How much should ethnographers involve themselves with the people, places, and processes they study? One answer has become increasingly popular: invert the standard method of participant observation ...into observant participation. This article draws on an ethnography of ambulance work to consider the trade-offs between these approaches. My fieldwork included “ride-alongs” with labor and management at a private ambulance firm in California (participant observation) and short-term employment as a novice emergency medical technician at the same company (observant participation). Beyond a simplistic distinction in “empirical depth,” I identify three issues at stake between participant observation and observant participation: field positioning, analytic gaze, and data assembly. Where participant observation presents more opportunities for mobile positioning, outward gazing, and inscription, observant participation presents more opportunities for fixed positioning, inward gazing, and incarnation. In addition to justifying such contrasts, I consider the advantages of mixing these styles into a hybrid approach when feasible.
This article reimagines poverty governance as a labor process. Extending theories of bureaucratic fields and street-level bureaucracies, the proposed model suggests that the state manages the poor ...through fragmented activities embedded in horizontal and vertical relations of production. I use an ethnography of 911 ambulance operations in a single California county to advance this perspective. From plugging gunshot wounds to moving sidewalk slumberers, ambulance crews interact with a mostly impoverished clientele base by transforming spaces in bodies and bodies in spaces. This two-sided governance puts the ambulance in recurrent contact with the hospital emergency department and the police squad car. Across these institutions, ambulance crews struggle with their nurse and police counterparts over the horizontal shuffling of burdensome work, shaping the life chances of their subjects in the process. At the same time, bureaucratic and capitalistic forces from above activate a lean ambulance fleet that is minimally wasteful and highly flexible. This verticality structures clientele processing through the ambulance and fuels tensions across the frontlines of governance. In an effort to advance theory and fill an empirical gap, this article proposes a new model for understanding the management of marginality and highlights an overlooked case of poverty regulation.
Medical sociologists argue that diagnosis is a critical component of medicine and that diagnosis is most obviously exercised by doctors. This scholarship, however, largely ignores other medical ...workers. I extend the concept of working diagnosis to help solve this problem. These are partial and preliminary medical classifications of suffering that are imposed between informal experiences of illness and formal classifications of disease. In a complex division of medical labour where doctoring is a minority practice, working diagnoses are critical forces that shape, and are shaped by, the relational conditions of medical production. To illustrate the analytical promise of this concept, I sharpen it through an ethnography of ambulance work in California. Working diagnoses in this case are officially referred to as ‘primary impressions’. I show how these impressions are deeply embedded in the relations of paramedical production. Three are specifically highlighted: the relations between ambulance crews and their patients, the relations between ambulance crews and their nurse and police counterparts and the relations between ambulance crews and their managers. I work towards a simple but rarely stated conclusion: medical sociologists should focus more heavily on how diagnostic processes influence labour processes and vice versa.
How might parole operate as a labor market institution, and how might it contribute to the governance of poverty and social marginality? Drawing on a series of correctional, employment, and arrest ...records for a cohort of parolees in Michigan, we show that parole generally supervises a jobless population, but also oversees a significant number of people who work. We also find evidence that parole, contrary to many expectations, increases the odds of employment. However, we do not find convincing evidence that parolee employment alleviates individual poverty or reduces the odds of recidivism. These results inspire a conceptualization of parolefare, another poverty regulating regime that successfully motivates worker-citizenship but does little to extend or protect the life chances of the poor.
Abstract
How is urban poverty governed? Scholarship emphasizes the significance of social assistance programs and criminal legal systems, but considerably less attention has been given to medical ...institutions. Drawing on contemporary and historical evidence across journalistic, bureaucratic, and academic texts, we conceptualize and compare three arenas for medically governing the poor in Los Angeles, California: clinical medicine, welfare medicine, and penal medicine. In addition to detailing the differences between these formations of medicine, we illustrate how each is embedded in similar political and productive relations. Ending with a call to reframe medicine as a primary institution for governing the poor, this article helps advance a relational vision of governance.
There is no alternative to theory-driven ethnography. Some ethnographers may refuse to acknowledge the epistemological bases of their respective methodological approaches, but this amounts to ...unreflexive rather than atheoretical fieldwork. This essay elaborates three theses along these lines with the aim of sketching out a self-consciously theory-driven approach to ethnography. First, all ethnography is necessarily theoretical whether researchers acknowledge it or not. Without acknowledging this point, ethnography remains a fundamentally unreflexive enterprise. Second, extending upward toward ‘structure’ from empirics illuminates the conditions under which observations tend to hold true. Third, theoretical reconstruction, rather than confirmation or discovery, is the primary goal of ethnography. Drawing on the works of Michael Burawoy, Imre Lakatos, and others, these three theses motivate a defense of what we term ‘hard-core fieldwork’. We distinguish this approach from both grounded theory and more contemporary iterations of empiricism in sociological ethnography.
Roughly 700,000 people are released from American prisons every year, yet we know little about their ground-level experiences at or near the moment of exit. This ethnographic study fills part of the ...gap by examining the aspirations and corresponding actions of soon-to-be-released prisoners, “short-timers.” While previous research suggests this population wants a “successful reentry,” few have detailed such a desire beyond its obvious mismatch with life chances. I show that in addition to verbalizing lucid hopes and plans for the “straight life,” short-timers act in reference to these aspirations while incarcerated by drawing on two meager resources: family and penitentiary. Such aspirations and actions are not markers of ignorance. Instead, I argue that they signal a practical orientation in a world where staff dominate inmates. In friction with the durable forces of inmate objectification, short-timers can use future-oriented perceptions and practices to realize some degree of selfhood. Meanwhile, their custodians, who are never committed to despotic control or total mortification, impose complementary lessons in personal responsibility through the discourse of prisoner reentry. Besides spotlighting a rarely studied moment in prison, I offer a model for how prisoner subjectivity emerges as both a rejection and product of penal power.
How is medical labor power, that being the capacity to assemble, adjust, or arrange medical subjects, converted into medical practice? Drawing on three qualitative case studies in the United States, ...Canada, and the United Kingdom, we argue that this conversion is shaped by pressures channeled through the relations that medical workers enter into with patients “from below” and managers “from above.” We demonstrate this by examining a common empirical object: ambulance labor. In addition to providing a unique window into the varieties of medical work, paramedicine offers a strategic venue for examining the kinds of productive relations that medical laborers enter into. Our research shows how the labor process is shaped by patient requests that can either conform or contradict workers’ shared sense of vocation. We also detail how this same process is simultaneously pressured by managers who are generally focused on increasing both the flexibility and the visibility of their workers. Many of these pressures, we argue, can be linked to common forces of neoliberalism across our three nations. Our analysis of the medical labor process inspires some practical recommendations to reform ambulance-based care. However, our primary aim is to advance a labor-centric approach to studying medicine.
•Examines medicine as a labor process through three case studies of ambulance work.•Unique pressures shape the conversion of medical labor power into medical practice.•Ambulance workers in U.S., Canada, and UK are pressured by patients “from below.”.•Those same workers are also pressured by managers “from above.”.•These pressures are linked to common forces of neoliberalism across our cases.
Ethnographic studies inside prisons are especially difficult to execute. In addition to facing amplified challenges in gaining site access, earning subjects’ trust, and tolerating the exhaustion of ...fieldwork, researchers who collect participant observation and in-depth interview data behind bars must confront an explicit asymmetrical power relation. Prison ethnographers penetrate, to varying levels of depth, a social universe where staff dominate prisoners and where prisoners, largely in response to the pains of their imprisonment, carve paths to dignity. This paper considers how and where non-staff and non-incarcerated ethnographers can awkwardly fit into (or fail out of) this space. Drawing on insights from two ethnographic studies in the United States, the authors detail their particular and common experiences across three phases: access, collection, and exit. These experiences motivate a description of prison ethnography as “punishing fieldwork.” Such research is not only exacting, it is also significantly contained and directed by penal power.
This article offers three interrelated critiques of Bourdieusian class analysis. First, Bourdieu replaces classes on paper with capitals on paper. He offers a false break from Marx in an effort to ...make capital more ‘relational’ via a theory of social space, but in doing so he neglects capital’s fundamental relation to labor. Second, Bourdieu offers a theory of domination without exploitation. Bourdieu’s classes live against one another, but it remains unclear how some classes might also live off of others. Third, and as a consequence of the first two missteps, he emphasizes position over production. Bourdieu typically sees ‘production’ as a form of ‘position-taking’ and as something best examined toward the top of social hierarchies. By largely ignoring labor and exploitation, he generates a theory of positions at the expense of a theory of production.
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