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decades of amazing experiences and encounters that have a lot to say about
the world today.”
––A. M. Capron, University Professor, University of Southern
California, and First Director, Ethics, Trade, Human Rights, and Law,
World Health Organization
“Renée C. Fox invites us to join her as a participant observer as she ‘mind
travels’ across the globe, exploring issues from outbreaks and immigration
to humanitarian crises and bioethics. Renée inspires us to be everyday
sociologists, questing and advocating for meaningful solutions to some of
society’s most pressing problems.”
––Peter Piot, Director, London School of Hygiene & Tropical
Medicine, UK
“Aging has finally done to Renée Fox what war, disease, discrimination
against women and other obstacles could not. Renée can no longer travel to
Europe, Africa and China to conduct her groundbreaking ethnographic
research, but the elegant essays in this book show that she is still exploring
her world.”
––William Whitworth, Editor Emeritus, The Atlantic
“One of twentieth century’s leading sociologists continues to write with
deep insight, empathy and force. My first contact with Fox’s writing was in
1984, when my life was redirected by her 1963 essay on how doctors are
trained for ‘detached concern.’ I became her student in 1989 and then really
saw her extraordinary mind and essayistic power up close. She has been a
constant teacher, by her words and example, to countless people in all walks
of life. And she is still teaching, with joy. In Explorations of a Mind-
Traveling Sociologist, each subtle observation opens into a whole world of
ideas—about living with constraints, about humanitarian medicine, about
contested elections, about the art of teaching itself.”
––Nicholas A. Christakis, Sterling Professor of Social and Natural
Science, Yale University, New Haven, CT, USA
Explorations of a Mind-Traveling
Sociologist
Renée C. Fox
Foreword by
Anne Fadiman
Anthem Press
An imprint of Wimbledon Publishing Company
www.anthempress.com
This edition first published in UK and USA 2020
by ANTHEM PRESS
75–76 Blackfriars Road, London SE1 8HA, UK
or PO Box 9779, London SW19 7ZG, UK
and
244 Madison Ave #116, New York, NY 10016, USA
Copyright © Renée C. Fox 2020
The author asserts the moral right to be identified as the author of this work.
All rights reserved. Without limiting the rights under copyright reserved above,
no part of this publication may be reproduced, stored or introduced into
a retrieval system, or transmitted, in any form or by any means
(electronic, mechanical, photocopying, recording or otherwise),
without the prior written permission of both the copyright
owner and the above publisher of this book.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library.
Library of Congress Cataloging-in-Publication Data
Library of Congress Control Number: 2019952770
ISBN-13: 978-1-78527-142-7 (Hbk)
ISBN-10: 1-78527-142-3 (Hbk)
ISBN-13: 978-1-78527-145-8 (Pbk)
ISBN-10: 1-78527-145-8 (Pbk)
This title is also available as an e-book.
This book is dedicated to the persons who throughout the course of my
professional lifetime as a sociologist I have been privileged to teach; to
those who have made it possible for me to conduct firsthand ethnographic
research in the United States, Europe, Africa and Asia, accompanying me in
the process; and to the companion coauthors and editors who enabled some
of the fruits of my teaching and research to be published in meaningful
prose.
CONTENTS
Foreword by Anne Fadiman
Preface
Acknowledgments
Part 1: Apartment Number 1103/4
1. Resilience
2. Apartment Number 1103/4
3. A Hallway Friendship
4. Making an Apartment House My Home
Part 2: Beyond Borders
5. Beyond Borders
6. The Meanings of My MSF Book
7. Venturing Out with a Rolling Walker
8. Election to the Explorers Club
Part 3: Medical Encounters
9. Encounters with Physicians
10. Plagues
11. Miss Balkema—and MaryBeth
12. Life, Death and Uncertainty in Physicians’ Memoirs
Part 4: Encounters with Current Events
13. Terrorist Bombings in Brussels
14. The 2016 Presidential Election
15. Donald Trump’s Executive Orders on Immigration
Part 5: On Being a Teacher
16. On Being a Teacher
17. What I Learned about the Language of Silence
18. A Bioethics Award and a Surrogate Lecture
Epilogue
FOREWORD
Anne Fadiman
What if you were a great sociologist who had devoted your life to fieldwork
that had taken you all over the world: to Europe, where you had
investigated the social and cultural aspects of Belgian medical research and
listened to carillon bells ringing from Gothic belfries; to Central Africa,
where you had traced the development of the Congolese medical profession
and walked through streets littered with broken glass from the Simba
Rebellion; to China, where you had observed how Deng Xiaoping’s Four
Modernizations policy played out in a Tianjin hospital and delivered a
lecture to the Chinese Academy of Medical Sciences in an auditorium so
cold that the entire audience wore padded jackets and long underwear; to
South Africa, where you had studied the strategies employed by Médecins
Sans Frontières to combat the HIV/AIDS pandemic and attended a mass
rally for antiretroviral treatment at which hundreds of Gugulethu residents
sang and danced in the rain; and to dozens of other countries where you had
conducted research in medical ethnography as a participant observer? And
what if, because of age and physical frailty, you were now largely confined
to your apartment? What would you do?
Most people would throw in the towel and feel their lives were over.
Renée Fox is not most people. Even though her outer landscape has
radically contracted, what she calls her “inner landscape” is so expansive
that her travels are far from ended. Her current mode of conveyance is her
mind. At 91, she is still a participant observer; she is still doing fieldwork;
she is still, in Clifford Geertz’s terminology, “thickly descriptive,” though
the subject of her thick description is now often her own daily life. The
essays in this book are the product of her inextinguishable ethnographic
curiosity, which allows the near to summon the far, the inward to summon
the outward, the present to summon the past.
Renée lives in an elegant apartment off Rittenhouse Square in
Philadelphia that is filled—but not cluttered—with books, maps,
photographs and art, most of it connected in one way or another to her half-
century of international research. The world comes to Apartment 1103/4 in
the form of phone calls, emails, cards and letters from her academic
colleagues, her fieldwork collaborators and, especially, her former students,
who continue to view her as a source of seer-caliber counsel. She keeps up
with current affairs, especially in the medical sphere, not only through
newspapers, radio, and television but through updates from friends who
work with Médecins Sans Frontières. From time to time a troop of Penn
medical students with an interest in writing—members of the Gawannabes,
so called because, secretly or not-so-secretly, they all aspire to be Atul
Gawande—blow in, along with a whoosh of millennial fresh air, to tell her
about their experiences in the anatomy lab and the surgical theater.
I teach writing, and on the first day of class, when I talk about the virtues
of concision, I always quote from a Wordsworth sonnet called “Nuns Fret
Not at Their Convent’s Narrow Room.” The topic of the poem is constraint.
Wordsworth tells us that just as nuns accept their cramped quarters and bees
enjoy the slender foxglove bells in which they gather nectar, so do poets
value the sonnet’s enforced brevity and strict rhyme scheme. From narrow
rooms come great things: prayer, honey, literature.
Unlike the nuns and the bees and the poets, Renée Fox has not chosen
her life’s constraints. The fates have handed her an existential deal that is
both kind and cruel: superlative mind, compromised body. She would
doubtless prefer that her leg, her arm, and her ribs had not been broken by
falls; she would doubtless prefer not to use the walker necessitated by post-
polio syndrome; she would doubtless prefer a less narrow room.
But dealing with constraints—or, to be more exact, refusing to be
constrained by constraints—has been a recurring theme throughout Renée’s
life. Polio at 17? She took a year off from Smith to recover and rehabilitate,
then returned to graduate summa cum laude. Limited academic
opportunities for women sociologists in the 1950s? After completing her
doctorate at Harvard (though with a diploma from Radcliffe, since women
were not yet permitted to receive Harvard degrees even after following the
same curriculum as their male classmates), she initially received no
teaching offers, so she accepted a research position at Columbia before
becoming a tenured faculty member at Barnard, chairing the sociology
department at Penn, and being inundated by a Niagara of medals and prizes,
including a knighthood: the Chevalier de l’Ordre de Leopold II, conferred
by the Belgian government. Too young and too female to be a likely
candidate for a Guggenheim Fellowship—not to mention that Guggenheims
were rarely granted to sociologists? She applied anyway, at 32, and of
course she got one.
I might add that although Renée routinely refuses to take no for an
answer, the refusals are always tendered with consummate politeness. The
word “lady” has fallen into disrepute of late, but Renée is a lady in the best
sense of the word. My favorite photograph in her apartment—it’s part of the
montage on the cover of this book—is of her walking in the copper mines
of Katanga with her friend Willy De Craemer, the Jesuit priest with whom
she collaborated on much of her research in the Congo. She is wearing a
chic dress, a chic scarf, and chic pumps. In 2010, Renée and I found
ourselves at a Harvard commencement together, I as a member of one of the
university’s governing boards and she to receive an honorary degree.
Female Overseers traditionally wear white gloves to commencement. Renée
immediately noticed that mine were … I blush to say it … nylon. It wasn’t
long before a package arrived at my home containing two exquisite pairs of
gloves, one silk, one leather.
By that time, Renée and I were good friends. We had met 11 years
earlier, when I became the editor of The American Scholar, a literary
quarterly to which she was a contributor and on whose editorial board she
served. I particularly enjoyed editing a piece she wrote about the year she
had spent as the 57th George Eastman Visiting Professor at Oxford. (Of the
previous 56, 55 had been men.) It wasn’t just a memoir, it was an
ethnography, in which, among other things, she analyzed the hierarchy of
the Balliol College Fellows as indicated by whether or not they had been
allotted silver napkin rings. (She had.)
A few months before the nylon-glove commencement, Renée called to
discuss Bill Whitworth, an editor who had worked with me at The American
Scholar and edited Renée’s autobiography, In the Field. Over the years,
Renée and I had both exchanged innumerable emails and had innumerable
phone conversations with Bill, but he worked from his home in Arkansas,
and neither of us had met him. Renée believed this situation demanded a
remedy, and she proposed one: we would fly to Little Rock and take Bill
out to dinner. She was 82 at the time, and although not yet housebound, she
moved with difficulty. But this was one of those instances in which Renée
was not going to take no for an answer. We had a wonderful time.
As I read the essays collected in Explorations of a Mind-Traveling
Sociologist, I thought of something the Belgian novelist Jan-Albert Goris
had said when Renée was 34 and had just published an article in Science
that shone an affectionate but high-wattage light on some of the more
problematically traditional aspects of his country’s culture. Whether or not
one agreed with Renée Fox, remarked Goris, “she has moed.” Moed is the
Flemish word for courage. Renée Fox still has moed.
PREFACE
When my book Doctors Without Borders: Humanitarian Quests, Impossible
Dreams of Médecins Sans Frontières was published in 2014, I knew it was
destined to be the last book of this sort I would write.1 I was still in
fundamentally good health and blessed with lucidity, but because of the
aging of my body and the post-polio symptoms it was manifesting, I could
no longer undertake the physically strenuous ethnographic research in the
array of American, European, African and Asian settings that underlay my
Doctors Without Borders book and characterized my research throughout
my career.
Journeying into the field as a questing sociologist and writing about
what I had learned and come to understand through the participant
observation it involved were so vital to my being that it was hard for me to
imagine a life, much less a book, without them. Slowly, however, the idea
for a feasible book that contained these elements began to take shape: a
book of thematically interconnected ethnographic essays drawn from a
range of things I was seeing, experiencing, thinking and feeling at this
juncture in my life, whose participant observer outlook would extend its
purview beyond autobiography or memoir.
***
Composing these essays has been an engrossing undertaking. It has
heightened and enriched the observations that I make in the course of my
daily life. It has enabled me to engage in “mind travel” to places I have
intimately known in the past and to places I have yearningly hoped to visit
but never have.2 It has strengthened my connectedness with persons who
have been important presences in my life—among whom figure
prominently persons I have taught over the years and persons who helped
me conduct the field research in which I was involved. And in fulfilling my
continuing need to write, I have experienced what the Israeli author David
Grossman has described as “the great miracle, the alchemy” of this act:
In some sense, from the moment we take pen in hand or put fingers to
keyboard we have already ceased to be at the mercy of all that
enslaved and restricted us before we began writing.
We write. How fortunate we are: The world does not close in on us.
The world does not grow smaller.3
***
A friend with whom I shared my plan to write this book characterized its
essence as “observations and analyses from your apartment, with a window
on the world outside and inside.” It is from that perspective that these
essays begin with an unexpected incident in my apartment.4
1 Baltimore: Johns Hopkins University Press.
2 I am indebted to Anne Fadiman for describing my nonphysical travel as “mind travel.”
3 David Grossman, “Writing in the Dark,” in Writing in the Dark: Essays on Literature and
Politics, trans. Jessica Cohen (London: Bloomsbury, 2008), p. 68.
4 In this book, when quoting from email messages and other correspondence, I have altered names
and other identifying characteristics to protect the identity of many of my correspondents.
Acknowledgments
I am deeply indebted to all of the individuals whose background, personal
stories, professional training and histories, value commitments and resonant
voices constitute the substance of this book of ethnographic essays. They
include family members, friends, colleagues, students and former students
and health professionals, many of whom appear in the book, who have been
integral to the meaningfulness of my past and present life and who have
helped me function on an everyday level at this elderly, physically restricted
phase of my existence. These persons also include the staff of the apartment
house in which I have dwelt for decades, and the home health aides who
more recently have enabled me to continue to live in my apartment,
surrounded by my library, my files of firsthand field notes and my personal
and professional memorabilia.
Notwithstanding all the support and help I have received in the course of
writing this book, it would never have found its way into print without
Jacqueline (“Jackie”) Wehmueller, whom I first came to know when she
was executive editor at Johns Hopkins University Press, where she
shepherded my previous book about Doctors Without Borders and me
through the publishing process. She has played an even more encompassing
role with regard to this book—including the many nuanced ways she has
edited its text, the generosity and skill with which she has facilitated my
communication with Anthem Press and the constant, uplifting
encouragement she has bestowed on me.
In addition, the vibrant, dedicated group of persons who have knowingly
and unknowingly, explicitly and implicitly, contributed to the coming into
being of this book consist of the following.
Anne Fadiman, the renowned essayist, writer of memoir and biography
and of literary nonfiction and inspiring teacher of writing at Yale University,
