Paper short abstract:

Through an ethnographic study of running communities, this paper uses the concept of tinkering to examine the role of CAM expertise in laypersons’ negotiation of multiple medical realities in their (self)care practices.

Paper long abstract:

While many STS scholars have focused on governance and formal interventions, this paper attends to how laypersons participate in shaping technoscience of their own accord. The analysis focuses specifically on the role that CAM expertise plays in laypersons’ reflexive negotiation of multiple medical realities in their (self)care practices in two communities: the online network, Running Mania, and the face-to-face running group, the Red Deer Runners Club. The theoretical framework builds on science governance discussions regarding the nature of expertise by examining laypersons’ attitudes toward CAM practitioners and then applies the concept of tinkering to settings of spontaneous, user-based participation. The ethnographic methods include participant observation of the Running Mania site and thirty-seven email/face-to-face interviews. The findings indicate that most runners value the expertise of CAM practitioners, including the expert practices appropriated by Western medical practitioners, such as physiotherapists. Their individualized and active approach to care seem to articulate well with runners’ embodied understandings, often better than evidence-based medical approaches. While these expert discourses are sometimes perceived as “controversial” because they fall outside a formal scientific framework, this tension seems relatively absent in runners’ care practices as various ways of doing the body coexist to achieve “good care”; one form of knowing does not necessarily have to “win out” as the dominant form of expertise. In reflexively tinkering with multiple medical discourses in their self (care) practices, these laypersons participate in shaping expertise and (re)producing a multiplicity of medical realities that blur the boundaries between among Western and CAM medicine.