Search

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 majority of information in the report comes from interviews performed by Dr. Good himself while on a medical trip in the Middle East. The article also includes stories and tales from other professionals as well; as such, the report encompasses not just experiences with epilepsy in the Middle East, but a multitude of diseases among unique cultural settings. 

1) early on the article, Dr. Good discuses how individuals would use the word "fainting" to described their tonic-clonic seizure episodes. This was quite divergent from the word "epilepsy" in Turkish, thus allowing the patient to distance themselves from the well-stigmatized diagnosis of epilepsy. It also served as a point of reference for what linguistic nuances could be expected during the course of the interview, as these can play a great deal into the narrative.

2) Dr. Good also discusses the work of Dr. Evelyn Early, who interviewed members of the Turkish female population. His description of Dr. Early's work states these narratives “allow the women she studied to develop an interpretation of the illness in relation to a local explanatory logic and the biographic context of the illness, to negotiate right action in the face of uncertainty, and to justify actions taken, thus embedding the illness and therapeutic efforts within local moral norms".

3) Dr. Good includes the story of Zeki Bey, an individual with generalized seizures for 15 years at the time of interaction. Dr. Good describes his narrative of his illness as being "[told with] immediacy, drama, and poignancy... His illness had a powerful and meaningful beginning, which gave shape and coherence to the larger narrative."

1) Hocas: an anglicized ottoman-Turkish word meaning "master, professor, teacher"; it evolved from "khawaja", and is an honorific title given to a teacher of the Muslim faith, particularly a sufi teacher. 

2) Tonic-clonic seizure: formerly described as "grand mal seizures", they include two sections (hence the "tonic" and "clonic"). The tonic phase includes the initial rigor and consciousness, while the clonic phase is the characteristic muscle spasms. These phases each last around 1 minute and 3 minutes, respectively.

3) Jinns: anglicized to "genie", this is the term for a supernatural creature in the Muslim faith. Many of the patients interviewed in Dr. Good's work spoke of a terrifying event prior to the onset of their epilepsy, often involving the presence of a "jinn". 

The bibliography is not included in the PDF uploaded, most likely because this a chapter excerpt from a larger work. However, there are several citations within the article, most of which are elaborated on. These descriptions indicate the works follow similar lines of thought and provide similar information to supplement Dr. Good's assertions. This includes his description of Dr. Evelyn A. Early's works (discussed earlier--ha), and several other prominent medical anthropologists. 

1)      From the perspective of readers or hearers of stories that are in process, plot is less a finished form or structure than an engagement with what has been told or read so far in relation to imagined outcomes that the story may bring - outcomes that are feared, longed for, or seem ironically or tragically inevitable.

2)      Second. several prototypical plot types can be identified among the illness narratives, as well as among the specific stories of which they are constituted. These have a distinctive cultural form, rooted in Turkish popular medical culture. They are present as the plot structures of the narratives we heard. They are also available as cultural resources for those in the midst of illness attempting to make sense of their experience; that is, they are possible stories one might reasonably tell about such an illness, potential plots giving order to the events one is experiencing.

3)       Meanwhile, he continues to work in a job at the municipality, where he is treated well by co-workers. His major concern is that he and his wife have had no children, and he wonders if either the illness or the medications are to blame. This, rather than treatment of the primary disease, organizes his interest in shaping the outcome of his illness story.

This chapter from the work "Medicine, Rationality, and Experience: an anthropological perspective" seems to most frequently appear on websites for various Universities and Colleges. Moreover, the work as a whole seems to have been cited several times by subsequent reports further defining patient narration and medical relations.

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.

Emergency response is not specifically addressed in the article. However, medical professional-patient relations are a key component of emergency response; as such, Dr. Good's assertions surrounding patient narrative should be taken into consideration in emergency situations. He notes that the methodology and cultural nuances of narration can provide a cornucopia of information that would otherwise be ignored.