Perhaps the most interesting bioarchaeological session to come out of a recent Society for American Archaeology conference symposium has now been published as an edited volume. Organized by Lorna Tilley and Alecia Schrenk, the session “Building a Bioarchaeology of Care” has impressively made the transition from oral presentations to the written page as New Developments in the Bioarchaeology of Care.
The volume opens with two chapters orienting the reader to the bioarchaeology of care, a perspective first raised by Lorna Tilley five years prior. Specifically, this approach uses human skeletal remains to reconstruct behavior in the past—of both an individual who needed care, often owing to a disability, and the person or people who cared for that individual. As twenty-first-century bioarchaeology takes an unabashedly biocultural perspective, Tilley's meshing of biological changes, archaeological and historical context, and Western medicine brings the model of receiving and giving care into contemporary anthropological discussions.
Part I of the volume includes a series of seven case studies that apply the Index of Care to a specific individual. The case studies are concentrated chronologically in the early to mid-second millennium AD, with one dating to the Bronze Age. Geographically, the case studies are split between Old World (United Arab Emirates, United Kingdom, and Poland) and New World (United States, Peru) locales. Two essays deal with individuals with leprosy (Roberts, Chapter 6; Matczak and Kozłowski, Chapter 7), two showcase traumatic pelvic ring fractures (Willett and Harrod, Chapter 4; Worne, Chapter 5), and the rest cover a variety of issues, including gigantism (Matczak and Kozłowski, Chapter 7), paralysis (Schrenk and Martin, Chapter 3), and neurofibromatosis (Conlogue et al., Chapter 8). In Jolly and Kurin's final case study in this section (Chapter 9), they look at the practice of trepanation not only as a response to cranial trauma suggestive of medical care but also as a cause of potential disability. All of the essays specifically employ the Index of Care approach to assess the activities each individual may have had trouble with and the extent of care each potentially needed in order to engage in necessary daily activities.
The second part of the volume expands on the idea of care in the past by broadening the scope of the data from one individual to one or more populations, and in this expansion, multiple themes emerge. Two essays tackle opposite ends of the human life span—early childhood (Oxenham and Willis, Chapter 11) and old age (Gowland, Chapter 12)—to demonstrate how life course analysis can add an important dimension to the bioarchaeology of care. The institutionalization of care is critically assessed in chapters by Wesp (Chapter 13) and Tremblay Critcher (Chapter 14), with the latter investigating the efficacy of care provided and the former raising important points about psychological care and structural violence that echo case studies in Part I (e.g., Chapters 7 and 9). Nystrom and Piombino-Mascali's chapter (Chapter 10) on mummies provides evidence for palliative treatment that is not usually found in bioarchaeological data, and three chapters outline how the study of care can be pushed in new directions and into new media with novel data (Milella, Chapter 15; Wilson et al., Chapter 16; Mennear, Chapter 18).
The volume concludes with a discussion of scientific ethics pertaining to the topic by ethicist David Doat (Chapter 17). Importantly, Doat argues that bioarchaeology needs a “more balanced vision of the way our human ancestors could plausibly [have behaved] in prehistory” (p. 339) and rightly points out the lack of representation of adults with disabilities in most exhibits of ancient daily life. This outsider perspective is a welcome one, complementing Jane Buikstra's (Chapter 19) summary of the volume's themes quite well.
This short review cannot do justice to the book's content, which ranges from intriguing to groundbreaking. The 19 separate chapters adhere closely to the theme of care in the past and are organized in such a way that the book could easily be adopted as the text for a seminar course. Additionally, the author list ranges from heavy hitters, to early and mid-career academics, to graduate students, uniquely highlighting the depth and breadth that can be achieved through a variety of perspectives. With references to and use of the freely available Index of Care (http://indexofcare.org), the collection lays bare the methodology behind the case studies in a way that encourages other researchers to employ it as well. In spite of a number of typos, particularly in the earlier chapters, this volume represents an extremely successful collection of essays that should be on any archaeologist's bookshelf.
