T. Kenny Fountain
Case Western Reserve University
My research interests—in rhetorical studies, technical communication, and visual cultural studies—are motivated by a wish to understand how people come to see according to the frameworks provided by their professional and disciplinary communities. More specifically, my work interrogates the role visual images and objects play in these processes of formal training and informal socialization. Based on my commitment to the history and theory of rhetoric, I approach visual objects as instantiations of knowledge, social processes, and ideological investments, which shape our perceptions of the world and induce in us certain beliefs, attitudes, and actions. Much of my scholarly work has focused on the rhetorical, social, and embodied practices involved in representing, displaying, and teaching the body in educational contexts. I have done this by exploring how participants in medical settings use visual displays to make claims about evidence, to understand anatomical phenomena, and to structure their learning.
I recently completed a research monograph, Rhetoric in the Flesh: Trained Vision, Technical Expertise, and the Gross Anatomy Lab, which is forthcoming in the Routledge ATTW Book Series in Technical and Professional Communication. This project is an ethnographic study of the visual rhetorics, institutional discourses, and embodied practices involved in cadaveric anatomy education. Through an analysis of fieldnotes, interviews, and photographic documentation conducted during yearlong fieldwork at one American medical school, I argue that anatomy education is a rhetorical endeavor. In particular, the anatomy lab is composed of two types of rhetorical demonstrations: (1) visual and multimodal displays used to exhibit anatomical knowledge and (2) institutional discourses used to inculcate the values of anatomical study and medical science. These demonstrations of evidence and values correspond to the ancient rhetorical notions of apodeixis (or displays of proof) and epideixis (or displays of cultural values). Together the multimodal displays and verbal discourses induce in participants a trained perspective that shapes how they view both the anatomical body of medicine and the lived body of human experience. This trained vision is the result of the participants’ bodily encounters with these multimodal objects (the atlas images, photographs, x-rays, and cadavers) and their repeated exposure to the epideictic discourses that laud cadavers as crucial to learning and eulogize the cadaveric donors as altruistic “gift-givers.”
In order to learn, teach, and even communication anatomical knowledge, participants must recognize the anatomical body in the multimodal displays of the lab. They do this by learning how to view, touch, move, and even manipulate the various “bodies” of the lab—both the nonhuman displays which represent anatomy and those living and dead bodies that present anatomical structures. The participants’ abilities to engage physically and conceptually in these embodied activities of demonstrating, observing, and dissecting are fundamentally shaped by the rhetorical discourses that influence how students and teaching assistants work with and even feel about these complex objects. In the anatomy lab, the development of anatomical knowledge and know-how coincides with participants’ skillful bodily engagements with objects and the suasory force of rhetorical discourses that shape those engagements. As my research demonstrates, professional dispositions, such as “clinical detachment,” are, in a significant way, rhetorically trained.
On a theoretical level, my work (specifically Rhetoric in the Flesh) seeks to demonstrate the usefulness of coupling classically inspired rhetorical theory (Burke 1969; McKeon 1987; Prelli 2006) with phenomenology and cognitive science. Merging theories of persuasion and theories of embodied cognition provides a robust way of explaining the role that objects, displays, discourses, and bodies play in the development of medical knowledge, embodied practice, and clinical expertise. Briefly, these theories of embodied mind contend that perception and cognition occur as we explore our connections to the world through embodied actions and the exercise of bodily skills (Noë  2006; Thompson 2010; Varela, Thompson, and Rosch 1991). Perception is “a kind of skillful activity” accomplished by way of the body, not just the brain (Noë  2006, 2). We make meaning in the world through our bodily engagement with the objects, tools, and displays that seem to function as corporeal extensions and incorporations (Hutchins 1995; Clark 2011). By engaging with the affordances of these objects, or the opportunities for action they seem to make possible, we develop the skilled capacity to make meaning with those objects and to perform meaningful action in this ecology of perceptual possibilities (Gibson  1986). Learning, then, is a matter of developing the bodily skills and habits necessary to cope with the objects in one’s environment, and we do so in a way that becomes almost second nature (Dreyfus 2005; Merleau-Ponty 1945; Merleau-Ponty 1968).
Keywords to Describe work
visual rhetoric, rhetorical displays, anatomy education, expertise development, embodied cognition, trained vision
Work in Relation to symposium keywords
The word connection relates most to my work.
Again, in order to understand how anatomical education involves both rhetorical and embodied practices, I turn to theories of enactive and extended mind, both of which arguably continue from the work of Merleau-Ponty ( 2005; 1968). Taken together, this work contends that the human mind is enacted through sensorimotor activity with the objects of one’s environment, objects over and through which our cognitive processes are distributed or extended. Theories of enaction and extension, which are at times in tension, agree that perception and cognition do not follow the computational model that reduces the human to a signal-processing machine that merely responds to environmental stimuli. Cognition is not merely something that happens in our brains but something we accomplish through actions involving objects.
Often we speak of rhetoric as if it too is a brain-bound process, as if it occurs exclusively in the hidden confines of the human head. But persuasion, identification, and inducement to action are accomplished by way of the human body’s interactions with texts, discourses, objects, and even people. And often that interaction takes the form of an embodied, physical engagement. In other words, texts, discourses, and objects operate as cognitive extensions that allow us to learn, work, communication, and even believe. We learn to make sense of and make meaning with those discourses and objects through the embodied actions we preform on them, with them, and through them. And we use these extensions to enact meaning. Rhetorical processes, then, are possible because of our embodied connection with the world around us.
As researchers and educators of medical rhetoric, medical communication, and medical humanities, our work is made possible by our embodied and interpersonal connections with medical practitioners and the texts, objects, and discourses they make and use. Through our interconnections with them, as research subjects or collaborators or both, we come to understand more of their perspective (their trained vision) as they come to understand more of our own. From my interest in rhetoric (as irreducibly social) and cognition (as embodied, extended, and enacted), I am convinced that scholars of medical rhetoric, medical communication, and medical humanities can only do the work we do because of the mutual bonds of connection and respect we diligently foster.
- How do you explain/define what you do to medical personnel and/or other stakeholders in the research process or to the public?
When I talk about my work with a medical practitioner, or anyone for that matter, I often begin with a broad description of the issue that motivates everything I do. Namely, I am interested in understanding how people some to see the world as they do. More specifically, I study how people learn to see according to the discourses, frameworks, and objects of their profession as well as the consequences of the trained vision they develop. Depending on the research project, I define the specifics of my work quite differently, yet I always connect it back to that broader issue of medical vision.
For example, in my ethnographic research into anatomy education, I study the practices of the labs to understand how students and TAs not only learn anatomy but also learn to observe, deliberate, and communicate according to the practices and culture of anatomical and medical science. I explain that I am interested in the training, socialization, and enculturation involved in becoming a physician, or dentist, or nurse, because I research how medical images, objects, documents, and practices encourage certain ways of seeing and certain actions and practices. That is, I usually say, what I mean by rhetoric—the use of language, objects, or practices to induce in others certain ways of seeing, thinking, and even being. These inducements to action and attitude might involve solid reasoning and valid evidence, or they might involve emotional responses, an unquestioning allegiance to cultural values, or even an inexplicable gut feeling. But in all cases, people are persuaded to think and act in a certain way. And these subtle and not-so-subtle persuasive acts constitute a large part of education and training. Sometimes I am asked if I incorporate psychological or cognitive theories of learning, and I usually take this as an opportunity to say a bit about the philosophical and cognitive approaches to embodied cognition, enactive and extended mind, and skill acquisition on which my work is based. How would you describe the relationship between medical rhetoric/health communication (however you see yourself) with other fields and sub-fields?
- How would you describe the relationship between medical rhetoric/health communication (however you see yourself) with other fields and sub-fields?
Definitions are extremely important and never unproblematic. The terms we use to describe what we do align us with certain disciplines, fields, and modes of thought, and those terms and allegiances can have practical and political implications. Often I describe the work I do as “rhetoric of science,” “medical technical communication,” or “visual rhetoric of science,” and I do so for three reasons. First, we are what we read and what we cite, and my work draws heavily from researchers in both English and Communication Studies who work in rhetorical theory, rhetoric of science, and visual rhetoric. Second, I see my work as hopefully contributing to and expanding what we mean my technical and scientific communication. I explicitly position my work as offering insights into medical practices (specifically anatomy and medical education) as well as technical communication practices. For example, my collaborative research investigating the design and use of protocols in evidence-based medicine is premised on the idea that hospitals and clinics are importance sites of technical communication (Longo and Fountain 2013; Longo, Weiner, and Fountain 2007). Specifically with the rise of protocolized medicine, technical documents and documentation take on a more profound role. Third, in a more pragmatic sense, my use of the terms “rhetoric of science” or “rhetoric of medicine” is influenced by how others have described my work. When I was on the job market, while finishing up my dissertation, one prominent scholar (wishing to help me more aptly define what I do) advised me to use the terms “rhetoric of science and medicine” as opposed to “medical rhetoric.” I did not (and do not), after all, focus very much on issues of health, the role of narrative, or doctor-patient interactions (whether face-to-face or mediated through medical or popular documents). While these are exciting avenues of study, my interests in visual displays, embodied practices, and rhetorical formations focus primarily on issues of education, socialization, and training. And I see my work as speaking to scientific education and technical training, more broadly. For better or worse, I have let these reasons shape the way I advise my graduate students. One of my PhD students is completing her dissertation on a rhetorical analysis of the American Heart Association’s Go Red for Women Campaign. And while she identifies primarily as a medical rhetoricians, I have encouraged her both to read work in the rhetoric of science and technical communication and to consider how her research might speak to these related audiences.
- 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?
In many ways, this question of orientation haunts my work—both my research and my teaching. As someone trained in rhetorical theory as well as ethnographic and qualitative methods, I struggle to define my own orientation as both a humanist and a social scientist. For me, the major distinction, if there is one, involves a researcher’s approaches to and relationships with methods and theory. Does she see herself as interpreting or analyzing texts by offering a close reading that is guided by theory? Does she see herself as a theorist or a historian? Does she see theory as a goal or a domain in itself? Or does she see herself as interpreting or analyzing data by way of some regularized coding scheme or framework? Does she see herself as a “researcher”? Is theory more of a tool or a set of ideas that must be empirically proven? These questions, no doubt, lead to quite stereotypical examples. But some form of them has come up for my students and me because we do the kind of work we do in an English Department. And I have seen my own concerns, my approach, the works I read, and the way I write slowly transform, particularly as I almost completed revised my dissertation into a book. Ultimately, I think a person’s orientation as a humanist or a social science is perspectival, rooted in one’s training, socialization, and personal identification. And it often involves “both/and” instead of “either/or.”