Tag Archives: medical rhetoric

Why the Patient Protection Act Doesn’t Protect Patients

This is really an update to my Jan. 18 post in which I talked about a paper I was planning to write on the rhetoric in recent healthcare legislation. The semester is now over, the paper is written, and I’m annoyed–but not surprised–at the findings of my paper.

The paper, which I’m hoping to publish, was originally titled “Women and Health in Women’s Health: A Linguistics-based Analysis of How Online Spaces (De)Value Women.” That title will probably evolve, but what I did was run six online texts through concordance software to see where, how, and how often the keywords women and health were used. I also ended up looking at the use of some other words, too, including second-person pronouns.

The most interesting result I found was in the recently passed Patient Protection and Affordable Care Act (PPACA). The PPACA used the term woman exclusively in connection with reproduction, and the term women was most often used with reproductive terms as well. (I also looked at the CDC and NIH sites, CNN.com’s women’s health page, WebMD’s women’s health page, and The Bump.) I was able to draw some (I think) interesting conclusions from the data, the foremost of which is that the government seems to value/define women in terms of their reproductive abilities instead of as human beings. I’d like to write more about this, but I think I’ll do so at some point after I’ve sent this paper out and gotten some feedback …

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As a sidenote, the software I used to do this analysis was Concorder Pro. I’ve heard of a number of other discourse and/or text analysis options and resources, which I’ll list here. I’d love to hear from anyone who has more options to add to the list.

http://www.textanalysis.info/

hyperRESEARCH

Tams Analyzer

NVivo

atlas.ti

Mind over body (matter)

I stumbled upon “Mind Over Body: The Pregnant Professional” by Robbie Davis-Floyd during readings for a different project, but I found Davis-Floyd’s work to have many intersections with what I’ve read so far of Sherry Turkle. Davis-Floyd argues in this essay that “body image not only mirrors social relationships but also worldview” (204). Interviewing 31 professional women, the author interrogates how they define their senses of self. Because of an (initially) unrelated study of home-birthers, Davis-Floyd also can draw some conclusions about the differences in how women define their selves.

The part that immediately struck me as being reminiscent of Turkle comes on the third page of the essay:

“I found it noteworthy that when I interviewed this women in their homes, they almost invariably would glance down at their casual sweats and tennis shoes and laughingly comments, ‘You are seeing my other self, my home self,’ but when I went to their offices they never said, ‘You are seeing my professional self.’ For most, the professional self was the primary self.” (206)

I wonder about that notion of “primary self.” It seemed to me at first that which self is primary would depend on context, and the author’s status as a scholar would make the women want to privilege their professional selves to her. But then Davis-Floyd points out that children and emotions do not enter these women’s offices, while paperwork and work calls often come into their homes.

Davis-Floyd theorizes pregnancy as a “violation of the professional/personal split” and proves that women understand and worry about this boundary breaking (although she also says those fears are rarely justified). They are aware that others see them as women rather than as professionals once the pregnancy becomes visible, and this forces a merger of selves much like the uncomfortable merging of windows I discussed in relation to Turkle’s “Who Am We?” article.

The author also complicates the separation of selves by introducing the idea of control. The professional women in her study spoke of a loss of control as the most undesirable aspect of pregnancy and embodiment. I wonder if there is a parallel between this loss of bodily control and the loss of control we experience when separating out a “self” for online use (or separate use in any other sense). There is something inherently frightening about acknowledging a self that does not adhere to the guidelines we (and others) have constructed for acceptable “selves.”

Finally, Davis-Floyd discusses technocratic life and compares the professional women in her study to home-birthers in another study she’s doing. While the home-birthers eschew reproductive technology as part of a oft-theorized technomedical takeover of women’s bodies, the professional women view technology as another means of control for their own use. The professional women “perceive the holism of the home-birthers … as frightening, irresponsible, limiting, and disempowering” (227). Both sets of women believe their method allows them more control.

So now I have to ask a series of questions that I don’t (yet) have answers for:

  • What role does control play in the mediation and construction of self/selves?
  • At what point is control no longer deemed desirable?
  • Can we talk about embodied control and virtual control in the same ways?
  • Is this need for control a gendered construct?

The essay discussed in this post comes from:

Sault, Nancy, ed. Many Mirrors: Body Image and Social Relations. New Brunswick, NJ: Rugers UP, 1994. Print.

Saving Lives

How’s this for a culture that uses technology to vital purpose and engages every day with questions of rhetorical silencing: nursing. In Saving Lives: Why the Media’s Portrayal of Nurses Puts Us all at Risk, Sandy Summers (RN, MSN, MPH) and Harry Jacobs Summers show that, indeed, the media’s portrayal of nurses is unfair–to say the least.

As a former member of the media, though, I recognized myself in some of their critiques. And my automatic response is to critique right back. I could easily have been one of the reporters who writes that “doctors put the victim back together.” But my argument is that such a use of the term doctor does not refer exclusively to MDs. Doctor is a broad term. It can refer to PhDs and dentists. Of course, it refers to MDs, but it can also be used to reference any medical practitioner–nurses included.

(In a similar vein, Summers and Summers critique instances when people who are not nurses are referred to as such; it seems to me that we are encountering a problematic conflation of general and specific terms. After all, one who nurses is a nurse, whether or not they are a CNA or LPN, just as one who doctors–including nurses–can be broadly referred to as doctors. The resistance to this seems to be an issue of hierarchy, or professional class.)

So why does my counter-argument fall flat, thus meriting this post? Because of two things: 1) not all journalists think like me, a fact largely due to the fact that I’ve always had one foot in academia and, more importantly 2) any decent rhetorician (journalists included) knows that intention doesn’t make a lick of difference. The public doesn’t read doctor and think that includes nurses. The Summers’ book isn’t so much about what journalists write … it’s about how the public perceives what journalists write. And there are a lot of misconceptions out there about nurses, including the idea that they’re all women and that all doctors are men. There is work to be done here on the part of journalists, the public, and nurses themselves. And, happily, this is exactly what Summers and Summers propose, asking that nurses take a role in altering their public image and, in Chapter 11, providing a sort of how-to manual for a variety of professionals to create more ethical portrayals of nurses. I would add to this that the most basic of solutions is for us all to be more aware of the rhetoric we use and how intention differs from perception.