STS Speaker: Toward Anti-Ontology: The Unmaking of Chronic Pain in Thailand

In this talk, I examine a Thai physician’s claim that “there is no chronic pain in Thailand,” and that “chronic pain is a Western invention.” Recent work in ontology has argued that diseases and disease categories are “enacted,” made iteratively by practices in context. In this talk, I will attempt an explanation of the opposite phenomenon: the active “unmaking” of (potential) disease, both as epistemological category and lived experience. I take my Thai physician’s claim in a slightly less positivist direction, and rather than argue that “there is no chronic pain in Thailand,” I will argue that chronic pain is instead actively “un-made” in Thailand. I will share how this process works: that it is unequal, tied to a class politics of suffering; that it is material, tied to the hospital as an organizing place; that it is spiritual, based on a Buddhist model of the human mind and how to intervene upon it; that it is political, emerging from the violent history of opium; and that it is ultimately unstable, as cracks slowly begin to form in the structures that keep chronic pain from becoming a “thing” in Thailand. To make these claims, I will share the stories of a series of Thai elders, some in the process of dying, others enduring chronic suffering, all caught in a web of the making and unmaking of pain.