The signifying disease: Difference, discrimination and the discourse of sickle cell anemia

There is today in the anthropology of medicine much talk of disease as a socio-cultural construct. This project attempts to practice a strategy that is more deconstructive in its orientation. That is, a project in which disease is viewed not as a metaphor but as a sign, and to regard disease as immediately accessible for such purposes.^ The subject is the relation of bodies to disease (sickling): how bodies coded as peculiar corpuscles, racial agents, or ones with/out civil rights came to be inscribed as the referential agencies for constituting a case of sickling. One need only try and think of sickling without the signified black body and motion of natural selection to grasp that the proposed project does not suddenly spring from the void.^ The central argument of the text is that a disease has no necessarily permanent and stable content and isn\u27t at once a discursive construct. To this end the text explores how sickling circulates as sign, and is produced as a particular ideological subject(s) through a variety of works.^ This shift from the conventional way of viewing sickling as an independent entity to one of the interdependence of sickling and representations, opens-up the field for an initial discursive structuring of physio-pathological observation of the cell--an abnormality of the cell in the most rigorous sense; secondly, the making of the black body as a discursive fact linked to the occurrence of sickling--the unequivocal racial coding in the constitution of sickling; and thirdly, sickling as the discursive locus where civil rights and genetics are structured by a symbolic ordering of opposing representations. Ironically, it was appropriating of sickling as a disease of the black body politic that rendered pertinent the question of civil rights. However, the last two discursive formations are not of the same register; for in one--the second--the issue of race as a unifying and forceful sign of difference is engaged at the physiognomic and/or mitochondrial level, while in the second (civil rights) race became a new discursive formation for celebrating difference in the service of othering. (Abstract shortened with permission of author.)