"I'm not a diabetic. I'm a senior": Identity Production in the Clinical Encounter among Adolescents with Type 1 Diabetes
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2014
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Haverford College. Department of Anthropology
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Thesis
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Award
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eng
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Abstract
This thesis is an ethnographic study that examines how adolescents with type 1 diabetes conceptualize the clinical encounter, how the interactions within this space contribute to identity formation, and the nature of the translation of the clinical encounter to the daily life of the patient. In my fieldwork observing a diabetes educator at Children's National Hospital, it became clear that adolescents with type 1 diabetes struggle to assume responsibility for self-management of this chronic disease partly due to a conflict that they experience between establishing independence as a young adult and relying on dependent relationships with parents and physicians for their health. Using Arnold Van Gennep and Victor Turner's theory of liminality in rites of passage, I argue that the patient's identity, in the form of autonomy, independence, and responsibility over self-care practices, is produced within the constraints of a clinical encounter through the interactions that occur between patient, parent, and physician. This study has implications for future treatment of adolescents with type 1 diabetes that could help improve health outcomes.