Browsing by Author "Solomon, Harris"
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Item Open Access 'Coming home does not mean that the injury has gone'-exploring the lived experience of socioeconomic and quality of life outcomes in post-discharge trauma patients in urban India.(Global public health, 2022-11) David, Siddarth; Roy, Nobhojit; Lundborg, Cecilia Stålsby; Wärnberg, Martin Gerdin; Solomon, HarrisTrauma results in long-term socioeconomic outcomes that affect quality of life (QOL) after discharge. However, there is limited research on the lived experience of these outcomes and QOL from low - and middle-income countries. The aim of this study was to explore the different socioeconomic and QOL outcomes that trauma patients have experienced during their recovery. We conducted semi-structured qualitative interviews of 21 adult trauma patients between three to eight months after discharge from two tertiary-care public hospitals in Mumbai, India. We performed thematic analysis to identify emerging themes within the range of different experiences of the participants across gender, age, and mechanism of injury. Three themes emerged in the analysis. Recovery is incomplete-even up to eight months post discharge, participants had needs unmet by the healthcare system. Recovery is expensive-participants struggled with a range of direct and indirect costs and had to adopt coping strategies. Recovery is intersocial-post-discharge socioeconomic and QOL outcomes of the participants were shaped by the nature of social support available and their sociodemographic characteristics. Provisioning affordable and accessible rehabilitation services, and linkages with support groups may improve these outcomes. Future research should look at the effect of age and gender on these outcomes.Item Open Access Death Traps: Holes in Urban India(Environment and Planning D: Society and Space) Solomon, HarrisItem Open Access Epidemiology in Motion: Traumatic Brain Injuries in Mumbai(South Asia: journal of South Asian studies, 2021) Solomon, HarrisItem Open Access Fighting for Life: War Trauma, Healing, and Ritual Communities in the American Pacific Northwest(2022) Webb, ChristopherThis dissertation traces the complex connections between violence, trauma, healing, and medicalization in North America. The project connects to conversations in medical anthropology and American studies, and intersects with science studies, postcolonial studies, the anthropology of militarism, and Native American studies. The central innovation in this dissertation is its focus on veterans who suffer from both the violence of war and the limits of trauma's conventional treatments. I track their experiences through a therapeutic system designed by and for Native people, and argue that questions about suffering and healing from war are inextricable from discourses and practices of gender, race, and territory.Since the Posttraumatic Stress Disorder (PTSD) diagnosis was codified in the Diagnostic and Statistical Manual of Mental Disorders in 1980, the object of combat trauma has grown to occupy significant space in popular culture. In the contemporary world, PTSD serves as the primary lens for translating military experience to both the public and veterans themselves. However, the diagnosis and all of its clinical appurtenances fall short of contextualizing the full range of traumas associated with military service and its treatments often fail to relieve sufferers of their symptoms. An early example of this was observed in American Indian veterans of the Vietnam War, who demonstrated marked “treatment resistance” to novel PTSD therapies that were developed in the 1980s. In response to this, a Veterans Affairs (VA) hospital in southern Puget Sound responded to requests by local tribal leaders to make indigenous healing and purification rituals available for American Indian veterans. Noting the efficacy of these rituals, a ritual community of indigenous veterans became established there who continue to practice their ceremonies today on a piece of sacred land adjacent to the VA hospital. The clinical PTSD diagnosis has evolved in accordance with medicalizing trends in the four decades since its recognition in the DSM. However, the social construct of combat trauma that is often known discursively as “PTSD” has grown and become increasingly entangled with various sociopolitical projects associated with war, gender, and racial/ethnic identity. In the 21st century, veterans increasingly prefer the signifier “warrior” over the civil term “veteran.” The warrior signifier conjures a more mythical notion of timeless, transcultural castes located in martial societies. At the same time, this warrior identity is being embraced by many outside of the military, including police and civilian defense contractors. Warriors are seen as a distinct kind of person who experiences war, suffering, and healing differently than civilians. Within this context, the combat trauma construct that is often generalized as “PTSD” becomes the fundamental marker of legitimate warrior experience. When the VA approved of making space for indigenous ceremony in the 1980s, it was because indigenous veterans were seen as denizens of “warrior cultures,” and understood to be ontologically distinct from non-indigenous veterans who were expected to heal best in a clinical environment. Until relatively recently, the ritual healing community was almost exclusive to the indigenous veterans it was created for. However, the ceremonies increasingly appeal to non-indigenous veterans and are now being seen as a therapeutic option for treatment-resistant veterans of all ethnicities. This situation creates the conditions for the complex intersection of several socioepistemological projects, including medicalization, race, indigeneity, militarism, and “warrior” identity among many other things. As a combat veteran with a PTSD diagnosis, my fieldwork centered on extended participation in the ceremonial life of this ritual community. Over a period of 36 months I made several trips to the site, including seven months of continuous fieldwork in 2019. I became close with the Elder Council, the team of experienced Native chaplains who officiate ceremonies in the ritual community. Drawing from several tribal traditions, particularly from Lakota/Plains traditions, these elders conduct sweat lodges, “talking circles,” and other ceremonies. These rituals serve a dedicated cohort of regular attendees, a segment of patients from the hospital’s inpatient PTSD program, and periodic visitors who are seeking healing after the failure of clinical therapy. My findings detail two developments: First, the ritual community exposes the limits of the 20th century process of medicalizing trauma associated with war/military service. For instance, ritual participants draw on the Lakota concept of iwáyazaŋ azúyeya, "the sickness one acquires from fighting others and the self" as the therapeutic object at stake, in contrast to "PTSD". Ceremonies directly address this sickness by highlighting Native experiences of colonization, the unique ways that trauma was experienced by Native veterans (particularly from the Vietnam War era), and the connections between violence and masculinity. Second, the site shifts the ways “warriordom” connects concepts of violence to concepts of culture. The notion that warriors are a unique kind of person who both suffer and heal differently from civilians may account for the increasing appeal of ritual therapy among non-Native veterans. However, the ceremonies compel veterans to confront warrior identity as a feature of white settler violence, and effectively turn healing into a process of social critique.
Item Open Access Free(dom)inated: A Feminist Examination of Hookup Culture’s Sexual Empowerment and Sexual Policing of Duke University Undergraduate Women(2017-05-05) Farless, HayleyHow do Duke University undergraduate women experience the seemingly empowering norms of hookup culture? While debate rages among feminists, scholars, journalists, and others as to whether or not hookup culture is beneficial for young women, this research offers a fresh perspective via an ethnographic examination of undergraduate women at Duke University in Durham, North Carolina, and how they experience hookup culture in a larger structure of male-privileged society. Based on interviews, qualitative surveys, and participant-observation on campus and at parties and bars, I explore the gendered elements of hookup culture and how they simultaneously sexually empower and oppress women at Duke’s campus. I argue that hookup culture polices women and their sexuality; that is, while hookup culture normalizes female participation in sex, it forces women into a prude–slut dichotomy. I then focus on the carnivalesque nightclub and the fraternity party as the primary sites where hookups are initiated, asserting that these spaces encourage female sexuality but also pressure women to objectify and commodify themselves. Finally, I consider the emerging, liminal space of the smartphone application Tinder and its gendered relation with hookup culture, in which women gain more control of the hookup space but are subjected to dehumanization and self-objectification. I argue that although the cultural norms of collegiate hookup culture seem to empower women’s expressions of sexuality by normalizing sexual activity for women, these same cultural norms actually contribute to Duke women’s sexual oppression by policing, objectifying, and commodifying female sexuality to serve male pleasure. This conclusion leads to a broader claim for future research: any degree of female sexual liberation that occurs within patriarchal society and male-privileging social structures only serves to placate women and perpetuate male sexual power.Item Open Access Learning from 2523 trauma deaths in India- opportunities to prevent in-hospital deaths.(BMC health services research, 2017-02-16) Roy, Nobhojit; Kizhakke Veetil, Deepa; Khajanchi, Monty Uttam; Kumar, Vineet; Solomon, Harris; Kamble, Jyoti; Basak, Debojit; Tomson, Göran; von Schreeb, JohanA systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery.All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings. Using mixed methods, they were quantitatively stratified by the standardized Injury Severity Score (ISS) into mild (1-8), moderate (9-15), severe (16-25), profound (26-75) ISS categories, and by time to death within 24 h, 7, or 30 days. Using peer-review and Delphi methods, we defined optimal trauma care within the Indian context and evaluated each death for preventability, using the following categories: Preventable (P), Potentially preventable (PP), Non-preventable (NP) and Non-preventable but care could have been improved (NPI).During the 18 month study period, there were 11,671 trauma admissions and 2523 deaths within 30 days (21.6%). The overall proportion of preventable deaths was 58%, among 2057 eligible deaths. In patients with a mild ISS score, 71% of deaths were preventable. In the moderate category, 56% were preventable, and 60% in the severe group and 44% in the profound group were preventable. Traumatic brain injury and burns accounted for the majority of non-preventable deaths. The important areas for improvement in the preventable deaths subset, inadequacies in airway management (14.3%) and resuscitation with hemorrhage control (16.3%). System-related issues included lack of protocols, lack of adherence to protocols, pre-hospital delays and delays in imaging.Fifty-eight percent of all trauma deaths were classified as preventable. Two-thirds of the deaths with injury severity scores of less than 16 were preventable. This large subgroup of Indian urban trauma patients could possibly be saved by urgent attention and corrective action. Low-cost interventions such as airway management, fluid resuscitation, hemorrhage control and surgical decision-making protocols, were identified as OFI. Establishment of clinical protocols and timely processes of trauma care delivery are the next steps towards improving care.Item Open Access Lifelines: The Traffic of Trauma(2022) Solomon, HarrisIn Lifelines Harris Solomon takes readers into the trauma ward of one of Mumbai’s busiest public hospitals, narrating the stories of the patients, providers, and families who experience and care for traumatic injuries due to widespread traffic accidents. He traces trauma’s moves after the accident: from scenes of road and railway injuries to ambulance interiors; through emergency triage, surgery, and intensive care; and from the morgue for patients who do not survive into the homes of those who do. These pathways reveal how trauma shifts inequalities, infrastructures, and institutions through the lives and labors of clinical spaces. Solomon contends that medicine itself must be understood in terms of lifelines: patterns of embodied movement that determine survival. In reflecting on the centrality of traffic to life, Lifelines explores a fundamental question: How does medicine move us?Item Open Access Living on Borrowed Breath: Respiratory Distress, Social Breathing, and the Vital Movement of Ventilators(Medical Anthropology Quarterly: international journal for the cultural and social analysis of health) Solomon, HarrisItem Open Access Paya Soup(Comparative Studies of South Asia, Africa and the Middle East, 2021-12-01) Solomon, HarrisAbstract This short story set in Mumbai imagines the enduring legacies of pandemic sickness and immunity. Everyday labors, pleasures, demands, and relations must be navigated across the fault lines of health, illness, and state surveillance.Item Open Access Perceiving Blood Sugar: Kaleidoscopic Re-framing of CGM-Driven Diabetic Datafication(2024-04-03) Sebastian-San Miguel, SabrinaThe means to enact the oversight of blood sugar levels have evolved throughout the history of type 1 diabetes. Using (auto)ethnographic methods of interviews, participant observation, and arts-based research creation, this thesis interrogates what new phenomena-in-practice accompanies the rise of continuous glucose monitoring (CGM) technology. The author argues that CGMs render glucose metabolism perceptible through the addition of new sensory modalities: visuality, audibility, and wearable materiality. In imparting these new perceptibilities, CGMs become more akin to medical visualization tools; dissolving the body-environment divide, CGMs project the metabolism into the environment through a variety of mediums. In turn, this more comprehensive association with the sensorium renders CGMs as more than a measuring technology. Presenting contributions across science and technology studies, disability studies, medical and visual anthropologies, this thesis explores the lived re-imaginations of the technological mediation of diabetic embodiments.Item Open Access Queering Oocytes: Laboratory, Body, Cell(2020-05-01) Zussman, JayRecent advances in stem cell technology enable new possibilities for biological reproduction among same-sex couples and transgender people who have undergone medical or surgical transition. Despite this promise of revolutionary queer futurity, biomedical science has been harnessed to marginalize the reproductive capacity of the poor, colonized, and people of color for eugenic and capitalist aims. This study draws upon firsthand experiences working in a reproductive biology laboratory and integrates perspectives from feminist science and technology studies, Black feminism, and queer and transgender studies. The work explores how the formation of scientific knowledge (re)produces racialization of reproductive bodies, capitalist manipulation of reproductive potential, and normative temporalities of reproductive bodies. Examining the dynamic plasticity of sexing and gendering gametes within the laboratory reveals a mechanism by which researchers instill their own internalized sex and gender norms onto their research subjects, essentializing sex and gender hierarchies across species, tissue, and cell boundaries. In vitro gametogenesis, an assisted reproductive technology on the horizon of human use, invites a politics of multiplicity through which to understand all mammalian tissues as potentially reproductive. This novel reproductive future elucidates the interconnections between human and animal reproduction within and beyond the laboratory context and enables groundbreaking new opportunities for interspecies reproductive intimacy and queer reproductive futurity. Ultimately, the work takes an ambivalent view of emergent reproductive technologies, acknowledging their reinforcement of eugenic and economizing racial logics even as they queer human and animal bodies, tissues, and cells and revolutionize kinship and reproductive capacity for bodies deemed non-normative.Item Open Access Short Cuts: Metabolic Surgery and Gut Attachments in India(Social Text, 2014) Solomon, HarrisItem Open Access The Detainment and Quarantine of HIV+ Haitians at Guantanamo Bay: A Biosecurity Case Study(2023-08) Dion, HaleyThis thesis investigates the relationship between Haitians, the HIV/AIDS epidemic, and the US government at the site of Guantanamo Bay. Through an exploration of this relationship, I utilize the concept of biosecurity to analyze the actions of the US government in response to the HIV/AIDS epidemic. I assert the need to evaluate the mechanisms and products of the government-sponsored biosecurity intervention at Guantanamo Bay within this framework. With a lens of xenophobia and racism, I highlight the differential treatment and human rights violations of Haitians with the US government’s perception of them as contagion-filled bodies. Utilizing archival sources, I outline the sequence of events that led to the Haitian refugee detainment at Guantanamo Bay and detail the implementation of quarantine and its consequences for the health of HIV+ Haitians. I connect US law and public health policy to analyze the ethics of the detainment and quarantine of Haitian refugees. I argue that the government-sponsored intervention at Guantanamo Bay served as a site for the implementation of biosecurity protocols in response to the HIV/AIDS epidemic. These procedures and their outcomes invoke future implications for the regulation of and response to emerging epidemics around the world that are essential to consider in the management of global health.Item Open Access Wound Culture(Annual Review of Anthropology, 2022) Solomon, HarrisThis review offers new perspectives on the anthropology of injuries and wounds. It maps how theories, methods, and ethnographic sensibilities converge on wounds, on the act of wounding, and on the wounded as instructive objects. The review assesses how anthropologists understand social forces to cause wounds and how they accord wounds the power to generate meaning about sociality. Organized across two themes, quot breach quot and quot repair, quot the review tests concepts of embodiment across clinical boundaries, manifestations of harm, and formations of justice. It examines how anthropological thought connects to wound culture and assesses links between embodiment and politics that develop in the domains of critical theory and medical anthropology. Ultimately, it aims to shed light on the connections between body politics and ethnography and to ask what wounds might generate as an anthropological concern.