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neled into a course of treatment regardless of its appropriateness” (p.30). For example, the mere fact
that a person exhibits an allergic reaction to a specific substance may lead a doctor to prescribe a pro
tracted and costly series of hyposensitization injections despite the lack of conclusive evidence to in
dicate that this type of treatment is always necessary or beneficial.
The Medical Merry-Go-Round was written by Morton Glasser, an M.D., and Gretel H. Pelto, a
medical anthropologist. Thus, it is another of those works which investigate a problem from more
than one angle of spezialization. Unfortunately, it does not fully live up to the potential offered by
such an approach.
The authors begin with a visit to a doctor’s office, where a nervous man suffering from a heart
condition is waiting to see his doctor, in this case a famous specialist who will receive a high fee for
this single visit. Later we are told that our patient, a rancher, has apparently improved after his con
sultation and subsequent therapeutic regimen. It is only when we find out that J. L. is a Navaho In
dian, and the doctor a Navaho “singer”, that the picture flip-flops dramatically. The reader is sud
denly confronted with an example of a disease known only too well and which is responding to a
treatment outside the ken of western medicine.
Glimpses into other societies’ medical practices are not the point of this book, but rather a means
to its end. We are, for example, informed that both the Western physician and his/her counterpart,
the shaman, have the same goal: the reestablishment of “harmony and balance” (p. 16) in the sick in
dividual. The two steps each carries out — the identification of the cause(s) of the disharmony
(diagnosis), and the correction of this imbalance (therapy) — are seen as universal procedures in
medical practice. But, whereas shamans in general treat the “whole” individual through a system of
actions that, whether intentional or not, deals with more than just the biological aspect of the illness,
the Western physician deals almost exclusively with this domain. The body is treated as a machine
which occasionally goes on the “fritz” and has to be overhauled. Because s/he forgets that the
machine has an operator, and that an intimate and not yet adequately understood relationship exists
between the two, the Western doctor ignores a crucial part of the healing process. The consequence is
that “...modern physicians are a type of shaman without the proper upbringing” (p.24).
Given the human organism’s ability to eventually recover from most of the physical set-backs of
life, Glasser and Pelto offer a quite plausible insight into the reasons behind the conservatism typical
of medical systems: since health will ultimately be regained anyway, “...every medical theory will be
proved correct in the majority of cases” (p.18). In other words, as long as a treatment is not too
dangerous (and sometimes even if it is, e.g. blood-letting), any credit for a patient’s improvement will
tend to accrue to the treatment. This tendency helps give rise to a body of faithful adherents to a par
ticular practice, with the result that outmoded procedures are often retained long after their ineffec
tiveness has been demonstrated.
Proceeding from this basis, we are led through a variety of medical practices, including circumci
sion (potentially dangerous in both Western and non-Western contexts), tonsillectomies (seen as a
particularly Western “rite de passage”), diabetes, allergies, radical mastectomies, psychiatry, heart
disease, and hypertension. For each of the examples, the message is the same: there is no conclusive
scientific evidence behind most claims supporting a particular practice or therapy. Drugs are tested
without the use of control groups. Surgical practices, developed within a particular theoretical
framework, continued to be applied long after new findings nullify the assumptions upon which they
are based. Therapeutic procedures are developed without an adequate understanding of the myriad
factors which may contribute to a condition, resulting in treatments which are effective for a disease
only under certain conditions, but which may nevertheless be prescribed for all cases.
As part of the solution to these problems, the authors advocate the use of better judgement in
medicine. An essential step is to include the patient in the deliberations about his/her fate. When a
given treatment entails risks and high costs, the patient should be informed of these before s/he
makes a decision. If there are controversies surrounding a particular method, then the patient should
be made aware of the fact, so that s/he knows that not all doctors think the same. The authors main