martes, 2 de noviembre de 2010

The space of the hospital I

Ok, then. So I will try to use this blog to start thinking about and writing on my dissertation.
Here is my first reflection on the space of the children's hospital where I conducted my fieldwork.
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Located in the heart of a middle class neighborhood the children's hospital is built in a two full city blocks area surrounded by four streets. It actually breaks the pattern of the streets and two streets bump into it and have to circumscribe it. The hospital has more than 20 buildings and more than 60 departments, services, and units. The children's hospital is dependent of the Buenos Aires city government, and is one of the two main pediatric hospitals in Argentina (patients and families come from all over the country, even from bordering countries). Jointly with the national children's hospital these two hospitals are the main public institution when high complexity is needed.
There is a wide range of social actors dwelling in these buildings: all sorts of professionals, administrative staff, family members, and children as patients or healthy siblings shape the human landscape of the hospital. Within this constantly changing assemblages a relatively small group of children live under critical conditions and are characterized and narrativized by different professionals as “terminally ill.” These narratives, of course, are never clear. The line is often drawn between the ones, who are still receiving curative treatment (Chemotherapy, Radiotherapy, and others), and the others, who “passed” to Palliative Care (PC). (Although children can move back and forth from one “phase” to the other endlessly.) This precise point in which some children are seen as non-adherent of any curative attempt, and, therefore, “pass” to palliation is critical. On the one hand, it shows the marginal position of the PC professionals who can only “receive” the children and have relatively few options to influence the trajectories of children and families within the hospital before this precise event; on the other hand, it frequently produces a separation from the curative professionals (Oncologists, Hematologists, etc.) that is seen through children’s and parents’ eyes more as denial and aversion: patients/families that have to be avoided, people that no longer require their services.
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The Palliative team at the children’s hospital has a connection with the Argentinean branch of Make a Wish Foundation. This is an organization that started in US with the aim of producing wishes to terminally ill children. Wishes of any kind are being generated all over the world through the hundred of branches. I think what is important here is desire in itself. The production of certain kinds of desire, with specific aims, under particular conditions, ultimately, is also producing desirability for certain kinds of terminally ill children. These “most wanted” children, “clients” of this foundation, need to be in the exact phase of their ill condition: they cannot be too ill (they would not enjoy their own wish, and the wish-makers would feel distressed) nor be too healthy (their wishes have no sense). In the picture below one can see a girl who has at least three sources of desirability (besides her cancer): her gender (woman), her ethnicity (from India), and her family status (orphaned) make her a desirable target of charity.
This technology permits to focus the gaze into desire, and, in so doing; it shows different intensities of the will. It is like desire produces a side-road of what you have to live (on both side, the wish-givers and wish-receiver): you know you are going to die, but death resides (for a moment) as the background.

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