In Tristes Tropiques, Claude Lévi-Strauss explained that it was his dread of teaching the same course over and over again that impelled him to travel to Brazil and pursue anthropology:
“After spending a happy year at the Mont de Marsan lycée, teaching and preparing my course of lessons as I went along, I was dismayed to discover at the beginning of the next school year… that I would have to repeat the same course for the rest of my life…” (p. 53)
For my part, I have taught the same upper-level undergraduate medical anthropology class (ANTH 475, “Perspectives in Medical Anthropology”) every year since I came to the University of Washington more than a decade ago now.
How is it that repeating the same course leaves me feeling not “dismayed,” but actually pretty jazzed? I can’t help thinking that perhaps if Lévi-Strauss had stuck with his lycée job a bit longer, he might have been able to discover through teaching some version of the same insight he arrived at in the Amazon: that a really good structure contains within itself endless creative possibilities. I think that the reason my “Perspectives in Medical Anthropology” class works well, and remains interesting and fun to teach over and over again, is because it has a robust and flexible structure.
The big idea for this course is that it is possible to create understanding about health, illness, and medicine not by looking inside the individual body, but by using ethnographic research to situate individual lives within broader contexts. (This is a very new idea to many of my students, the majority of whom are upper-level undergraduates hoping to pursue careers in medicine, nursing, public health, pharmacy, and other health-related professions). Since the world obviously does not present itself in pre-packaged chunks of context, ethnographers must make choices – at once theoretical and methodological — about what and whom to include, what and whom to leave out, and why. Following from this, the course is structured in a manner intended to highlight conceptual differences among ethnographic studies, such that students may get a sense of how it matters whether, for example, one begins with questions about meaning, or questions about power, or questions about technology, etc.
The course thus does not “cover” any set list of specific illness conditions, nor any particular world area. Topic headings for each day and for each week are meant to help students situate specific ethnographic studies assigned for the day, as examples of how particular theoretical & methodological approaches may be applied. The specific articles assigned often change from one year to the next; the weekly topics also shift and change a bit over the years, reflecting developments in the field. I select articles that I want to read, and ones I love — because they are written clearly and well, and exemplify the best potential of ethnographic research, to yield surprising and challenging insights.
Key to the success of this structure are the writing assignments, especially the “reflection paper.” This is something I dreamed up the first year I taught the course, that has proven to work wonderfully well. On the first day of class I tell students that for the next class meeting they must write a short (2-3 page) account of an episode of illness and healing that they know about at first hand. An open-ended assignment such as this, at the very start of the quarter, inevitably creates some anxiety, and they always want to know more specifically what I am looking for; I tell them, “Just write an honest account.” (I reassure them that these will not be graded; I also advise them to bear that in mind when deciding what to write about, that that these will be read and commented on by their classmates as well as by me.)
On the second day of class, I ask the students to tell me about some of the choices they found themselves making when they wrote their accounts, and I list these on the board. Referring to this list, I talk about how the choices that each of them had to make are similar to some of the choices faced by ethnographers, and segue from there into a discussion of what ethnographic research is.
At the end of the quarter, after exploring many different approaches and topics, reading some very compelling articles, watching documentary film clips, and writing two analytical papers, the students are asked to look back at their firsthand account, and write a paper that reflects on it in light of what they have learned. I leave this very open-ended, and encourage them to draw connections with whatever articles seem most relevant and helpful. I advise them that they can treat their firsthand account as “data” and reflect on how they told that story (what they left out, what voice they chose to adopt, etc), or they can consider the specific health problem about which they wrote in light of what they may have learned about it through the class readings, or they can write about what sort of research they might want to pursue on the topic about which they wrote, if they were to go on to become an ethnographer.
For the final class session, small groups of students are assigned to read each other’s firsthand accounts and reflection papers, and discuss them. The course is thus structured to end by positioning the students as authors who create new understanding, informed by scholarly research, about matters they know at first hand, and also colleagues who respond respectfully and thoughtfully to the work of others. And when that is what one repeats, teaching the same course every year can be not a grind, but a positive joy.