Blood Work: Life and Laboratories in Penang by Janet Carsten

Abstract

Reviewed by: Blood Work: Life and Laboratories in Penang by Janet Carsten Jenna Grant Janet Carsten. Blood Work: Life and Laboratories in Penang. Durham: Duke University Press, 2019. 256 pp. Janet Carsten's Blood Work: Life and Laboratories in Penang opens in an operating theater during a triple bypass surgery. The reader encounters the technological complexity of the procedure, which depends on a heart-lung machine to ensure the transmission of oxygenated blood to the body and the removal of carbon dioxide while the heart is stopped. The scene conveys a sense of the embodied expertise of the professionals involved—nurses, perfusionists, anesthetists, and the cardiac surgeon—who perform their tasks seriously and in quiet, casual sociality, talking shop and talking holidays. This counterbalance of life and death with the everyday, which Carsten maintains elegantly throughout the book, brings forward the significance of blood for anthropological inquiry. Blood has unique material properties—"striking color, liquidity, warmth while in the body, its smell, and the way it solidifies and changes color when spilled" (6)—and capacities of animation, namely sustaining life and bringing back to life those at the brink of death. Carsten argues that blood's material properties and its animating capacity are key to its elaboration as a metaphor in diverse domains, including kinship, religion, ethnicity, politics, and morality. Thus, blood, as both metaphor and material, is central to understandings of social and biological life. Blood Work explores the everyday labor of maintaining life through the donation, screening, labeling, cross-matching, and transfusion of blood in private hospitals in Penang, Malaysia. Siting an ethnography of blood in the pathology lab is an inspired choice as it foregrounds mid-level, often neglected actors in the hospital hierarchy—technologists, technicians, and managers, who tend to be women and Chinese Malaysian. (Malay, [End Page 483] the dominant ethnic group in Malaysia, are favored in education and employment; Chinese Malay constitute a slight majority in the population in Penang, though quotas favoring Malays still apply.) Blood work is both risky and boring, existential and technical. It must be carried out in minute exactitude. Rather than focusing on facts produced by heroic scientists, Carsten's laboratory study centers around spaces, people, and practices in the lab, including discourses and practices of blood, but it also encompasses much more—sharing food and exchanging gossip about weddings, scandals, and elections. As it turns out, a blood lab in Penang is an interesting place to learn about social relations, gender, religion, and ethnicity in Malaysia. Thus, Blood Work is also about contemporary urban life in Penang, conveyed with a historical richness and ethnographic sensitivity that only decades of sustained engagement allow. Penang's cosmopolitanism is shaped by its long history as an entrepôt, its religious and ethnic diversity, as well as its colonial and post-colonial classifications of citizens that, at times, conflate ethnicity, nation, and religion, as demonstrated by the categories on a statistical report on blood donors: "Chinese," "Indian," "Muslim," "Other" (42). Ethnicity shows up in jokes and repartee, discussions of weddings and funerals, and the pragmatism behind desires to diversify the lab so staffing is easier over various religious holidays. Ethnic diversity is part of Malaysia's self-narration of nationhood.1 Penang also has a lot of medical facilities, which are emblematic of the technocratic development policies under Prime Minister Mahathir and the post-independence state more broadly. Most staff in the lab were married women in their 30s with young children. Many were first generation college graduates and thus were representative of demographic trends toward increased opportunity for education and women's entry into the paid workforce. Carsten argues that social processes that have marked Malaysia are encapsulated in the spaces and trajectories of staff in the lab. The book moves from blood donation events (Chapter 1) to the laboratory spaces and the people who work there (Chapter 2) to the types of "blood work" carried out in the lab (Chapter 3). Chapter 4 explores the practices that make these spaces sociable and the sometimes-metaphysical anxieties that accompany efforts to demarcate the lab from the outside world. Analysis of the permeability of society and the institution of the hospital is...