THE  INTELLIGENCE  OF  HEALING:  BLACK  AMERICAN  ETHNOMEDICINE  AS   ALTERNATIVE  KNOWLEDGE     By     Aron  Shields  Patton                                     A  THESIS     Submitted  to   Michigan  State  University     in  partial  fulfillment  of  the  requirements     for  the  degree  of       African  American  and  African  Studies  –  Master  of  Arts     2015       ABSTRACT     THE  INTELLIEGENCE  OF  HEALING:  BLACK  AMERICAN  ETHNOMEDICINE  AS   ALTERNATIVE  KNOWLEDGE     By     Aron  Shields  Patton       The  aim  of  this  research  is  to  investigate  and  identify  the  ways  in  which  African   descendants  in  the  Diaspora  utilize  a  medical  lexicon  to  place  their  discourse  of  healing  and   health  within  larger  sociopolitical  structures  and  to  examine  how  African  American   conceptions  of  health  and  healing  expands  widely  held  beliefs  about  what  is  and  what  is   not  ‘political’.    It  seeks  to  explore  and  analyze  the  following  questions:  How  do  African   Americans  practice  traditional  healing  within  a  larger  sociopolitical  context?  Do  their   medical  practices  take  into  account  larger  community  and  social  issues?  If  so,  do  they  view   community  and  social  issues  as  contributing  to  individual  well-­‐being?   Using  ethnographic  interviews  and  participant  observations  of  African  American   practitioners  of  traditional  medicine  in  Detroit,  Michigan,  this  study  is  designed  to   illuminate  the  intersections  between  the  medical  and  the  political  and  the  ways  in  which   these  two  ideas  are  in  constant  flux  with  one  another.  I  seek  in  part  to  utilize  performance   theory  to  examine  how  African-­‐Americans  practice  traditional  medicine.  I  will  combine  this   framework  with  an  ethnomedical  framework  in  order  to  emphasize  social  roles,  health   beliefs  and  practices,  and  the  culture  in  which  such  healing  is  taking  place.     TABLE  OF  CONTENTS     Chapter  1  Introduction   Healing  and  Knowledge  Production……………………...……………………...………………...……..1   Research  Problem………………………………………………………………………………….....………….4   Research  Questions……………………………………………………………………………………………...6   Theoretical  Framework…………………………………………………………………...…….....................9   Overview  of  the  Thesis…………………………………………………………………...…………………..12     Chapter  2  Literature  Review…………………………………………………………..………….……….…………13   Early  African  American  Health……………………………………………………….…………………...15   Biomedicine  and  African  American  Folk  Medicine……………………………………………….19     Healing,  Political  Knowledge  and  Intellectualism…………………………………………………24     Summary………………………………………………………………………………………………………...…31     Chapter  3  Interviews……………………………………………………………………………..….…..………………32   Karla  Mitchell…………………………………………………………………………………………………….32   Kimberli  Boyd…………………………………………………………………………………………………....43   Tissheama  Pizzimenti……………………………………………………………………………...…………50   Leppel  Payne……………………………………………………………………………………………………..57     Discussion………………………………………………………………………………………………………….63   Scene:  Structural  Poverty,  Race  and  the  Loss  of  Ethnomedical  Knowledge……………63   Act,  Agency,  and  Agent:  The  Performance  of  Ethnomedicine………………………………..66   Black  Ethnomedicine  and  Biomedicine………………………………………………………………..74   Purpose:  Significance  of  ethnomedical  practitioners……………………………………………81       Chapter  4  Summary  and  Conclusion……………………………….……..…………………….……………...…83     REFERENCES…………………………………………………………………………..………………………………..…..87   iii       Chapter  1   Healing  and  Knowledge  Production   In  the  introduction  to  her  book  Body  and  Soul:  The  Black  Panther  Party  and  The  Fight   Against  Medical  Discrimination  sociologist  Alondra  Nelson  (2011)  argues  that  Black   Americans  and  women  have  obtained  social  rights  primarily  through  civil  rights;  health   benefits  were  most  often  received  through  employment.  Because  the  social  inclusion  of   minority  groups  and  the  rights  that  come  with  it  rest  so  heavily  upon  civil  rights  granted   via  powerful  institutions  and  organizations,  normative  assumptions  undergirding  social   inclusion  and  rights  are  not  critiqued.  Nelson  terms  this  phenomenon  citizenship   contradiction.  Many  Black  Americans     possess  an  emaciated  citizenship  that  may  be  ‘conditional  on  political  whim’  or  the   vagaries  of  the  market…we  can  understand  the  organization’s  [Black  Panther  Party]   health  politics  as  an  effort  to  provide  resources  to  poor  blacks  who  formally  held   civil  rights,  but  who  by  virtue  of  their  degraded  social  status  and  social  value  lacked   social  and  economic  citizenship  and  thus  the  privileges  that  accrue  to  these,   including  access  to  medical  care  (Nelson,  10).       Nelson’s  words  give  cause  for  concern.  If  citizenship  and  the  rights  and  resources  therein   are  acknowledged  solely  through  institutions,  what  do  people  who  have  been  historically   excluded  from  and  abused  by  these  institutions  do  to  secure  resources  such  as  healthcare?   Touted  as  a  pure  science,  biomedicine  is  the  dominant  form  of  medical  care  in  the  United   States  and  in  many  places  around  the  world.  Biomedicine’s  reliance  on  science  as  empirical,   logical,  and  objective  ignores  the  ways  biomedicine  is  a  culturally  based  practice  not  so   easily  separated  from  the  histories  and  sociopolitical  realities  of  the  individuals  and  groups   that  compose  it.  Black  Americans’  ethnomedical  practices  have  stood  outside  biomedicine     1     and  have  been  denigrated  or  all  but  erased.    A  number  of  scholars  (Mitchem,  2007;  Fett   2002;  Chireau  2006:  Mitchem  and  Townes  2008;  Long  2012;  Fontenot  1994)  have  given   great  insight  not  only  into,  what  has  been  termed  by  some,  Black  American  “folk”  medicine,   but  also  into  Black  Americans’  engagement  with  dominant  biomedical  knowledge  and   institutions.  Many  Black  Americans  have  engaged  biomedicine  in  a  myriad  of  ways  while   also  retaining  use  and  belief  in  traditional  ethnomedical  practices.       This  paper  examines  the  ethnomedical  practices  of  four  Black  ‘healers’  in  the  Detroit   metro  area.  Previous  research  on  the  ethnomedical  practices  of  Black  Americans  have  often   highlighted  what  is  traditionally  considered  to  be  ‘folk’  practices.    These  practices  range   from  the  practices  of  African  descendants  in  the  United  States  such  as  conjure,  hoodoo,  and   voodoo  as  well  as  those  practices  of  other  African  descendants  throughout  the  Diaspora  –   Candomble,  Santeria,  etc.  The  pronounced  African  influence  of  these  ethnomedical   practices  often  justifies  scholars’  use  of  the  term  ‘folk’  alluding  to  a  notion  or  essence  of   Africanness,  that,  while  syncretized,  is  predominantly  practiced  by  Black  people  and  widely   understood  to  be  a  Black  ‘thing’.    However,  the  extent  to  which  some  Black  Americans  have   combined  other  forms  of  healing  –  Reiki,  Sukyo  Mahikari,  homeopathics  –  with  Black   Christianity  and  Black  cultural  ideas  of  health,  illness,  and  healing  do  we  then  not  consider   these  authentically  Black?  How  can  we  speak  of  Black  healers  in  way  that  validates  the   inevitable  process  of  hybridization  Black  Americans  have  been  forced  to  undergo  in   various  social,  cultural,  and  political  spaces  while  acknowledging  the  authenticity  of  their   healing  practices?   Thus,  in  one  sense,  this  thesis  seeks  to  push  against  the  tendency  to  view  Black   American  ethnomedical  practices  strictly  through  the  lens  of  ‘folk’  practices.    Viewing  Black     2     American  ethnomedical  practices  in  this  way  assumes  a  type  of  authentic  Blackness   separate  from  the  myriad  ways  in  which  Blackness  manifests  and  is  practiced  across  class,   gender,  and  sexual  lines.  Instead,  the  idea  of  hybridization  frames  my  analysis  of  these   healing  practices  and  conceptions  of  health.  The  interactions  between  Africans,  African   Americans,  Native  Americans,  and  White  Americans,  in  many  cases  characterized  by   coercion  and  force,  inevitably  lead  to  the  incorporation  of  different  ideologies,  practices,   values,  and  beliefs  into  Black  American  ethnomedical  practices.  Ethnomedicine  examines   different  societies’  and  cultures  conceptualizations  of  health  and  illness  “including  how   people  think  and  how  people  act  about  well  being  and  healing”  (Quinlan,  381).   Utilizing  ethnographic  interviews  of  four  Black  healers  in  Detroit  and  field  notes   acquired  from  my  time  spent  in  these  healing  spaces,  I  find  a  thriving  community  of   practitioners  who  believe  in  the  medical  and  spiritual  efficacy  of  their  ethnomedical   practices.    Perhaps  equally  important  to  note  is  the  community  within  which  these   practices  occur  and  how  members  in  the  community  seek  the  counsel  and  expertise  of  the   Black  healers.  Each  of  the  interviewees  offers  a  critique  of  Black  social,  political,  and   economic  inequalities  and  of  the  dominant  system  of  biomedicine  in  one  way  or  another.     My  interest  in  this  thesis  topic  in  part  derives  from  the  historical  and  contemporary   fact  that  Black  Americans’  experience  the  social,  economic,  and  political  realities  of  the   United  States  fundamentally  different  due  to  a  stain  of  racism  and  white  supremacy.  Deeply   iniquitous,  “the  American  Republic  in  its  founding  and  in  the  ordering  of  its  institutions  was   consciously  set  up  to  place  the  enslaved  Africans  in  a  situation  of  dis-­‐ease  and  imbalance,  a   most  unhealthy  situation”(Mitchem  &  Townes,  39).  These  systemic  realities  bear  most   notably  upon  the  Black  being.    Here,  I  place  ‘being’  in  opposition  to  ‘body’  to  draw  attention     3     away  from  the  body  and  towards  the  being  -­‐  the  mind,  body,  and  spirit  connection.  Healing   and  health  have  always  played  a  central  role  for  Black  Americans  however,  schisms   between  Black  American  understandings  of  health,  illness,  and  healing  and  those  of  the   dominant,  biomedical  model  contribute  to  the  negative  relationship  many  Black  Americans   have  with  biomedicine.     Research  Problem     The  continued  use  of  ethnomedicine  amongst  Black  healers  suggests  a  level  of   continued  relevance  that  has  implications  for  biomedicine  and  its  claim  to  authoritative   knowledge.  Secondly,  the  fact  that  Black  ethnomedicine  extends  past  the  individual  to  view   health  and  illness  as  deeply  connected  to  community  and  society  (Mitchem  2007;  Chireau   2006;  Mitchem  and  Townes  2008)  suggests  a  critical  awareness  of  and  engagement  with   social  structures,  socially  constructed  ideologies  and  politics  to  then  address  individual   health.  Thus,  healing  knowledge  entails  a  political  knowledge  and  a  potential  intellectual   quality  that  allows  for  a  questioning  of  the  ways  we  conceptualize  knowledge,  how  it  is   obtained,  who  possesses  it  and  how  it  is  known.     Black  Americans  have  carried  with  them  an  interpretive  framework  of  health  and   illness  providing  a  culturally  salient  way  to  understand  and  address  health  and  illness.   Religion  and  spirituality  are  nearly  inseparable  from  ideas  of  health  and  healing  in  much  of   the  Black  American  community.  This  contrasts  with  much  of  Western,  European  culture   where  the  body  and  the  mind  are  often  seen  as  separate  entities.    Rene  Descartes  asserts   this  belief  in  his  theory  of  ‘Cartesian  Dualism’  in  1641  where  he  “separates  the  natural  from   the  supernatural,  and  the  world  of  ideas  and  actions  from  the  physical  (visible,  touchable)   world…Biomedicine  conventionally  divides  pathologies  into  mental  illness  and  physical     4     disease”  (Quinlan  387).    In  many  African-­‐based  healing  religions  the  spiritual  realm  is  not   viewed  as  separate  from  the  physical,  but  often  as  interwoven  with  the  physical.  Yvonne   Chireau  (2006)  in  her  book  Black  Magic  defines  ‘magic’  as  the  ability  of  the  spiritual  to   affect  change  in  the  physical  world.  Yet,  Chireau  suggests  the  term  ‘magico-­‐religious’  to   refer  to  the  intimate  connection  between  magic  and  religion  in  the  Black  American   conjuring  tradition.  Chireau’s  explanation  speaks  to  a  linking  of  aspects  of  the  physical   world  -­‐  health  and  healing  -­‐  as  ideologies  with  larger  cosmological  understandings.  Political   scientist  Anthony  Bogues  (2003)  examines  two  important  strains  within  Africana  political   thought:  the  heretical  strain  and  what  he  terms  the  redemptive  prophetic  strain.  This   redemptive  prophetic  strain  of  Black  political  activists  is  characterized  by  a  deep   spirituality  and  an  episteme  existing  outside  of  Western  rational  and  political  thought.   Black  ontological  beliefs  cannot  be  separated  from  religion  and  spirituality.  These  Black   thinkers  form  political  thought  and  intellectual  engagement  outside  of  a  traditional   Western  and  European  episteme  challenging  us  to  conceptualize  social  organization  in  new   and  revolutionary  ways.     On  one  hand,  the  findings  in  this  thesis  offer  a  critique  of  and  challenge  to   biomedical  authoritative  knowledge  and  hegemony.  Key  findings  highlight  the  importance   of  aspects  of  healing  such  as  an  emphasis  on  the  mind,  body,  spirit  connection,  emotional   accessibility,  and  the  role  of  community  that  are  largely  absent  from  biomedicine.    Thus,   many  of  the  findings  within  this  study  would  positively  contribute  to  increasing  the   potential  for  biomedicine  to  reach,  help,  and  understand  diverse  populations  where   historical  and  contemporary  tensions  have  prevailed.    However,  this  thesis  calls  attention   to  other  forms  of  knowledge  operating  simultaneously  with  biomedical  authoritative     5     knowledge  and  resists  the  occlusion  and  erasure  of  Black  American  healing  knowledge  and   practices.     Research  Questions   Given  the  fact  that  many  Black  Americans  have  a  tortured  relationship  with   biomedical  institutions  and  practitioners,  this  thesis  explores  the  ways  Black  Americans   take  matters  of  health  into  their  own  hands  in  culturally  specific  ways.    How  do  we   understand  contemporary  ethnomedical  practices  as  occurring  within  a  larger   sociopolitical  context?  How  do  these  ethnomedical  practices  constitute  alternative  forms  of   political  and  intellectual  knowledge?    As  a  result  scholarship  on  biomedicine  and  its   relationship  with  Black  Americans  we  know  the  ways  in  which  the  lives  and  realities  of   Black  Americans  have  been  excluded  from  the  creation  of  biomedical  systems  with  the   ability  to  address  and  alleviate  debilitating  medical  issues  and  used  as  experimental  objects   for  the  advancement  of  medical  science.     Black  American’s  health  experiences  in  the  United  States  cannot  be  separated  from   the  slave  experience  and  from  the  subsequent  legacy  of  white  supremacy  and  anti-­‐black   sentiment.    Under  the  condition  of  slavery,  poor  sanitation,  improper  shelter  from  the   environment,  a  nutrient  deficient  diet,  and  the  cramped  conditions  of  slave  cabins  where   families  of  three  or  more  cohabitated  lead  to  serious  illnesses  amongst  slaves  (Savitt,   1978).    Serious,  debilitating  diseases  such  as  cholera  and  venereal  disease  were  viewed  as   ‘Black’  diseases.    The  white  belief  in  an  increased  immunity  and  reduced  susceptibility  to   various  diseases  amongst  slaves  served  to  justify  inhumane  treatment  of  slaves.   Importantly,  health  and  illness  amongst  Black  slaves  was  only  important  insofar  as  a     6     concern  with  these  issues  appealed  to  the  dominant  sociopolitical  and  cultural  structure  of   the  United  States  and  the  central  role  of  slavery  to  the  economic  functioning  of  the  country.     Prior  to  the  late  19th  century,  medical  care,  for  both  Black  and  White  Americans,  was   unsystematic  and  largely  guided  by  a  moral  and  spiritual  understanding  of  health  and   illness.  The  subsequent  rise  in  objective,  rational,  and  empirical  scientific  thought   transformed  medical  care  in  the  United  States  and  can  be  viewed  as  the  beginnings  of   biomedicine.  Yet  newly  emancipated  slaves  and  other  free  Black  Americans  were  excluded   from  receiving  biomedical  care.  The  realities  of  war  and  the  turbulent  shifting  of  social,   economic,  and  political  institutions  in  the  United  States  during  emancipation  and   reconstruction  placed  many  Black  Americans  in  a  medical  abyss.    Jim  Downs  (2012)   analysis  of  Black  American  health  post-­‐1865  finds  that     the  distress  and  medical  crises  that  freed  slaves  experienced  were  a  hidden  cost  of   war  and  an  unintended  outcome  of  emancipation.  While  sickness  and  epidemics   certainly  existed  in  the  South  before,  the  Civil  War,  like  many  major  wars   throughout  the  nineteenth  century,  gave  rise  to  explosive  epidemic  outbreaks  and   inordinate  mortality  and  suffering.  (Downs,  7)   This  exclusion  from  biomedical  care  as  well  as  noted  biomedical  abuses  against  Black   Americans  have  contributed  to  much  of  Black  America’s  skepticism  concerning   biomedicine.  Regardless,  Black  American’s  have  realized  the  importance  of  having  access  to   biomedical  care.    Accessing  biomedical  care  has  been  central  to  Black  American  struggles   for  equality.  Importantly,  this  does  not  imply  the  nonexistence  of  a  Black  American   ethnomedical  practice,  rather  it  implies  Black  American’s  recognition  of  biomedicine’s     7     many  benefits  and  the  belief  that  many  forms  of  healing  exist  and  have  a  place  in  obtaining   general  health  and  well-­‐being.   Social  worker  and  researcher  Joy  DeGruy  Leary  (2005)  reminds  readers  that  the   perceived  inhumanity  of  Black  people  has  undergirded  objective,  rational  and  empirical   science  in  disciplinary  fields  such  as  medicine  and  anthropology.    Thus,  for  a  significant   portion  of  United  States  history  Black  Americans,  through  force  of  circumstance,  have  had   to  address  health  issues  within  the  Black  community  with  little  reliance  on  outside  forces.   Yet,  the  perceived  reality  of  Black  inhumanity  did  little  to  stop  medical  experimentation  on   Black  Americans.  Beyond  the  often  cited  Tuskegee  experiments  and  ‘Mississippi   appendectomies’,  biomedical  experimentation  on  Black  bodies  ranged  from  instances  of   individual  doctors’  abuses  to  implicating  the  United  States  government  in  grotesque   nuclear  radiation  testing  on  Black  subjects  (Washington,  2008).     Any  examination  of  Black  ethnomedical  practices  cannot  be  separated  from   historical  and  contemporary  events.    These  events  occur  within  multiple  and  specific   sociohistorical,  sociopolitical  and  cultural  concepts  forming  the  backdrop  of  these   practices.    Thus  it  is  plausible  to  assume  that  Black  healers  acquire  knowledge  of  the  world   and  the  ways  these  phenomena  impact  Black  health.  In  many  of  the  cases  presented  here,   the  healers  are  not  anthropologists,  sociologist,  political  scientists  or  the  like.  Their   awareness  of  larger  social  forces  and  its  impacts  on  people  is  largely  experiential  in  nature   but  also  acquired  and  deepened  through  their  ethnomedical  practices.    Knowledge  for   these  Black  healers  then  does  not  always  occur  through  institutions  and  channels  widely   considered  normal  and  acceptable.  Their  knowledge  of  larger  societal  happenings  plays  a   crucial  role  in  the  ways  they  formulate  their  explanatory  models  regarding  health  and     8     healing.  Further,  diagnoses  and  patient  interaction  amongst  these  healers  is  socially  and   culturally  mediated  and  politically  charged.    Thus,  this  thesis  draws  attention  to  notions  of   embodied  knowledge,  spiritual  knowledge,  faith,  and  intuition.  These  ways  of  knowing   exist  in  contrast  to  the  confluence  of  objectivity,  rationality,  logic,  and  empiricism   characterizing  science  and  scientific  thought.  Additionally,  the  emphasis  on  text  as  the   primary  medium  through  which  knowledge  can  be  transmitted,  received,  and   comprehended  stands  in  contrast  to  the  ethnomedical  practices  examined  by  this  thesis.     The  interviews  with  Black  healers  suggest  an  ethnomedical  practice  that  is  not   deeply  mired  in  the  physical  body.  Rather,  diagnoses  and  symptoms  exist  in  different   spheres  of  being  –  mind,  body,  and  spirit.  Similarly,  the  formation  of  these  practices  have   existed  within  and  across  institutions  at  times  remaining  intact  and  other  times  shifting,   transforming,  and  melding  with  other  interpretive  frameworks  and  healing  practices  to  not   only  remain  relevant,  but  also  effective.     Theoretical  Framework   To  gain  a  more  comprehensive  insight  into  the  ethnomedical  practices  of  Black   Americans,  I  utilize  Performance  Theory.    Much  has  been  made  about  Performance  Theory   lacking  clear  theoretical  and  methodological  boundaries,  however,  while  true  that  the   theoretical  and  methodological  boundaries  are  flexible,  this  does  not  suggest  a  lack  of   structure.  Rather,  Performance  Theory  contains  a  necessary  permeability  allowing  much   more  subtle  inquiry  into  the  ways  social,  political,  and  cultural  realities  are  expressed   through  the  everyday  experiences.  For  the  purposes  of  this  thesis,  Performance  Theory   embraces  the  existence  of  alternative  knowledges  –  embodied  knowledge,  intuition,   tradition,  and  those  knowledges  and  practices  existing  outside  of  key,  Western  knowledge     9     producing  institutions.  The  emphasis  on  the  everyday  and  its  ability  to  reveal  the  existence   and  practice  of  alternative  forms  of  knowing  becomes  all  the  more  important  when  dealing   with  Black  Americans  as  well  as  other  people  of  color.    Given  that  biomedicine  did  not  arise   in  a  vacuum,  but  rather  was  formed  within  and  in  relation  to  other  aspects  of  society,  it  is   no  surprise  that  by  and  large  biomedicine  reflects  racism,  sexism,  and  other  socially   constructed  barriers.  Anthropologists  examining  the  rituals  and  sacred  healing  practices  of   other  cultures  note  how  many  cultures  take  on  the  spirit  and  resemblance  of  an  animal,   spirit,  God,  or  ancestor.    With  regards  to  Hmong  healing  ceremonies,  Conquergood  (1992)   characterizes  these  sacred  rituals  as  performances  providing  psychosomatic  healing  by   embodying  disease  and  illness  through  the  use  of  culturally  relevant  religious  stories.  By   doing  so,  the  healer  provides  relief  and  assurance  to  the  afflicted.  In  Suburban  Shaman,   Cecil  Helman  (2006)  paints  biomedicine  as  a  performance.  These  performances  are  about   transformation  for  Helman.     Although   surgical   masks   are   worn   solely   for   a   practical   purpose   –   to   reduce   the   threat   of   infection   to   the   patient   –   I   believe   they   may   also   have   another,   more   subliminal  role.  To  my  anthropological  eye  it  seems  that,  in  addition  to  the  merely   technical   procedure,   something   else   is   going   on   during   a   surgical   operation,   something   rather   akin   to   those   tribal   ceremonies.   For   with   their   fixed   rituals   and   choreography,  their  standardised  costumes,  and  rigid  rules  of  behaviour  and  speech,   surgical  operations  can  also  be  seen  as  a  type  of  masque,  an  allegorical  performance   carried  out  by  masked  actors.  In  this  setting,  the  mask  helps  transform  an  ordinary   mortal   doctor   into   a   type   of   archetypal   superhero,   someone   daring   and   brave.     In   this   cool   green,   disinfected   operating   ‘theatre’,   with   its   beeping   machines   and   low     10     murmuring  voices,  this  masked  hero  is  now  ready  to  confront  the  forces  of  Disease   and  Death  –  and  defeat  them;  to  impose,  with  the  help  of  all  the  powers  of  Science   that  he  incarnates,  Order  onto  Chaos.  (Helman,  40)   In  this  case,  when  the  surgeon  ceases  to  be  understood  solely  as  a  surgeon,  he  or  she   becomes  an  actor,  a  person  who  performs  but  whose  sole  being  is  not  tied  to  this   performance.  The  surgeon  performs  many  roles  in  life  and  all  of  these  roles  play  a  part  in   the  surgical  process.  In  a  way,  Performance  Theory  does  away  with  the  idea  that  people   ‘leave  their  baggage  at  the  door’  when  they  step  into  professional  spaces.  Instead,  the   multiple  roles  a  person  plays  manifest  in  words  and  actions.  These  words  and  actions   emerge  from  and  simultaneously  influence  sociopolitical,  cultural,  and  historical  realities.     Marsha  Quinlan’s  explanation  of  ethnomedicine  helps  to  clarify  my  use  of  performance   theory:   Cultural   ideas   –   about   the   nature   of   the   body   and   illness,   but   also   pervasive   cultural   philosophies  about  morality,  responsibility,  autonomy,  powerful  forces,  and  so  forth   –   converge   to   form   an   ethnomedical   system.   This   convergence   of   notions   forms   a   system   of   ‘internal   logic’   for   understanding   illness.   What   may   be   a   logical   medical   determination  according  to  one  set  of  beliefs  may  seem  like  a  bad  idea  in  the  logic  of   a   different   ethnomedical   system,   because   each   system   has   its   own   internal   logic…Explanatory  models  are  often  so  intertwined  with  other  cultural  beliefs  that   identifying  ethnomedical  theories  can  be  challenging.  (Quinlan,  383)   Thus,  both  the  surgeon  and  patient  cease  to  be  understood  in  such  narrow  and  limiting   terms.    They  bring  to  the  biomedical  encounter  many  nuances  which  Performance  Theory   is  poised  to  ascertain  through  its  focus  on  the  being  and  doing  of  human  interaction.       11       Similar  to  Helman,  I  view  the  ethnomedical  practices  of  Black  Americans  as  well  as   biomedical  interactions  as  performances.  Through  their  self-­‐described  interactions  with   other,  their  discussions  of  spirituality  and  its  impact  on  their  healing,  and  their   understandings  of  larger  social  forces  bearing  upon  Black  American  health,  these  Black   healers  perform  healing.  They  take  on  the  role  of  healer,  embodying  its  various  meanings,   practices,  and  implications  while  combining  it  with  a  Black  aesthetic  and  worldview  that  is   also  embodied.     Overview  of  the  Thesis   Chapter  two  of  this  thesis  provides  a  review  of  relevant  literature  including  work   done  by  scholars  examining  Black  ethnomedicine  and  a  review  of  key  definitions  and  ideas   surrounding  performance  theory.    Also  reviewed  is  literature  that  defines  and   characterizes  aspects  of  biomedicine  that  will  be  engaged  in  the  discussion  section  of  this   thesis.  Chapter  three  presents  interviews  with  four  Black  healers  in  Detroit  as  well  as  the   discussion  section  with  relevant  themes.    These  themes  lead  to  a  discussion  on  the  political   and  intellectual  character  of  Black  ethnomedical  practices.  Chapter  four  gives  a  summary   and  conclusion  of  the  thesis,  including  contributions  to  biomedicine  and  research  on   knowledge  production.    Suggestions  for  further  research  are  also  presented  in  the  fourth   chapter.                           12     Chapter  2   Literature  Review       For examining the ways in which contemporary African American ethnomedical practices constitute an alternative form of intellectual knowledge and critique, both Dwight Conquergood’s (2002) essay Performance Studies: Interventions and Radical Research and Paul Gilroy’s (2003) essay Jewels Brought From Bondage: Black Music and The Politics of Authenticity lay important theoretical groundwork for examining the ways in which not only alternative forms of knowing and knowledge exist outside, and quite independently of, written text, but also how the myriad manifestations of human communication can be ignored and erased via overemphasis on discursive practices. Conquergood (2002) addresses the erasure of other ways of knowing and communicating at length arguing that an overemphasis on textuality represents an ‘epistemic violence’ (p. 146) because academicians and others ignore the extent to which marginalized peoples are not afforded the same avenues of expression and communication given to privileged groups. The extent to which those marginalized people express and experience the world through the workings of the physical body – embodied knowledge – is lost to those operating within an epistemic framework of textuality and effectively limits the intelligibility of those practices and forms of knowledge. Orality, dance, and music constitute other important forms of human communication and knowing which Performance Studies primarily concerns itself with. Paul Gilroy’s (2003) analysis of the aesthetics of Black music demonstrates how Black musical aesthetics are not simply artistic, but intellectual creations and endeavors most clearly articulated as such through their critique of Modernity. Gilroy makes this abundantly clear in his essay wherein Black musical traditions and aesthetics have “supported the formation of a distinct, often priestly caste   13     of organic intellectuals whose experiences enable us to focus upon the crisis of modernity and modern values with special clarity” (Gilroy, 141). Considering the contributions of both Gilroy (2003) and Conquergood (2002), not only can Black American musical traditions represent a form of intellectual knowledge and a political critique outside of more traditional institutions and normative modes of communication, but I assert the contemporary ethnomedical practices of African Americans similarly represent intellectual and political knowledge and critique. My thesis then compels a few pertinent questions: how do Black American ethnomedical practices act as intellectual and political knowledge? What is the relationship of these ethnomedical practices to the dominant biomedical model? Do Black American ethnomedical practices offer, if anything, not only to biomedicine, but also to larger, mainstream societal understandings of health and healing or to political policy making? Relatively little literature exists in medical anthropology on Black American ethnomedical practices as a form of intellectualism. Similarly, connections between performance theory and conceptions of health and healing remain nascent. A review of the literature from Performance Studies provides a fresh theoretical lens through which to examine and analysis contemporary Black ethnomedical practices.   14     Early African American Health The poor treatment of Black American ethnomedical practices in scholarly writing can in part be attributed to Robert Voeks (2009) argument that within the fields of ethnobotany and ethnomedicine scholars have made various erroneous assumptions about the ways in which ethnomedical knowledge is acquired. Key amongst these assumptions is the notion that African Diasporic peoples lack the long-term residency in the Western Hemisphere necessary to sufficiently acquire medicinal knowledge about the surrounding flora and fauna. He states, Most ethnobotanical narratives, whether stated or implied, assume that knowledge profiles are the outcome of long-term residence and gradual cognitive familiarity with the floristic environment. Particularly in the tropical realm, where biological diversity is extreme and plant frequency low, the ability to recognise, label, categorise and especially learn the material and spiritual values of individual plant species is take to be a glacially slow process…Native people are characterised as repositories of ancient plant wisdom handed down as sacred oral text from generation to generation. Diaspora communities, on the contrary, are often portrayed as part of the problem rather than the solution. Their relatively recent arrival in a protean landscape is seen as inconsistent with the acquisition of significant ethnobotanical knowledge, and their alien worldviews and modes of subsistence are perceived as threats to the ecological balance developed over time by indigenous societies. Nowhere is this dialectic more strikingly apparent than among the descendants of African slaves in America’s humid tropics. (Voeks, 276) The fact that Black Americans, as well as, in the case above, those within the Diaspora have traditional rituals, social healing practices, and explanatory models of disease and health to say nothing of a history of ethnomedical practice, eludes researchers and scholars operating   15     within a narrow interpretation and understanding of ethnomedical knowledge and practice. However, various scholars examining Black American ethnomedicine have disrupted this understanding and provide a view of the healing beliefs and practices amongst Black Americans (Fett, 2002; Long, 2012; Covey 2007; Mitchem, 2007). The examination of these scholars’ works focuses heavily on Black American ethnomedical practices in the antebellum South. Their work, like that of Voeks (2009), serves as a historical corrective through its attention to the existence of alternative medical systems paralleling biomedicine and gives much needed attention to African American medical knowledge providing a roadmap to ask deeper and more pertinent sociohistorical, cultural, and political questions. Slavery represents a crucial historical period in the analysis of African American ethnomedical practices. As an economic system controlled by white plantation owners, slavery morphed the Black body into a tool used for labor and the enrichment of the United States. Subsequent functions of the Black body such as reproduction as well as its needs, like healthcare, were controlled and monitored by White slave owners. In Doctoring Freedom: The Politics of African American Medical Care in Slavery and Emancipation, Margaret Long (2012) states that the majority of   African   Americans   spent   their   entire   lives   enslaved   in   the   rural   South,   and   an   array   of   laws   granted   their   white   owners   control   over   their   bodies.   This   control   extended  beyond  labor  to  sexual  access  and  to  medical  treatment  that  could  include   decisions   about   everything   from   amputations   to   whether   to   rely   on   allopathic   or   homeopathic  practitioners.  (Long,  2012)   Laws determining the care of or disregard for enslaved Black bodies ensured White control of the labor force. Sharla Fett’s (2002) in depth examination of antebellum slave   16     medicine Working Cures: Healing, Health, and Power on Southern Slave Plantations examines the doctrine of ‘soundness’ and how it guided Southern plantation owners’ assessment of their slaves’ health. In contrast to health, the doctrine of soundness referred to the capacity of a slave to continually provide revenue to the White slave master. The plantation-based Southern economic system wholly depended upon the health and longevity of the enslaved. However, this doctrine not only assessed physical health, but also extended to mental and moral dimensions of slave health as well…The objectification of black health under slavery was thus not simply a matter of persons reduced to physical bodies but also of minds and personalities subjected to market assessments. (Fett, 20). The principles and interests of the emergent capitalistic endeavors of the state guided any diagnosis of illness among slaves. Fundamentally, whether or not a slave was ‘sound’ determined the basis of transaction between buyers and sellers and the ability of either to make a profit. Yet Fett (2002) states that with the commodification of the Black body also came “the objectification of African American health” producing a limited definition of “slave health permeated by concerns of slaveholder status and wealth. Questions concerning slaves’ mental and physical health influenced the very nature of economic transactions in slave property” (Fett, 18). Thus, the principle of human property profoundly shaped the development of practice and theory in Southern medicine. Racist notions of the Black body contributed to slave owners’ perceptions of illness and health amongst enslaved African Americans. For example, determining whether or not an illness was feigned was a prerogative of the slave master and mistress. Largely founded upon racist beliefs about the capabilities and constitution of the Black body, enslaved Black Americans were believed to be more susceptible to certain diseases and possess an increased immunity or   17     resistance to others. Conveniently, these beliefs rarely examined the impact of such realities as the grueling working and living conditions, nutrition, or proximity to malarial swamps on the general health of enslaved Black Americans (Savitt, 1978). In African American Slave Medicine: Herbal and Non-Herbal Treatments, Herbert Covey (2007) highlights how the health of slaves deteriorated during the Jacksonian and antebellum periods; the mortality rate of Black infants was four times that of white infants (Covey, 2007). As enslaved Black Americans served as exploitable, free labor in the construction of the United States, similarly, their bodies became the experimental site upon which nascent biomedical breakthroughs would take place. Consistent with the belief that enslaved African Americans did not feel pain to the same extent as whites, Black bodies were subjected to horrific and deadly experimentation in the name of medical advancements. Harriet Washington’s (2006) book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Time to Present documents in excruciating detail the untold abuse on Black Americans through biomedical experimentation. As one painful example, Washington notes how during the 1850s, James Marion Sims, now a medical icon, experimented upon slave women with vesicovaginal fistula (an abnormal opening connecting the vagina to the bladder) to discover a cure to be used on white women. His surgical procedure sought to “close the unnatural openings in the ravaged vaginal tissues; he had to make the edges of these openings knit together. He opted to abrade, or ‘scarify’, the edges of the vaginal tears…he then closed them with sutures and saw them become infected and reopen, painfully, every time” (Washington, 65). Though Black slaves were considered in every way inferior to whites, ironically, the belief in Black inferiority did little to deter white physicians from using Black   18     bodies as test subjects for the benefit of white health. In many regards Black bodies were expendable or valuable only insofar as they advanced the health of white bodies. Biomedicine & African American Folk Healing The interaction between Whites and enslaved Blacks regarding health and well-being was one of control, violence and exploitation wherein enslaved Blacks provided White plantation owners with free labor to acquire untold wealth and capital and, critically, to advance biomedical knowledge. Not easily disconnected from the violent realities of the slave economy, enslaved Black Americans viewed biomedicine with extreme mistrust and doubt. More importantly, through the 1800s science was often used to justify Black enslavement. Scientific literature detailing so called “Black” diseases and illness conferred legitimacy to the slave system as well as the concomitant ideology of White racial superiority. Text, then, becomes the vehicle through which the authority of scientific knowledge and the authority of White supremacy is expressed and disseminated. In his examination of biomedicine within an African context, author David Baronov (2008) theorizes biomedicine as occurring within three ontological spheres: 1) as a scientific endeavor wherein biomedicine reflects the ascendance of scientific reason within the physical sciences during the late 18th and early 19th centuries, 2) as a symbolic-cultural expression revealing the “material-ideological contours of Western capitalist societies”, and 3) as an expression of social power owing to biomedical institutions and their relative compatibility with corporate powers (Baronov, 2008). Biomedicine can then be understood as the summative achievement of four hundred years of Western Enlightenment thought. Thus beholden to an Enlightenment ethic of ceaseless, utilitarian progress and innovation, biomedicine embraces medical practices that follow the strict empirical norms of the   19     experimental sciences. Human health or disease is defined as any variance from the normal statistical ranges for the species’s regular physiological functioning, and the human body itself is laid before biomedicine as a soulless, multifunctional machine whose detailed internal structures require precise probing via a sophisticated complement of capital-intensive biotechnology…As a scientific enterprise, objectivity, standardization, and the peer-reviewed rigor of the scientific method provide biomedicine with the only conceivable investigative techniques for its phenomenal forms. (Baronov, 34-35) The integration of science with medicine is largely attributed to the work of Abraham Flexner. Abraham Flexner’s report is considered one of the most influential documents effecting biomedicine. Published in 1910, the Flexner report called for the incorporation of the scientific method found in the natural sciences into the medical sciences (Chapman 1974). Flexner also pushed for more rigorous educational requirements for those wishing to become doctors and criticized the inadequate curricula that existed for many medical students. The far-reaching effects of his report still deeply shape biomedical practice today. Currently within biomedicine “theoretical, scientific knowledge formulated in context-free and value-neutral terms is seen as the primary basis for medical knowledge and reasoning. This knowledge is grounded in the basic sciences; the academy accommodates less comfortably the practical skills and distinct moral orientation required for successful practice in medicine” (Cooke, David, et. al 2006). These objective, rational standards of the scientific method were met with wide acceptance by both scientists and non-scientists and used for overarching claims of universality and superiority. Such a conception of health and wellness limits health and illness to observable and measurable data - physical phenomenon, things easily apprehended with sight.   20     Biomedicine, then, stood in contrast to traditional Black American ethnomedical practices. Margaret Long (2012) argues that “slave healers relied primarily on their own traditional methods and worldview, and slaves experienced mainstream medicine, with its harsh treatments, largely at the behest of their owners” (Long, 22). Stephanie Y. Mitchem and E.M. Townes (2008) in Faith, Health, and Healing in African American Life place traditional Black American ethnomedical practices in a larger sociohistorical and political framework. They remind us that as slaves Black Americans existed as human beings only within their slave communities. The healing process within enslaved communities “cannot be that of private health because the slave possessed no privacy and while the institution of slavery was a public and legal institution, the enslaved person had no public persona. Thus, the health of the enslaved always redounded to the situation of the owner. Only within the orders of a moral community created by the enslaved themselves does a self or soul as the human locus requiring compassion, care, and concern appear.” (Mitchem & Townes, 41) Slaves became human beings rather than property within their respective communities and thus, their bodies, minds, and spirits became objects of health and well-being. Conceptions, knowledge, and traditions of health and healing within slave communities arose from traditions from their respective African ethnic orientations and blended with North American indigenous knowledge of the surrounding flora and fauna. Syncretism of healing and health knowledge occurred between enslaved Africans, Native Americans, and Europeans within a context of systemic racism, sexism, domination and imperialism. (Fett, 2002; Covey, 2007). Particularly important are the similarities between Native American and African conceptions health. The merging of “Native American with traditional African medicinal practices made the most sense   21     because both emphasized the importance of spirituality in the healing process and relied on prevention and the use of natural substances, such as herbs and plants.” (Covey, 27). Fett (2002) points out that enslaved Africans not only in North America, but throughout the Diaspora have maintained distinctively African-centered healing and health practices which are inseparable from their religious practices and beliefs. These ‘cultures of healing’ ranged throughout the Diaspora from “Haitian Vodou to Brazilian Candomble to North American hoodoo, Black Atlantic religions of healing, still thriving today, reflect their particular place within the history of enslavement and forced migration. African American healing traditions, while deeply embedded in the regional history of the American South, must also be understood in this context of the African diaspora.” (Fett, 3) A central aspect of these African-based healing traditions is the centrality of the community. While stressing balance between mind, body, and spirit, the community played a pivotal role in individual health. The individual did not exist alone, but was rather made into a complete human being through the relational aspects of the larger community. Moreover, the connection between healing, spirituality, and religions such as the syncretized, African-based religions of hoodoo, conjure, and voodoo (Anderson, 2008; Mitchem, 2007) was pivotal to a holistic conception of health and healing. Mitchem (2007) identifies religion and spirituality as being important areas in which African American Folk healing arises. Through religion and spirituality, African Americans placed greater value upon the afterlife. This relational and spiritual view of health and healing with its emphasis on the health of an invisible soul stands in stark contrast with a biomedical focus on the visible, material, and mechanical view of the human body. African American healing practices   22     “insisted on a collective context for both affliction and healing; it honored kinship relations by bridging the worlds of ancestors and living generations; it located a healer’s authority in the wisdom of elders and divine revelation. In these respects the relation vision of health carried forward important dimensions of West and West Central African religions and worldviews.” (Fett, 6) The self then, is comprised of many interpersonal relationships and is neither made nor sustained through a strict adherence to individualism. Therefore, traditional Black ethnomedical practice conceptualizes health and illness as either resulting from the imbalance or illness in either the mind, body, spirit, community or any combination of these. In contrast to this idea of health, biomedical models generally seek to locate illness and disease as emerging in a single point of origin. In Bordering Biomedicine (2006) James Davies’ essay “The Anthropology of Aetiology” examines the reductionist trend characterizing biomedicine since its emergence in the late eighteenth century. Davies argues that even given various biomedical practitioners acknowledgement of the complex nature of causality in human illness and disease, there is still an emphasis on ‘first cause’. According to Davies, this is due in large part to the social context in which biomedical practitioners and biomedical structures are forced to compete for resources and status. (Davies, 2006) Black American ethnomedical practices have fundamentally sought to achieve the overall health of the Black body; yet, when these practices occur within an extremely racist and oppressive system, they often act as modes of resistance. Fett (2002) argues that the extreme abuse and control enacted upon the Black body, specifically the body of enslaved African women, created a context in which health practices and healing epistemologies of enslaved women constituted a form of resistance to systemic white supremacy and patriarchy. These   23     practices challenged the view of enslaved Africans as perpetual laborers and chattel. Most notable in this view are the ways enslaved women, charged with the healthcare of children, taught rituals of protections and preventative health measure to ensure safety. (Fett, 2002). Yet Mitchem (2007) resists the view that Black American ethnomedical practices were solely or primarily meant as resistance against White supremacy and the slave system. Resistance “cannot be considered the singular motivation for folk healing’s continuance. Certainly, although racism is still experienced, Black Americans proactively used religio-cultural forms such as folk healing to construct views of life that advance their own humanity. Black views of humanness can simultaneously be more positive and more complex. African American folk healing encompasses these nuances of resistance with construction, and this adds depth and texture to our study.” (Mitchem, p. 78) Healing, Political Knowledge, and Intellectualism In Domingo Alvares, African Healing, and The Intellectual History of the Atlantic World James H. Sweet (2011) examines the figure of Domingos Alvares as an African healer with significant influence and power who was captured and enslaved in Brazil. Sweet’s examination of this African figure seeks to disrupt the fact that much Atlantic world history revolves around American and European empires and aspirations. These historical narratives rarely factor in the role Africans have played in the formation of an Atlantic history. The "Black Atlantic" tends to be described in terms of Eurafricans, or through those African-descendants within the diaspora who speak European languages and participate in Euroamerican institutions (Sweet, 2011). James argues that Domingos performed critical functions with his setting in which he was able to glean larger political and social meaning from the concept of illness and impart this knowledge to believers and patients such that he transformed and created new communities around concepts   24     of well being. Domingos’s version of political discourse was firmly grounded in an African epistemology of health and healing that served as an alternative to the imperialist discourses of his time. As Sweet argues, Domingos’s healing discourse conflicted with Western and Atlantic “modernities” – capitalism, colonialism, monotheism, state formation, biomedicine, and so on…Healing retains it salience and remains thoroughly “modern” through negotiation and adaptation to the changing world; yet as a part of these transformations, certain “bundles of meaning and practice” from the deep past survive across the longue duree, providing a persistent and durable resource for mediating change. (Sweet, 227) These ‘bundles of meaning and practice’ to which Sweet refers are the cosmological and epistemological orientations dictating how one is to view and approach the physical world. Even while the world changes, some cosmological, ontological, and epistemological understandings remain relevant while others must change. Thus, Sweet regards African and African-descended healers as intellectuals who offered an alternative language of health and healing that simultaneously defied the socioeconomic outcomes of imperialism and sought ingenious translations of them. The ambiguities and apparent contradictions embedded in this discourse were the natural outgrowth of political conflict and compromise that emerged in new communities. (Sweet, 230) These political discourses challenged the mercantilistic and expansionistic trend within imperialism and revealed the extent to which the emerging capitalistic empire contained it’s own ambiguities and internal anomalies.   25     In a similar vein to Sweet’s analysis of Domingos Alvares, Paul Gilroy’s (2003) Black Music and The Politics of Authenticity argues that Black American critiques of modernity are anchored in a “continued proximity to the unspeakable terrors of the slave experience” and creates an ambivalence amongst Black Americans with regards to modernity. This ambivalence has been critical to the formation of Black Atlantic political culture. However, Gilroy asserts that though the terrors of the trans-Atlantic slave trade were unspeakable, they were not therefore inexpressible. The continued expression of these terrors contributes to the “volatile core of AfroAtlantic cultural creation” (Gilroy, 138). Music served as an avenue for communication of the Black Atlantic experience and is both modern and modernist. Their creolized, hybridized nature as well as their resistance to cultural appropriation undergirds his assertion; furthermore, it is this character – being of the West and resisting through critique Western society and structure – that constitutes Black music as decidedly modern and modernist. Gilroy further states that “the antimodernity of these forms, like their anteriority, appears in the (dis)guise of a premodernity that is both actively reimagined in the present and transmitted intermittently in eloquent pulses from the past” (Gilroy, 139). Black American musical expression and aesthetics remain deeply connected to the slave experience and insist that the reality of slavery continues to shape the contours of modernity. Black American’s collective memory of slavery as well as the larger Black experience (i.e. Jim Crow, Segregation) places Black Americans along the margins of modernity in ways that allow for a sharp critique of the systems and functioning of modernity. According to Gilroy, Black musical traditions serve as alternative avenues for these critiques and perspectives to gain voice as opposed to more traditional, perhaps Eurocentric, routes of intellectual and political expression. Thus, Gilroy asserts that the study of Blacks within the Diaspora and their musical aesthetic have   26     supported the formation of a distinct, often priestly caste of organic intellectuals whose experiences enable us to focus upon the crisis of modernity and modern values with special clarity. These people have often been intellectuals in the Gramscian sense, operating without the benefits that flow either from a relationship to the modern state or from secure institutional locations within the cultural industries. They have often pursued roles that escape categorization as the practice of either legislators or interpreters and have advanced instead as temporary custodians of a distinct and embattled cultural sensibility which has also operated as a political and philosophical resource. (Gilroy, 141) For many Black Americans the distance from key cultural institutions renders any intellectual and political insight or critique unintelligible and subject to dismissal by those within those institutions and those whose understanding of intellectual and political pursuits occurs solely through these cultural institutions. Nonetheless, Black music, both in the U.S. and outside, remains an area of Black life wherein both a close examination and deep understanding of modernity and the state is firmly rooted in a Black aesthetic and possesses political and intellectual knowledge often times unknown, erased, and marginalized. Gilroy (2003), Sweet (2011), and Bogues (2007) go far in advancing an understanding of the ways in which political and intellectual knowledge need not, and many times do not, manifest in simply one way. Their research provides an apt framework to answer a key question of this thesis: how are we to understand Black American ethnomedical practices as a form of social and political knowledge distinct from more standard or mainstream political knowledge as these practices occur within a larger sociopolitical context? To answer this question, I will use performance theory. Richard Schechner (2002) maintains that performance theory has the ability to highlight the significance of the ordinary or everyday actions through its ability to   27     mark identities, bend time, reshape and adorn the body, and tell stories. Performances – of art, rituals, or ordinary life – are made of “twicebehaved behaviors”, or “restored behaviors”, performed actions that people train to do, that they practice and rehearse…Social action – politics, protests, revolutions, and the like – are large-scale collective efforts either to maintain the status quo or to change the world. The whole span of individual human development can be studied “as” performance. This includes large-scale events such as social actions, revolutions, and politics. Every action, no matter how small or encompassing, consists of twice-behaved behaviors. (Schechner, 22-23) Performance scholar Eric Striff (2003) echoes Schechner’s description of performance stating that performance draws our attention to how we “represent ourselves and repeat those representations within everyday life, working on the assumption that culture is unthinkable without performance. The theatricality of everyday activities…can be analyzed in terms of performance studies” (Striff, 1). In his examination of funeral performances in the Black Atlantic, Joseph Roach (2003) is concerned with the ways in which cultural performances act as routes to collective memory. Utilizing Richard Schechner’s concept of ‘restored behavior’ or ‘twice-behaved behavior’ Roach maintains that the cultural performances of African descendants as collective memory is transmitted via the body and acts as a kind of bodily, or kinesthetic, awareness and knowledge. Roach’s term ‘genealogies of performance’ is useful in thinking about this thesis’s examination of contemporary Black American ethnomedical practices. These practices are part of a larger cosmological and epistemological thread shared amongst many   28     African-descendants throughout the diaspora. Their continued use and relevance demonstrates the ways these ethnomedical practices take into  account  the  give  and  take  of  transmissions,  posted  in  the  past,  arriving  in  the   present,  delivered  by  living  messengers,  speaking  in  tongues  not  entirely  their  own.   Orature  is  an  art  of  listening  as  well  as  speaking;  improvisation  is  an  art  of  collective   memory  as  well  as  invention;  repetition  is  an  art  of  recreation  as  well  as  restoration.   (Roach,  136) Performance  Theory  emphasizes  an  embodied  knowledge  that  differs  insignificant  ways   from  a  textual  knowledge,  which  dominates  knowledge  production  generally,  and  Western   laws,  policies,  and  institutions  more  specifically.     Dwight  Conquergood  (2002)  states  this  observation  most  succinctly  in  Performance   Studies:  Interventions  and  Radical  Research  arguing  that  the  emphasis  on  textuality  within   academia  mirrors  other  Western  forms  of  knowing  (i.e.  empiricism,  evidence-­‐based)  such   that  other  ways  of  knowing  and  being,  most  often  associated  with  social  “Others”,  become   marginalized.    Only  knowledge  based  in  text  is  considered  legible,  knowable,  and  valid  due   to   the visual/verbal bias of Western regimes of knowledge [which] blinds researchers to meanings that are expressed forcefully through intonation, silence, body tension, arched eyebrows, blank stares, and other protective arts of disguise and secrecy…subordinate people do not have the privilege of explicitness, the luxury of transparency, the presumptive norm of clear and direct communication, free and open debate on a level playing field that the privileged classes take for granted. (Conquergood, 146)   29     The overemphasis of textuality represents an ‘epistemic violence’ in which academicians and others ignore the extent to which marginalized peoples are not afforded the same avenues of expression and communication given to privileged groups. The extent to which those marginalized peoples express and experience the world through the workings of the physical body – embodied knowledge – is lost to those operating within an epistemic framework of textuality and effectively limits the intelligibility of those practices and forms of knowledge. In his work on Hmong shamans, Conquergood (1992) demonstrates the complexity of Hmong shamans. Within this context, performance highlights “the interplay between sickness, calling, and curing in the context of shaman and patient is a highly complex set of doublings and transformations” (Conquergood, 49). Moreover, Conquergood asserts that Hmong shamanism represents A series of applications, contacts, and adjustments to other cultures. Shamanism is a theatrically sophisticated, complex, and contextually nuanced performance practice enmeshed in the current cultural politics of Hmong people struggling to cope with the post-Vietnam War devastation of refugee of people, displacement, disbursal, and domination. (Conquergood, 43) The performance of a displaced religion amongst the Hmong takes on new meanings and becomes highly politicized via their healing performances when performed in a situation of exile and displacement within a hegemonic structure in which they are perceived as Other. Critically, Conquergood connects this experience of “othering” amongst the Hmong with other ethnic minorities who are represented “in print and electronic media as exotic performers [and] is a contemporary response to and containment of the ‘problem’ of diversity, difference, and demographic change which is transforming the sociological landscape of late twentieth-century   30     America” (Conquergood, 60). The social and cultural context in which Hmong minorities perform healing practices makes of these practices not only a type of healing addressing illness, but also a type of political intellectualism largely unread and unintelligible within a context of strict textuality. Summary This chapter presented a review of pertinent literature to the subject and analysis of African American ethnomedical practices. Much of the work done on African American ethnomedical practices, aside from a few works such as Stephanie Mitchem’s (2007), has been historical in nature. Moreover, these works have not analyzed these ethnomedical practices in terms of performances and performance theory. The next chapter examines the ethnomedical practices of a number of contemporary Black healers in the Detroit metro area and considers the ways in which these healers have both retained various traits, practices, and behaviors of earlier Black American healing practices as well as departed from these practices in significant ways.                 31     Chapter  3     Interviews     In chapter three of this thesis, I present interviews with four Black healers in the Detroit area. To exemplify the themes that arose within each of the interviews, relevant sections and paragraphs have been taken from the larger transcript while endeavoring to maintain a level of flow and coherency in the presentation of the interviews. I provide commentary throughout the presentation of the interviews, however a larger discussion of the significance and deeper meanings within the interviews is reserved for the discussion after the interviews. Karla Mitchell Located in North Detroit, Karla Mitchell’s business is dedicated to the improvement of overall health through the use of natural remedies. The business description reads “a natural and holistic healing center where health is improved using natural methods and remedies. Home of whole health raw juice and the urban apothecary.” The area where her business is located is a lower income, predominantly Black area of Detroit. One can find many long closed businesses with graffiti on the outside as well as soul food restaurants and corner stores. From the street, Exhalation Integrative Wellness is a non-descript building and one would not assume the cozy and inviting healing space inside. Upon entering the building, patients are met with a decorative glass table upon which are advertisements and announcements. Behind the table is the name of the business painted on the wall. The building contains a large space for group exercise and healing activities as well as multiple smaller rooms in which not only Karla, but others who rent the rooms conduct their various healing practices as well. Karla notes the diversity of the individuals who practice healing in the space including a woman who identifies strongly with her South American indigenous heritage endeavoring to keep alive their specific ethnomedical practices. For Karla, a Detroit native, healing was not always her primary profession.   32     My background has not always been natural health and medicine and I worked in the automotive industry because in the city of Detroit, that’s all that there is. And I started out working at GM and eventually evolved a pretty accomplished career as a senior level sales business development and marketing professional. So what that means is my job, I managed about a 140 million dollar book of business where we make manufacture car parts. I work for a tier two supplier so we manufactured car parts for the big three. All kinds - the turn signal switches, the head lamp switches, window lift switches, door locks. Karla’s business began simply with her determination to save money and the help of friends and community members. She housed her healing practice in small office housed in a secure facility in downtown Detroit while continuing to work a full time job in the automotive industry. However, after encountering a situation wherein clients were told to wait outside of the facility when she was absent, Karla began to look for alternative sites. One of Karla’s clients gave her the number to a building as a possible site of relocation. I had that phone number for probably seven months before I even thought about coming up here, because she told me how big it was. So one day I was playing hooky from work, drove past, "let me go and just see." I see the building and whatever so I said 'Hi I got your number from such and such you know are you in the building’ she goes, ‘well I am not there but I can be there in five minutes you want to see the inside?’ I said ‘ya!’ Walked over here, came in here and was just like it looked like somebody threw a bomb in here from the 1960's and it was, you could just tell, her husband was a dentist and he retired and they had just used it for a storage facility. And it was just all this old panel furniture and it was just hideous so it was giraffes and elephants and monkeys everywhere it was crazy and then too I was intimidated by the size. How am I going to   33     pay this, and you know it was too much. So as she was walking me through the space literally talking about this and talking about that she was going on and on, something came up in my spirit said, ask her does she know your father. out of the blue this thought came. So I asked the lady I said, ‘did you know Carl’ and she stopped dead in her tracks, her eyes welled up with tears, and she said, ‘he took me to my prom.’ And I said, ‘ok’, and she said, ‘wait a second, are you Carla?’ And I said ‘ya my father was a dry cleaner and he used to clean dry clean band uniforms for a lot of the Detroit public schools.’ And she said, ‘I remember you’ and she was the athletic director at Redford High School, and she said, ‘your father used to have you with him all the time’ she said ‘you would be running around the gym and me and him would be picking up bag up the uniforms’ and it was just that kind of kismet moment that said, ok, then she said ‘wait a second. What are you trying to do?’ And I said ‘well…’ and she goes ‘well you can do it just whatever you do, you come on in here and just do what ever you need to do. And we can talk about paying me later and so she gave me like a six or seven month head start, and I invested in relaying of the space and new textures and stuff. Karla’s deeply established connection to the Detroit community enabled her to move her business to a site that would readily allow her to accommodate her growing number of patients. While currently Karla’s business is firmly established and looking to expand in significant ways, her experience with and belief in alternative medicine and ethnomedical practices has not always been the case. A number of personal health events and experiences with biomedicine involving herself, her son, and her father have led Karla to examine alternative and natural medicine. Karla’s father was diagnosed with Glioblastoma multiforme and underwent an experimental surgery to   34     remove the tumor. Unfortunately, the tumor returned prompting Karla to research alternative therapies to help her father. Through a continuing education class at a community college, Karla took classes in Reiki with a registered nurse who took particular interest in Karla’s ability to sense energy. She started doing things with me like um sending me letters and numbers telepathically. So we would be sitting just like this in the class and she said ‘I’m going to send you a number and you’re going to tell you what it is. And this is how she honed my “sixth” sense for lack of a better word. She said ‘I’m going to send you a number’ and …… and it was funny … and she would be like go, I would be like seven and she’d be like oh! But as i am doing this I'm like, ‘this is crazy’ how am I doing this cause I couldn't…then she taught me to kind of hone in to how I was receiving that message because I wasn't seeing it like a thought I wasn't hearing it, you know what I mean? It was just I could literally sense something in there and so then she went from letters to numbers to colors to colored shapes and we kind of did that. And it was really phenomenal and I ended up going through all levels of her Reiki training and I adopted those techniques in working with my father. In using Reiki and energy work on her father, Karla remembers God speaking to her: “I just remember him saying, ‘your dad’s healing is not physical you’re doing exactly what you’re supposed to do. His healing is not manifesting in the physical. You’re cleansing him spiritually; keep doing what you’re doing.” After obtaining an abnormal pap smear, Karla’s doctor advised her to seek biomedical treatment. The doctor pressed upon Karla that more than 60 days without biomedical care would lead to proliferated cells to the point that a hysterectomy would be the only option. After   35     researching various herbal remedies and options Karla began to teas, tinctures, and other herbal preparations. I made tonic that I soaked tampons in and I would wear those tampons that I had soaked in this herbal preparation; I made poultices which are biodegradable clay which would look like hotdogs and you just roll it in the dry herbs and when I wasn’t wearing tampons I would wear these dissolvable poultices inside. I did hot alternating Sitz baths. Upon her return to the doctor, no abnormal cells were present. Importantly, Karla attributes this success to God answering her prayers. Following this event, Karla became pregnant against the advice of her doctor. Her son was diagnosed with Markonium Aspiration Syndrome; Karla explained that due to the excessive scar tissue resulting from a previous cervix examination, her son was late and her labor had to be induced. It was traumatic labor, I hemorrhaged, I almost passed out. I think my hemoglobin had gotten down to four. And so when he was born they suctioned so much the neooncologist said I have never seen this much having to be suctioned; he wasn’t breathing when he was born. So I didn’t get a chance to hold him. They whisked him down to Children’s Hospital and that was the testimony right there because at that moment I said, ‘Lord, alright I am in this bed, I need you to hurry up and get me together because my son cant be without me for more than three days.’ That third day, they released me, I went down there and I just started laying hands on my son; and at the time I was using essential oils a lot and I was rubbing essential oils on his feet and I would just lay there and hold his feet and I would say this is where you are supposed to be, come on in, I’m gonna live around you. And I want to say after about a week he started pulling his   36     feeding tube out of his mouth. They told me he would never be able to breast feed and the first time I breast feed, he breastfed for 45 minutes; they thought that he was going to have developmental delays that he would not have suck-swallow-breath reflex, they told me he would have to leave the hospital on oxygen and again it was just exercising these techniques that I had learned in Reiki… by the time my son was born, I had begun that technique as well so I just employed those techniques and engaged my prayer partners and we worked around my son. They thought he was going to be in the hospital for months and he came home in three weeks and today my son is 4 years old, in kindergarten, he reads just like he is very bright and so what they thought he would turn out to be, none of that stuff came to pass. I think that when you disrupt the energetic flow or or when you work in ether, you can change a lot of things cause that's where the blueprint resides. Karla’s experience with her father’s health issues, as well as her son’s and her own served as important gateways into alternative healing practices. Through each of these experiences, the validity and efficacy of practices such as prayer, energy work, and the use of herbs were proven time and again. Importantly for Karla, these practices do not exist in a vacuum but rather are effective in that they address ‘deeper’ or alternative aspects of health and healing that address the ‘blueprint’ mentioned above. For Karla, this blueprint comprises three important aspects, which she addresses. I think about everything realizing that there is absolutely a correlation between what you think and experience, how you feel about it, and how not accurately processing thoughts and experiences can manifest itself physically in the body. And i kind of looked at that through theories in bio-energetic medicine I’ve come to understand that there’s   37     absolutely no way that health exists without recognizing that connection between those three things, that's why we are a trinity right? Mind, body and spirit. Period, period. The blueprint to which Karla refers can be viewed as the key to optimum health and overall well being. Referring to the blueprint relates to the spirit and the mind as being integral to health as opposed to the biomedical model which gives priority to addressing the physical aspects health, disease, and illness. However, while these three aspects play an integral role in Karla’s explanatory model about health, she emphasizes the role of community and her participation in that community as an aspect of health and healing. So if I had to describe the way my business is organized, it is through primary care, naturopathic primary care, substance abuse treatment, community outreach and education which is kind of where I go and establish partnerships in the community that teach people…let me back up and say more along the lines of community and public health. I go into communities and teach people how there are alternatives to vaccines, or how there are alternatives to managing asthma. Instead of over medicating your kids with the inhaler there are alternatives to flu shots. How can you boost your immunity? So there is community outreach and education and then there’s work that involves social responsibility… So, I do that so, naturopathic primary care, substance abuse treatment, community outreach and education and social responsibility, I just think that those are the four pillars of my work. Karla describes her work by the saying “with great power comes great responsibility”. Her dedication to community empowerment and improvement via her alternative health business connects individual health with the larger community. Karla describes this as building a   38     collective consciousness around health in the Black community. In relating her participation in the Detroit Black community, Karla describes the work as occurring amongst ‘her own’ or with her own people. She addresses larger systemic and social issues that affect Black health “… when you look at what is happening in the city of Detroit right now, there is this resurgence of the city, the city is being rebuilt. But if you look at the factions who appreciate and don't appreciate that, the distinction between that is privilege and color.” Gentrification and structural poverty are reoccurring issues in the city of Detroit. As with many metropolitan areas in the United States, phrases and words such as ‘beautification’, or ‘resurgence’ carry with it the implication of the removal of poor residents and residents of color; in this specific instance, this is translated to the removal and replacing of Black residents. Larger, systemic realities such as these negatively impact Black health. In articulating these phenomena, Karla highlights how many Black residents exist within spaces of general negativity. It does not.....out of one comes many, and if the prevailing consciousness is not positive, then that is where geo-pathic and environmental stress comes in. It has an influence on every living thing. That's why I am…and there’s a relation…and the other parallel I want to make is, think about media programming and the images that we are constantly fed. And social engineering; perception is reality is reality, and if the prevailing perception is the man got us down, we don't have access to stuff, then you not going to go and look for it, cause you don't think it's available to you. Do you know what I mean? So I absolutely, it's hard to describe there being, a direct connection because the concept is so vast; like this conversation that you and I are having, I can't have it with an every day person without having a series of conversations because it is hard to conceptualize how collective conscience effects us on an individual level.   39     To Karla, the connection between not only the mind and body, but the collective mind and the individual as well as the social body is vast, intricate, complex and not always easily relatable. She identifies the media and everyday life within many Black communities as being a powerful force in molding the collective consciousness. Importantly, the location of Karla’s business allows her to intervene in the shaping of collective consciousness and influence the knowledge being produced and disseminated. In doing so, Karla engages in a series of conversations, as stated above, with every day people in order to arrive at a deeper level of conversation with individuals about health and its connections with collective consciousness. However, while many may not possess the knowledge Karla possesses, Karla nonetheless labels knowledge on healing and achieving optimum health as innate to all. Within her narrative she uses the image of a grandmother and the preparation of certain medicinal teas as emblematic of this innate quality of healing knowledge. It was funny about a month and half ago, I was at home making a hot toddy because I was not feeling well. And I mean really in the process of making the hot toddy is very similar to making an elixir. You preserve it with brandy; and um you boil down your herbs, you boil down whatever you're going to put in it, and you use raw honey to make the flavor easier. And I said to myself, well I'll be damned, my grandmother was formulating years ago, because we used to drink hot toddies as a kid and be sweating to death, but be fine the next day. No cold. You sweat it out That is natural medicine. And then she used to give us Senna leaf tea at the beginning of summer at the beginning of fall, and we would be in the house going to the bathroom all day like this is killing us, but i understand now why she did it. That is native medicine. That’s resident medicine. That   40     is trans-generational. It is that simple. It is not that complex. But you know pharmacology feeds medicine and medicine feeds the economy, and there it is. The presence of Karla’s grandmother is significant not only because it occurred in other places within her interview, but more importantly because it reflects a knowledge that spans generations. As Karla would say, it is ‘resident medicine’. This type of medical practice is often juxtaposed against the dominant biomedical model and viewed as a lesser form not only in terms of efficacy, but also in terms of the knowledge base associated with it. Karla describes the ideology behind alternative healing methods. These are diseases that you guys create. Just because a person has a propensity to develop that, or genetic miasma where their DNA structure has the likelihood to develop, doesn't mean they ever have to get it. Just because your mama had high blood pressure doesn't mean you have to get it. Medicine is presumptuous, because they don't think you are smart enough to do something different than what your parents did. They think that just because your mother had fat back and greasy greens, whatever she had you're going to eat it therefore you gonna get it any way so let's just put you on a path to hypertension. This is something you're going to get. So that when you do start having some little bit of issues, we not going to tell you to back off your diet, we just going to give you a pill. That's the difference between naturopathic medicine and bio-medicine; in naturopathic medicine, we focus on vibrational frequencies and resonance; a large part of my work is bio-energetic. Palmeopathy; like balances out like; so the idea then is everybody, your body is one big electrical circuit and if your body is not functioning at an ideal frequency, then we have to counteract that frequency with the frequency of a natural substance that balances that out to bring you back to a healthy vibration. That's   41     the difference. Modern medicine or conventional medicine is focused on symptomatology, not root cause; Naturopathic medicine is focused on root cause.   42     Kimberli Boyd Spiritual dance is a way to express and exalt God through our body temple. The ultimate union of mind, body and spirit is attained when the power of God is expressed through the spoken word, magnified through music, and finally, anchored in the physical body through spiritual dance and sacred movement. Upon first meeting Kimberli Boyd, I immediately noticed her earrings which contained a picture of a Black woman with an Afro. Her earrings had an Afrocentric feel to them and in some ways alluded to the slogan ‘Black is beautiful’ used during the Black Power Movement. Kimberli presents herself with a calm, confident energy and her knowledge of her craft comes from a mix of formal education and spiritual acumen. As CEO and founding artistic director of “Dancing Between the Lines”, Kimberli approaches healing from dance and body movement. “So I have been a professional dancer for a long time and, for me, the practice of dance is very much a healing practice and historically for certain cultures, or groups of people, to move the body in celebratory ways or creative ways is very much a part of a healing modality or a healing practice. And so I have always balanced the two. And sometimes the story that I tell young people sometimes is that I danced all of my life until about middle school when, for various reasons, I stopped dancing and a whole bunch of other terrible things started to happen and suddenly I really couldn’t find myself and was getting into all sorts of trouble I had never gotten into before. So I guess one answer to the question is that I came into the practice of healing through movement as a way of healing myself. So in addition to modality of movement, I came to the practice of yoga very much from the place of needing some emotionally healing for myself.”   43     Healing for Kimberli initially was a way to heal and return to a healthy state of being for herself. Referring to her dance and yoga healing work as a ‘movement modality’, she realizes the importance of body movement ‘in celebratory ways’ as being intimately tied to various cultures. This characterization reflects a trans-generational and potentially diasporic aspect of healing. Through the physical practices of healing such as yoga and dance, Kimberli notes the ways these practices gave her the ability to emotionally heal. Kimberli notes the ways in which her healing practice through movement can heal the individual and also heal the community. So now I have access to movement and healing that is either creative, through the creative process, because when I work in movement settings, my particular expertise and passion is not so much in leading a traditional dance class for technical purposes, but it is in facilitating people into a creative process which often times ends up being very illuminating and healing personally, emotionally. In terms of community, we find out a lot by moving our own bodies and moving together as a community, as a whole. So I practice movement as a way to bring…to understand issues of diversity of, you know, you name it. There is a way that you can approach movement as a way of learning about yourself individually, or the community as a whole… I would say this, there is a lot, once again taking it to science, there have been a lot of interesting studies, and the reason why the yoga therapy program I am in is being embraced by the Beaumont Center and by the same Charlie Health Center and others is because there are a lot of interesting studies that have found that when people who find themselves in community or have some sort of connection to others, or prayer, or meditation, or reflection, do better. That you’ll feel better. Kimberli steers away from the technicalities of dance in order to highlight and utilize the creative aspect. It is in the creative aspect of dance that the healing aspect is to be found. Described in this light,   44     healing is a creative process that has the ability to heal communities from social issues that inhibit group and individual well-being. Moreover, Kimberli convincingly states that healing in a community setting promotes individual health; these two aspects are profoundly interconnected. Through her work she has come to see many patients that complain of chronic pain often summed up in the simple statement ‘I am stressed’. Interestingly, using science to explain how pain becomes lodged in the body and can toxify the body leading to illness, Kimberli turns to a more biomedical explanation. She emphasizes the ways in which the amygdala allows human beings to respond to danger, real or perceived, in order to protect the self. “So there is this deep place in the brain that just takes over when it senses threat and what it…when it tells the body that there is a threat then what it starts to do is dump into our blood stream what are called stress-response hormones. And the stress-response hormones, or cortisol, start to tighten certain muscles, start to tighten certain muscles in the body that can cause us to run really fast or punch really hard, or freeze and kinda, you know, hide in the landscape… but when we live in a chronic state of stress, then that hormone becomes toxic to the overall system, and then when that hormone, enough of it has toxified the system, then we become imbalanced. And then we start to break down. Our immunity goes down, we start to get sick, we are tired, all kinds of other things. So if you go to the doctor, they are going to look at three things. They are going to look at what you eat – nutrition is a whole other conversation – they are going to look at your level of exercise, and your level of stress, what you are naturally predisposed to. So there is a way in which understanding how to move the body can literally help to de-stress it. Kimberli views her work as revolutionary. She realizes the importance of taking her patients from a place of chronic, and in some cases, debilitating pain or illness to a place in which they are able   45     to regain the ability to think. Importantly, for Kimberli this is accomplished through a bridging of biomedical and natural healing practices. “What the practice of yoga invites you to do is to sit and breathe and be, or stand and breathe, because when you calm that deep place in the brain that I was talking about before what happens is that you can regain the ability to rethink critically and creatively because what happens is it comes down to survival, there is not creativity in that. It just is what we have to do to stay alive… But even getting people to do that much, you know getting people to be aware of something going on in my body that I don’t necessarily have to live with chronically, I can do something about it. And then giving permission to do so is revolutionary. It’s a revolutionary act. I was talking to somebody else in describing to them what I do, and he said ‘oh you break people out of prison’.” However, though Kimberli and others view her movement and healing work as being revolutionary, a way to create and think critically, according to Kimberli there are many African Americans who are resistant to her healing methods. Christianity presents a conceptual barrier for some Black Christians who believe that they are potentially worshipping other gods. So when I leave practice in the city of Detroit, in and around the metro area then typically yes, because mine is, admittedly, an urban practice. And part of what I came to it with was, you know what, Black people in particular because we tend to be primarily Christian in terms of religious orientation, whether we are practicing or not, got a lot of questions about whether yoga is a religion. Does practicing yoga mean I am praying to some other God because there aren’t words, and there is chanting, what is that? So my practice is making it okay to enter the practice of yoga and demystifying it, but, in a way that honors the tradition of yoga.   46     Kimberli rejects much mainstream yoga practice that strips it of its philosophical, cultural, and spiritual roots. She sees much of the spiritual and philosophical aspects of yoga to be complimentary to or aligned with some of the best aspects of Christianity. “And there is a deep connection to perhaps a spiritual power in a way of being that honors things like compassion, and felt study, and being reflective, and being nonviolent, and for me, the best aspects of Christianity are also asking you to do that. New Testament Christianity.” This emphasis on the spiritual in healing the physical body is something that Kimberli stresses consistently. Moreover, she also remains acutely aware of how emotional health can effect our physical state. Healing is typically what we go to the doctor for. Fix this, make it better. As a series of scientific protocols where I know I can be admitted and take medication and it’s well, or take it to surgery or some other protocol and we can fix the issue. But it is possible to be cured of the thing but you’re not healed. Right? Because often what will happen is you will go to the doctor, you get fixed and part of what they call to mind is, okay, now we fix the heart, physically what was wrong with it, but we need to take a look at your relationship to stress. Because some of what might be stressing you out is relationships of unforgiveness… And so then, so that’s the physical stuff you can get an emotional space if you are tight and constricted because of something that happened in 1932 that you were still holding on to and you are waiting for that apology from that person who is going on with their lives or maybe even died, it is unresolved. The best type of healing one can receive, according to Kimberli, is the healing that we can give ourselves. This type of healing is based in balance wherein we work in accordance with our bodies natural ability to heal itself. However, the reality for many inner city people, especially Black Americans, is a lack of access and knowledge. “So I’m just curious about is there some way we can   47     practice everyday being well so that we don’t get to those places where you know there is a dialysis center on every corner, liquor store, dialysis store. Check cashing place… You know, pick an urban center and that is probably what you see. Check cashing center and the fast food joints. More fast food places than grocery stores.” Healing and health in this context, specifically teaching self-healing in a balanced way, constitutes a political act. “Well you asked if I was a revolutionary and there comes a point where that being healed is a revolutionary act because you realize that you can take care of yourself. You know, it’s really interesting watching what’s happening in the political landscape, watching the affordable healthcare and  so  I  think  that  the  most  affordable  kind  of  care  you  can  give   yourself  is  to  take  care  of  yourself  so  that  you  don’t  have  to  rely  on  emergency  room   as   you’re   well-­‐visit   which   tends   to   happen   in   urban   centers   where   people   can’t   afford  to  be  sick.  But,  unfortunately,  you’re  engaging  in  behaviors  that  are  not  doing   anything   to   keep   them   well   because   there’s   more   fast   food   and   you   can   feed   the   whole   family   for   a   few   dollars   on   the   bucket   of   chicken   or   whatever.   It’s   going   to   clog  the  arteries  or  its  going  to  exacerbate  whatever  else  is  going  on  as  opposed  to   taking   the   time   to   create   a   fresh   meal   because   sometimes   it   comes   down   to   a   dollar.   There’s  a  real  challenge  like  Detroit  went  through  with  the  whole  water  thing  and   people’s   water   being   shut   off   and   they   had   to   march   and   help   people   understand   that  water  is  a  human  right.  Eating  is  one  thing,  but  when  you  cut  off  people’s  access   to  clean  and  safe  water,  we  got  a  real  problem.  So I think that the most affordable kind of care you can give yourself is to take care of yourself so that you don’t have to rely on emergency room as you’re well-visit, which tends to happen in urban centers where people can’t afford to be sick. But, unfortunately, you’re engaging in behaviors that I’m   48     not doing anything to keep them well because there’s more fast food and you can feed the whole family for a few dollars on a bucket of chicken or whatever it is. It’s going to clog the arteries or its going to exacerbate whatever else is going on as opposed to taking the time to create a fresh meal because sometimes it comes down to a dollar.” Key to Kimberli’s narrative is the influence and mentoring she received from an older Black woman. Kimberli characterizes this woman’s work as not only transformative but also healing. She was born in Wyoming. Her father was a buffalo soldier. She was in Oberlin College in the school of Social Work because although she has the heart of a dancer certainly her parents thought that was no career path so she went to the school of Social Work. But there was a dance department at the school and so she danced at the same time that she was doing her studies in Social Work. Her name is Margerie Wit Johnson. What she did was put together her love of dance choreography with her work in the field of Social Work. So she worked in Cleveland Ohio at a place called the Caribou Settlement House and it was one of those places that was funded by revolutionary, I guess you would call them, Caucasian people, who were socially minded enough who wanted to find a recreational center in an urban environment. So she works for them both as a social worker, but because of her love of dance she brought that into her therapy. So she started to put together what she learned, the social worker protocols with choreography, and started to develop dances that came out of the experiences of the young people she was working and gave them voice to who they were and what they were experiencing, get them off the street and build the community. Her work was absolutely healing, and transformative and revolutionary. Because in the 30s and 40s especially, I don’t know   49     what history would say about when for African Americans the whole idea of coming into college became a part or desire that was a part of the broader community rather than the few that had means or had a passion for it but that was in and of itself was revolutionary. The healing for that community, in terms of giving the students that she worked with a sense of themselves, a sense of possibility. Tissheama Pizzimenti Tissheama Pizzimenti’s herbal shop is connected to her husband’s chiropractic practice on one side and on the other an all natural and organic vegan café serves fresh meals and smoothies to customers. Tissheama explains her rationale for opening her own herbal shop. I got into herbs because conventional medicine – don’t persecute me – I believe is killing people. Not killing people, but sometimes can do more damage than good. And you don’t know how many people I see who get on one medication and then the side effects from that medication actually puts them on another medication and by the end of it all they are taking 12 – 15 medications. I mean, like, think about it. That is depressing in itself. Tissheama laments the reality that many patients taking medication for one ailment must often times take a series of other medications to address and control the adverse side effects of one medication. Taking multiple prescriptions drugs to address one problem is commonplace. Tissheama’s son’s bout with an incessant fever and the inability of biomedical care and practitioners to address it lead Tissheama to search for alternative care methods. Nope, other way around, no, no, no. So with my experience with herbs, my first true experience was when I had my first son, who is 14 now. He had the most stubborn fever ever. I mean it just would not quit. Before, I was using Motrin, I was using Tylenol, and I went to the doctor and the doctor came in and he had like this rash on his face. I’m like   50     ‘why should I listen to you about ANYTHING’? You see me right? I was like, uh OK. He was like, yeah you can take like the Motrin and Tylenol together, you could use both of them. I was like, that sounds dangerous, my son is 2. I was like, should I be missing this? He’s like, you can use as you need to. I really thought that then, so this isn’t going to go away? You know, I really felt, like, hopeless cuz he wasn’t giving me no answers. And plus I couldn’t get past like, you’re a doctor, why do you have that big rash on your face? So, I took him home and I was using that medicine, and it still wasn’t breaking. And what did I think of using on my baby? I went to the store, the health food store, and got some Echinacea, some drops, and I just kept dropping that in his little juice, dropping it, giving it to him. And eventually the fever broke. He did break into a rash, which was fine, but that was his body releasing all those toxins, probably from the medication. Who knows!? Despite Tissheama turning to herbal treatments for her son, she notes the ways in which she continued to utilize conventional medicine because of a general fear. Considering she had grown up with biomedicine as the dominant form of care in her household, Tissheama attributed this fear to a fear of the unknown. Placing her past fear of alternative medicine within a larger social understanding, Tissheama addresses the lack of knowledge amongst patients of alternative methods to health and healing. What we don’t understand is that there are alternatives out there. We’re not really taught that. We’re not taught to look in our backyards and say ‘oh’. We’re not even taught that plants in our backyards can heal us, OK? Let alone go in the back yard and say, this is good for this and I can take that. We’re taught, oh dandelions are evasive cut them down. Let’s shoot chemicals on them and kill them so we can have nice pretty yards. When   51     dandelions is the very thing we need to detoxify our liver. And get half the chemicals and metals out of our bodies. Tissheama’s narrative concerning the lack of knowledge on alternative and natural medicine becomes more of a narrative about loss throughout her interview. Framing natural medicine as a part of Black American culture, Tissheama, like other Black healers in this examination, paints a picture of an older, Southern Black existence wherein natural medicine was practiced. This is our culture. You know? I can’t believe that we have been so dumbed down that we don’t even remember where we come from. We don’t know that this is really innately inside of all of us. We have been so bombarded with the culture that tells us that medicine, conventional medicine, is the way to go. You know, that’s dirty, don’t do that, don’t let your baby touch this, don’t let that baby put that in his mouth. We’ve been so just bombarded by these theories that don’t even apply to us. It’s our culture. I mean, our grandmothers grew up on the farm. They knew, you know, certain things to go out pick, and mix, and slather on your body if you had the measles, or the chicken pox. They knew to throw you in the bathtub full of, you know, maybe comfrey. You know when you were itching and the chicken pox were upon you. So we’re kind of like, we’ve lost that. Important to Tissheama’s narrative is the emphasis on Black women. She specifically notes grandmothers as being keepers of natural medicinal knowledge. Yet, herbal knowledge, for Tissheama, is encompassed within a larger view of health wherein the mind and spirit play an integral role.   52     Because holistic, I mean, because healing is holistic. It’s not just about, oh let me come and get these herbs to heal. That is not what life is about. Life is about, when you wake up Saturday morning, how are you feeling? Are you happy that it’s Saturday? Or are you dreading that it’s Saturday because you don’t wanna go to work. Are you dreading that it’s Saturday because your husband is beating you? Are you dreading that it’s Saturday because your kids are home? OK, that takes a big big effect on your psyche, your emotions, and therefore the cells in your body. What you’re thinking and how you’re feeling is what your cells are thinking and feeling. So have you ever seen like a person who’s hunched over and has a scowl on their face. That comes from how they’re thinking, ok? How their feeling about life, you know? There are only assistants to health. Really your health comes from you. How you’re feeling, how you’re looking at life, how did you take in what that person said to you that wasn’t so positive. How did you digest that? You know, how are you digesting life on a daily basis. That’s really what health is about, in my opinion, 80% of health is about that even more so than diet, even more so than herbs, even more so than body work. How are you feeling emotionally, you know? I tell people, ‘close your eyes’, think of something that you just really don’t like about yourself and feel how that feels in your body.’ And then I’ll say, ‘now think of a time when you were just happy, ecstatic, life was going right, what were you doing, where were you?’ ‘What people were around you?’ Just that really glorious time in your life where you just felt high. Two very different feelings in the body, right? Two very distinct…differently, just different. The first one where you’re just thinking low about yourself, you feel like, you know. That’s what health really is. How joyful you’re feeling. Now when you’re thinking about that time when you’re just really high on life, you don’t   53     feel the aches and pains in your body, you don’t feel what’s going on, you’re like this, oh my God, feels good! So imagine if you could that way all the time? That’s really what health is. Herbal medicines are but one aspect of Tissheama’s healing practice and philosophy. Equally important, if not more so, is the way one’s thinking, emotional state, and physical environment can deeply impact health and overall well-being. Without considering these aspects Tissheama’s practice and dedication to alternative health would not be holistic and therefore less effective. However, the loss of traditional modes of healing in Black American communities is a real issue for Tissheama, who characterizes such practices as being innate and a part of Black American culture. Tissheama attributes this loss to a ‘bombardment’ by biomedical institutions. I really think that it has a lot to do with the medical field. Because before, even marijuana, which is an herb, which is really used for natural medicinal purposes. Even that was kinda taken from us. Because the medical industry and the pharmaceuticals, they wanted to get those first and sell those and patent those, you know, so you push aside the medicine that really works, you know what I’m saying, and give to the people things that really don’t work as well. Really it’s just a superpower is what I’m getting at. The medical industry is a superpower and whatever they say, goes. OK, so then that gets pushed to the side and we get bombarded by, you know, ‘go see the doctor, go see the doctor, go see the doctor.’ Eventually you gonna lose what’s natural. So, same thing, if people just sang in the streets all day and danced, and then when they put TV in their homes, we’re gonna stop being creative, cuz we’re sitting down watching other people be creative.   54     Tissheama argues that the ubiquitous nature of biomedicine prevents the knowing of alternative methods of healing. Often times, biomedicine becomes the only option to address everyday aches and pains to debilitating ailments. Any knowledge that exists outside of biomedicine is absorbed into existing biomedical institutions and sold to consumers for profit. Relating to an earlier quote by Tissheama, she argues that many people don’t know that oftentimes what is needed to address health concerns exists outside of biomedicine in our backyards and is free. Importantly, it is not just biomedicine that plays a role in the loss of traditional medical knowledge amongst Black Americans. Tissheama speaks at length about the role of structural poverty in Black American health and ethnomedical knowledge. Basically, we really have to look at what we’re doing. And it’s like, I don’t see, like I live right here in the middle of the hood and I don’t see any access to the children here, or to the moms here, or to the dads in this community that say this is the human body, and guess what, this is how it works. And if you want it to run efficiently, this is what you put in it. You put premium gas in there, you don’t put crap. You see what I’m saying? What happens when you go to some of the stores around here filled with liquor, chicken, and pop, gum, donuts and whatever else, OK? The grocery store over here the meat is rotten. But people don’t even know. They don’t even know that when they go in there that smell that they smell is rotten meat. The eggs are expired, the bread is expired. OK so this all in our community as Black people. We’re not being taught how to be healthy. How to be upright. How to be, you know? The wonderful, strong people that we are, it’s being taken from us. And what’s on the corner over here? The crackhouse. You see what I’m saying. The liquor stores are there. The schools with holes in the ceiling and where   55     the kids have to share textbooks. It’s there. So all that is happening in our community so health is like, the last thing, that people are thinking about. You know, so no wonder why we’re filled with diabetes, cancer, stress, high blood pressure, you know? It’s just not being taught to us. It wasn’t taught to me! Importantly, Tissheama and her husband Bob have strategically placed their business in an impoverished, Black area because of their belief that this area constitutes a higher need of their healing practices. Tissheama’s knowledge of herbal remedies, and, as evidenced above, her knowledge of the Black community in which she resides allow her to impart knowledge of alternative healing. Tissheama argues that some of this alternative knowledge contains aspects of Black American heritage and culture lost to many Black Americans as a result of ‘biomedical bombardment’.   56     Leppel Payne Leppel Payne is a practitioner of Sukyo Mahikari and a friend of Tissheama Pizzimenti. Sukyo Mahikari’s healing philosophy emphasizes giving light to yourself and others as a way to spiritually cleanse and heal. Though currently a practitioner of Sukyo Mahikari, Leppel characterizes himself as a healer before he became aware of Sukyo Mahikari. When I was 21, my cousin, I had moved back to Ohio and my cousin, my little cousin Andrea had fallen down the stairs and broker her arm. And when she fell down the stairs and broke her arm, well, I automatically took her to the hospital and they put a cast on her arm and said she was gonna be in the cast for probably 6 months. You know, then the cast would come off. And I used to babysit Andrea a lot when my cousin May was out. My counsin May was her mom. And one day we were sitting there on the couch, just me and Andrea in the living room and something told me, the spirit of God, the universe, told me to put my hand on her cast and pray. And I did! I was obedient, I listened. And I put my hand on the cast and I said my prayer and I asked God to make her whole again, and two or three weeks, that cast was off. Important in Leppel’s narrative is the emphasis on Christianity and God. Leppel describes himself as obedient to the word of God and to the power this obedience gave him to heal his cousin. The practice of ‘layin on hands’ is well known in Black Baptist worship. So that's when I kinda recognized that there was something to this energy, but it’s something that I have seen practiced in the Baptist church of layin on hands. It’s part of the spiritual practice that we as Black people have always done is laid on hands, or transferred that energy, or used that energy. It kinda got lost along the way and the light work that I do, or the energy that I work with Sukiyo Mahikari, it's been passed over to   57     the Asians. It was passed over to the Asians, like I told you earlier, 3,000 years earlier during the Jung period. That's when the practice was actually handed to them and it was probably handed to them because we probably misused it in the past, so they transferred the spiritual practice somebody I guess. We as Black folks, indigenously, during the time of, or in the period of ancient Kemet, when we were the parent race, which we are, when we were the only melanated race on the planet, we practiced that back during the time. That's how the pyramids got made, is with this transfer or this use of that energy. They had a higher use of the energy because basically the Egyptians, everything they did was dealing with the spirit, and the universe, and the astrology, so that the combination of those, that knowledge kinda gave them the force and the energy to build the pyramids and to do the things that they did. The architecture. Some things that they’re still trying to figure out and they can't even explain but, it was all done through the use of vibration and with this prayer. What this prayer, this Sukiyo Mahikari, when I’m giving energy or I’m giving light to someone there's the energy and vibration that comes from the word. There's an ancient prayer that I have to say before I even do the prayer in order for that chi to open up and really do its work. It's always there. It's in you, it's in me, it's in everybody. An afrocentric worldview deeply informs Leppel’s characterization of Sukyo Mahikari. Not only does he connect the spirit work of Sukyo Mahikari with the Black Baptist practice of ‘layin on hands’ but he goes further in connecting both of these phenomena to ancient Africa, specifically Egypt or Kemet. The architectural feats of ancient Egypt are attributed to their strong spiritual foundation and practices.   58     In Leppel’s explanation of Sukyo Mahikari, he describes the relationship between the body and the spirit. To get me, or anyone that's giving light, focused in on just the spirit of the individual. Because we are not dealing the body. We're not dealing with the body at all. We're dealing with the spirit. So we're unblocking passages in the body. There are certain passages in the body when they become blocked you cannot receive signals or information from the universe. Or kinda, I put it like this, kinda stunts our growth, spiritually. The passages in the body that allow spiritual energy to flow struck me as chakras. Upon asking Leppel to further explain, he gave a detailed answer. But it's not just our chakras. We have, well I guess they would be considered chakras or meridians, because some of the same points that we give light to are some of the same points that they do when they are giving acupuncture to release or to, to set forth energy, or to bring, make energy manifest in the body. They’re just electrical currents. Yeah, just like with the chakra situation. So even, like with the chakras. And you’re dealing basically with chakras because, I don't know if you've read anything or studied anything about chakras where they claim that we only, we have nine chakras, there's nine chakras, from the root up until here. Well there is seven here. But there are chakras that go past. Actually we have more than 20. Sukiyo Mahikari, they don't even speak of chakras, but we're still dealing with chakras. All they speak of basically is just dealing with unblocking passages or those points that we give energy to. But dealing with chakras, there is never no mention of chakras, mentioned in Sukiyo Mahikari period. They're only   59     dealing with the spiritual aspect of it. They're not dealing with the physical-spiritual aspect of it. To do this work, Leppel again compares it to the Black church where nurses are spiritual practitioners who “had to pray and get prayed up before they would even go out in the space or the room to help with the situation of somebody fallin out when the spirit hit them or whatever”. Importantly, there is much more emphasis on spiritual healing than physical healing even though the two are certainly connected. Oh yes there has to be a connection the between two, because when one is sick the other is sick. So we're dealing with the spiritual. We're trying to unblock that path and you're trying to help purify the spirit. We're not trying to purify the body. Period. It has really nothing to do with the body. That takes place with the individual, after the healing takes place with the spirit. That's on the individual to handle or to take care of. So we're not looking at the physical, we're not trying to be physical doctor. I look at it like being a spiritual nurse. You're helping to take care. While acknowledging the connection between the body and the spirit, Leppel maintains a sort of prominence with the spirit. Through spirit work, physical work and health then become possible. Practitioners of Sukyo Mahikari heal the spirit so that the individual can then find physical health. However, through spiritual healing, physical healing can manifest also. My individual experience is knowing that I sat there and I prayed someone and I've given them energy and I helped them make a breakthrough on even a pain in their body. I had one, the last lady that I remember giving, I've done it in here a couple time, but I think the last time I gave light to a lady, a young lady that came in for the first time that was having trouble with her shoulder. She said I can't sleep, I can't even sleep on this side, it   60     won't even go away. She couldn't have been no more than 45 years old, maybe if she was that old. Anyway, I did the prayer, I did the prayer and I did the work and right after she said, my God this really works! She said it's gone! And she grabbed me and she hugged me, it's like OK, I'm glad but, it's not me that's doing the work. It's the presence of God that's doing the work. That's the energy, but me recognizing the presence of God and her God awakening up that presence. That's the humbling part of the whole thing, is that we are able to sit down with the individual one on one and pray with the individual and use our spiritually energy to help them get a spiritual breakthrough and help them to achieve spiritual cleansing. And it's all for spiritual cleansing, it has like I repeated and said before, nothing to do with the physical. The physical is going to take care of itself if the spirit is right, but the spirit has to be right in order for anything physical to take place. When I asked about the role of the mind in healing, Leppel answered, “The mind has nothing to do with it.” Instead, Leppel spoke of ‘divine consciousness’ as having a more important role in spiritual healing. The ability to understand one’s divinity and “the understanding that you're energy and your breath is God. And that's what we're dealing with is energy. And breath, which is God so everything else is not relative.” While the mind may not play a role in the actual healing process, it can lead to impediments to spiritual health creating “blockages [which] manifest in thought, one. Our very thoughts are things, so when thoughts manifest, blockages can take place or disease or dis-ease, disease and dis-ease can take place and a lot of it comes from thought.” Because much of his explanation about the spiritual healing in Sukyo Mahikari centered around parallels with the Black church and Christianity, I asked about the concept of the Holy Trinity and how it may or may not relate to his spiritual practice.   61     Well you know all of that, you know the Trinity is part of the whole thing. The father, the son, the Holy Spirit. And it's the spirit God within us that is actually doing the work, it's not us. It's not us. We, it don't have nothing to do with us, it don't have nothing to do with me. When I give someone light or energy and they get a breakthrough, it's because I helped them spiritually to get the breakthrough. It's the God in me that's doing the work. So when we do this type of work you have to leave ego and self out the way and you have to be an open vessel and allow the spirit and the energy of God in us to do the work and not be big-headed about it. You know it ain't, you know if it was all that possible, I would be walking around here perfect, well I give myself light, too. Leppel’s last statement about giving himself light is important in his narrative as it highlights the role of the community in healing. In Sukyo Mahikari, one does not only give light to others, but through that process light is also given to the self and vice versa. Leppel I'm getting it back. I'm receiving. When I'm giving you light, that is bouncing back at me. It's bouncing back at me. When I'm focusing in on, energy on your heart a lot of people when you hear them chatter, chatter, chatter, chatter, well what I found out is that's heart asking and looking for attention. So when I'm giving light to your heart, when I'm giving light to your heart I'm giving light to my heart. So if there's any healing that needs to take place in your heart, that healing is also going to be taking place with me. We're one spirit. We're one spirit. So, like I said, when I told you earlier, when I'm doing that prayer for me and it's effect you, but its not just effecting you, its effecting your ancestors.               62     Discussion     Scene:  Structural  Poverty,  Race  and  the  Loss  of  Ethnomedical  Knowledge     To  structure  a  discussion  about  the  ethnomedical  practices  of  Black  healers  in   Detroit  I  use  Kenneth  Burke’s  (1945)  dramatistic  pentad.    Burke  proposes  we  examine   human  activity  through  five  terms  of  dramatism:  act,  scene,  agent,  agency,  and  purpose.   Within  this  framework,  Black  healers  are  agents  whose  healing  acts  and  performances  have   a  purpose  and  occur  within  a  certain  social  scene  or  setting.  Equally  important  is  Victor   Turner’s  (1982)  understanding  of  all  performances  as  occurring  within  what  he  terms   ‘antistructure’  and  ‘structure’.  As  used  by  Turner,  structure  refers  to  a  larger  social  system   and  order  where  concepts  such  as  authority  and  hierarchy  operate.  Antistructure  refers  to   human  action  occurring  outside  of  these  concepts.   The  scene  against  which  these  Black  healers  perform  their  healing  is  one  of   structural  poverty  and  biomedical  authoritative  knowledge.  Structural  poverty  was   strongly  linked  to  not  only  the  loss  of  ethnomedical  knowledge  amongst  Black  Americans   but  also  the  ability  to  gain  knowledge  on  health  and  healing.  Karla  Mitchell’s  story  about   her  work  in  the  Black  communities  of  Detroit  (see  p  44  –  45),  Kimberli’s  emphasis  on  the   political  realities  of  Black  Americans  in  Detroit  (see  p  55),  and  Tissheama’s  experience  with   food  deserts  in  Detroit  (p  62  -­‐63)  demonstrate  the  sociopolitical  structure  with  which  their   healing  practices  must  contend  in  order  to  adequately  address  and  understand  individual   manifestations  of  health  and  illness.         Kimberli  illustrates  an  urban  landscape  with  signs  of  poverty  and  an  inability  to   access  nutritious  foods  (see  p.  55)  Moreover,  she  places  these  signs  of  urban  decay  within   larger  examinations  of  the  affordable  care  act  and  Detroit’s  relatively  recent  debacle  where     63     residents  were  cut  off  from  the  water  system.    Similarly,  Karla  speaks  of  “privilege  and   color”  in  the  gentrification  of  Detroit  as  central  to  Black  American  health  issues  (see  p  44).     The  renewal  of  certain  urban  areas  of  Detroit  distinctly  privilege  those  of  certain  class   statuses  and  racial  backgrounds  such  that  many  African  Americans  find  themselves  priced   out  and  excluded  from  major  redevelopment  of  the  city.  Furthermore,  Karla  mentions  her   work  in  community  gardens  in  Detroit.  In  one  experience,  Black  residents  in  the  garden   expressed  extreme  mistrust  of  a  white  woman  who  Karla  invited  to  help  tend  to  the  garden.   It  was  not  until  Karla  gave  her  stamp  of  approval  to  the  woman  in  front  of  the  Black   residents  that  they  accepted  her  presence.  For  Karla,  this  represents  racial  tensions  with   deep  historical  roots  in  the  city  of  Detroit.    According  to  Karla,  for  Black  residents  in  Detroit   “the  prevailing  perception  is  I  can't  trust  somebody  else  that's  not  me.  To  have  an  ulterior   motive…how  do  I  know  that  the  seeds  that  ya’ll  are  planting  in  my  garden  ain’t  going  to  kill   three  generations  of  my  kids  down  the  road.  Are  these  GMO  Seeds?  What  is  this?  Have  you   sprayed  these  seeds  with  something?  You  know  what  I’m  sayin’?”       Tissheama  argues  that  as  result  of  structural  poverty  in  many  Black  neighborhoods   of  Detroit,  health  is  often  the  last  thing  that  people  are  concerned  about  until  health  issues   becomes  serious  and  debilitating.  Perhaps  most  powerful  in  Tissheama’s  narrative  is  her   observation  that  for  some  Black  residents  even  the  smell  of  decaying  meat  is  unidentifiable   because  it  is  ubiquitous  and  many  have  become  accustomed  to  this  way  of  life.  The  stores   that  are  available  to  many  Black  residents  in  Detroit  do  not  often  sell  the  kinds  of  foods  and   provisions  conducive  to  total  health  and  well-­‐being.  Moreover,  Tissheama  connects  her   discussion  of  inadequate  food  to  the  existence  of  substandard  textbooks  in  many  urban,   predominately  Black  schools  and  crackhouses  in  Black  neighborhoods  (see  pp  62  –  63).     64       Gentrification  and  the  displacement  of  Black  residents,  food  deserts,  drug  addiction,   and  the  decay  of  public  education  in  urban  areas  have  been  well  documented.  These   structural  issues  are  not  only  a  problem  in  Detroit,  but  occur  in  major  urban  areas   throughout  the  United  States.  Undoubtedly,  these  realities  contribute  to  the  health  crisis   facing  many  Black  Americans.  With  these  realities  in  place,  it  then  becomes  difficult  not   only  to  achieve  a  true  sense  of  health  and  well-­‐being,  but  perhaps  most  important  it   inhibits  the  ability  of  individuals  to  gain  the  knowledge  and  tools  necessary  to  educate   oneself  on  achieving  health.    Thus,  according  to  Tissheama,  there  is  a  general  ignorance   surrounding  how  the  body  works,  what  it  requires  to  perform  at  its  best.  Independent  of   this  all-­‐important  knowledge  are  the  tools  –  access  to  nutritious  foods  and  resources,   education  –  needed  to  achieve  health.       The  loss  of  ethnomedical  knowledge  amongst  Black  Americans  can  be  attributed  in   part  to  the  existence  of  deep  structural  poverty.    As  noted  above,  during  the  Black   migration  from  the  North  to  the  South,  Black  Americans  had  limited  access  to  the  flora  and   fauna  which  formed  the  basis  of  their  ethnomedical  practices  in  the  South.  Though  this   knowledge  is  not  lost  entirely  due  to  the  continued  significance  ethnomedicine  holds  for   Black  communities  and  the  ways  in  which  Black  ethnomedicine  hybridized  with  other   healing  and  medical  practices  and  ideologies,  it  has  been  limited  to  small  number  of   individuals  who  have  either  retained  this  knowledge  via  family  and  generational  routes,  or   it  has  been  relearned  and  combined  with  other  healing  practices.  The  move  from  rural   areas  to  urban  environments  and  the  attendant  issues  of  structural  poverty  have  created   knowledge  deserts  in  pockets  of  the  Black  American  communities.  Largely,  these  pockets   have  been  filled  by  biomedicine.     65         Act,  Agency,  and  Agent:  The  Performance  of  Ethnomedicine   Acknowledging  the  summative  effects  of  these  social  inequities  on  the  lives  and   well-­‐beings  of  their  constituency,  Black  healers  act  in  ways  that  resist  the  effects  of   structural  realities  on  the  health  of  individuals  in  the  Black  community.  One  way  to  resist   this  reality  is  through  acts  of  remembering.  All  the  healers  strive  to  deliver  a  type  of  healing   that  draws  from  older  historical  healing  practices,  many  of  which  derive  from  Eastern   cultures  and  philosophies,  believing  that  valuable  knowledge  and  guidance  is  to  be  found.   Karla’s  Reiki  practices,  Kimberli’s  use  of  yoga,  Tissheama’s  herbalism,  and  Leppel’s  use  of   Sukyo  Mahikari  light  energy  healing  serve  as  concrete  examples  of  Black  healers’  use  of   healing  practices  not  necessarily  grounded  in  the  African  American  experience.  Equally   important  in  these  healers’  remembering  are  the  ways  these  healers  make  connections   between  Black  American  healing,  religion,  and  spirituality  and  the  different  cultural   practices  that  compose  their  healing  practice.  One  notable  example  of  this  is  Leppel’s   connecting  of  Sukyo  Mahikari  with  a  Black  American  tradition  of  ‘laying  on  of  hands’.  The   ‘laying  on  of  hands’  has  roots  in  the  Black  church  as  a  spiritual  and  religious  act  of,  firstly,   spiritual,  and  subsequently,  mental  and  physical  healing.    The  emphasis  on  the  order  in   which  wholistic  healing  can  take  place  is  reflected  in  Leppel’s  narrative  (see  pp  65-­‐66).     More  specifically,  using  the  hands  as  the  spiritual  conduit  and  touching  the  physical  body  in   order  to  heal  reflects  a  genealogical  performance  in  many  Black  American  communities.     The  act  of  laying  hands  on  another  with  the  intent  to  heal  is  known  without  verbal   explanation.  Healing  begins  with  this  gesture  and  becomes  known  to  the  healer  and  those   who  witness  the  healing  act;  healing  is  then  recreated  and  affirmed.       66     Kimberli  Boyd’s  performance  relies  on  what  she  terms  a  ‘movement  modality’.   Learning  to  use,  control,  appreciate,  and  experience  the  spiritual  through  the  body   constitutes  an  act  of  individual  and  community  healing.  According  to  Kimberli,  through   movement  of  the  body  and  the  cultivation  of  compassion  and  understanding  revolutionary   acts  occur  (pp  50  -­‐  52).  Like  Leppel,  Kimberli  notes  the  ways  in  which  movement  of  the   body  in  celebratory  and  healing  ways  is  characteristic  of  many  cultures.    While  her  use   yoga  is  not  what  one  would  think  of  as  a  Black  American  practice,  she  nonetheless  uses  it  to   address  issues  of  diversity  and  structural  poverty  within  Detroit  and  the  Black  community.   Admitting  that  her  practice  is  urban  and  relating  her  knowledge  and  beliefs  surrounding   events  in  the  Black  community  highlights  how  Kimberli  translates  her  practice  in  culturally   relevant  ways  to  achieve  healing.    Importantly,  Kimberli  connects  the  religious  aspects  of   yoga  with  those  of  Christianity  in  her  discussion  of  some  Black  Americans’  aversion  to  non-­‐ Christian  practices  and  beliefs  (see  pp  53).     While  an  important  aspect  of  Black  American  ethnomedical  practice,  the  healers   interviewed  connected  these  culturally  diverse  practices  with  those  of  Black  Americans.  All   interviewees  mentioned  an  older  Black  woman  as  being  influential  in  the  maturation  of   their  spirituality  and  healing  practices  and  philosophies.  Thus,  the  older  Black  woman  can   be  seen  as  a  keeper  of  ethnomedical  knowledge;  however,  this  theme  was  most   recognizable  in  Karla  and  Tissheama’s  interviews.  This  theme  is  significant  in  that  it   suggests  ethnomedical  knowledge  and  healing  practices  are  significantly  gendered.     According  to  Stephanie  Mitchem,  Black  women   have   found   ways   to   work   around   their   marginalized   status,   including   use   of   folk   knowledge  in  the  development  of  new  forms  of  folk  healing…Black  women’s  access     67     to   ideas   of   folk   healing   is   due   to   the   continued   existence   of   embodied   spirituality.     This  spirituality  may  be  nurtured  at  home  or  in  church.  African  American  women’s   embodied  spirituality  is  more  than  charismatic  expression.  Embodied  spirituality  is   grounded  in  a  different  perspective  of  the  human  person,  a  perspective  that  unifies   body   and   soul   within   the   life   of   the   past,   present,   and   future   community   in   conversation   with   an   ever-­‐present   God.     This   holistic   view   of   the   person   in   community   is   a   ready-­‐made   construct   for   development   of,   or   attachment   to,   folk   healing.   This   holistic   view   of   the   human   reflects   African   cognitive   orientations,   thereby   linking   black   people   across   the   African   Diaspora   with   religio-­‐cultural   patterns  from  the  African  continent.  (Mitchem,  85)   Black   ethnomedicine   in   Detroit   and   its   healers,   through   the   act   of   remembering,   make   the   presence   of   either   an   older   family   member,   the   history   of   their   particular   healing   medium,   or   religion   and   spirituality   central   to   their   healing   philosophy   and   practice.     All   healers  interviewed  realized  the  centrality  of  history  and  how  the  knowledge  they  acquired   of  healing  and  health  was  in  large  part  a  type  of  legacy  passed  to  them.     In  performing  their  respective  healing  practices  and  in  the  ways  they  articulate  their   explanatory  models  of  health  and  illness,  Black  healers  engage  in  an  embodied   remembering  opposing  the  loss  of  ethnomedical  knowledge.  The  above  concepts  are  easily   summarized  by  the  concept  of    ‘genealogies  of  performance’  (Madison  and  Hamera,  2005).     Moreover,  performance  scholar  Richard  Schechner  (2002)  uses  the  phrase  ‘restored   behavior’  to  describe  performances  as  containing  historical  continuity.  Victor  Turner’s   notion  of  liminal  and  liminoid  performances  as  well  as  the  concept  of  ‘mimesis’  in   performance  studies  allude  to  the  way  all  performances  use  the  traditional  to  create  the     68     new.    No  performance  or  performative  act  is  completely  new,  but  responds  to  the   sociopolitical  and  historical  context  in  which  it  occurs.  Knowledge  of  the  past  deemed   relevant  for  the  present  is  reinvented  through  its  use  in  present  situations.  The   performance  of  certain  behaviors,  beliefs,  and  cultural  practices  handed  down  through  the   generations  of  a  particular  cultural  practice  constitute  a  historical  continuity  and  lineage.   Similarities  between  Black  American  healing  practices  and  aspects  of  various  Eastern   healing  practices  and  philosophies,  steeped  in  traditional  knowledge,  are  established  and   applied  towards  the  goal  of  healing  contemporary  manifestations  of  illness  and  imbalance.   Generational  practices  expressed  through  behaviors  and  actions  reflect  larger  Black   American  spiritual  beliefs.         The  performing  of  memory  amongst  Black  healers  also  entails  a  type  of   hybridization.  The  melding  of  Black  American  ethnomedical  practices  with  other   traditional  healing  philosophies  and  practices  represents  a  process  of  hybridization  As   Stephanie  Mitchem  points  out  in  her  book  on  African  American  folk  medicine,   hybridization  has  been  a  salient  theme  of  Black  ethnomedicine  since  the  arrival  of  African   slaves.    This  hybridization  has  occurred  amongst  Europeans  and  Native  Americans  and   served  as  a  key  way  in  which  African  elements  were  retained  and  reinvented.    In  his   examination  of  the  African-­‐Portuguese  world,  James  Sweet  (2003)  charts  the  influxes  of   various  African  ethnicities  that  arrived  in  what  is  today  knows  as  Brazil  during  the   Portuguese  slave  trade.  Key  to  Sweet’s  analysis  is  the  way  he  divides  the  African  continent   into  four  distinct  regions  in  which,  he  argues,  there  exists  shared  linguistic  and  cultural   understandings  (Sweet  2003).  During  various  periods,  African  slaves  arrived  from  different   regions  to  the  ‘New  World’;  however,  despite  the  arrival  to  the  Western  Hemisphere  of  a     69     number  of  African  cosmologies  and  ideologies,  the  shared  linguistic  and  cultural   understandings  outlined  by  Sweet  were  sustained  throughout  the  slave  trade  creating   communities  in  which  a  cohesive  African  based  worldview  thrived.  Conceptualizations  of   health  and  healing,  intimately  tied  to  religion  and  spirituality,  were  maintained  to  a  certain   degree  and  practiced  in  various  slave  communities.  Similarly,  in  the  United  States,  different   regions  witnessed  the  forced  migration  of  enslaved  Africans  from  various  African  regions.   Jeffrey  Anderson’s  (2008)  text  Hoodoo,  Voodoo,  and  Conjure:  A  Handbook  looks  at  the   formation  of  hoodoo  in  the  in  the  Southeastern  United  States  and  Voodoo  in  Louisiana   specifically.  Though  differing  in  terms  of  the  African  regions  that  form  their  base,  these   African  derived  religions  nonetheless  maintained  key,  shared  characteristics  amongst  each   other.       Certain  African-­‐based  cosmologies  and  ideologies  surrounding  healing  and  health   have  survived  migration  and  the  slave  trade,  however  their  ability  to  remain  relevant  and   useful  amidst  social,  historical,  and  cultural  changes  and  upheavals  greatly  depended  on  a   process  of  hybridization  and  syncretism.    Newly  arrived  African  slaves  were  forced  to   acclimate  to  a  new  social  and  environmental  landscape.    This  landscape  differed   significantly  from  the  various  African  flora  and  fauna  which  constituted  key  elements  of   religious  and  healing  ceremonies.    Native  American  knowledge  of  the  landscape  and  the   inevitable  influence  of  Europeans  shaped  Black  American  ethnomedical  practices  (Covey   2008).    Enslaved  Africans  carried  with  them  knowledge  of  traditional  health  care  traditions   from  their  respective  ethnic  orientations  and  incorporated  them  with  knowledge  of  North   American  flora  and  fauna  provided  by  various  indigenous  groups.  Syncretism  of  healing   and  health  knowledge  occurred  between  enslaved  Africans,  Native  Americans,  and     70     Europeans  with  a  context  of  systemic  racism,  sexism,  domination  and  imperialism.    Even   so,  Fett  (2002)  points  out  that  enslaved  Africans  not  only  in  North  America,  but  throughout   the  Diaspora  maintain  distinctively  African-­‐centered  healing  and  health  practices  which  are   inseparable  from  their  religious  practices  and  beliefs  (Fett,  2002).  These  ‘cultures  of   healing’  ranged  throughout  the  Diaspora  from  “Haitian  Vodou  to  Brazilian  Candomble  to   North  American  hoodoo,  Black  Atlantic  religions  of  healing,  still  thriving  today,  reflect  their   particular  place  within  the  history  of  enslavement  and  forced  migration.  African  American   healing  traditions,  while  deeply  embedded  in  the  regional  history  of  the  American  South,   must  also  be  understood  in  this  context  of  the  African  diaspora”  (Fett,  3).     During  the  1950s  and  1960s  as  Black  Americans  left  the  South  in  search  of  better   economic  and  social  opportunities  in  the  North,  ethnomedical  practices  again  shifted  and   changed  with  the  social  and  political  climate.    Yet,  importantly,  the  reality  of  hybridization   does  not  therefore  negate  the  existence  and  endurance  of  African  based  cosmologies  and   ideologies  of  health  and  healing.  Rather,  hybridization  “helps  explain  the  adaptability  of   African  American  folk  healing.  Adaptability  is  another  reason  the  practices  have  survived.   In  the  new  urban  environments,  practices  changed.  The  plant  life  was  different  and  the   ability  to  get  herbs  and  roots  was  not  what  it  had  been  in  the  South.  No  longer  could  people   walk  in  the  yard  to  find  the  plant  life  needed  for  certain  cures  and  fixes.  Pharmacists   became  new  suppliers  of  roots  and  herbals”  (Mitchem,  70).    Biomedical  practice  came  to   dominate  the  medical  landscape  in  the  United  States.  This  is  consistent  with  Tissheama’s   observations  that  biomedicine  bombarded  the  health  framework  of  many  African   Americans.       71     Another  key  element  arising  throughout  the  interviews  the  role  of  the  mind,  body,   and  spirit  and  how  these  four  elements  make  healing  possible.  Karla  argues  that  healing   can  only  happen  when  mind,  body,  and  spirit  are  addressed  and  refers  to  the  ‘blueprint’  of   the  person  as  being  the  site  where  healing  must  occur.  This  blueprint  to  which  Karla  refers   is  the  spirit.  It  is  the  basis  of  being  from  which  healing  must  occur  in  order  for  the  other   facets  of  being  –  mind  and  body  –  to  be  able  to  function  optimally.  Kimberli  also  seeks  to   heal  holistically  by  taking  into  account  mind,  body,  and  spirit.  Through  what  she  terms   ‘movement  modalities’  Kimberli  addresses  health,  illness,  and  well-­‐being.  Interestingly,   however,  is  the  way  Kimberli  frames  how  she  addresses  healing.  From  her  narrative,  the   body  and  movement  of  the  body  becomes  the  gateway  through  which  she  accesses  the   spirit  and  the  mind.    This  is  not  unusual  given  Kimberli’s  explanation  that  celebratory  and   spiritual  movement  of  the  body  is  quite  common  to  various  cultures  around  the  world.       Though  Tissheama’s  healing  work  focuses  heavily  on  herbs,  she  recognizes  the  ways   in  which  spirit  and  mind  factor  prominently  into  health  and  illness.    From  her   consultations,  in  which  she  spends  a  considerable  amount  of  time  speaking  and   communing  with  clients,  to  her  belief  in  the  spiritual  being  of  herbs  and  plants,  Tissheama   acknowledges  the  deep  connection  between  mind,  body,  and  spirit.  Leppel  Payne  also   acknowledges  this  connection.  While  his  practice  privileges  the  spirit  as  the  focus  of   healing,  when  healing  does  occur  within  the  spirit  it  can  manifest  itself  physically  as   evidenced  by  the  woman  experiencing  pain  in  her  shoulder  and  finding  relieve  after   receiving  light  from  Leppel.     The  above  examples  illustrate  the  varying  ways  these  healers  conceptualize  the   connection  between  mind,  body,  and  spirit  and  how  this  connection  enables  them  to     72     carrying  out  healing  activities  both  effective  and  culturally  relevant  for  their  patients  and   clients.  Many  Black  Americans  acknowledge  the  existence  of  mind,  body,  and  spirit  because   in  many  ways  it  connects  with  the  Christian  concept  of  the  Holy  Trinity;  however,  as  many   healers  above  have  mentioned,  this  concept  does  not  necessarily  translate  to  one’s   individual  health.    Part  of  their  healing  work  is  to  address  this  disconnect  and  make   patients  aware  of  this  connection  and  its  vital  role  in  combating  illness  and  maintaining  a   sense  of  health  and  well-­‐being.     Because  performances  are  done  in  the  presence  of  others,  the  spectator  nature  of   performances  directs  attention  to  the  fact  that  a  key  element  of  the  performance  of  healing   is  the  dependence  on  the  audience,  or,  as  I  argue,  the  community.  Community  remains  a   key  role  in  the  ethnomedical  practices  of  many  Black  Americans;  while  many  interviewees   maintained  the  importance  of  the  mind,  body,  and  spirit  in  terms  of  each  individual’s   health,  their  framing  nonetheless  occurred  within  a  larger  narrative  of  the  centrality  of   community  in  individual  healing  and  their  commitment  to  the  improvement  of  community   health.  Those  community  members  who  witness  gestures  and  behaviors  emblematic  of   varying  aspects  of  Black  American  culture  –  style,  affect,  spirituality,  religious  – acknowledge  these  practices.    Karla  Mitchell  and  Tissheama  Pizzimenti  have  strategically   placed  themselves  in  certain  communities  they  perceive  as  having  the  most  need  of  their   healing.  Community  members  validate,  in  part,  Tissheama  and  Karla’s  healing  practices  by   seeking  their  services.     In  their  attempt  to  educate  the  Black  community  about  the  importance  of  the  mind,   body,  spirit  connection  and  by  their  active  participation  in  this  community  demonstrates   the  central  role  community  plays  within  this  healing  trinity  of  mind,  body,  and  spirit;     73     Community  composes  an  often  glossed  over  fourth  aspect.  Community  as  a  foundational   aspect  of  Black  American  healing  and  ethnomedical  practice  can  be  traced  to  parts  of   continental  Africa.  The  idea  of  an  individual  existing  as  a  being  separate  from  society  and   interpersonal  relationships  was  largely  a  foreign  concept  (Mitchem  2007).    The  individual   was  thought  to  be  a  composite  of  relationships  extending  from  those  still  living  to  those   ancestors  that  had  passed  on  into  the  next  life.  Moreover,  in  contrast  with  much  of   contemporary  biomedical  practice  healing  was  not  centered  on  the  physical  body  but   considered  an  activity  that  was  only  successful  when  viewed  as  a  holistic  activity   addressing  the  multiple  aspects  of  the  human  being.  As  healing  was  an  activity  that   addressed  the  spirit,  it  could  not  be  accomplished  in  separation  from  religion  or   spirituality;  religion  and  spirituality  were  communal  affairs.  Hence,  without  community   and  the  awareness  that  interpersonal  relationships  formed  the  individual,  healing  could   not  take  place.    These  ideas  and  practices  are  present  in  many  areas  of  the  Black   community,  most  notably,  the  Black  church.  The  Black  church  has  historically  served  as  the   nexus  of  the  Black  community  wherein  Black  nurses  practiced  primarily  spiritual  healing   and  the  Black  community  as  a  whole  found  solace  from  larger  social  ills  and  a  vehicle   through  which  to  organize  and  address  these  systemic  issues.       Black  Ethnomedicine  and  Biomedicine     In  her  work  on  the  diagnoses  and  pharmaceutical  management  of  common  chronic   illness,  Linda  Hunt  (2012)  notes  that  prescription  drug  spending  in  the  United  States  is  six   times  greater  than  in  the  1990s.  She  notes,  “45%  of  Americans  have  a  least  1  diagnosed   chronic  condition,  and  60%  of  the  most  prescribed  medications  were  for  hypertension,   high  cholesterol  levels,  and  diabetes”  (Hunt,  452).    Moreover,  adverse  side  effects  from     74     pharmaceuticals  tripled  between  1995  and  2005  and  are  the  fourth  leading  cause  of  death   in  the  United  States  (Hunt  2012).  Hunt’s  article  gets  at  the  heart  of  these  alarming  statistics   considering  the  factors  that  undergird  these  issues  as  well  as  how  these  developments   manifest  themselves  in  the  management  of  common  chronic  illness  in  biomedical   institutions,  specifically,  primary  care.    The  diagnostic  threshold  which  determine  a  healthy   person  from  a  person  who  has,  or  is  at  risk  for,  hypertension,  high  cholesterol,  and  diabetes   has  been  lowered.  Thus,  those  individuals  that  were  once  considered  healthy  and  not  at   risk  for  the  illnesses  listed  above,  now  are  pegged  as  needing  care  and  biomedical   intervention.  This  is  exacerbated  by  the  growth  of  programs  within  clinical  care  rewarding   physician’s  performance  when  their  diagnoses  are  in  line  with  standard  quality  measures.   Hunt  argues  that  a  substantial  number  of  “insurance  companies  assess  individual  clinicians   on  the  basis  of  whether  their  patients  meet  these  standards,  often  paying  substantial   bonuses  that  encourage  clinicians  to  respond  to  marginal  test  results  with  aggressive  use  of   pharmaceuticals”  (Hunt,  453).    These  clinicians  often  interact  with  pharmaceutical   representatives  on  a  weekly  basis  and  received  incentives  such  as  bonuses,  free  samples,   and  lunches  for  their  compliance  and  participation.    Hunt  found  that  many  clinicians  did   not  questions  the  aggressive  use  of  pharmaceuticals  to  obtain  desired  numbers.  Moreover,   there  is  no  consensus  on  whether  or  not  the  use  of  multiple  pharmaceuticals  to  address  an   illness  results  in  improved  outcomes  (Hunt  2012).     Without  undermining  the  desire  of  many  biomedical  professionals  to  practice   medicine  in  a  way  that  is  patient-­‐centered,  the  current  state  of  affairs  with  biomedical   institutions,  practitioners,  and  patients  is  cause  for  alarm.  The  desire  for  increased  profit   and  the  perpetuation  of  pharmaceutical  companies  engenders  neither  a  patient-­‐centered     75     clinical  experience  nor  a  context  of  trust.  Biomedical  professionals  with  the  best  of   intentions  and  desires  enter  dangerous  territory  where  health,  healing,  and  well-­‐being  are   commodities  to  be  exploited  and  exchanged.     Mary-­‐Jo  Delvecchio  Good’s  (1995)  analysis  of  the  global-­‐local  dynamic  within  what   she  terms  ‘clinical  narratives’  between  patients  and  healthcare  professionals  are  influenced   by  the  dynamic  between  local  medical  cultures  and  the  political  economy,  global  standards,   and  technologies  of  biomedicine.    Good,  then,  suggests  a  multiplicity  of  biomedicines   operating  in  a  single  medical  encounter  between  a  medical  professional  and  a  patient.   However,  Good  also  notes  the  ways  in  which  the  concept  of  ‘local’  can  itself  be  a  loaded   concept.  Reflecting  on  her  experience  amongst  public  health  professionals  from  European   institutions,  such  as  WHO  and  the  United  States,  and  those  from  less  wealth  countries,  Good   reflected  on  the  ways  wealthier  nations  determined  the  scientific  trajectory  of  the  research   –  from  what  questions  to  ask,  methodologies,  and  the  type  of  science  to  use  (Good,  1995).   Transnational  flows  of  capital  between  biomedical  and  pharmaceutical  corporations   sponsoring  biomedical  research  between  select  wealthy  nations  determines  the  route   biomedical  research  will  take  as  well  as  the  premises  upon  which  it  will  be  built.    Good’s   findings  led  her  to  critique  the  breakdown  in  biomedical  professionalism  -­‐  competence,   trustworthiness,  and  responsibility  towards  patients.   If  biomedicine  is  indeed  characterized  in  part  by  larger  global  inequities  based  on   geographic  location,  it  is  reasonable  to  assume  that  local  aspects  of  biomedicine  will  reflect   this  larger  tendency;  these  same  dynamics  can  and  do  occur  within  biomedicine  in  the   United  States.    Furthermore,  the  political  and  social  dynamics  at  play  on  a  global  scale   between  nations  does  not  exclude  cultural  premises.    The  historic  relations  between  what     76     are  currently  labeled  first  world  and  third  world  nations  were  undoubtedly  premised  upon   a  relationship  characterized  by  an  imbalance  of  power  fueled  in  large  part  by  European   White  supremacy.     Biomedicine  is  a  cultural  system  in  which  illness,  healing,  and  health  are  culturally   constructed.  According  to  Arthur  Kleinman  (1978)  health  care  systems  occur  within  three   social  arenas:  popular,  professional,  and  folk.  Sickness  is  primarily  managed  in  the  popular   realm  wherein  seeking  aid,  decisions  on  who  to  consult,  compliance,  and  efficacy  of   treatment  occur.  It  then  would  seem  odd  that  biomedical  institutions  and  practitioners   would  either  denigrate  the  interpretive  frameworks  occurring  within  the  popular  realm   and/or  disregard  outright  its  significance.  Ultimately  this  disregard  stems  from  the  idea   that  clinical  practice,  and  more  generally  biomedicine,  is  a  scientific  endeavor  that  is   objective  and  generalized.  As  with  many  professions  seeking  a  level  of  credibility  and   authority,  claims  to  science  often  provide  validation  due  to  the  widely  held  perception  that   science  is  an  objective  and  rational  process  primarily  translated  through  the  use  of   numbers.    Not  unlike  contemporary  calls  for  colorblind  ideology,  an  objective  and  rational   science  undergirds  biomedical  impulses  to  claim  homogeneity  amongst  a  diverse  patient   constituency.    Arguable,  then,  biomedicine  reflects  larger  sociocultural  inclinations  to   flatten  diversity  in  the  name  of  management  and  understandability.  Thus,  biomedicine   clashes  with  other  interpretative  frameworks  of  health  such  that  “certain  obstacles  to   effective  health  care,  such  as  major  discrepancies  between  the  therapeutic  goals  of   practitioners  and  patients,  are  built  into  the  workings  of  the  health  care  systems…”   (Kleinman,  1978).       77     Encounters  with  and  beliefs  about  biomedicine  are  central  to  the  narratives  of  Black   healers  in  this  thesis  and  influence  their  healing  philosophies  and  the  way  they  perform   their  healing.  In  any  endeavor  to  deliver  care  to  communities  that  do  not  have  dominant   group  status,  here  specifically  with  regards  to  Black  Americans,  understanding  the  ‘ways  of   knowing  and  being’  by  which  some  Black  Americans  conceptualize  and  assess  health,   healing,  and  illness  is  paramount  to  any  biomedical  institution  or  practitioner  wishing  to   deliver  the  utmost  in  quality  healthcare  (Kirmayer,  2012).     Taking  into  account  such  explanatory  models  that  often  diverge  from  biomedical   explanations  can  greatly  improve  the  quality  of  healthcare  delivered.    For  example,   acknowledging  the  social  determinants  of  illness  and  health  of  Black  Americans  encourages   not  only  open  dialogue  and  increased  medical  compliance,  but  also  sheds  light  on  aspects  of   culture  (habits  and  practices)  that  influence  overall  health.  Moreover,  much  of  a  person’s   culture  identity  “resides  in  patterns  of  interaction  that  depend  on  families,  groups,   communities,  and  institutions  including  those  of  global  society.  Culture,  therefore,  must  be   viewed  as  fluid,  situated  and  negotiable  intersubjective  systems  of  meaning  and  practice   relevant  to  specific  social  contexts”  (Kirmayer,  252).    Viewed  as  a  constantly  fluctuating  yet   firmly  grounded  phenomenon,  culture  consists  of  various  understandings  of  symptoms,   health,  and  illness  based  on  larger  moral  and  value  systems.    Understanding  these   complexities  necessitates  an  understanding  of  not  only  the  specific  cultural  background  but   also  the  larger  sociohistorical  and  sociopolitical  context  in  which  it  operates.       Currently,  clinical  knowledge  and  practice  in  biomedicine  are  based  on  a  narrow   and  normalized  population  (i.e.  middle-­‐class,  white,  educated)  and  generalized  to  fit   diverse  populations  creating  skewed  and  at  time  spurious  findings.  This  fact  has  led  some     78     towards  a  person-­‐centered  care  practice  in  which  patients  with  their  understandings  of   health  and  illness  become  the  focus  (Kirmayer,  2012).  This  move  towards  person-­‐centered   clinical  practice  affirms  the  existence  of  culturally  diverse  interpretive  frameworks  with   their  own  ideas  of  authority,  knowledge  with  regards  to  health,  and  how  knowledge  can  be   acquired  and  known.    These  interpretive  frameworks  encompass  ideas  of  health  and   healing  which  in  some  cases  are  “important  expressions  of  traditional  forms  of  spirituality,   social  organization  and  worldview.  Traditional  systems  of  healing  were  grounded  in  a   specific  cultural  ontology…the  loss,  disruption  or  displacement  of  traditional  healing   practices  went  hand-­‐in-­‐hand  with  the  undermining  of  worldviews  and  the  destruction  of  a   way  of  life.    Revitalizing  culture  and  community  then  can  be  achieved  in  part  by  reinstating,   strengthening  and  investing  in  culturally  grounded  healing  practices”  (Kirmayer,  253).       Importantly,  the  interpretive  framework  in  which  these  conceptions  of  health  and   healing  occur  may  not  place  a  high  value  on  text  as  a  means  of  social  communication.  Betty-­‐ Anne  Daviss’  argues  that  players  within  the  health  care  system  operate  on  a  system  of   varying  logics  (scientific,  clinical,  personal,  cultural,  intuitive,  political,  legal,  and  economic)   and  assume  that  these  logics  are  then  logical.  Accordingly,  “different  types  of  people  using   different  systems  of  logic  will  arrive  at  differing  perceptions  of  how  to  manage  birth”   (Daviss,  443).    Interestingly  Daviss  notes  how  some  Inuit  viewed  “the  white  need  for   hierarchical  power  structures  as  immature”  (Davis  447).  Within  these  hierarchical  power   structures  a  type  of  knowledge  becomes  authoritative  in  that  it  possesses  the  ability  to   promote  and  perpetuate  itself  and  subdue,  objectify,  and  devalue  other  forms  of  knowledge   that  exist  outside  of  it  and  its  concomitant  institutions.    One  of  the  most  central  aspects  of   this  piece  is  the  author’s  admittance  to  practicing  midwifery  without  official  recognition     79     from  a  government.  Undoubtedly,  this  recognition  would  have  manifested  in  the  form  of   certification,  a  paper  document  asked  for  by  those  wanting  verification  of  skill  and   knowledge  and  submitted  for  the  very  same  reasons.  This  example  clearly  demonstrates   the  reliance  on  text  within  Western  medical  and  biomedical  institutions  and  frameworks.   Simply  stated,  text  validates  knowledge.     Thus,  knowledge  about  health  and  healing  may  not  be  readily  known  to  biomedical   professionals  and  those  existing  outside  of  the  cultural  community.  The  ways  in  which   knowledge  is  known,  transmitted,  and  put  into  practice  may  differ  significantly  from  what   much  of  Western  society  is  accustomed  to.  While  many  may  argue  that  such  an  interpretive   framework  diminishes  the  likelihood  that  knowledge  can  be  preserved  over  a  long  period   of  time  and  utilized,  it  is  important  to  remember  that  within  our  current  biomedical  system   based  heavily  on  text  and  textuality,  there  are  numerous  instances  in  which  not  all  research   is  valued  the  same  and  receives  less  attention  and  decreased  chances  of  dissemination.     The  significance  of  ethnomedical  practitioners  in  Detroit  is  in  part  seen  by  their   narratives  about  biomedicine.  Tissheama’s  first  comment  when  beginning  the  interview   stated  she  believed  conventional  medicine,  or  biomedicine,  was  killing  people.    Later  in  her   interview  she  remembers  visiting  a  hospital  and  realizing  that  biomedicine  was  not  really   helping  people  in  crucial  ways;  nonetheless,  Tissheama  does  realize  the  importance  and   place  of  biomedicine  in  the  lives  of  all  people.    “You  know,  and  I’m  not  going  to  sit  here  and   say  that  I  don’t  believe  in  conventional  medicine,  because  that  would  not  be  the  truth.   There  is  a  place  for  all  forms  of  healing.  If  I  go  out  on  Woodward  and  get  hit,  don’t  put  no   herbs  on  me.  You  better  call  the  ambulance!”  Within  Tissheama’s  explanatory  model,  all   forms  of  healing  have  a  place.    Significantly,  Kimberli’s  explanatory  model  melds     80     ethnomedical  explanations  and  views  with  biomedical  and  scientific  explanations.    These   two  healers  see  the  value  in  biomedicine,  but  realize  biomedical  hegemony  occludes  the   benefits  of  ethnomedicine  practices  and  erases  the  very  possibility  that  other  forms  of   healing  exist  outside  of  a  biomedical  understanding.     Though  Karla  and  Leppel’s  narratives  do  not  speak  of  biomedicine  in  a  similar   manner  as  Kimberli  and  Tissheama,  their  narratives  nonetheless  correlate  by  highlighting   the  belief  in  the  inability  of  biomedicine  to  provide  a  key  aspect  of  health  –  emotional   accessibility  and  healing.  Historically,  Black  American  ethnomedical  practices  encompassed   divination  and  conjuring  as  key  aspects  of  healing  (Chireau,  2003).    In  some  examinations   of  these  ethnomedical  practices,  healing,  divination,  and  conjuring  more  generally  are   viewed  as  magic  in  nature.  Yet,  a  strong  spiritual  and  religious  basis  often  accompanies   these  practices.  These  aspects  can  be  described  as  addressing  the  psychosomatic  aspects  of   health  and  well-­‐being  with  relevance  to  the  Black  American  community.  These  historical   aspects  of  Black  American  ethnomedical  practices  have  continued  to  the  present  day  and   lead  many  interviewees  to  argue  for  the  continued  use  of  alternative  medicine.    In  contrast,   biomedicine  often  derides  emotional  aspects  of  health  and  healing  in  favor  of  a  strict  focus   on  the  physical  manifestations  of  illness.     Purpose:  Significance  of  ethnomedical  practitioners       Black  healers  in  Detroit  perform  healing  in  a  way  that  honors  Black  American   ethnomedical  traditions  as  well  as  the  traditional  healing  practices  of  other  cultures.   Gaining  this  knowledge  and  imparting  it  amongst  community  members  both  so  the   community  can  learn  and  heal  can  be  viewed  as  a  performance  of  embodied  remembering.   Through  this  remembering,  Black  healers  ensure  that  cultural  knowledge  around  healing  is     81     kept  alive  and  relevant  to  those  they  serve.  Importantly,  the  healers  profiled  in  this  thesis   are  aware  of  larger  structural  and  social  realities  adversely  effecting  Black  health.    Their   knowledge  of  these  issues  compels  them  to  become  active  in  the  community  and   communities  they  inhabit.    A  lack  of  understanding  of  these  social  inequities  would  surely   limit  their  ability  to  perform  healing  or  limit  the  human  connection  between  healer  and   healed  which,  as  I  argue,  forms  a  crucial  aspect  of  healing.       Thus,  through  the  act  of  healing,  Black  healers  embody  knowledge  of  both  healing   and  society  implying  an  intellectualism  often  ignored  because  it  exists  outside  of   biomedical  institutions  and  conceptions  of  health  and  illness.  While  their  performances  of   healing  contain  knowledge  and  awareness  of  larger  social  issues,  when  presented  with   people  who  seek  their  healing  they  remain  cognizant  of  the  individualized  nature  of   healing.    This  fact  is  important  in  that  it  demonstrates  the  many  levels  of  knowledge  and   awareness  operating  simultaneously  in  any  given  healing  encounter.    Healers  must  fine-­‐ tune  their  practices  and  knowledge  to  the  particular  situation  at  hand.       Moreover,  as  stated  by  Kimberli,  these  healing  acts  and  performances  are  politically   revolutionary  because  they  address  the  effects  of  social  inequality  by  providing  people  the   tools  to  heal  themselves  without  reliance  on  either  biomedicine  or  the  healer.    Through   their  healing  practice,  Black  healers  provide  people  the  tools  to  be  self-­‐sufficient  in   maintaining  health  through  preventative  measures  and  also  addressing  illness  at  multiple   levels  (i.e.  mind,  body,  spirit).    By  unearthing,  embodying,  and  imparting  a  memory  of   wholistic  healing  to  their  communities,  Black  healers  subvert  hegemonic  biomedical  claims   to  universal  knowledge  of  health  and  illness.    Furthermore,  Black  healers  resist  the   erroneous  assumption  that  optimal  health  is  only  to  be  found  within  biomedicine.         82         Chapter  4   Summary  and  Conclusion   The  objective  of  this  thesis  was  the  examination  and  exploration  of  contemporary   Black  American  ethnomedical  practices.  Central  questions  within  this  examination  were   how  do  Black  ethnomedical  practices  occur  within  a  larger  sociopolitical  context  and  how   do  these  ethnomedical  practices  constitute  alternative  forms  of  political  and  intellectual   knowledge?  Ethnographic  interviews  with  four  Black  healers  in  the  Detroit  area  were   conducted  to  give  their  voice  prominence  within  this  thesis.    I  utilized  Performance  Theory   as  a  theoretical  framework  emphasizing  embodied  knowledge  and  the  social  and  political   implications  behind  our  actions  and  everyday  realities.  Schechner’s  concept  of  ‘restored   behavior’  allows  me  to  draw  important  connections  between  Black  ethnomedical  practices   both  historically  and  politically  (Cite)     The  review  of  literature  first  examines  Black  American  health  and  healing  in  the   early  years  of  the  United  States  during  slavery.  The  mortality  rate  of  both  adult  slaves  and   infants  were  extraordinarily  high.  Lack  of  access  to  clean  water,  inadequate  housing,   grueling  work  conditions,  and  lack  of  nutrient  rich  foods  made  slaves  much  more   susceptible  to  diseases  such  as  cholera,  yaws  and  pneumonia  than  whites.    Though  some   whites  attempted  to  treat  slaves  using  white  doctors,  the  prevailing  belief  that  Blacks  were   fundamentally  different  from  whites  physically,  culturally,  and  spiritually  lead  many  white   physicians  to  erroneously  infer  the  existence  of  distinct,  Black  diseases  and  illness.   Unsurprisingly,  these  illnesses  and  diseases  attributed  to  enslaved  Black  Americans   mirrored  the  larger  U.S.  sociopolitical  landscape  and  often  served  to  perpetuate  the  system   and  ideology  of  slavery.         83     While  the  Black  American  ethnomedical  practices  manifested  within  the  crucible  of   enslavement  wherein  Black  people  served  as  free  labor,  Black  American  conceptions  of   health,  illness  and  healing  constitute  existed.  The  distinct  African  elements  of  these   ethnomedical  practices  and  can  be  viewed  as  continuations  of  an  African  worldview.   Healing  practices  such  as  conjure,  hoodoo,  and  voodoo  can  be  linked  to  Central  and  West   African  religions  and  healing  practices.  The  hybridization  with  European  and  Native   American  conceptions  of  health  and  healing  is  significant.  As  North  American  biodiversity   was  largely  foreign  to  both  Africans  and  Europeans,  knowledge  of  the  flora  and  fauna  in   various  regions  of  the  U.S.  undoubtedly  came  from  Native  American  indigenous  knowledge.       Largely  determined  by  racist  ideology,  the  medicalization  of  Black  bodies  occurred   during  a  time  when  forced  human  labor  was  the  linchpin  of  U.S.  economic  development  and   sustainability.  Biomedicine,  then,  similarly  developed  within  this  context.  The  rise  of   scientific  thought,  characterized  by  the  scientific  method  and  an  insistence  upon  objective,   rational,  and  material  results,  rejected  previous  beliefs  in  the  connection  between  morals,   spirituality,  religion  and  medicine.  Moreover,  biomedicine’s  experimentation  and   exploitation  of  Black  Americans  placed  biomedicine  in  stark  contrast  to  the  ethnomedical   practices  of  Black  Americans.    Characteristic  of  the  contrary  and  illogical  nature  of  racism,   Black  Americans  were  simultaneously  barred  from  biomedical  care  and  practice  while   serving  as  experimental  subjects  in  the  name  of  biomedical  advancement.    Thus  healing   practices  amongst  Black  Americans  often  served  as  the  first  line  of  curative  and   preventative  care.     My  examination  of  these  practices  is  guided  by  a  key  question:  how  does  Black   ethnomedicine  constitute  a  form  of  knowledge  that  is  both  intellectual  and  political?    Key     84     texts  relevant  to  my  analysis  of  Black  ethnomedical  practices  are  Dwight  Conquergood’s   (2002)  essay  Performance  Studies:  Interventions  and  Radical  Research,  Paul  Gilroy’s  (2003)   essay  Jewels  Brought  From  Bondage:  Black  Music  and  The  Politics  of  Authenticity  and   Anthony  Bogues  (2003)  Black  Heretics  and  Black  Prophets.  Both  Gilroy  and  Bogues’  texts   examine  the  ways  political  and  intellectual  knowledge  production  occur  within  Black   communities.  For  Gilroy,  Black  music  was  an  important  vehicle  entailing  sociopolitical   knowledge  and  producing  critique  of  dominant  and  normative  structures.  Similarly,   Bogues’  examination  of  Black  political  activists  and  critics  characterizes  the  action  and   works  of  Black  activists  whose  political  critiques  derive  from  spirituality  and  religion  as   part  of  the  redemptive  prophetic  tradition  (Bogues,  2003).    These  two  works  parallel   Dwight  Conquergood’s  work  in  which  he  argues  against  the  tendency  of  normative,   Western  institutions’  inclination  to  erase  other  ways  of  knowing  and  communicating  that   do  not  hold  text  to  be  the  sole  legitimate  way  for  knowledge  to  be  known.     A  key  theme  identified  throughout  all  the  interviews  is  the  emphasis  on  the  mind,   body,  spirit  connection  and  health.  For  these  healers,  wholistic  healing  occurs  at  these   three  levels.    Similarly,  the  root  of  some  illnesses  can  occur  in  one  of  the  three  aspects  and   cause  dysfunction  in  the  others.  Communicating  this  understanding  of  health  and  healing  to   those  within  their  communities  is  understood  as  a  necessary  requirement  of  their  roles  as   healers.    Thus,  I  argue  that  community  and/or  social  responsibility  constitutes  a  fourth   aspect  to  healing  in  addition  to  the  three  previously  discussed.  Beyond  giving  their   community  the  tools  necessary  to  heal  themselves,  Black  healers  recognize  that  social  or   community  dysfunction  can  manifest  within  individuals  and  cause  illness.       85       Black  healers  identified  structural  inequality  as  a  major  detriment  to  Black   American  health.    Healers  mentioned  racism,  drugs,  inadequate  or  lack  of  access  to  nutrient   rich  foods,  poverty,  inadequate  educational  resources,  and  some  cultural  traditions  as   having  a  negative  impact  on  the  health  of  both  Black  individuals  and  the  community.    In  an   effort  to  mitigate  the  effects  of  structural  poverty  and  inequality  some  healers  have   strategically  placed  themselves  in  Black  communities  where  they  feel  their  knowledge  and   practices  can  have  the  most  impact.       All  of  the  Black  healers  in  this  thesis  see  their  call  to  healing  and  the  practice  itself  as   innate  and  natural.  While  all  were  trained  in  their  respective  healing  practices,  the   knowledge  of  how  to  proceed  about  the  act  of  healing  and  of  how  to  heal  was  described  as  a   form  of  internal  knowing.  Thus,  these  Black  healers  complicate  current  beliefs  and  ideas   about  knowledge  –  how  it  is  known,  created,  and  transmitted.  The  innate  and  natural   quality  of  their  knowledge  diverges  from  predominantly  Western  and  European  ideas  of   knowledge.  Authoritative  knowledge  exists  within  biomedicine  and  legitimizes  itself  while   denigrating  and  in  some  cases  erasing  the  healing  knowledge  of  other  groups.                                     86                                             REFERENCES       87       REFERENCES       Anderson, J. 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