Technologies of Difference

A Post-plural Anthropology of Diabetes in Japan

Each network makes a whole world for itself, a world whose inside is nothing but the internal secretions of those who elaborate it. Nothing can enter the galleries of such a network without being turned outside in. Bruno Latour, Irreductions

My dissertation examines the various forms of incorporating biomedical knowledge of aging by looking at the politics of difference and similarity in the case of the so-called ‘lifestyle-related diseases’ (seikatsu shūkan byō). I focus on the multiplicities of diabetes: its moral apparatuses, scientific discourses, technological enhancements and embodied languages.

Building my analysis around the anthropological concept of embodiment, I try to describe how daily encounters with medical technologies and popular health practices introduce new ways of attending bodies (of self and other). My argument, in short, is that the daily routines of disease (here, the treatment of high sugar levels in the blood) mobilize new and rich sensory modalities through a restructuring of basic processes of the collective social and technological shaping of experience.

Diabetes is a major health problem in Japan affecting more than 10 million people directly. Its public health implications grow along with the potential market of newer and simpler medications making it one of the most dynamic fields of collaboration between the state, scientific research and private pharmaceutical companies. My concern is to describe how mundane medical technologies of glucose control and hypoglycemic agents (i.e. diabetes drugs) perform these links, which, in turn, articulate biological and cultural differences by measuring, negotiating and imaging them in medical practice. This is an ethnographic attempt to draw attention to the important and often neglected dimension of the mediation between scientific facts and cultural meanings at various sites of disease. Its methodological framework combines (1) participant observation at a diabetes center and other health care facilities throughout Japan (especially in the northern city of Sapporo and two neighborhoods in Tokyo) with (2) interviews of patients, medical professionals and pharmaceutical salesmen, along with the assessments of (3) endocrinology literature and popular media.

One, if not the most, important aim of such an ethnography of disease is the critique of the dominant pluralist mode of the social sciences that, in short, understands medical knowledge as an extension of cultural and/or human diversity. These episodes, events and narratives of diabetes are empirical attempts to engage the critical role of particular objects and particular technologies in drawing out the connections between scientific facts and human suffering.