on which decisions were made within local family/neighborhood/medical networks, decisions about her sanity and ultimately about whether “she could or could not behave like a human being,” as her mother-in-law put it. Depersonalized and overmedicated, something stuck to Catarina’s skin—the life-determinations she could no longer shed.
But this work was not only about finding “the truth” of Catarina’s story. It also precipitated events. With the help of several doctors, we scheduled medical examinations and brain-imaging, and we discovered that Catarina’s cerebellum was rapidly degenerating. We then embarked on a medical journey to identify her ailment and determine what could be done to improve her condition. She was fighting time, and there was a real urgency about the knowledge being generated. As fieldwork linked Catarina to Vita, Catarina to her past, and her abandonment to her biology, it also occasioned Catarina’s reentrance, if all too briefly, into the worlds of family, medicine, and citizenship. These events in turn led to a familiarity with the machinery of social death in which Catarina was caught and an understanding of the effort it takes to create other possibilities. As the realpolitik of abandonment came into sharp relief, questions of individual and institutional responsibility were addressed in new and different ways.
As fieldwork came to a close, Oscar, one of Vita’s volunteers on whom I depended for his insights and care, particularly in regard to Catarina, told me that things like this research happen “so that the pieces of the machine finally get put together.” In our conversations and in her writing Catarina was constantly referring to matters of the real. Had I focused only on her utterances within Vita, a whole field of tensions and associations that existed between her family and medical and state institutions, a field that shaped her existence, would have remained invisible.6
Catarina did not simply fall through the cracks of these various domestic and public systems. Her abandonment was dramatized and realized in the novel interactions and juxtapositions of several social contexts. Scientific assessments of reality (in the form of biological knowledge and psychiatric diagnostics and treatments) were deeply embedded in changing households and institutions, informing colloquial thoughts and actions that led to her terminal exclusion. Following Catarina’s words and plot was a way to delineate this powerful, noninstitutional ethnographic space in which the family gets rid of its undesirable members. The social production of deaths such as Catarina’s cannot ultimately be assigned to any single intention. As ambiguous as its causes are, her dying in Vita is nonetheless traceable to specific constellations of forces.
Once caught in this space, one is part of a machine, suggested Oscar. But the elements of this machine connect only if one goes the extra step, I told him. “For if one doesn’t,” he replied, “the pieces stay lost for the rest of life. Then they rust, and the rust terminates with them.” Neither free from nor totally determined by this machinery, Catarina dwelled in the luminous lost edges of a human imagination that she expanded through writing. By exploring these edges alongside a hidden reality that kills, we have a way into present human conditions, ethnography’s core object of inquiry.
One reads many books and borrows from their languages to understand the world one lives in. One also takes them into the field, where their propositions might not always work that well but are nonetheless helpful in generating figures of thought. This is one of the many good things about anthropology and the knowledge it produces: its openness to theories, its relentless empiricism, and its existentialism as it faces events and the dynamism of lived experience and tries to give them a form. In this book, I integrate theory into the descriptions of what I found in my work with Catarina, the medical establishment, and her family. In a similar vein, I relate her ideas and writing to the theories that institutions applied to her (as they operationalized concepts of pathology, normality, subjectivity, and citizenship, for example) and to the general knowledge people had of her. Rationalities play a part in the reality of which they speak. They form part of what Michel Foucault calls “the dramaturgy of the real” (2001:160) and become integral to how people value life and relationships and “enact the possibilities they envision” for themselves and others (Rosen 2003:x). I want this book to convey the active embroilment of reason, life, and ethics—as human existences are shaped and lost—that fieldwork captures.
One set of ideas that I initially brought to this work and that I briefly explore here concerns a person’s “plastic power.” “I mean,” wrote Friedrich Nietzsche in The Use and Abuse of History, “the power of specifically growing out of one’s self, of making the past and the strange one body with the near and the present, . . . of healing wounds, replacing what is lost, repairing broken molds” (1955:10, 12). Rather than speaking of an essential individuality or of an all-knowing subject of consciousness, Nietzsche calls our attention to modifications in subjective form and sense vis-à-vis historical processes and the possibilities of establishing new symbolic relations to the past and to a changing world.
Such plasticity—whether we think of it as the capacity for being molded or the adaptability of an organism to changes in its environment—is a theme moving through readings of anthropology, psychoanalysis, psychiatry, and cultural history. It appears in the “allo-plastic” capacity of Sigmund Freud’s neurotic patients to alter reality through fantasy (in contrast to “auto-plastic” psychotics) (1959b:279); in Bronislaw Malinowski’s argument about the “plasticity of instincts” under culture (as an alternative to the notion of a mass psyche) (2001:216); in Marcel Mauss’s ensemble of the social, the psychological, and the biological, “indissolubly mixed together,” in “body techniques” (1979:102); in the intrasocial and intersubjective debate that Gananath Obeyesekere regards as the “work of culture” (1990); in Arthur Kleinman’s reading of patterns of social and moral upheaval in individual symptoms of distress (1981; Kleinman and Kleinman 1985); in Nancy Scheper-Hughes’s account of the medicalization of the bodily common sense of “nervoso” alongside hunger (1992); in the body of the old person becoming an “uncanny double” in the liminal space between households and the science of old age, as evidenced by Lawrence Cohen (1998:269); and in the self-empowerment afforded to the subjected by ambiguity, as Judith Butler (1997) argues in The Psychic Life of Power. The notion of the self as malleable material runs through these otherwise divergent arguments; it is central to our understanding of how sociocultural networks form and how they are mediated by bodily affect and the inner world.7
A related literature expands this theme of malleability, finding it not so much in particular persons as in the plasticity of reality as such—that is, synthetic frameworks mediate social control and recast concepts of a common humanity. Theodor Adorno, for example, politicizes Freud’s group psychology model and argues that the peculiarity of modern authoritarian ties lies not simply in the recurrence of primordial instincts and past experiences but in their “reproduction in and by civilization itself” (1982:122; my emphasis). According to Adorno, Nazi science and propaganda created new mechanisms of identification that bound German citizens together, and against outsiders, in a state of moral blindness. Modern subjective reassemblage goes hand in hand with rational-technical politics and state violence.
In “Colonial Wars and Mental Disorders,” Frantz Fanon (1963) identifies and critiques the colonized subjectivity of the Algerian people under French imperialism. From Fanon’s perspective, the locus of imperial control is not necessarily the political and economic institutions of the colonizer but the consciousness and self-reflective capabilities of the colonized.8 Subjectivity is a material of politics, the platform where the agonistic struggle over being takes place. He states: “Because it is a systematic negation of the other person and a furious determination to deny the other person all attributes of humanity, colonialism forces people it dominates to ask themselves the question, constantly, ‘In reality, who am I?’” (1963:250). Fanon’s answer is one of deconstruction: whose reality?
Fanon rethinks Freud’s characterization of psychotic experience as being cut off from reality and being incapable of achieving transference.9 Rather than excising the psychotic from
