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C h a p t e r 3 Moksha and Mishappenings [It is] an action transposed into a world, into a kind of space-time, which is no longer quite the same as everyday life. [This involves] . . . the mystery of a body which suddenly as though by the effect of an internal shock, enters into a kind of life that is at once strangely unstable and strangely regulated, strangely spontaneous, but at the same time strangely contrived and, assuredly, planned. —Paul Valéry, ‘‘Philosophy of the Dance’’ (1983 [1936]) Some days in the ward we pick stones out of rice, a task so common to Indian women’s kitchen worlds that it has its own verb. I sit on the floor with Pooja, Sanjana, Riti, and Isma. The rice arrives from the kitchen in a plastic bag. Pooja pours it onto plates, one for each person. The sound of grains on metal is like a shower of tiny bells, loud in the sleepy hush. We lean over, bodies reaching earthward, fingers walking through shifting dunes. Our eyes fall on flashes of gray. Our fingertips catch something sharp. A husk. A bad seed. A stone. A density that could break a tooth. The sustaining element of the next meal—what makes it food—moves through our hands and we became absorbed in our white microcosms. It is not easy to tell stories this way, eyes down, fingers in motion. There are long pauses, drifting minutes between comments. Through this void, words rush by like meteorites. They connect to nothing. They burn out quickly. This is ‘‘time-pass.’’ It is also waiting. It is therapy. And work. And it is hunger, the slow rise of emptiness in the stomach, the intensity of stillness, the pulse of purposeful concentration. It has meaning, but only just. 118 Chapter 3 In Moksha, as with Ammi’s family, I constantly felt the limits of research. As I spent time in a mode best described as punctuated habitation, at points it was clear that my activities could no longer be labeled research, though it was not easy to say what they were or identify the aim of talking, sitting around, and just being there, aside from talking, sitting around, and just being there. I spoke with women who passed through, and I got to know those who stayed longer. Many were eager to have their situations recorded, acknowledged, and shared. Many were quite lucid, though I was aware that even in lucidity some things were recognizable as ‘‘the things crazy people say,’’ equal parts symptom and testimony. Others were far from lucid. As the notion of lucidity became a matter of impression, I became acutely aware of the ability of psychotic speech to express uncomfortable truths. More important than these plays of consciousness were the immediate conditions of affliction, the way suffering had to do with the place itself. Many women whom I would neither treat nor regard as research subjects were nonetheless inhabitants of a place in which they felt contained. This did not change the fact that feelings of persecution can be part of schizophrenic feelings and terrors. Parsing ways of perceiving constraint seemed less important than documenting flows of time and feeling across the real (but slippery) divide between psychotic speech and lucidity. Then there was the matter of understanding practices common to Indian psychiatry with what we might call cultural sensitivity, that is, in a way that attended to the realities of life and medicine in India and gave due note to doctors’ own ethical considerations, their sensitivity to social conditions , and their struggles to practice good medicine under difficult conditions . I was often in the presence of behaviors that in other places might be questionable but that here were quite normal. Knowing when to be outraged and when understanding of doctors’ struggles was a challenge. Some things I was uneasy labeling as crises. Some I wavered on. Some I was comfortably appalled by. For example, untruths told to ‘‘protect’’ patients from their circumstances fit into a consistent logic of care that extended from clinics to schools to households. So did the use of physical aggression, threatened swats to the face, real slaps. But neither untruths nor slaps were things I could relegate to a relativist sense of ethics or see entirely from doctors’ perspectives. This is largely so because it was clear that patients wanted to be told the truth about their circumstances and did not want to be hit...


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MARC Record
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