UBC Theses and Dissertations

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UBC Theses and Dissertations

“I think I should be feeling bad about it” HIV/AIDS, narrative, and the institutional voices of medicine – towards a conceptualization of medical consciousness Hancock, Sara Catherine


For those living in resource rich countries such as Canada a positive HIV diagnosis no longer means an imminent death. In response to this change, numerous treatment and therapeutic institutions have arisen to assist individuals with managing their illness. Illness narratives then, the stories people tell and retell about their illness experience, are constructed by and within this multiplicity of medical frameworks that can interact in ways that are both complimentary and contradictory. Drawing on ethnographic data obtained through two months of participant observation and seven in-depth interviews at an HIV/AIDS treatment facility in Vancouver, British Columbia I discuss how illness narratives reveal the presence of and an orientation towards the powerful discourses of medicine. Some of the frameworks evident in the narratives I examine include biomedical understandings of health and disease, support group dialogues on self-empowerment, tenets of complementary and alternative medicines, clinical models of low-threshold access to health care, notions of health services as a human right, and addiction treatment concepts. In order to afford a place for the institutional discourses of medicine in my analysis, the subjective experience of illness is contextualized with reference to it’s situatedness amongst the myriad of other voices that both construct and constrain narrative production. Ultimately, I seek to demonstrate how the incorporation of disparate institutional voices into a subjective story of illness reflects the development of a unique orientation to the institutions of medicine an understanding that I conceptualize as medical consciousness.

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