UNIVERSITY OR CINCINNATI
I am working on a monograph tentatively titled Chronic: Rhetorical Agency and Disobliging Bodies. The exigence of understanding chronic disease as a cultural form is increasing given the current status of health in the United States. Chronic diseases more generally include a multitude of comorbidities and are the leading cause of death and disability in the United States with 133 million Americans – 45% of the population – have at least one chronic disease (Wu & Green, 2000). These numbers suggest that we are no longer a society at risk for disease but a society largely living with disease. As medical practices transition to more patient centered language and practices patients are being asked to engage as partners rather than passive recipients or consumers of their health care.
In this new landscape of “living chronic” rhetoricians of health and medicine are tasked with re-assessing our view of what qualifies as agency in chronic illness contexts. I argue that approaching agency in this context through a rhetorical lens that examines the intersections among people, texts, practices, experience, and expertise (Derkatch & Segal, 2005) makes a form of agency visible that is not discerned by the medical community.
To address my research question of what qualifies as agency in the rhetorical spaces of chronic care, I analyzed texts produced by patients with diabetes and providers working with diabetic patients in two collaborative health spaces: group educational appointments (appointments with one medical provider and several patients) and a patient social networking website. Using the concepts of expertise and parrahisis (truth telling), I reveal the mechanisms for rhetorical agency in these spaces and argue that collaborative spaces provide an opportunity to advance a theory of rhetorical agency as a relational concept (Herndl & Licona, 2007; Koerber, 2006) and to provide health care practitioners with an alternative definition of agency that could be more suitable for current health care practices.
KEYWORDS TO DESCRIBE WORK
Online health communication, patient-provider communication, qualitative methods, medicine and narrative,emerging medical genres, rhetorical agency in patient-centered care and shared decision making
- How do you explain/define what you do to medical personnel and/or other stakeholders in the research process or to the public?
This is a question I struggle with. When I tell medical stakeholders I’m a technical communicator I often am seen as a copyeditor for the project. If I tell them I’m a qualitative researcher, they seem to see me as someone that would do program evaluation work (surveying and interviewing people to see how successful an intervention was) at the end of a project. I think there are opportunities to better articulate our role with efforts such as the PCORI work, but I have not been very good at doing so yet.
- What do you see as the primary distinctions between a “humanities” orientation to research and a “social sciences” orientation? what is at stake in these different orientations?
My experience is that health in communication can be more social science in terms of methods, particularly in the use of quantitative data use. I would also say the health communication based in social sciences tends to focus on critique of medicine from the outside, similar to the sociology of medicine, more than the humanities do. The humanities, and by this I mean professional and technical communication scholars typically based in English departments, seem to engage in the application of theories and concepts on a more consistent basis.
- What are some of the most pressing questions in health and healthcare that health communication/medical rhetoric scholars can help answer?
I think these will be related to patience-centered practices and shared decision making. Although this language is pervasive in health care, the actual definition of these practices and the exercise of such practices, including involving patients in a different way than they have been in the past, are areas timely for rhetorical inquiry.
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.