title: Chronic Subjunctivity, or, How Physicians Use Diabetes and Insomnia to Manage Futures in the United States.
abstract: Prognostication has become central to medical practice, offering clinicians and patients views of particular futures enabled by biomedical expertise and technologies. Drawing on research on diabetes care and sleep medicine in the United States, in this article we suggest that subjectivity is increasingly modeled on medical understandings of chronic illness. These chronic conceptions of the self and society instill in individuals an anxiety about future health outcomes that, in turn, motivate practices oriented at self-care to avoid negative health outcomes and particular medical futures. At its most extreme, these anxieties of self-care trouble conceptions of self and social belonging, particularly in the future tense, leading patients and clinicians to consider intergenerational and public health based on the threats that individual patients pose for others.
authors.affiliation: a Department of Anthropology , Binghamton University , Binghamton , New York , USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Wolf-Meyer
authors.affiliation: b Center for Medicine, Health and Society , Vanderbilt University , Nashville , Tennessee , USA.
authors.forename: Celina
authors.initials: C
authors.lastname: Callahan-Kapoor
mesh_terms: D060432:Anthropology, Medical; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D033262:Narration; D010820:Physicians; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012306:Risk; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000628:therapy; D014481:United States
keywords: Anxiety; chronic illness; control societies; precarity; temporality