Medication by Proxy: The Devolution of Psychiatric Power and Shared Accountability to Psychopharmaceutical Use Among Sol
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Medication by Proxy: The Devolution of Psychiatric Power and Shared Accountability to Psychopharmaceutical Use Among Soldiers in America’s Post-9/11 Wars Jocelyn Lim Chua1
The Author(s) 2020
Abstract With the United States military stretched thin in the ‘‘global war on terror,’’ military officials have embraced psychopharmaceuticals in the effort to enable more troops to remain ‘‘mission-capable.’’ Within the intimate conditions in which deployed military personnel work and live, soldiers learn to read for signs of psychopharmaceutical use by others, and consequently, may become accountable to those on medication in new ways. On convoys and in the barracks, up in the observation post and out in the motor pool, the presence and perceived volatility of psychopharmaceuticals can enlist non-medical military personnel into the surveillance and monitoring of medicated peers, in sites far beyond the clinic. Drawing on fieldwork with Army personnel and veterans, this article explores collective and relational aspects of psychopharmaceutical use among soldiers deployed post-9/11 in Iraq and Afghanistan. I theorize this social landscape as a form of ‘‘medication by proxy,’’ both to play on the fluidity of the locus of medication administration and effects within the military corporate body, and to emphasize the material and spatial ways that proximity to psychopharmaceuticals pulls soldiers into relationships of care, concern and risk management. Cases presented here reveal a devolution and dispersal of biomedical psychiatric power that complicates mainstream narratives of mental health stigma in the US military. Keywords Psychopharmaceuticals Psychiatric medications Sociality Military personnel United States Army
& Jocelyn Lim Chua [email protected] 1
University of North Carolina at Chapel Hill, Chapel Hill, USA
123
Cult Med Psychiatry
Introduction As a light-wheel vehicle mechanic deployed to Iraq in 2006, Alex had a lot to keep track of during his 15- to 18-h workdays. He maintained and fixed vehicles, regularly went on convoys to Baghdad in search of repair parts, and pulled observation post-duty over a highway running through Fallujah. As his platoon’s Motor Sergeant, Alex was also responsible for the training, welfare and morale of his lower-ranking soldiers, duties that demanded a different kind of eye for detail. For instance, Alex told me he could infer a lot about the mental health of his soldiers by tracking their movements. Soldiers might need to arrange to get themselves on convoys in order to pick up medication or to meet the brigade psychiatrist at a larger base. ‘‘It would be, ‘Hey, someone needs to head to Baghdad,’ or ‘Somebody needs to head to Bagram,’ and we’d have to arrange a flight for them or get them on a truck. So you started picking up on what was what.’’ There were other ways of figuring out who needed looking out for. When Alex conducted ‘‘hooch checks’’— inspections of sleep and work areas—opened drawers and dumped shave kits revealed which psychiatric medications were being
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