Doubting Dualisms Michael L. Dorn, Carla C. Keirns, and Vincent J. Del Casino Jr Introduction According to the standard interpretation, there were two dominant subgroups of medical geography in the mid-to-late twentieth century (Mayer 1982; Paul 1985). The first subgroup – disease geographers (or ecologists) – typically traced their lineage back to the work of Jacques May in Southeast Asia during World War II and his subsequent employment by the American Geographical Society (AGS) to produce the first world atlas of disease (May 1950; Mayer & Meade 1994). The second subgroup – the “access to health care” researchers (or health care geographers) – then became concerned with medical services planning during the “spatial science” era of the late 1960s and early 1970s (Pyle 1983). In the 1980s and 1990s disease ecologists and health service planners in medical geography were joined by a third tradition, health geography (or the geographies of health), drawing on themes in critical cultural and social geography, and explor- ing health in broad terms, particularly the experiences of service users, sick people, and groups bearing biomedical labels (Eyles 1985; Gesler 1991; Kearns 1993; Del Casino 2009). Within this and other common renditions of the sub-discipline’s history, medical geographers are expected to identify with one term of a dichoto- mous pair of traditions: space as container or place as process; spatial analysis of diffusion or place integration; human ecology or social engineering; biomedicine or alternative medicine; geographical epidemiology or health systems planning; human- ism or science; physical or mental illness; health or medicine. These dueling tradi- tions each have a set of practitioners, methods, and audiences; and funders and consumers of medical geographic knowledge typically analyzed problems, such as the spread of communicable diseases or the optimal placement of new facilities, lending themselves to one mode of analysis or the other. Like many other commentators, the authors of this chapter were put off by the exclusiveness of the divisions that have historically been constituted in the program- matic literature of medical geography. The recent effort to reconstitute medical Chapter 4 c04.indd 55 7/20/2009 6:36:50 PM