Clothing Signification in a Methadone Clinic

Jay E. Caldwell
12 February 2009

[This represents an attempted response to this week’s readings. I was, sad to say, buffaloed by most of them. I suppose the take-home (theory) message I derived came mostly from the chapter by Marshall Salhins, whom I presume is a Marxist theorist, in which he argues that commodity production is determined by consumption and that consumption is the product of a social/cultural system. Nothing has any inherent value or utility; that is what a society imparts to it. Finally that utility/value is nearly completely arbitrary, like a Saussurean sign system. Salhins introduces Saussure in a section about clothing, which he labels “a veritable map . . . of the cultural universe” (179). Attempting to hang on during this barrage of theory, I believe an interaction in which I was involved at “work” today, is tangentially on point.]

My work the last two days has been in Anchorage, Alaska. I am the Medical Director of the Narcotic Drug Treatment Clinic there, that is to say, the methadone treatment center for Alaska’s most populous region.
It was “intake day” and I had just finished interviewing, examining, and chatting with Becky [not her real name, or even close to it], a 26-year-old, 16-week-pregnant, heroin abuser. Jennifer, the nurse had just handed her her 30 milligrams of methadone in a carmine-colored liquid tasting apparently of cough syrup. She gulped it down, winced, then settled back against her large blue and back parka, that, when she stood, reached to about her mid-thighs. Earlier, she had hung it back over the back of her chair so that I could examine her. She had to watch a short video on methadone and pregnancy, one in which the talking health heads used words and phrases like “morbidity,” “symptom management,” “detoxification,” and “statistically associated with.” I had paperwork to complete.
I should add that Becky was attired, from bottom up, in a pair of rank, old Nike running shoes, blue and silver as I recall, but filthy; a ragged and formless pair of fleece “pajama” pants with a print of which I have little recollection beyond its colors, blue and green; a scooped neck, black nylon “tank top” with spaghetti straps, very long spaghetti straps, straps so long that the scooped neck ended about halfway down her gravid breasts. She had thrown her hair up on her head and fixed it there with a dirty scrunchie into a kind of a knot.
Becky finished the video, or I should say the video finished, and I finished my paperwork about the same time. Jennifer, leaning against a file cabinet, looked at her and observed casually, “if you dress like that tomorrow, you won’t get dosed.” I should also add this girl was a mess even though her midnight heroin injection (“three buggies”) was holding her (and I hope her fetus) quite well. In order to protect the fetus, pregnant users do not have to “demonstrate” narcotic dependence to get admitted to the program, as do all other potential patients. The usual method of “proof of addiction” is not to use for 48 hours, then show up at the clinic totally messed up. But she was messed up just from the surface effects of six years of horse. She had a large, old, scar inside her left elbow where she had gotten an abscess last year and ended up in the hospital with respiratory failure from pulmonary emboli, blood clots in the lung (that’s another, long, but not especially germane, story). She didn’t have any veins left and so there were both fresh and old puncture marks on the backs of both wrists and on both her breasts. She had been financing her and her unemployed husband’s $400-a-day habit by “borrowing” money, being a “middleman” in the drug distribution chain, and doing $200-a-pop “private dances” (and “that’s all, nothin’ else”) for a stable of about a half dozen of her “personal clients” whom she’d lined up when she danced at PJ’s, a local strip bar. “No, if Ron [the Clinical Director, in charge of all the day-to-day operations at the Clinic] sees you dressed like that, he’ll throw you out,” she went on.
That seemed reasonable to me, so I added “Yeah, and you might consider long sleeves.”
“You’ve got to look professional. Ron won’t allow any pajamas in the Clinic. You need to look like you’re going to a job.”
“Pajamas?” I asked. “Jeez, I wore some pants like that out to dinner last week in Tucson. You wouldn’t call that leisurewear?”
She was shocked. “No?! That’s sleepwear and that’s one of Ron’s hard and fast rules. No pajamawear.”
Other than thinking about how Jennifer was more bent out-of-shape by her fleece slacks than by her provocative top, I didn’t think much more about that until I had gotten fairly far into Salhins’s chapter in Culture and Practical Reason and come across his Figure 11 (“Schema of functions signified in American clothing”). Salhins employs a bipolarity postulated by Roland Barthes for establishing the “systemic rules for social categorization of the clothing form” (185). In essence the “social significance of costume” is conceived of as either active or passive, doing or being, work or leisure.” Without employing the theory, surely even unaware that it existed, Ron had defined attendance at the NDTC as work, the work addicts had to undertake. Even Jennifer, when she had described the dress code, used the terms of business. And it made sense, because until then Becky’s life had been focused on identifying herself as exploited, exploitative, (sex) object, addict, persecuted, victim, abused. Although she may have perceived her life as work-oriented, at least in terms of getting hold of $400 daily, it was rather, as Ron perceived it, one principally of self-despair and misdirected identity. For Ron, a change in clothing signification was the first step in overcoming the cycle of addiction. The signification of sleepwear, of fleece pajamawear, was of greater relevance than the erotic impropriety of her tank top. He saw this as her initial step in entering the workforce and escaping a life of unworthy self-indulgence.