UNIVERSITY OF CALIFORNIA SANTA CRUZ DISIDENTIFICATION WITH DIABETES: DIABETIC PUBLICS IN THE U.S./MEXICO BORDERLANDS A dissertation submitted in partial satisfaction of the requirements for the degree of DOCTOR OF PHILOSOPHY in ANTHROPOLOGY by Celina E. Callahan-Kapoor June 2016 The Dissertation of Celina E. Callahan- Kapoor is approved: ____________________________________ Professor Danilyn Rutherford, Chair ____________________________________ Professor Matthew Wolf-Meyer, Co-chair ____________________________________ Professor Nancy N. Chen ____________________________________ Professor Charles L. Briggs ____________________________________ Tyrus Miller Vice Provost and Dean of Graduate Studies Copyright © Celina Callahan-Kapoor 2016 CONTENTS LIST OF FIGURES ................................................................................................... viii LIST OF ABBREVIATIONS AND KEY TERMINOLOGY ..................................... ix ABSTRACT .................................................................................................................. x DEDICATION ............................................................................................................ xii ACKNOWLEDGMENTS ......................................................................................... xiii INTRODUCTION: PRODUCING, CIRCULATING, AND RESPONDING TO AN UNMOORED TRUTH ................................................................................................. 1 Dis-identifying with Diabetes ................................................................................... 1 Publics Formed through Identification and Dis-identification ................................. 6 Humiliation of Particularity: Publicity and the ever-present body as text .............. 13 Impossibility of Care in the U.S./Mexico Borderlands ........................................... 20 Methodology ........................................................................................................... 24 Mariana Clinic ........................................................................................................ 26 CrossFit and Zumba ................................................................................................ 27 Popular Media and Academic Scholarship ............................................................. 29 Outline of the Chapters ........................................................................................... 31 CHAPTER ONE: NEVERMORE THE “AMERICAN CONGO” ............................ 37 Who Belongs with Whom, and Why ...................................................................... 39 Contemporary Context of the Rio Grande Valley .................................................. 41 Constant Surveillance ......................................................................................... 42 Hub of Activity ................................................................................................... 44 iii Things You Can’t Know through the Census ..................................................... 45 Interconnection ................................................................................................... 47 Migration to the Rio Grande Valley ....................................................................... 50 Migrants for Work in Medicine .......................................................................... 51 Migrants for Work in Home Care, Construction, and to be With Family .......... 53 Colonias .................................................................................................................. 55 Bodies of Agriculture; Bodies of the Region .......................................................... 59 On Representation ................................................................................................... 62 Who Belongs with Whom, and Why ...................................................................... 67 INTERLUDE: SEDIMENTARY LAYERS OF HISTORY ...................................... 71 CHAPTER TWO: WHAT IS DIABETES? ............................................................... 72 Certainty and Doubt .................................................................................................... 72 Diabetes in Allopathic Medicine and Public Health ............................................... 77 Prevalence ........................................................................................................... 79 Social Science and Diabetes ............................................................................... 80 Diabetes History ...................................................................................................... 82 Melting Flesh, ‘Pissing Evil’, and a Dog Named Marjorie ................................ 82 Diabetic Economy ............................................................................................... 87 Diagnosis and Management in the Rio Grande Valley ........................................... 89 Diabetic Until Proven Otherwise ........................................................................ 89 Diagnosis............................................................................................................. 91 Management ........................................................................................................ 94 iv Making Up “We”: Who Is In The Measured Group? ......................................... 99 Conclusion ............................................................................................................ 111 INTERLUDE: DIABETIC UNTIL PROVEN OTHERWISE ................................. 113 CHAPTER THREE: “YES, BUT:” LIVING WITH MURKY ETIOLOGY .......... 114 Esme: Una Vida Agringada .................................................................................. 119 Conclusion ............................................................................................................ 131 INTERLUDE: EVERYDAY LIFE ........................................................................... 134 CHAPTER FOUR: TEMPTATION AND THE IMPOSSIBILITY OF CARE IN QDAY LIFE .............................................................................................................. 138 Learning QDay Life .............................................................................................. 144 Hopes and Dreams ................................................................................................ 146 Managing Consumer and Metabolic Temptation: Talking to Your Body, Caring for Your Family and the Nation ................................................................................. 150 Managing Temptation: Social Propriety ............................................................... 155 Responding to the Teaching of QDay Life ........................................................... 158 Gloria: Maintaining QDay Life by Imagining Necretizing Limbs ................... 158 Marianéla: Managing Temptation with Technology ........................................ 163 Edgar: Social and Seasonal Temptation ........................................................... 164 Temptation Nation: Non-profits, Raffles, Give-Aways, and Migration ............... 168 CHAPTER FIVE: BODY-BASED PUBLICS ......................................................... 178 CHAPTER SIX: MEDIATING BELONGING ........................................................ 211 Unmoored Statistics on TV ................................................................................... 234 v Gallup Polls: Questioning the Production ............................................................. 215 Responding to the Gallup Polls............................................................................. 218 Circulating the Unmoored Truth: Diabetesville, USA .......................................... 221 Diabetesville, USA ............................................................................................... 223 Description of Q&A .............................................................................................. 228 CHAPTER SEVEN: LEAVING DIABETESVILLE, USA ..................................... 243 A Visit to “Diabetesville, USA” ........................................................................... 243 Proxies and Publics ............................................................................................... 246 Aimée: Right Living, Genes, and the Nation ........................................................ 248 Illnesses You Have to Fight Not to Get ................................................................ 258 Estrella: Recalibration and the Feeling Body ....................................................... 260 Conclusion ............................................................................................................ 264 INTERLUDE: Border Fright .................................................................................... 267 Hortensia: Paper Borders ...................................................................................... 271 Eugenia: Radio-mediated Border .......................................................................... 275 CONCLUSION: IMPOSSIBLE BELONGING……………………………………278 REFERENCES ......................................................................................................... 292 APPENDICES .......................................................................................................... 323 Appendix A. Diabetic Creed ................................................................................