introduction 27
women learned to read; the Christians, Muslims and Jews were involved in
trade and practiced religions that emphasized learning a sacred text (Gough
1968: 133, 151).
Kerala’s literacy rate plays a role in shaping the world of illness and healing.
As we will see later, people in Kerala learn about treatment options via news-
papers and magazines. Th ese same media sources disseminate popular and
professional Western-style psychiatric discourse, which appears in patients’
descriptions of their inner states in the form of English idioms such as “stress”
and “depression.” Th ese idioms and discourses may in turn aff ect how patients
experience their illnesses.
The Problem with Saying “Thank You” and Other Features of the
Social Self in IndiaWhen I fi rst arrived in Kerala I stayed with relatives of a friend from the
United States who is originally from India. Based on American assumptions
about hospitality, I had planned to stay with this family only a few days until I
found my own place—after all, I thought, I only know their niece. Th is family,
however, had assumed I would stay the whole year, and they were surprised and
disappointed to discover that I wanted to fi nd my own housing—after all, they
fi gured, I know their niece. I explained that I had to move for my work, that liv-
ing with them was enjoyably distracting and I was not getting enough done. Yet
I quickly found that in Trivandrum, a city of one million people, there were very
few realtors or agencies who advertised or rented places to individuals. If one
needs a place to rent, one relies on word of mouth, one uses one’s social network.
I eventually learned—through friends and contacts, of course—of a person who
fi nds places for rare individuals like myself who look for a place on their own.
I visited this realtor with the uncle of the family I was staying with. When
we arrived at the realtor’s offi ce, the uncle spoke for me, telling the realtor what
I wanted and responding for me as to whether a place was worth seeing—I,
meanwhile, repeatedly tried and failed to gain an entree into the conversation
to speak for myself. In the end, I did not choose any of the apartments shown
by this realtor, and returning to the world of social connections, I ended up
renting an addition in the house of a friend, a clinical psychologist whose
insights on health and healing are occasionally cited in this study.
I tried to thank this family for their support, but that felt awkward, as I
sensed this would be essentially a distancing gesture. Th e Malayalam word that
translates as “thank you” (nani) is only used on formal or extraordinary occa-
sions, as when addressing an audience or a judge in a courtroom, and not on