An immense parceling out of the specific ways communities, families, and personal lives are assembled and valued and how they are embedded in larger entrepreneurial processes and institutional rearrangements comes with on-the-ground study of a singular Other. Still, there was always something in the way Catarina moved things from one register to the other—past life, Vita, and desire—that eluded my understanding. This movement was her own language of abandonment, I thought, and that forced my conceptual work to remain in suspense and open as well.
I visited Catarina many times over the past four years, seeing her last in August 2003. I listened intently as she carried her story forward and backward. In addition to tape-recording and taking notes of our conversations, I read the volumes of the dictionary she continued to write and discussed them with her. I greatly enjoyed working with Catarina—looking into her eyes; speaking openly of things one does not understand; searching and finding, with someone else, not a perfect form but the means of knowing. And one must also search for ways to make the knowledge of singularity and immediate history that one finds in the field contribute to the care of self and others (Rabinow 2003; Fischer 2003). Talking extensively to friends and colleagues about my conversations with Catarina led the study—and also Catarina and her writing—into new contexts and possibilities. I am thinking not solely of the force of her poetic imagination to reach other lives but also of the thoughtful ways in which some health professionals and administrators interacted with Catarina, with her social and medical condition, and with her critical thinking as this investigation progressed.
At times, I began to act like a detective, seeking out the concrete trajectory of Catarina’s exclusion from everyday life, the acceleration of her physiological deterioration, and the roots of her language-thinking. Taking Catarina’s spoken and written words at face value took me on a journey into the various medical institutions, communities, and households to which she continually alluded. With her consent, I retrieved her records from psychiatric hospitals and local branches of the universal health care system. I was also able to locate her family members—her brothers, ex-husband, in-laws, and children—in the nearby industrial town of Novo Hamburgo. Everything she had told me about the familial and medical pathways that led her into Vita matched the information I found in the archives and in the field. Through return visits, patience, proximity, the laborious production of data that was not meant to exist, and the thick description of a single life, a certain block of reality came into view.
In tracing Catarina’s passage through these medical institutions, I saw her not as an exception but as a patterned entity. That is, she was subjected to the typically uncertain and dangerous mental health treatment reserved for the urban working poor. Medical technologies were applied blindly, with little calibration to her distinct condition. Like many, she was assumed to be aggressive and thus was overly sedated so that the institution could continue to function without providing adequate care. The diagnoses she received varied from schizophrenia to postpartum psychosis to unspecified psychosis to mood disorder to anemia. I interacted with health professionals who had overseen her treatments as well as with human rights activists and administrators who were involved in efforts to reform these services. I was attempting to directly address the various circuits in which her intractability gained form, circuits that seemed independent of both laws and contracts (Zelizer 2005).
After talking to all parties in Catarina’s domestic world, I understood that, given certain physical signs, her ex-husband, her brothers, and their respective families believed that she would become an invalid, just as her mother had become. They had no interest in being part of that genetic script. Catarina’s “defective” body then became a kind of battlefield on which decisions were made within local family/neighborhood/medical networks, decisions about her sanity and ultimately about whether “she could or could not behave like a human being,” as her mother-in-law put it. Depersonalized and overmedicated, something stuck to Catarina’s skin—the life-determinations she could no longer shed.
But this work was not only about finding “the truth” of Catarina’s story. It also precipitated events. With the help of several doctors, we scheduled medical examinations and brain-imaging, and we discovered that Catarina’s cerebellum was rapidly degenerating. We then embarked on a medical journey to identify her ailment and determine what could be done to improve her condition. She was fighting time, and there was a real urgency about the knowledge being generated. As fieldwork linked Catarina to Vita, Catarina to her past, and her abandonment to her biology, it also occasioned Catarina’s reentrance, if all too briefly, into the worlds of family, medicine, and citizenship. These events in turn led to a familiarity with the machinery of social death in which Catarina was caught and an understanding of the effort it takes to create other possibilities. As the realpolitik of abandonment came into sharp relief, questions of individual and institutional responsibility were addressed in new and different ways.
As fieldwork came to a close, Oscar, one of Vita’s volunteers on whom I depended for his insights and care, particularly in regard to Catarina, told me that things like this research happen “so that the pieces of the machine finally get put together.” In our conversations and in her writing Catarina was constantly referring to matters of the real. Had I focused only on her utterances within Vita, a whole field of tensions and associations that existed between her family and medical and state institutions, a field that shaped her existence, would have remained invisible.6
Catarina did not simply fall through the cracks of these various domestic and public systems. Her abandonment was dramatized and realized in the novel interactions and juxtapositions of several social contexts. Scientific assessments of reality (in the form of biological knowledge and psychiatric diagnostics and treatments) were deeply embedded in changing households and institutions, informing colloquial thoughts and actions that led to her terminal exclusion. Following Catarina’s words and plot was a way to delineate this powerful, noninstitutional ethnographic space in which the family gets rid of its undesirable members. The social production of deaths such as Catarina’s cannot ultimately be assigned to any single intention. As ambiguous as its causes are, her dying in Vita is nonetheless traceable to specific constellations of forces.
Once caught in this space, one is part of a machine, suggested Oscar. But the elements of this machine connect only if one goes the extra step, I told him. “For if one doesn’t,” he replied, “the pieces stay lost for the rest of life. Then they rust, and the rust terminates with them.” Neither free from nor totally determined by this machinery, Catarina dwelled in the luminous lost edges of a human imagination that she expanded through writing. By exploring these edges alongside a hidden reality that kills, we have a way into present human conditions, ethnography’s core object of inquiry.
One reads many books and borrows from their languages to understand the world one lives in. One also takes them into the field, where their propositions might not always work that well but are nonetheless helpful in generating figures of thought. This is one of the many good things about anthropology and the knowledge it produces: its openness to theories, its relentless empiricism, and its existentialism as it faces events and the dynamism of lived experience and tries to give them a form. In this book, I integrate theory into the descriptions of what I found in my work with Catarina, the medical establishment, and her family. In a similar vein, I relate her ideas and writing to the theories that institutions applied to her (as they operationalized concepts of pathology, normality, subjectivity, and citizenship, for example) and to the general knowledge people had of her. Rationalities play a part in the reality of which they speak. They form part of what Michel Foucault calls “the dramaturgy of the real” (2001:160) and become integral to how people value life and relationships and “enact the possibilities they