Book Review: Hospital Land USA

coverDeath is certain. Time of death is not. But in Hospital Land USA, the other S&M (Science and Medicine) as Wendy Simonds calls it, death is a failure, something to be suspended and avoided at whatever cost. And there is no safe word. The surreal ordinariness of it all – from appointments and forms to waiting rooms, scripts, and winning advertorials; exams and tests to bills, claims, and satisfaction surveys; sighs of good news to the emotional rollercoaster of risks, harms, hopes, and uncertainties – reduces individuals to a collection of body parts to be increasingly scrutinized and managed. The curing and caring that co-exists in this medicalized space too often fails to account for the suffering involved in caring for the sick and the old. Highly recommended.

–Gayle Sulik, author of Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health

When sociology Professor Wendy Simonds’ friend and colleague, Chet Meeks, was diagnosed with advanced cancer she started to think more about the role of medicine in everyday life. After his death in 2008, she understood with certainty that Chet’s story was more than an idiosyncratic tale of dying young of cancer. It served as a starting point for examining how social issues such as medical treatment, scientific innovation, and care for the sick transcend the particulars.

Biomedical advances contribute to longer life spans for some along with, almost inevitably, a supramedicalized state that involves constant evaluation, intervention, and the nearly obsessive management of risk, susceptibility, enhancements, and a broader range of conditions than ever before. Simonds acknowledges that biomedical techniques and technologies help many and cure some. Innovations ranging from vaccines to antibiotics to diagnostic technologies (like X-rays, MRIs, and PET scans) to surgical technologies (lasers, robotic arms, etc.) have helped to mitigate suffering and improve lives. Sometimes people receive respectful, affirming, and life-saving treatment that certainly qualifies as care.

Yet embedded within the medical industrial complex of Hospital Land USA, there are “broad cultural in/sensibilities and conventions” that negatively impact treatment, embodiment, identity, and mortality (p. 33). For example, Chet Meeks writes on January 13, 2007:

So my treatments are now more than halfway over. I really hope this is the end of everything because, to be quite honest, I cannot imagine doing more chemotherapy after this set is over. This is actually the end of my 19th!! treatment, and by the time I reach #24, I wonder what’s going to be left of my body. I know my kidneys are in bad shape because I can feel them throbbing sometimes. My hair is now basically coming out in gobs. I’m shaving it all off soon. And even though, compared to others, I tolerate these treatments quite well (recovering quickly, leading a basically normal life for about 8 out of every 14 days), I’m really, really, really getting sick of it.

Everyone keeps telling me it looks like I’ve lost weight, but in actuality I’ve gained 4 pounds since beginning chemotherapy. I’m convinced that this weight gain is poison…. 4 pounds of poison trapped inside of my screaming body. Today I feel like my entire body has been marinating in toxins for the last 6 months. The poison is coming out of my skin. I have acne again, like when I was 13 but even worse. My hands look like the hands of an 80-year-old, and my skin is peeling off. My sweat smells like a something you’d scour the bathroom with. I won’t sicken you with a discussion of my digestive tract. (p. 43).

Chet’s experience is not unusual. It is quite possible that the chemical cocktail and surgical treatments that quickly aged him 50 years and left him feeling revolted by the look, feel, and smell of his own body might have given him a few months longer to live. But the current medical system is not set up to acknowledge or address his experience in meaningful ways. A culture of biomedicine with its taken-for-granted magic and mysticism is organized around its efforts to forestall death rather than to embrace a more complete definition of healing that would include recognizing the devastation of treatment and disease while “putting into place procedures that recognize and honor the inevitability of endings” (p. 34).

I too knew Chet Meets. We went to graduate school together at the University at Albany, State University of New York. This book honors his theoretical mind, careful skepticism, and humor even as it carefully articulates and contextualizes the reality of his suffering in an age of biomedicalization.

Wendy Simonds is a professor of sociology at Georgia State University and teaches courses in the specialty areas of gender and sexuality and family, health, and the life course. She is coauthor (with Barbara Katz Rothman and Bari Meltzer Norman) of Laboring On: Birth in Transition in the United States (Routledge, 2007), author of Abortion at Work: Ideology and Practice in a Feminist Clinic (Rutgers,1996), co-author (with Barbara Katz Rothman) of Centuries of Solace: Expressions of Maternal Grief in Popular Literature (Temple, 1992), and co-editor of Sex Matters: The Sexuality and Society Reader (WW Norton), now in its fourth edition (2014).

Hospital Land USA: Sociological Adventures in Medicalization by Wendy Simonds. Routledge (2016). 262pp. ISBN: 978-0415748087, $45.95 (Paperback).


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