Rolling and the health care challenges of the disabled

The New England Journal of Medicine is carrying an article by researcher Gretchen Berland, which describes her work documenting the health access needs of the wheelchair-bound:

By the time Galen Buckwalter's physician knocked on the exam-room door, Buckwalter's video camera had been recording for nearly 40 minutes. He had booked the appointment because his shoulders were hurting, and the camera recorded his view of the examination table, the comments he made while waiting and, eventually, a largely transactional and superficial exchange with his physician. Two weeks later, in his home, the camera would record a strikingly different take on his shoulder pain -- a growing problem that, Buckwalter worried aloud, might cost him even more of his cherished independence.
As an internist, I was disturbed by the contrast between those two scenes, the second revealing the depth of Buckwalter's concerns and fears, none of which were apparent during the conversation with his doctor. In the later tape, Buckwalter's struggle is palpable. If such stark contrasts are common, how much do I really know about my own patients? Probably far less than I care to admit.

She doesn't call it medical anthropology, but it is a nice example of the use of new ethnographic methods (in this case, video observation) to document social interactions. I think it would be a great article for introductory courses; it provokes a range of reactions. Berland describes the film that she made from some of the video, titled Rolling, and the reactions to the problems faced by one of the covered subjects, an MS patient named Vicki Elman:

Rolling has been shown in many venues, perhaps most memorably One World Berlin, a human-rights film festival. After one screening there, several audience members -- some from the German disability community, others Berlin health care providers -- approached Elman. Having seen her experiences in the United States, they had some advice: Stay here.
It was tempting to contemplate that a move might alleviate some of her problems, but Elman had built her life in Los Angeles, not Berlin. Still, I savored that moment, because other viewers were less sympathetic, convinced that the responsibility for change lay with Elman, Buckwalter, and Wallengren. At a meeting of a state medical society, a physician asked whether the participants were taking antidepressants: it might make things feel less difficult, he advised. At one screening, a medical student even inquired whether the participants had considered having their legs amputated, in order to make transfers from their wheelchairs easier.

I know I have a lot of readers interested in the medical aspects of human variation who might not notice an article in NEJM. This one helps to illustrate the ways that cultural anthropological methods can be valuable.