Review of addicted.pregnant.poor. Kelly Ray Knight, Durham, NC: Duke University Press, 2015, 328 pp.

n answering the question, “What forms of life are possible in the daily-rent hotels of San Francisco?” addicted.pregnant.poor is not for the faint of heart. Over the four years that Kelly Ray Knight follows the addicted, pregnant, and poor women who work the daily-rent hotels, they experience and she witnesses flagrant violations of human rights and dignity in ontologically insecure lives. Enacting a ceaseless precarity, this situation produces in the author the disquieting sense that she has become an anthropological species of vulture. “Vultures don’t just clean up the dead. By ingesting the dead, the dead become part of them” (p. 215).

Vultures are multiply misunderstood beings—they themselves cannot kill but instead must shred the already dead, tearing remains to pieces. But the vultures most common in northern California are named Cathartes aura, a name that evokes a stirring coastal breeze. The commitments that Kelly Ray Knight brings to her book clear the air by making make visible how institutions of care and coercion produce settings that reproduce vulnerability, victimization, and precarious forms of power and predation to which her subjects are subject (p. 31). With grace, clarity, and not a shred of sentimentality, Knight’s ethnography incorporates grief and loss but also wit, tenacity, and love.

Readers seeking evidence of social and governmental incapacity to make sense of the multiple traumas visited son sex workers and drug users will find it here. Most smoke crack and do other drugs as a matter of course; all are addicted, pregnant, and parenting under conditions of extreme structural and symbolic violence. The book grapples honestly with the “problematic behaviors” of all implicated actors:

the poor policy-making, the ongoing drug use, the social scientific vulturism. . . [and] the structural conditions (the perception of resource scarcity, the rising gentrification, the inadequacy of drug treatment modalities, the criminalization of addiction, the intergenerational poverty) that produce the behaviors, bind these actors together, and prolong suffering. (p. 232)

This evocative text is a masterful synthesis of sincerity and sophistication, intensely self-reflexive, making for an exemplary text for graduate seminars in qualitative, ethnographic methodology.

Structured so readers might relive what we might call “ethnographic time,” the heart of the book concerns “temporalities that mattered for making sense of addicted pregnancy” (p. 72). These arrhythmic temporalities entwine as women live out “addict time, hotel time, pregnancy time, jail time, treatment time, epidemiological time, biomedical time, memorial time, and life time” (p. 72). Legalistic and technocratic framings for such matters, like the epidemiological and biomedical registers, flatten, distill, and reduce to silhouette the “ontological fluidity” that addicted, pregnant women embody in the midst of the constant churn of fairly unlivable realities. As Knight’s sense of her own ethnographic position becomes more central to the narrative, she feels herself transmogrifying into an “anthro-vulture,” numbering her own among the innumerable predatory practices to which the women who inhabit the daily-rent hotels of the San Francisco Tenderloin are subject.
People, places, and practices that could be considered “vulturistic” in relation to women who are addicted, pregnant, and poor include those who profit, those who police, those who adjudicate, and those who mete out care, compassion, and coercion on behalf of city and state. In taking seriously the claim that “everything happens as if a society had ‘the maternity that suits it’,” Knight cleverly reframes Georges Canguilhem’s observation about death as a social phenomenon that expresses social priorities and results from social conditions. “The management of pregnant, addicted women can tell us a great deal about social valuation, viability, and allowable social failure,” she writes. Indeed, it seems that the lives and preventable deaths of these relatively young women should be of concern, but there is no redemption for the women of addicted.pregnant.poor, some of whom were already dead as of the writing of this review.

Exhorted to take personal responsibility for themselves and the fetuses they carry wittingly and unwittingly, innocently and non-innocently, willingly and unwillingly, the women with whom Knight worked were entangled in past trauma and present violence. They defied classification into the categories of victim or villain, perpetrator or plaintiff. She followed them as they met the adjudicating gaze of social services, mental health, and criminal justice agencies. She observed everyday interactions with the keepers of daily rent hotels whose exploitive practices and rates amount to what one of the photographs of graffiti that appears in the book poignantly put it, the “daily rape” (p. 46). Such exploitation is underwritten by enduring conceptions about the addicted, the pregnant, and the poor, but by the vast cultural repository of ideas about how addiction, in particular, works as a compulsive force in these women’s lives.

What endures from historical conceptions of addiction is a strained emphasis on “choice” and “free will” (p. 160); a continual salvationist moralism around pregnancy and mothering and a socially condoned savagery toward those who fail to meet gendered social expectations; and an ongoing political will to quarantine, exclude, or otherwise complete a social isolation of those who continually make wretchedly “bad choices.” What is new is the social order of the “neurocrat,” a figure who has internalized the “new sciences of addicted pregnancy” (p. 160), including the notion that addiction is a brain disease; a problem of co-occurring mental health issues; and a condition of ongoing post-traumatic stress disorder. The “neurocrat” facilitates the relationship between addicted women and the state such that disability payments and social services supplement earnings from sex work and “getting by,” but only in the most grudging of ways. What is new is the continual contraction of reproductive rights and an increased willingness to attack pregnant and parenting women in cases not only of abortion, but pregnancy loss and new laws targeting pregnant women with enhanced or special punishments.

None of the women in the book are pictured. Their absence is palpable by contrast to the fulsome descriptions of their personalities and activities. Knight’s argument about visual representation is mounted as an argument against sentimentality and reductionism, and for a more holistic rendering that does not depend on sensationalism. Whereas historical memento mori were used to suture maternal bonds with dead children, Knight’s project is to disown the privilege of spectatorship, to overcome the detachments of the “anthro-vulture” she feels herself becoming.

Choosing not to publish photographs of the women with whom she interacts in the field, Knight instead depicts the decrepit furniture that pervades their lives, trappings that literally illustrate the trap we are in when it comes to the representation of the addicted, pregnant, and poor. These stained mattresses and weary toilets; stark sinks and cluttered desks; matter-of-fact crack pipes, cigarettes, and syringes; purses, cell phones, and paperwork; pens, combs, calendars, towels, lighters, and cryptic signs leave no uncertainty about the state of worthlessness to which these women have been consigned by their society. The photographs capture mundane moments that serve as the memento mori of an age in which the modes of maternity available to the addicted, pregnant, and poor are barely viable and prematurely socially dead.

Insisting on confronting the risky commitments and predatory practices with which her subjects contend, Knight characterizes herself as “vulturistic, indebted, intimate, paternalistic, helpless, judgmental, empathetic, and confused over four years” (p. 28). But I maintain that she is no vulture who documents stories that would otherwise be buried unincorporated into a society that does not wish to see.

Reference Cited
Canguilhem, G.
1978 On the Normal and the Pathological. C. R. Fawcett, trans. Dordrecht, Netherlands: D. Reidel Publishing Co.