Susan, Stanley, and Roger: How the Experiences of Three Lung Cancer Patients Highlight Uncertainties and Ambiguities of Entering the “Sick World” of Biomedical Cancer Treatment

Anthropological research on biomedicine voices patient perspectives of medical encounters and describes biomedicine as a cultural, historical construct. It reveals sociocultural particularities of biomedicine obscured by the illusion of objective, rational, and natural reality, or a so-called “aura of factuality”(Geertz 1973, Rhodes 1996). Uncertainty and discomfort arise for patients facing culturally-specific models of illness and healing considered acultural by biomedical discourse.Medical anthropologists have long described biomedicine as a socioculturally-embedded site of social control, reflective and reproductive of broader social priorities such as depersonalized capitalist efficiency, power-reinforcing hierarchy, commodification of bodies, neoliberal individualism, alienation of body and mind, etc. (Foucault 1975, Baer et. al 1986, Martin 1987, Scheper-Hughes and Lock 1987, Kleinmann 1988). Others have depicted the biomedical clinic as a culturally unique space that breaks otherwise ubiquitous norms—for example, giving a near-stranger (a doctor) unprecedented physical access and knowledge of one’s body—and requires re-socialization for its participants (healers and patients) to accept unique social rules (Taussig 1980, Konner 1987, Good 1994). Biomedicine as a system of knowledge and practice thus has a special role of both breaking and reinforcing social codes. Biomedicine is a socially distinct structure that presents itself as natural and consistent with the rest of society, by way of justification through scientific rationality and mirroring of other societal power structures—ultimately creating ambiguities and confusion for the seriously sick seeking biomedical care.This is not to strictly distinguish biomedicine as confined to the clinic, or to depict it as a distinctly bordered institution ready for the sick to enter—on the contrary, biomedicine’s explanatory models pervade everyday consciousness in the Western world. As Baer et al. (1986) write, “the dominant ideological and social patterns in medical care are intimately related to hegemonic ideologies and patterns outside of medicine”(95). This makes it difficult to epistemologically disentangle the biomedical domain from the rest of society.Nonetheless, from a patient’s perspective, there is a distinct social territory, or a “sick world” for the seriously sick who seek biomedical treatment. As Sontag (1978) puts it, “everyone who is born holds dual citizenship, in the kingdom of