Spring 2015 Bulletin

An Intellectual Journey and Personal Odyssey

Arthur Michael Kleinman

Editors’ Note: We are inaugurating a new feature in this issue of the Bulletin: notes and short essays written by Academy Members on their current work or on new developments or topics of interest in their fields and professions. We invite all Members interested in contributing to “On the Professions” to contact the editors of the Bulletin at bulletin@amacad.org. We hope that this new feature will be a medium through which Members address one another and share in the excitement of each other’s work.

In 1973, at the very outset of my career in psychiatry and anthropology, I published four papers that would become the foundation of my journey as a scholar, teacher, and practitioner. One paper drew upon the research I had already initiated on patients, their families, and healers in Taiwan – where I had served as an NIH fellow in the U.S. Public Health Service seconded to the U.S. Naval Medical Research Unit No. 2 – to formulate a model of health care systems. A second paper sketched a way of studying the history of public health in China through the Cultural Revolution, which Chinese society was then undergoing. Another put forth a practical clinical method for eliciting patients’ culturally shaped expectations of care to improve diagnosis and treatment. The last work was at once the most ambitious and least developed: it proposed studying medicine as a cultural system that could provide a way for biomedical science and clinical practice to become an object of cultural enquiry – an anthropology of science.

Over the years to come, I would work on each of these subjects with shifting intensities, and in so doing I crossed back and forth between medical anthropology, cultural and clinical psychiatry, social medicine, global health, the medical humanities, and China studies. While the driving force behind this broad interdisciplinary mobility doubtless was in part my personal peculiarities and predilections, I owed the rest to those whom I engaged as intellectual interlocutors and academic collaborators along the way.

I have always been passionate about transdisciplinary collaboration. Working with historians, sociologists, and humanists, on the one side, and with biomedical practitioners and scientists, on the other, taught me respect for the different forms of knowledge creation and education. Biosocial processes linking disease pathology, illness experience, caregiving, or health systems required that the social world be understood as embodied in populations and individuals and that psychophysiological processes in such conditions as depression, AIDS, or diabetes be reinterpreted (resocialized) in terms of the political economy of poverty, the moral economy of relationships, and the culture of institutions. To do so meant reading broadly across disciplines, engaging in academic conversations with those working in archives as well as laboratories, and forging ties in field research and teaching with different kinds of scholars. With them I have published and taught courses on topics from social suffering to SARS, subjective wisdom to global health policy, psychotherapy to neoliberalism, religion to pharmaceuticals, narratives to local biology.

And these border crossings have affected my academic career as much as my personal life. I have chaired the Department of Social Medicine at Harvard Medical School and the Department of Anthropology in Harvard’s Faculty of Arts and Sciences, and I have directed the Harvard Asia Center and the Division of Consultation-Liaison Psychiatry at the University of Washington. I have practiced psychiatry in general hospitals and spent years in ethnographic field research. I have taught undergraduates and medical students, and I have mentored Ph.D. students and postdoctoral fellows. And I have felt equally at home in Brooklyn, where I grew up, at Stanford, where I studied, in Boston, where I now live, in Washington, D.C., where I consulted at the NIH and Institute of Medicine, and in Taipei, Changsha, and Shanghai, where I conducted field research across five decades.

Those different worlds and ways of knowing have made me better able to understand the shared existential condition of what really matters for ordinary men and women facing the dangers and uncertainties of living. They have sharpened my awareness of the incompleteness and multiplicity of human conditions. They have better prepared me to appreciate not just the joys but the failures of aesthetic, moral, and religious quests. Shaking up my perspectives and expectations has curiously centered my understanding of the world. By forcing me to rethink and reimagine, these different worlds have served to free me from overly narrow, culturally constrained, and professionally circumscribed ways of knowing. Together with numerous former students I have worked toward uniting theory, research, practice, and policy so as to create a different kind of academic field. As a clinician and scholar who crosses disciplinary boundaries, I have learned to ask different questions, go against the grain, put findings into practices of care, and build a career and sustain a life.

The multiple worlds, cultural contestations, and near-constant personal disorientation of a globalized career – with its intellectual dissonances and tense post-colonial professional experiences – used to seem particular; but now that it is increasingly the world we all inhabit, I feel the benefits of advanced preparation for a new age. It is a transitional age in which no single academic or intellectual perspective is adequate to capture the complexity of society and the rapidity of perceptual, affective, and value transformation. It is at once a dismaying and appealing time: challenges to the very idea of what is human, the differing notions of a good or at least adequate life, and the clash of an idealistic pursuit of social justice and humanitarian practices with the cynical reality of systemic corruption and extremist violence make it clear we really do not yet possess the concepts or language to adequately make sense of what we are facing. We are right now building a world whose environmental, health, technological, developmental, and ethical conditions have set us in a whole new reality. But what that reality is and what it will require of us to endure by fashioning an appropriate ars vivendi, no one knows. It is honest awareness of our ignorance and often the hypocrisy of our claims – as well as our urgent need to cross intellectual and practical domains of life in order to begin to get a handle on the radically new configurations of things – that tell me I haven’t been wrong in centering my work on the meaning of lived experience. And yet, I am humbled by having rarely succeeded in taking full advantage of what was once a precocious intellectual quest and is now a widely shared enterprise of interdisciplinary, collaborative, and useful (if incomplete) knowledge about global life in our times.

Arthur Kleinman is the Esther and Sidney Rabb Professor in the Department of Anthropology at Harvard University and Professor of Medical Anthropology in Global Health and Social Medicine and Professor of Psychiatry at Harvard Medical School. He is also the Victor and William Fung Director of Harvard University’s Asia Center. He was elected a Fellow of the American Academy in 1992.

© 2015 by Arthur Kleinman

Selected works from Arthur Kleinman’s career include Arthur Kleinman, “Toward a Comparative Study of Medical Systems,” Science, Medicine and Man 1 (1973): 55–65; Arthur Kleinman, “The Background and Development of Public Health in China: An Exploratory Essay,” in Public Health in the People’s Republic of China, ed. Myron E. Wegman, Tsung-yi Lin, and Elizabeth F. Purcell (New York: Josiah Macy, Jr. Foundation, 1973), 1–23; Arthur Kleinman, “Some Issues for a Comparative Study of Medical Healing,” International Journal of Social Psychiatry 19 (3/4) (1973): 159–165; Arthur Kleinman, “Medicine’s Symbolic Reality: A Central Problem in the Philosophy of Medicine,” Inquiry 16 (1973): 206 –213; Arthur Kleinman, “Concepts and a Model for the Comparison of Medical Systems as Cultural Systems,” Social Science and Medicine 12 (1978): 85 –93; Arthur Kleinman, Leon Eisenberg, and Byron Good, “Culture, Illness, and Care: Clinical Lessons from Anthropological and Cross-Cultural Research,” Annals of Internal Medicine 88 (2) (1978): 251–258; Arthur Kleinman, Patients and Healers in the Context of Culture: An Exploration of the Borderland Between Anthropology, Medicine, and Psychiatry (Berkeley: University of California Press, 1980); Wayne Katon, Arthur Kleinman, and Gary Rosen, “Depression and Somatization: A Review, Part I and Part II,” American Journal of Medicine 72 (1) (1982): 127–135 and 72 (2) (1982): 241–247; Arthur Kleinman, Social Origins of Distress and Disease: Depression and Neurasthenia in Modern China (New Haven, Conn.: Yale University Press, 1986); Arthur Kleinman, The Illness Narratives: Suffering, Healing and the Human Condition (New York: Basic Books, 1988); Arthur Kleinman, Rethinking Psychiatry: From Cultural Category to Personal Experience (New York: Free Press, 1988); Paul Farmer and Arthur Kleinman, “AIDS as Human Suffering,” Dædalus 118 (2) (1989): 135; Arthur Kleinman and Joan Kleinman, “How Bodies Remember: Social Memory and Bodily Experience of Criticism, Resistance, and Delegitimation following China’s Cultural Revolution,” New Literary History 25 (3) (1994): 707–723; Arthur Kleinman, “An Anthropological Perspective on Objectivity: Observation, Categorization and the Assessment of Suffering.” in Health and Social Change: An International Perspective, ed. Lincoln C. Chen, Arthur Kleinman, and Norma Ware (Cambridge, Mass.: Harvard University Press, 1994); Arthur Kleinman and Joan Kleinman, “The Appeal of Experience, the Dismay of Images,” Dædalus 125 (1) (1996): 1–23; Arthur Kleinman, Veena Das, and Margaret Lock, Social Suffering (Berkeley: University of California Press, 1997); Arthur Kleinman, “Experience and Its Moral Modes: Culture, Human Conditions and Disorder,” in The Tanner Lectures on Human Values, Vol. 20, ed. Grethe B. Peterson (Salt Lake City: University of Utah Press, 1999), 357–420; Arthur Kleinman, Renee C. Fox, and Allan Brandt, eds., “Bioethics and Beyond,” Dædalus 128 (4) 1999; Arthur Kleinman, What Really Matters: Living a Moral Life Amidst Uncertainty and Danger (Oxford: Oxford University Press, 2006); Dominic T. S. Lee, Joan Kleinman, and Arthur Kleinman, “Rethinking Depression: An Ethnographic Study of the Experiences of Depression Among Chinese,” Harvard Review of Psychiatry 15 (1) (2008): 1–8; Arthur Kleinman, “Global Mental Health: A Failure of Humanity,” The Lancet 374 (9690) (2009): 603–604; Arthur Kleinman, “A Search for Wisdom,” The Lancet 378 (9803) (2011): 1621–1622; Arthur Kleinman, “Culture, Bereavement, and Psychiatry,” The Lancet 379 (9816) (2012): 608–609; Arthur Kleinman, “Caregiving as Moral Experience,” The Lancet 380 (9853) (2012): 1550–1551; Arthur Kleinman, Yunxiang Yan, Jing Jun, Sing Lee, Everett Zhang, Pan Tianshu, Wu Fei, and Jinhua Guo, Deep China: The Moral Life of the Person, What Anthropology and Psychiatry Tell Us about China Today (Berkeley: University of California Press, 2013); Paul Farmer, Jim Yong Kim, Arthur Kleinman, and Matthew Basilico, eds., Reimagining Global Health (Berkeley: University of California Press, 2013); Arthur Kleinman, “Why William James Still Matters,” in The Ground Between: Anthropologists Engage Philosophy, ed. Veena Das, Michael Jackson, Arthur Kleinman, and Brighupati Singh (Durham, N.C.: Duke University Press, 2014); and Iain Wilkinson and Arthur Kleinman, A Passion for Society: How We Respond to Human Suffering (Berkeley: University of California Press, forthcoming).