Biomedicine on the spatial periphery: The (Re)production of a metaphoricallandscape by rural health care practitioners in Northern California

I examine the use of spatial concepts by rural health care practitioners in Northern California and suggest that rural and urban spatial metaphors are important means of expressing and (re)producing problems associated with t heir search for legitimacy and moral authority within a field of relations defined by biomedicine. I present three broad ways in which spatial metapho rs are used by rural health care practitioners to continuously enact a "met aphorical landscape." I situate this landscape in the context of a hierarch ical field of relations within biomedicine, which is itself underpinned by a distinct urban bias and the uneven distribution of material and technolog ical resources. I suggest that this landscape is partly the result of the r ural health care practitioners' position within this field of relations and partly the result of implicit and historically situated frameworks of spat ial meanings derived from capitalism. [rural health care practitioner, Unit ed States, landscape, metaphor, embodiment].