The logic of well being : Therapeutic narratives in Cairo, Egypt

This paper examines understandings of curative action among women in a traditional (baladi) quarter of Cairo, Egypt. It is based on research in a mother-childhealth (MCH) clinic and the surrounding urban area. It probes healing strategies and understandings revealed in therapeutic narratives. These narratives are commentaries on disease progression, curative action and surrounding events--both relevant and irrelevant. Fragments of narratives embedded in conversation are framed by stylistic shifts; they are eventually codified into elaborated accounts which are referenced for years after the illness episode. Therapeutic narratives present a system of knowledge which mediates between the everyday experience of diagnosis and curative action and the cultural context (ethnoetiology, ethnophysiology, concepts of fate and envy). They provide a biographic and experimental context for perception and diagnosis of illness. They also facilitate transformation of diagnosis and prognosis. The article presents baladi therapeutic narratives as a specific instance of a culture-wide phenomenon of 'tacking down' illness episodes to make sense of them. Discussion also highlights the baladi-specific curative system with its principles of regularity and fluidity, and the baladi-specific logic of proximity, specificity, and multiplicity which organizes baladi therapeutic narratives. Cases presented demonstrate how baladi women evaluate the meaning of experience and action while recounting illness episodes and how they corroborate their curative action with past experience and community standards. Through continual re-evaluation a finely woven web of rationale evolves as a woman with a difficult problem such as delayed conception or a persistently weak child moves through curing strategies. Diagnosis is always subject to revision; explanations of what is happening are constantly generated--whether in respect of mundane activity or of the event's meaning. Narrative recounting is the locus par excellence for the aggregation of cognitions concerning a whimsical universe where baladi people's main power lies in their skill at verbal manipulation. However, it is not used in lieu of action. Narratives provide an arena for the negotiation of reality and of correct action; they do not discount reality, but make sense of it.