Lifelines: The Traffic of Trauma
Lifelines: The Traffic of Trauma is a medical ethnography authored by Harris Solomon. The book chronologically documents trauma's occurrence, treatment, and recovery. The book is quite thorough and educational. As the author conducts study in hospitals, it provides us with insights on numerous dimensions.
The book's preface provides a thorough overview of the book's topics. The subheadings between the chapters provide us a glimpse of the contents and describe the book's main subject in an odd, briefly elaborated way. Also, he talks about his research techniques and writing style as he considers several methodologies for each chapter. Because of this, the book is not monotonous. Solomon has a knack for wordplay. He has used the keywords in their various dimensions, which will be discussed further. The usages of those words are very impressive.
The first chapter is named "Carrying: The Lifelines of Transfer." This chapter accounts for Solomon's conversation with ambulance drivers, local train drivers, hamaals, and even victims. A past trauma victim gladly relates his experience at the beginning of the chapter. According to his memories, he refers to his saviour as an angel rather than recalling his face. Solomon illustrates how trauma is significantly influenced by traffic. He talks about ambulances, which are the primary means of conveying trauma. Private and public ambulances are part of the free 108 services, a public-private collaboration. Public and private ambulances' operations, expenses, and costs are covered. As an ethnographer, the author must have been present in ambulances to observe how the paramedics save the lives of trauma victims. However, he also understands how an unwelcome presence can cause obstacles. He says, "I do not ride when the ambulance must carry an injured person. This is purposeful. It is cramped inside the van, and every bit of space is necessary to perform resuscitation. I believe my presence could be a burden, specifically one that could drag processes that require less and not more obstruction" (p. 35). Solomon's goal in writing this chapter was to highlight embodied, interpersonal kinds of carrying and of being as specific as possible about who starts occurrences for someone who is severely injured, how it might happen, and why.
Triage refers to assessing a casualty's need for appropriate care. In the second chapter, Solomon describes how patients are first sent to the closest facility for first aid and triage before being transferred. A patient's life revolves around shifting in a significant way. The author discusses the two ethnographic grounds and their comparison at the beginning of the chapter. The first is a local nursing home called Maitree Hospital, while the second is a tertiary hospital called Central Hospital. The entire book is anchored by Central Hospital. He explains how shifts serve as lifelines because they allow for the translocation and gestural adaptation that generate and reproduce social structures.
The next chapter is "Visiting," which is termed "The Lifelines of Home." Once more, home is in two dimensions: both a permanent home (the actual residence) a temporary home (the hospital). The hospital serves as the temporary home while you're receiving treatment. The patient's family members stay there with them as well. Even their daily activities are carried out from the hospital itself. The visitation does, however, also have another aspect. When it comes to providing for victims of trauma, visitation is discussed both ways here. Both family members and members of the medical team visit hospital patients who are receiving care at home. Solomon gives the opinions of medical professionals from several nations, including India, on how to treat and manage families through a difficult period. Also, he discusses the drawbacks of visits. Even though family members' visits give patients some solace, they can occasionally put doctors in danger. Solomon draws attention to instances of hospital-based doctor violence. The disruptions that visitors cause in the ward and the excessive usage and waste of hospital resources are further issues. The hospital's efficient operation is frequently hampered by pointless and persistent demands. The staff becomes evasive and cold upon refusal and denial.
The next chapter is "Tracing: The Lifelines of Identification." The trauma sufferers are frequently discovered unresponsive or in a semi-conscious state. It becomes challenging for the hospital to keep the patient's record in that situation. The police play the crucial role locating and identifying the victim's family. Concerns about a person's identity, including who they are and how they are, arise through tracing procedures. The act of tracing involves putative differentiation of two things at once: the injured body's potential for repair and mobility, and the manner that a person's identity may be acquired rather than given. The way that tracing works is through vectors; it can both fix people in their most basic forms and look for hints that can help the injured get in touch with their loved ones and leave the hospital. What constitutes as fixed and what counts as dynamic may change for identity and injury status. This unpredictability provides tracing the capacity to create lifelines. Every conscious or unconscious word that the victim says is taken into account when determining his origins and identity. The cops perform the last rituals in the event that the unidentified victim passes away in the hospital. In this case, they do, if it is practicable, take religion into account. There is frequently someone in the hospital who is attentive to small details like a cross tattoo or circumcision.
A continuation to "Tracing" is a chapter named "Seeing: The Lifelines of Surgery." For whatever reason, Solomon did not designate this chapter as the following one in the book's chronology. But in this chapter, he describes his own surgical experience after receiving a diagnosis of a brain tumour while conducting research for the book. It wasn't life threatening because it was found extremely early. Yet after that, he observes other people's surgeries as well, drawing comparisons between being watched and being the observer.
Chapter 5 discusses the very basis of life: breathing. Solomon discusses the comparison between the Indian and American healthcare systems and the choice of continuing and discontinuation of ventilators. The author examines the function of ventilators in relation to a case of a trauma victim who was involved in a car accident together with his entire family. He was the most seriously hurt and was on life support (ventilator) in a vegetative state. Except for his wife, who passed away right there, everyone was saved. He goes into great depth about how the ventilator intubation process works. Solomon describes his interactions with the hospital engineer who is in charge of maintaining the medical equipment. Harris Solomon also discusses that ventilators are life support only, they do not guarantee life extension.
The next chapter is the study of forensics named "Dissecting: The Lifelines of Forensics." He explains in this chapter how in the trauma ward, after death, the person who transformed into a patient changes into a body. As he covers multiple dimensions with his studies, he also presents the views of different anthropologists on mortality and post-mortem (p. 180). He describes the procedures that lead up to the dissection of the body (p. 182) and how the bodies are preserved if necessary. He also records the conversation with doctors who experience typical nightmares after performing dissection.
The final chapter is "Recovering: The Lifelines of Discharge." Tracking individuals who are not dead but got out safely is equally crucial to tracking those who were injured, transferred, received medical attention, and even died. After an injury, healing and discharge are crucial steps. Carelessness after discharge sometimes leads to several consequences. Recovery requires appropriate post-discharge care, as demonstrated in this chapter. After being discharged, Solomon encounters various patients and describes his interactions with them. Some unhappy patients criticise the hospital and the doctors and are on the verge of suing for damages for their inconvenience. Some chose to use legal means, while others turned to the media.
When Solomon finished the book's epilogue, COVID-19 had just begun, and he had to take a flight back to the United States. He was obligated to maintain an eye on the Indian healthcare system even from a distance because he had spent so much time nearby. During the COVID lockdown, he recounts the scenario in India and the state of its healthcare services. However, Solomon contends that simply addressing the trauma of COVID in the epilogue is insufficient and that further ethnographic time, attention, and a more thorough investigation are required.
Lifelines: The Traffic of Trauma by Harris Solomon is a book we did not realise we needed. Yet after reading the book, we learn how our healthcare systems actually operate. The book is extremely detailed and top-notch in terms of ethnographic methods. But, it becomes confused when the narration switches between different points. When one tale doesn't end and another one begins, it can be difficult for readers to know which victim's story is now being told. What made this book unique was the way the author compared their explanation of a certain circumstance to past perspectives made by other anthropologists. In the healthcare industry, we only see the problems we encounter, but this book presents both sides of the story—those of the system's employees (the medical staff) and its beneficiaries (patients). The book doesn't support a cause or take a position. It is merely an ethnography that examines all the complexities and subtleties of the healthcare system in a fair and objective manner. The narration is excellent, and because of the author's "I" factor, it gives the impression that the readers are going through what the author describes. Although the book is really good, references might have been given as footnotes rather than endnotes to help the readers track it. But, apart from that, the book was a good read.