Life Beside Itself: Imagining Care in the Canadian Arctic by Lisa Stevenson (review)

In Life Beside Itself, Lisa Stevenson raises a question that all those working in the caring professions should ask themselves: What do my standards of care mean for the person who I am treating? Drawing on historical records and her own ethnographic work with Inuit people living in Nunavut, Stevenson examines the effects of Canadian approaches to two epidemics: the tuberculosis epidemic that afflicted many Inuit communities from the 1940s to the 1960s and the epidemic of suicide, which seemed to take its place and still persists today. Drawing on material from all over the world, she examines care as a product of colonialism – measuring success by the prevention of death, regardless of the effects of such efforts on the lives of the people concerned.

By examining the gap of understanding between how the dead are situated in the minds of the Indigenous peoples in Iqaluit and Igloolik as well as in other Arctic communities and the way in which deaths are perceived and recorded by workers for the Canadian state, Stevenson demonstrates how Inuit mistrust of the Canadian provision of health and welfare arises. When the hospital boat arrived in port, many Inuit would hide until its departure lest they were found to have tuberculosis and taken aboard and then south to the sanatorium, which in this case was in Hamilton, Ontario. If the Inuit survived their treatment, often they could not be sent home because no record had been kept of their next of kin and the village to which they belonged. In the end, patients were given a tag with an identification number, another manifestation of the impersonal nature of the treatment they received.

Lisa Stevenson tells us that her book suggests “a mode of anthropological listening that makes way for hesitation” (2). Within this space, the Inuit need to know much more than that their loved ones have died; they need to hear their names spoken. The names of the dead live on in the mouths of the living. The presence of a raven who stays around the cabin suggests that a beloved uncle, recently deceased, is “still there.” Babies are not only named after someone recently departed – they take on that person’s role so that when a grandfather dies, the baby receives the respect and the love that that person had in his own lifetime – the child becomes parent to its own parent. Thus, when the dead live on among the living in these ways, the saving of life has less meaning. The very impulse to save lives, she tells us, effaces the identity of the patient. The bio-political approach of the state cares for a population rather than for individuals. This approach has the continuing psychological impact of colonialism and results in the anger expressed by the Inuit over state care.

The writer maintains that the anonymous care provided – in that all individuals must be treated alike – is a murderous form of care and that the Canadian North has been a laboratory for a massive social experiment, an experiment in assimilation. Inuit have endured longer stays in southern hospitals long after modern medicine made this unnecessary so that they could be taught to live in the Canadian way. Stevenson believes that Inuit death, especially suicide, is seen by Canadians as an indicator of the failure of the system. She describes the state’s system of impersonal care as “soul blindness.”

Turning to the suicides of so many young Inuit, Stevenson points out, that in northern Indigenous communities, suicide is normal. There is no one who has not felt suicidal, attempted suicide, or knows someone who has killed themselves. Again, she suggests that suicide help lines and caregivers also offer something that is impersonal and that their work is suicide prevention, rather than trying to listen and to understand the wish to die of the person at the other end of the line.

Stevenson examines the dreams of the living where the dead appear and can offer wisdom...