Today in my Medical Anthropology class. we discussed a long article entitled, “A Life: Between Psychiatric Drugs and Social Abandonment,” by Joao Biehl. It is a condensation of a book of a similar name: Vita: Life in a Zone of Social Abandonment. 

The article started this way:

“In my thinking, I see that people forget me,” Catarina said to me as she pedaled an old exercise bicycle while holding a doll. This woman of kind manners and a piercing gaze was in her early thirties; her speech was lightly slurred. I first met Catarina in March 1997 in southern Brazil at an asylum called Vita. I remember asking myself, Where on earth does she think she is going on this bicycle? Vita is the end point. Like so many others, Catarina had been left there to die.” 

We picked the article apart. It is the professor’s style to start with a set of simply put but complex questions and then to lead the class through the discussion as if he himself is reading the article for the first time. He poses questions and then searches the article for the exact wording of the answer. I like this because it makes the answer conclusive. This is what it says. Right here.

Then he turns around and writes, makes lists, sets up dichotomies, the purpose of which is to provide the framework for our discussion. He does this effortlessly and I envy that. When I taught, I always needed to be so prepared. Have my notes and slides ready. He only needs a dry erase marker.

We trace the story of Catarina, an impoverished Brazilian woman who is living in a place called Vita that in America would be called a very badly run homeless shelter. She is thought to be mentally ill so she is treated with all manner of psychotropic drugs which have terrible side effects which, when combined with the inherited neurological disease she actually has, eventually render her unable to walk. In the meantime, though, she pedals on the stationary bike and writes her dictionary, full of frightful and poignant words like “A cure that finds the soul,” “dead alive, dead outside, alive inside,” and “I offer you my life.”

It turns out that Catarina’s fall from family life was precipitated by her physical illness which is erroneously labeled mental illness and was then accelerated by her husband’s infidelity and her brothers’ unwillingness to care for her. She ends up with nowhere to be, too sick and too drugged to fight back.

The professor traces the social and cultural context of this horrible trajectory. He begins with Brazil, then lists neo-liberalism (also known as privatization of government services), poverty, the prevalence of free psychotropic drugs, the difficulty of mental illness diagnosis, family dynamics and then a student mentions gender. “I think she was treated differently because of her gender.” And then others talk about how her husband was cheating on her at the time of her entry to Vita and how he had given away her older daughter to a boss. I’m grateful that someone has put gender on the list. It would have been me but I spoke up last week and, as an auditor, I try to pace my commentary. The professor adds “gender” to the list, it’s a faded “gender” because the ink in his marker is running low.

It’s all gender! I want to say. Gender is overarching! It helped my argument that her brothers who also manifested symptoms of the same inherited disease were living at home on government disability while their sister festered on a stationary bicycle. Gender shouldn’t be down on the list. It should be at the top of the list. But then it would seem that I’m one-dimensional, unable to take into account the full panoply of contextual variables. See the big picture.

The other students in the room are young, very young. Sexism seems like an artifact from another time, I feel it like an arrowhead in my pocket. It is so real to me it makes me sick. I know in my heart that Catarina would never have been left to die had she been a man and I feel like she’s my sister. Don’t ask me why.