Blood Work: Life and Laboratories in Penang by Janet Carsten

Abstract

Reviewed by: Blood Work: Life and Laboratories in Penang by Janet Carsten Stephen Pemberton Janet Carsten. Blood Work: Life and Laboratories in Penang. Durham, N.C.: Duke University Press, 2019. xvi + 240 pp. $25.95 (978-1-4780-0481-3). The centrality of blood to cultural understandings of kinship would seem to make blood banks and clinical laboratories fitting sites for ethnography. Our decades-long practice of framing blood donation as a gift exchange is another compelling reason for anthropological study of these sites. Since the 1990s, anthropologists have explored kinship with great acuity through cultural analyses of genetics, genomics, and organ donation. Yet the wait for an ethnography of a hospital-based blood laboratory has been surprisingly long. Janet Carsten’s Blood Work fulfills the [End Page 271] promise these medical settings have long signified. Her book should also serve as a model for anyone willing to consider that blood cultures may teach us as much about kinship as cultural analyses of organs, genes, or genomes. Carsten’s fieldwork involved extensive study of Penang’s private hospital labs and blood banks between 2005 and 2015. Her interest in these medical settings stems, in part, from her well-regarded scholarship on kinship, marriage, and migration in rural Malaysia. Blood Work extends Carsten’s prior expertise to the “atypical” Malaysian state of Penang (p. 16). As a former British colony, Penang’s current reputation for multicultural diversity and cosmopolitanism distinguishes it from much of Malaysia. As Carsten puts it, her book is about “multiple interconnectedness” in Penang (p. 26); it “follow[s] the blood” in order to disclose the complex sociocultural relations that make Penang and its people distinctive (p. 28). In this analysis, blood operates as “an idiom of connection between persons” (p. 4) as well as a “polyvalent” substance that is never reducible to any one of its forms, facets, or functions (p. 9). Carsten’s meticulous descriptions of blood work also situate blood as a substance in flux. Blood is at once denatured (p. 13) and rehumanized (p. 29), purified and hybridized (p. 11). For Carsten, Penang’s blood cultures are always reanimating blood with meanings that are extraneous to the clinical objective at hand. Reading Carsten’s book is also a fluid experience. Chapter 1 communicates Carsten’s observations of blood donation efforts in Penang. The donors appear genuinely motivated by their imagined kinship to gift their blood, a fact that is also expressed in their misgivings about any arbitrary restriction or commercial transaction of their donated blood. Chapter 2 moves to the clinical labs where blood is handled, giving attention to the social categories and distinctions that the medical lab workers use to make sense of their technical roles. Chapter 3 returns to the handling and management of blood and the peculiar kind of cultural work that laboratory technicians do to make blood clinically useful. Chapter 4 is the most unusual of these ethnographic chapters because Carsten maintains that local beliefs about ghosts, food, and interethnic spirituality seep back into the blood work of the laboratory. For Carsten, this “porous seepage” between work and social life reanimates and rehumanizes the blood with cultural significance (p. 199). On the one hand, the “uncanny” aspects of this seepage reflect the inherent risks and hazards of blood work that could endanger the worker’s health or the well-being of others (p. 186). On the other hand, there are “convivial” aspects to the seepage that give deeper meaning to the discipline and routine of the job (p. 166). Carsten is rigorous in showing the interconnectedness between blood work and the interethnic and multicultural aspects of Penang society. The book’s four ethnographic chapters on the hidden worlds of blood work are each preceded by an interlude on the “public life of blood.” These interludes detail how events communicated in Penang’s news media affect the social lives of blood donors, blood recipients, and blood workers. Consider, for example, her third interlude. It details how, in 2008, Malaysia’s national politics became fixated on a blood sample from Anwar Ibrahim—a chief political opponent of the Mahathir government. Anwar’s moral status and political fate reportedly hinged on his blood...