Introduction: Citational Politics in Medical Anthropology

Abstract

Medical anthropology is the study of health and healing in cross‐cultural and evolutionary perspective. This chapter reviews the basic elements of research design and provides a framework for matching methods to questions across different research traditions. The breadth of medical anthropology makes it impractical to discuss the full range of relevant methods of data collection and analysis. Research design is about posing good questions and finding empirical answers. A better starting point for thinking about research design is to recognize a continuum of research objectives, ranging from exploratory to confirmatory research questions. Methods of data collection in medical anthropology fall into three broad categories: participant observation, systematic observation, and interview methods. Medical anthropology, like the social sciences generally, is often described in terms of a dichotomy between “qualitative” and “quantitative” methods of social research.

When Medical Anthropology Quarterly’s editorial board met during 2021 and 2022, a consistent theme of its collective work was rethinking how the journal communicates its aims and commitments to the communities of practice that contribute to it. Our shared goal was to query the reproduction of power in the field of medical anthropology. Ideas for doing this included the publication of revised guidance for authors and peer reviewers focused on creating supportive and inclusive feedback, and the crafting of a more explicit statement of the principles to which the journal was committed.1 The board also moved to create a new, experimental “In Conversation” section: a peer-reviewed space where medical anthropologists can think collectively about emerging questions or ideas. By making “In Conversation” a cataloged and indexed part of the journal, we wanted to encourage—and formally acknowledge—medical anthropologists who are thinking critically and carefully with one another about what counts as theory, method, and praxis in our discipline, especially given its historical tendency toward whiteness and Euro-Atlantic institutional exclusivity.

This “In Conversation” focuses on the theme of citation. A wave of recent scholarship observes that citation functions, in Sara Ahmed’s words, as a “reproductive technology: a way of reproducing the world around certain bodies” (2013, also cited in Mulla and Davis, and Blell, this issue). At a basic level, citations give credit to the provenance of ideas. They lend scientific validity by indexing facts. They also reflect the views of several people and institutions (authors and their colleagues, editors and reviewers, departments and programs) about the boundaries of particular empirical and theoretical conversations. The MAQ “information for authors” page cites Toni Morrison’s (1989, 8) observation that “canon building is empire building.” To cite something is to amplify it—to help it circulate and gain traction or power.

The Cite Black Women movement, initiated by Christen Smith in 2017, asks academics to reflect consciously on how everyday practices of citation occur within the politics of language, nationality, gender, and race. Feminist Anthropology, first published in 2020 with the goal of magnifying and centering scholarship that had been cast to the margins, has regularly published articles on the theme of citational practice (Craven, 2021; Smith and Garrett-Scott, 2021). Cultural Anthropology released a 2022 Colloquy (Makhulu and Smith, 2022) from the Cite Black Women Collective with articles interrogating citation by Anne-Maria B. Makhulu (2022), Christen A. Smith (2022), Faye V. Harrison (2022), Savannah Shange (2022), and Bianca C. Williams (2022). Catalyst: Feminism, Theory, Technoscience charts a pathway where citation network can function as an “antidiscriminatory practice” (Mills, 2021). MIT’s Relata project, of which Cultural Anthropology has been an early partner, reimagines citation as a collaborative and interpretive project that allows communities to think through not only explicit scholarly connections but also absences, silences, and critiques among different forms of scholarship (Society for Cultural Anthropology, 2021). The Anthropology and Environment Society has conducted a multi-year Ancestors Project, “an effort to acknowledge those intellectual ancestors whose contributions to anthropological theory have been silenced or overlooked due to their gender, race, ethnicity, nationality, or the intersection of those aspects of their identity” (Pouchet, 2020).

This collection aims to build on these prior efforts by situating the conversation about citation within our own subfield. To that end, we asked the contributors to the collection to address the following questions: Given its historic whiteness and Euro- and US-centrism, what is medical anthropology’s role in confronting citational politics? In what ways is citation entangled with research ethics, especially for scholars whose work involves collaboration with medical scientists or ethnographic work in/on scientific projects? Given the frequent obligation to maintain informant anonymity, how do we acknowledge the nonanthropological academic work of those with whom we collaborate? How does the glaring exclusion of non-Euro-American scholarship in many highly ranked medical anthropology journals reflect a problem of differences in language, and how does it speak to a deeper division about whose presence and whose knowledge is deemed as legitimate? What happens when transformative ideas emerge from beyond the narrow sphere of academic books and journals? Finally, what might happen if bibliographies were treated less as adjuncts to the prose that precedes them and more as scholarly documents in and of themselves?

We believe that MAQ is a good place to unpack these questions, not least because medical anthropology straddles humanistic and metrics-driven fields, with their different strategies of citation. We thus see an opportunity to provoke new ways of valuing and attributing different forms of knowledge, both as a means of enriching anthropology in general and of critically engaging with medical anthropology’s neighboring fields of thought and practice. Now that we are a fully online journal, we are also in a good place to reflect on how citation is tied to changing forms of media: How can social media, online publications, and public scholarship gain a foothold in medical anthropological discourse? In the company of other journals, we are also considering our own auditing practices: How can we build geographical and demographic breadth of citation into rubrics for manuscript review? What should we ask reviewers to consider? Too often, the academic labor of thinking about such problems is not recognized in hiring, tenure, and promotion metrics—how can we make this work count?

In curating this “In Conversation,” it quickly became obvious that tallying the composition of voices in our bibliographies is neither simple nor sufficient. Rather, what is necessary is a sustained conversation about citation as praxis. It is telling that to acknowledge the seeds of this conversation, we ourselves must adopt unconventional citational methods. Movements to critically reflect on what counts as knowledge in our discipline have gained traction and visibility in the spaces of social media, and legacy journals like MAQ still have yet to find ways to properly integrate scholarly conversations in these spaces with those that happen in our (now virtual) pages.

One of the key lessons of this collection is that conversations about the whiteness, masculinity, or Euro-American-ness of scholarly discourse have a long history. As several contributors show through reflexive accounts of their own intellectual journeys, professional standards regarding whom to cite are instilled well before scholars submit their first manuscripts for peer review. Even when scholars of color and scholars from the Global South were admitted into “elite” northern spaces, this admission was often conditioned upon a willingness to reproduce the very networks of knowledge that minimize or invisiblize their presence in these spaces. Natali Valdez’s article offers a critical ethnographic study of two of medical anthropology’s citational calling cards: the practices of “studying up” and “multi-sited ethnography” (Marcus, 1995; Nader, 1972). While anthropologists of biomedicine and the biosciences frequently position themselves as undertaking a critical analysis of “global” elite cultures and spaces, Valdez’s experience as a queer woman of color shows how the very ability to do research at the intersection of medical anthropology and science and technology studies is predicated on the possession of economic, linguistic, and social capital. Her article provides important insight into the unspoken privileges of race and class that often enable collaborative relationships with experts in other fields or the security one might feel when claiming medical anthropology as their disciplinary “home.”

Valdez is not the only contributor for whom the topic of citation raised questions about what it means to be at home in medical anthropology. Nolwazi Mkhwanazi’s contribution, for example, reflects on the relationship between citational practice and the formation of professional and personal identities. She notes that despite concerted efforts to bring more Black scholars into South African anthropology after the formal end of apartheid in 1994, her students, even as late as 2016, were not taught about the contributions that many African scholars have made to the discipline. Mkhwanazi suggests that citational practice is an active choice about who scholars “bring with them” to the classroom, to and from the field, and beyond. Citation is thus a form of kin-work, as Mkhwanazi puts it, and kinship requires a mutual recognition of relatedness.

Mwenza Blell, following Smith et al. (2021) points out that while citation should and can be a “radical” act—an act that works upward from the roots of knowledge—it is taught as a hierarchical act—one that looks downward from the “shoulders of giants.” Both Blell and Mkhwanazi use their articles to deconstruct the familiar Western trope of the humble scientist “standing on the shoulders of giants.” Blell suggests that the dehumanized and forgotten “mule,” a figure emerging from Black feminist anthropology and fiction, may be a more appropriate one for thinking through citational conditions in medical anthropology. We can do better by learning from Black feminists (e.g., Craven, 2021; Jhally, 1997; Smith et al., 2021) about how to reverse citational injustice. This requires tackling systemic nonattribution and appropriation, but the goal is not to cite different giants. Rather, it is to more broadly distance ourselves from the “cult of giants.” To do so, Blell outlines several concrete steps offered by the Cite Black Women movement, also adding insights from her experience studying menopause with British Pakistani women, who were theorists of menopause themselves.

Might medical anthropologists have more difficulty confronting their complicity in the reproduction of whiteness and elitism in the academy because of their stated commitments to unmasking the power dynamics built into biomedical systems? Sameena Mulla and Dana-Aín Davis’s contribution to this special issue suggests that medical anthropology’s roots in the study of structural violence and its long-term reliance on a Foucaultian critique of biomedicine have frequently made the subdiscipline, particularly in the US, a space of “unbearable whiteness.” By “unbearable,” they mean that medical anthropology’s historic citational practices in the field “do not support or scaffold the work we need to do as anthropologists.” Breaking the intellectual and bibliographic supremacy of the canon, they suggest, requires new ways of carrying ideas. Their contribution challenges medical anthropologists to break the hold of white epistemology by thinking with “more insurgent and literary forms of work.”

Doing so, we may stand a better chance of widening our notions of what counts as theory and method. In his contribution, Gideon Lasco illustrates how the field’s conventions reproduce the harmful idea that theory emerges from the metropole, while scholarship from the periphery of former and contemporary empires has value primarily as empirical fodder. When the MAQ board members discussed launching an “In Conversation” collection about citation, Arachu Castro raised the idea of asking the journal’s reviewers to explicitly consider if authors have cited academic works written by people in the country where the fieldwork took place. Lasco’s piece pushes the request further: authors need to not only cite work from the country where they are working but meaningfully engage with theory developed by academic collocutors in the Global South. His article unmasks the ease with which the embrace of so-called “double-blind” review makes the enforcement of theoretical apartheid look like sound science.

In response to these trends, Mulla and Davis call for a recentering of the discipline on the purposive study of health. Such a move might mean an expansion not only of the metaphors we use to think about citation—from architectural edifice to needlework (see Mariner, 2022) but also the modes through which we cite. Here, Sherine Hamdy’s call for greater attention to the visual media through which health and healing are imagined is prescient. Hamdy’s article examines two contemporary web comics, both of which take up the challenges faced by women training as physicians. Her argument is that such media are more than illustrations or auxiliary materials. They can also transform how we teach anthropology to students. Hamdy’s discussion of citation is simultaneously a reflection on teaching and being taught. Witnessing the education of other kinds of medical professionals—in this case, doctors in training—we become more able to see the traumas and aggressions (large and small) that attend the making of “expertise,” as well as the creative, pragmatic, and radical acts of relating that open space for thinking and doing health otherwise.

We are pleased to share this collection with MAQ’s readers, and our hope is that it opens space for further experimentation in the narrative genres and forms that authors adopt in their work, from reflexive positioning to visual storytelling. Just as importantly, we urge readers and future contributors to reflect on and challenge medical anthropology’s conventional citation practices. All of the contributors to the special issue point out that citations help to make our communities. What kinds of relationships are we calling into being?

Note

We wish to acknowledge the contributions of board members Nessette Falu, Hannah Brown, Carolyn Smith-Morris, Zoë Wool, and Lesley Sharp to these crucial pieces of the journal’s internal architecture, as well as to Dana-Aín Davis, Sean Brotherton, Stacey Langwick, Arachu Castro, and Junko Kitanaka, whose reflections on the “In Conversation” project helped shape our curation of this collection. Emily Yates-Doerr acknowledges the ERC grant #759414 for providing support for editing and writing.

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