No Aging in India: Alzheimer's, the Bad Family, and Other Modern Things (review)

Abstract

Reviewed by: No Aging in India: Alzheimer's, the Bad Family, and Other Modern Things Rishi Goyal (bio) Lawrence Cohen . No Aging in India: Alzheimer's, the Bad Family, and Other Modern Things. Berkeley: University of California Press, 1998. 367 pp. Hardcover, $45.00. Paperback, $22.50. From the very first days of medical school, would-be physicians are told that 80 percent of diagnoses can be made solely based on the patients' telling of their histories. This bioethical axiom announces the value of listening well against the arresting and spectacular technologies of CAT scans, MRIs, and invasive diagnostic biopsies; yet, it is repeated so often, it is drilled so deeply, that it becomes almost lost in the meaningless echo of cliché. Percentages aside, the will to listen can prove achingly elusive in the modern world and it requires a gifted and laborious listener. Such is Lawrence Cohen, former medical student and current anthropologist, who, while clearly stepping outside of the biomedical box, marks the act of listening as central to his cross-cultural study of aging, and in so doing writes a work of astonishing beauty, conviction, and intelligence. In No Aging in India: Alzheimer's, the Bad Family, and Other Modern Things, Cohen attempts to untangle the excessive meanings that overdetermine the bodies of the old in the modern era. He wants to realize "the processes by which the age of a body comes to matter" (xvii) and, specifically, how the practices "by which bodily decay is experienced, named, measured, treated, and drawn into law and history and science" (xvii) are constituted. Through readings of nineteenth-century tropical medical textbooks, aryuvedic rasayana rejuvenation therapies, Indian nationalistic films, retellings of ancient epics, and American supermarket tabloids, Cohen shows that old age is a cultural construct participating in other forms of knowledge and power: biomedical, sociological, colonial, and historical. Through these imbrications and excesses, the old person is no longer seen as himself or herself, but instead as a metaphor for the moral decay of the family and the nation. In particular, Cohen distinguishes between cultural and biomedical understandings of old bodies. He traces a genealogy of gerontology from colonial discourses about "cerebral softening" and accelerated tropical aging to Dr. Ignatz Leo Nascher's disciplinary codification of "geriatrics" in the early twentieth century as a splitting of aging into its normal and its pathological forms. But this split was never so discrete, and the normal and the pathological spill into each other, leaving only a medicalized discourse that shies away from individuality and humanity. [End Page 369] Cohen initially went to Benares, a holy city on the Ganges, looking for senile dementia, but to his surprise and consternation couldn't find it. Instead, he found a set of languages and ideologies that denied the very existence of the plaques and tangles he was searching for. Suddenly, he found himself in new and frightening territory. He had come to study and classify diseases and people but discovered that those very classifying mechanisms were not as stable as he had thought. There was no aging in India—at least not until Western ideologies had seeped into the fabric of the nation. Alzheimer's was not a disease of the brain, but a disease of the family. The decay of family ties, and not some etiologic agent of disease, was seen as the causative factor of particular forms of dementia. Increasingly, Cohen became aware that Alzheimer's was not a fixed, ontologically secure entity but a "set of local and contingent practices rooted in culture and political economy" (6). What began as a simple anthropological study became a much larger exploration of how modernity and discourse shape the treatment and alienation of aging people. The old body, like Benares, is a plural-field site, where meanings become layered, one on top of another. Age is only one kind of difference, but "as a way of representing and understanding other sorts of differences between individuals and classes of individuals, [it] is critical to the articulation not only of individual bodies but of collective ones" (4). From the bakbak or apparently "crazy" mutterings of an old pagli woman to the profane sayings of a 109...