The Demise of the Bumbler and the Crock: From Experience to Accountability in Medical Education and Ethnography

Abstract

In this article, I consider Howard Becker's 1955 research among medical students in relation to my own late-2000s research on standardized patients, or SPs (i.e., people hired to portray patients in staged clinical encounters with medical students). Becker's mid-20th-century subjects used the term crock for patients who presented obstacles to their acquisition of valued kinds of clinical “experience.” SP simulations, as one among many forms of simulation used to teach clinical skills today, exclude the possibility of crocks. While medical education has changed, so too has ethnographic practice. Becker's account of his fieldwork, like many at midcentury, portrayed the ethnographer as a clueless “bumbler” who, through experience, gains understanding and expertise and is transformed into a professional anthropologist. Today, by contrast, the necessity to account in advance for the risks, rewards, and outcomes of ethnographic research has rendered bumbling inadmissible. I argue that the disappearance of the “bumbler” and the “crock” as regular figures in the discourses of anthropology and medicine points toward a revaluation of “experience” in both fields and a shift toward new regimes of accountability, grounded in the changing political economy of knowledge production. At risk of being lost in the process are faith, surprise, and humor.