Does “Reasonable” = Racist?

What can anthropology contribute to the critical conversation about race in America, following the welcome jury decision in the Derek Chauvin trial?

After they amassed and presented a week’s worth of technical details–medical, anatomical, temporal, legal–in the end, the prosecuting attorneys’ case against Derek Chauvin rested on a simple claim: A “reasonable” police officer would have removed his knee from George Floyd’s neck well before the excruciating 8 minutes and 46 seconds it took to kill him.


Miraculously, a jury of 12 peers unanimously agreed with that argument.

Every Black American (and probably every U.S. historian) knows how unlikely that verdict was. Indeed, on average, only one or two killings of a civilian out of a hundred by a police officer even goes to trial in the U.S. Why? Because, at base, the general assumption goes that a “reasonable” police officer would have acted the same way, given the challenging circumstances, so there’s no need to put him (or her) on trial.

And, until now, that argument–both its racist assumptions, and its racist implications–won out.

But what does it mean to invoke the “reasonable man [or woman]” as a model for a jury’s decision?

Back in 1955, the eminent social anthropologist, Max Gluckman, pointed out that the notion of the “reasonable man”–which lies beneath all Anglo-Saxon as well as many other systems of jurisprudence–is, at base, founded on cultural values.

He didn’t put it in quite that way. In analyzing the legal system of the Barotse or Lozi people of Zambia, he wrote:

“as Barotse judges define the reasonable man, they bring into their definitions many facets of Barotse life which are not ostensibly part of the law. These facets include a variety of social and personal prejudices. I believe the same process can be detected in the decisions of our own judges and juries.”

From: Max Gluckman, “The Reasonable Man in Barotse Law,” in Order and Rebellion in Tribal Africa (New York: Free Press, 1963)

Those “prejudices”–which we might as well consider equivalent to “values”–dictate what members of particular societies consider what is, and is not, “reasonable.” Like most cultural values, these cultural models are neither universal nor unchanging.

Before the Derek Chauvin verdict, police departments across the U.S. judged it “reasonable” for 98-99 police officers out of 100 (likely, a white officer) to kill a civilian ( likely, a Black civilian), because of the particular context. Even in the rare cases that police officers killing civilians are formally charged, it is unlikely that the trial will result in a conviction–and, especially, a conviction of murder.

Last week, a jury in Minneapolis gave America a gift. Suddenly, the racist justification for (white) police officers easily killing (Black) civilians is no longer a basis for a “reasonable” decision.

As Black commentators have been pointing out since the moments after the verdict was handed down in court, it will take far more than one trial to change cultural values. For, in the end, cultural values are at stake–and such values do not change quickly or easily.

Yet, thanks to the past year of BLM events remaining front and center around the country (even the globe), racism is one cultural value that no longer holds primacy in the white American imagination. Now that the eyes of the nation were trained on the Minneapolis courtroom, there is no going back to assuming that a white officer killing a Black civilian is, automatically, “reasonable.”

We must, of course, keep pushing for accountability in all police killings. Even more importantly, we must keep pressing for structural change not only to put murderous police officers on trial, but to retrain all police officers in de-escalation tactics. Re-labeling them as “peace officers” or “safety officers”–emphasizing their potential for nurturing rather than violence–might be a good, discursive start. Incorporating mental health professionals and social workers into their departments–as the city of Santa Fe did last week with their new “Alternative Response Unit”–would be a great, more tactical start.

Meanwhile, I remain proud of my discipline. The late Max Gluckman fundamentally got it right when he argued that, ultimately, legal systems rest on cultural values.

But, community standards of “reasonableness” hold sway–until they don’t. If he’d been around to hear last week’s verdict, I’d like to imagine Gluckman breathing his own sigh of anthropological relief as he nodded approvingly.


The Witches Invade Washington

They should have asked an anthropologist.

The political and military professionals ignored the warnings presaging last week’s Capitol invasion.  But many who conduct research in rural Africa, while untrained in cyber-espionage, could have predicted the attack.

From living in small, rain-forest villages hosted by the Beng people of Côte d’Ivoire for nearly two years, here’s what I learned about the risks of the interregnum. 

African villagers know that any transfer of power is always fraught—sociopolitically, ritually, emotionally.  This liminal period–“betwixt-and-between,” as anthropologist Victor Turner described it–leaves the nation neither fully in one political space nor another.  Whether they last minutes or months, liminal moments beyond life’s normal categories invite creativity, artistic license—and danger.

In Ivory Coast, Beng practices for seating a new king are a study in (ritual) risk management.  Spiritual peril precedes every king’s inauguration.  Before the installation, it is said that witches roam freely during the daylight hours, exploiting the temporary power vacuum.  Normally, witches reportedly wreak havoc only at night; their daytime boldness is taken as especially disquieting. 

Nevertheless, Beng witches are neighbors.  At night, they may transform into animal familiars or other abnormal forms, but by day, they revert to their normal human appearance.  One might not know that the ordinary-looking person next door, or even one’s cousin or uncle, is plotting evil using mystical means.

As the king’s ritual seating approaches—the Beng equivalent of hand-on-the-Bible-swearing—the witches’ work reaches a fever pitch, culminating in maximal damage during the moments preceding the climactic ritual.  A Beng friend claimed that more people die from witchcraft during the interregnum than any other time.  Babies, children, and pregnant women never attend a king’s investiture: youth of all ages are considered especially vulnerable to the witches’ power.  

King Bonde Chomo of Bengland (photo: Alma Gottlieb)

One might dismiss such accounts as irrelevant to a modern democracy.  I suggest otherwise.

Let’s take “witchcraft” as a metaphor for any illegitimate power unleashed by evil and spiritually powerful actors aimed at harming regular humans.  (That’s the Beng perception.)  Defined thus, the ritual drama of Beng kingship illuminates last week’s insurrection in Washington.  

The insurgents might as well have been witches.  Like Beng witches, they plotted their moves secretly, online.  The Internet served as the high-tech equivalent of the Beng witches’ night—complete with mysterious spaces known colloquially (with its undertone of racist imagery) as the “dark Web.”  

After stealthy planning, the insurgents accomplished acts of violence ranging from physical to moral to spiritual.  After all, the building they assailed was, as American schoolchildren learn, the quintessential symbol of America. 

In their rampage, the insurgents obeyed their outgoing, would-be god-emperor.  Crafting the persona of a religious cult leader, Trump has referred to himself as the “King of Israel” and “the second coming of God.”  He once re-Tweeted a follower’s Tweet that he was “heaven sent.”  Former Energy secretary Rick Perry praised Trump as “God’s chosen one,” and plenty of other self-described Christian devotees have referred to him, implicitly or explicitly, as “the Messiah.”  

Trump even attracts acolytes espousing outlier religious traditions.  One much-photographed participant in last week’s assault—a buffalo horn- and bearskin-toting QAnon follower–called himself a “QAnon shaman,” ostensibly impersonating the classic shamans of the Mongolian steppes.  Such flashy devotees merely exaggerate the religious fervor Trump himself ignites; his toxic narcissism flaunts the charismatic charlatanism in which religious cult leaders often specialize.  

Last week, the energy of Trump’s mob erupted so intensely that the great French sociologist, Emil Durkheim, might have termed it positively effervescent.  Over a century ago, Durkheim took the explosive bubbles of a champagne bottle as an apt metaphor for the religious excitement generated by large crowds of worshippers.  Durkheim had in mind large ceremonial gatherings of Aboriginal peoples of Australia convened to venerate ancestral spirits of the land.  Tragically, the religious fervor we witnessed in the U.S. capital aimed at murder, not spiritual enlightenment.

Until January 6th, the genius of the American political system had managed to contain the potent energy of previous interregnums, accomplishing handovers peacefully.  Following last week’s attempted coup d’état, the relevance of Beng kings’ installation rituals becomes urgently clear: moments of political transition pose the most perilous times of civic life. 

Modern-day witches sport all manner of dress.  Most appear commonplace, while some appropriate intimidating regalia ranging from would-be garb of the military to pseudo-shamanic adornment of Mongolia.  Like their African counterparts, these American witches—unnervingly, our neighbors and relatives–simultaneously wield and mock potent symbols to perform sedition.

Two Lessons I Learned about the Transfer of Power while Living in Africa

1. The moment that any transfer of power occurs from one individual or regime to another is fraughtritually, sociologically, emotionally.

Why? This is a liminal period–“betwixt and between,” as the great anthropologist Victor Turner described it–neither fully in one political space, nor in another. Liminal moments offer options for creativity, inviting artistic license. They also represent spaces of danger.

Here’s what I’ve learned about the liminal times of interregnum–those intervals between political regimes–from West Africa.

For the better part of two years, I lived in small, rain-forest villages hosted by the Beng people of Côte d’Ivoire. Their practices for seating a new king are a study in (ritual) risk management.

The late King Bonde Chomo of Bengland, Côte d’Ivoire
(photo by Alma Gottlieb)

Beng people rank a king’s inauguration as an extended moment of extreme spiritual danger. During the days and, especially, hours before the installation concludes, witches reportedly roam freely during the daylight hours, taking advantage of the temporary power vacuum. As the time approaches for the king to be ritually seated, the witches’ work increases to a fever pitch, culminating in maximal damage during the moments right before the climactic ritual. It is said that more people die during the interregnum period than at any other time. Babies and children never attend a king’s investiture: parents fear that their weakness and youthfulness would render them especially vulnerable to the power of witches. Likewise, a pregnant woman assiduously avoids the event, protecting her fragile fetus.

Some in the modern world might dismiss such accounts as anachronistic relics of an ancient era. I suggest otherwise.

At the broadest level, let’s take “witchcraft” as a metaphor for the unleashing of any illegitimate and mystical power aimed at causing harm in the lives of ordinary humans. (That’s how the Beng perceive witches.) It becomes clear how the ritual drama of Beng kingship illuminates the events of last week in the American capital. The insurgents attacking the U.S. Capitol building played the role of witches, spreading spiritual chaos.

The much-photographed costume of the fiercest-looking insurgent was worn by one Jacob Anthony Chansley–an Arizonan man who forsook his prosaic name in favor of “Jake Angeli,” with its obvious religious reference to “angel.” But his attempt to wield spiritual power was not only through reference to Christianity. In a second perverse act of cultural appropriation, the terrorist also drew on indigenous religious traditions, calling himself a “QAnon Shaman.”

Voice actor/conspiracy group QAnon follower appropriating stereotypical image of a shaman to visually persuade others of his power (spiritual and otherwise)
(Getty Images–source here)

That is not just a meaningless moniker. The now-notorious Arizonan claims spiritual powers equivalent to those of the classic shamans of the Mongolian steppes. Chansley has categorized himself as a “multi-dimensional or hyper dimensional being” and claims he can “see into these other higher dimensions that these entities – these pedophiles, these rapists, these really high up people … that they can almost hide in the shadows in.” 

Beyond Chansley, QAnon–the amorphous collection of groups with which Chansley associates himself–itself displays many qualities of a religious cult. For one thing, its strangely spelt name hints at a secret identity: Anon[ymous]. The secrecy encoded in its very name implies mystical foundations.

Then, too, the conspiracy-oriented group promotes hyperbolic but vague claims drenched in sensationalist innuendo: Satanic kidnapping, pedophilia, child trafficking.

Moreover, according to NY Times reporter Kevin Roose, QAnon followers have also been “flooding social media with false information about Covid-19, the Black Lives Matter protests and the 2020 election.” Some have, additionally, embraced anti-vaccine and anti-child-trafficking movements; others make further “claims about the assassination of John F. Kennedy, the existence of U.F.O.s, and the 9/11 ‘truther’ movement.”

What’s more, its messages are sometimes penned in cryptic language.

All these features smack of religious cults.

Dare I point out that this shambolic collection of creative but unrealistic fears constitutes a veritable witches’ brew?

Chansley is now in custody. I’m guessing that the higher powers with which he claims to be in touch may not prove persuasive in a court of law.

*

But Chansley is just the side show. The main act, of course, is Donald Trump. These past four years. Trump has turned into a religious cult leader par excellence.

Trump may not drape himself flamboyantly in bearskins or sport buffalo horns, but his toxic narcissism produces just the sort of charismatic charlatanism in which certain types of religious cult leaders have long specialized. Allying himself with flashier devotees merely highlights the religious fervor he ignites on his own.

As I watch reruns of the mob scene that Trump incited, I imagine that the great French sociologist, Emil Durkheim, would have recognized the energy as effervescent, when large gatherings of people create great emotional intensity dedicated to serving ancestral spirits. Tragically, the religious fervor we witnessed in the U.S. capital produced tragedy rather than spiritual enlightenment.

*

Last week in Washington, D.C., the bureaucrats in charge of security failed our nation miserably. Eventually, a systematic inquiry will determine whether this failure originated in inattentive incompetence or coordinated sedition. (All signs are currently pointing toward the latter.)

For now, I humbly point out what those in charge might have learned from Beng villagers (assuming they actually wanted to protect the nation): moments of political transition represent the most dangerous times of civic life.

During periods of political interregnum, society cannot be too cautious. Leaders must take all conceivable steps to protect the vulnerable and safeguard the polity, lest the forces of chaos–modern-day witches–avail themselves of the power vacuum and take charge.

2. The institution of democratic rule is strong, sturdy, and stable–until it’s not.

In the village, my Beng friend Yacouba once told me, “When the walls have holes, the cockroaches get in.”

Yacouba had in mind the ravages of his two co-wives. In his view, their endless bitter arguments were causing all their children to constantly fall sick; one had even died.

Yacouba’s cockroach lesson might be applied to the broader house of civil society. Once foes scratch cracks into the walls of an institution, elements of destruction expand those chips and find their way in.

In Côte d’Ivoire, the initial challenge to the modern nation’s first democratic elections occurred in 1994. The past 26 years have seen more failed coup attempts than I have counted, punctuated frequently by violent civil unrest and two periods of out-and-out civil war. Today, the nation remains as unstable as it was at the beginning of those early political challenges. Côte d’Ivoire’s recent history should serve America as a warning.

During the past week, we have heard many journalists and political experts write that America is on a precipice. But, if we want to be honest with ourselves, we must acknowledge that, from the nation’s earliest days, America began in violent efforts to either subjugate or annihilate people of color–first, native peoples; then, Africans kidnapped and brought to these shores while enslaved. To claim that we are on a precipice now implies that this is the first time we face stark choices concerning racism. In truth, we have been balancing uneasily on that precipice since the founding of the republic.

Nevertheless, each time we venture farther out on that cliff, we come closer to toppling over its edge.

The lessons of Côte d’Ivoire’s difficult modern history are still something from which it’s not too late to learn. There’s still time to conduct thorough inquiries into who organized last week’s insurrection and then prosecute them. All of them. Even if he neither resigns nor is removed from office via the 25th amendment nor is impeached, Donald Trump can, and should, ultimately be judged–ideally in court, but certainly by history.

Meanwhile, we have an interregnum to plow through.

Long Past Time for the 25th Amendment*

There will be plenty of time for Biden to use his extraordinary faith and energy and creativity to think about how this divided nation might be healed.

For now, there is only one first step to be taken, and taken today. Trump must be removed from office. Now.

* “. . . the President is unable to discharge the powers and duties of his office. . .”

Ed Bruner: In memoriam

August 8, 2020

Ed Bruner at his home in Illinois (2005)

Ed Bruner passed away yesterday, at 95–peacefully, at home. I wish my daughter and I could have been with him, but–Covid.

Ed started out as my senior colleague in the anthropology department at the University of Illinois. He soon became a mentor, then writing/editing buddy, then dear friend, then adoptive grandfather of my daughter. With 37 years of a richly multi-layered relationship, how do I begin to mourn?

I will post some memories soon. For now, I just wanted to inform my anthropology colleagues that our discipline has lost a great scholar.

Meanwhile, if you’re not familiar with Ed’s wonderful writings, a few of his many brilliant articles are available for download on his ResearchGate page here–catch them while you can.

August 8, 2020

Some especially strong memories of Ed Bruner will always remain. Here’s one.

In my early years as a professor, he and Ann Anagnost and I co-created a graduate course (on Symbolic and Interpretive Anthropology) and co-taught it twice. I learned so much about how to teach from that semester, watching Ed masterfully lead discussions like an orchestra conductor. He always knew when to lecture, when to call on the quiet student, when to apologize for having been unclear or unfair, and how to lighten the moment when two students risked having their theoretical disagreement turn nasty. In that classroom, Ed taught me to be an anthropologist of our students, to pay attention to their realities and meet them where they were. He also modeled the righteousness of democracy.

Although Ann and I were un-tenured assistant professors, and Ed was already a full professor and had been head of the department many years earlier, he treated the two of us as fully his equals. We co-created the syllabus, each of us meticulously responsible for one-third of the readings and leading one-third of the class sessions; we divided up all other responsibilities equally, even the grading–Ed never shirked on his share of work. In that classroom, Ed modeled egalitarian values that I still try to live out.

There’s also this: When Ann and I both became visibly pregnant toward the end of our second round of co-teaching, Ed never made us feel out of place, as many male colleagues might have, for our bulging bellies. In fact, he joked about his disadvantaged position as the only non-pregnant instructor. Although he came of age well before the second wave of feminism changed America, Ed’s basic humanity led him to feminist stances, even if he didn’t know to call them such. So, when I started schooling him in the basic tenets of feminism, he was a quick study. I was just giving him a vocabulary for something he already knew–that women are human.

In my next post, I’ll address that hunger to learn.

August 9, 2020

Ed Bruner celebrating his 91st birthday in our Illinois home (2015)
Photo by Alma Gottlieb

August 9, 2020

Soon after I arrived as a new professor at the University of Illinois, a graduate student in my department offered me his version of a rundown on all my new colleagues, complete with some juicy nicknames he’d concocted. His moniker for Ed Bruner: “What’s-New Ed?” This grad student gently mocked Ed for having switched intellectual paradigms more than once. I was intrigued and resolved to understand what lay behind such multiple shifts.

What I discovered was a voracious appetite for knowledge. Ed frequently asked me what I was reading and told me excitedly about what he’d just read. For years, he was a member of an interdisciplinary reading group that exposed him to new trends in the humanities. In mid-career, reading interpretive theory led him to migrate away from the positivist orientation of his graduate school training and help forge what became known as interpretive anthropology. Ed edited two influential collections of essays (one, with Victor Turner, one of my own mentors in grad school) that marked the interpretive turn in anthropology. To further cement this major shift and legitimize humanistic perspectives in anthropology, Ed helped found the Society for Humanistic Anthropology, and (ever generous) he (anonymously) funded its Victor Turner Prize in Ethnographic Writing.

For all his humanism, Ed also loved science. His first major in college was engineering; his son became an engineer; and he never relinquished his fascination with the latest STEM discoveries. Into his 90s, Ed was always the first person I knew to buy (and master!) the latest cell phone model; I learned about GPS technologies installed in cars from Ed, who once proudly gave me a detailed tour of his new car that had one of the first GPS technologies available. Once my son started working as a software engineer for Apple, Ed enjoyed geeking out with Nathaniel about the most minute of tech niceties. When the field of anthropology was being torn apart by bitter and rivalrous claims between the humanistic and scientific ends of the discipline, Ed wrote a piece for the major anthropology newsletter gently taking us all to task for seeing the two perspectives as mutually exclusive. When that disciplinary rupture started tearing apart our own department, Ed’s was always the calm voice of reason at faculty meetings at which reason was in short supply.

Ed’s intellectual adventurousness didn’t only lay in theory–he also lived it. He conducted his earliest research with Native Americans, then switched to study Indonesia (and learned the Indonesian language). Late in life, he started a major new fieldwork project of studying tourist behaviors around the world. Observing American tourists in Asia, Africa, and the U.S., Ed helped forge Tourism Studies as a serious discipline.

Ed and Cookie Bruner (left) interviewing Maasai performers for tourists in Kenya (1984)

Ed’s book, Cultures on Tour, a compilation of his best articles on the topic, is must-reading on every Tourism course syllabus.

Back in 2014, a session at the annual meeting of the American Anthropological Association addressed Ed’s impactful work on tourism. That session was so strong that the participants decided to publish their talks. Such projects always take more years than anyone predicts. As Ed’s health declined, awaiting the publication of that book became one of the things that kept him going.

Ed Bruner at a session on tourism organized by Naomi Leite and Queetzil Castañeda in his honor at the American Anthropological Association (2014)
Photo by Alma Gottlieb

When The Ethnography of Tourism: Edward Bruner and Beyond appeared last October, Ed felt gratified that much of his life’s work had firmly found its place in the scholarly world.

For my part, Ed’s scholarly globe-trotting gave me courage to contemplate my own major fieldwork switch (from Côte d’Ivoire to Cabo Verde). I was thrilled when Ed agreed to write what turned into a magisterial chapter for a book I edited (The Restless Anthropologist), thoughtfully and honestly looking back on his (then) 60 years of global field research.

Ed didn’t only read scholarly work; he also devoured fiction. Once, my writer-husband, Philip Graham, mentioned a list-in-progress he kept of his favorite works of contemporary world fiction, to share with his students. Ed begged for the list and soon started reporting his impressions of the books he was reading. After plowing through the initial list of hundreds of novels and short story collections, he kept requesting Philip’s periodic updates.

In short, Ed was a model for his students, and for me, of how to be a scholar–not the kind of scholar who revels in the trivial, or who defends a single idea to the grave, but the kind of scholar who remains perpetually intellectually alive and open to the world of ideas.

August 11, 2020

Today’s more personal memories of Edward M Bruner . . .

When she was three years old, our daughter Hannah declared that she needed us to find her a grandfather. Both of her biological grandfathers had died before she was born, and she felt that lack early. I asked her if she had anyone in mind. She asked me to list all the older men in our lives who she knew. When I got to Ed’s name, she stopped and said, “That’s my grandpa.”

At that point, our daughter had only met Ed a few times. Until they were old enough to balk, my husband and I regularly dragged our children to conferences, dinner parties, lectures, classes, and even some faculty meetings (poor things), to keep them an active part of our lives. That meant, they got to know a lot of adults. At the cocktail parties that Ed and his wife Elaine (“Cookie”) hosted, Hannah was usually the only child present. Ed had always taken kind notice of Hannah: asked her what she’d like to eat, found her a cozy spot to sit, asked if she was afraid of his large dog (she was, and Ed removed the animal to another room). Clearly, Hannah (always emotionally wise beyond her years) intuited that Ed was someone who was sensitive to other people’s realities, even those of a far different age category. Hannah picked well.

Over the next 23 years, Ed indeed became our daughter’s grandfather. (He already had grandchildren from his son, but they lived a couple of states away.) Year after year, Ed and Cookie bought our growing daughter the perfect, age-appropriate presents for her birthday and for Chanukah. When she was young, there was a stuffed panda bear about three times Hannah’s size, which occupied a very large corner of her bed for many years.

In middle school and high school, there was an increasingly sophisticated set of jewelry gifts. In college, there was a designer purse. When Ed was heartbroken that he couldn’t travel to Rhode Island to attend Hannah’s college graduation in 2017, he sent the largest flower bouquet he could.

Nor did Ed’s involvement end at charming and extravagant gifts. In elementary school, Ed-as-Grandpa came to Hannah’s school performances; in high school, he watched her cheerleading gymnastics. When the first serious boyfriend entered Hannah’s life, Ed insisted on meeting him and giving him The Grandfather Talk (complete with You’d-Better-Treat-My-Darling-Granddaughter-Right sort of warnings). When Hannah had an offer of an internship at a very prestigious art gallery in NYC the summer after her junior year in college, Ed helped subsidize her overpriced NYC studio sublet (which happened to be close to the old site of Stuyvesant High School, the competitive high school that Ed had attended decades earlier). When it came time (a few years back) to donate his professional papers to the Wenner-Gren Foundation and figure out what to do with his extensive library, Ed had Hannah sort through his books and papers and organize and pack them up.


Elaine (“Cookie”) Bruner, Hannah Gottlieb-Graham, and Ed Bruner in our Illinois home (2015)
Photo by Alma Gottlieb

Last week, Ed learned from his doctors that the end of his days on this earth was approaching, and he wrote me a farewell note. After tearing up, I shared the terrible news with Hannah. Immediately, she called Ed on FaceTime and they had their final conversation. By now, Hannah had a new partner. She’d hoped to introduce Andrew to Ed on a trip back to Champaign-Urbana (for a dear friend’s wedding) this past May, but, to everyone’s deep dismay, Covid postponed that trip (and wedding) until next May. Hannah fretted greatly about the delay in seeing her rapidly aging grandfather; last week, her worst fears were confirmed.

It meant the world to her that she was able to introduce Andrew to Ed over FaceTime. I don’t know what Ed said in that final conversation, but it must have been just the right thing. Ever an anthropologist, Ed must have managed to intuit Hannah’s mood and speak to it because, although Hannah emerged crying, she also emerged in peace.

Thank you, Ed, for that final gift to your beloved, adopted granddaughter–and for living out your scholar’s understanding of the bonds of kinship. Anthropologists have long known that what we used to call “fictive kinship” can feel as real, as deep, and as meaningful as any bonds forged by biology. Ed demonstrated that theoretical insight as lovingly as anyone might.

August 12, 2020

Last installment of my thoughts about Edward M Bruner (at least for now).

Ed and I were 30 years apart. When we met, he was twice my age. That age difference might appear to offer an unpromising basis for a friendship. In choosing friends, most of us tend to find a path to people who are like us in some obvious ways. Age and gender often rank high on the list of shared criteria. For Ed and me, somehow, neither of those differences interfered with our friendship.

My inspiration was my long-ago Beng friend, Amenan Véronique. One late afternoon, while we were chatting in her compound in the rain forest of Côte d’Ivoire, Amenan excused herself from a conversation, to take dinner over to someone across the village. When I asked about the recipient, Amenan said she was bringing the dish to a very elderly woman who couldn’t easily cook for herself any more. I asked if she was an aunt–in those villages, most people are related to each other in some way or another. Amenan surprised me by telling me that they weren’t related at all–they were friends. At the time, Amenan was in her early 30s, and the age gap further surprised me. “Age doesn’t matter for friendship,” Amenan quietly declared. Ed re-taught me that lesson.

Over the years, Ed and I indeed became friends, of the sort that, in most places, women typically reserve for each other. Ed told me about changing dietary decisions and showed off a new suit or cashmere sweater he’d bought himself. We regularly confided in each other about family issues. As he aged, he asked my opinion about whether he should get this or that medical treatment for this or that condition. That sort of vulnerability that is the hallmark of a good friendship is harder to establish across age and gender divides; to Ed, it came easily.

None of those intimacies prevented Ed from critiquing my work when he thought I needed to rethink a point in a manuscript-in-progress. But it did mean that his critiques were delivered especially kindly, and that I took them especially seriously.

Four years ago, telling Ed that Philip and I would be retiring and moving to Rhode Island was the hardest Goodbye I had to say when we left east-central Illinois after 33 years. Ed was already 91, and increasingly feeble. Nevertheless, he managed to give a beautiful speech at the retirement party my department hosted.

Ed Bruner speaking at my retirement party from the. University of Illinois (May 2016)
Photo by Philip Graham

We left unspoken our worries that we might not see each other again. I am grateful that I did see Ed during a trip back to Champaign-Urbana a year later.

Thank you, Ed, for our 37 years of friendship.

What Anthropology Teaches Us about COVID-19, Part 4: A Conversation with Physician-Anthropologist, Dr. Bjørn Westgard

Recently, I checked in with Dr. Bjørn Westgard, to see how he was doing.

A person wearing a suit and tie

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Back in the ‘90s, Bjørn was enrolled in a wildly demanding, combined M.D./Ph.D. program at the University of Illinois, where I had the pleasure of serving as his academic advisor.  After completing his medical school coursework, Bjørn conducted doctoral research in cultural anthropology in a small town in northern Senegal, studying the complexities of intersecting local and global medical systems as they sometimes complemented one another and sometimes competed.  He intentionally combined “bottom-up” and “top-down” perspectives, interviewing everyone from village-based farmers and healers to biomedically trained nurses and doctors.  (From that research, Bjorn is fluent in French and Wolof, the most widely spoken language in Senegal; he also speaks Serer and Mandinka, two linguistically unrelated languages spoken in the region of his research.)

When it came time to choosing a medical specialty in which to pursue his residency, Bjørn surprised me: he decided against his early interest in pediatrics or family medicine and opted instead for emergency medicine.

Initially, I was disappointed: I thought that working in ER rooms would waste Bjørn’s formidable scholarly skills.  How could he get to know transient patients and put his extensive training in biomedical cultural sensitivity to work?  Of course, Bjørn had already thought through that concern.  “There are more return patients than you’d think,” he explained.  Bjørn understood what few others in the U.S. yet knew: that many, many uninsured Americans used emergency rooms for routine medical services.  That included the poor and the undocumented—for all of whom, Bjørn (with his ample wading into the deep waters of culturally sensitive issues) would have special insights.

Bjørn had an additional reason for selecting emergency medicine that made equally compelling sense.  “There’s so much wrong with the American medical system, and a lot of it is encapsulated in ERs,” I remember him explaining.  “As an anthropologist, I can start addressing the systemic problems if I have a position working in the belly of the beast.”  At the time, no one was talking about this problem in such clear ways–at least, not in public conversations about healthcare policy.  I remember being instantly both impressed and persuaded: Bjørn was making the right decision.

Besides, if I thought about everyone I had ever known, Bjørn would have been my first pick for an ER doctor.  He has the sort of calm temperament and clear, logical mind that would make him the obvious choice for captaining any sinking ship.

Fast-forward fifteen years, and Bjørn now finds himself working as Research Director and Senior Staff Physician at Regions Hospital, a Level 1 Trauma Center in Minneapolis that sees over 90,000 Emergency Center visits every year.  A Fellow of the American College of Emergency Physicians, Bjørn holds secondary medical appointments in emergency departments of four other hospitals in Minnesota and Wisconsin.

Over the years, Bjørn has researched heart disease among Somalis in Minneapolis (with support from the National Institute for Health); has specialized in hyperbaric oxygen therapy for certain medical conditions; and has helped create an innovative program finding housing and lifestyle amelioration for homeless people in Minneapolis.

Clearly, Bjørn has harnessed the wisdom he gained from studying pluralistic health practices in a small town in Senegal to the technical skills he gained in studying medicine.  With his incredible combination of scientific and humanistic talents, I was unsurprised to learn that Bjørn is now leading a medical team that is fashioning policy responses to COVID-19 for the state of Minneapolis.

On his home page, Bjørn describes his approach to medicine this way:

My teaching and research have focused on Emergency Department use for preventable conditions among priority populations, “food deserts” and diet-related Emergency Department visits, longitudinal changes in Emergency Department use among the homeless, supportive housing, and reducing health disparities in emergency care.

Who could be more qualified than an ER physician-anthropologist such as Bjørn Westgard to understand the COVID-19 crisis in both scientific and human terms?

(You can read a brief bio of Bjørn Westgard here and his LinkedIn page here.)

Recently I had a conversation with Dr. Bjorn Westgard about this long COVID-19 moment—about what he has learned, and what he can teach the rest of us.

BW = Bjorn Westgard

AG = Alma Gottlieb

AG: An ER doctor in New York, Dr. Cameron Kyle-Sidell, recently claimed that ER doctors around the world may have drastically misjudged the nature of the COVID-19 beast when it enters the lungs, and may have unintentionally harmed patients by keeping them attached to respirators administering too much pressure on fragile lungs.  His claims are quite striking and disturbing!  If this ER doctor is right, it’s tragic to think of what damage might have already been done by mis-calibrating those respirators.  What do you think of his claims, medically?  And, why do you suppose he posted this video on YouTube for general consumption?

BW: This has gotten a lot of play.  Unfortunately, his understanding of high-altitude pulmonary edema is a little off, and no one has put anything together about his critique that is systematic or peer-reviewed.  However, multiple physicians from China, Italy, and New York in particular (on some emergency medicine podcasts and the like) have raised the possibility that treating COVID using ventilator parameters for ARDS [acute respiratory distress syndrome] may be incorrect, at least initially. 

The ventilator management of these patients doesn’t sound incompatible with early ARDS, but it is still very controversial.  I just got into a heated argument with an intensivist earlier today for even bringing up the above.  There is fear among all sorts of health professionals right now, especially among those who tend to “know what they know” with the most certainty.  So the idea of managing critical pathophysiology that might be different from what is expected–requiring a veritable, Kuhnian paradigm shift–can be very anxiety- and anger-provoking. 

To add further fuel to that fire, there has also been discussion of a possible hemoglobin issue (oxygen carrier in the blood), but there has been nothing other than a pre-press 3D computer modeling paper out of China in the rapid-fire literature to support that idea.  However, a group from NYU did use machine learning to predict severe disease, with results that could support the idea of a hemoglobinopathy.  I even have colleagues in my other Board specialty, hyperbaric medicine, who are working on a trial to use hyperbaric oxygen to get around the possible hemoglobin issue.  I think there’s probably more to the receptor for COVID, which is present in all of the body’s vasculature, which could potentially trigger inflammation and coagulation that way, and that inflammation and small clots, which we’re finding everywhere in coronavirus patients, could be causing diffuse injury.

It’s fascinating to watch the accretions of science and knowledge in the age of the Internet and social media.  Already, cranks are hawking conspiracy theories and supplements in response to the “censored” knowledge above.

As an emergency physician and an anthropologist, I’m a bricoleur of the contingent and the emergent, by trade.  I’ll consider new ideas if they make pathophysiologic sense, and I have no doubt that someone will examine these ideas further and more systematically, so I’ll keep watching for more evidence.  For now, I’ll care for the patient in front of me and adjust their vent settings as needed.

AG: That sounds like a good strategy both for an ethnographer and a doctor.  But then, I always thought that all doctors ought to have training in anthropology.

BW: I hope I didn’t give you the impression in my last email that I was resistant to the ideas presented, just that I’m looking for more information, whether from personal, clinical experience or other data.  I’m just not generally inclined to change my clinical practice in response to social media.  I’m in the middle of our Thursday morning residency conference right now, and we’re discussing initial and ICU ventilator settings, given developing information, and it’s fascinating to hear an intensivist colleague suggest that “we’re all in the same boat here, the attendings [fully credentialed, attending physicians], the fellows, the residents, and the med student . . . we’re all learning together as we go.”

AG: Speaking of combining social and technical approaches, we’ve been reading about efforts to systematically calculate social contacts for COVID-19 patients, to help track the socio-geographic spread of the disease.  What do you think of those?

BW: Very cool.  I’m trying to get our state to do something similar using an app I’ve worked with a team to develop.  I’m arguing with our Department of Health, who have difficulty appreciating how technology might help.  But they’re also feeling less pressure to consider novel options, since our state is doing relatively well.

AG: Here’s something else I thought you might have a lot to say about . . . the whole “herd immunity” question strikes me as so interesting for anthropologists.  I’ve been reading a lot about this recently.  This piece in the Boston Globe really caught my attention.

First, there are the epidemiological questions.  How accurate is the concept of “herd immunity” to begin with?  As a doctor and scientist, I assume you’ll have much to say about that.

Second, there are the sociological implications.  How can your perspective as an anthropologist speak to the epidemiological factors?  If the US (and/or other nations) adopts a “herd immunity” approach at some point (before a vaccine is widely available), what sorts of people will be allowed—or even encouraged–to be exposed to the virus?  What sorts of people should be allowed, or even encouraged, to be exposed to the virus?  Are those two groups of people the same?  Or, will socioeconomic disparities intervene, and might large numbers of the wrong people (the most vulnerable) end up being exposed to the virus?  I’m thinking about this because, over the past two weeks, many mainstream journalists in the U.S. have begun noting racial disparities in COVID-19 mortality.  Of course, that’s no surprise to anthropologists (and some other social scientists), though it seems to be surprising plenty of politicians.  Thinking about these social factors, are there new risks to perpetuating racial disparities with a “herd immunity” strategy?

Third, there are the symbolic/conceptual/philosophical implications.  As a scholar steeped in sensitivity to discursive implications, what are the ramifications of using a metaphor of (non-human) animal behavior for human behavior, in evoking “herd” immunity?

The maddening “organism at the edge of life” (as virologist E. P. Rybicki describes viruses) that is far too dangerous to appear this beautiful

BW: I haven’t had time until after my shift this evening to get to your questions, but I like them.  It prompts me to reflect and consider with a wider lens.

I’m not an expert in infectious disease or epidemiology, but my understanding is that “herd immunity” is primarily a statistically useful concept that expresses the aggregate balance between immune systems and infectious vectors such that there’s enough immunity to prevent ongoing transmission.  But when you get into the immune system, things become very complex very quickly.  Talking about vaccines and immune medications (like those being discussed as treatments for cytokine storm, for example), the questions pertain not just to the dose of a drug in the volume of an aqueous human, but also to what the most productive triggers are for the bodily machinery churning out the immunity widgets of antibodies.  The questions become: What is needed to trigger the production of immunity?  How effective is the immunity that is produced?  Does it wane, and if so, when?

And all that is without discussing the social patterns of intermixing that we all experience, and which have become the main means by which we are currently intervening upon the spread of this pandemic.  I think that’s where the concept of “herd” becomes interesting.  Anthropologists and many others are comfortable with the idea of the population as a biopolitical concept generated by a certain kind of governmentality.  But how do we, the multitude, deploy that in an effective, self-governing manner? 

It seems to me that the concept of the “herd” could allow us to conceive of our collective biology, our animality, in a way that is positive and potentially collectively empowering, rather than biostatistically disempowering.  That said, it seems clear that a “herd immunity” strategy that treats the lot of us like chattel (the flip side of the “herd”), positing that we should all “put on our big boy and big girls pants” and accept that a lot of people must die, will undoubtedly do more harm.  We’re seeing this in those areas of the country where few or late actions have been taken to mitigate the spread of coronavirus. 

It’s my hope that we’ll use available information from around the world to develop better methods that capitalize upon our current collective engagement.  It seems like “flatten the curve” has brought the collective back to the biostatistical.  Hopefully, well-thought-out approaches to “reopening” and easing social/policy measures could do the same.  But the evidence for these measures is thin, and we are all learning about one of my favorite areas or research, complex population models of disease. This is another area where science is being built daily, as the pandemic provides some of the first empirical test cases for these tools.

But it is disheartening that in areas both with and without aggressive measures, we see the impact of racial and socioeconomic disparities.  Those disparities are at play in health inequities and inequitable care in the best of times.  Now, resources are strained, so it would be almost unthinkable that those factors would not be significantly at play in the pandemic.  In areas with less, or late, social and political measures to isolate people, the historic clustering of populations through systemic segregation, with associated increases in population density and decreases in access to resources, lead to syndemic conditions.  In areas with more social and political measures to isolate people, many who work low-end jobs become unemployed, with all the accompanying fears and hardships, while those who keep their low-end jobs–clerks, janitors, service workers, etc.–are left out in public in positions that put them in contact with large numbers of potentially infectious people.  So, between the two groups, disparities in rates of infection and adverse outcomes should come as no surprise.

I’ll get back to you with more, as this is the next bit of thinking required.  In Minneapolis, the group I’ve assembled between HealthPartners and the University of Minnesota are going to consider how to model this process to provide guidance for the long term of the pandemic.

AG: Yes, racial disparities are emerging with disturbing alacrity and intensity in the US.  But, as you say, that’s hardly a surprise, for all the reasons concerning systematic, structural disempowerment that have characterized US society since Europeans set foot on these shores.  Those sorts of disparities have begun to be part of a growing national conversation since the Civil Rights movement of the ’60s, and they took on new force more recently with the Black Lives Matter movement.  One of the components of the current horrible moment that I’m actually finding most heartening is the extent to which social conditions ARE finding their way to being front and center of many conversations.  It strikes me that this moment of national (and global) crisis offers America new opportunities to expand that conversation and really take its lessons seriously in a new way for the first time in US history.  And, medical researchers and doctors will be at the forefront of that conversation.  Someone like you, with your dual training, is especially well positioned to think systematically about just how to operationalize those lessons in ways that work with public health protocols.  That’s why I’m excited about our continuing conversation!

BW: I think it’s very clear that this virus is hitting communities in both indiscriminate ways (with some reportedly healthy individuals going on ventilators or even ECMO life-support machines) and in VERY discriminating ways, hitting poorer communities and those of color.  What I haven’t heard exactly is any discussion about ways to focus resources on those communities that are hardest hit, which is disappointing but not unexpected, given the current national leadership. 

I actually think race and structural inequalities and violence have very much come to the fore within medical practice.  It’s just that our sphere of influence is limited.  For example, in Minnesota, our healthcare system has an Equitable Care Committee that has done a lot of great work, although it has vacillated between focusing on equitable care and health equity, depending upon what we think we can actually achieve.  Residents and med students, particularly the med students, are very aware of disempowerment, and it’s one of the things I teach about when I’m on shift [teaching residents].  In fact, next week, I’ll be drawing directly from anthropology in giving a talk as part of a panel at our Society for Academic Emergency Medicine national meetings (now online!) about teaching residents to be “structurally competent”—meaning, thinking about larger, structural issues that shape the experiences they see in particular patients. 

What’s most difficult is to figure out how to get beyond the clinical domain and affect pathologies upstream, closer to their source.  It helps one understand why Paul Farmer long ago advocated for large-scale wealth transfers between north and south, and why we need to do the same in the U.S.  That’s actually some of what was achieved by the Affordable Care Act but then was largely undone or undercut by recent tax cuts for the wealthy.  So it’s good that these issues are front and center, but I think they could be even more so.  And it’s good that we’re thinking communally, as I said before, but the idea that we might differentially focus collective resources upon communities that are hardest hit seems to meet resistance with predictable frequency. 

AG: In Rhode Island, where I now live, there’s actually a vigorous initiative (Beat COVID-19) with just that emphasis.  Beyond the capital, the two cities hardest hit in Rhode Island are Central Falls and Pawtucket, both of which have large, immigrant communities of color (mostly from Latin America and Cape Verde).  The current rate of infection in both those cities currently surpassess that of New York City.  Nationally, these two small cities are invisible in news reports, but locally, a multidisciplinary coalition has formed that is forging creative approaches to reach these communities. The coalition includes a normally unlikely set of folks, including a local doctor, representatives from the state’s Department of Health and the two cities’ police departments, marketing specialists, local community organizers and advocates, translators, and even yours truly, as an academic critic.  I’ve been heartened to see a far more open-minded approach to reaching these communities than I would have imagined.  For example, since many residents of these neighborhoods feel more comfortable speaking either Spanish, Portuguese, or Care Verdean Kriolu, a new COVID-19 hotline in these three languages now welcomes callers, and there are now public service announcements in those three languages that are being promoted online in all sorts of social media spaces where people from these communities are likely to read them.  I’m so impressed by what I’m seeing that I’m starting to consider this local initiative a model for communities elsewhere.

Once COVID-19 starts hitting the white heartland–as now seems inevitable–because of resistance both by Republican governors and local residents to maintain social isolation procedures, and insistence to “re-open” the economy prematurely and indiscriminately–it will be interesting to see how those communities respond to the crisis suddenly invading their families.  As a physician, I imagine you must feel quite frustrated by those conditions.

BW: Just look at the largely white nationalist forces that have hijacked what began as small-business protests about state efforts to enact social-distancing policies, in an effort to minimize the impact of the COVID surge. 

Photo by MEGAN JELINGER via Getty Images
A local militia group is seen at a rally to protest the stay-at-home order amid the Coronavirus pandemic in Columbus, Ohio, on April 20. For the third time that week, hundreds of protesters gathered at the Ohio State House to protest the stay home order that was in effect until May 1.
Source here.

Those folks are having trouble getting on board with just the baseline collective actions needed for public health.  Currently, so many folks in the rural parts of the country see this crisis as an urban thing.  But if we look back at the influenza pandemic of (supposedly) 1918-19–which actually lasted three years (my grandfather nearly died of it in 1921)–the initial wave hit densely populated areas, but the next waves were largely rural.  And today, if you look at rural areas, they’re as disproportionately disadvantaged as are many of the low-income, urban communities from which we’ve divested as a society.  In fact, rural America overall is actually less insured, has less access to services, and is more dependent upon government transfers of resources than is most of urban America.  So, I’d really like us to be able to see both of those kinds of communities with one gaze.

AG: That makes a lot of sense both politically and intellectually.  It will be interesting to see if white conservatives come around to that position, once they are affected.

Since you’re enjoying thinking about epistemological issues raised by COVID, I wonder what you might think of an e-mail I recently received.

A prominent medical school has decided to confer MD degrees a little early, for med students who had completed all their training and were scheduled to receive their degrees within a few months.  (The e-mail subject line read: “Emergency Powers Exercised: Approved Early Degree Conferral of 4th Year Medical School Students.”)

That will allow these brand-new medical residents to start practicing in COVID-19 hotspots and help alleviate the hospital crisis in those areas.  Seems like a great idea–this is a good time to challenge bureaucracy, right?

But I also saw an online petition on a related question that made me more nervous–to grant “registered nurse” (RN) licenses to “licensed practical nurses” (LPNs), who have quite a bit less training than registered nurses do.  That struck me as way riskier.  But perhaps I’m being too conservative.  Maybe LPNs are actually being asked to do the work of RNs in this crisis, and so they should be credentialed and salaried accordingly.  What do you think?

BW: I definitely agree with deploying fourth-year medical students early.  It strikes me as a safe move at this time in their training.

However, in areas that are not already seeing surge conditions, I think the country would be best served by deploying medical students to do case-contact tracing.

And I agree with you that granting RN licenses to LPNs is riskier.  Credentials are indicators of different kinds of training, and their significance should be maintained, though that’s the professional in me coming out and maintaining boundaries.

As with many things at the moment, one could simply and temporarily alter practice parameters for surge or crisis standards of care.

AG:  I recently read another, especially thoughtful piece in the New York Times, about when to “re-open America”—with the intentionally provocative title, “Restarting America Means People Will Die. So When Do We Do It?”  A staff writer for The New York Times Magazine moderated a panel discussion with five people with varying backgrounds (a minister, an economist, a global health specialist, a civil rights specialist, and a bioethicist).  They raised sociological issues related to those raised in the Boston Globe piece about “herd immunity”–but from broader perspectives, and more critically, I think.  Lots of food for anthropological thought here.  As a physician-anthropologist, you can, I imagine, bring special perspectives to this emerging national conversation about how we think about risk in “re-opening society.”

BW: There definitely needs to be attention to those who are at higher risk for contracting and dying from COVID-19, and to those communities whose residents don’t have a choice about going back to work.  It’s really a matter of whether people are forced to be at risk, or are allowed to be agents of their own risk and that of their loved ones.  Are we going to make re-opening businesses opt-in?  

Unfortunately, the baseline state of affairs in America is far from a level playing field.  Some people will, essentially, be forced to work so that states don’t have to pay them unemployment benefits, and small business owners will be forced to run risk so they can qualify to get loans and other state-funded stimulus funds.  Yet, somehow, there’s no national conversation questioning whether oil, airlines, and other large industries should be bailed out. 

I think we could consider restarting by focusing on the social and the scientific.  I think most of us would be doing better with all of this isolation, quarantine, and lockdown if we had a few more people to connect to.  If you look at places that are opening up, or even how we started this all, we could start clustering in smaller groups, 10 people or fewer.  Just folks who you would know were sick.  And we could get the kids back together.  Given the low likelihood of adverse effects in children, the fact that they have been much less symptomatic, but that they are also very good at transmitting disease to each other (just ask any parent of a daycare child), getting them back together would get us started with herd immunity.  Bioethicist and oncologist, Zeke (Ezekiel) Emanuel was one of the first to say that we should probably get summer camps up and running.  To me, that makes sense.  But, again, it’d have to be opt-in, both for those who run the place and those who go to camp. 

AG: Scholars and doctors aren’t the only ones talking about how to protect ourselves from this virus.  I just discovered a pretty awesome rap video about COVID-19 from Y’en a Marre, a group from Senegal (here).  Any thoughts?

BW: Y’en a Marre are a great group.  They were instrumental in mobilizing the youth vote to get Wade out of power in Senegal, so I feel like they’re always “au service du peuple et de la nation” [in the service of the people and the nation].  It’s so interesting how hip-hop and other forms of art in a smaller country, fending for its own identity and economy with a smaller media space due to the constraints of language, can be called on–if not officially (like this probably was), then culturally–to serve the body of the nation.  In this new video of theirs, I love how they’re all doing scientific activities–looking at charts, microscopes, and blood specimens–instead of just striking stereotypical poses in hazmat suits.  It’s a solid video.  I can’t imagine many hip-hip artists in the States pulling something similar off with the same tone–in Minnesota, maybe Atmosphere, but not many others in the national mediasphere.

Senegalese group, Y’en a Marre, in a new music video (singing in Wolof) advocating safety measures to protect against COVID-19
Source here

AG: You mentioned that you’ve just co-authored a short piece about COVID-19 that you’ve submitted to a medical journal.  Can you talk a bit about the orientation of that article?  Were you able to insert an anthropological perspective into an article for a medical journal?

BW: In Minnesota, we’ve just had a huge decline in visits to the emergency department and to the hospital for just about everything.  Most of the news outlets have covered it, but no one has published any numbers or more detailed reports of what’s not coming in.  I’m fine with a slowish day in the ER, but across the country, particularly in those places not seeing the surge, the changes in patient volume have had devastating effects on clinics, hospitals, and health systems that have to operate at near full capacity and with razor thin margins in normal times just to stay afloat.  So, at the same time as we have surge, we’re also seeing mass furloughing and pay cuts for nurses, doctors, and even (gasp) administrators. 

So we just pulled the numbers for before and after our great Governor Walz’s announcement of a statewide “peacetime emergency,” comparing volumes and visits to a year ago, and we found a 70% drop off in strokes, and a 50% drop off in heart attacks, but also declines in really painful things like kidney stones, too.  And, who’s not coming in?  Well, it’s the elderly, children, and those who have insurance through Medicare.  Much of this drop is likely prudence on the part of high-risk individuals, but we know there’s also some desire to not burden the health systems with non-COVID related care, as well as some fear of actually contracting coronavirus in healthcare settings. 

Similar trends have been seen in China, Taiwan, South Korea, and Europe, as well as in chronic care.  In Minnesota, the HealthPartners Institute has a chronic care surveillance group, and they saw visits drop off by 90% in three days after the statewide announcement. 

We’re interested in doing follow-up studies, monitoring for the effects of delayed or deferred care, both acute and chronic, and seeing who comes back first, and with what.

AG: That sounds like an important set of considerations I haven’t yet seen anyone talking about in the press.  Everyone is so focused on the now of the emergency, and how to extricate ourselves from it, that few I’ve seen are allowing themselves the luxury of imagining ancillary questions such as those you’ve just raised.  Again, I imagine your training in anthropology makes it easier for you to keep your eyes focused not only on the big picture, but on seemingly unrelated factors that, in the end, turn out to be deeply related.  That’s what we do in anthropology, right? 

Well, let’s end on a positive and practical note.  Last week, the team you’re leading produced a new app, “SafeDistance,” to provide up-to-date information about COVID-19 incidence in micro-neighborhoods. 

Online, the website for the new app describes it this way:

SafeDistance is a free, non-profit app and website that crowdsources symptom data to help detect, predict, and prevent the spread of COVID-19, while assuring your privacy.

·         Personalized, social distancing recommendations

·         Neighborhood-level COVID-19 risk map

·         Privacy assured – no account required, you remain anonymous

Can you talk about what sorts of social knowledge about Minnesotans factored into how you designed the app for ordinary people?

BW: The basics are maintaining privacy while collecting data of actionable utility.  So we’re focusing on anonymity–both to allay privacy concerns, and also to make it an easy tool to begin using.  Instead of identifying individuals, we’re mapping and doing analytics by neighborhood.  This approach allows both individual users, and anyone else who is interested in the data from a more sociogeographic perspective, to have some granularity to what they’re seeing. 

If you look at most of the data that’s out there, even the Johns Hopkins and Unacast or SafeGraph data, it’s mostly out there in county form, which is fine if you’re interested in the temperature of the pandemic locally, but it doesn’t tell you the weather and how much caution you should be exercising.  Right now, that’s not a huge deal, because we’re all being very cautious with our efforts to self-isolate, mask and the like.  But as we open up, and we find that our prior efforts burn out and COVID-19 flares up in different spots, we’ll probably have to dial up and dial down and differentiate our self-protective and collective efforts to deal with the virus.  As I said, the “1918” influenza pandemic actually lasted until 1921, so it’s like [epidemiologist] Mike Osterholm has said, we need tools to figure out how we’re going to live WITH this virus, since it’s unlikely that we’ll just out and out defeat it–at least, until an effective vaccine is available globally.

AG: You initially launched the app in and for Minnesota, but it’s now available for anyone across the U.S. via a user-friendly website.  Do you imagine it could have equal relevance anywhere in the country?

BW: If all the app does is give users good information and maps that convey the details of the pandemic in their neck of the woods, I’ll be satisfied. 

But the detailed neighborhood maps that will be produced in the app from new user data will soon be available nationwide.  If the data that are generated can be combined with other datasets to get us to a geospatial SEIR model that would allow us to predict more accurately when and where future outbreaks might occur, that would be a real contribution to fighting this pandemic–as well as to science more generally.  

Well, it’ll likely only be the former, but hope springs eternal.

N.B. Another version of this post appears on the website of the anthropology journal, Public Anthropologist. You can find it here.

UPDATE, June 19, 2020: Bjorn has just published a co-authored article analyzing changes in the numbers and kinds of patients arriving at ERs in one large, public Minneapolis hospital. You can request a copy here: https://www.researchgate.net/publication/342111120_An_analysis_of_changes_in_emergency_department_visits_after_a_state_declaration_during_the_time_of_COVID-19

What Anthropology Teaches Us about COVID-19, Part 3: A Few Thoughts about Culture, and What We Can Learn from Artists . . . and the Homeless

What is “culture”?

Early generations of anthropologists offered all sorts of definitions. No matter what their specifics, the various definitions inevitably shared one feature: “culture” is identifiable. Above all, it encompasses a set of beliefs and behaviors that, together, are premised on an enduring set of values.

Or something like that.

And, as such, culture (it was thought) offers a source of stability. It occupies broad swaths of time and space: associated with a delimited place, and occupying long patches of history. For these reasons, culture makes for a certain level of predictability in the lives of community members.

Source here.

Or does it?

Starting in the 1960s, anthropologists started questioning those assumptions. Marxists pointed out that ever since, oh, the advent of capitalism, or feudalism, or agriculture (pick your favorite starting point), “culture” has been perpetuated by the ruling class. Once the poor get fed up enough, they protest; eventually, they revolt. Then, suddenly, what passed for an enduring model of “culture” turns into a set of values to be challenged, and “culture” — or, one particular version of it — doesn’t seem so reliable or inevitable.

This “Occupy Everything” poster featured on Day 14 of the Occupy Wall Street movement of 2011 summed up a great deal of diverse social justice perspectives that sheltered under the umbrella of the global social movement. Source here.

Around the same time, feminists began pointing out that “culture” has been perpetuated by men-in-power. Once women get fed up enough, they protest; eventually, they revolt. See above.

One can repeat similar arguments focusing on many other oppressed groups: racialized minorities, religious minorities, ethnic minorities, citizenship minorities, language minorities . . .

Nor is oppression the only reason for change. “Culture” also mutates when people from different backgrounds meet up, live near each other, work with each other, eat each other’s foods, dance with each other at street fairs, marry each other, have children with each other.

This ethnic-restaurant map of Queens, NY–an area of 109 square miles/52 square kilometers–hints at the extent to which large numbers of people from diverse cultural backgrounds (21,000 of whom live in every square mile) encounter each other daily.
Source here.

You get the point. “Culture” turns out to be way less permanent, less bounded, less intractable than early anthropologists claimed.

Unlikely neighbors enjoy dancing together at a street fair in the Mountain View section of Anchorage, Alaska — which is currently America’s most ethnically diverse neighborhood. Source here.

Not that the idea of culture is worthless. Contra some serious critics (Lila Abu-Lughod famously urged anthropologists to “write against culture“), I still find plenty of value in the notion. That’s because I see a lot of space between worthless and intractable. Culture can be malleable, adaptable, dynamic, while still remaining rooted in something. And, although the values that buttress culture can change, while they are active, they are powerful. They lie behind many (perhaps, for the privileged few, most) of our decisions.

Still, in pop culture, the current generation of anthropologists’ critiques of what culture is, and isn’t, hasn’t taken hold. Instead, in texts ranging from newspaper articles to corporations’ reports, we easily read disturbingly essentializing claims about “the Chinese” and “the French” and “the Muslims” as if all Chinese people, all French people, and all Muslims were easily interchangeable, eagerly sharing all values and forever speaking with one voice.

Or we read simplistic assertions about “corporate culture” in the halls of this or that company, as if all employees endorsed and enacted daily the corporation’s stated idealistic goals.

Along comes COVID-19.

The maddening “organism at the edge of life” (as virologist E. P. Rybicki describes viruses) that is far too dangerous to appear this beautiful

Of course, the most poignant takeaway of COVID-19 is the tragic demise of its most vulnerable targets.

But alongside the wrenching announcement of the day’s latest mortality statistics, as a cultural anthropologist, I find myself fascinated to read “culture” changing before our eyes — weekly, daily, even hourly. What we took as immutable practices grounded in deep-seated values are turning out to be far more pliable than most of us imagined.

Take the case of exercise. For the first few days of their local “lockdown,” people who got their workout in gyms despaired. How could they stay fit with health clubs closed?

Enter human ingenuity. Gyms have figured out ways to run “live” classes online. The acronym du jour — WFH for work from home — is expanded by some clubs to WFHBT: work from home better together. Buttressing that conceptual adaption is a simple technical one. Don’t have weights at home? How about using any heavy-ish household item you have lying around that you can hold? Say, pasta sauce jars, six-packs . . . or suitcases.

Coach Andrew Samuels of New York’s Mile High Run Club models creativity in suggesting the “suitcase squat.” Source here.

In such cases, people substitute one space for another. The exercise formerly done in the gym is now done in one’s living room.

But for some urbanites, studios may prove way too tiny to offer space for exercise. City-dwelling coaches are undaunted. Some suggest finding new purpose in a balcony.

Coach Marni W. of New York’s Mile High Run Club demonstrates lunges on her tiny balcony. Source here.

For fitness enthusiasts, daily habits of organizing one’s life around outings to the gym morph into organizing one’s life around coaches’ new online classes. That may entail switching work and sleep schedules to accommodate new class times. But the stable source, here, remains the commitment to “fitness,” no matter where, when, and how. That part of local culture and its underlying values remains stable.

But, for a stronger challenge to “culture,” let’s look at a different physical practice common to most of us: that of ordinary walking. For those who learn to walk competently some time in the second year of life, walking becomes a rote activity by the third year. As adults, we rarely contemplate our gait, pace, or stride. No matter where in the world we live, we have a sense of exactly how much distance we should put between us and the next person in order to avoid being judged creepy or reported as criminal. In a New York City subway, that space might be just an inch or two; in rural Sweden, it might be quite a few feet.

Whatever the interpersonal space bubble that feels “natural” to us while out in the world, we must all now confront our unconscious body awareness as we constantly re-calibrate distance. Keeping six feet from the nearest person may now require crossing the street to avoid being too close to the person approaching you on a narrow sidewalk.

Previously, such an action might have seemed, at best, rude; in some contexts, it could have been deemed racist. (As a short film by Cydney Cort called “Passing” once suggested, even speeding up while walking on the same side of the sidewalk can be motivated by racialized fear). Now, not crossing the street to avoid someone approaching you might be assessed as thoughtless, selfish, even potentially murderous.

Normally, producing such a 180-degree turn in what constitutes proper etiquette doesn’t happen overnight. Anthropologists and sociologists from Erving Goffman on have chronicled the deep-seated values that lie behind bodily practices as basic as walking styles. Those values tend to make somatic habits relatively resistant to quick or arbitrary changes.

French sociologist Pierre Bourdieu termed such practices, habitus. He spent much of his celebrated career studying how we experience and embody entrenched assumptions about the world and our place in it, and how these assumptions shape everything from architectural styles to taste in dinnerware.

But with COVID-19, much of what heretofore passed for habitus has suddenly become its evil twin. An attempt at a friendly hug might as well be a curse.

If maintaining a span of two meters from the nearest human may require doing a sort of dance down the sidewalk, suddenly, we are all turning into novice choreographers, performing an awkward solo tango across the street. What was heretofore a routine somatic movement becomes a basis for uncomfortable improvisation.

Perhaps the professional dancer, actor, and jazz musician can teach us a thing or two. All these artists learn the art of improvisation as part of their training. It may seem odd to think of improvisation as something to be learned. But improvisation is actually a discipline that students practice in dance, theater, and music classes. Ironically, it turns out that the art of improvisation is, indeed, a teachable skill, and the rest of us non-artists are suddenly being required to master it. If you’ve got an artist friend or relative, ask them for some tips.

Gwendolyn Baum is one of many dancers now offering online classes — including how to plan for a dance audition. Source here.

Artists are now designing striking face masks, teaching us to find beauty in even this new health requirement while enjoining others to do the same.

Abiquiú, NM-based artist, Suzie Fowler-Tutt, showing off her hand-sewn face mask color-coordinated with her hair adornments. Source here.

Powerful new works of art, such as this one by performance artist, Miles Greenberg, may speak to how many people feel these days — alone, awkward, defenseless, shackled.

This short but moving work of performance art by Miles Greenberg is part of a COVID-19-themed series for Document Journal. Source and video here.

But artists no longer have a monopoly on improvising new ways to cope with unprecedented challenges. Many who never considered themselves especially creative are finding themselves inventing new ways to cope with challenges and celebrate what remains noteworthy.

Neighborhoods are now organizing weekly shout-outs to thank those who risk their own health daily to care for the sick.

Every Friday night at 7 pm, residents up and down the street of this suburban neighborhood in RI stand outside their houses to clap, bellow, and bang their gratitude for local health care workers. Source here.

And those whose jobs put them daily in harm’s way are, themselves, figuring out the life-saving art of improvisation. In the U.S., thanks to an infuriating two months of inattention to the looming pandemic on the part of the Trump administration, medical professionals at risk of infection because of inadequate supplies are actually making their own masks.

In the U.S., lack of preparation for COVID-19 by the Trump administration propels hospital workers to sew masks. Unsurprisingly, this is feminized labor. Source here.

Workers in plenty of private businesses are also digging deep to find new modalities.

Distilleries that otherwise produce vodka have found a new use for excess alcohol: they are re-purposing that newly-hyper-valued substance into one of the rarest commodities of the day, sanitizing wipes.

Source with video clip here.

Inside supermarkets, managers are getting creative about indicating six-foot intervals delimiting where people should wait on the checkout line.

Meanwhile, gig-economy musicians position themselves outside those supermarkets, where they entertain customers awaiting their turn to enter at safely-spaced intervals.

With all this creativity occurring in the economy, I find all the more reason for us to take another look at the homeless.

And, no, I don’t mean because they are especially vulnerable. They are, but we already know that. We’ve known that for a long time. Too many books have been written about their vulnerability, with not nearly enough done to address it. Here, I’d like to point out something we rarely think about when we consider the situation of those who live on the streets.

By necessity, the homeless are masters of improvisation. From whatever tragedies led to their plight, they must scrounge anew for food and safe spaces daily. As if that weren’t enough, they must often manage these demanding tasks while being stigmatized, mocked, even arrested or assaulted. Although the homeless are more frequently the object of derision than admiration, their life skills in the face of almost unimaginable obstacles are extraordinary. Along with artists, they, too, could teach the rest of us some important life lessons.

As an anthropologist who researches the lives of homeless people in Leipzig, Germany, Luisa Schneider writes in a new poem:

while you wait it out at home

part of an expanding digital universe

connected to those you love

millions of us

have no doors to close behind us

or doors behind which

violence waits

or loneliness

or emptiness

or fear

(Source here.)

Even as many in the middle class (and beyond) are now coming to appreciate for the first time the low-paid workers who (often, invisibly) make their privileged world work — producing payroll checks, bagging groceries, cooking restaurant meals, packing and delivering packages, cleaning houses, teaching children — the one group that remains invisible for their life skills is the homeless. When this COVID-19 state of emergency finally passes, might this moment of global reflection produce new policies of compassion for helping the homeless to find new living quarters, while also helping them adapt their formidable survival skills to new careers?

What levels of grit and ingenuity are required to amass and transport daily this collection of necessary life goods as an impoverished, homeless urban nomad across the streets of NYC? Source here.

*

At the biomedical level, the most urgent lesson of this COVID-19 moment, of course, remains: isolate, isolate, isolate. For understanding the epidemiological challenges of this infectious disease emergency, we can turn to readable digests and thoughtful analyses of the week’s scientific COVID-19 findings such as this one, by the brilliant infectious disease specialist, Dr. Bill Rodriguez.

But that biomedical level has its counterpart in sociological factors — inevitably, given that humans are, above all, a social species.

The new catch-phrase guiding our lives is “social distancing.” For some, the required new habits of isolation are causing great loneliness and worse. For others, the phrase couldn’t be more of a misnomer, as people with access to advanced technology forge ingenious ways to stay in touch with those they hold near and dear. In the global North, Zoom is making geeks of technophobes.

I do not mean to underplay the suffering that the most vulnerable are enduring. Of course, that group includes not just the homeless but also the incarcerated and the medically compromised — the elderly, and those with the now-famous list of “underlying medical conditions” that, especially, stress the heart (diabetes, cancer, obesity, serious organ issues) as well as the lungs (asthma and respiratory conditions).

But it also includes the sociologically most vulnerable — the poor. And, in most parts of the world, that means, especially — for historical reasons having everything to do with the past half-millenium of European colonial expansion — people of color. Maps plotting those five groups — the homeless, the incarcerated, the medically vulnerable, the poor, and Black and Brown populations — are disturbingly close to isomorphic.

In a future post, I will explore these sorts of social vulnerabilities in this COVID-19 moment. Here, I want to end on a different note.

COVID-19 is forcing us to do no less than not only reinvent ourselves as individuals, but reinvent components of who we are as communities. For those who fear change but recognize the suddenly urgent need to embrace it, artists and the homeless alike offer powerful models of inspiration.

The transformations now occurring at every level of society will offer anthropologists research topics for years to come — starting with reëvaluating some unexpected benefits of what we might have formerly dismissed as fragility, and what we mean by “culture.”

Source here.

What Anthropology Teaches Us about COVID-19, Part 2: An Optimist’s Scenario

Here’s what I imagine could–and should–emerge from this viral nightmare.

Locally, stranger-neighbors will (re)discover each other. Re-appreciate the bonds of co-residence.

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  • Translate that appreciation into forging new relationships, even new neighborhood groups. Friendly elevator chats, book groups, block parties, children’s after-school clubs.
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  • Remember that our common humanity unites us more than our cultural differences divide us.

Online, new connections and groups will form.

  • In this often scary and lonely world, like-minded folks will find their way online to one another, whether as individuals or in groups.
  • The non-tech-savvy will discover their Inner Geek and figure out how to connect virtually.
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Politicians who specialize in policies of the heartless–generously supporting their own kind, and pretending their ilk have a monopoly on being human–will recover their souls.

  • Re-learn empathy for anyone other than their immediate families and business associates.
  • Translate that empathy for other humans into public policy supporting those other humans.

Globally, political leaders will recognize that it is actually possible to band together with parallel, even coordinated, strategies for the common good.

  • Translate that realization into new, viable policies to counteract climate change.
  • Dismantle the fossil fuel industry.
  • Enact international legislation promoting sustainable energy.
  • Invest in civic-minded engineers and their research.
  • Save the planet.

It’s true that I have a reputation for being a bit of a Pollyana in my family.

Still, even I don’t dare hope that any or all the above will happen overnight. Once the microscopic creatures causing COVID-19 chaos have (mostly) died off, we will need time to remember who we were.

But, also, time to think about who we want to be.

This horrible moment provides an important opportunity for us—as individuals, as communities, as nations, and as a globalized species—to rethink, well, everything.

What Anthropology Teaches Us about COVID-19, Part 1-Early Thoughts

Lesson 1:

Like the ducks and brants my husband and I see congregating regularly by the dozens along the shore’s edge of Narraganssett Bay near our coastal home, we humans are a social species.  (Audobon’s description of the Brant: “Feeds in flocks at most times of year”),

Whether indoors or out, whether in small numbers or large, whether in person, online, or at a distance, we crave others.  And not only for emotional needs.  Also, for economic and survival reasons.  With precious few exceptions, we modern humans haven’t survived the past ~100,000 years as hermits.

So, it’s no surprise that, when the bizarre daily habitus of “social distancing” becomes the “new normal,” we suffer.  We were meant to.

Lesson 2:

Like the Leonardo da Vincis or Zora Neale Hurstons we read about in chronicles of our most creative ancestors, we humans are a clever species.

Okay, so, we’re not all Albert Einstein or Sappho.  But, whether working at an easel or a computer, whether laboring alone or in a team, whether doing work of the mind, heart, or body, we specialize in problem solving.  We haven’t survived the past 100,000 years as modern humans by walking over cliffs en masse as lemmings do when they run out of choices. 

Yes, life and society have apportioned privileges unequally, contributing to unequal doses of resiliency at the individual level.  That is a heavy burden that psychologists specialize thoughtfully in addressing, even as our politicians ignore their responsibility in producing the structural inequalities that create such unequal apportioning. Once we emerge from this global crisis, even our most heartless politicians should have greater awareness of what it takes at the structural level to sustain a compassionate community.

For now, it’s important for all of us to remember that, collectively, we are a resilient lot.  Unlike every other species, we’ve figured out brilliantly how to safely move through, and even inhabit, every environment on earth, from sky to water, from arctics to tropics. 

Now is not a time for despair. The tiny creatures underlying today’s global crisis will not defeat us.

Lesson 3:

The bad news:

Coping with COVID-19 won’t be fun.  Some among us will suffer more than most—financially, emotionally, logistically. 

Those who survive on daily coffee and lunch dates, and weekly dinner parties or movie outings, may become especially frustrated and depressed.

A very small number of those among the most vulnerable of us–especially the elderly, those with compromised immune systems, and those in both categories–will not survive a viral attack.

That is a potential source of collective tragedy we must all work hard to mitigate.

The good news:

We are learning to thoughtfully prioritize scarce resources, with the greater good in mind.

Face masks are for front-line health workers, and for those with disease symptoms, to prevent them from spreading disease when they must go out and about.

Some stores are limiting the amount of COVID-related items they’ll allow shoppers to buy. Hoarders of masks and toilet paper are being shamed in cartoons, and warned everywhere to change their behavior.

Individuals aren’t the only ones being monitored. Stores are, too.

New York City has already issued $275,000 in fines to stores that have charged more than 10% higher-than-usual prices on hand sanitizers, disinfectant wipes, and face masks. The fines will apply for at least two months.

The community spirit being promoted by this pandemic has other positive effects. For those with Internet access at home, social media offer us amazing alternatives for remaining in touch with those near and dear to us. They also help us find our way to many new communities that can offer solace.

In the U.S., for those with limited Internet and data access, new options are emerging daily to provide access. Companies are actually offering expanded smartphone data at no charge, creating new Wi-fi hot spots, and offering free international phone calls.

No doubt, these profit-oriented corporations will return to greedy practices once the pandemic subsides.

But for now, at least some of them are actually being part of the solution. Their unusual pivot reminds us that, as a species, we will survive this challenge, as we survived all known pandemics—the Black Death, HIV-AIDS, Ebola and others.

Not only that, but if we live up to our vaunted cleverness, we may actually emerge stronger.

The moment will produce many heroes.  

Front-line health staff will bravely reduce the suffering of patients. 

Humane politicians will offer financial supports.  Germany has “promised companies ‘unlimited’ credit to keep them afloat” in an economic package . . . worth at least 550 billion euros ($614 billion) initially — the biggest in Germany’s post-war history.” Politics will even make strange bedfellows. Mitt Romney has just endorsed Andrew Yang’s proposal (at last for now) for a universal basic income.

Brilliant infectious disease specialists will analyze all available data and translate statistical and arcane knowledge into readable syntheses for ordinary readers.

Medical researchers will eventually create a vaccine.  The EU has already invested an emergency $89.4 million into the project.

And those are only the headline heroes.  We will have far more heroes who will never make the headlines.

On my neighborhood list-serv, someone who loves to cook has offered to bake a loaf of bread, and personally deliver it on foot, to any elderly or quarantined neighbor who requests one.  To be realistic, she clarified the approximate radius of how far she might walk to deliver samples of her kitchen’s output. Another neighbor soon magnified the offer: he’ll drive to pick up the loaves and deliver them by car to anyone farther than the generous baker’s walkable zone.

And that was only Day Two since my state’s governor declared first steps of “social distancing.”

Not convinced of our species’ capacity for creative and even limitless commitment to one another, no matter how far the physical distance required?  Check in soon for more encouraging ethnography, large and small.

Meanwhile, remember: As a species, we’ve got this.

Writing about Coffee

Despite being a lifelong non-coffee-drinker, I somehow found myself reading two fantastic books about coffee recently.

The first, Miriam Sagan’s A Hundred Cups of Coffee, hijacked me from reading the OTHER coffee book I’d just started. Sagan’s series of short meditations inspired by drinking a cup of coffee (and, occasionally, tea) here, there, and everywhere got me thinking profound thoughts as only Miriam (poet extraordinaire) can, about life, death, and everything in-between.

The second–David Liss’ The Coffee Trader–is another wildly compelling read about coffee, but in a totally different register. It’s a historically based novel set in 17th-century Amsterdam and has way more fascinating character development than a book with this good/fast a plot by rights should have.

Beyond the obvious (human) characters, the major, implicit (non-human) character is the relationship among the highly problematic trio of Secrecy, Trust, and Mendacity. I won’t say more about the gripping story other than to predict that if you are a fan of (or are intrigued by) one or more of the following, you’ll probably love this novel: coffee / Sephardic Jewish history / early-modern Europe / Dutch history / the development of global commodity capitalism / Jewish-Protestant relations / a gripping story (with sub-plots within sub-plots).

Enjoy both these each-in-its-own-way-amazing books over your favorite cuppa (fill in the blank).

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