Blood Work: Life and Laboratories in Penang. Janet Carsten, Durham: Duke University Press, 2019, 256 pp.
“What is blood?” is the question at the core of Janet Carsten’s Blood Work: Life and Laboratories in Penang. As she states at the outset and illustrates throughout the text, the “answer to this question is not self- evident” (p. 6). Rather, as she demonstrates, blood is a densely symbolic substance that is simultaneously the object of literal and figurative boundary making while continually exceeding such boundaries.
Blood, rendered as kinship, has been a rich subject in American anthropology since its very early days when Lewis Henry Morgan  established kinship as a central theme for anthropological analysis, articulating the idea of “streams of blood” in his study of American Indian kinship practices. In 2012, Carsten, celebrated for her nuanced work on kinship in Malaysia, delivered the prestigious Lewis Henry Morgan Lectures, an annual series honoring Morgan at the University of Rochester. Blood Work, a project examining blood in urban Penang, Malaysia, is based on these lectures.
Carsten’s entry into this examination of blood began in a rice field on the island of Langkawi, Malaysia, where she was struck by villagers’ familiarity with and interest in the physical properties of blood. In particular, Carsten writes, she was intrigued by the fact that “the physical properties of blood were a subject of keen speculation … and in ways that were not necessarily obvious, they connected to its symbolic range and potential” (p. 5). Her interest in exploring this phenomenon led her to a multi-year ethnographic project following the physical and metaphorical dimensions of blood in and beyond the clinical pathology labs at two hospitals in urban Penang where blood is drawn, processed, stored, and analyzed.
Tacking deftly from the general to the specific, Carsten explores the daily work involved in managing blood as it becomes and functions as a biomedical object. In so doing, she demonstrates the complex “pathways along which blood travels as it moves between different domains of life,” illuminating how “people negotiate between the physical manifestations of blood in everyday workplaces, such as clinical pathology labs, blood banks, or operating rooms, and its metaphorical allusions” (p. 5). These pathways include excursions into additional areas of classic anthropological concerns related not just to kinship but also religion, gender, ethnicity, class, and the metaphysical domain of ghosts. These varied excursions make the book potentially well suited for an introductory course in cultural or medical anthropology.
With Blood Work, Carsten joins an important and expanding group of scholars extending work in the anthropology of science beyond the Western settings typically associated with what Donna Haraway  identified as technoscience. Blood Work is distinctive even within this group in that Carsten’s focus on technoscience builds on deep familiarity with Malaysia rooted in her prior long-term ethnographic engagement in the country. She thus brings substantial nuance to her analysis, repeatedly drawing the reader’s attention to the tensions between assumptions about the universality of medical technologies and the distinctively Malaysian dimensions of the ways such technologies are taken up in the laboratories in which she works.
This familiarity is both a strength and a weakness as it occasionally leads Carsten to make assertions of local distinctiveness that may seem clear to her but are not evident to the reader. For example, when Carsten illustrates lab workers anthropomorphizing and attributing kinship to a piece of lab equipment, it is not obvious that this is distinctively Malaysian. How is it different than someone in a lab in the United States making a “come to Momma” comment or describing their samples as their “babies”? It certainly is possible to imagine the local differences she observed but the text would have been richer with more elaboration.
Carsten repeatedly points to the complex ways that ideas about and commitments to a multicultural society deeply inform the experiences of those working in the hospital labs where she conducted her research. For example, we observe how attention to religious difference can and does code for race or ethnicity in the Malaysian context. Even greater elaboration of how such coding plays out in everyday life would have strengthened the text. At the same time, Carsten examines how those working in the lab value colleagues from diverse religious backgrounds, even if for the practicality of having colleagues willing to work and be on call during others’ observation of religious holidays. Carsten points to “broad agreement” among lab staff that their preference “was to increase ethnic diversity” (pp. 103–4, emphasis in the original). Such a perspective offers a subtle counterpoint to the increasingly loud anti- immigrant and racist discourses currently on the rise in the United States, United Kingdom, and much of Europe today.
In moving from the rice paddy of her earlier work to the clinical pathology laboratories that are the focus of Blood Work, Carsten makes an additional important contribution to our understandings not just of blood as a biomedical object but also of modernity and modern lives. She points to Bruno Latour’s  argument that the denial of the “connections between nature and society … is crucial to the project of modernity” yet “are actually central to how science works” (p. 168). While not alive, Carsten repeatedly calls the reader’s attention to the fact that blood has animating properties, including “emotional, moral, and truth-revealing qualities” that extend into laboratory contexts associated with modernity (p. 205). Such properties mean that blood never fully becomes a biomedical object divorced from the subjects from whom it comes. Rather, those working in labs repeatedly “rehumanize” the blood they work with in ways that draw on the social world beyond the lab. By illustrating this “messy complexity of ordinary, everyday life—not just in Malaysia but elsewhere too” (p. 208)—Carsten nicely extends Latour’s observations into new realms, illuminating the dynamics not only of modernity but also of everyday of modern lives.
Haraway, D. 1988. Situated Knowledges: The Science Question in Feminism as a Site of Discourse on the Privilege of Partial Perspective. Feminist Studies 14: 575–99.
Latour, B. 1993. We Have Never Been Modern, translated by C. Porter. Cambridge, MA: Harvard University Press.
Morgan, L. H. 1871. Systems of Consanguinity and Affinity of the Human Family. Washington, DC: Smithsonian Institution Press.