by Zach ObajiChapter 5 in the Encultured Brain discusses Memory and Medicine, and memory plays a crucial role in medical decision making. Author Cameron Hay proposes a “neurological model of knowledge that compares how sociocultural traditions and neurological processes co-create distinctive possibilities for remembering (Hay, 142). After conducting fieldwork on coping and the medical traditions of the Sasak people in Indonesia, Hay conducted research in Southern California and to study the different neurological basis of memory in the American medical tradition compared to the Sasaks. The bicultural studies of medical traditions in America and Indonesia reveal significantly different practices in patient care, and both traditions have completely different neurological processes that work differently within the context of memory and healing. The chapter also discusses the four important memory systems along with their neural structures that correlate to the specific type of memory used in medical traditions.
The four memory systems that are important to medical traditions are episodic, semantic, procedural, and working memory. Episodic memories are memories of autobiographical events that can be explicitly stated or conjured. A physician who remembers examining his patient would be an example of episodic memory (Hay, 146). Secondly, semantic memory consists of general facts and knowledge such as the fact that acetaminophen is an analgesic. Episodic and semantic memories are both explicit and declarative, which enables content knowledge (Hay, 146). The third important memory system involves the memory of learned motor behaviors and skills that are unconscious—procedural memory. Imagine a surgeon who performs an appendectomy. The surgeon is likely using procedural memory, removing this vestigial organ is a smooth operation that the surgeon has likely performed hundreds of times. Lastly, working memory “involves allocating attention and linguistic resources for second or minutes to address problems at hand [that] may be relevant in both healers’ conscious efforts to address unfamiliar illnesses (Hay, 147). The three critical neural structures that are important to these memories involve the hippocampus, basolateral amygdala, and the basal ganglia. The hippocampus is found in the medial temporal lobe, and it is essential for episodic memory. Also located within the medial temporal lobe, the basolateral amygdala is an important structure that makes up important nuclei. Stress responses stimulate these nuclei, and the amygdala plays an important role in “episodic and effortful semantic memory recall” (Hay, 147). The basal ganglia is important to procedural memory, which catalyzes memory processes independent of the hippocampus. Hay compares and contrasts the American medical traditions to the those of the Sasak people in Indonesia. The Sasak medical tradition revolves around memory precision that is central to their medical practice; these potent “memorized formulate” are almost always retained from oral knowledge and are passed down from ritualized distribution. The knowledge retained by the Sasak are “primarily tightly constrained, episodic learning dependent on the hippocampus, medial temporal lobes, and the prefrontal cortex (Hay, 155). The knowledge within the American medical tradition differs greatly from that of the Sasak. American medical knowledge is obtained through not only through a scientific basis, but are also further refined from clinical experience. Hay describes the American medical knowledge as “encoded semantically, episodically, and procedurally and over time reconsolidated into schemas that can be accessed through the hippocampus as well as through the basal ganglia (155). As we can see, the Sasak medical tradition differs significantly from that of the American tradition. However, neither system is wrong, just extremely different.
10 Comments
Brian Rivera
3/4/2019 01:08:39 pm
I felt this chapter went out of its depth. I felt that it cut many corners in the explanation of the creation of medical knowledge to make the process fit the narrative of the “two forms of memory”. I think that the different paths of memory described for either the Sasak or the American medical experts is overly simplified and makes huge assumptions about what we know about memory and how memories are stored in the brain. I had not encountered a description outlining such a clear way in which semantic and episodic memories are stored, encoded, and recalled in the literature of neuroscience and education. This makes made me skeptical of this description. It seems that if there were such a simple mechanism to instill knowledge in students, we would have solved a lot of the problems that education faces. Additionally, medical students are highly self-selected members of society who are committing time and energy to learn medicine, to take them as an example of how brain learns knowledge says very little about how the average (if not most) people learn. I think it is ironic that Richard Feynman was quoted to challenge the seeming authority of scientific knowledge being that one of Feynman’s most famous quote is “The first principle is that you must not fool yourself – and you are the easiest person to fool”.
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Kaitlyn May
3/5/2019 09:49:26 am
Brian, I agree entirely. I was very skeptical of this chapter. I agree that they made a lot of claims about the memory paths without the necessary citations or proof to support these claims. Like you said, it felt out of depth and very much like conjecture. I think the comparison of the Sasak to American medical tradition would have been better paired with a discussion on the culture of schooling and how this affects how we treat knowledge and the consequential effect this treatment has on learning strategies (at least from a cultural standpoint), rather than a discussion on memory itself. I can certainly see the cultural forces implicit to education and learning strategies, but I question whether memory itself can be cultural-- to me it seems more biological.
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Vanessa Marshall
3/5/2019 03:51:53 pm
Zach. This is amazing. The control you showed in your summary-analysis was admirable, especially given the potentially controversial way this chapter could be interpreted. I think you presented the information in an unbiased way, as highlighted by your last sentence. I look forward to hearing your thoughts in class.
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Casey Fulkerson
3/5/2019 05:10:17 pm
As someone who knows very little about neuroscience (let along the different types of memory), I thought that this was an interesting chapter to read. Personally, I thought it was ingenious to use approaches to medical knowledge to demonstrate the emphasis on different types of memory. I thought that Hay's statement on page 160 that the Sasak approach to medical knowledge makes amazing diagnosticians while the American approach to medical knowledge is useful for developing diagnoses and treatment plans for new illnesses was interesting. Zach, you wrote a wonderful summary and analysis of a dense chapter and like Vanessa pointed out, maintained a very anthropological attitude toward the two traditions.
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Leah Fontaine
3/5/2019 05:26:21 pm
Until reading the comments of you all above, I had no skepticism of this chapter, but I think that's due to my lack in knowledge of the brain. I'm embarrassingly trusting when reading scientific articles because I know so little. Looking back now I see how this could be a not quite compatible comparison. I think the comparison was really interesting though when it was brought up that the Sasak have some access to modern medicine, but chose not to seek it out to begin with not because it didn't help the person, but because they believed that it only made them heal faster and did't cure the root. This is most likely an over generalization of what the Sasak believe, but it still would be interesting to see that community vs another local one with similar proximity and see how often each community seeks out modern medical attention while also comparing reasons and death and birth rates.
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Elisabeth Nations
3/5/2019 06:23:21 pm
I was surprised to read the critical comments above; I am far from an expert on neuroscience or the brain, so I had no qualms about how the information on memory was presented in this chapter. Perhaps it is a brief overview that leaves out some important complexities of how the brain works without sacrificing too much meaning? Regardless, I thought this chapter was very interesting. It reminded me of the chapters about embodiment as it relates to sports and physical movement, as the Sasak and Americans have different patterns and practices of memorization in medicine based on their culture. I disagree with Brian in that I don't believe this chapter is making any claims about memory formation and use in the Sasak and American cultures as a whole ("the average people"), but instead just about the highly specialized area of medicine within these cultures. I also disagree with Kaitlyn; I could be wrong of course, but I don't think Hay is trying to talk about differences in actual memory formation between cultures as much as he is focusing on differences in patterns of memorizing and learning. Like I said, I have not studied the brain much, so my opinion is influenced by that!
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Madi Moore
3/5/2019 09:14:22 pm
Zach, I really enjoyed reading your review on chapter 5. One thought that went through my mind while reading this chapter deals with the limbic system, how memories work, and how culture plays a part as well. There is so much variation among humans, yet our limbic system, which plays a huge role with memories, is one of our brain's most primitive networks. How do these things (general human memory variation, the fact that our limbic system is "evolutionarily old," and culture) interact? Does culture shape the way we encode/retrieve memories? How does this happen? I somewhat agree with Kaitlyn May in the comment above that memory is more biological. But, biologically speaking, are we not cultural beings? I feel as though memory itself might in fact have an important cultural aspect. I am excited about this class discussion!
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DANIEL J QUILLEN
3/6/2019 09:44:33 am
The author focuses a fair amount on neurological basis of memory and it's actual biological structures. While this overview might be a little basic I fail to see how the connection is made between the two types of medical techniques and different types of memory. These two types of treatment in all likelihood both require all types of memory recollection in order to properly learn and treat patients. This is wear better portable neuroimaging techniques need to come into play so studies can show exactly how each physician is recalling during treatment. Then we can ask how cultures effect the memory recall pathways.
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Kaitlyn May
4/24/2019 07:27:57 pm
Looking back on this blog post, I still feel a little skeptical of this book chapter. However, less so than before. Discussing the chapter in class helped me to understand the perspective of the authors and in so doing give them more credence to their argument. While I still feel like their argument could benefit from having a co-author who has an expertise in neuroscience, I can appreciate the ingenuity of their approach and the importance of their study.
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AuthorThis blog is group authored by Dr. DeCaro and the students in his ANT 474/574: Neuroanthropology. Archives
April 2019
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