Sienna Craig's ethnography explores the recent impacts of biomedicine and the global “pharmaceutical nexus” (8, 57) on Tibetan medicine and its practitioners across the Himalayan region and beyond, from the mid-1990s to the 2010s. Written in her characteristically clear, accessible, and even novelistic prose, Craig's book is a groundbreaking and wide-ranging analysis that will have broad interdisciplinary appeal. It is eminently suited for undergraduate and graduate syllabi in the anthropology and sociology of Tibet, Nepal, and China, as well as in medical anthropology, science and technology studies, and the critical study of development and globalization.

Indeed, the great strength of Craig's account is that she brings her training in critical theory (Foucault was a particularly important interlocutor), Tibetan and Nepali studies, and medical anthropology, and her long experience in international and grassroots NGO work, to bear on an extraordinarily wide range of field sites in Nepal (Mustang, Dolpo, and Kathmandu) and China (Lhasa, Qinghai, and Yunnan). Her strong language skills in Lhasa-dialect Tibetan, especially, allow her to delve further than most and produce a richly qualitative account of what she calls the “social ecologies” of Tibetan medical practice, from marginalized rural clinics in highland Nepal to shining high-tech urban institutes in western China, all under the intensifying pressures of commodification and nationally mediated global “best practices” regulations. The stakes, as Craig tells us in her concluding chapter (260), are exceedingly high, in that generational shifts, climate change, land appropriation, commodification, and over-harvesting all threaten the very existence and value of Tibetan medicine, as well as the capacity of non-elite patients to access the healing resources it once provided. She holds out hope, however, that such an approach will allow for a rethinking of the very nature of efficacy, not just as a clinically testable measure of a medicine's “bioavailability” (7), but also as a simultaneously biophysical, political economic, and sociocultural process. That, she argues, could, in turn, pave the way to a more equitable world of “translational science,” one that allows for forms of medical pluralism and resourced spaces for Tibetan medical practitioners to thrive on their own terms (5, 259).

This is no condensed or “dumbed down” undergraduate textbook; it draws on the entire swath of Craig's career in the region over the past two decades. Yet the book is structured and written to be as accessible as possible. In fact, it is voiced throughout as a meta-dialogue, between herself in the first person and “you” the reader. The seven main chapters, framed by an introduction and conclusion, all end with “summary” sections that remind “you” of their methodological goals. The chapters are structured complexly to focus, first, on Tibetan medicine as a socioculturally embedded process in multiple locales, and then to transition, via the fourth chapter's look at “therapeutic encounters,” to a focus on medicines as circulating objects and values (21).

Throughout, Craig's voice is rarely set apart in discussions of theory; instead she relies on the ethnographic present tense to narrate multiple visits and formal meetings (always accompanied by local coworkers or translators) in organizations and offices, staging long dialogues, presented as direct quotes, with and between her interlocutors. In this, she goes a long way toward achieving what Fabian called “coevalness” in the writing, presenting others as commensurate theorists and herself as learning from them, weighing their views and modifying her own. This approach allows her to navigate the risky and delicate problem of writing about and critiquing the well-intentioned development and business circles she herself participates in, something that all anthropologists of development amidst capitalist pressures must contend with. Given Craig's observant eye and masterful scene-setting descriptions, the book reads like an experience of a well-done documentary film, in which readers go along and “look over her shoulder” during meetings, and chapter sections cut abruptly to scenes sometimes vastly distant in time and space.

Such an elegant account highlights the promise of multi-sited ethnography. Yet it also raises questions about its limitations, in that the details of meetings in such disparate times and places can be hard to follow at times, sacrificing some of the sociocultural depth and community-based everyday life that Craig's approach to “social ecologies” of medicine would presumably call for. Most importantly, the rapid cuts between temporal contexts (from, say, the late 1990s in one section to the 2010s in the next) can inadvertently neglect key historical and political economic shifts. This is particularly important to consider in light of the major restrictions Craig alludes to (135) on foreign researchers in politically sensitive Tibetan regions of China. As Craig well knows, avoiding dangerous topics there can also evacuate the work of any in-depth local and historical analysis.

All in all, though, this book sets the standard for a multi-sited anthropological analysis with interdisciplinary appeal. Similarly to the work of Anna Tsing on global environmentalist movements, it wonderfully succeeds in bringing interlocutors at multiple scales into dialogue in the increasingly high-stakes world of commodified “alternative medicine.”