Atlas of Human Anatomy by R.D. Sinelnikov

By R.D. Sinelnikov

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40 Narratives are subjective constructions, then, and they are also social. Social processes determine what stories can be told, what stories must be told, what stories cannot be told. Those who narrate select from a vast store of events and memories, putting the selections into temporal and causal orders: this happened and then that happened; this happened because that happened. In narratives, what may have seemed random is made coherent. Narratives join affect and cognition, what we think about and how we feel—not only for tellers (or writers) of tales but for the ones who listen (or read).

She sees individual biology and behavior as the root causes of disease and is blind to larger social and political concerns—or if not completely blind, she at least sees attention to such concerns as well outside her job description. The transformation is so profound that Frederic Hafferty (1991) has compared it to a doctrinal conversion in which old values are repudiated and new identities assumed. Much evidence supports this familiar story, evidence that has remained quite consistent over five decades of research on medical training and despite major changes in both the content of medical curricula and the diversity of entering students.

Locally trained doctors are desperately sought by the public health sector, even while training programs are derided by some donors as an unjustifiably intensive use of scarce resources—in essence, an inappropriate technology for the region. It is my contention that the African student who takes on the identity of African doctor here is a figure whose very existence confronts and destabilizes the theoretical oppositions mapped above. These students are not “us,” elsewhere. To this very challenging clinical milieu they bring experiences and histories that matter for the doctors they ultimately become.

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