Anthropology & Aging Quarterly  2013: 34 (1) 38

Book Reviews

Coughlin, J. & D’Ambrosio,L., 
Eds. Aging America and 
Transportation: Personal 
Choices and Public Policy. New 
York: Springer. 2012. ISBN-
10: 0826123155.288pp. $65 
(Hardcover)

Aging America and Transportation is a 
collection of essays that focus on the 
growing concerns about mobility and 
transportation that will be needed to 
accommodate the aging Baby Boomer 
generation.

Section 1 of the book provides a 
backdrop to set the reader up for a 
contextual understanding of the ways is 
which the Baby Boomers are currently 
and will continue to be a generation 
to age in their own way at their own 
time. The projected impact of the aging 
Boomers will be more widely felt than 
in prior generations of older adults. 
The authors force us to consider the 
tremendous impact that the Boomers 
will likely have on the shaping of 
policy, technology, services, and 
infrastructure. Trends will be strongly 
influenced by the Boomers’ statistically 
high income and education levels; 
delayed retirement and improved 
medical care; desire for travel and 
recreation; and for continued personal 
independence as they age. Projecting 
ahead, we will see more Boomers 
caring for both children and parents, 
adding to a picture of continued strong 
social and economic engagement that 
will require high levels of mobility.

To illustrate the implications, Chapter 
4 by Sandra Rosenbloom provides a 
helpful discussion on land-use, urban 
design, and projections for residential 
patterns. The picture that is painted 
includes the increase of “aging-in-place” 
trends, where people will demand to 
“age in place” at home- whether that 

be in urban, rural, or suburban areas- 
instead of in specialized care facilities. 
However, Rosenbloom argues that 
policy changes in urban housing and 
pedestrian planning could lead the 
way in reversing these trends.
 
Section 2 introduces us to emerging 
technological trends in the automotive 
industry. This part of the book mainly 
addresses integrated driver assistive 
technologies and emergency response 
systems and increased connectivity. 
All of these can help accommodate 
diminished cognitive and physical 
abilities that may currently prevent 
older people from driving. This section 
delves into scenarios for technological 
advancements between now and 2021. 
The suburbanization of the landscape 
has resulted in a near-complete reliance 
on the automobile for commuting, 
shopping, and socializing and this is 
a key concern in looking at the at the 
Boomers’ past, present, and future 
relationship with the automobile. 
Year 2021 projections are shared 
through some thoughtful and plausible 
concepts for innovative integration of 
technology in automobiles.

Chapter 6 addresses changes to 
infrastructure to provide for better safety 
for older drivers, offering a number 
of examples of design adjustments 
that have been made to account for 
visibility, readability, signaling, and 
overall sharing of the road. Chapter 
7 focuses on both private and public 
transportation, including many useful 
suggestions to improve services and 
the transportation experience for older 
riders. These suggestions range from 
simple wayfinding design strategies, to 
car sharing programs, to smart parking 
(or the use of wireless technology to 
reserve parking and more seamless trip 
planning). 

Section 3 moves us beyond the 
material players of infrastructure and 

technology to the actual players - the 
drivers themselves. In this section of 
the book, behaviors and characteristics 
of future generations of older drivers 
are projected through charts and 
graphs that show rising rates across the 
board from the 2020s through to the 
2050s. While it is projected that these 
older drivers will be healthier and more 
active than the older drivers of today, it 
is known that there is greater concern 
about physical inactivity, obesity, and 
effects from smoking with the Boomer 
generation. Based on these predictions, 
concern about chronic medical 
conditions (e.g., cardiovascular disease 
and obesity) will continue to grow.

This section also addresses, through 
a variety of statistics, the sobering 
reality that, next to drivers in their 20s, 
older folks in their 70s and beyond are 
the most vulnerable to deaths from 
automobile accidents. To maintain 
safe roads, licensing and legal policies 
will have to be adapted to provide 
for the increasing number of older 
drivers who will require licenses. One 
of the authors, Bonnie Dobbs, argues 
strongly for increased involvement 
of the medical community in setting 
standards for driving ability.

The chapters that follow reveal the 
other side of the coin, discussing 
the shamefully apparent lack of 
public transportation options for 
senior citizens and, aside from a few 
glimmers of hope, the lack of design 
for disabilities in much of the public 
transportation infrastructure that does 
currently exist. However, projections 
for 2021 indicate that public and 
community transit systems will be 
greatly improved. Chapters 11 and 
12 review and critique current driver 
education and training options for 
older adults. These chapters point out 
that evidence of the efficacy of these 
programs is currently inconclusive 
while offering many suggestions for 



 39 Anthropology & Aging Quarterly  2013: 34 (1)

Book Reviews
improvement of these programs for 
the future. These suggestions include 
curriculum changes to existing 
programs, integration of technology, 
customized content for individuals, 
policy change, shifts in service, 
distribution and overall accessibility 
to mature drivers, and incentives that 
would further encourage participation 
in mature driver education.

The book concludes with Section 
4, which provides ideas for the 
integration of a variety of services, 
systems, programs, and policies. All of 
these strategies could be implemented 
to address the transportation needs and 
goals of an aging population including 
driving and alternatives to driving. 

Ultimately, I found that the discussion 
of technology and policy in Part 2 was a 
useful section of the book for students in 
urban planning or design. Technology 
in the form of mobile communication 
devices, the widespread integration of 
GPS, surveillance devices, sensors, etc. 
is nothing new or surprising. However, 
understanding this technology in 
the context of the needs of the older 
driver and/or rider (like GPS as a tool 
for people with Alzheimer’s) takes a 
bit more legwork. With this is mind, 
the rich content of these chapters 
provides an excellent basis for creative 
discussion. 

All of the chapter contributions in the 
book are well researched and thorough, 
offering generous statistics, examples, 
and proposals for improvements for 
future implementation. Although I find 
this book to be an excellent resource, 
it was not quite the launch pad for 
a creative conversation about the 
future of mobility as I had hoped. The 
writing is bold yet the projections are 
still conservative and I feel presents a 
bit of a one-dimensional picture of the 
future. The authors consider current 
technology but do not do a great job 

of projecting future developments in 
technology that will provide even more 
profound changes to our landscape 
and how we move through space. As a 
designer, I feel that this volume could 
use a little bit more futurism in its 
attempt to visualize and move forward 
design options nowadays.

Siobhan Gregory, M.F.A.
Senior Lecturer in Design

Wayne State University

Sanford, J. Universal Design as 
a Rehabilitation Strategy. New 
York: Springer. 2012. ISBN-
10: 0826125522. 304 pp. $55. 
(Hardcover)

Universal Design as a Rehabilitation 
Strategy is a comprehensive addition to 
the literature on the history, approaches, 
successes, and limitations of universal 
design. Sanford proposes that universal 
design in the context of rehabilitation 
strategies can be a “change agent” in 
fostering social equality of the elderly 
and people with disabilities. Sanford 
argues that design for rehabilitation 
is all-too-often specialized. Instead 
he contends that when the concepts 
and principles of universal design are 
applied to rehabilitation, the stigma 
and social segregation associated with 
disabilities can be diminished or, at 
best, eliminated.

The book sets the stage by dispelling 
misunderstandings that universal 
design is a concept that is special 
to people with disabilities (and the 
guidelines and codes of the People with 
Disabilities Act) and that universal 
design is more costly and of a low 
aesthetic quality. This introduction is 

critical in positioning the text within 
existing design literature discussing 
some skepticism about the “universal-
ness of universal design”. For example, 
one of the most popular books in the 
field of industrial design is Donald 
Norman’s The Design of Everyday 
Things (1988). It is widely referenced in 
the area of design education. Although 
a bit dated, Norman presents the built 
environment by providing imagery 
and narratives that help the reader to 
begin to critique for themselves how 
the designed objects of our lives - door 
handles, appliances, technological 
devices, etc. - make us feel enabled or 
disabled. Norman’s work resonates 
because he forces us to see that it is the 
built environment, which in essence is 
simply a series of design decisions (good 
and bad, sensitive and insensitive), that 
serves to create inherent categories of 
ability and disability.

Beforehand Sanford also addresses this 
idea in his introductory chapter, which 
critiques the usefulness and limitations 
of a number of “social construction 
models.” Through his critique of 
these models, he helps the reader 
understand universal design as a shift 
in philosophical design approaches 
from the intrinsic towards the extrinsic 
and from the individual towards the 
social. He also lets us know that these 
models are still insufficient when it 
comes to rehabilitation strategies and 
that clearly there is work to be done. 
His main critique is that these models 
are conceptual and do not help in 
fostering an understanding of the “real 
and tangible.”

It is possible that some social scientists 
could take issue with this way of looking 
at things. However, Sanford dives more 
fully into this critique in Chapter Two. 
Here Sanford more clearly illustrates 
(with the use of many examples 
including the 2000 Presidential Election 
butterfly ballot, countless barriers in 



Anthropology & Aging Quarterly  2013: 34 (1) 40

Book Reviews
urban infrastructure, and complex 
menu navigation in electronic kiosks), 
how everyday design “disables,” 
leaving room for specialized design 
to “enable.” Sanford prefaces this 
discussion by presenting the spectrum 
of established levels of ability to 
disability and that in reality most 
humans fall below maximum mental, 
physical, and communication abilities.

Chapters Three and Four offer 
solutions through an introduction 
on assistive technology, accessible 
design, and specialized design. 
Sanford then contrasts these categories 
with universal design, which rather 
than being approached as an add-on 
strategy, is factored in from the very 
first phases of the design process, 
considering a better experience for 
everyone and not just people with 
disabilities. Guiding principles 
of universal design are discussed 
including flexibility, simplicity, 
equality, modes of communication, 
designing for human error, physical 
exertion, and consideration to sizing, 
positioning, and arrangement. Stanford 
also discusses the importance of social 
and cultural context in this section. 
Lastly, he includes rating systems, 
which begin to identify the evaluation 
of successful universal design.

Part Two of the book addresses housing 
and workplace environments and the 
need for these environments to work 
for us at all the points in our lives. In 
these two chapters lies the strength of 
the book as a teaching tool for designers 
and a resource for critical evaluation of 
design. Sanford builds the argument 
that with rising healthcare costs and 
the widespread prevalence of chronic 
conditions, the home is playing an 
increasing role in health maintenance 
and health care.

In Chapters Five and Six, Sanford 
carries us through the areas of the home, 

from the point of entrance through 
the various rooms in a home, and the 
many activities that are performed in 
the home, identifying various physical 
barriers as well as opportunities for 
the successful integration of a broad 
range of modification strategies and 
home healthcare technologies. His 
suggestions range from the simple use of 
labels and signs as cognitive reminders, 
to the integration of color and texture 
change on flooring to help prevent falls 
in transition spaces, increasing light 
levels for better visibility, increasing 
heights of toilets seats and other 
seating surfaces, wider doors and 
entrances, the integration of sensors 
and forms of electronic monitoring, 
and much more. The overview on 
bathing and toileting is especially 
useful. As a resource for designers and 
design educators, Sanford’s audit of 
design opportunities provides a variety 
and breadth of suggestions to begin a 
robust conversation in the classroom 
and beyond. Additionally, these 
sections would be useful for industrial 
designers, interior designers, assistive 
technology engineers, healthcare 
professionals, or non-professionals 
looking for strategic ways to update 
their interior environments to better 
serve them as they age. 

Sanford provides a similar analysis 
of the workplace, arguing further for 
the social benefits to be had when a 
workplace is designed for diversity and 
integration over exclusion. This chapter 
provides further suggestions not only 
for design strategies for architecture but 
also for computing, communicating, 
and comfort during a variety of work-
related activities. Sanford concludes 
Part Two of the book with a discussion 
on policies and the current model 
of the U.S. healthcare system as 
the key barriers to widespread and 
effective implementation of universal 
design strategies. Ultimately, Sanford 
concludes that a greater deal of power 

is in the hands of the consumer/user.  
He believes that a greater awareness of 
universal design strategies and benefits 
will help bring about positive change 
in our built environments and our 
increased capacity to navigate healthily 
and happily through our lives. 

When I am teaching design students 
about universal design, I ask them to 
imagine a world where the majority of 
the population are wheelchair-bound, 
where the use of our legs would be 
rare and considered a special need. 
What would the built environment 
look like? Everything we design from 
cars, planes, buildings, furniture, and 
appliances would be different. I ask 
this question because this vision of a 
flipped reality encourages designers 
to accept that difference in physical 
abilities should be reflected through 
design. Universal design, in its most 
successful examples is not special or 
specialized- it is just better. Sanford’s 
book provides the evidence to help 
communicate this idea. I will gladly be 
teaching from this book.  

Siobhan Gregory, M.F.A.
Senior Lecturer in Design

Wayne State University

Goldsmith, J. The Long Baby Boom: 
An Optimistic Vision for a Graying 
Generation. Baltimore: The Johns 
Hopkins University Press. 2008. 
ISBN-10: 0801888514. 
232 pp. $25.95 (Hardcover)

 The Long Baby Boom written by Jeff 
Goldsmith, the president of Health 
Futures, Inc. and an associate professor 



 41 Anthropology & Aging Quarterly  2013: 34 (1)

Book Reviews
of public health sciences at the University 
of Virginia, discusses his view of the 
continuing positive impact that the baby 
boomer generation can make on society. 

This approach is different than the 
“doom and gloom” attitudes frequently 
predicted about the impending economic 
burden that will be caused by baby 
boomer aging in the US. Jeff Goldsmith’s 
book considers at length what the value 
of this next generation of older adults will 
be. To frame this discussion, Goldsmith 
reflects on what baby boomers have 
contributed to this society in a wide-range 
of important areas such as civil rights 
and environmental issues.  Goldsmith 
talks about the baby boomers, not as a 
burden on Social Security and Medicare, 
but in the ways they will continue to 
be important societal contributors. For 
example, Goldsmith asserts that the baby 
boomers are likely to be working longer, 
staying healthier, and having impact on 
social policy for much longer than earlier 
generations of retired people. “This is 
an optimistic book about a generation of 
optimists.” (Goldsmith 2008: xvii)

Goldsmith uses fictional characters as 
examples to show how baby boomers 
are different from past generations, 
and highlight intragroup variation 
among the baby boomers too. And 
while the situations he describes are 
somewhat predictable, they do prove 
his point that a single solution to the 
baby boomers’ aging issues may also be 
fiction. Acknowledging that there is not 
one simple solution to Medicare, Social 
Security, and other such programs, is key 
to finding more innovative ways to solve 
some of the problems that are facing the 
baby boomers and American society. 
Goldsmith’s argument that the future is 
bright and baby boomers will continue 
to contribute in meaningful and relevant 
ways is the core of the book.  He discusses 
each topic in detail explaining the 
positive impact they can continue to have 
on American culture. In short, the book 

“explores the baby boomers’ current 
state: their lives, health, and wealth and 
how they differ from the generations 
of older American that preceded them 
(Goldsmith 2008: xv).

  The book is divided into two basic parts. 
The first half gives some history and 
perspective on who the baby boomers 
really are, since the term is used so 
often without full understanding of 
what it means to be a boomer. Starting 
with the prologue, Goldsmith tells of 
three different fictional baby boomer 
characters all with very different life 
circumstances who are each approaching 
retirement age.  These different sets of 
circumstances allow Goldsmith to “test” 
what the impact of the different policy 
solutions discussed throughout the book 
would be. It is important to remember 
how diverse a group the baby boomers 
are not just culturally, but they cross the 
spectrum of socio-economic class as well, 
so the “one size – fits all” solutions will 
most likely fail to address the needs of 
this generation.

 The first half of The Long Baby Boomer 
explores topics such as music, TV, college, 
the women’s movement, Vietnam, civil 
rights, how the work place has been 
redefined, the divorce rate and the 
“disintegration of the nuclear family,” 
(Goldsmith 2008:15)  which influenced 
the baby boomers. Goldsmith discusses 
why all of the events and culture shifts 
that have taken place in the baby boomers’ 
life times directly impacted the way they 
think of themselves. Additionally, he 
argues that these views will impact the 
choices that the baby boomers make as 
they enter retirement.
 
 Goldsmith also discusses a common 
perception in American society that– that 
the baby boomers are a “social burden.” 
His argument is that as the baby boomers 
work longer, and stay healthier than 
their parents their aging will be less of a 
burden.  To illustrate, Goldsmith would 

like to see a way for people who are 
still working after they turn 65 to defer 
enrollment in Medicare and allow their 
employer to continue coverage on them, 
which would create less of an impact on 
the system and less of a burden on the 
program (Goldsmith 2008: 126).
 
 The second half of the book is focused on 
entitlement programs like Medicare and 
Social Security; it discusses ways to reform 
the programs that would be beneficial. In 
his chapter on Medicare aptly named the 
“Mt. Everest of Entitlements”, Goldsmith 
outlines a four-step plan for positive 
changes in the program. By simplifying, 
changing incentives for health care 
providers, allowing people to buy into 
Medicare starting at 55, and deferring 
enrollment if they are still working, 
Goldsmith maintains that the Medicare 
system would have the flexibility to 
serve the baby boomers’ needs without 
bankrupting the system. His plan is well 
thought out, and can contribute to the 
broader national discussion on needed 
changes to Medicare currently going on 
in Washington.

 Goldsmith also dedicates a chapter to 
Social Security.  He sees the debate over 
this program’s reform as the bitterest 
domestic political debate in the last 
decade.  As the centerpiece of Roosevelt’s 
New Deal, Social Security was designed 
for the past generations of retired workers, 
but since the baby boomer generation is 
generally living longer, this demographic 
reality has put a huge strain on the 
system.  Goldsmith discusses several 
ideas that might help with this problem, 
but his section regarding raising the age 
of eligibility really shows the conundrum 
of the whole system.  Goldsmith believes 
in the creation of private accounts, and 
explains five different sources for the 
funds. However, he believes that there is 
too little popular or political will to fully 
discuss some of these ideas at this time.  
Lastly, Goldsmith presents his overall 
conclusions on the state of the baby 



Anthropology & Aging Quarterly  2013: 34 (1) 42

Book Reviews
boomer generation and hopes for the 
future. Importantly, Goldsmith reiterates 
how certain kinds of culture change 
would need to occur for the political 
machine to correspondingly react with 
truly innovative new aging policies and 
programs.
 
The Long Baby Boom is a positive book 
about one the nation’s most significant 
issues. Goldsmith feels that too many 
critics want to predict the worst regarding 
the potential economic burden the baby 
boomers represent.  They fret about will 
happen when the baby boomers start to 
retire in larger numbers and collect on 
the benefits they have come to expect.  
Goldsmith is worried that the inability or 
the lack of flexibility, on the part of the 
politicians will thwart making positive 
and productive changes needed with the 
large baby boomer population of retirees. 
This book is a good start to understanding 
the complexities that are involved in 
such a shift. The ideas that Goldsmith 
presents are a useful contribution to the 
meaningful current debate on how the 
United States needs to think about baby 
boomers as they enter their golden years.

Susan Ward, M.A.
Department of History

Wayne State University

Manderson, L. Surface Tensions: 
Surgery, Bodily Boundaries, and 
the Social Self. Walnut Creek, 
California: Left Coast Press. 2011. 
ISBN-10: 61132-098-5. 294pp, $ 
32.95 (Paperback)

In this book, Manderson uses case 
studies to explore “catastrophes of 
the body”. In particular she seeks to 

understand how people respond to 
extreme bodily changes in terms of 
functional ability, personal and social 
identity, and aesthetics. Manderson 
sets the stage for her approach to this 
topic by briefly explaining her own 
experience of “catastrophe” which 
involved the rupturing of a nerve 
in her arm resulting in permanently 
reduced function in her left hand. 
As part of this altered bodily reality, 
Manderson needed to start regularly 
wearing a splint. Over the years, 
she has engaged with the split as a 
functional device and also as a site of 
artistic expression since she treats it 
as a piece of jewelry.  Manderson’s 
own experience informs her analysis 
of the other case studies she goes 
on to present in this book. Next 
Manderson provides a moving case 
study of Perdita, a woman whose life 
was irreversibly altered first by colon 
cancer and then by breast cancer.  
Perdita’s story which includes both the 
need for a stoma and a mastectomy 
gives the reader a glimpse into the 
complex bodily issues that will be 
explored in the following chapters. 
These issues include but are not 
limited to: experiences of the body 
and what they mean, the relationship 
between the body and mind, identity 
development, and cultural beliefs 
about the body.
In chapter one, Manderson draws 
on the theoretical work of scholars 
from multiple disciplines who have 
written extensively about the body.  
She uses these ideas to understand the 
complex processes that individuals 
undergo as “they seek to make sense 
of the necessary, yet often undesirable 
embodied changes” (Manderson 2011: 
24).   She begins with a discussion 
of Descartes, in particular his views 
on the distinction of the body and 
mind. Further, Manderson draws 
on the work of Leder, Canguilhem, 
and Striker for understanding ideas 
about identity and what are often 

categorized as bodily abnormalities. 
As part of this discussion, it is noted 
that throughout much of our lives 
we pay very little attention to our 
bodies. However, as we experience 
bodily changes resulting from illness 
or accident, we are confronted with 
the physiological challenges as well as 
the socially and culturally constructed 
views of the body. Importantly, 
Manderson describes her rationale for 
including the conditions/experiences 
discussed in subsequent chapters. 
This rationale involves choosing 
cases where there “appeared to be 
surface tension for individuals, usually 
above the surface, although in the 
case of transplants, the discordance 
is largely below the surface” (p. 46). 
Lastly, she provides an explanation 
of the ethnographic methods used to 
collect data on functional loss, living 
with a stoma, what it means to be 
feminine after breast cancer, and organ 
transplantation. 
In chapter two, Manderson explores 
“our cyborg selves”.  In particular, 
she reflects on the role of science 
and technology that enhance 
lives through the use of advanced 
surgical techniques, implanted 
devices, and adaptive equipment, 
many of which are now viewed 
as commonplace.  She notes that 
enhancements in surgical technology 
has allowed for increasingly more 
innovative and effective treatment 
for skeletal/muscular conditions as 
well as opportunities to minimize 
hearing and sight loss (e.g., cochlear 
implants and laser eye surgery). As 
one example, she uses her mother’s 
aging experience and resulting bodily 
changes to demonstrate how as we age 
we often move into the realm of the 
cyborg (e.g., hip replacement, cataract 
surgery and lens replacement, dental 
crowns, use of walkers and pick up 
reachers for activities of daily living). 
Manderson takes the discussion 
further by moving into the realm 



 43 Anthropology & Aging Quarterly  2013: 34 (1)

Book Reviews
of more controversial areas such as 
radical transplantations (e.g., face, 
hand) as well as cloning.  One of the 
most significant points articulated in 
this chapter is the notion that as we 
age we are more likely to fall into the 
category of cyborg (e.g., hip, knee, and 
other joint replacement, pacemakers, 
adaptive equipment/technology, etc.) 
and yet the cultural representations 
of the cyborg are young, beautiful, 
stronger, faster, and smarter. For 
example, consider here many of the 
cultural examples are taken from 
popular television shows and films 
including but not limited to the Bionic 
Woman, the Six Million Dollar Man, 
and the Terminator. While Manderson 
does not address it, it may be inferred 
that these representations of the young 
super-able cyborg is possibly due 
to ageism. Importantly, Manderson 
acknowledges that universal access to 
such “high tech” medical techniques 
and adaptive equipment does not 
exist. Noted barriers include health 
care infrastructures and resources to 
pay.
In chapter three Manderson explores 
how people cope with loss, whether 
it be loss due to amputation, stroke, 
or traumatic injury.  Throughout 
the discussion, Manderson provides 
insightful commentary on many of 
the challenges that individuals face 
as they rehabituate themselves in 
their everyday lives. As part of this 
process, individuals need to both learn 
to care for the “sites of trauma” as 
well as reinvent their ways of being 
and doing.  A challenge to this effort 
is dealing with the cultural and social 
expectations which often involve 
inclusion/exclusion and stigma/
acceptance. A significant amount of 
this chapter’s discussion is related 
to the construct of masculinity and 
how it is impacted by amputation 
and other forms of loss. Manderson 
describes how men experiencing loss 
use sports to “use their bodies as 

vehicles of agency and control.” She 
describes similar concerns among 
women regarding femininity and their 
efforts to restore feeling feminine in 
chapter five as she explores life post-
mastectomy. 
Manderson begins chapter four, 
“Body Basics: Living with a Stoma” 
with data documenting the numbers 
of individuals dealing with issues of 
incontinence, bladder and colorectal 
cancer both in the United States and 
Australia. Importantly, she notes 
that often individuals do not seek 
medical care until their symptoms are 
severe and their medical condition is 
advanced. Many of the stories in this 
chapter illustrate the challenges one 
experiences when his/her body is 
permanently altered by the need for 
a stoma. Manderson acknowledges 
that stoma surgery never results from 
uncomplicated medical histories; 
therefore there are many factors that 
come into play as individuals seek 
to understand “the stoma in relation 
to their sense of self and being in 
the world” (Manderson 2011: 148). 
Manderson revisits the point that 
when no physiological symptoms 
are present, we go through our daily 
lives with little if any thought to our 
internal bodily processes. However, 
bodily change as significant as the 
need for a stoma brings these bodily 
processes to the center requiring new 
ways of doing (e.g. toileting and care 
of stoma site) as well as managing 
the cultural perceptions about adult 
hygiene and intimacy. 
Chapter five explores what Manderson 
refers to as “the feminine in question.” 
This chapter addresses the importance 
of breasts in how women identify 
as “being women” as well as 
“being feminine”. All of the women 
interviewed for this chapter, except 
one, reported not feeling “normal” 
after their mastectomy. Moreover, 
they described feeling incomplete 
or no longer the woman they were 

prior to the surgery. Throughout 
the discussion Manderson focuses 
on the “meaning of the presence or 
absence of breasts” (Manderson 2011: 
184). She notes the contrast in male/
female experiences of loss especially 
as women tend to tie notions of self 
-worth to both their perception of 
appearance and others perceptions of 
appearance.   She addresses the aspects 
of embodiment that women have 
difficulty adapting to (e.g., scarring, 
lack of symmetry). To overcome these 
negative feelings many women chose 
reconstructive surgery to restore 
them to what they perceived as their 
“normal” selves. 
Chapter six, “Replaceable Parts: The 
end of Natural Life” explores the 
notion of embodiment as it relates 
to organ transplantation. She begins 
by contrasting the visible embodied 
changes that result from amputation 
to the “under the surface” changes 
that come with organ transplantation. 
She argues that when we notice the 
limb loss of others we react based 
on preconceived notions about the 
potential cause of this loss.  This 
response is not the case in response 
to those who have undergone organ 
transplantation as the visible signs on 
the body can be concealed from the 
casual observer.  Manderson goes on 
to note that embodiment for  organ 
recipients is equally complex because 
of the number of bodies involved in 
the transplant process (e.g., donor, 
recipient, family members).  Included 
in the discussion is how cultural 
values impact notions of living 
donors, the reality that in many cases 
that someone had to die in order for 
another to live, and what connections 
if any exist between the donated 
organ, the donor, and the recipient.
In the concluding chapter, Manderson 
reiterates many of the key points 
presented in previous chapters. She 
reiterates the notion that “bodies 
are gendered, and gender does not 



Anthropology & Aging Quarterly  2013: 34 (1) 44

Book Reviews
dissolve with disability or illness; 
rather, it provides one way of both 
receiving and doing disability” 
(Manderson 2011: 262). Overall, I 
found the ideas throughout the book 
to be well articulated and thought 
provoking. I highly recommend it for 
anthropologists interested in notions 
of embodiment and how these notions 
change as we experience disability and 
bodily change at different moments in 
the life course.  The ideas presented 
in this book may be used to inform 
how notions of embodiment and social 
identity change as one ages, and in 
light of bodily changes. 

Amy Paul-Ward, Ph.D.
Department of Occupational Therapy

Florida International University

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