Associate Professor of English
University of Alabama at Birmingham
I became interested in the ways in which medical systems construct narratives of the illness experience when I became a patient of breast cancer in 1993. As I’ve grown as a scholar and as a survivor these past 20 years, I’ve discovered a wealth of disciplinary opportunities and cultural perspectives that have enriched my work. I’d argue that anyone who identifies as a rhetorician is, by default, a maker of discourses through which health is understood and a co-creator of practices.
Several of my current and ongoing research interests reinforce the notion of medical rhetoricians as meaning makers (as opposed to mere observers or critics of discourse).
Homeless with Cancer
Since 2009, I have worked firsthand with homeless cancer survivors in my adopted city of Birmingham, Alabama. My research within this population has focused on obstacles to healthcare alongside an examination of the illness narratives homeless survivors construct.
In conjunction with this work, in 2010, I founded Street Smarts™, an annual breast cancer education program for homeless women. Organized and facilitated with the assistance of homeless survivors, Street Smarts™ provides breast health information in a spa environment. Participants are pampered, fed, and encouraged to care for their bodies in ways that are realistic and attainable given their day-to-day circumstances.
Cancer in Cross-Cultural Context
I have also pursued several projects involving medical institutions and cancer survivors around the globe. In 2008, I investigated medical tourism in the southern region of Tamil Nadu, India. In 2010, my research took me to Zambia, Africa, where I examined the development of modified cervical cancer care prevention programs to reach women living in poverty. In 2011, I considered the obstacles faced by cancer survivors and their families in Kathmandu, Nepal, and in 2013, I am returning to India (this time to Gujarat and Rajasthan) to interview women who are collaborating with NGOs to set fair market prices for their traditional labor and handicrafts, in the process creating opportunities for health care, insurance, savings collectives, etc.
Through these projects and others, I have pursued publication outlets that reach an audience beyond academia. My work has appeared in popular newspapers (e.g., USA Today, Chicago Tribune) and national magazines (e.g., Cancer Today). Most recently, I have begun to work with fashion photographer David Jay (www.thescarproject.com) to document the lives of young cancer survivors in Birmingham, Alabama, as well as those living throughout the Black Belt, who lack health insurance (see, for example, the story “Forever Young”: http://cancertodaymag.org/Spring2013/Pages/Young-adult-breast-cancer-survivors-photo-essay.aspx).
My overarching goal in all of the work I pursue is to use my knowledge and skills as a trained rhetorician and breast cancer survivor to bridge the experiences of several different communities. It is in the “doing” of medical rhetoric that I think we have the greatest opportunity to shift discourses that are sometimes marginalizing and almost always incomplete.
Key words to describe work
Community outreach, problems of neo-liberalism, survivorship narratives, qualitative research, cross-cultural perspectives, media representations of health and illness
Work in relation to symposium keywords
The words that relate most to my work are dissemination, ethics, and communication.
Dissemination of our work is crucial. I believe that our role in the academy is to inform our colleagues (within our home departments and schools and across disciplinary boundaries) what we do as medical rhetoricians and the value of this work. Beyond our own institutions, I’d argue that our work needs to be disseminated to other communities: health care professionals, non-profit organizations involved in reaching disparate communities through education and other services, politicians and government officials who make decisions that affect the lives of many, researchers, advocacy groups, media outlets, etc. Since our research takes us into a number of contexts, we should find ways to give back—knowledge, resources, and so on—to those located in these contexts.
Ethics and Connections (I know I’m cheating by doubling up here)
I think that one of the most powerful messages we can send as medical rhetoricians is that much of we believe to be “true” is based on positivist ideals and biomedical priorities. There are, in fact, numerous other ways to perceive the body, the institutions that treat the body, etc.
There’s an ethical imperative, then, to disrupt connections that are false (e.g., “morality” and “health”) and introduce connections that are oftentimes ignored (e.g., “disparities” and “neoliberal mandates”).
- How do you explain/define what you do to medical personnel and/or other stakeholders in the research process or to the public?
I tell stakeholders outside the academy that I am an archaeologist of sorts (yep, borrowing from Foucault a bit on this one). I like to dig into the language and practices of institutions (the media, hospitals and medical clinics, government policy guidelines that regulate behavior, etc.) to figure out when, why, and by whom they were invented. How are they used within the culture at a particular time and place? Then, I think about how the past might be changed to make health care more equitable in the present. This approach acknowledges that we are all implicated in “the way things are” and that we will assume responsibility for the future alongside other stakeholders.
I also think that people are more receptive to the work we do if we take the time to express how what we think about and write about will influence their institutions or touch on their professional priorities or personal values. I’m going back to my response to the first question on this form: I think we gain ethos when we “do” medical rhetoric as opposed to examine discourse from an outsider’s perspective.
- What research challenges have you experienced and how did you solve them? Choose to focus on one or two specific examples that can help the group develop strategies for overcoming these types of challenges.
The greatest obstacle I’ve faced in conducting research is, as suggested in my response to the question about defining our work, identifying the best angle for addressing a particular discourse. In other words, where should I start? What’s the central question I need to begin with to move the project and my ideas forward? How do I determine answers to these questions, and how do I assess the choices I’ve made along the way? How can I assess the many discursive layers at stake in a study and identify the most promising inroad?
While I’d love to claim that I’ve discovered answers to all of these quandaries, the fact is that I still find myself stumped a good deal of the time. The little wisdom I have gained can be articulated as follows:
For human subject research I always begin with others—those who are situated in contexts with which they are more comfortable than I. From their experiences, I develop grounded theory, and then revisit participants and the discourses in which they engage to refine this theory.
For text-based research, I read. Then, I read and read and read some more, always looking specifically for the central questions other researchers have
posed and the ways in which they’ve drawn on their data to address these questions. I’m also looking for those gaps, both articulated and just beneath the surface, that might apply in an interesting way to the discourse I’m examining.
Lastly, no matter the scope of the research project, I’ve learned always to qualify my findings and always to entertain the possibility of shifting my framework, rethinking my assumptions, and starting again if necessary. It’s not necessarily “truth” that I’m after, but an improved understanding of the complexity that lies in discourses.
- What are some of the most pressing questions in health and healthcare that health communication/medical rhetoric scholars can help answer?
Wow, this is a tough one to narrow down I’ve come up with the following:
In conversations about (and I’m including practices in my use of the term “conversations”) health and medicine, whose perspectives get left out? What does this absence mean for the entirety of the conversation? Who benefits and loses out from the oversight?
How can we begin to steer conversations about health care away from discourses of blame that oversimplify the individual human agent? In what ways can we, as medical rhetoricians or health communication experts, engage with the political pundits who reduce good and poor health solely to individual choices?
What are some ways in which we can partner with individuals outside academia to address questions in which they have stakes? How can we become more accepting of the information and perspectives that “non-experts” bring to our discipline?
The length for this portion is entirely up to you. (But since I promised many of you that the preparation wouldn’t be onerous, concision is always appreciated!) These questions and your answers will be used as ways to start more involved discussions during our time together.