Two Rivers


My research is about how moving deeper into the Anthropocene will transform human health systems. It is also about practices (some long-standing, others newly emerging) that could offer practical alternative trajectories for health systems coming to terms with the ecological and social dynamics of a novel geological epoch. The Anthropocene is already marked by global warming, altered weather patterns, environmental decimation, energy and resource shortages, financial crises, and massive movements of populations, not only of humans, but of birds, wolves, ocean mammals, monarch butterflies, and disease vectors. Since 1950, the scale of growth in humanity’s economic sphere has burned enough fossil fuels to begin changing the patterns of the Earth’s seasons, of its landscapes, and of the less visible biophysical cycles that sustain life on this planet.

The growth of the economy has also fueled the expansion of human society. We now have more people, more cities, more roads, more electricity, more complicated technologies, more pharmaceutical drugs, and more scientific knowledge than at any other point in the long life of the Earth. We also have fewer species, less tropical rainforest, melting polar ice caps, and a smaller number of languages. The parts of the world that are not incorporated into an international division of labour are diminishing and the number of people with access to digital technologies is rising. In the Anthropocene, human economic, social, and political activities will determine the course of ecological change. It is an era of unprecedented global connectivity and social complexity. It is also a time of great fragility and vulnerability to crisis and nonlinear change. Together we each face global risks (climate change, nuclear disasters, pandemics), but lack the collective identifications and institutional mechanisms for a global-scale response.

Health systems in the Anthropocene are floating down two rivers. One is wide and rushing. It is the strong current of high technology, of novel gene therapies, nanomedicine, robotic surgical techniques, wearable tech, and pharmaceutical drugs. It is the medicine of an industrial capitalist, highly complex society; it cures individuals, extends the lifespan, and enshrines health as a human right. The other river is slow and deep. It is the age-old, innate human capacity to imbue life with meaning, to care for each other, and to heal with the pharmacopoeias of nature and human consciousness. It is the medicine of place-bound communities in a resource constrained world; it is embodied, ritualistic, invested with cultural significance, and is community-centric rather than individualized. In the Anthropocene, the two rivers meet.

Some references:

Baer, H. A., Singer, M., Susser, I. 2013. Medical Anthropology and the World System: Second Edition. Westport, CT: Praeger.

Beck, U. 2016. The Metamorphosis of the World. Cambridge: Polity Press.

Bednarz, D., Beavis, A. 2012. “Neoliberalism, degrowth and the fate of health systems.”

D’Alisa, G., Demaria, F., Kallis, G. 2014. Degrowth: A Vocabulary for a New Era. New York: Routledge.

Farmer, P.E. 1999. “Pathologies of power: Rethinking health and human rights. ” American Journal of Public Health 89(10): 1-11.

Greer, J. M. 2009. The Ecotechnic Future: Envisioning a post-peak world. Gabriola Island: New Society Publishers.

Harrison, M. 2004. Disease and the Modern World: 1500 to the Present Day. Cambridge: Polity Press.

Homer-Dixon, T. 2006. The Upside of down: Catastrophe, Creativity and the Renewal of Civilization. Toronto: Vintage Canada

Ophuls, W. 2011. Plato’s Revenge: Politics in the age of ecology. Cambridge, MA: The MIT Press.

Quilley, S. 2012. “System Innovation and a New ‘Great Transformation’: Re-Embedding Economic Life in the Context of ‘De-Growth.’” Journal of Social Entrepreneurship 3 (2): 206–29.

Quilley, S. 2015. “Navigating the anthropocene: Environmental politics and complexity in an era of limits.” In Economics for the Anthropocene.

Rockström, J., et al., 2009. “A safe operating space for humanity.” Nature. 461:472-475.

Singer, M. 2014. “Transcending ‘Ordinary Times Rules’ in Environmental Health: The Critical Challenge for Medical Anthropology.” Medical Anthropology 33(5): 367-372.

Steffen, W., Broadgate, W., Deutsch, L., Gaffney, O., Ludwig, C. 2015. “The Trajectory of the Anthropocene: The Great Acceleration.” The Anthropocene Review January.

Turner, V. 1977. The Ritual Process: Structure and Anti-Structure. New York: Cornell University Press.

Zalasiewicz, J., Williams, M., Steffen, W., Crutzen, P. 2010. “The New World of the Anthropocene.” Environmental Science & Technology 44 (7): 2228–2231.

This blog was also published on

Disclaimer for an Autoethnography of Research

The purpose of this blog is to document my ongoing research while participating more fully in current conversations about medicine in the Anthropocene. For most social scientists, the early stages of the research process are kept private, with observations living in field notebooks instead of out where other people can read them. Although there are many good reasons for this, I find myself settling in to a more reflexive approach.

It has already taken me many years to begin, and before I launch into too much public writing I think it will be helpful to set out a few points about the nature of these posts. The first thing I should say is that my formally published academic work will necessarily be more painstakingly crafted, having gone through official channels of peer review and revision, than what appears here. What I am trying to capture in this context are the beginnings of ideas and the way they change over time. This blog is meant to be a record of research paths, some followed closely, others abandoned, and still others left to grow wild for a time before being returned to. In this way it represents an autoethnography of the research process which is more tentative than complete. As an autoethnography, it reflects not only changes in my thinking but also more encompassing shifts in my worldview deriving both from my personal experiences and from the inseparability of these experiences from the social, cultural, economic, and ecological positions that I occupy as a person living in this place at this time.

It may be worth being a bit more specific about this situatedness. I am thirty years old, am married to a man, and have two step-daughters that live with us part of the time. I live in an old house close to downtown in Kitchener, Ontario that my parents and my husband’s parents helped us to buy. My parents both run small businesses at a local farmers’ market, my father importing rocks and crafts from Asia and Latin America, and my mom selling coffee. I am an only child, and my parents had a relatively amicable and non-traumatic divorce when I was a teenager. On my dad’s side my grandfather was a teacher in Poland, then worked as a security guard after immigrating to Canada; my grandmother cleaned houses in Rosedale and developed early onset Alzheimer’s when I was a toddler. On my mother’s side my grandfather was a communist and an alcoholic and left when she was little, so no one knew him. My grandmother was a single mother living in Regent Park who went back to school in her forties and worked at a mental health NGO before retiring early and gardening for the rest of her life. I know almost nothing about any of my great-grandparents, am not acquainted with an extended family beyond my parents’ siblings, and have very little sense of cultural connection to my European ancestry. I was raised without religion and with few set assumptions about my future aside from the expectation that I would go to university, which I did. I have an undergraduate degree in Anthropology from Mount Allison University and an MSc in Medical Anthropology from Oxford, and am currently in a PhD program at the University of Waterloo.

Returning to the purpose of this blog, it is also relevant to mention that I have been compulsively journaling for over fifteen years. Long ago I left behind the fear of writing things that I found difficult to process intellectually or emotionally. This means that my writing can be exceedingly honest but also informed by impulses that travel only at the edge of my awareness. These impulses need to be considered thoroughly before being committed to, but can’t be properly considered without first being articulated in some (inevitably incomplete) form. Journaling has on the one hand made me very comfortable with writing about uncomfortable things, but has also made me unafraid of changing my mind and curious about the process that leads me through a tunnel from one perspective into another.

By contextualizing my work in this way I am not trying to make it immune to meaningful critique. I am instead attempting to define this blog as a place to articulate and refine ongoing research, hopefully in conversation with others, or at least in dialogue with unfolding public discussions related to health systems in the Anthropocene.