UC Berkeley

What is surgery like in China and why does it matter? This dissertation is an ethnography of cancer surgery at one of China’s top academic hospitals. Based on sixteen months of fieldwork over eight years, this dissertation looks at the inner worlds of surgery, following surgeons through their training, operations, teaching conferences, and political climbs. What makes surgery in China different is how surgery in China is enmeshed in larger political narratives. Each surgeon strives to be “a cut above,” not just for personal success but out of a sense of duty to prove China’s strength through numbers, metrics, and research, to further a narrative of medical-technonationalism.Surgery is one of many tools which are now in service of the nation, attempting to prove something about China’s strength. While my ethnography begins in the operating room, it extends outwards, to consider the specific configuration of technology, expertise, structures, systems, and ethical or moral norms which come together. Thus, I draw on Collier and Ong’s concept of global assemblage to consider not only how surgical practice takes place in the context of tertiary academic hospitals in China, but also how global knowledge emerges from this context, and the barriers to how that knowledge is shared and circulated, and how that knowledge might be operationalized. What makes a “good surgeon” determines what surgeries can be done; what constitutes surgical knowledge determines what aspects of a surgery deserve to travel beyond a particular context. I show that the endeavors to legitimize, showcase, and prove China’s distinction in and beyond the surgical field shape surgical practice in China. A Cut Above captures China’s healthcare system at a crossroads: simultaneously trying to prove their place within an international community and rejecting the need to “catch up” to others, determined to prove their strength on their own terms, through autonomy and decoupling from international expectations and norms. These tensions reflect China’s global rise as the Chinese Communist Party (CCP) set policy goals to become a “technological and scientific leader” and China’s role within the international scientific community has grown. Despite this, medical evidence from China is not taken seriously by the global scientific community. This dissertation explores these tensions, between state priorities and international norms, between national politics and personal ethics, between standardization and expertise to consider what an anthropology of surgery can teach us about China and global knowledge production today.