Instead of carrying hometwo babies wrapped in blue blankets, Shauntay brought home one babyand planned a funeral for the other.

“I have Christ in the labora-tory,” she told me. “Whenever I go to do a procedure, I ask that he enlighten meto do things well.”

North american audiences tended to be amused and skeptical. to them, invokingGod in the lab sounded like rote behavior, rather than a deeply felt interior state ofbelief. but instead of questioning the inner convictions of Ecuadorian IVF prac-titioners and patients, we can understand them as engaging in an integral prac-tice.

Dunne’s work exemplifies a type ofanthropology that fails to problematize its own mythical idealized self, that con-tinues to view the other as all that the self does not contain or condone, namely,nonegalitarian sexual relations, the oppressive rule of men, gender-based sexual-ity, patriarchy, and so forth

An anthropology that cannot abandon the mytholog-ical West as a reference point will continue to use it as the organizing principlefor all of its arguments.

While she regularly affirms her commitment tonormative civic values, she also supports the presidentprecisely because of the way he flouts those values, suc-cumbing to this contradiction

With that said, I want to suggest that Candace’s incon-sistent and contradictory statements speak to an insidi-ous reality unattended to by our civic discourse on poli-tics: subjects are always to a degree incoherent—lackinga unified, consistent worldview or stable identity (Butler1990).

Less obvious to her, perhaps, is that the stakes in producing “clinical miracles” are even higher in California. For many practitioners in California, clinical success is almost essential in making a living. Wendy Luo, an acupuncturist trained in Shanghai, recounted her experiences a'er immigrating to San Francisco in #$%# as follows:When I (rst started making a living here as an acupuncturist, many people did not know much about acupuncture and herbal medicine. Pa-tients only came to me for illnesses that Western doctors could not cure. )ese were o'en very di*cult cases. )at’s mostly true even today. And patients have very little patience—they would not want to come back if they did not see results quickly. )at is a bit unfair—this is medicine, not magic! And why should people expect overnight cures from us, when they have had the illness for years and Western medicine could do noth-ing about them? But, anyway, I was lucky to soon realize that I had to Downloaded from http://read.dukeupress.edu/books/book/chapter-pdf/643302/9780822392132-004.pdf by COLUMBIA UNIVERSITY user on 16 August 2022

Moreover, authoritative discourses of science play important roles in delimiting the legitimate space of traditional Chinese medicine in relation to biomedicine, even as the changing contours, tra-jectories, and positions of traditional Chinese medicine call into question what counts as science, what counts as biomedicine, and what counts as traditional Chinese medicine. As I will show in the following section, it is only when the scope of scienti(c rationality and clinical e*cacy is normal-ized in terms of the capabilities of biomedicine that the e*cacy of tradi-tional Chinese medicine is translated into something extraordinary and everyday practice becomes a site for the birth of “miracles.”

he bot-tom line is that they have exchanged any interest in reducing treatmentsfor the goal of increasing them. No matter how obvious this might seemnow, I didn’t see the connections right away, even when pharmaceuticalresearchers said it directly: “No one is thinking about the patients, justmarket share.”25

Furthermore, the disempowerment of the doctor is compounded bymany of the direct-to- consumer advertising campaigns such as tv com-mercials. These ads often portray active consumers-become-patients whopaid attention to the tv or a website and recognized a risk that their doc-tors missed or even misdiagnosed. Consumers can self- diagnose onlineor even by listening to their symptoms as defined in the ad, and increas-ingly they are arriving at their doctors’ offices with demands rather thanquestions. Doctors, in turn, because of the multiple pressures of limitedpatient time, keeping up with rapidly changing information, and the con-straints of health maintenance organizations and insurance, are quitevulnerable to these demands.19Third, the relation of the researcher to the state of knowledge is nar-rated as one of deep submission. Referring to “the latest” clinical trialmay seem like an authoritative move, but it implies that what the re-searcher may have told the patient the day before is now false. Here thejokes are more sinister: health and illness and treatment are continuallysubject to revision. The consumer as being potentially at risk must main-tain vigilance with regard to health information. Health must become apreoccupation. And indeed it has.20Finally, it may not be surprising that the latest clinical trials almostalways recommend more treatment for more people. But the researcher’shappy sense of the trend quoted above, “Five or more drugs for life is aminimum!” is still disturbing. Declaring a minimum implies an open-endedness to the number of drugs we should be on for life. Given thelogic and authority of his claim, it seems that only large-scale clinicaltrials can help determine whether someone would actually benefit froma treatment. As we will see in chapter 4, because large-scale trials arerun by pharmaceutical companies as investments, the only trials theycan afford to run are those that, if successful, will return that investmentthrough indicating more treatments.These characteristics of mass health—chronic treatments for risk re-duction, health as known through limited clinical trials, ever-increasingnumbers of drugs—are the subject of this book. They are not secret, ex-