Monday, June 13, 2011

Statement of purpose: From Medicine to Medical Anthropology

by Gideon Lasco, MD

As a Filipino doctor, one of the most important questions I see is this: For a Filipino, what does it mean to be healed? As medical student and then as a full-fledged physician, I have offered cures for countless patients, but treatment is one thing, healing is another. Why are traditional healers so effective in making their patients satisfied, to a point that a substantial number of patients go to them instead of going to hospitals? Could these healers be tapping into a therapeutic way that, though unknown to physicians, resonates well with patients and their expectations?

In the larger context, what does it mean to improve health care in the Philippines? Universal Health Care is emerging as a sought-after direction in our country's health care. But will universal access to health care translate to a health care that is responsive to the felt needs of the people? Who defines what is 'health care' in the first place? Although I am part of the Universal Health Care Study Group as a writer, researcher, and advocate, I believe that the cultural perspective must have a voice in this debate; if we are to move on to Universal Health Care, we must move to one that is culturally relevant.

Medical anthropology, I believe, can help me join the growing (and timely) search to find answers to these questions. My personal experiences and interests led me to discover this exciting field. I have travelled around the country - from Itbayat to Bongao – first as a travel writer and mountaineer, and then as a researcher interviewing indigenous healers. The intrepid and inquisitive spirit I have developed in all these travels and adventures will help me confront, and then push beyond, our understanding of culture and health in the country. If it requires travelling to far-flung areas - or immersing into marginalised sectors of our society - then I shall welcome it.

As a doctor, my calling is to heal and I am convinced that for healing to take place, one must first understand. This is my clinical motivation for pursuing medical anthropology: The awareness that the pursuit of it has the potential to improve health care in the country; it is at least as important for health as a research scientist's latest discovery about the human DNA, or a clinical researcher's innovation on a surgical technique. And, to use medical terminology, since medical anthropology enables understanding and understanding leads to healing, I contend that medical anthropology is a field that is both diagnostic and therapeutic.

In my fieldwork around the country, interviewing traditional healers, I am reminded of a divining ritual called 'pagtatawas', in which the healer makes the sign of the cross using ‘tawas’ (alum crystal), cooks it, and interprets the finished, molten product. "What comes next?" I asked. The healer answered: "Nothing. That's it. That's the treatment." For them, treatment consists of the patient being shown what happened to him or her, what caused the illness. Diagnosis and treatment are seen as one; for the patient, to understand is to be healed.

There is no magic in traditional medicine. But it deserves to be taken seriously because it is taken seriously by the people. My task as a future medical anthropologist is not to glorify or reject traditional or Western medicine, but to study them, and in studying them, find ways to apply the lessons to our health care. My field will not be the villages alone, for there is as much culture in the hospitals as there is in the far-flung areas; both are valid foci of study, both realms will tell us a lot, and I yearn to be part of the growing (and much needed) interest in making sense out of them. If we follow through, from listening to understanding and then to applying what we’ve learned, then medical anthropology would not only be clinically relevant, but also relevant to the people (which I see as the ultimate end of research, whether in the social or empirical sciences).

This is the 'medicine' that I hope to someday offer the Filipino people; the perspective that I hope to bring to the body of scholarship. I strongly believe that medical anthropology is much needed in our country, and that my experiences, interests, and advocacy can find unity in this field. Thus, I am committed to pursue a career in Medical Anthropology.

June 13, 2011