Todd Meyers, our own book review editor here at Somatosphere and Assistant Professor of Anthropology at Wayne State University, has written a phenomenal book titled The Clinic and Elsewhere: Addiction, Adolescents, and the Afterlife of Therapy, which should be on the bookshelf of any social scientist interested in biomedicine’s clinical practices and spaces, as well as, of course, anyone interested in addiction. Todd was just interviewed by Points: The Blog of the Alcohol and Drugs History Society and here’s an excerpt of how he describes his book in “terms your bartender could understand”:
“The book tells the story of a small group of teenagers (some quite young) who abuse opiates (heroin, prescription painkillers) as well as other drugs, and what drug dependency treatment was like for them. I met most of them during their time at a residential drug treatment center in Baltimore – a treatment center that, oddly enough, was once a monastery. I was fool enough to attempt following them around for long periods of time to gain an appreciation of how addiction and treatment took shape in their lives – how these two “modes” (drug dependency and its treatment) blur in unexpected ways. And that’s really one of the key arguments of the book – that clinical activities and thought reach into this thing we call “the social” and vice versa, thus the title of the book, The Clinic and Elsewhere. All of the kids I followed were treated with a relatively new pharmaceutical therapy (buprenorphine) for withdrawal and replacement therapy, and I followed that treatment process through their time in residential care and back into their homes or other institutional environments. The book is simultaneously about the new pharmaceutical therapy itself – tracing its development and approval as a new treatment modality. The book is a bit theoretical (what are the experiential dimensions of therapeutics? of patienthood? of success and failure of medical intervention? of concern? etc.) and a bit straight storytelling (that is to say, it’s ethnographic, through I’m becoming less and less satisfied with the salience of ethnography as both the technology and product of fieldwork). I attempted, at times clumsily, to make sense of treatment and addiction alongside these kids and their families as they themselves struggled with its meaning.”
The rest of the interview is over at Points. After reading it, I wanted to follow up with Todd, so I posed a couple of additional questions. Here’s our conversation (conducted over email):
Eugene: One of the things I most appreciate about your book is the tone. It’s not only written with restraint, as you mention in the Points interview, but some parts are quite funny and self-deprecating. That’s a rare feel for an ethnography to have, regardless of the subject matter and it is particularly refreshing for medical anthropology (and especially writing about addiction), in which writing with a breathless intensity has almost become the norm. Was this the way you set out to write the book or did this tone emerge as you wrote?
Todd: I should say from the outset, I don’t find fieldwork romantic – or probably more accurately, my romance was short-lived. Doing fieldwork in Baltimore – living there, going to school there, having a history there – the lines would constantly blur, and for me, the city would be cut up along these strange, emotional axes. At one point I was doing a lot of fieldwork in the Brooklyn and Cherry Hill neighborhoods in southwest Baltimore. In the thirty minutes that it took me to drive down from my own neighborhood, I would think of a thousand excuses why I should just turn around and go home. I never quite knew what would be waiting, and every interaction I had was awkward. All I knew was that what I had read of ethnography – brought forth with confidence, understanding, and ease – in no way reflected my experience of complicity, ineffectualness, and apprehension. Of course I’m probably overstating this now, but that’s how I felt. So, what is at times self-deprecation in my writing could also be called accurate reporting. During these early moments of fieldwork, largely because I was growing weary and maybe a little fed up with myself, I stopped asking, “What’s the ‘correct’ comportment?” and instead asked, “What was I willing to sacrifice to be ‘correct’?” For example, one day a couple kids who had been remanded to treatment attempted to escape by scaling a back wall of the residential treatment center where I conducted the majority of my work for the book. From the top floors all the kids and staff could see the “get away” car on the other side of the wall, idling, the driver and passenger unaware that their friends had underestimated what it takes to scale a twelve-foot high brick wall. The whole thing sort of petered out after fifteen minutes or so – and a little while later, the car drove away with same number of passengers as it had arrived. The two boys, defeated, slowly walked back inside. A few staff members ambled in behind them, appearing equally reluctant to return. The moment this little event was over, the whole place sort of kicked back into gear like nothing had happened. There’s something tragic and comical about this scene. There’s something miserable and ridiculous about how it broke the monotony of the day, only to have that monotony repaired seconds later. What’s the right way to write about this, if at all? Is humor out of bounds in the human sciences? It probably needs to be said that ethical relationships in fieldwork take different forms, and a state of perpetual piety or hollow empathy simply stifles any possibility of reflecting on human experience (again, I’m old-fashioned this way). Here, Pamela Reynolds’ work has been particularly instructive, which in no small way derives from her thoughtful reading and interpretation of the philosophy of Emmanuel Levinas. Tragedy, humor, the condition of the present…anthropology has a lot to learn from Charlie Chaplin.
So to answer your question, the tone of the writing is a combination of my aversion to the “breathless intensity” you describe and an embrace, in fieldwork and writing, of the inspired absurdity that flows from any human interaction.
Eugene: Could you tell us a little about the resonances between this book and the historical work you’ve been doing with Stefanos Geroulanos on the history of ideas in medicine and biology?
Todd: Probably most obvious is the link to the work of Georges Canguilhem. Stefanos and I have worked together on translations of Canguilhem’s Knowledge of Life and Writings on Medicine, and through this work we’ve been trying to tackle the kinds of questions about life and its various knowledges that Canguilhem raises, largely centered on medical thought and practice. Rather than remaining on the level of commentary (a kind of broad accounting of epistemology in medicine and the life sciences through the usual suspects – Bachelard, Fleck, von Uexküll, Koyré…), we’re attempting, collaboratively, to locate problems that have this dual feature of the contemporary and the historical. For example, Stefanos and I just finished a book for a German press, August Verlag, on the neurologist Kurt Goldstein (someone hugely important for Canguilhem) and his conceptualization of the individual through his experiments (largely with wounded soldiers). This same problem of the individual as the target of therapeutic offering, the medium of medical knowledge, arises in my fieldwork and writing. This is just an example. Certainly the distinction between “healing” and “cure” that I write about in the book owes a huge debt to Canguilhem’s thought. But even more than these specific links, Stefanos and I have made an effort to create a bridge between anthropology, historical, and philosophical studies in the Forms of Living series – the effort is to put the work of other scholars in conversation. The point here is that my “historical” and “anthropological” work informs the other without having to become enmeshed in the same project.
Finally, the University of Washington Press, which published The Clinic and Elsewhere as part of its In Vivo series, put together this nice video trailer for the book:
Forms of Living book series, Fordham University Press, edited by Todd Meyers and Stefanos Geroulanos