I was initially drawn to Cornelia Guell’s recent article entitled “Candi(e)d Action: Biosocialities of Turkish Berliners Living with Diabetes” ( Medical Anthropology Quarterly (25(3):377-394, 2011), by the focus on Turks—I grew up in Turkey—but I soon found myself enmeshed in her writing, which I found inspiring in a way. It focused on the proactive, problem-solving nature of this diabetic community’s collegiality and collective action, rather than on the structural constraints and other mechanisms of marginalization so commonly emphasized in academic and journalistic writings about people of Turkish descent in Europe. I liked the (balanced) emphasis on people’s creativity, cooperativeness, joint action; and I liked the implicit recognition that people of Turkish descent in Germany could also be doctors and pharmaceutical representatives, and others of middle class stature; they were not only unskilled labourers taking away German jobs, victims of discrimination, or financial drains on the broader German collective. I liked the inclusion of illiterate older women, described using modern technology with equanimity, understanding the medical regimes required of diabetics. All these aspects gave an air of hopefulness to the article; people are creative and adaptive—something I truly believe.
I wondered at first what biosocialities were (I’ve not read the literature the author cites): She defines these as “…social groups forming around biological identities marked by ill health or illness susceptibility” (p. 378). In the article this concept was linked with social marginality in general, and in this case with the well-established marginality of Turks in Germany.
Yet, the concept seemed to apply to myself and many of my equally aging, mostly financially comfortable, friends and relatives—few of whom would be considered marginalized in the conventional sense. The common concerns among my age group, though, with both our own health, which is in some senses failing, and the health and care of our aging and vulnerable parents, dominate our discussions. These topics serve as linking or bonding mechanisms with new acquaintances and additional social glue with old friends and family, near and far, rich and poor. We come together in person, by email, via Facebook, on the phone; we are linked more passively through organizations like AARP, the Democratic Party, life insurance groups; or actively in yoga groups or as volunteers for Meals on Wheels. We frequent similar medical professionals, through routine physical exams, submitting to mammograms, prostate checks, colonoscopies and all the other invasive indignities to which we (and our parents) are subjected in the shared effort to maintain or prolong our health. These are all contexts for shared experience, knowledge, and conversation, despite our generally middle class, or even elite statuses.
Is this a form of ‘biosociality’? I wonder, is the association of biosocialities with marginality overly constraining?; am I failing to acknowledge the degree to which older Americans, regardless of their socio-economic status, are indeed marginalized?; do I seriously misunderstand the concept?
I am also reminded of the centrality of the health care debate right now in the US, prompted surely partly by these recurrent, ubiquitous concerns of an aging population—perhaps rendered more politically ‘central’ by the non-marginalized status of many of today’s elderly. Guell’s article reminds me of our own capacities to act, to deal directly with our own and our families’ health, but also, by extension, to act politically to rectify the broken US health care system, in which:
- The costs of today’s care serve to marginalize those already marginalized and to render marginalized those who have been in the mainstream;
- the lack of attention to prevention exacerbates the growing problems of today’s elderly, and ignores the general health status of the population (with adverse, long-term implications as today’s youth age); and
- the fragmentation of health care, with different doctors addressing different parts of the same body, reduces efficiency and efficacy in dealing with human beings, whose parts come together within one mind/body.
Looking at the use we make of our national resources, it is hard to avoid the conclusion that our priorities are seriously confused. Why can’t we, one of the richest countries on earth, create a workable system that addresses these issues directly, providing adequate health care for all? In fact I believe we can. We just need to do it.
Guell’s article—on sick and marginalized people of Turkish descent living in Germany—reminded me of my own belief in our ability and responsibility to do this, to act in pursuit of better health care for all (in our own country and beyond).