Cruel Apprenticeship: National Imaginaries in China’s Operating Rooms

Bonnie O. Wong
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Abstract

Doctors learn to be doctors through clinical or therapeutic apprenticeships. By following, observing, and being mentored by more experienced physicians, trainees at various stages acquire embodied knowledge, affects, and ethics via both taught and hidden curricula. Previous research has demonstrated how biomedical training reproduces the social authority of scientific knowledge. This research article examines how for Chinese surgeons, apprenticeship not only immerses individuals within the scientific logics and hierarchical norms of biomedicine, but also embeds trainees within scientific imaginaries on a national scale. Drawing on ethnographic fieldwork in a Chinese academic hospital and a surrounding network of community hospitals, I examine how apprenticeship for Chinese surgical trainees extends beyond medical school and residency programmes, both in terms of temporality and geography. I examine how ‘technonational’ narratives, which permeate medical practice in China, impact the affects and ethics embodied by Chinese surgical trainees, and argue that changes in training expectations and the scope of training generates entanglements, dreams, and attachments which are cruel in their optimism. Thus, the therapeutic apprenticeship of Chinese surgical training reveals a ‘cruel apprenticeship’, a framing which encourages further exploration of the political and ethical stakes which permeate medical training and practice.
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残酷学徒制:中国手术室的民族想象
医生通过临床或治疗学徒学习成为医生。通过跟随、观察和接受更有经验的医生的指导,不同阶段的受训者通过教授和隐藏的课程获得具体的知识、情感和道德。先前的研究已经证明生物医学训练是如何再现科学知识的社会权威的。这篇研究文章探讨了对于中国外科医生来说,学徒制不仅让个人融入生物医学的科学逻辑和等级规范,而且让受训者融入全国范围内的科学想象。我在一家中国学术医院和周围的社区医院网络中进行了民族志实地调查,研究了中国外科实习生的学徒制如何在时间和地理上超越医学院和住院医师课程。我研究了渗透在中国医疗实践中的“技术国家”叙事如何影响中国外科学员所体现的情感和道德,并认为培训期望和培训范围的变化会产生纠缠、梦想和依恋,而这些都是他们乐观中残酷的。因此,中国外科训练的治疗学徒制揭示了一种“残酷的学徒制”,这种框架鼓励进一步探索渗透到医学训练和实践中的政治和道德利害关系。
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