Depending on the audience, I usually describe myself as a rhetorical critic of health (and/or healthcare), environmental, and science communication. My most substantive, longest-term work in rhetoric of health(care) has been on Ontario midwifery professional communication (a final article on this research has just been submitted). The texts or rhetorical actions that I and colleagues (Susan James, Pamela McKenzie) studied for this project included policy and legislation documents as well as recorded healthcare visits between women and their midwives. More recently, I have been involved in a combined rhetoric/social studies of science/information studies project (co-researchers: Roma Harris and Flis Henwood) that studied older adults’ views on contemporary neo-liberal healthy living imperatives. The data for this study were 50 semi-structured interviews conducted in 4 locations (3 in Ontario, 1 in the UK). Building on my interest in the issues of ‘healthy eating’ and ‘health citizenship’ developed through this latter project, I have most recently begun working with Colleen Derkatch on rhetorics of ‘local food’ in Ontario (and intersecting terms/values such as ‘organic food’ and ‘sustainable eating’). This project is just beginning and still very loosely formed. A significant motivating interest for me is to explore how the neo-liberal civic imperative of personal responsibility for health is becoming intertwined with an additional duty to care for the environment, as evidenced in the context of ‘local food’ discourse. The first stage of my analysis has been to try to map some of the multiple, and not necessarily entirely compatible, values that public health communication about ‘local food’ associates with this new ‘god-term’.
Some of my other work in environmental and science communication also partially connects to rhetoric of health(care), for example, research I’ve done (with Chantal Barriault and Rebecca Carruthers den Hoed) on public engagement and health risk communication in a soils study of mining contamination.
When I call myself a rhetorical critic, I mean that I use the resources of rhetorical theory (and affiliated areas such as discourse studies) to analyse the forms and functions of specific health(care) rhetorical actions within specific contexts. I select, combine, and deploy these resources in generally impure ways according to what I think might be helpful to the particular communicative situation I am trying to understand. In virtually all my work, I principally am interested in understanding how ‘micro-level’ discursive or rhetorical practices (including visual, material, non-verbal practices) engage with ‘macro-level’ socio-political-ideological structures, institutions, norms, and values. I find rhetorical theory (which Lisa Keränen has aptly called ‘meso-level’) helpful for tracing these engagements because, unlike for example Foucauldian governmentality approaches, it assumes a degree of rhetorical agency for all local actors and situational difference/possible resistance to dominant norms and macro-level discourses in the enactment of local rhetorical actions; however, as a rhetorical critic always concerned with the constitutive and ideological functions of discourse, I aim to understand how particular rhetorical actions and actors may simultaneously reproduce/recirculate and reconfigure/possibly-somewhat-resist macro-level meanings and values—in other words, how hegemonic discourses both shape and are re-shaped by specific actions and actors.
In the context of health(care) discourse, for me this means looking at how neo-liberal ideologies of health are communicated in public health discourse and how healthcare providers and recipients (or health publics more broadly speaking) situationally take up, negotiate, and reconfigure these ideologies-discourses (including values such as individualism, informed choice, healthcare consumerism, information as empowerment, self-care, entrepreneurialism, etc.). In my most recent project on ‘local food’ discourse, I am especially interested in exploring how these values of neo-liberal health citizenship are merging with the values of a possibly equally neo-liberal conceptualization of environmental citizenship (that is, one focused on our personal responsibility to care for the environment through individual ‘green’ behaviours such as consuming local food).
Keywords to describe work
Rhetorical criticism, healthcare, moralization, ideology, citizenship, environmental values
Work in relation to symposium keywords
Connections and theory are the words that resonate most with my work.
Since I began working in rhetoric of health(care) (as well as science and environmental communication), all my research has been collaborative and interdisciplinary. So, these kinds of ‘connections’ are inherent to what I do. However, while I have found these research connections generally very productive and stimulating, they are also always challenging because of the different scholarly ‘terministic screens’ that I and my colleagues bring to the studies—these cannot simply be collapsed together or added on to each. Recently, I have begun to collaborate, for the first time, with another rhetorician on a health discourse project and I am finding it nicely refreshing that we speak the same language. I could say more about other kinds of connections (e.g. with healthcare professionals, patients/clients, research participants)
I debated between this key word and ‘methods’ because I see them as inextricably linked. As a rhetorical critic, I draw on rhetorical theory to analyse or critique health(care) communication of diverse forms, functions, and contexts. How (methodologically) that analysis unfolds depends on the rhetorical concepts or theory I employ to make sense of or interpret the language-action and rhetorical situations I am analysing. As someone from an English-Humanities background, I still find it strange to write a separate ‘methods’ section after the conceptual-theoretical introduction to a paper—though I have become used to the terminology of ‘data collection’, ‘sample size,’ etc. Fundamentally, however, what interests me most in the work that I do and that I read is how theory (rhetorical or other) is used to make sense of situated rhetorical actions, and in turn how those analyses may refine or build theory.
- How would you describe the relationship between medical rhetoric/health communication (however you see yourself) with other fields and sub-fields (e.g., rhetoric of science)? For example, we struggled with what to name the symposium. Some suggested medical rhetoric, but that doesn’t comfortably fit some from Communication nor from English Studies. In other words, how do you align what may be a specific focus with broader disciplinary concerns and tensions?
I think the relationship between rhetorical studies of health and medical communication and rhetorical studies of any other kind of communication (such as rhetoric of science) is pretty straightforward and not difficult to articulate: what changes is the kind of communication being studied but not the overall (albeit very multi-faceted, wide-ranging) critical-theoretical orientation. However, if ‘rhetoric’ is understood simply as the practice being studied (rather than the theoretical orientation being used), then I think it’s much harder to name the relationships and distinctions among fields and sub-fields.* Thus, although in some senses I think of my area of research as ‘health communication’ (and tend to use this phrase when describing my field to non-Humanities and Social Science people inside and outside academe), I also know that my research interests, perspectives, assumptions, objectives, and interpretive findings may be quite different from those of other health communication researchers.
So when trying to explain relationships between fields and sub-fields of health/medical communication research, I think the most important thing to try to articulate are the different (though possibly intersecting) theoretical-conceptual frameworks and assumptions that inform the research. And my own experience tells me that this can be quite challenging, especially when addressing co-researchers and reviewers from outside rhetorical studies: to explain what it means to take a rhetorical approach to studying health communication as distinct from (yet related to) other fields and sub-fields (e.g. discourse analysis or a Foucauldian governmentality perspective). I tend to rely on Burke’s idea of language as action along with the concepts of rhetorical situation and rhetorical actor (or agent) as a basic vocabulary for naming a rhetorical perspective to non-rhetoricians—but, as I’ve suggested above, these concepts are no more nor less applicable to the study of medical/health communication than they are to the study of other kinds of communication.
This returns me to the point that relationships between fields and subfields—or between specific areas of research and broader disciplinary (and, especially, multi-disciplinary) concerns and tensions—are most interestingly and usefully taken up in terms of theoretical-analytical frameworks and assumptions rather than in terms of the kind of communicative activities being researched. For me, the value of articulating these relationships, distinctions, and possible tensions lies in developing a more textured understanding of differences in conceptual and methodological/analytical approaches—not in order to preserve boundaries but to be able to see better both what and how these approaches may be combined fruitfully (fostering the richness of impure research) as well as points of possibly inherent incompatibility or incommensurability (e.g. epistemic, ontological, ideological).
Focusing a symposium around some kind of human practice—such as health communication/medical rhetoric—is, however, a good way to create sense of inclusion and foster conversation among diverse fields and sub-fields, diverse theoretical and methodological approaches.
- What other keywords would you add to the list above (connections, dissemination, ethics, methods, and theory) and why? (no more than three additions)
Politics: I was going to propose two key words, ‘politics’ and ‘ideology’ but then figured that one can’t really consider the politics of a situation or communicative action without (at least implicitly) considering its ideological dimensions. And from there I started to think about all the other terms that cluster around ‘politics’ which many health communication/medical rhetoric researchers, as well as other stakeholders, seem to be concerned about: power, policy, consumerism, citizenship, economics, culture, commodification, gender, ethnicity, sexual orientation, and so on and so on. Mainly, I am suggesting ‘politics’ as a generative umbrella term to foreground these significant content-dimensions of what we research and discuss, but it also can refer to the complicated and inevitable ‘politics’ of carrying out research: the politics of scholarship and funding, of engagement with professional and/or public groups, of publication and legitimacy/validation, etc.
Questions: This suggestion is a bit tongue-in-cheek, but maybe it’s worth considering, in the sense that the kinds of questions we and others ask about health communication/medical rhetorics both reveal and shape our research motives, theories, methods, ethics, findings, and so on.
- 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.
Both my examples of challenges relate to the basic issue of how to collaborate and communicate effectively with others during research projects. My first example is a not-so-happy-story that has nonetheless served as a very valuable learning experience for me; the second story is a happier one.
As far as I could tell, the stakeholders present at the meeting were not, for their own situated-political reasons, all that interested in what I would call real public engagement or dialogic communication, and I think instead mainly hoped that we would help them to tailor an effective public-messaging campaign (i.e. a transmission approach) that would minimize any potential adverse public reaction to the Study’s final report. Of course, expecting them simply to switch, on the basis of one conversation, from commonplace, embedded transmission assumptions to a more dialogic conceptualization of communication was highly unrealistic on our part—even without taking into account their situated motives for preferring a transmission approach.
Because the meeting was organized by my well-meaning but perhaps too- optimistic colleague, I encountered the challenge of having little control over how we prepared for it and how we shared key aspects of the analysis I had undertaken (for example, meeting participants received a not-yet-published article of the analysis—intended for a scholarly-rhetorical studies type audience—as reading material ahead of time, rather than engaging in a more conversational exchange with us during the meeting, supported by research explanations better suited to fostering a productive dialogue about issues of mutual concern.
I tell this story not to criticize either the stakeholders or my colleague (or myself, for that matter), but instead to (re)foreground some of the multiple potential problems of ‘sharing’ research findings, recommendations, and/or processes, both with non-academic groups as well as scholars outside one’s own field. ‘Sharing’ is a very nice word for what is a sometimes a very difficult process. I am quite skeptical about the extent to which the work that I do (and possibly that other health-medical communication scholars do) will be valued or welcomed by the professional or community sectors whose rhetorical actions and situations form the focus of my research, especially since the questions that I tend to ask—and hence the answers that I develop—may not be the questions—and hence answers—that primarily interest them.
This certainly doesn’t mean that I don’t think we should share our work beyond the borders of academe nor that working with non-academic research collaborators or participants can be extremely productive and illuminating; it just means that I think we do well to be attuned to the rhetorical complexity—the trickiness, the tensions, the messiness, the unpredictability—of doing or sharing health(care) communication research with others whose motivations, objectives, assumptions, and so on may well not align with our own (and I don’t mean to imply here that ‘we’ are all aligned in these matters either!). Although the meeting I’ve just described could be characterized as a rhetorical failure in several ways, I do think it could have unfolded in a much more constructive-dialogic, less contentious-defensive way with better planning and preparation as well as more informal, one-on-one interactions between me and some of the other participants ahead of time. A one-off encounter such as this meeting was likely doomed from the start because I was more or less parachuted in: we did not put enough time and effort into gradually developing relationships of trust and respect between the researcher (me) and the community stakeholders, relying instead on the strength of my senior colleague’s pre-established relationships with a number of them to create a mutually receptive situation.
My second example, which is more generic than situation-specific, also concerns working and communicating with others outside my field, though in this case it’s about working with co-researchers from other disciplinary backgrounds. As I’ve already explained in above, virtually all of my rhetoric of health(care) research has involved interdisciplinary collaborations, and all of them, I am pleased to say, have been productive and rewarding in many ways.
The main challenges I have struggled with in working with researchers outside rhetorical studies have been:
- to explain to them what it means to do rhetorical research (already discussed above);
- to figure out how best to integrate a rhetorical approach to ‘data’ (this is the term I have learnt to use though it still sounds a bit foreign to me) with other conceptual and methodological approaches—a fundamental challenge of interdisciplinary research.
What I have come to realize—and this probably should have been obvious to me much sooner but I’m a slow learner—is that it’s best for me to think about interdisciplinarity as involving hierarchical rather than horizontal integration (I have also started to think this way in relation to the teaching I do within several interdisciplinary graduate programs). By this I mean that I now aim less to merge a rhetorical approach with other approaches (as in two or more lanes of traffic merging) than to develop with my co-researchers a cluster of more discrete bits of data-analysis, each of which is developed according to the lead author’s primary theoretical-disciplinary orientation. This means that if I take on leading a particular facet of analysis, I am now much more comfortable unabashedly using a rhetorical framework as the primary perspective: inevitably, this will involve drawing on the conceptual-analytical expertise of my co-researchers to enrich this perspective but I am less concerned than I used to be about trying to ‘fit’ our multiple theoretical-disciplinary orientations together every time we develop an analysis. I know that mixed-methods (and mixed-analysis) research can be very successful and illuminating, but in my own case, I find that interdisciplinary research works better if each co-researcher draws mainly on her own expertise (with input from others) to develop textured discussions.
I also have come to realize that there are only some disciplinary-theoretical-methodological orientations that I feel able to ‘inter-discipline’ effectively with; these essentially are perspectives that share my own epistemic-ideological commitments to critical and unapologetically interpretive analysis. So, to sum up, two ways that I have (tried to) overcome the challenges of interdisciplinary research are:
- making my own disciplinary perspective primary when I am leading an aspect of the research and
- choosing to work with colleagues who share some basic assumptions about knowledge-making and knowledge-politics.