Paper short abstract:

The role of the ethnographer is attached to the grounds of first-instance access. I discuss how my enquiry into the worlds of schizophrenia patients at clozapine clinics holds anthropological value, albeit compromised by conditions of access to settings otherwise reserved for the clinically trained.

Paper long abstract:

The role of the ethnographer in exploring the worlds of the extremely medically vulnerable becomes particularly complicated in the terrain of treatments for the severely mentally ill. The therapeutic process and outcomes, such as significant life expectancy gaps attributable to heart disease more than suicide, expose shortfalls in health equity and effectively 'accessing' the patient. Further, critical anthropological insights become inevitably inseparable from the grounds of first-instance access to the treatment setting. This paper discusses barriers to anthropological access to patients with schizophrenia being treated with clozapine, the gold standard antipsychotic that requires ongoing physiological monitoring and management.

As a non-clinician anthropologist, the pursuit of ethnography in clozapine clinics has necessitated extensive consultations and support from medical authorities. This has shaped my enquiry into one that demonstrates clinical value and renders me a 'researcher'; 'medical anthropologist' confuses my non-clinical role and 'anthropologist' is too unfamiliar to my participants. I cannot access everyday lives outside of the clinical setting - my conversations, interactions and observations (questionably participatory) are confined to clinic opening hours. I am not involved in any aspect of recruitment and consent and, dare I mention, the official paperwork granting me access to the clinic has taken over a year and no less than 20 different authorisations. I will be discussing the points at which my enquiry is credibly anthropological and the points at which I must compromise in order to access anything of an ethnographic setting otherwise reserved for the clinically trained.