Analyze

Drawing on a long career as a Black critical health equity researcher, Bowleg quotes Black feminist Audre Lorde in arguing that the “master’s tools”—in order words, conventional theories and methods—"will never dismantle the master’s house”—intersectional structures of oppression from which health inequities are produced. Bowleg elaborates by explaining that conventional theories and methods “valorize almost exclusively individualistic and social cognitive approaches (Cochran & Mays, 1993; Weber & Parra-Medina, 2003); ignore the foundational roots of structural and intersectional inequality (Bowleg, 2012, 2020); center White, Western, cisgender male, middle-class, and heterosexual people and their experiences as normative (Henrich et al., 2010); prioritize amelioration, not transformation (Fox et al., 2009a); and view Black people primarily through the lens of deficit or pathology” (237).

Thus Bowleg offers 10 critical lessons for Black and other health equity researchers of color that she links with system and structural-level strategies. Bowleg also cautions that these lessons are risky and could damage one’s academic career—but that it is exactly this kind of risk that is necessary for change. Among these include: embrace critical perspectives, embrace a critical qualitative stance, learn research paradigms (e.g. positivist paradigm = a master’s tool, must learn to counter), foster community-based partnerships and collaborations, and highlight black communities’ strengths, assets, and acts of resistance. Bowledge also encourages researchers to “tell it like it is”: “Epistemological ignorance is one of the master’s most formidable tools. Epistemologies of ignorance refer to the examination of different types of ignorance and their production, maintenance, and functions (Sullivan & Tuana, 2007)” (239). Here, Bowleg emphasizes the importance of language by discussing how it can alternatively reveal or obscure structures of oppression as well as it shapes the nature of research.

Byron Good, Ph.D., is a professor of Medical Anthropology at Harvard Medical School. His primary area of research is mental illness and how social perceptions evolves around these issues, in terms of both treatment and social acceptance. Dr. Good has several works on these issues, including several that explore the perspective of bio-medicine in non-western medical knowledge, the cultural meaning of mental illness, and patient narrative during illness. His publications including several papers, books, and edited volumes; he is regarded as a major contributor to the field of psychological anthropology. 

The article primarily asserts that how a patient narrates or describes their medical history is deeply rooted in their native culture. As such, physicians must be aware of how an individual's medical experiences can be altered based on this. In turn, physicians must recognize the importance of story-telling and anecdotes when receiving information directly from patients. Narratives project the patient's experience and events through their perspective, granting professionals a glimpse into their thought processes and action patterns.

The author, Byron J. Good, is a Harvard professor in the department of global health and social medicine. He is the director of the International Mental Health Training Program, and has significant experience with field research that has led to many publications.

The article’s main argument is that the narration of an illness is founded in the emotional connection it has to the sufferers life, the place from which they view the illness which includes individual and cultural aspects. Furthermore any lack of factual accuracy is an indicator of the social and cultural environment in which the illness presents itself and is revealing as to how it will be perceived and treated.

The main argument is supported primarily through interviews with many individuals living in Ankara, through which they describe the first presentation of their seizures and in many cases the steps they tool to attempt a cure. Along with the interviews, statistics of the individuals interviewed and their diagnoses is used to provide a reference point to better understand their stories. Finally the article includes an analysis of narratives in a more general sense that can be applied to the narrative of an illness.

• “… illness narratives - both the corpus of story episodes and the larger life "story" or illness narrative to which they contribute - have elements in common with fiction. They have a plot; succession is ordered as history or event, given configuration.” (164)
• “The diverse accounts of the illness in these narratives represent alternative plots, a telling of the story in different ways, each implying a different source of efficacy and the possibility of an alternative ending to the story. My point is not that persons having access to a plural medical system do not simply choose among alternative forms of healing but instead draw on all of them” (155)
• “Predicament, human striving, and an unfolding in time toward a conclusion are thus central to the syntax of human stories, and all of these, as we will see, are important to stories about illness experience.” (145)

The article provides statistics and excerpts of interviews to support its analysis of the narrative of illness. There are also several quotes from other works that analyze story and narrative to support the claims of the importance of emotion as a method of sharing the plot.

Emergency response is not addressed in this article however it does provide emergency responders with insight into the stories those suffering from illness will have to explain their suffering. As emergency responders will often be working in societies and cultures very different form their own in the case of disaster response, it is important to understand that what may seem like fiction in a story cannot be dismissed without considering the deeper cultural significance of those elaborations.

This article has not been references extensively, it appears to have been used in further research done by the author but I could not find other articles that referenced this one.