Wednesday, December 26, 2012

Neolithic Medical Care

An article in the New York Times this week highlighted the life of a young man in northern Vietnam between 3,700 to 4,500 years ago. "M9" as archeologists have named him, was paralyzed from the waist down and would have had very limited upper body mobility. Yet he apparently lived into his early 30s.

How was survival possible in a subsistence Neolithic community? The answer, writes Lorna Tilley, of Australian National University, in the International Journal of Paleopathology was round-the-clock, high quality personal care. This would have included regular bathing, toileting, massaging, and turning to avoid pressure sores.

Ms Tilley and her co-author make some interesting observations about the ethics of care. In modern society, people with extreme disability often succumb to depression, sometimes resulting in suicide either directly, or indirectly by refusing care. In a Neolithic community depression would have been lethal.

Survival, therefore, meant that the young man lived in "a secure, emotionally-supportive, inclusive environment in which care was provided ungrudgingly, enabling M9 to grow to adulthood, to develop a role for himself within the group, to retain a sense of self-respect, and to interact with others in his community at whatever level was possible. In view of the prolonged and particularly demanding nature of the care provided, it seems justifiable to speculate that the carers' motivations included compassion, respect and affection."

As for M9 himself, the "bioarcheologists" suggest that he must have had a remarkable personality. "M9's prolonged survival with disability suggests an extraordinarily strong will to live; a robust psychological adaptation; a self-esteem capable of overcoming the complete loss of independence; and a personality capable of inspiring others to maintain high quality and costly care over time."

This is not the only example of a prehistoric ethic of care. A Neanderthal who lived in Iraq 45,000 years ago survived cranial trauma, amputation of his right arm, other injuries and osteomyelitis thanks to the care of his community. A skeleton dating back 10,000 years ago in Calabria exhibited signs of severe dwarfism. Since the young man would not have been able to keep up with other tribesmen in searching for food, his companions must have accommodated his handicaps.

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