by Kelly Likos
M. Cameron Hay comparatively discusses Sasak medical cultures and American medical cultures in Chapter 5: Memory and Medicine. The questions studied through out the comparative study revolves around the connection between medical assumptions and the active use of memory. Additionally, Hay attempts to argue three points within the chapter: that memory and medicine must work together within contexts, that these interactions must take place within the sociocultural locations of the world, and that we must strive to stop separating biological sciences from the social sciences.
Hay references Budson & Price (2005) and Squire (2004), who describe memory as “a collection process embedded within or, more accurately, catalyzed by specific brain structures”. Four brain structures are thought to be vital to the memorization of medical traditions. Hay goes in depth to define episodic, semantic, procedural, and working memory. Particularly episodic and semantic memory are described as “explicit and declarative”. Hay believes that there is a relationship between environmental influences and the biocultural style of learning. Hay hopes to show this through the comparative look at Sask medical education and American medical education.
The Sasak ethnic group commonly lives on the Island of Lombok, which is known for it’s abundance of small hamlets and poor health. Jampi is the exclusive set of medical concepts used by a majority of Sasak people. Biomedicine is not believed by the Sasak to be a form healing. Therefore, many do not seek help from a clinic unless they have already attempted jampi treatments. Jampi is passed down verbatim through family lines. It is believed that if more people than necessary know jampi, it leads to a weakening of the healing properties.
To contrast the Sasak, who rely solely on a set of memories to provide medical treatment, Hay dives into the set of knowledge composed into American medical traditions. Hay notes the common assumptions of American medical education: competent medical practice is scientifically based, scientific knowledge is wrong and can always be improved, and that scientific knowledge should be integrated into one’s already existent knowledge. Schemas are a common and encouraged tool when attempting to memorize many different forms of information. Schemas allow for new knowledge to be assimilated efficiently into categories and allow for selective forgetting that has the ability to be independent from hippocampal stimulation.
Interestingly, Hay speaks extensively on the role of the hippocampus. The hippocampus facilitates memory consolidation and memory plasticity. Recalling information that has been placed into categorical schemas requires plasticity to facilitate the movement between varying schemas. In relation, the amygdala is responsible for “mediating both biological and emotional stress by focusing on various brain structures to gather memories in order to resolve the stressor”. In American medical traditions, anxiety is associated with not being able to recall information, or in this case, a particular unfamiliar illness.
Sasak healers utilizing jampi use schemas that have primarily social reinforcement and must be precisely associated with symptom cues. In contrast, American healers work primarily with core knowledge which can be integrated into other aspects of medical care. American healers must retain the ability to change information in their minds as new knowledge is gained. Through the different ways the Sasak healers and American healers encode medical knowledge, we began to see the larger problem of knowing what information to utilize at what time. This is troubling when healers must actively take in information concerning symptoms and associate them with particular illness. Memory plasticity is a necessity.
Hay’s chapter provides a detailed and fascinating learning contradiction between two strikingly diverse cultures. The formation of schemas and the ability to move between them permits for a beautiful insight into the ever-changing knowledge surrounding neuroplasticity. More profound differential examples, like the Sasak, would allow for an even greater understanding of memory and how it shapes cultural traditions. This is a particularly interesting case study under the field of neuroanthropology. Memories and traditions, paired with neurological function allow for potentially great window into new neuroanthropolgical knowledge.
Lende, Daniel H.; Downey, Greg (2012-08-24). The Encultured Brain: An Introduction to Neuroanthropology (141-167). The MIT Press.