a smack in the jaw

Every Thursday, one of the clinics located on the campus of the local referral hospital holds a journal club. A doctor, resident, or medical student presents an article. The article is sent out by email earlier in the week. The person presenting gives an exegesis of the article, provides some contextual information, and discusses the article's strengths and weaknesses, and its applicability or relevance for clinical practice in Botswana.

My medical student friends joke with me now and again about how much medical knowledge I've picked up in the course of my research. I'm getting to the point of feeling that I 'speak doctor' well enough now, and that it's time to move on and find another perspective. (There are a couple of problems here: 1) 'med student' is the easiest role for me to slip into; 2) I have a good idea of what things look like from an American practitioner's perspective, but the non-American practitioner's perspective is not so easy to obtain, in part because of point #1.)

But no matter how well I blend in among the American doctor crowd, my little anthropological mouth fell open yesterday afternoon when the following article was referenced in a presentation on HIV and renal failure:

Cantor et al. 1991. Effect of race on expression of acquired immunodeficiency syndrome-associated nephropathy. Archives of Internal Medicine 151 (1)

All of a sudden, I was an anthropologist again.

Where do I begin? Is 'blackness' a risk factor for renal disease? Can data from 'black' Americans be extrapolated onto 'black' Africans? What proof is there that this has anything to do with 'blackness', or is 'blackness' here a gloss for the corporeal manifestations of structural racisms with their own particular histories? What to make of a medicine that refuses to relinquish or interrogate its categories and cartographies of difference?

There is so much -- about race, about the conditions of practicing American-trained biomedicine in 'Africa', about difference -- that is glossed over in these institutions. I keep my eye on it when I can, but so rarely does it jump out and hit me in the jaw like this.

I didn't design my research to be about race or racism, but there's absolutely no way I can talk about what's going on here without talking about it.