Editorial - Helen Ker
The recent science of epigenetics shows how our gene expression is altered by daily life. Diet, stress and parental care can switch genes on and off, providing a mechanism through which our experiences of the world may become embodied. Doctors must try to understand their patients’ cultural and physical environments because they matter not only personally but biologically.
As Dr. Hinemoa Elder puts it in an interview on cultural identity it’s about ‘placing the individual amongst the interdependent issues’. Māori world views have appreciated this connection between the body and environment for centuries. In a pepeha you introduce yourself in relation to the land and people you come from — your mountain, river and family. Who you are goes at the very end, because in a way that is the least important part. Of greater importance are the stories of the people you come from and the histories of the places you grew up, because that environment is part of you.
Social and political environments matter as well. As Alex Ker writes in his essay on gender and eating disorders, ‘our minds and bodies are ever-changing landscapes that deserve to heal.’ A media representation of anorexia that excludes trans and gender-diverse bodies makes it less likely for people to recognise themselves in a state of illness. In order to heal, Alex explains how he first needed to acknowledge that his body was worthy of help, something most of us take for granted. Health systems have a moral imperative to create safe spaces for all their users and to recognise and celebrate their differences. We have a long way to go, but conversations are opening and increased recognition of the individual suffering within each trans experience appears to be reducing stigma.
History leaves marks on our bodies. Rayhan Langdana explores the transference of Western medicine to India as a tool of colonial expansion. A similar colonial process took place in New Zealand in many ways. For example, the Tohunga suppression act of 1907 deemed it illegal for Tohunga (traditional Māori healers) to practise what were labelled their ‘regressive Māori attitudes’. Tohunga were not just spiritual healers, they were repositories of tribal knowledge, whakapapa and history. The contemporary health status of Māori today reflects this cultural domination and it is something we cannot ignore when treating our patients, particularly because these histories are still so young in New Zealand.
Bodies respond to their immediate surroundings. ‘The home is an autobiographical and private space that maintains the body’s edges,’ Samantha Dutton writes in her essay on bodily affectivity — a concept describing the malleability of bodies and the way in which they respond to their built environments. While these experiences are not quantifiable in any hard scientific terms, we don’t need external proof of their existence. Walking into a big building, a quiet library, or a busy cafe, we sense how our bodies close up or expand.
Issue 02: explores how our bodies respond to their cultural, physical and historical environments. Providing holistic and effective medical care means getting to know our patients better, understanding where they come from and what is important to them. Rather than treating our patients as though they all come from the same, homogeneous environment, let’s treat them in their own time and space.