who are not even familiar with bodies or medicine or the medical industry to better understand the many different societal, historical, economic, cultural factors that affect the type of care people receive and how certain sicknesses are understood and perceived. I also enjoy that she is very neutral, being sure to include the many different perspectives, along with examples, that can be used to analyze different patient-doctor relationships. Her book also encourages people to think more about how we create our medical knowledge, and how we think and talk about our bodies and so on. In other words, she shows her readers that often what we think and what is actually going on are two very different things. For example, when she discussed the issue of medical discourse, at first I just believed it was natural to share a different vocabulary than doctors as they are more educated in the domain, however, now I see it is kind of a power they have over us when we are unfamiliar with certain terms, symptoms, diseases, treatments etc.  The vocabulary is also very generalized, I think that any adult who can read would be able to make sense of it. If the book is being used for a course, we must do a more in-depth and critical reading of it, but the book can also just be read as a past time to demonstrate the many different ways of looking at and making sense of health.  My favorite thing about her book is that all the parts are interrelated. For example she discusses social constructionism in chapter 1 and then by chapter 5 or 6 she brings it up again in reference to Foucault. Therefore, it shows that in healthcare, many factors exist at once and those factors affect people in different ways. I enjoy books that open the mind and provoke new thoughts about other factors in society like social control, surveillance, the body as a form of social control.  Also, in regards to the price, I bought my book online for half the price and it arrived within a week with a free bookmark so people who complained should have just searched around for the best deal. 
- Shay Baker

In Deborah Lupton’s Medicine as culture, we are presented with what she states as the “illness of our time” (Lupton, P.66.) Cancer. This section focused on our modern interpretation of the cancer metaphor. She states that this metaphor is linked with various other discourses such as the military discourse she stated in a previous chapter, “As mentioned above, a dominant discourse surrounding cancer in modern western societies is that of hope. This discourse is related to military and sporting metaphors and discourses, for it postulates that ‘winning’ the battle against cancer is intimately linked to having a positive attitude to getting better.” (Lupton, P.67.) She expresses that the discourse of hope was often popular when media would talk about cancer. As she states various women magazines talk about personal stories whom have triumphed this illness and survived, “Such cases are held up as a public example of how personal courage and the constant maintenance of a positive hopeful attitude, in conjunction with medical knowledge and skill, can save people with cancer from death.” (Lupton, P.68.) This section of the book basically expressed how cancer metaphors are created, she used various example in how media portraits cancer and how people cope with it. I personally really liked this book it was a good mix between a biological/medical analysis and a sociological perspective. Though a horrible illness, this chapter expresses how having a support system is crucial in fighting cancer.  In most of her chapters before taking about the social issue within the illness she would explain what the illness was. It was rather well organized and I would recommend that you keep this book if you ever have to teach sociology of health! It was very clear and simply written. I enjoyed the chapters! 
- Gabriella Pelletier

Personally, I do not have anything very negative to say about the textbook by Lupton that was used to compliment the course. I thought that it was relevant to the teachings and was good tool to be able to see many different angles of the medical discipline. One critique I would like to make is that it focuses primarily on the western world. This became very evident when trying to find more information on topics that focused more on other parts of the world. It became a little confusing as to how it could be used in an anthropological context. When looking at the title, the world culture resonates that the book would explore a variety of different possibilities in regards to diversified culture. I found myself reading more about diversified ideologies and study methods instead. However, as a westerner the information was easy to relate to. On top of the, the information was greatly organized and easy to navigate. The index was also very helpful and the chapters were an appropriate length for a teacher who would like to assign weekly or biweekly readings, in the sense that reading twenty pages is very doable in that time frame. 
- Marie-Sophie Terp-Magnan

Disease and The Body, was a very good choice for a textbook. The material, although generally quite a heavy subject, was made very clear throughout the book. The book was clear, concise and understandable for a university level course. A specific chapter that I found interesting was The Lay Perspective on Illness and Disease, which was chapter four of the book. The chapter brought forth historical perspectives, scientific medicine, contemporary experiences, biographical disruptions, moral dimensions, hospitalization, the sick role, and the lay perspective on causes.I enjoyed the book as a whole. 
- Laura Battley

I decided to review the first chapter in Medicine as Culture: Illness, Disease and the Body by Deborah Lupton. I think this chapter was crucial to much of the text book because it covers the basis of different theories and perspectives needed to compare different concepts amongst topics within our culture and medicine.  Some of these key perspectives or views discussed within this chapter were Functionalism, The Political Economy Perspective, Social Constructionism and Medical Anthropology. I believe these perspectives were clearly discussed and analysis throughout the chapter, to further elaborate on culture and medicine. With discussing theses perspectives, it opens the door for key concepts that can help with research and understand how some people are affected by the health care system or the stigmas that come with an illness. Two of the crucial perspectives the author used effectively to set up the rest of the book would be Functionalism and Social Constructionism.  In the chapter, it discusses Functionalism which is the view that society works like a mechanism and social roles are kept in line by having certain defined roles (Lupton, 2012, p. 3) well and discusses a key concept in functionalism called sick roles. The explanation of Functionalism within this chapter was key in my point of view for readers throughout the book because it gave a good basis of knowledge and the ability to look through different lens when looking at certain controversial issues, for example Abortion. The author used efficient means define key concepts and try to get the readers to understand the basis of the book by explaining each perspective. For example, within Functionalism it is discusses, the rick role which is when the person is excused of normal day activities and responsibilities, she or he is not blamed but expected to get better as soon as possible and to go through all necessary steps to improve (Lupton, 2012, p.4). With this said, it gives the readers the tools and understanding to see where the writer will be going when talking about certain topics in a functionalism perspective. As for Social Constructionism, it is key for readers to understand this perspective because it gives the readers an idea how this perspective will be connected to certain material. Social Constructionism focuses on truths and how knowledge is related to social relations and that knowledge is changeable and dependable of social influences (Lupton, 2012, p.9).  This allows readers to take into consideration that certain things that happen within society are influence by the way human interact and construct ideas which directly affect surrounding factors. The way the author broke down this chapter is perfect, Deborah Lupton used effect cauterization of perspectives and key concepts to better construct arguments. It was not all over the place and easily understood. The writing level was moderate and was an appropriate writing style that focused on meanings and avoided complex terminology’s or heavy material which would create most people to feel over whelmed with the material. She used simple and concise definitions and to the point – and I feel like it can reach a wide population through high schools, colleges and universities. The only criticism I have about this chapter and maybe the whole book would be the lack of imagery and visuals, I feel like an author can intrigue readers more if they have visual explanations or images of possible issues so the reader can have a crisper picture of what they are dealing with and feel more personal to the topic. Although the first chapter is very perspective base and it is difficult to incorporate visuals for that section I believe the author could add some through the other chapters where they discuss specific material. Other than that, I think the author explained and describe key perspectives used repeatedly through the book well and allowed the readers to wrap ideas around their head and prepare them for the following chapters. Not only the two perspectives were effectively used throughout this chapter, the rest were as well, I just believe that the two discussed; Functionalism and Social constructionism were the most important to single out and praise. 

- Adam Rand

I decided to review the first chapter of the book, which is Theoretical Perspectives on Medicine and Society. In this chapter Lupton looks at how social interactions and power relations have shaped our understandings of the world and our own personas while she also includes theories where we have the potential to create new social facts. Through out ther explanations she points out how we're results of our environment and the society we live, but she also notes how our own society is a product of a culmination of knowledge and the way how we connect them in order to create a higher entity so called society. Instead of focusing on the content of her work, as I agree and like the way how she connects theories and points of concerns together, I'll take a look at the structure of the work and if she includes several points of view for the same theory.  Like on eevery chapter, she starts off with an introduction that gives us context to what we're about to read and how it relates to broader social issues. Furthermore, after this being done, she immediately proceeds to explain all the different theories within their own segments while also giving smooth transitions into these topics. I have to say, not only does she represent and point out the point of view of each theory, but she also points out the weaknesses of each one of these and also how they potentially link with Foucaults work or other sociologists. She does this several times, when she finally comes to the conclusion of the paper and tries to merge all theories in one as she claims that all theories have valid points and concerns of social issues. I think she did a great job with the chapter because of the above stated reasons. 

- Nikola Jovicic

This chapter describes through the introduction of social constructionism certain fields of research in the sciences have studied medicine and all of its entities. It also looks at the the developmental stages since the 20th century. It looks at certain factors in medicine, health and illness. Three theoretical perspectives such as functionalism, the political economy and as mentioned above the social constructionism were used to analyze the factors. Lupton goes further into depth and introduces the concept of discourse and ends with the reasoning behind embodying the self with in the medical world. Through the media, further analyses can be made throughout the changes of the historical dimension. The medical field is extremely important in order to determine the social sciences and all it involves. 
- Gina Lavallee Patenaude

I personally enjoyed the book Medicine as Culture by Deborah Lupton, the very first chapter of the book “Theoretical Perspectives on Medicine and Society” discusses different views regarding the different perspective and theories on health and how they have evolved through time. Each section within the chapter, whether it is the functionalist view, the historical dimension, or the political economy perspective, bring different arguments and theories regarding health issues, the author than compare and contrast some of these theories. What I particularly liked about this chapter is how the author introduces us to topics such as the AIDS epidemic and stigmatization of gays, which is then discussed throughout the book. Each chapter somehow connects and ties to one other, therefor the author is continuously developing on topics throughout the book. I find that because the chapters and topics tie with one another it makes it easier for me to obtain a broader understanding on how certain aspects such as society, technology and the media affect our perception of health. I also really liked how the author decides to create different sections within her chapters, it makes it easier to follow and if I want to go back to certain specific topic, well I know exactly where it is. The explanations of certain concepts and theories were usually clear and provided many examples to real life situations, the only explanation I had difficultly understanding was her explanation of the constructionist view on health in chapter 1. I think that this is actually one of the rare textbooks which actually generated a lot of in class discussions, it had so many examples  and different content to discuss in class. 

- Gabrielle Rouillard

In this chapter, it talked about the evolution of the medical world and how it was viewed. Starting by giving some historic about the medieval times, to the Enlightenment period to eventually talking about the modern day medicine. It was discussed that it can be observed that doctors were not always seen in a good way, as they were not always trusted. Finally, in the 18th century, they finally built some trust and started to make some medical advancement. Much of the patients through time have said how they would feel alienated when getting looked at by the professionals, as there was no common courtesy in these times. The sick role was changed forever; eventually it got better, as nowadays the relationship between a doctor and a patient is very personal and will remain to be to benefit both of them. We can see that many did not like the lay perspective, as you treated as a subject who needed help, not a person whom needed to be cured. 
- Samuel Fontaine

One of the most interesting section to my liking from the book Medicine as Culture: Illness, Disease and The Body is the section of SOCIAL THEORY AND THE BODY. It explained how the body has gotten very little interests in “social histories of medicine” due to the avoidance of “biological determinism of the ‘hard’ human sciences” a long time ago. It goes in depth to explain that our body is the ultimate criteria that enables our social identity.  Since people nowadays are becoming very conscious about their body, tremendous efforts have been placed into the study of body. Unfortunately, those efforts did not come easily, the bodies had to house deadly disease such as HIV/AIDS in order for certain studies to be done regarding its reaction, and detrimental patterns. Also obesity, diet and health habits contributed into further research pertaining to the body. One powerful statement, which I find fascinating is “[B]odies, then, are not born: they are made.” Indeed, it is true, and I completely agree with that statement. The same way someone can renovated their house, one can decide to renovate their body through plastic surgery, and/or exercise. The section place great emphasis into every intricate details relating to the body and its changes. 

- Dedline Laine

About The Student Reviews

Lauren Nelis, Philippe Despars, Michael Usher-Jones, Vincent Dubé, Mehana Heins, Laetitia Felix, Michelle Slawich, Shay Baker, Gabriella Pelletier, Gabriella Pelletier, Marie-Sophie Terp-Magnan, Laura Battley, Adam Rand, Nikola Jovicic, Gina Lavallee Patenaude, Gabrielle Rouillard, Samuel Fontaine, and Dedline Laine are presently studying at Bishop's University located in Quebec, Canada. Student reviews were written about Deborah Lupton's Medicine as Culture: Illness, Disease and the Body (2012) for a course titled SOC307 Sociology of Health in the Department of Sociology.

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