skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.


Title: Escaping the Clinic: Exposure as Care among Military Medical Professionals at War
This article examines exposure in the mobile reach of care in war in order to theorise exposure as care. It does so from the margins, focusing on US military medical professionals of the officer class in the Iraq and Afghanistan wars, who feel distanced from the ‘real’ war experience represented by the infantry soldier, and thus engage in practices of exposure to gain the ‘trust’ and ‘respect’ of their soldier-patients. To grasp something of the promise and perils of exposure and its everyday enactments, I analyse one army physician assistant’s accounts of secretly stealing away on combat missions and the use of an ambulation tool called ‘the walkabout’ by the military mental healthcare community. The material, operational, and tactical settings of counterinsurgency and the professional cultures of military care occupations dynamically intersect to engender specific contexts for, opportunities within, and risks associated with exposure among military elite. An examination of exposure reveals that military medical professionals recast the hegemonic authority of proximity to soldiering in terms of the ethical norms and professional values of medicine: in a word, as care.  more » « less
Award ID(s):
1851014
PAR ID:
10390987
Author(s) / Creator(s):
Date Published:
Journal Name:
Medicine Anthropology Theory
Volume:
9
Issue:
2
ISSN:
2405-691X
Page Range / eLocation ID:
1 to 25
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. null (Ed.)
    Abstract With the United States military stretched thin in the “global war on terror,” military officials have embraced psychopharmaceuticals in the effort to enable more troops to remain “mission-capable.” Within the intimate conditions in which deployed military personnel work and live, soldiers learn to read for signs of psychopharmaceutical use by others, and consequently, may become accountable to those on medication in new ways. On convoys and in the barracks, up in the observation post and out in the motor pool, the presence and perceived volatility of psychopharmaceuticals can enlist non-medical military personnel into the surveillance and monitoring of medicated peers, in sites far beyond the clinic. Drawing on fieldwork with Army personnel and veterans, this article explores collective and relational aspects of psychopharmaceutical use among soldiers deployed post-9/11 in Iraq and Afghanistan. I theorize this social landscape as a form of “medication by proxy,” both to play on the fluidity of the locus of medication administration and effects within the military corporate body, and to emphasize the material and spatial ways that proximity to psychopharmaceuticals pulls soldiers into relationships of care, concern and risk management. Cases presented here reveal a devolution and dispersal of biomedical psychiatric power that complicates mainstream narratives of mental health stigma in the US military. 
    more » « less
  2. This article reveals how law and legal interests transform medicine. Drawing on qualitative interviews with medical professionals, this study shows how providers mobilize law and engage in investigatory work as they deliver care. Using the case of drug testing pregnant patients, I examine three mechanisms by which medico-legal hybridity occurs in clinical settings. The first mechanism, clinicalization, describes how forensic tools and methods are cast in clinical terminology, effectively cloaking their forensic intent. In the second, medical professionals informally rank the riskiness of illicit substances using both medical and criminal-legal assessments. The third mechanism describes how gender, race, and class inform forensic decision-making and criminal suspicion in maternal health. The findings show that by straddling both medical and legal domains, medicine conforms to the standards and norms of neither institution while also suspending meaningful rights for patients seeking care. 
    more » « less
  3. Background Over the past 2 decades, various desktop and mobile telemedicine systems have been developed to support communication and care coordination among distributed medical teams. However, in the hands-busy care environment, such technologies could become cumbersome because they require medical professionals to manually operate them. Smart glasses have been gaining momentum because of their advantages in enabling hands-free operation and see-what-I-see video-based consultation. Previous research has tested this novel technology in different health care settings. Objective The aim of this study was to review how smart glasses were designed, used, and evaluated as a telemedicine tool to support distributed care coordination and communication, as well as highlight the potential benefits and limitations regarding medical professionals’ use of smart glasses in practice. Methods We conducted a literature search in 6 databases that cover research within both health care and computer science domains. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology to review articles. A total of 5865 articles were retrieved and screened by 3 researchers, with 21 (0.36%) articles included for in-depth analysis. Results All of the reviewed articles (21/21, 100%) used off-the-shelf smart glass device and videoconferencing software, which had a high level of technology readiness for real-world use and deployment in care settings. The common system features used and evaluated in these studies included video and audio streaming, annotation, augmented reality, and hands-free interactions. These studies focused on evaluating the technical feasibility, effectiveness, and user experience of smart glasses. Although the smart glass technology has demonstrated numerous benefits and high levels of user acceptance, the reviewed studies noted a variety of barriers to successful adoption of this novel technology in actual care settings, including technical limitations, human factors and ergonomics, privacy and security issues, and organizational challenges. Conclusions User-centered system design, improved hardware performance, and software reliability are needed to realize the potential of smart glasses. More research is needed to examine and evaluate medical professionals’ needs, preferences, and perceptions, as well as elucidate how smart glasses affect the clinical workflow in complex care environments. Our findings inform the design, implementation, and evaluation of smart glasses that will improve organizational and patient outcomes. 
    more » « less
  4. The advent of wearable or body-borne electronics is rapidly changing how the Department of Defense (DoD) provides diagnostic and therapeutic medical care to the warfighter. Multiple DoD entities, from the U.S. Army Combat Capabilities Development Command’s Chemical Biological Center, to the Defense Threat Reduction Agency, are seeking bioelectronics that can transform military medicine by providing medics with valuable information to improve acute care on the battlefield, and aiding military doctors providing prolonged care. For instance, bioelectronics sensors that measure multiple signals, including heartbeat and the secretion of metabolites in perspiration, can provide remote monitoring of warfighter medical status during operations. Next-generation bioelectronics can be delivered by implantation or can be swallowed so as to deliver therapeutic medications. A seamless integration of such bioelectronics with the soft, complex, and 3D shape of the human body is inherently challenging due to the geometrical, material, and mechanical dichotomies between the two. Conventional electronics are typically fabricated via planar, top-down processes on a rigid substrate. Conversely, the human body is an irregularly shaped and highly flexible, stretchable construct. Significant research has been dedicated to overcoming this challenge, including the design of stretchable, flexible electronics, the development of electronic skin tattoos, and the manufacturing of electronic textile and bioelectronic implants. This article proposes and highlights the advancement of a multimaterial and multiscale 3D printing approach that can enable the fabrication of bioelectronics to better interface with the human body. Specifically, the article highlights the development of (a) a freeform electronics fabrication approach that allows for the creation of complex 3D systems, and (b) the multimaterial-printing of an ingestible gastric resident system that allows for non-surgical and needle-free delivery of wireless electronics into the human body. 
    more » « less
  5. Abstract Background The prevalence of burnout and distress among palliative care professionals has received much attention since research suggests it negatively impacts the quality of care. Although limited, research suggests low levels of burnout or distress among healthcare chaplains; however, there has been no research among chaplains working in specific clinical contexts, including palliative care. Objective This study explored the distress, self-care, and debriefing practices of chaplains working in palliative care. Method Exploratory, cross-sectional survey of professional chaplains. Electronic surveys were sent to members of four professional chaplaincy organizations between February and April 2015. Primary measures of interest included Professional Distress, Distress from Theodicy, Informal Self-care, Formal Self-care, and debriefing practices. Result More than 60% of chaplains working in palliative care reported feeling worn out in the past 3 months because of their work as a helper; at least 33% practice Informal Self-care weekly. Bivariate analysis suggested significant associations between Informal Self-care and both Professional Distress and Distress from Theodicy. Multivariate analysis also identified that distress decreased as Informal and Formal Self-care increased. Significance of results Chaplains working in palliative care appear moderately distressed, possibly more so than chaplains working in other clinical areas. These chaplains also use debriefing, with non-chaplain palliative colleagues, to process clinical experiences. Further research is needed about the role of religious or spiritual beliefs and practices in protecting against stress associated with care for people at the end of life. 
    more » « less