Diagnostic Emplotment in Q’eqchi’ Maya Medicine

Abstract

Medical diagnosis is a process of illness discrimination, categorization, and identification on the basis of careful observation and is central in biomedicine and many traditional medical systems around the world. Through a detailed analysis of several illness episodes and healer interviews among Maya communities in southern Belize, we observe that the diagnostic processes of traditional Q'eqchi' healers reflect patterns of narrative 'emplotment' that engage not simply the individual patient but also significant spiritual and cosmological forces. Three diagnostic techniques of the Q'eqchi' Maya healers are described and their connections to Maya concepts of personhood and cosmovision are presented. This research fosters an appreciation of how Indigenous knowledge systems shape clinical encounters and healing dramas, widening the spheres of clinical narrative co-construction and dialogue beyond the material and physical contexts implicit within Western clinical encounters.

Ethnopharmacological Field Study of Three Q'eqchi Communities in Guatemala

“…The use of medicinal plants by the Q'eqchi' of Guatemala has been the subject of previous studies using different approaches, some of the most recent being studies on a specific species to treat the culture-bound illness “susto” (Mullally et al, 2016 ), the antifungal activity of a single species (Ta et al, 2016 ), the diagnosis of the single culture-bound illness “emplotment” (Hatala and Waldram, 2017 ), the investigation and review of Q'eqchi women's reproductive health in the Lake Izabal region (Michel et al, 2016 ), the broad study of Mayan phytomedicine in Guatemala and a further proposal for patient-centered boundary mechanisms to foster intercultural partnerships in health care (Hitziger et al, 2016 , 2017 ). The present study differs from these previous studies because it was conducted in three communities of Alta Verapaz with a normal population (no traditional healers).…”

Embodiment, Empathic Perception, and Spiritual Ontologies in Q'eqchi’ Maya Healing: An Ethnographic Exploration

“…In some ways, a patient's emotions or story are irrelevant in a Q'eqchi’ healing encounter, for the body knows and the blood speaks (Hinojosa 2002). As we have shown, aj iloneleb’ describe knowing through their bodily sensations and spiritual perceptions about details of their patients that are untold or unnarrated, and patients often say little and remain passive participants in Q'eqchi’ healing encounters (Hatala and Waldram 2016, 2017; Waldram 2015). Relationships with spirits and corresponding sensations in the healer's body act on behalf of the patient, communicating and helping the healers know, empathize with, and understand the patient experience (Figure 6).…”

“…As symbols that arise in the healer's body, these sensations can also point beyond themselves to the patient's underlying emotions, feelings, motives, thoughts, or desires, including the deeper spiritual or cosmological forces involved. This polysemous nature of spiritual perception situates the healers’ experiences teleologically, guides the specific improvisational elements of the aj iloneleb’ therapeutic performance, and “emplots” a particular medical case within a broad framework of Q'eqchi’ epistemology and nosology (Hatala and Waldram 2017). Importantly, this mode of embodied perception does not require the patient to narrate their experience in any significant way (Hatala and Waldram 2017; Waldram 2015).…”

“…This polysemous nature of spiritual perception situates the healers’ experiences teleologically, guides the specific improvisational elements of the aj iloneleb’ therapeutic performance, and “emplots” a particular medical case within a broad framework of Q'eqchi’ epistemology and nosology (Hatala and Waldram 2017). Importantly, this mode of embodied perception does not require the patient to narrate their experience in any significant way (Hatala and Waldram 2017; Waldram 2015). Rather, in Q'eqchi’ therapeutic interactions a confluence of spirits, blood, and bodies speak, communicate, mesh, and blend together.…”

“…In Q'eqchi’ healing, a treatment encounter almost entirely involves direct contact between healer and patient, typically through the pulsing of the patient's wrists. In grasping a patient's wrists to communicate with the blood or become attuned to sensations within his own body, Q'eqchi’ aj ilonel locate a condition within a known taxonomy of disorders and work out the most appropriate treatment (Hatala and Waldram 2017). To a great extent, this prognostic process is not something one can think through—in the typical linguistic sense—rather, it must be sensed, a manner of thinking through one's body.…”