restricted access Chapter 5: Xiguan, Consumption, and Shifting Cancer Etiologies
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Chapter 5 Xiguan, Consumption, and Shifting Cancer Etiologies At sixty-two, Gandie was an active, healthy, and warm-hearted man. He was the father of Erjie, the thirty-six-year-old woman with whose family I lived. He liked drinking and smoking; in fact, he was “fierce” at it (xiong de hen), as his son-in-law remarked in January 2005, the month leading to his death, when his condition had dramatically deteriorated. When I was first introduced to Gandie on his birthday (October 19, 2004) by Erjie, he had been diagnosed with esophagus cancer at the beginning of the month but was himself still unaware of his illness. Around fifty people attended his birthday party, but Gandie was clearly not in the mood for celebration. He ate nothing and paced the courtyard dressed in his best traditional silk shirt, a dark blue jacket reminiscent of revolutionary times, and a hat. He looked unsettlingly tense and restless, and seemed to be in pain. An amount of over 500 yuan was spent on fireworks alone, because, as Erjie put it, “Next year he will not be able to celebrate his birthday” (Mingnian guo bu cheng shengri). This chapter will unpack the relationship between cancer, consumption practices (including eating in general, smoking, drinking, and consuming preserved vegetables), and health more broadly. As many locals argued openly, ability to eat constitutes good health. I explain that this equivalence between eating and health may be understood as a form of habitus (Bourdieu 1977, 1990) fostered by historical experiences of food shortage. As they affect the sufferer’s ability to eat, esophagus and stomach cancer therefore also challenge this historically rooted foundation of health. Indeed, the terms locals employed (and in some cases still employ) to designate these illnesses—“choking illness” ( gengshi bing) and “vomiting illness” (huishi bing) respectively—describe degrees of Xiguan, Consumption, and Shifting Cancer Etiologies     145 inability to eat. Forming a backdrop to later chapters, I begin by narrating how esophagus cancer was experienced by and affected the family of Gandie. Gandie’s decreasing ability to eat made him aware of his illness, and it presented a parameter through which he and his family measured his physical decline. But through the development of cancer, the definition of what constitutes eating was revised to make sense of his condition and come to terms with it. The concept of habitus is inadequate to encapsulate the subtle changes in their attitudes. I propose that the locally prevalent concept of xiguan (habit) is more adept for making sense of bodily habits that are at once stable and flexible and produced through everyday practices. Epidemiological studies regard consumption of preserved vegetables , tobacco, and alcohol as a possible cause of stomach and esophagus cancer ( J. Chen et al. 1990). While villagers are aware of this, they often dismiss it. I explain that this is due to the clashing ideals of moral (or immoral) subject that are produced by such etiologies. While epidemiologically , smoking and drinking are presented as individual practices for which individuals alone may be blamed, villagers highlight the social pressure and expectations, for men in particular, to engage in such practices , as well as the social capital derived from them. In this sense, when attributing cancer to smoking and drinking, villagers do not blame individuals alone. Likewise, consumption of preserved vegetables is understood within the historical and economic context that gave it rise rather than attributed to individual preference. The respective moral economies current at times of food shortage and at times of relative prosperity may account for why preserved vegetables are associated with cancer in the past but not in the present. With reference to Gandie’s and Uncle Wang’s cases, I show that particular etiologies are adopted when it is morally feasible and productive. For this reason, attribution of cancer to particular causes varies in the course of illness and after death. As cancer unfolded, Gandie’s family members’ perceptions of his illness and what caused it changed. Tracing these changes stage by stage highlights not only how illness itself develops but also how Gandie and his family attempted to rebuild their moral universe in the face of illness—to avoid blaming Gandie or other members of the family. Such shifts are also forms of family caregiving. In turn, this delineates both family relations and morality as emergent and processual rather than firm and undisputed and articulates comments on the moral economies of the past 146     Making Sense of Cancer and the present...