Paper short abstract:

Working with the category of 'Chronic Kidney Disease of 'Unknown Origin' as a contemporary medical enigma, this paper examines the methodological value of 'thin' and 'thick' descriptions when producing explanations of unexplained phenomena

Paper long abstract:

In recent years, across countries in the global south, e.g. Central America, Southeast Asia and parts of Mexico, there has been an unexplained increase in Chronic Kidney Disease, newly categorised as Chronic Kidney Disease of Unknown Origin (CKDu). CKDu has been described as a 'medical enigma' because it cannot be accounted for in conventional aetiological terms, i.e., it is not directly attributable to increases in diabetes or hypertension, but variously linked to social, cultural and environmental concerns. CKDu affects a comparatively younger demographic, is linked to informal, precarious work, (e.g. agri-industries and mining), as well as to long-term environmental harm. Those affected by it tend to be from poor communities, often working with pesticides, and/or in the context of heavy metals and contaminated water supplies. However, despite growing efforts among different scientific communities, the search for single causes and the reliance on conventional analysis has made little progress. CKDu, as its classification suggests, resists standard explanations and approaches across both the biosciences and the social sciences. As a consequence, no one discipline can claim epistemic authority on the issue. Taking CKDu as a contemporary empirical case, I ask, when ontology is itself at stake, are we faced with a descriptive challenge or an interpretive one? On finding new virtue in 'flat' readings and 'thin' description, I engage Heather Love's orientation to the descriptive turn as a provocative extension of the turn to practice, to examine what we are pragmatically confronting in the enigma of CKDu.