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Tidwell Dissertation FULL Distribution Agreement In presenting this thesis or dissertation as a partial fulfillment of the requirements for an advanced degree from Emory University, I hereby grant to Emory University and its agents the non-exclusive license to archive, make accessible, and display my thesis or dissertation in whole or in part in all forms of media, now or hereafter known, including display on the world wide web. I understand that I may select some access restrictions as part of the online submission of this thesis or dissertation. I retain all ownership rights to the copyright of the thesis or dissertation. I also retain the right to use in future works (such as articles or books) all or part of this thesis or dissertation. Signature: ___________________________________ ____________________ Tawni Lynn Tidwell Date Imbibing the Text, Transforming the Body, Perceiving the Patient: Cultivating Embodied Knowledge for Tibetan Medical Diagnosis By Tawni Lynn Tidwell Doctor of Philosophy Anthropology ______________________________________ Carol M. Worthman, Ph.D. Advisor ______________________________________ Sienna R. Craig, Ph.D. Committee Member ______________________________________ Melvin J. Konner, Ph.D. Committee Member ______________________________________ Chikako Ozawa-de Silva, Ph.D. Committee Member Accepted: ______________________________________ Lisa A. Tedesco, Ph.D. Dean of the James T. Laney School of Graduate Studies __________________ Date Imbibing the Text, Transforming the Body, Perceiving the Patient: Cultivating Embodied Knowledge for Tibetan Medical Diagnosis By Tawni Lynn Tidwell T.M.D. (Kachupa-equivalent), Tibetan Medical College, Qinghai University, 2015 M.A., Emory University, 2013 B.S., Stanford University, 2004 Advisor: Carol M. Worthman, Ph.D., Harvard, 1978 An abstract of A dissertation submitted to the Faculty of the James T. Laney School of Graduate Studies of Emory University in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Anthropology 2017 Abstract Imbibing the Text, Transforming the Body, Perceiving the Patient: Cultivating Embodied Knowledge for Tibetan Medical Diagnosis By Tawni Lynn Tidwell Tibetan medical diagnostics provide a powerful lens for understanding embodied expertise among Tibetan physicians. This investigation probes the transmission and practice of Tibetan medical diagnosis as a gateway to understanding the epistemic grounds for Tibetan conceptions of illness and healing. Participatory research as a student at two major sites for Tibetan medical training, Men-Tsee-Khang in north India and at Sorig Loling in Amdo, focused on the role of embodied knowledge in diagnosis along two analytic dimensions, namely physician as embodied diagnostic instrument, and patient as embodying disease processes. Training of physicians as diagnostic instrument is elucidated using biocultural methods, Mauss’s notion of habitus, and understandings of enacted cognition, memory, metaphor, and visualization from cognitive neuroscience. Disease processes embodied in the patient are tracked through a bioecocultural model of development and logics of biomarkers. Grounded theory from seventh century Buddhist logician Dharmakīrti’s approach to valid cognition—pramāṇa theory–acts as interlocutor with Western scholarship on these dimensions. This work challenges common assumptions about “rote memorization” and pedagogical values in Western education. It suggests that memorization, recitation, metaphor, and learning through praxis generate a conceptual-perceptual dialectic that drives processes cultivating embodied knowledge transmission. For the Tibetan physician, “methods of becoming” are “methods of diagnosis” by developing the senses, training the mind, and sculpting the physician’s skilled body as vessel and instrument for diagnosis and healing. Rigorous practice and associated self cultivation form the grounds for acquisition of expertise. This project documents a distinctive approach to medical education that simultaneously fosters rigorous medical knowledge and humanistic skills with distinctive diagnostic and therapeutic value. Imbibing the Text, Transforming the Body, Perceiving the Patient: Cultivating Embodied Knowledge for Tibetan Medical Diagnosis By Tawni Lynn Tidwell T.M.D. (Kachupa-equivalent), Tibetan Medical College, Qinghai University, 2015 M.A., Emory University, 2013 B.S., Stanford University, 2004 Advisor: Carol M. Worthman, Ph.D., Harvard, 1978 A dissertation submitted to the Faculty of the James T. Laney School of Graduate Studies of Emory University in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Anthropology 2017 Acknowledgements This dissertation would not exist without the support and community of many people and institutions. Special thanks to Carol Worthman who has supported my path and taken interest in my inquiries from the first day we met in north India. I am grateful for her piercing intellect, ceaseless energy, and brilliant wisdom that, fused with a courageous and boundless heart, enables her to apply deep inquiry into lasting benefit for the lives she touches. To Amchi Khenrab Gyamtso who accepted me as his student and patient, and has taught me with deep patience and care from our first lesson of the Gyushi and continues today. His vast understanding of Tibetan medicine and embodiment of humility and compassion are exemplary. Thank you to Sienna Craig for her rigorous scholarship, illuminating writing and ability to bring the heart of those with whom she works into all her narratives and analyses; I am indebted to you for helping me find my voice and your innumerable formative insights. Thank you to Mel Konner for his mastery in conveying ideas, indispensable agnosticism, inspiration for the fusion of humanistic medicine and technical brilliance, and his caring support. I am grateful to Chikako Ozawa-de Silva for pushing my scholarship and deepening my fluency in anthropological theory and its applications in all research. I am deeply appreciative to Susan Bauer-Wu for mentoring me as a young scholar in cancer research, teaching me rigor in clinical review, and her commitment to supporting young researchers and clinicians, culturally-sensitive inquiry, and mind-heart-centered scholarship. Beyond my committee, special thanks to Geshe Lobsang Tenzin Negi for providing cultural leadership and opportunity, foundational science-Tibet bridges, and commitment to and excellence in implementing the practicalities of His Holiness the Dalai Lama’s grand vision; Bobby Paul for building the foundations for productive cross-cultural discourse and collaboration between Western and Tibetan intellectual traditions; Gen Tsepak Rigzin, Sangey Tashi, and Gendun for training me in Tibetan language, literature, and colloquial discourse—I am indebted to you for your rigorous tutoring that gained me admittance to Men-Tsee-Khang and fostered a passion for Tibetan language within me; John Dunne for his exemplary scholarship and innovative transdisciplinary work, for his mentorship in Buddhist philosophy and translation skills, and for his generous and incisive feedback on this work; Sara McClintock for her great mind and humble heart, and for her patience in mentoring me in the massive edifice of academic Buddhist philosophical studies; Joyce Flueckiger for teaching me what ethnography is really about, joyfully providing her insights, sharing her mastery in craft of reading and perceiving culture; Tara Doyle for introducing me to the Tibetan world, shaping me as a young scholar and leader, and providing a treasured friendship that has seen me through the hardest times; Vincanne Adams for her close mentorship, dedicated support, perspicacious and foundational scholarship—it is an honor to carry on her anthropological lineage. I am grateful to Barbara Gerke for her dear friendship, warm heart and constant inspiration of rigorous scholarship. Bradd Shore for introducing me to psychological anthropology and analogic thinking, and encouraging me to write on embodied cognition in animal tracking. Bruce Knauft for early discussions helping formulate my research; Carl Brown for endless inspiration in adventures into the natural world; Chuck Raison for his brilliance and enthusiasm, and supporting me in all possibilities of my research; and Cat Prueitt for reading endless drafts and versions of my dissertation, and being the greatest informal writing boot camp director I could have ever had the great fortune of experiencing. Thank you to Emory University’s Department of Anthropology staff for excellence in administrative support, especially our cornerstone Lora McDonald. I am grateful to my cohort and our faculty for an inspiring and enriching intellectual environment. And I am thankful to the generous funding of the National Science Foundation and Wenner Gren Foundation for their support of this research. I am deeply grateful to all at Men-Tsee-Khang who have made my time there possible. Thank you to His Holiness the Dalai Lama for guiding my way from the beginning. Special thanks to Amchi Tamdin, personal physician to His Holiness the Dalai Lama, for accepting me as a student and unveiling how treatments reveal the nuances of diagnostics; Amchi Yeshi Dhonden for entrusting his remarkable life story with me; Men-Tsee-Khang director Tsering Tashi and Men-Tsee-Khang college principal Gen Tenpa Choepel for their kind support of my studies; Gen Jamyang for discussions and constant support in my development in Tibetan medicine; Gen Yeshe Gelek
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