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Memoriam note

Clark E. Cunningham’s Cutting-edge Contributions to Research on Biomedical Appropriation in Southeast Asia

Contributions de pointe de Clark E. Cunningham à la recherche sur l’appropriation biomédicale en Asie du Sud-Est
Lorraine V. Aragon et Susan Orpett Long
p. 193-202

Résumés

Clark Edward Cunningham (1934-2020), professeur émérite de l’université de l’Illinois (États-Unis), a été le pionnier dans les domaines de l’anthropologie médicale et de la biomédecine en Asie du Sud-Est dans les années 1960 et 1970. Les contributions de C. Cunningham à l’anthropologie de la Thaïlande et de l’Indonésie sur les questions de santé, la structure sociale, le symbolisme et l’habitat, sont le fruit de décennies de travail sur le terrain. Ses influences exemplaires en matière d’enseignement et de recherche perdurent. Au-delà des détails biographiques et des réflexions personnelles de deux anciennes étudiantes (Lorraine V. Aragon et Susan O. Long), cette note commémorative scindée en deux parties met en lumière la clairvoyance et la perspicacité de l’article que publia C. Cunningham en 1970 dans la revue Social Science and Medicine intitulé “Thai Injection Doctors: Antibiotic Mediators”. Malgré le caractère bref et le style propre au xxe siècle de cet article, les points principaux portant sur un mode de guérison biomédicale populaire et semi-illicite qui a fait son entrée sur le marché rural thaïlandais sont toujours d’actualité cinquante ans après sa publication.

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Texte intégral

The authors wish to thank Dr. David W. Plath and Karla Harmon for their assistance in locating photographs and providing biographical information. We are also grateful to Nathalie Cunningham and Eric Cunningham for their permission to use the 1960s fieldwork photograph.

Part I. by Lorraine V. Aragon

1Clark Edward Cunningham (1934-2020), professor emeritus at the University of Illinois (USA), pioneered the subfields of medical anthropology and biomedicine in Southeast Asia during the 1960s and 1970s. Cunningham’s wide-ranging contributions to the anthropology of Thailand and Indonesia emerged from decades of fieldwork in the region. He published ground-breaking articles on an array of topics including Thai rural medicine, Indonesian (West Timor) social structure, Atoni (Meto) Timor cosmology, kinship, and house symbolism; and Indonesian (Toba Batak) migration patterns within Sumatra and beyond. Clark Cunningham’s academic leadership positions and institutional collaborations were extensive, as were his efforts to train and support Ph.D. students in Anthropology, including many from Southeast Asia. The respect and admiration C. Cunningham generated among scores of pupils and colleagues over his long career emanated from the profound depth of his intellectual scholarship combined with his even-tempered personality, disarming kindness, generosity, and dry wit. As befitted the son of a police detective from Kansas City, Missouri, Clark was an eager adventurer, an excellent poker player, and highly adept at the felicitous but indirect kinds of speech observed in many Southeast Asian places.

2A Rhodes Scholar, C. Cunningham completed a bachelor of letters and D. Phil (1963) at Oxford University where he studied under Rodney Needham, one of the first British scholars to engage with, edit and translate the writings of Claude Lévi-Strauss and the Dutch structuralist F.A.E. van Wouden (Aragon & Russell 1999a: xl). Also while at Oxford, he was attracted to the work of Edward Evans-Pritchard. Professor Cunningham’s first position was as a Lecturer at Yale University, where he had earned his B.A. degree. He soon was invited to join the faculty of a newly established Department of Anthropology in the University of Illinois at Urbana-Champaign where he stood out not only as a teacher and mentor, but also for the energy he poured into developing new programs.

3C. Cunningham was Head of the Anthropology Department for five years during the period it became one of the leading departments in the nation. He helped expand Southeast Asian studies in the University’s Center for Asian Studies, and he was a member of the campus team that created an innovative program whose students graduated with an MD degree as well as a PhD in an academic discipline. C. Cunningham created a course in Asian-American Studies, which he taught voluntarily as an overload for several years until an Asian-American Studies Program was established. In retirement he continued to do field studies of, and publish his findings on, Indonesian-Americans. When the new Spurlock Museum of World Cultures was opened on campus in 2002, he became its Curator for Southeast Asian Ethnography, and donated his personal collection of Indonesian textiles. He sat on the Museum’s Board of Trustees and served a term as its president (2008-2009). His students and colleagues honored C. Cunningham with a volume of original research essays and an effort to theorize how structuralism and poststructural theory evolved through anthropological studies of Southeast Asia in particular (Aragon & Russell 1999b).

4C. Cunningham survived his Finnish-born wife Aulikki Kokko-Cunningham, a professor of medicine at the University of Illinois, with whom he shared an interest in all things medical and cross-cultural. C. Cunningham transcended some mid-life medical challenges to continue his teaching, research, and professional engagement until and beyond retirement. He passed away at home, attended by his two adult children, Eric and Nathalie, in Urbana, Illinois, on 18 April 2020.

5Moving beyond these brief biographical details, this part of the Memoriam essay will highlight the foresight and continued significance of C. Cunningham’s prescient 1970 Social Science and Medicine article titled “Thai 'Injection Doctors': Antibiotic Mediators.” Despite its brevity and clipped twentieth-century style, the main points of this essay hold up well fifty years after its publication. With keen observational skills, C. Cunningham discerned, documented, and worked to explain how the social and knowledge gap between Thailand’s urban-based licensed physicians and traditional village healers was filled by “unlicensed doctors” whose skills included injecting biomedical drugs (antibiotics, vitamins, rehydration fluids, even contraceptives), which were readily accessible without a prescription at that time in rural Thailand. C. Cunningham recognized a new appropriation of biomedical knowledge when he saw it, and also made penetrating observations about changes to the local Thai economy of healing.

6In the “Thai Injection Doctors” article, C. Cunningham presents local statistics on healer types and villagers’ choices, ethnographic descriptions of injection treatments, and interview data from two practicing injection doctors. He also presents a table of seven categories of related terms used by his informants for various types of “doctors” or local healers, ranging from degreed physicians to traditional ritual healers (Cunningham 1970: 3). Most importantly, C. Cunningham analyzes how, without engaging in the customary ritual ceremonies of Thai “ancient” healers, the new medical technicians known as injection doctors worked much “like electricians or mechanics,” generally under the radar of state supervision, essentially making para-biomedical healing practices into a “market-type activity” (Cunningham 1970: 9).

7With this short and unassuming article, C. Cunningham demonstrated how unlicensed “injection doctors” had created a new “grassroots” healer niche, one which was widely preferred by Thai rural villagers in search of fast, “modern” treatments delivered in their familiar village setting. C. Cunningham used a straightforward anthropological case study model that established the significance of investigating local appropriations, interpretations, and adaptations of biomedicine in Southeast Asian social contexts. Most crucially, he avoided simply pitting traditional versus biomedical practices along a single spectrum of rural Thai healthcare preferences. Instead, he identified the emergence of a novel modality of healing that fit into neither the indigenous-traditional or imported-biomedical categories.

8To highlight the usefulness of the “Thai Injection Doctors” article as a medical anthropology investigative model, I offer a comparison with my own research, which addresses Indonesian sociocultural change but not medical anthropology per se. I conducted my dissertation fieldwork mostly among minority Protestant communities in Muslim majority Indonesia, rather than Theravada Buddhist Thailand, and my focus was on religion and national development, not healing specifically (Aragon 2000). I discovered quickly, however, that European Protestant missionaries in the late 1800s and early 1900s had utilized biomedicine, everything from aspirin and iodine to laxatives, as “free gifts” and services, goods which tempted potential converts by demonstrating Christian missionaries’ superior biomedical knowledge and cosmological power (Aragon 1996). What I recognized was that biomedicine and religion could not be separated in the highland Central Sulawesi context.

9When I conducted my longest period of fieldwork in highland western Central Sulawesi between 1986 and 1989, Salvation Army Protestant communities still were served by church-run village medical clinics and hospitals, whereas all others in the region, including the Muslim populations, were served separately by government-funded, state-run biomedical centers. I observed that European Christian missionaries, the last ones to be permitted to work in the upland Christian-majority areas, and their local church-educated health workers and ministers, still emphasized to their congregations and patients that biomedicines alone would not cure them. They asserted, rather, that only biomedicines in conjunction with the blessings of God upon the truly faithful would heal. It was easy for me to see that religion and healing could not be separated in the region, just as they had been combined under the indigenous priestly healers (tobalia, Uma language) before the Netherlands East Indies and the post-World War II Independent Indonesian state defined a separate category of scriptural religion (agama, Indonesian).

10What I did not think about when I wrote my 1992 dissertation and 2000 book, however, was how what C. Cunningham had noticed in his “Thai Injection Doctors” article was also at play in highland Central Sulawesi villages, at least on a small scale. I saw what the missionaries were doing and how they pitched the religious significance of their duties of care—which indeed were generally beneficial to the many villagers suffering from tuberculosis, pneumonia, malaria, cholera, dysentery, breech births, infected wounds, and more. I also saw the continuity of older ideas about severe illness being curses caused by transgressive behaviors. I observed many uncertainties about whether common folk medicines—herbal tonics, poultices and the like—were allowed by the church or considered wicked devil’s work. As one elderly woman who hesitated to show me her poultice-making skills put it, her family and community did not want any “trouble with religion” (persoalan agama, Indonesian).

11But, there was one health worker, a popular one, whose significance I did not fully appreciate at the time of my fieldwork. I only recall and tell her story now in light of rereading the “Thai Injection Doctors” article carefully. The elder woman I will call Tina Marie once had worked as a Salvation Army nurse but, unlike most Salvation Army “officers,” she had left her post (for reasons unknown) and returned to village life as a rice farmer and homemaker. During my fieldwork, she did a bustling side business in biomedical healing, outside the village’s formal medical clinic, which was located very near to her house. Just as C. Cunningham described, patients preferred to come to Tina Marie’s village home, or have her come to their houses for treatment.

12Tina Marie was a locally born, ethnic Tobaku woman and thus she was a native speaker of the local Uma language. She knew how to communicate with everyone in the area with a full grasp of all local terms for body parts, ailments, and their expected causes. Most of the Salvation Army clinic nurses, by contrast, were from Java or other Indonesian islands. None of them came to their posts speaking the local languages, which are distinctly different from Indonesian (or Malay). Instead, the nurses assigned to the Sulawesi highlands expected all patients to communicate with them in the Indonesian national language. Salvation Army policy, in fact, was to avoid placing staff back into their home areas for fear that they would give into family or other hierarchical pressures and perhaps even turn to financial corruption. Although C. Cunningham did not emphasize linguistic issues in his article, it stands to reason that preferences among local modalities of healing—with or without newly imported biomedical elements—correlate closely with service providers whose vernacular languages closely match those of their patients.

13Tina Marie provided her highland Central Sulawesi neighbors with midwifery support, biomedical pills (all available without a prescription) from in-town pharmacies, and also injections, which she had learned to give through her earlier training as a nurse. Essentially, Tina Marie’s home-based healing also was a “third way” between the state- or church-run biomedicine clinics and the villages’ older “traditional” healers who worked without any biomedical training. I did not think to follow C. Cunningham’s lead to survey the extent of Tina Marie’s practice, relative to the other modes of healing (traditional and clinic-based), within the community where I carried out my research. In essence then, the easily missed brilliance of Clark Cunningham’s early contribution to medical anthropology was his ability to collect the needed data, transgress the dichotomy of biomedicine versus traditional healing, and recognize the tacit yet tolerated eruption of a third way of managing care in rural Southeast Asia. This was a bold step forward in 1970. It will be interesting to read contemporary research to see whether that third mode of care has continued to evolve, as we can expect it has.

Fig. 1. C. Cunningham in Timor, Indonesia, 1960s

Fig. 1. C. Cunningham in Timor, Indonesia, 1960s

Photo: C. Cunningham collection, courtesy of Nathalie Cunningham

Part II. By Susan Orpett Long

14C. Cunningham’s training at Oxford as a social anthropologist led him to maintain broad interests in social organization and social change throughout his career. Included in his dissertation fieldwork in the 1950s was some attention to health behavior and conceptions of illness, but only as part of a broad ethnographic study. Later, in two extended periods of fieldwork in northern and north-central Thailand in the 1960s and 1970s, he focused his research specifically on health and illness behavior, tying these to population change and urban-rural dynamics. His most well-known and accessible publication in medical anthropology, discussed above, “Thai 'Injection Doctors': Antibiotic Mediators” (Cunningham 1970) came out of that fieldwork. He also began a decades-long collaboration with colleagues on the faculty of Chiang Mai University regarding rural health and medical education, encouraging the incorporation of social sciences into the medical school curriculum.

15C. Cunningham’s work in Thailand led him to work with colleagues to establish the Medical Scholars program at the new medical campus in Urbana of the University of Illinois College of Medicine. Over the years that program resulted in not only MDs with PhDs in the sciences and the arts, but also attracted a number of joint MD/PhD candidates pursuing anthropology and medicine. By the mid-1970s, C. Cunningham was also regularly teaching a course in the anthropology department to introduce students to the emerging field of medical anthropology. I was fortunate to take that course in 1976, and it has had a major impact on my career as a medical anthropologist specializing in Japan.

16The Anthropology of Health and Illness introduced students to some of the major scholars who were instrumental in defining the emerging field: Alexander Alland, George Foster, Charles O. Frake, Charles Leslie, Richard Lieban, Benjamin Paul, Arthur Rubel, and others. The course reinforced for me as a graduate student specializing in sociocultural anthropology that the biological and the cultural are inseparable, and that numerous ethnographic approaches could contribute to understanding human health and illness. As an instructor, C. Cunningham also encouraged his students’ medical anthropological imaginations by including readings about emic definitions of haak ts’an [a local illness category with symptoms resembling measles but with an etiology of spirit loss] and measles in Hong Kong (Topley 1970), and the practice of drinking “fairy water” to treat cholera in southwestern China (Hsu 1955). We learned more about Thai injection doctors, hierarchies of treatment resort, and plural medical systems based in part on C. Cunningham’s own research. Some of the course’s most significant messages are that expectations matter, that things are not always what they seem to biomedical practitioners, and that “traditional” and “modern” medical systems, practitioners, and beliefs are not dichotomous, but equally grounded in the reality of their political economic and sociocultural setting. Rather, as Mei Zhan would express decades later concerning the globalization of Chinese medicine, specific medical and cultural practices are “not building blocks upon which a system of differences [can] be built; rather, they [are] relationally produced from particular sociohistorical locations and encounter” (Zhan 2009: 184). The lessons from Cunningham’s course have remained with me and have continued to inform my teaching of medical anthropology.

17In his class, I discovered a personal passion for medical anthropology that led me to a path as a sociocultural and medical anthropologist in my own career. My dissertation topic looked at the careers of Japanese biomedical practitioners and the social organizational and cultural factors that impacted the local practices of biomedicine there, which of course later allowed me to see the many ways in which medicine is negotiated, constructed, and appropriated in the US, as well. My first publication was called “The Ins and Outs of Doctor-Patient Relations in Japan” (Long 1980) and subsequent work has continued to interrogate the relationship between medical practice and illness behavior on one hand, and social structure, health policy, and cultural factors in Japanese life on the other.

18A colleague who worked in northern Thailand under C. Cunningham’s direction, Daniel Weisberg and I had many discussions during and after graduate school about the culturally specific meanings of biomedicine we encountered in our fieldwork. A special issue of Culture, Medicine, and Psychiatry entitled, “Biomedicine in Asia: Transformations and Variations,” that we co-edited (Weisberg & Long 1984) documented the varieties of biomedical practices found in plural medical systems in a number of settings in Asia and raised questions of patient and practitioner choice, cultural meanings, and biomedical appropriation. My own interest in all of these topics can be traced back to “Thai Injection Doctors” specifically, and more broadly, to my coursework and discussions with C. Cunningham. Medical anthropology has continued to frame my work even as I have worked in more recent years on related issues of elder care and biomedical ethics.

19As I mourn the death of a professor who has had such a large influence on my career, I am reminded also about the ways in which he was a model of what it means to be an excellent professor. Although we might count numbers of his publications or graduate students trained as a faculty member’s measure of achievement, what I think of first is his vast knowledge in anthropology and Southeast Asian studies, his genuine kindness, and his willingness to mentor students like myself, even when they were not officially his own. He was quietly enthusiastic and sincerely friendly in the classroom and out. He had a wonderful dry humor and a humility about his own accomplishments that made him readily approachable. I hope that by including this note of memorial in the current collection, Clark Cunningham’s early explorations of medical anthropology in Thailand will inspire future work on biomedicine and its appropriation in Southeast Asia and beyond.

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Bibliographie

ARAGON, Lorraine V., 1996, “Twisting the Gift: Translating Precolonial into Colonial Exchanges in Central Sulawesi, Indonesia”, American Ethnologist, 23 (1): 43-60.

ARAGON, Lorraine V., 2000, Fields of the Lord: Animism, Christian Minorities, and State Development in Indonesia, Honolulu: University of Hawai’i Press.

ARAGON, Lorraine V. & RUSSELL, Susan D., 1999a, “Introduction: Delineating Theoretical Approaches to Southeast Asian Anthropology,” in Structuralism’s Transformations: Order and Revision in Indonesian and Malaysian Societies (Papers Written in Honor of Clark E. Cunningham), Lorraine V. Aragon & Susan D. Russell, eds., Tempe, AZ: Arizona State University Program for Southeast Asian Studies Monograph Series Press, xxiii-lxii.

ARAGON, Lorraine V. & RUSSELL, Susan D., eds., 1999b, Structuralism’s Transformations: Order and Revision in Indonesian and Malaysian Societies (Papers Written in Honor of Clark E. Cunningham), Tempe, AZ: Arizona State University Program for Southeast Asian Studies, Monograph Series Press.

HSU, Francis L.K., 1955, “A Cholera Epidemic in a Chinese Town,” in Health, Culture and Community: Case Studies of Public Reactions to Health Programs, Benjamin D. Paul & Walter B. Miller, eds., New York: Russell Sage Foundation, pp. 135-154.

LONG, Susan Orpett, 1980, “The Ins and Outs of Doctor-Patient Relations in Japan”, American Journal of Chinese Medicine, 8 (1): 37-46.

TOPLEY, Marjorie, 1970, “Chinese Traditional Ideas and the Treatment of Disease: Two Examples from Hong Kong”, Man, New Series, 5 (3): 421-437.

WEISBERG, Daniel & LONG, Susan Orpett, eds., 1984, “Biomedicine in Asia: Transformations and Variations”, Culture, Medicine, and Psychiatry, 8 (2): 117-205.

ZHAN, Mei, 2009, Other Worldly: Making Chinese Medicine through Transnational Frames, Durham: Duke University Press.

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Annexe

Clark E. Cunningham Bibliography of Life’s Works

CUNNINGHAM, Clark E., 1958, The Postwar Migration of the Toba-Bataks to East Sumatra, Cultural Report Series, no. 5. New Haven, CT: Yale Southeast Asian Studies Program [multiple printings 1958-1977].

CUNNINGHAM, Clark E., 1962, People of the Dry Land: A Study of the Social Organization of the Indonesian People, D.Phil., Faculty of Anthropology and Geography, University of Oxford, Oxford.

CUNNINGHAM, Clark E., 1964, “Atoni Borrowing of Children: An Aspect of Mediation”, Proceedings of the American Ethnological Society, pp. 21-37.

CUNNINGHAM, Clark E., 1964, “Order in the Atoni House”, Bijdragen tot de Taal-, Land- en Volkenkunde, 120: 134-68. [Reprinted in: 1972, Reader in Comparative Religion, W. Lessa & E. Vogt, eds., New York: Harper and Row, pp. 34-68. Revised in: 1973, Right and Left, R. Needham, ed., Chicago: University of Chicago Press, pp. 204-238].

CUNNINGHAM, Clark E., 1965, “Order and Change in an Atoni Dynasty”, Southwest Journal of Anthropology, 21 (4): 359-382.

CUNNINGHAM, Clark E., 1966, “Categories of Descent Groups in a Timor Village”, Oceania, 37: 13-21.

CUNNINGHAM, Clark E., 1966, “Urgent Research in Northern Thailand”, Bulletin of the International Committee for Urgent Anthropological Research, 8: 57-74.

CUNNINGHAM, Clark E., 1967, “Atoni Kin Categories and Conventional Behavior”, Bijdragen tot de Taal-, Land- en Volkenkunde, 123: 54-70.

CUNNINGHAM, Clark E., 1967, “Recruitment to Atoni Descent Groups”, Anthropological Quarterly, 40: 1-12.

CUNNINGHAM, Clark E., 1967, “Soba: An Atoni Village of West Timor”, Villages in Indonesia, Koentjaraningrat, ed., Ithaca: Cornell University Press, pp. 63-89.

CUNNINGHAM, Clark E., 1968, “Thai Traditional Doctors”, Proceedings of the XXVIIth International Congress of Orientalists, Abstracts, Bloomington: Indiana University Press.

CUNNINGHAM, Clark E., 1969, “Characterizing a Social System: The Loose-Tight Dichotomy”, in Loosely Structured Social Systems: Thailand in Comparative Perspective, Hans-Dieter Evers, ed., Cultural Report Series, Southeast Asia Studies, Yale University, pp. 106-114.

CUNNINGHAM, Clark E., 1970, “Thai 'Injection Doctors' Antibiotic Mediators”, Social Science and Medicine, 4: 1-24.

CUNNINGHAM, Clark E., 2008, “Unity and Diversity among Indonesian Migrants to the United States”, in Emerging Voices: The Experiences of Underrepresented Asian Americans, Huping Ling, ed., New Brunswick: Rutgers University Press, pp. 90-108.

CUNNINGHAM, Clark, E., 2008, “Indonesian Americans”, Encyclopedia of Race, Ethnicity, and Society, Los Angeles: Sage Publications.

CUNNINGHAM, Clark E., 2008, “Indonesian American Experience: History and Culture”, Asian American History and Culture: An Encyclopedia, New York: M.E. Sharpe.

CUNNINGHAM, Clark E., CARLE, Rainer, DAHM, Bernhard, et al., 1981, Cultures and Societies of North Sumatra. Proceedings of the International Interdisciplinary Symposium on Cultures and Societies in North Sumatra, Hamburg.

CUNNINGHAM, Clark E., DOEGE, T.C. & NA BANGXANG, N., eds., 1970, Studies of Health Problems and Health Behavior in Saraphi District, North Thailand, Chiang Mai University, Thailand [Cunningham lists 8 chapters (4, 5, 6, 7, 8, 9, 12, and 13) that he co-authored].

CUNNINGHAM, Clark E., FERNANDEZ, James W., DOUGHERTY, Janet W. & WHITTEN, Norman Jr., eds., 1981, “Symbolism and Cognition”, Special Issue of American Ethnologist, 8 (3): 413-660.

DOEGE, T.C., WHITEHORN, W.V., MARTIN, B., & CUNNINGHAM, Clark E., 1976, “Chiang Mai and Illinois: A Cooperative International Project, 1962-1970”, Journal of Medical Education, 51: 94-100.

RUSSELL, Susan D. & CUNNINGHAM, Clark E., 1999, Changing Lives, Changing Rites: Ritual and Social Dynamics in Philippine and Indonesian Uplands, Ann Arbor: University of Michigan Press.

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Table des illustrations

Titre Fig. 1. C. Cunningham in Timor, Indonesia, 1960s
Crédits Photo: C. Cunningham collection, courtesy of Nathalie Cunningham
URL http://journals.openedition.org/moussons/docannexe/image/8254/img-1.jpg
Fichier image/jpeg, 638k
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Lorraine V. Aragon et Susan Orpett Long, « Clark E. Cunningham’s Cutting-edge Contributions to Research on Biomedical Appropriation in Southeast Asia »Moussons, 38 | 2021, 193-202.

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Lorraine V. Aragon et Susan Orpett Long, « Clark E. Cunningham’s Cutting-edge Contributions to Research on Biomedical Appropriation in Southeast Asia »Moussons [En ligne], 38 | 2021, mis en ligne le 25 novembre 2021, consulté le 03 décembre 2021. URL : http://journals.openedition.org/moussons/8254 ; DOI : https://doi.org/10.4000/moussons.8254

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Auteurs

Lorraine V. Aragon

Lorraine V. Aragon (Ph.D. Anthropology, University of Illinois, 1992) is a sociocultural anthropologist who teaches as an Adjunct Associate Professor of the Anthropology and Asian Studies Departments at the University of North Carolina, Chapel Hill, USA. Aragon’s research and fieldwork in Indonesia and other Southeast Asian nations spans more than three decades. She is author of Fields of the Lord: Animism, Christian Minorities, and State Development in Indonesia (2000, University of Hawai’i Press) and many other publications on Indonesian religion, ethnic minorities and state development, civil conflicts, regional arts, and the expansion of intellectual and cultural property laws over indigenous cultural expressions.

Susan Orpett Long

Susan Orpett Long (Ph.D. Anthropology, University of Illinois, 1980) is Professor Emeritus of Anthropology at John Carroll University in Cleveland, Ohio, USA. A sociocultural and medical anthropologist, she has conducted fieldwork in Japan and in the US focused on medical careers and comparative medical systems, alternative medicine, decisions about mortuary ritual in interfaith families, Japanese elder care, bioethics and culture, and end-of-life decisions. Among her publications, her book, Final Days: Japanese Culture and Choice at the End of Life (2005, University of Hawaii Press) was awarded the Francis L.K. Hsu Book Prize by the Society for East Asian Anthropology.

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