University: University of Cincinnati
Description of Work:
This blurb is for my current book project.
This book-length manuscript about rhetorical agency in this chronic illness context. It draws on contemporary scholarship in rhetorical studies that defines agency as relational (Herndl & Licona, 2007; Koerber, 2006). This view of agency argues against a bond between structure and resistance to that structure as a given outcome (Koerber, 2006), a stance that arose in large part from Foucault’s (1982) theory of resistance, which is based on power relationships in a binary equation between individual and ‘other.’ The representation of agency within such a framework of domination and struggle creates a picture of resistance in which the individual struggles against the dominant structural forces of institutions. Such a view has been popular in social movement rhetoric such as that of disabilities studies and some feminist movements, but in the climate of contemporary health care, seeing patients as an organized force of social resistance to oppressive forces is counter‐productive. In these discourses it may be more productive to view the relationship as occurring in a complex, fluid network (Herndl & Licona, 2007; Schryer, Lingard, Spafford, & Garwood, 2003), as I do in this project.
In the manuscript I specifically address the questions of what qualifies as agency in the rhetoric of diabetes and what the relationship is between agency and expertise. I theorize both agency and expertise as performative and transitory. Therefore, my analysis focuses on and prioritizes the spatial and temporal aspects of the network of materials and relationships within which agency operates. The specific spaces I analyze are public spaces of health care—shared medical appointments (appointments that include several patients and a doctor rather than a single patient and single doctor) and online patient communities. My central argument is that these liminal spaces (Bhabha, 1994; Jeyaraj, 2004; Lewiecki-Wilson, & Cellio, 2011; Turner, 1967) are risky but they are also conducive to agency by allowing the personal, social, and clinical worlds flow into one and other.
Wired for Agency – the Insulin Pump Cyborg
People with diabetes have been wearing insulin pumps for more than 30 years. These computerized devices consist of a small tube that connects the pump, which holds a reservoir of synthetic insulin, to a needle inserted under a person’s skin to deliver the medication. Unlike individuals passively tracking health data by devices like Fitbit, the estimated 350,000 people using pumps (Chait) adjust and re-adjust the amount of insulin delivered with what they eat and how much they exercise. More public practices of manipulating pumps, or biohacking, have been documented as well. For example, Jason Adams developed software that basically hacks into a child’s pump so the parent can monitor the child’s blood sugar when away from home. Jay Radcliffe biohacked his own insulin pump at a hackers conference to show how a software bug could allow other people to take remote control of the device (Reuters).
The way diabetics (and parents of young diabetics) interface with their pumps complicates the relationship between human bodies and wearable medical technology in a way that profoundly affects theories of cyborgs, agency, and identity in post human rhetorics. These new cyborgs (pumpers) are embodied and situated, as Haraway suggested, but in this case humans and the technology are not seamlessly articulated, as Hayles might propose. Pumpers do physically “plug in” to the technology to replace a malfunctioning biological process, but more interestingly, they use the pump as a vehicle to alter identities. For example, Miss Idaho, Sierra Sandison, became an advocate for people with diabetes when she made the decision to visibly wear her pump in the swimsuit competition of the Miss America pageant (Tucker). Pumpers can become weekend sports warriors by decreasing their insulin dose. Teen-age girl pumpers can skip insulin doses to lose weight and create a skinnier self.
These examples show how this wearable technology shifts the interface between human and machine in ways that both extend and challenge post human theories of identity and agency. To examine these new cyborg identities I use ethnographic observations of 8-10 pumpers to formulate a theory of agency re-invigorated by the concept mêtis. Mêtis is particularly useful for discussing these biohacked bodies because it is not only flexible and practical (de Certeau) but related to knowing and doing in shifting contexts and ambiguous situations (Baliff; Detienne and Vernant; Dolmage), like the one of constantly tweaking blood sugar levels that vacillate out of a desired range.
After establishing the relationship between metis and agency, I offer a rhetorical analysis of the public discourse surrounding the biohacking practices I have outlined in this proposal. The questions I am interested in answering through this analysis align with those suggested in the special issue call for proposals.
• How does biohacking complicate post human rhetorics of technology?
• What is the agential potential of this medical monitoring technology?
• What counts as actionable knowledge in discourses about insulin pump technology?
• How can examining these discourses inform our theories of the rhetoric of wearable technologies more generally?
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Chait, Jan. “Insulin Pumps Not Just for Type 1.” Diabetes Self-Management. 20 June 2014. n. pag. Web. 1 Dec. 2014.
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Dolmage, Jay. Metis, Mêtis, Mestiza, Medusa: Rhetorical Bodies Across Rhetorical Traditions. Rhetoric Review 28.1 (2009): 1–28. Print.
Hayles, N. Katherine. How We Became Posthuman: Virtual Bodies in Cybernetics, Literature, and Informatics. Chicago: The University of Chicago Press, 1999.
Haraway, Donna. “A Manifesto for Cyborgs: Science, Technology, and Socialist Feminism in the 1980s.” Feminism/Postmodernism. Ed. Linda J. Nicholson. NY & London: Routledge, 1990. 190–233. Print.
Linebaugh, Kate. “Citizen Hackers Tinker with Medical Devices; Diabetes Patients, Family Members Try to Make Glucose Monitors More Useful.” Wall Street Journal (Online). 6 Sept. 2014: n. pag. ProQuest. Web. 7 Dec. 2014.
Reuters. “Rapid7 Hires Jay Radcliffe, Diabetic Who Hacked His Insulin Pump.” Reuters. 29 May 2014. n. pag. Web. 1 Dec. 2014.
Tucker, Miriam E. Hey, “Miss Idaho, is that an Insulin Pump on Your Bikini?” NPR.org. 17 July 2014. n. pag. 11 Dec. 2014.