Physicians at Work, Patients in Pain

Univ. of North Carolina, Chapel Hill. Addresses the interplay between traditional healing and biomedical treatment and the strengths and weaknesses of each. Concludes with a discussion of the problems faced in reconciling their training in biomedicine with the cultural dimensions of the society in which they practice. Softcover.

Kaja Finkler is Professor of Anthropology at the University of North Carolina, at Chapel Hill.

List of Tables

viii

Series Editors' Introduction

xi

Preface to the Second Edition

xv

Preface

xxi

Acknowledgments

xxix

Introduction

1

(20)

Part One The Setting

The Mexican Context

21

(14)

Sickness: A Mexican View

35

(16)

Typical Symptoms

36

(3)

Etiological Beliefs

39

(12)

Environmental Assaults and Diet

40

(1)

Anger

41

(1)

Nerves

42

(1)

Susto

43

(1)

Heredity

44

(1)

Witchcraft

45

(6)

Health Care Delivery in Mexico

51

(14)

Biomedicine in the Public Sector: Institutional Health Care Delivery

51

(2)

Biomedicine in the Private Sector

53

(1)

Salud Hospital

53

(3)

Nonbiomedical Treatment Options

56

(2)

Patients' Trajectories Within Health Delivery Options

58

(7)

Part Two Biomedical Practice in Mexico

History of Medicine in Mexico

65

(16)

The Preconquest Period

65

(1)

The Colonial Period

66

(2)

Independence

68

(2)

Contemporary Biomedicine

70

(2)

Psychiatry

72

(1)

Recruitment into the Profession and Medical Education

73

(2)

Physicians' Social Status

75

(6)

Biomedical Beliefs and Practices

81

(18)

General Considerations

81

(2)

Biomedicine in Mexico

83

(1)

Etiological Beliefs

84

(6)

The Diagnostic Process

90

(2)

Treatment Management

92

(3)

A Model of the Cultural Transformation of Biomedicine

95

(4)

Variations in Biomedical Beliefs and Practices

99

(32)

Description of Individual Physicians

99

(4)

Individual Variations in Physicians' Practice

103

(3)

Jose

106

(3)

Sharon

109

(8)

Nomi

117

(14)

The Medical Consultation

131

(42)

Arthur

137

(9)

Serge

146

(6)

Esperanza

152

(6)

Thelma

158

(15)

Part Three Patients' Responses to Biomedical Practice

Patients and Their Complaints

173

(8)

Sociodemographic Profile

173

(2)

Health Characteristics and Patient Complaints

175

(6)

Patient-Perceived Therapeutic Outcomes: An Aggregate Analysis

181

(24)

Response to Treatment

181

(2)

Patients' Diagnosed Conditions and Characteristics as Related to Recovery

183

(3)

The Medical Consultation and Patients' Perceived Recovery

186

(8)

Sickness Management

194

(2)

Sociodemographic and Socioeconomic Variability

196

(1)

Social Supports and Life Events

197

(2)

Attributions for Recovery

199

(6)

Patient-Perceived Therapeutic Outcomes: A Phenomenological Perspective

205

(22)

Jose

206

(1)

Arthur

207

(3)

Serge

210

(3)

Esperanza

213

(3)

Thelma

216

(3)

Nomi

219

(8)

Part Four Two Systems of Healing

A Comparison Between Sacred Healing and Biomedicine

227

(10)

Conclusion

237

(6)

Methodology

243

(4)

Glossary

247

(2)

References

249

(32)

Index

281

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Physicians at Work, Patients in Pain

Summary

Author Biography

Table of Contents

Supplemental Materials