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  • The Pastoral Clinic: Addiction and Dispossession along the Rio Grande
  • Paul Draus
The Pastoral Clinic: Addiction and Dispossession along the Rio Grande By Angela Garcia University of California Press. 2010. 248 pages. $55 cloth, $21.95 paper.

The landscape of northern New Mexico is both beautiful and forbidding. On the tops of foothills of reddish rock dotted with sagebrush, you will see the occasional crosses planted, the monuments of penitentes, an order of Catholics who physically recreate the suffering of crucifixion. Suffering runs deep in the bones of the aptly named Sangre de Cristo Mountains. In The Pastoral Clinic: Addiction and Dispossession along the Rio Grande, Angela Garcia provides a painful, multilayered ethnographic portrait of the [End Page 328] people who inhabit the valley villages, and their struggles with endemic heroin use. Like other recent works that examine the interpenetration of illicit drugs with the lives of particular places (Glendenning 2005; Bergmann 2009; Bourgois and Schonberg 2009; Reding 2009), Garcia's book is both an exploration of local culture, geography and history, as well as a deeply personal narrative journey. While its grasp sometimes exceeds its reach, The Pastoral Clinic is a perceptive, compelling piece of work.

An anthropologist, originally from New Mexico, Garcia becomes enmeshed in the lives of heroin users while working at an addiction clinic on the outskirts of the town of Espanola. The book, which began as a dissertation project, gradually moves beyond the confines of the clinic and into the arroyos and adobe houses of the surrounding communities as Garcia develops relationships with numerous individuals, primarily women, whom she meets in the course of her time there. As she acknowledges, the experience of addiction, like that of suicide, is ultimately solitary and incomprehensible to the observer, no matter how committed. Her larger subject is not heroin addiction per se, but its complex entanglement with the harsh but poetic landscape, the history of colonization and the enduring economic malaise of the valley, as well as the persistent dynamics of gender and power.

Fittingly, the book begins and ends with stories, stories that illustrate the embedded complexity that Garcia confronts. Both stories take place at the Nuevo Dia clinic in Espanola, and both connect the experience of addiction to the surrounding landscape, both physical and social. In the first story, Garcia accompanies two users, a man and a woman, in different stages of detox, from the clinic down to the Rio Grande, in the hopes of providing some respite from the bleak boredom of life inside the clinic. The walk brings up some pleasant memories of childhood, but ends abruptly at the river's edge with the sight of "a heroin cooker made of an old soda can, along with two discarded syringes." John, the man, spots the syringes and summarily states, "Este rio esta muerto [This river is dead}." Garcia has already found, upon her return to the land of her childhood, that syringes are everywhere, both as mundane material objects and as symbols, incorporated at times into the Christian iconography, but also appearing mysteriously in the landscape, like the hand-fashioned memorials to the dead, or descansos, that one sees along roadsides and riverbanks. In this manner, she writes, "New Mexico's landscape makes visible the existence of addiction, and addiction shapes and is shaped by New Mexico's landscape. Each has its own processes of sedimentation, which are entangled in ways that this book tries to understand."

As the book's title indicates, this sedimentation includes the region's long history of dispossession, extending back to Spanish colonization in the 1600s. The subjection of Native American tribes is layered beneath that of the Hispanos, or Spanish-speaking peoples, whose own residency long precedes the existence of the United States. With the establishment of New Mexican statehood in 1848, land rights of many local Hispanos were revoked, and this occurred again when Los Alamos was transformed into a federal nuclear laboratory during the Cold War. In the complicated tri-ethnic configuration of contemporary northern New Mexico, both Hispanos and Native [End Page 329] peoples must contend with the economic and political dominance of Anglos, who largely reside in the wealthy cities of Santa...

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