Abbott - Notes on: Reification and the consciousness of the patient (Taussig) 3 - I am going to argue that things such

as the signs and symptoms of disease, a s much as the technology of healing, are not "things in themselves" are not only biological and physical, but are also signs of social relations disguised as na tural things, concealing their roots in human reciprocity. -intrinsic to this problem lay the phenomenon of reification - the thingificatio n of the world, persons, and experience, as all of these are organized and recon stituted by market exchange and commodity production...It is with the phantom ob jectivity of disease and its treatment in our society that I am concerned. 4 - science like medical science can explain the "how" but not the "why" of dise ase -my disease is a social relation and therapy has to address that synthesis of mo ral, social and physical presentation [azande conception] It is a specifically m odern problem wherein things like my bodily organs are at one instant mere thing s and at another instant question me all too insistently with all too human a vo ice regarding the social significance of their dis-ease. -above all it is with disease with its terrifying phantoms of despair and hope t hat my body becomes ripe as little else for encoding that which society holds to be real-only to impugn that reality. And if the body becomes this important re pository for generating social meaning, then it is in therapy that we find the f inely gauged tuning whereby the ratification of socially engendered categories a nd the fabulation of reality reaches its acme. -The sick person is one who is plunged into a vortex of the most fundamental qu estions concerning life and death. The everyday routine of a more or less uncrit ical acceptance of the meaning of life is sharply interrupted by serious illness which has its own pointed way of turning us all into metaphysicians and philoso phers, not to mention critics of a society which leaves its sick and their famil ies to fend for themselves . this gives the doctor a powerful point of entry int o the patient's psyche, and also amounts to a destructuration of the patient's c onventional understandings and social personality. it is the function of the re lationship between patient and doctor to restructure those understandings and th at personality; to bring them back into the fold of of society and plant them fi rmly within the epistemological and ontological groundwork from which society's basic ideological premises arise. 5 - the arbitrariness of the sign is disconfirmed and no longer seen as arbitrar y because it is affixed in the patient. - likewise the patient and the concept of disease have been recruited in the ser vice of building a reality whose stability, which cannot be denied so long as pr ofessional expertise bears down, is nevertheless prone to violent altercations a s the pressure of denied authorship and reciprocity makes its presence felt. NB-medical practice inevitably produces grotesque mystifications in which we all flounder, grasping ever more pitifully for security in a man-made world which w e see not as social, not as human,, not as historical, but as a world of a prior i objects beholden only to their own forces and laws, dutifully illuminated for us by professional experts such as doctors. There are many political messages su btly encouraged by all this for those who become patients and we all become pati ents at some time, and we are all patients in the metaphorical sense of the soci al doctors who minister our needs. Don't trust your senses. Don't trust the feel ing of uncertainty and ambiguity inevitably occurring as the socially conditione d senses try to orchestrate the multitude of meanings given to otherwise mute th ings. Don't contemplate rebellion against the facts of life for these are not in some important manner man-made, but are irretrievably locked in the realm of ph ysical matter. to the degree that matter can be manipulated leave that to scienc e and your doctor.