When offered the chance to take the page 99 test, I imagined that page 99 of my dissertation would have little to do with its core purpose—using anthropology as a tool to understand, honor, document, and share the experiences of patients whose access to healthcare in the US is stipulated by their im/migration status. I was pleasantly surprised when I turned to page 99 and read the following passage.
“Of the seven focal participants in this research, four were women and mothers. Flor and Esperanza had both come to the United States in their 40s and did not have children in the United States. However, both were grandmothers when we met during fieldwork and were well-experienced in the healthcare options available for young children and their mothers in Philadelphia’s immigrant community. In this section, I will discuss healthcare access in maternity wards for uninsured and, specifically, undocumented women through the stories of Evelin and Gabriela, two women from Honduras. Both were in their 30s when we met, and both were (and still are) in long-term relationships with undocumented Latinx men working in manual labor positions.
Evelin has seven children, and five were born in Honduras. She gave birth to her youngest son, Wilmer, in New York City in 2016. Evelin gave birth to her youngest daughter, Jessica, during my fieldwork. I was there with her and Antonio at Philadelphia’s Hahnemann Hospital on
January 9th, 2019, when they welcomed Jessica to their family. Gabriela has three children, and one child was born in Honduras. Before we met, Gabriela gave birth to her two youngest sons, Augusto, and Bruno, at Einstein Hospital and Hahnemann Hospital, respectively. With pregnancy experience in both the United States and Honduras, Gabriela and Evelin had much to say about the healthcare systems in the United States compared to the healthcare system in Honduras.”
Looking at this passage, a reader can glean some key points about my dissertation. First, it focuses on the experiences of a focal group of undocumented and uninsured Latinx patients in Philadephia, and second, it offers insights from research done in medical settings. The reader would be right on both counts. My dissertation relies on ethnographic data collected during five years of Philadelphia-based fieldwork completed across medical and non-medical settings. It includes data from field notes, transcriptions of interviews, and a corpus of audio-visual materials. The reader can also estimate that my dissertation boldly underscores the knowledge and insights of the focal participants. Right again! My analysis revealed that undocumented and uninsured immigrants complete many valuable roles within our healthcare system beyond that of simply the patient. One example of this is the participation of undocumented immigrants in
Philadelphia’s 2020 census program known as “Philly Counts,” in which they served as trusted community messengers who helped increase Census participation, thereby increasing federal funds allocated to the city’s health centers, which remain major access points for uninsured and underinsured Philadelphians.
This page 99 passage, however, leaves out two crucial components of my dissertation:
the theoretical foundations and the wider-reaching contributions. Broadly, my dissertation uses frameworks from linguistic and medical anthropology, and more specifically, it utilizes Lynette Arnold’s (2016) concept of “communicative care,” which she defines as “all the ways that language functions to sustain human existence” (38). With this grounding in the excellent work of my predecessors, my dissertation aims to provide nuanced empirical evidence of the lived expertise of patients whose rejection by the healthcare system informs their strategic efforts for policy reform and their movement for the ratification of healthcare as a human right.
References:
Arnold, Lynnette. 2016. “Communicative Care Across Borders: Language, Materiality, and Affect in Transnational Family Life.” Doctoral Dissertation, University of California Santa Barbara.


