The family, as this ethnography illustrates, is increasingly the medical agent of the state, providing and at times triaging care, and medication has become a key instrument for such deliberate action.17 Free drug distribution is a central component of Brazil’s search for an economic and efficient universal health care system (a democratic gain of the late 1980s). Increasing calls for the decentralization of services and the individualization of treatment, exemplified by the mental health movement, coincide with dramatic cuts in funding for health care infrastructure and with the proliferation of pharmaceutical treatments. In engaging with these new regimes of public health and in allocating their own overstretched and meager resources, families learn to act as proxy psychiatrists. Illness becomes the ground on which experimentation and breaks in intimate household relations can occur. Families can dispose of their unwanted and unproductive members, sometimes without sanction, on the basis of individuals’ noncompliance with their treatment protocols. Psychopharmaceuticals are central to the story of how personal lives are recast in this particular moment of socioeconomic transformation and of how people create life chances vis-à-vis what is bureaucratically and medically available to them.18 Such possibilities and the fore-closures of certain forms of human life run parallel with gender discrimination, market exploitation, and a managerial-style state that is increasingly distant from the people it governs.
I need to change my blood with a tonic
Medication from the pharmacy costs money
To live is expensive
The fabric of this domestic activity of valuing and deciding which life is worth living remains largely unreflected upon, not only in everyday life, as Oscar, the infirmary coordinator, mentioned, but also in the literature on transforming economies, states, and civil societies in the contexts of democratization and social inequality. As this study unfolded, I was challenged to devise ways to approach this unconsidered infrastructure of decision-making, which operates, in Catarina’s own words, “out of justice”—that is, outside the bounds of justice—and which is close to home. Fieldwork reassembled the decision-making process at various points and in various public interactions.
This ethnography makes visible the intermingling of colloquial practices and relations, institutional histories, and discursive structures that—in categories of madness, pharmaceuticals, migrant households, and disintegrating services—have bounded normalcy and displaced Catarina onto the register of social death, where her condition appears to have been “self-generated.” Throughout this chain of events, she knows that the verb “to kill” is being conjugated; and, in relation to her, the anthropologist charts and reflects on what makes this not only possible but ordinary. This is also, then, a story of the methodological, ethical, and conceptual limits anthropology faces as it goes into the field and tries both to verify the sources of a life excluded from family and society and to capture the density of a locality without leaving the individual person and her subjectivity behind.
From the perspective of Vita and from the perspective of one human life deemed mad and intractable, one comes to understand how economic globalization, state and medical reform, and the acceleration of claims to human rights and citizenship coincide with and impinge on a local production of social death. One also sees how mental disorders gain form at the personal juncture between the afflicted, her biology, and the technical and political recasting of her sense of being alive.
How to restore context and meaning to the lived experience of abandonment? How to produce a theory of the abandoned subject and her subjectivity that is ethnographically grounded?
Catarina is subjected
To be a nation in poverty
Porto Alegre
Without an heir
Enough
I end
In her verse, Catarina places the individual and the collective in the same space of analysis, just as the country and the city also collide in Vita. Subjection has to do with having no money and with being part of an imaginary nation gone awry. The subject is a body left in Vita without ties to the life she generated with the man who, as she states, now “rules the city” from which she is banished. With nothing to leave behind and no one to leave it to, there remains Catarina’s subjectivity—the medium through which a collectivity is ordered in terms of lack and in which she finds a way to disentangle herself from all the mess that the world has become. In her writing, she faces the limits of what a human being can bear, and she makes polysemy out of those limits—“I, who am where I go, am who am so.”
Catarina’s subjectivity is discovered in her constant efforts to communicate, to remember, to recollect, and to write—that is, to preserve something unique to her—all of which take on new and special import in the zone of abandonment where she and I encountered each other. In a place where silence is the rule, and the voices of the abandoned are regularly ignored, where their bodies are politically useful only in the publicity of their dying, Catarina struggled to transmit her sense of the world and of herself, and in so doing she revealed the paradox and ambiguity of her abandonment and that of others. The human condition here challenges analytic and political attempts to ground ethics or morality in universal terms, or in the exceptions who stand outside the system. As I had to grapple with the ways Vita creates a humanity caught between visibility and invisibility and between life and death—something I came to call, sadly, the ex-human—I also had to find ways to support Catarina’s efforts to make feasible her own way of being.
In Vita, then—beyond kinship, the right to live, and the taboo against killing—emerges the social figure of Catarina. Her language, bordering on poetry, autopsies the human and grounds an ethics:
The pen between my fingers is my work
I am convicted to death
I never convicted anyone and I have the power to
This is the major sin
A sentence without remedy
The minor sin
Is to want to separate
My body from my spirit
The book brings forth the reality that hides behind this “I,” coming to a final line in Vita. It also transmits the struggle to produce a dialogic form of knowledge that opens up a sense of anticipation in this most desolate environment. How can the anthropological artifact keep the story moving and unfinished?
Vita 1995
Vita 1995
Vita 1995
Vita 1995
Vita 1995
Vita 1995