Define medical rhetoric?!?

posted by Lisa Meloncon

Over on twitter, the discussion got started on defining medical rhetoric. I liked this idea a lot because I know that under the big tent of rhetoric we approach research from different perspectives.

Heifferon and Brown (2008) argued in their book  for the use of health: “we used health care to bring in all of the health professions, the health professionals and the many attendant rhetorical situations available under this moniker. We also were cognizant of a more positive and constructive spin on the term: move from a narrowly mapped medicine…to deconstruct but also to positively reconstruct or build for the first time an alternative discursive practice…ones that communicate more effectively than the ones presently in use by health care providers” (p.4).

I can still hear Gary Kreps comment in my head from the 2013 Symposium when were discussing what we should call ourselves. He argued passionately that we did not need to include medicine because those areas are already widely covered.

I can appreciate this orientation and the need to emphasize a broader and more inclusive paradigm for research by focusing on health, which is decidedly more patient centered and probably something most folks in the area would advocate.

I have to wonder, however, whether omitting medicine actually excludes a large audience that in theory we would love for our research to reach, that is, the medical practitioners, policy experts, those in public health, and the many working professionals who set policy and create health education materials for thousands of patients. What many of the external stakeholders have in common is the fact that have little to no awareness of our work, and I’ll boldly state it—our work can enormous positive impact and ultimately improve patient outcomes.

This is why I was so happy to see this attempt on twitter to define medical rhetoric or to define the more broad term rhetorics of health and medicine. This latter term is starting to be used more often—even with hesitancy by those that may still have problems with it, and I’m one of those (more on that later)—because it was this emerging field’s first attempt at definition by at least settling on a name and a broad purpose. Blake Scott, Judy Segal, and Lisa Keränen (2013) “advocate[ed] that scholars adopt the term rhetoric or health and medicine to signal a broad array of health publics, their nomoi, and their discursive practices, some of which only partially intersect with medical institutions….Expanding our purview to include the broader set of health texts, artifacts, genres, and practices allows rhetorical scholars interested in medicine and health to address more fully the constellation of symbolic and material rhetorics that influence daily life and public meanings, and practice” (para. 2).

I was also reminded of Kelly Happe’s work and her insistence that “discourse is where institutional practices, cultural norms, and dominate beliefs converge. Researchers are embodied persons who must draw not only from an agreed on and disciplinary-specific lexicon, but also from tropes, metaphors, narratives, and arguments that circulate outside of the scientific context, but to which they are in no way immune….A rhetorical perspective attends not only to shared beliefs across multiple discourses but also to the inner workings of the texts that form them. (pp.14-15)

Here’s what our twitter conversation generated. Huge props to Lori Beth De Hertogh for curating the responses into a storify. (and yeah, I know I can embed that storify here but then this post would be scarily longer than it is 🙂

It’s true that I’ve shied away from positing my own definition. I’m not quite there yet because I’m one of those people who is still trying to accept the “rhetorics of health and medicine” moniker as one that has room for me and what that room may look like. It’s not that I am opposed to the term. Actually, I like it a lot, and have argued recently (CDQ intro forthcoming) that it is one our emerging field should use. I am also a rhetorician, who has long used (depending on the situation) John Poulakos’s definition: “Rhetoric is the art which seeks to capture in opportune moments that which is appropriate and attempts to suggest that which is possible. Very briefly, this undertaking which concerns itself with the how, the when, and the what of expression and understands the why of purpose.”(p. 26).

I am drawn to the possibility in Poulakos’ definition, and it is the possibility of the rhetorical work that we do in health and medicine and what the possibility could afford the practice and purpose of health and medicine that is exciting and daunting and important.

Possibility opens up many avenues for the work of rhetoricians of health and medicine one of which is theory. For example, I have long shied away from theory because I have always seen myself as more practical, more applied. But what I have learned over the last several years is that theory is a vital part of the work that we do. And in thinking of theory I can’t escape conversations with and the work of Blake Scott and Karen Kopelson. Karen so eloquently argued at the 2013 symposium that we need theory and we can’t and shouldn’t be all practice. That resonated and still does. Theory provides us a way to see the same thing differently. And one of the contributions our emerging field can make is a theoretical one where our research provides scholars in rhetoric new ways to use and enact theory in their own work. In this way we offer the broader rhetorical community a version of sustainable scholarship, which is what Johanna Hartelius (2009) called for in her review of work in this area.

Rhetorical possibility could be a powerful construct and one that could offer the emerging field a way to provide a capacious umbrella for the different approaches and methods and methodologies to this interrogation of the discourses of health and medicine.

One of the reasons for defining anything is to give it a set of parameters, to give it a shape, and just as importantly, to be able to tell other people what it is and why it matters. As Judy Segal (2009) aptly points out, “Projects in rhetoric of health and medicine, in general, aim to be useful. Their usefulness often lies in their ability to pose questions that are prior to the questions typically posed by health researchers” (p. 228). What we do matters, and it can be useful. But for us to able to better engage with the public about the work that we do, this idea of defining it becomes paramount.

Definitions are hard. Naming is hard. But we do have a start. Part of the work as we move toward defining and naming is the necessity to engage with existing definitions, even if scholars haven’t labeled their work in that way they have engaged in trying to limit or identify boundaries. Part of this work, too, is finding a set of key terms that need to be considered from multiple angles to continue to build our theories. For me those terms include: people, experiences, technology, contexts/situations/networks/ecologies/articulation/[whatever term symbolizes a larger set of practices], rhetoric or discourses, power [and can also include other critical terms like politics, gender, race, class, etc.], and some attention to publics (however that is being defined). Other useful terms for exploration of definitions and locations are ethics, theory, embodiment, methods, place, space, performance, agency, techne, poiesis, dialogue, and visual.

This post went much longer than intended and it’s definitely more exploratory than any sort of cogent argument about definitions. Rather, it’s something to encourage thinking about definitions and naming within the emerging field and to encourage moving this and related discussions forward within our social media and hallway conversations and more importantly, in our scholarship.

 

Happe, K. (2013). The material gene: gender, race, and heredity after the Human Genome Project. NY: New York University Press.

Heifferon, B., & Brown, S. C. (Eds.). (2008). Rhetoric of healthcare: Essays toward a new disciplinary inquiry. Cresskill, NJ: Hampton Press.

John Poulakos, i. r., eds. John Louis Lucaites, Celeste Michelle Condit and Sally Caudill, 25-34 (New York: Guilford Press, 1999), 26. (1999). Toward a Sophistic Definition of Rhetoric,. In J. L. Lucaites, C. Condit & S. Caudill (Eds.), Contemporary Rhetorical Theory: A Reader (pp. 25-34). New York: Guilford Press.

Scott, J. B., Segal, J. Z., & Keranen, L. (2013). The Rhetorics of Health and Medicine: Inventional Possibilities for Scholarship and Engaged Practice. Poroi, 9(1), Article 17.

Segal, J. Z. (2009). Rhetoric of health and medicine. In A. Lunsford, R. Eberly & K. Wiliamson (Eds.), The sage handbook of rhetorical studies (pp. 227-246). Los Angeles: Sage.