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The Body in Time

in which things disappear, or merely seem to

My Grandmother's Letters

"I notice," I said, "that most of your trips ended m disaster of some sort or another, and yet you went on making them, which strikes one as a little strange."

Three decades before me, my grandmother came to Varanasi. She and my Grandpa Bill, a carpet distributor and later a sales manager for a Bible Belt carpet manufacturer from Tennessee, traveled around the world combining business and pleasure. In their later years of globetrotting, they were joined by Mr. and Mrs. J., the carpet manufacturer and his wife, to form a quartet. The Tennessee couple were devoted to spreading Jesus's message, and a friend once suggested to me the source of my grandfather's unlikely friendship with Mr. J: "Your Grandpa sold carpets, he sold Jesus." While the men were selling, Grandma and Mrs. J. took long walks through the parks and museums of whichever city, they were in, and wrote. Grandma kept a travel diary and Mrs. J. wrote poetry. This vänaprastha idyll did not last: my grandparents grew older, during their African safari a vulture made off with part of Mrs. J.'s hand, and then my grandfather died suddenly, in a hotel room in Tokyo on one of his trips alone. Some years later, still struck by the manner of his exit and desirous of some greater connection with that generation, I tried to enroll in a course on Japan at college. The professor was not captivated by the origins of my interest, and declined to admit me. At the suggestion of a friend I joined another seminar that had an opening, one on religion in India. The rest, as they say, is history, and though Akhil Gupta and James Ferguson appropriately dismiss such banal accounts of the anthropologist's "choice of a field"[2] (a concern that is of a piece with Bourgois's critique of the anthropology of suburbanized alienation), of such cloth are redemptive encounters fashioned for many.


My grandmother was less ruffled, either by vultures or her place in history. She fondly remembered her Benares and that early morning boat ride on the Ganges. When my grandfather was still alive, the two of them would give slide shows in the lobby of their co-op apartment in Florida: the round-the-word adventures of the footloose Cohens. Grandpa drew on Hollywood images in advertising the shows: "Call Me Bwana" and the Crosby-Hope Road to . . . pictures. I remember being all of eleven and fascinated, sitting in the lobby during Christmas vacation, by the adventure and the animals. Sensing this, Grandpa took me to Lion Country Safari the next day. But Grandma's advice for me, on the eve of my first departure for India, was more practical. "Don't give the beggars money, dear," she warned me, and then explained: "If you give something to one beggar, then they all come after you and follow you for hours, and won't go away until you give each one something." She paused: "It will break your heart."

Years later, uncomfortable with that heartbreaking vision of the sightseer, I tried to deflect the family legacy of beggars and beasts through the mediations of anthropology. Yet the field as it was often taught reenacted a more subtle touristic mode. The Grand Tour for the anthropologist of South Asia in the 1980s did not skim along the Ganga at sunrise, but dipped into the equally overdetermined waters of the relational self. Though I became critically engaged with the liquefactions and softenings of the embodiment of colonial difference, I somehow managed to replicate them through participation in the fluid dynamics (selves, signs, polities) of the Chicago School and its dispersed successors.[3] The traces linger Indians, when push comes to shove in much of this book, are written of through a relational, fluid, and soft language of anger and affect, and Europeans and Americans through a monadic and hard-wired one of memory and cognition.

This tenacity of troublesome metaphor within the contemporary touristic mode of the anthropologist—the continual failure of the best of intentions—remains rooted in the attempt to capture difference within the language of "they're not like us." This linguistic awkwardness cannot be avoided; difference as the organizing principle of anthropological knowledge attracts normatively polarized statements like flypaper. My sense that in Varanasi memory was seldom as central as anger in anchoring discussions of behavioral change and of the self in old age was one such two-edged sword. The language of hot brain allowed me to question the "naturalness" of forgetfulness as a necessary figuration of the senile body. But in suggesting that affective, rather than cognitive, change was strongly marked in the social construction of senility in India, I managed to resuscitate an older and less liberating opposition: the Occident as the rational brain, the Orient as the emotional body. Like the nineteenth- and early-twentieth-century European climacteric theorists I have discussed who distinguished between male cerebral dementia and female genital menopause, I have perpetuated a reading of the Self as cerebral and its Other as quite literally subcortical: Reason versus Nature.

What is to be done? The irony is not simple; I remain committed to the project of interrogating naturalized categories like dementia, memory, and cognition.


Emotion and affect are complex domains of thought and are not the antithesis of reason; one could make strong neurobiological arguments for their importance to dementia research and treatment, despite the language of DSM-IV. A cultural politics of generation that hears old voices as hot and dry and unstable, and younger voices as colder and wetter and more stable, may indeed revisit simplified structuralisms that can only work through colonial erasures of much of social life. But to assume that the generational politics of the former is simply encompassed by the colonial politics of the latter is naive and risks yet a more powerful erasure of the subject. To work through these and several other frames of difference, conjoint but not congruent, I have sketched a perspectivist model whereby the anthropologist pays attention to first-, second-, and third-person "knowledges" as distinct windows onto local processes.

Generational difference, like colonial difference, is here not simply an object of social science; it forms a central question of method. The study of generational difference is fraught with its own colonialism; most gerontologists are simply not all that old. The tourism in gerontology is less overt. But like Cohn's description of the touristic mode for knowing India, the country of the old has its route, the passage to and through an exotic realm by those who wish to master it. The stops along the route—the appeals to ageism, the bittersweet oral history, the reproduction of the "aging enterprise" through the necessity of grant hustling and the reduction of anthropology, to "qualitative methods" and cookbook methodologyare—are well marked.

At a first glance, the politics of this engagement differ from that other, overtly colonial encounter. The natives of the country of the old, for those of us who visit as tourists, are our own future selves. There are no hermeneutic impasses to be broached; we are all aging. Yet I always pause when I discuss my work with my grandmother. Why? The hesitancy—and the slight embarrassment that generates it—is in the first place my sense of the hubris in proclaiming myself to her as an old age expert. I may be aging, but I am not old. The aging enterprise reminds me of the Varanasi land surveyors standing outside Nagwa slum and its pond and measuring the commons: it would soon be a well-groomed colony, but not for its current users. Gerontology as colonialism offers a self-conscious theory of improving the natives—"to make old age a good age" is its frequent refrain, another hint that without the field there would be "no aging"—and for me to claim the status of future native is of necessity to imagine a world in which parents and grandparents have been erased, in which I will be the redeemed old body of this imagined horizon.

Time and generation, the markers of colonial difference, are imploded by gerontological theory in several ways, blurring the political context of its practice. Thus the ever imminent demographic explosion glides the anticipated future—too many old people, requiring new forms of generational regulation—into the present. The urgency of the apocalypse legitimates the delegation of gerontological authority to experts. Disaster scenarios offer the postapocalyptic old bodies of


their authors as truer objects of gerontological practice, practice that is imposed on the present bodies of pre-apocalyptic elders: we will suffer from the explosion's fallout, so we study you. Like the "other victims" of Alzheimer's, apocalyptic gerontology hints at a truer victimhood than that which can be claimed by the proximate objects of practice, old people here and now.

The move is similar to the American deployment of other, nondemographic, forms of apocalypse: particularly given market-driven anxiety over the costs of the increasingly mechanized and expensive but still low-yield intensive care of the elderly, the deployment of a rhetoric of "futility" and "rational death" by an interesting alliance of rational-choice theologians and policy elites under the sign of Ethics.[4] Not surprisingly, those most resistant to the rationality of withholding futile care are groups with disproportionately lower access to basic health.[5] The rational calculus of appropriateness and limits presumes a world of available care challenged by an aging population: the old become those who would take resources from the poor, an equation of particular significance in the American context of corporate medicine.

Throughout the two years I lived in Nandanagar and in the Bengali quarter, my grandmother's regular letters from Montreal or Florida reminded me of the complexity of what was at stake in being old back home. The letters never mentioned "old age," either in Grandma's questions about my work or in her discussions about herself. She wrote about my aunts, uncles, and cousins, about who had had a baby or a bat mitzvah, and about the annoying habits of her neighbors in the Florida co-op where she had lived for over two decades. Like Kaufman's interviewees, my grandmother did not write "as" an old woman. She wrote as herself.

My other—maternal—grandmother, who migrated from a violent corner of Europe between the world wars and who lost much of her extended family to the Holocaust, was neither comfortable in English nor with the particular civilities of middle-class Anglo-American life in which both myself and my paternal grandmother had been raised. She never wrote. But in phone conversations before, during, and after my period of fieldwork, she mentioned old age frequently. "What can I tell you, Lawrence? I'm an old lady. I have problems, problems, you shouldn't know what problems." (In a sense, I can only rewrite her voice as shtick: its bakbak insistence on idioms of the body became a nostalgic site for a generation of American Jews marking an affectionate difference from their parents, and is by now a national clicheé.) Then, and since, old age has remained a central interpretive category for her. It is not a conspicuous silence, marked by the ominous changes noted in everything around her, as in the letters of my other grandmother. Old age is proclaimed from the rooftops. "I am old" appears to soak up all meaning.

I thought often, in the course of this work, of the disparity between my grandmothers' reflection on their embodied worlds. Their experience of their age and of their bodies has differed radically, though their clinical histories do not differ


considerably and they are only a few months apart in age. But they are old quite differently. They both came into the world the daughters of eastern European Jews, but on different continents and in radically different social and economic circumstances. They both lived most of their adult lives in Montreal, but in different neighborhoods amid different institutions: home/factory/market/clinic/old age home versus home/college/synagogue/golf club/retirement co-op. The logic of geriatrics, embodied old age as unremitting normality, makes sense for the lifeworld of only one of them. The meaning behind the intensely embodied life world of my other grandmother was taught to me during my formal training in geriatrics: "hypochondriasis." Some old patients, I was once told by a caring preceptor as we strolled the regimented and kinless floors of the old age home where I was clerking, only speak of their ailments: they have a pathological need for attention. He spoke without irony.

The seeming universality of old age draws simultaneously on the hegemony of certain representations of the old and on the universals of the body. Around the world, for those who survive into old age, eventual debility and death are certainties. But the material effects of death are as variable and specific as are those of taxes: death for Anupa, who mutters, "I want the Ganga, take me to the Ganga," over and over in her corner of the slum, is not the same as death for the poet Narayan, who celebrates life in all its indignity. Debility in Nagwa means something quite different from debility in the colonies or debility, for that matter, in Montreal.

Though my paternal grandmother never mentioned being old in her letters, old age was addressed obliquely throughout. She favored a vigorous morning constitutional and swim. The letters frequently mentioned other residents of the co-op who would sit by the pool all day and talk, too complacent to consider an ocean swim or a walk along the shore. Immersed in accusations of Banarsi bakbak , I sensed congruencies. "Some old people," she would write, "do nothing but complain all day of all their troubles, or of how their children never visit them. They're bored, and boring. They have nothing to do because they do nothing. No one visits them because they just complain and complain."

Old age, throughout our correspondence, was represented by its absence. I avoided old age in avoiding discussing the content of my research. My grandmother projected old age onto other "old people." These old people were the others of the apartment complex. Over two years of these letters, the inertia and bakbak of the co-op crowd grew and grew. My grandmother chronicled the aging of her world, a change that touched her deeply and yet was kept at arm's length. "I have more things wrong with me than she does, but I just keep my mouth shut. What's the point of dwelling on such things?"

Behavioral difference and threats to autonomy in the lives of these others were particularly noted by my grandmother. More and more of the women who had been her friends for years were increasingly described by her as "changed." Few old friends escaped her disapprobation. Some of my relatives wondered if my


grandmother herself was developing Alzheimer's, "forgetting" all her old friends. They asked me as a student of dementia what I thought. What I thought was that something particularly important was at stake, for all of us in the family, in this question of mental status. Alzheimer's was simultaneously something feared and denied and yet the ever-present idiom, in North America, of the old body in relation to others. In the middle of fieldwork, I returned to Montreal for a family wedding. I learned that a great aunt had been put in an old age home two blocks from where I was staying. I asked my paternal grandmother if she wanted to come visit her sister-in-law. She said no, but when I decided to go anyway she changed her mind. When we arrived on the floor, my great aunt was in the day room along with the other residents, awaiting her lunch. She didn't recognize me but did recognize my grandmother. But the residents were being wheeled in for lunch. After several months of being socialized to the imperatives of the total institution, my aunt became nervous at our potential violation of the routinized meal time. Afraid of missing her meal and more afraid of asking the nursing aide if she could delay eating or take the meal in her room, she urged my grandmother to wait outside the dining room for ten minutes. We waited, on a bench in the hallway by the nurse's station, near the physiological monitors. Across from us, an old man sat unattended in a wheelchair, staring fixedly out in space, a line of drool coming from his mouth. My grandmother grew increasingly uncomfortable, and after a minute and a half into the ten she told me she would wait downstairs.

My great aunt represented the sort of threat for my grandmother that I have rarely seen in India, a threat magnified but not encompassed by the old age institution. More than old age in itself, senility and dementia were the silence in my letters to Grandma, the things it seemed bad form to mention to the grandmother for whom bad form would matter. Despite her frequent discussions of the old complainers, my grandmother seldom brought up demented or institutionalized persons like her sister-in-law. My grandmother was herself old, equally subject to the paradoxes of geriatrics. She could not constitute herself as the primary, "other" victim: she was no tourist.

When my other grandmother decided she wanted to live in the Jewish Centre d'Accueil , another Montreal old age home, she was from the beginning openly concerned about "the crazies" she was now forced to endure. They were upsetting to her—one rather vicious old woman in particular—but they were not things from which one averted one's gaze or noted through silences or displacements. Though she was not as sharp as she used to be and after a year in the home was noted by my family to have lost some short-term memory, encounters with other demented people were for her from the outset not some grim foreshadowing of a future without personhood but one more set of embodied incidents, confirming a continuity of experience.

These are "Aunt Minnie" stories, invocations of one's own old relatives in gerontological argument analogous to the anthropological defense: "Not in my village." But not only does it seem fair play to invoke one's own grandmothers if one


is in the business of writing about everyone else's, but their quite different embodied histories and second-person experience of other people's old age are cautions to a parceling out of styles of embodied old age along simplistic cultural lines. The Varanasi stories I have told are similarly varied, though they share a world in which biomedicine, as of the late 1980s, had failed to articulate significantly with the practices of being old, being old and sick, or dying. The final vignette turns back to Somita Ray in Calcutta, whose children's understanding of their mother's strange behavior—hiding utensils, calling out to the neighbors that she was being beaten—was that these actions were of a piece with a lifetime of distrusting her daughter-in-law. But then the plaques and tangles of Alzheimer's—through the mediation of the superintendent of the Nava Nir home, of the detail men from Farmitalia, of the geriatrics collection of the British Library, and of a foreign anthropologist—came to matter, in an interesting way.

No One Here Ccares About Alzheimer's

Somita Ray and her husband the professor had had one son, Mithun; as a result of the estrangement between the mismatched couple, Mithun became the primary outlet for his unhappy mother's affections. The anthropologist Manisha Roy has written of this particular triangulation as common among the Bengali middle class, Sudhir Kakar has suggested it is common to the Indian family,[6] and others have framed it as a more general figure of male narcissism and female dependency. But for Mithun and particularly for his wife, Sharmila, Somita's dependence on her son and her consequent dislike of her daughter-in-law were unique and extreme.

Mithun became a photographer; Sharmila, a librarian at the British Library. Sharmila resented her mother-in-law's dependence on Mithun; Somita, she felt, had never made any efforts to acknowledge her from the wedding day onward. Mithun could not find steady work and grew increasingly depressed. Sharmila continued to work full-time in the library. Her salary supported the family, and after Mithun's father, the professor, died the three were forced to move to a downstairs fiat in her parents' house.

In the house of her daughter-in-law's parents, Somita increasingly began to wander. She would get lost in the neighborhood; Sharmila began to feel embarrassed. What kind of daughter-in-law was she, people must be asking, who allows her mother-in-law to go about like a beggar? She began noticing more and more utensils missing, finding them among her mother-in-law's possessions. Mithun began spending most of his time at home to watch his mother; he stopped looking for work. One day Somita called out the window, "Get the police, get the police," accusing her family of maltreating her. Sharmila interpreted all these episodes—to her husband, to a few close family friends, and to myself—as an exacerbation of Somita's hatred of her. She accused Somita of destroying Mithun's career to keep him home with her. The strains between the three in the small, one-bedroom flat were considerable.


Mithun had a wealthy cousin, Aloka Mitra, whom we have earlier met as one of the founders of the Nava Nir homes in Calcutta. At Sharmila's urging, he approached her to see if Somita might be admitted to one of the homes. Like the other "old aunties," the poor relations of the Nava Nir founders, Somita was eventually admitted. But the old age home is here the beginning, and not the end of the story. Three days later, the superintendent of the Nava Nir sent word to Sharmila and Mithun that they must take back their mother: she was unacceptable for the home.

The couple arrived at the institution to find Somita sitting outside. Sharmila's description of this moment, several months later, is vivid. A transformed Somita crouched on the stoop; her eyes were flashing, her hair was in wild disarray. The figure Sharmila paints is the classic pagli . In her retelling, the institution itself had transformed Somita, or at the least brought out a truth concealed until then. The superintendent, however, a short woman with the demeanor of a drill sergeant, refused to believe that anything had changed. "You lied to me," she angrily accused them. "She is crazy. She doesn't belong here; she is your responsibility."

Crazy old people do not belong in old age homes : they invoke the Bad Family, and challenge the institution's benevolent self-construction. Somita required considerable care, the one thing the Nava Nirs could not provide, despite their rhetoric of neolocal kinship. The superintendent took refuge in the Bad Family only at this juncture; earlier, Somita was defined as the poor old aunt of a board member.

The image of the pagli articulated and legitimated a next move for Sharmila, her seeking out psychiatric care with the hope of diagnosing her mother-in-law as mad, like the superintendent had said, and having her admitted to a psychiatric nursing home. Though madness in itself was stigmatizing, it was less of a threat than the dangers of the Bad Family that a screaming mother-in-law at the window or an accusing superintendent evoked. The couple took Somita to the clinic of one of Calcutta's best known psychiatric families. They were seen by the junior member of the family, Dr. S. Nandi. Recently trained, Nandi was familiar with the differential diagnosis of dementia; its limited clinical salience was less of a problem for him than its importance in the texts of international cosmopolitan medicine. He had been visited the previous month by detail men pushing Dasovas. They had stressed the increasing prevalence of Alzheimer's disease and the need for vigilance: Ask about memory. They gave Nandi a free sample.

For Nandi, Somita offered a rare opportunity to do a dementia workup and to evaluate the claims of the Farmitalia men. He told Sharmila that he felt her mother-in-law had a serious disease of the brain tissue known as Alzheimer's, about which there was much information in the West but little yet in India. He noted that few medicines appeared to have much effect. He admitted his uncertainty as to whether Dasovas would work, but Sharmila and he agreed to try it for Somita. He said that Sharmila should not feel guilty; Alzheimer's was a biological condition.

The psychiatrist told Somita that he could not be certain if Alzheimer's were


the problem. He therefore recommended a computerized tomography (CT) scan of the brain to enable him to make a more definitive diagnosis. Following the scan, he told the family that the result confirmed his opinion: Somita had Alzheimer's. An unfamiliar diagnosis is affirmed through the largely symbolic use of high technology. CT scans are neither necessary nor sufficient tools for diagnosing dementia; the changes in cortical and ventricular size they measure are nonspecific. They may rule in a rare diagnosis, normal pressure hydrocephalus, but NPH can be suspected by a classic set of symptoms that did not characterize Somita's behavior. More than offer the psychiatrist new information, the CT placed Somita in a new framework of high technology. Like Dr. Bharati's electron microscope in the India Today article, "The Better Brain," the CT scanner can reveal the truth about brains, truths hitherto unavailable in India. The machine allows for the possibility of Alzheimer's.

Armed with a diagnosis of a complex biological disease, Sharmila was considerably relieved. To friends and acquaintances who knew of the family situation, she announced the fact that Somita had a brain disease. The medications did not seem to have much effect, but Somita was diseased and a legitimate candidate for a psychiatric nursing home. The couple began investigating homes with great expectations. Then came the surprise: Despite the old woman's diagnosis, none would consider Somita. Even armed with the elaborate medical diagnosis of Alzheimer's, Sharmila was made to feel that responsibility both for Somita's care and her condition lay with her. Her new lament: "No one here cares about Alzheimer's." The couple were advised to care for Somita at home, the same advice they had been receiving before the diagnosis of Alzheimer's. The only homes that would take her were very expensive facilities.

One home, in the far north of the city near the airport, eventually accepted Somita. It was a one- to two-hour commute in Calcutta traffic, and her family rarely could visit Somita. When I visited her there, her nurses reminded me—defensively, it seemed—that this old woman had a serious medical condition.

What was wrong with Somita? Diagnosis is contested, as is the future of her body. Sharmila believed Somita had always hated her and that she had just gotten worse in old age. The relation echoed classic sas-bahu narratives. Sharmila represented Somita as the cruel mother-in-law. Somita, although conversations with her had little evident give-and-take, suggested through gesture and the occasional accusation that the problem lay with the evil daughter-in-law who was trying to turn her son against her and even to kill her. Her accusations gained in coherence from the figure they drew upon, the selfish wife and weak husband of Ghar Kali. Sharmila's firm control over her husband and their unusual matrilocal residence reinforced the meaningfulness of Somita's words and the locus of pathology in the sas-bahu relationship and not merely her aged body.

Sharmila resisted the Bad Family, blaming Somita's lifelong inability to adjust to her for all that is wrong with her life, chiefly her husband's failure—and consequently hers—to amount to much. The episode at the old age home pathologized


what had until then been a contested family matter. In hearing and labeling Somita a crazy woman, the superintendent meant by madness less an index pointing to the old woman than a sign of family neglect. When Sharmila arrived for Somita, she for the first time saw her mother-in-law as a madwoman, with the pathognomonic Medusa-like eyes and hair of a woman possessed. She reinterpreted the accusation of madness to point to the old woman and went to see Dr. Nandi.

With the diagnosis of Alzheimer's, mediated through the fortuitous appearance of the drug salesmen and the visualizing power of expensive machine technology, the family could shift the locus of pathology from themselves onto Somita's brain. The diagnosis also offered them an armamentarium, drugs like Dasovas. But these did not seem to work very well, nor did the diagnosis of Alzheimer's gain Somita admission into a psychiatric institution during an anxious year of application. Alzheimer's, as of 1990, could not displace the stigma of the Bad Family. It did not cure Somita and was an ineffectual response to the family drama delineated by her weak body and angry voice. Sharmila's considerable pain at the rigors of putting up with Somita and the added insult of being seen as the cause of her own suffering was healed by the understanding that she was not to blame, much as families in Varanasi used understandings of balance or weakness to deflect the Bad Family stigma.

But balance and weakness point simultaneously to the old person and her environment; not so Alzheimer's. Rather than responding to the critical issues of familial interdependence and the maintenance of a familial self, the disease isolates the body of the old person and denies her intersubjectivity. Sharmila has a diagnosis, a CT scan, and a drug, but her newfound explanation does not engage Somita's familial body or its location in postapocalyptic time and space as fully as its scientific and global origins initially promised.

Did Somita have Alzheimer's? Quite possibly. Alzheimer's disease makes rational sense of Somita's situation in the process of unmaking the sense of her family. It suggests to Sharmila that Somita does not hide household objects under her bed to spite her; it might suggest to neighbors, friends, and passersby that Somita is not necessarily the tortured and neglected old woman she is heard to be. It offers her family the hope of a cure and—even if Dasovas is not significantly better than placebo over the long run—it offers them at the very least the opportunity of the gift, a chance to maintain the flow of Seva .

Yet in locating the problem solely in the old person's brain, Alzheimer's denies these multiple frames of difference in the constitution of the senile body. Somita's family is unhappy, in a Ghar Kali sort of way. Sharmila all but silences Mithun while blaming all their troubles on his mother; he for his part has consistently refused to intervene to effect some kind of truce between the two women in his life that might have laid the grounds for a less traumatic negotiation of what the family now faces. To flip the sas-bahu narrative around: Somita has long been jealous of her daughter-in-law and has done little to make her life easy: The tensions and


silences that riddle the history of these three frame their responses to each other's behavior. The family share a small, one-bedroom apartment in a crowded city. There is little room for any of the three to escape the others, even for a moment. The presence of Sharmila's parents upstairs adds to the intensity of a sahi nahin situation.

The family's economic position structures both the possibility of Somita's survival and the inability of a way out. The old man in Nava Nit who angrily reflected on the old age of his class fellows, dumped in a handcart, reminds us that far more than even Nagwa slum, the majority of Calcuttan elderly simply aren't: that is, they are unlikely to survive as old for very long. Kamzori is its own cure: weakness, thinness, and death are all bound together. Somita eats—there is barely enough money for rent, but there is no shortage on food in this family—and survives.

The invocation of Alzheimer's and other dementias pushes the complex sources of the hearing of a bad voice aside. The multiple valences of weakness and balance, the culture and politics of the family, the commodification of memory loss by Dasovas detail men, and the local moral world of this family and their community are silenced. Like balance, weakness, and the narrative of the Fall, Alzheimer's is as much knowledge against as for meaning, allowing families to move the locus of aging from transactions between family members onto the old person or onto larger social processes.

A classic debate in medical anthropology centers on the status of what Kleinman and Byron Good, along with several colleagues, defined as "explanatory models." In an early work, Patients and Healers in the Context of Culture ,[7] Kleinman developed the explanatory model (or EM) as a heuristic to suggest that a similar narrative process constitutes professional, folk, and popular discourse on the body. In so doing he created a useful tool to challenge the marginalization of patient narrative and experience by physicians as being peripheral to well-being. "EM theory" advanced a model of clinical engagement as communicative action, the continual renegotiation of the meaning of an illness experience among and between patients and healers.

Allan Young in a 1981 article criticized EM theory for what he took as its cardinal assumption: that the practice and experience of people confronting illness are structured primarily as organized and rational models. People who fall sick do not so much construct models, Young suggested, as draw upon different types of what he termed prototypical knowledge.[8] Here I would focus less on the debate than on some shared assumptions that may have made it possible: that theodicy is the work of culture, that people make and live their worlds to "make sense" of suffering and loss, and that the business of the anthropologist is to come up with a framework to represent this process of making sense and its differential constitution.

But the important question of how people make sense of suffering may obscure a different anthropological question. The work of culture is not only or always to


make sense of illness, particularly when what is at stake is the ontology of the nonsensical. The bad voice of old age threatens because its hearing already and powerfully presumes a sense, in this case that of the inadequate transactions that have failed to sustain a familial body. The meanings given to the senile body are not just a making sense of experience, but a response to the already meaningful world in which bodies in time mean far too much. I have suggested three sorts of knowledge that are drawn on to resist the excessive signification of the old voice.

First, bodies decay and die and are politically marginalized, so persons turn to other frames of self and change—indignation, niyam, Sannyasa , the joke, grandparenthood, retirement, and the construction of a new category of "senior citizen"—to forestall particular anxieties of loss and dependency Second, children become their parents and yet old parents do not go away, so children turn to the experiences of balance and weakness and to the ideological assemblages that gloss these. And third, societies are confronted with new circulations of technology and capital and new hierarchies of embodiment as their forms of marginalization within a world system shift, so they struggle for coherent narratives of the national and the modern—the Bad Family, the Forgotten Elder—to locate the absences of postcolonial modernity through bodies and in history. A meaning-centered analysis of the body is inadequate without tracing the ways in which knowledge is appropriated both for and against meaning, resists as well as creates coherence, and deforms as well as demands the possibility of a scientia senilis .

Lost At The Fair

During the Kumbh Mela, while Devraha Baba gave his darshan, local newspapers contained several reports of lost old people.[9] Distraught children were interviewed; their parents had wandered off and were nowhere to be found. Reporters described the plight of the children, wandering among the hundreds of thousands at the fair, looking for their mother or father. Many Banarsis were cynical about such stories of missing parents. The many kasivasi old people of the city, they suggested, did not come there solely out of a desire to die in holy Kashi, far from their land and their family. Children abandon their parents, people knew, sometimes just dumping them at the station. Whether or not it was a Forest of Bliss, no old householder would willingly renounce his or her home for Varanasi.

The lost old person was a familiar figure on television news. Local stations in the 1980s were given airtime to show photos of missing persons of all ages and describe their last known whereabouts; frequently, such missing persons were elderly. Their stories were similar: a family from a village or small town visits a big city The old person wanders and gets lost in unfamiliar surroundings. The children consult the police; a report is filed. The old person is seldom found. When pressed by reporters, families of such persons noted that the lost person was old and mentally weak. The police inspector in the old city of Delhi responsible for missing persons concurred, telling me that most of his missing elderly cases were people


with a "mental defect." Yet he also noted that many lost old persons in Delhi were eventually found at or near train stations, reinforcing the Banarsi hermeneutic of suspicion. "But I don't know for certain," he concluded. "Although we record and report these cases, our work is with the children." The sisters from Mother Teresa's Varanasi ashram, where Dulari from Nagwa eventually moved, regularly combed the train stations of the city for destitute old and sick people. They, too, agreed with local accusation: a son brings his mother on pilgrimage to Kashi and "loses" her at the train station, leaving her to die, liberated.

"You didn't speak of the loneliness of old people," the Vasant College faculty had told me. The wanderer wanders because he has been abandoned; the bakbak dog lady barks because she has no one. The Bad Family soaks up all meaning. Neither the policeman nor the nuns, whatever their institutional concerns with the traffic in children or Christians, were wrong. Wandering and being lost point in several directions. The suffering old body is simultaneously an autonomous entity in physical decline and a socially constituted entity in political decline. Both illuminate why so many lost old people get on television news. Old people may get disoriented, and confused; old people may be at greater risk for being neglected or abandoned by their younger relations. And old people are good to think with: their abjection becomes a sign that fixes the blame for the decay in the order of things, assigns it to bad children, an exploitative society, the seductions of modernity, the cruelties of Western culture. And perhaps, if demographic transitions take hold in north India and if certain kinds of medical knowledge become more useful, the decay in the order of things can be laid at the door of the brain, the cell, and the gene.

Though a century from now a different paradigm may have replaced it, I am of my time and irrevocably committed to the usefulness of Alzheimer's as an explanation for a set of behaviors contingently demarcated and grouped as dementia. But invoking Alzheimer's within the globalizing discursive milieu of Alzheimer's hell asserts that the cognitively organized clinical syndrome it represents is in every case the most real and relevant representation of what might be at stake. Invoking Alzheimer's asserts far more, asserts enough to send Janet Adkins into that final embrace with Dr. Kevorkian in the Michigan trailer park. Plaques and tangles point to embodied processes, however overdetermined their figuration of indelibility and plenitude, but they are not the font of all suffering nor of the meaning of a mindful body facing its decline. Alzheimer's ideology posits normal aging against total and unremitting pathology; in so doing, it both denies the complex experience and the personhood of the old persons it would represent and shifts attention away from the social origins of much of the weakness of the old.

Like suspicions as to how one gets "lost" at the fair, debates on Kevorkian have been a way for the American media and its various experts to raise the issue of a social constitution of a dying space. Unlike the triumphalist narrative of Adkins's authorizing her death, the 1996 case of Gerard Klooster, a retired physician from the San Francisco area diagnosed with dementia whose wife had considered the services of Dr. Kevorkian, was reported with greater ambivalence. One of


Klooster's children, also a physician, spirited his father away from the rest of the family when he became convinced they were trying to kill him, and the case ended up in the courts. Unlike Janet Adkins, Gerard Klooster could not offer a voice in the moment of its own extinction, and the question of assisted suicide versus forced euthanasia could not be resolved. The irony of the tears of the other victim, usually restricted to tabloid reality, could here break through into the mainstream press.[10]

As sorts of places to be abandoned, gerontopoli like Varanasi or Allahabad are different from the embrace of Dr. Kevorkian, if only in the ideology of renunciation they seem to embody, the radical frame by which families can divest themselves of the expectations of Seva . But Kevorkian's relationship to the disenchantment of the dying space is anything but obvious. In the summer of 1996, he responded to his critics in an address to the National Press Club in Washington, D.C. Against concerns that he and his various instruments of assisted suicide—the "Thanatron" and later the "Mercitron"—promised a less dignified death than his advocates claimed, the Michigan doctor responded:

Well let's just take what people think is a dignified death. Christ. Was that a dignified death? Do you think it's dignified to hang from wood with nails through your hands and feet bleeding , hang for three or four days slowly dying , with people jabbing spears into your side, and people jeering you? Do you think that's dignified? Not by a long shot. Had Christ died in my van, with people around Him who loved Him, the way it was, it would be far more dignified. In my rusty van .[11]

The space of Kevorkian-death is not that of a household, but neither is it the modern institution of the hospital or the institutions—the legislature, the judiciary, the media, the church—which Kevorkian sees as ranged against him, sustaining the hospital's algorithms[12] of alienated machine death. Neither home nor hospital work as dying spaces here, but a middling space in between, characterized by an accessible pioneer ethos of the trailer-park wild, the rusty-van West, and the trash technology of tubes and gas masks and crazy pathologists who get off designing ever simpler and less alienating death machines. Jesus is reclaimed for this new world, but not the Crucifixion, not the resistance of suffering and death to their rational management. Kevorkian's rusty van offers a bloodless Pietà , a seamless move from life to the arms of the Mercitron, Mother of Death. Old age vanishes.

Perhaps the exemplary figure of this new bloodless comfort at the American end of the millennium is not Doctor Death but the man I see as his counterpart, a Doctor Life fashioning not middling death but middling life, and not out of tubes and the pioneer West, but out of exotic Indian wisdom, the language of hormones and genes, and the imagined Arthurian and pagan past of whiteness. Deepak Chopra, the great purveyor of neo-Rasayana to the world, in book after best-selling book and in repeatedly broadcast television shows and videos and motivational seminars, offers Unconditional Life and an Ageless Body, Timeless Mind .[13] His 1990s writing has turned ever-more toward Arthurian and other European imag-


ined pasts of enchantment, integrating these with the ancient truths of Ayurveda.[14] Life and death, within Chopra's world of the ambient, are a nondualist blur, and middle-aged adults make their quietus by both ignoring and embracing decay yet seemingly never having to suffer it. Kevorkian-death and Chopra-life refashion the ends of time and the body; emptying sickness and frailty and confusion of any presence.

That a migrant from India can brilliantly recommodify his heritage into such a gift of no aging seems telling, at the close of the century amid the World Bank and Government of India's efforts to achieve a far greater articulation of India into the global market. Rishis travel well, though in the process they seem, like sage Chyavana, to grow younger. Chopra began his New Age career by trying to help his guru Maharishi Mahesh Yogi to bring Ayurveda to America. But at some point he seems to have outgrown Maharishi, and the figure most Americans associate with Ayurveda is not a white-bearded old rishi but his former disciple, the middle-aged Chopra, in business suit or leisure wear. Chopra offers an India without guilt, and for those who would embrace the other India, there is always Mother Teresa, ready like the Mercitron to make Third World death a good death. The Indian anthropologist at Zagreb could offer the good family against the cold biologism of the available West, though back at home the Bad Family awaited, and the absence to which it tried to speak. To that absence and to several of its own, such a West could in turn offer Reason, and Mercy.


A Last Few Trips up the River

Bakbak . My last morning, I got up at five and went out on the river in Shankar's boat to immerse my image of Saraswati, goddess of Culture, and have a final look at the fabled city. Shankar pushed off from the bank; I held Saraswati in my lap. I had learned about the immersion of festival images in that first class on Indian religion. Four years later in Calcutta, my first day in the country, I asked the physiologist who had picked me up from the airport (the nephew of the mother of a former tenant of my mom's secretary) to stop the car his aunt had hired so that we could watch a crowd of young men immersing a large image. I had arrived in the city the day after a major Puja, and I had been taught that after the period of worship God's presence no longer inhabited festival images and they were supposed to be immersed, returned to the river and to the elements. We had been talking about cancer research; he looked at me strangely, and declined to join me in running after the young men to the river's edge.

I had bought this particular image before Saraswati's annual celebration in 1989, from a lane lined with hundreds of Saraswati statues. Having the embodiment of Culture in the house of an ethnographer seemed a good idea. I no longer ran after processions and was spending more of my time talking to scientists; still, old habits die hard. But I held off immersing my 1989 Saraswati in the Ganga on the day after the Puja. It was a lovely image, and it seemed wise to keep it intact. But fieldwork was over.

Marwari Mataji, as always, watched from her window as Shankar pushed off. Far to the south, I could see Nagwa slum beyond the line of ghats and temples. When I was working full time in Nagwa, I had stopped coming to the ghats. Their dense groupings of religious things seemed to reinforce the exclusion the Nagwa Chamars often talked about. But such truths were difficult to live by for one brought up On the glories of ageless Varanasi, and when I turned to middle-class


fieldwork I allowed myself to move back into the old city, to the home by the river that turned out to be the former residence of Swami Karpatriji, he of antiChamar politics.

It was still quite early, that final morning. This was the boat we had used when the two men from Mughalsarai had asked me why Muslims didn't get sixtyish. I had not been able to give them the answer they wanted. When I turned the question back to them, the man who replied had said it was all about who had bad families, and who didn't. But he thought there was more to it.

The two men had eventually disembarked, and I had stayed put, sitting there on the boat working it all out. Shankar had grunted and with a long oar pushed us back out onto the river. He began rowing upstream again—past Brahman experts, tourist vendors, old women bathers, appropriate-technology-armed Ganges savers, practicing wrestlers, argumentative babas, strolling policemen, and fisherman putting away their nets—and I theorized. Then Shankar spoke: "Don't listen to them, brother. Everyone is the same." Meaning Hindus and Muslims. He paused. "Except for money. If we poor people had some, we would never get so old and weak."

Shankar rowed hard against the current. I sat there. Each of us, on his own side of the boat and in his own way, imagined something like no aging in India. And on the bank, the timeless vision of Varanasi and its ghats drifted by, propelled by Shankar's hands and feet. No shortage of metaphor, in anthropology.

On that last day, we again sat silent and midstream, watching Saraswati the goddess of Culture sink and dissolve under our mutual gaze. Something about tourism in my family: "It will break your heart."

Shankar spoke: "Where to now?"


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