代謝を生きる : 移動性をめぐる実験的考察 (特集 身体のハイブリッド) Life of the Metabolism : An Experimental Inquiry into Mobility
In the past decade and a half, anthropology, along with other human sciences, seems at last to have opened up its once-rigid theoretical frameworks and methodological toolkits to embrace the concept of life-not as something that divides social and natural phenomena, but rather as something that highlights how they relate to and include each other in practice. Interestingly enough, this relatively new concept of life has been emerging from research activities that follow the movement of living objects: genes between laboratories and regulatory agencies, mushrooms between distant mountains and global markets, and organs between living bodies, to mention just a few. In such moves, life becomes a target of and a ground for comparison. Lives and life forms are constantly compared (metrically, culturally and experientially), calling for further research that explores the relation between comparative practices and the traveling objects of medicine and the life sciences in general. This paper explores the consequences of such mobility by drawing on current ideas of translation and hybridity within science and technology studies (STS) and anthropology. How does the body of the diabetic patient-from (thrifty) genes to fat bellies-become an experimental site of technological and social innovation in contemporary Japan? What is at stake when those bodies move across different locations and scales in the comparative practices of epidemiology and genetic research? These are the questions I pursue through two ethnographic vignettes of diabetes research, which together show the fluidity between different values and different ways of ordering reality. Few diseases have pervaded the landscape of Japanese health care in the past half century as thoroughly as diabetes. It has transformed from an obscure and acute condition to one of the paradigmatic issues of biomedicine, involving the interaction between state-of-the-art science and public health intervention on a massive scale. Different facts and experiences that structure the knowledge about diabetes emerge within particular interferences between scientific and cultural attributions. Some repertoires invoke "Japanese genes," while others inscribe a stereotypical male diabetes patient: the sarariman, or company employee. The puzzle is this: how do these different subjects of molecular biology and epidemiology come to stand for the same disease, if they do at all? It will be argued that such interaction is made possible through the constant work of the metabolism. Taking a diabetes clinic as its point of departure, this paper explores the mediation between such ontological variations. In Chapter 2, I look at two ways in which high blood sugar is included in biomedical research: the recruitment of company employees in clinical studies, and the attempt of building a national database for diabetes using glycated hemoglobin as an indicator of population differences. Epidemiology, as I show, does not simply reflect popular ideas about ethnic and national identities, but is a domain in which such identities are actively articulated and reworked. In Chapter 3, I extend my analysis by following such ethnic differences to a site of genetic research. The collaborative research project I describe here is founded on the classification of populations that emerge from epidemiology. Here, however, ethnic difference signifies genetic variations and their possible consequences for developing newer and safer medications for Japanese people. The emphasis on the interfering effects of differentiation in medicine is grounded in and reflects the importance of metabolic activities in diabetes research that, in turn, leads me to rethink the anthropological significance of motion in Chapter 4. In diabetes research, the body is objectified as a metabolic system. Daily sugar action and the long-term accumulation of body fat are targets of both epidemiological studies and drug development. The metabolism is constantly susceptible to both the inner and outer worlds that flow through it in the daily acts of eating, drinking, digesting, defecating and urinating. Self and other are in a constant state of interaction, making any claim to a specific, whole identity part of other levels of difference, such as health and disease, or sugar and fat. Once we take seriously the challenge of accounting for such mobility, it reminds us of the difficulty of drawing the boundaries between "lifeways" in the plural and "life" as a singular object of the biological sciences. My aim, thus, is to highlight how facts of biomedicine and cultural meanings of gender and ethnicity are made to articulate each other in clinical practice, and how, yet again, they are included in pharmaceutical marketing strategies and diabetes research. I trace the means by which social anxiety is naturalized and the "working man" becomes a marked subject of diabetes in the clinic and beyond. The ways in which such notions of gender difference are mapped onto a polarity of the Japanese versus the Western in genetic research and clinical trials reflect the differentiating implementations of diabetes in contemporary Japan. My analysis of the two case studies suggests that genes and lifestyles, patients and researchers, Japanese and American people, or men and women interfere with each other in their differences, and it is such differences that have to be forged through a standard and universally valid biomedical knowledge of diabetes. Such interferences across populations, markets, disciplines and disease entities compel and stimulate a permanent movement between different scales and locations. In tracing metabolic mobilities and their enactments in epidemiology and genetics, a complex world opens up in which questions of parts and wholes are settled in practice. At the same time, they suggest a novel way for anthropologists to examine heterogeneity-on the move.
文化人類学 76(3), 288-307, 2011