© 2018 Lindsey A. Whitmore ALL RIGHTS RESERVED
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© 2018 Lindsey A. Whitmore ALL RIGHTS RESERVED ECOLOGIES OF CARE: WHITENESS, CLINICAL POWER, AND POST-OPIOID FUTURES By LINDSEY A. WHITMORE A dissertation submitted to the School of Graduate Studies Rutgers, The State University of New Jersey In partial fulfillment of the requirements For the degree of Doctor of Philosophy Graduate Program in Women’s and Gender Studies Written under the direction of Dr. Carlos Decena and Dr. Kyla Schuller And approved by ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ New Brunswick, New Jersey January, 2019 ABSTRACT OF THE DISSERTATION Ecologies of Care: Whiteness, Clinical Power, and Post-Opioid Futures By LINDSEY A. WHITMORE Dissertation Directors: Dr. Carlos Decena Dr. Kyla Schuller This project seeks to reveal and dismantle the many consolidations of power (racial, capital, ethical, affective) that structure and vitalize systems of clinical care in the U.S., both currently and historically. Attending to such consolidations of power exposes the ways in which individual harm and collective crisis function as forms of currency and value in U.S. clinical medicine today. These forms of currency and value are differentially distributed depending on one’s proper relation to the state and to key markers of difference—race in particular. As such, the contemporary sphere of U.S. opioid politics serves as a key backdrop for theorizing racial difference generally and whiteness more specifically as specific kinds of clinical and cultural capital in current systems of care. By examining U.S. opioid politics alongside three keywords – Pain, Crisis, and Recovery—this project ultimately seeks to track the ways in which available mechanisms for recognizing and responding to the supposed “fact” of pain in U.S. clinical medicine have resulted in the un-even enfolding of white bodies into the protective structures of the clinic under false promises of endless re-capacitation, while ii communities and bodies of color are systematically denied such access. Ethnographic research with participatory, peer-to-peer recovery communities in Franklin County, Massachusetts demonstrates vital alternatives for theorizing and enacting care otherwise by centering those who have largely been excised from institutional and state protection in the work of community-directed healing. Ultimately, this project argues that only by coming to terms with—and by becoming accountable to—the histories of violence and extraction that vitalize and securitize bodies of U.S. clinical power will we be able to imagine and then generate other systems and praxes of well-being and of care moving forward. iii Acknowledgements It is a pleasure and a privilege to finally turn this work out to the world—to take a deep breath and to let it live outside of the porous yet wholly protective shell that has nurtured it, fed it, and helped it to grow in ways I could never have conjured on my own. Thank you for meeting us here, where we are at. A dissertation is, it seems, an exercise in endurance. It pushes us and also permits us to remain enthralled in what Octavia Butler calls “positive obsession” in Verse 39 of The Book of the Living: God is Change, And in the end, God prevails. But meanwhile… Kindness eases Change. Love quiets fear. And a sweet and powerful Positive obsession Blunts pain, Diverts rage, And engages each of us In the greatest, The most intense Of our chosen struggles.1 In the midst of the ongoing traumas precipitated by the U.S. state and in the midst of the collective push to look directly at, turn out, and then re-figure all of the histories of iv dispossession that lay at the heart of what it means to “belong” in the United States, a “sweet and powerful” positive obsession such as this work has been, quite often, a very welcomed respite. Over and over again, this project has encouraged me to turn away from the structures and stories we’ve been invited (compelled, even) to invest in about the roots of harm and the labor of care. It has likewise encouraged me to turn towards, listening deeply to all those who believe that other worlds are in fact possible. I listen, and I learn, and in these pages, I try to apply the critical and emotional tools I’ve honed to the work of unraveling what we have been given and weaving something else from the refuse. If a dissertation is an exercise in endurance, one that has facilitated for me the pleasure of positive obsession—it is also, in many ways, a birth. It is a coming-to-term of a mash-up artifact made from what is inside me, blended and stirred together with infinitely generous offerings from all of the people, places, ideas, and lines of flight that comprise these words and these arguments. The energy of the gratitude I hold for such a birth is tremendous. First and foremost, I want to begin by expressing external gratitude to the two folks who believed in this project wholeheartedly from its very beginning: my mentors and committee co-chairs Dr. Carlos Decena and Dr. Kyla Schuller. I was first exposed to Kyla’s brilliant mind and incredibly supportive and dedicated mentorship during my first semester as a PhD student in the Department of Women’s and Gender Studies at Rutgers in the core seminar “Technologies and Poetics of Race, Gender, and Sexuality.” As a fresh-faced first year, I was immediately inspired by an incisive theorist who also demonstrated critical, ongoing commitments to the domains of feeling, sensation, and v affect. Later, as Kyla’s Research Assistant throughout the production and publication of her brilliant first book, The Biopolitics of Feeling: Race, Sex, and Science in the Nineteenth Century, I learned first-hand about the nitty-gritty work of producing rigorous critical scholarship and the many ways in which such a process demands a unique kind of endurance cultivated through learning to believe that there is indeed value and worth in one’s perspectives, arguments, and words. Kyla taught me much about how to tap into and become accountable to such forms of self-valuation. Bearing witness to Kyla’s ongoing, often relentless negotiations with the bodily realities of illness while also undertaking the daily work of endurance and the exertive work of pushing back against the disciplining norms of mainstream, Western bio-medicine has continuously shaped and re-shaped my own vision of what critical work can look like. I am exceedingly grateful for all that Kyla has so generously given both to this project and to me directly in the form of friendship and the opportunity for convivial collaboration. I look forward to so much more. Although I did not have the chance to work with Carlos Decena in the classroom, I came to him seeking guidance and mentorship around my nascent dissertation ideas just after completing course work. I was beginning to consider integrating ethnographic methods into my work on economies of care, and Carlos’ critical, interdisciplinary, ethnographic work with queer Dominican communities was a compelling model for my own inquires. He received me and my seedling project with open, inviting arms. From the time of our very first meeting, Carlos’ guidance and perspective breathed life into this work by encouraging me—pushing me, even—to tap into the vital commitments I maintained to family and community as key sources of inspiration in my academic work. vi In the process, Carlos was one of the first mentors in my graduate experience to “see me” in my full complexity as first-generation college student with working-class roots who wanted to integrate such experiences fully into my critical contributions. Such recognition sanctioned me to speed ahead in ways that shame and fear had often squelched prior to our relationship. I am eternally grateful to have found such recognition and encouragement. Later, as I slogged through the many drafts of these chapters, Carlos continued to remind me to center the vital pleasures of writing and to cultivate a writing practice that honored the spiritual and even erotic dimensions of this work as much as the labor of reading and writing. Following such encouragement to turn towards the many pleasures of this process, to revel in the psychic play of crafting argument, and to not drown in doubt and fear is a major part of what sustained this work and I have Carlos to thank for such gifts. In addition to the committee’s two co-chairs, I am also massively grateful to the rest of my committee, which is comprised of three additional, equally brilliant mentors who have shepherded and supported this project through to its completion. Thank you to Dr. Jasbir Puar, whose fearless commitment to a politics of liberation no doubt shows us how to do the critical work that will move us closer to the different world we vision. Thank you to Dr. Sylvia Chan-Malik, whose methodologies seminar was central to my own move towards ethnography and who shows us everyday what it looks like to live critically in the world in a way that is full and that honors all the many parts of our selves. And thank you to Dr. Lisa Diedrich of Stony Brook University, who I met as I was just beginning my PhD process and whose work has since proved indispensable to me for vii thinking through the politics and political economy of the clinic. It is a true privilege to know that each of these scholars is taking the time to attend to my work. In addition to my dissertation committee, I would also like to extend gratitude to Zakia Salime of Rutgers’ WGS and Sociology departments.