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This poetry collection explores my grapplings with my Mad and trans identities within the curative, diagnostic, medical model discourses of the medical industrial complex. Using an autoethnographic Mad and trans poesis, I seek to situate these grapplings within historical and present-day systems of power, privilege, and oppression, confronting the hauntings (Gordon, 2008) that arise from my simultaneous complicity in and disruption of these institutionalized structures of harm and violence that disproportionately target bodyminds that are deemed non-normative. By engaging in this process through poetic expression, I center an embodied form of knowledge production that challenges sanist notions of rationality and hetero- and cis-normativity constructed and perpetuated by white settler colonial ideologies. My unearthing of these hauntings (Gordon, 2008) and my relationship to them on an internal, interpersonal, and systemic level is merely a beginning in a life-long journey of trans and Mad becoming.

Drawing on the work of Ivan Illich, our special issue reanimates iatrogenesis as a vital concept for the social sciences of medicine. It calls for medicine to expand its engagement of the injustices that unfold from clinical processes, practices, and protocols into patient lifeworlds and subjectivities beyond the clinic. The capacious view of iatrogenesis revealed by this special issue collection affords fuller and more heterogeneous insights on iatrogenesis that does not limit it to medical explanations alone, nor locate harm in singular points in time. These papers attend to iatrogenesis' immediate and lingering presences in socialities and structures within and beyond medicine, and the ways it reflects or reproduces the racism, sexism, and ableism built into medical logics. [ABSTRACT FROM AUTHOR]

Medicine in the twenty-first century is constituted and propelled by the production of evidence. Once produced, the use of that evidence is complicated by features inherent in the American and global biomedical economy itself. With the exponential rise in the use of cardiac devices as my case study, this think piece traces the links among evidence-based medicine, insurance reimbursement policies, and clinical trial outcomes to reveal how evidence produced by trial findings creates treatment standards. Those standards, in turn, expand what is thought to be ‘treatable’ by reconceptualizing risk as a condition that deserves intervention. Such standards affect what physicians recommend and what patients decide to do. The essay emphasizes that evidence-based medicine can be a source of anxiety that patients and families feel when considering how to proceed. It highlights the debates, increasingly common both within and beyond the health professions, about what is actually best as we grow older. It provides an example of how, today, most deaths, even among the very old, are considered premature. In an aging society, the treatment protocols that fall under the evidence-based medicine umbrella constitute an enormous truth-making regime that determines the goals of medicine and shapes health care consumers’ quandaries about medical intervention, and especially the quandary, for those in later life, about crossing the line of too much treatment.

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