The Geography of Madness: Penis Thieves, Voodoo Death, and the Search for the Meaning of the World’s Strangest Syndromes By Frank Bures. Melville House, 2016. 9781612193724.
In multiple regions of the world, there is a medical syndrome in which men, and sometimes even large groups of men, go into a panic because they believe their penises are disappearing either by shrinking or being pulled inside their bodies. As traumatic as that would be on its own, in some places it’s understood that if the penis disappears fully, the victim will die. People blamed for causing the disappearance by magical means are assaulted and sometimes killed. When the stories appear in the news, they’re reported as regional oddities or some strange resurgence of primitive beliefs. Bures takes it much more seriously. He went on a multi-continent search to interview people who had suffered this malady and the doctors who had treated them. As he tells the story of his journey, he shares his extensive research into medical problems that are limited to certain cultures or countries.
While the doctors he interviewed about penis theft often blamed the syndrome on lack of education and superstition, Bures found research on similar culturally influenced medical problems for almost every country. High levels of education and a scientific viewpoint didn’t seem to prevent them. There is a heart problem that is only diagnosed in Germany, a liver problem that is only diagnosed in France, and a foot problem that only occurs in England. There are conditions that only occur in some places: anorexia is only diagnosed in cultures that value thinness. Syndromes can spread through cultural contact, like the high rates of lower back pain that spread from West Germany to East Germany after reunification. Others rise and fall over time with no change in their supposed physical cause, like carpal tunnel syndrome. These are cultural syndromes: every society has a culture and every culture has its syndromes.
Bures makes it clear that no one is faking or making it up: people who have these illnesses really do suffer, but the biomechanical model of illness can’t fully explain what is happening and why. Your medical diagnosis shouldn’t change when you cross a border, but it happens: Lynn Payer, an editor and medical correspondent for The New York Times got wildly different advice from her doctors when she moved to France. In her book Medicine and Culture (quoted by Bures on p. 85) she wrote that “all one must do to acquire a disease is to enter a country where that disease is recognized — leaving the country will either cure the malady, or turn it into something else.” Incidence rates of some illnesses increase based on how long an immigrant group has been in their new home: exposure to a new culture becomes a risk factor for disease.
Bures’ research is fascinating (don’t miss the chapter endnotes, they contain astonishing stories as well), and he writes in a sympathetic and engaging voice. He’s investigating the cultural sea each of us exists in and can’t recognize. Culture isn’t just native dress and food, it’s how we understand and experience reality.