Reading Response #2 Topic 4

This drawing here has very few defined outlines, is a blur to look at, and almost seems “pieced” together. As a reader, it’s hard to comprehend what he truly looks like. This ties into one of our earliest class discussions on the patient-doctor relationship. We explored the postmodern issue of patients who lack a role in their own treatment methods. Patients themselves barely exist in any clinical assessment because modern medicine only focuses on disease mechanisms. A few ways that we’ve learned how patients can exist in medicine is through storytelling and understanding their different cultural perspectives. Thus, doctors actually need a definite body, a true image, one capable of speech to clearly communicate to the observer or they will risk walking away with only pieces of their entire tale.
Another image packed with connections to our discussions on the patient-doctor experience is of Dunlap-Shohl describing the “language of Parkinson’s.” First, this image is displayed in many boxes and could possibly cause confusion as the reader looks at one place immediately to the next. This arrangement reflects the difficulty to grasp all that Parkinson’s disease encompasses. Even the wide vocabulary of words is difficult to understand because they seem to have multiple pronunciations and many different ways to look at them. What’s even more frightening is that these are the odd conversations that circulate in the world of medicine in which doctors like to bombard patients with all the nitty-gritty medical terminologies.
A final image is one that personifies Parkinson’s disease—a green monster. There’s only one bright side to looking at this monster, and that’s that it gives the disease a meaning. Thus, Dunlap-Shohl is helping the reader identify with this disease in a way that restores understanding so that we can respond appropriately to his incredible memoir.

Paragraph 1. Image to the left

 

 

 

Paragraph 2. Image to the right.

Works Cited

Dunlap-Shohl, Peter. My Degeneration: A Journey Through Parkinson’s. Pennsylvania State University Press, 2015.

 

How titles and snow create a narrative

Before the book even begins the reader is presented the table of contents: here lies the road map of the graphic memoir that equips the reader with what to expect in the pages to come. The organized list of titles is contrasted by the sporadic background of what appears to be snow. Upon a closer examination we can see circles and even letters. The author can be found in the corner: cold and alone. The difference between the uniform types words and the hand drawn letter and circles can show how the unpredictability PD and the comfort of Dunlap-Shohl’s career are combined into one page. The letters and circles seem to be hand drawn, perhaps the author was practicing his letters as his condition progressed. The black border at the top of the page is almost like a transition of what our reality and narrative is to the author’s story. it is like  Without getting into too much of the contents of the graphic memoir, one is able to graph the type of narrative Dunlap-Shohl is presenting.

The first title explicitly tells us that there is a sad beginning, the author is going to experience his diagnosis of Parkinson’s and is experiencing depressing feelings. From the second title, the reader can infer that he is learning to understand and work around the struggles of having PD. There is an educational experience that comes with an illness that changes one’s life. It is like a culture with its own language and mannerisms and one must adapt to it because it takes on a visible role in one’s life. 

In the third chapter, Parkinson’s is personified to create an identity for the disease: separate from the author. Though they are of the same body, they are two different “people”. This can be interpreted as the author not accepting PD as a part of his life and as a part of himself while also understanding that he is still a multifaceted person though he has a debilitating disease.

The fifth chapter’s title along with the chapter’s first page shows a confusing reality. This notion is supported by the graphic novel-esque form: cartoons and drawings are not reality. They mimic reality but are not a complete copy of what is perceived as 3D or real. The prism is not only changing his view on life but also how the author is viewed by others: “it changes the way you perceive things and the way you are perceived” (Dunlap-Shohl 50). It is a combination of the disease, medication, and his personal thought processes that create his reality. 

The last chapter title reminds me of a musical where musical numbers have reprises, or songs that appeared earlier and entering the story once more. Reprise means to repeat, to show up again: which is odd to think that there is another diagnosis for a disease that does not “leave” or have the ability to “come back”. Yet the last title has a more hopeful meaning in a sense that the author is returning to where he started. There is a tone of finality: a final negotiation of the diagnosis and its meaning for the author’s life. 

A restitution narrative does not seem fitting due to the nature of Parkinson’s, there is no return to a life without Parkinson’s once one is diagnosed: “Yesterday I was healthy, today I’m sick, but tomorrow I’ll be healthy again” (Frank 77). They are restored to their former self, pre-illness with the help of medicine. I don’t think any story about Parkinson’s will fit the restitution narrative. “So mark this moment with gratitude and relief, and anticipate the next ten years” (Dunlap-Shohl 96). This quote contradicts the end of what a restitution narrative should end like, it is ten more years of living with Parkinson’s disease.

The titles are giving the reader a timeline which contradicts the chaos narrative which is anti-narrative in a sense. Chaos narratives “are chaotic in their absence of narrative order” (Frank 97). The progression of Parkinson’s is “linear” for everyone though there is a lack of control because there is no cure for Parkinson’s. Events are not by chance, they are predictable in the sense that the patient will progressively get worse and lose their motor skills. There is a sequence of events that Peter Dunlap-Shohl is telling the reader: there is a beginning, middle, and end. 

 From the titles, there does seem to be a journey that is compliant with a quest narrative. “Quest stories have at least three facets: memoir, manifesto, and automythology” (Frank 119). There is a plot, the genre is a graphic memoir, and there is a story acceptance. 

 

Dunlap-Shohl, Peter. My Degeneration. The Pennsylvania State University Press, 2015. 

Frank, Arthur W. The Wounded Storyteller: Body, Illness, and Ethics. University of Chicago Press, 1997.

Structural Competency and Personal Narrative – Katy Meier

Prompt: In describing the experience of being black and pregnant, Villarosa intertwines a personal narrative and facts/figures. Explain why might or might not be an effective way to better understand Metzl and Hansen’s concept of “structural competency?”

Structural competency is an educational approach devised by anthropologists that focuses on the social and economic structures of healthcare and involves training in 5 core themes. These include factors that shape clinical encounters, structural language outside the clinic, defining culture in structural terms, creating structural interventions, and structural humility (Metzl and Hansen 126). Metzl and Hansen portray structural competency as an action-oriented approach requiring education, arguing that “clinicians require skills that help them treat persons that come to clinics as patients, and at the same time recognize how social and economic determinants, biases, inequities, and blind spots shape health and illness” (Metzl and Hansen 127). However, they describe the premises of structural competency with a very abstract and theoretical attitude which manifests itself in the genre and language they employ. Metzl and Hansen publish this article in the academic journal titled “Social Science and Medicine”, targeting their research towards a scholarly audience interested in theory. In addition, their use of matter of fact and generalized language to describe overall conditions of “food deserts” and “zoning laws, economics, schools, and courts,” furthers this abstract tone of the article as opposed to inclusion of personal narratives (Metzl and Hansen 127). It pairs this objective language with action-oriented and encouraging language such as “our call for structural competency” (132) and “clinical training must shift its gaze” (127) in order to motivate the reader to apply this theoretical approach to medical education. Unfortunately, I think these literary devices detract from the personal implications of a structural competency approach, creating a detached feeling in the reader. I believe that the literary devices employed by Villarosa more effectively portray the important purpose and core meaning of structural competency through how she interweaves personal narratives with statistics. Since Villarosa is working within the genre of a popular news article, she has the advantage of using photographs, hyperlinks, dialogue, and block quotes to communicate more clearly the core principles of structural competency and its urgent need. Metzl and Hansen’s journal article explicitly state the core principles of structural competency and the need for it to be put into practice. On the other hand, Villarosa conveys the same idea but uses more subtle and implicit techniques that elicit emotion from the reader, communicating the idea of structural competency in a more impactful manner. Villarosa uses Landrum’s story to embody the social and economic structural difficulties addressed in Metzel and Hansen’s article. And uses Giwa to exemplify the positive effects of a structural competency approach in action because she was aware of the structural barriers faced by Landrum yet managed to navigate them and make the birth of Landrum’s fourth child a better experience. Ultimately, I believe that focusing on a specific situation that embodies structural competency, as Villarosa did, is a more effective communication method as opposed to exploring the theoretical framework of a concept as Metzl and Hansen did.

 

Works Cited

Metzl, Jonathan M, and Helena Hansen. “Structural Competency: Theorizing a New Medical Engagement with Stigma and Inequality.” Social Science & Medicine, vol. 103, 2013, pp.126–133.

Villarosa, Linda. “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis.” The New York Times, The New York Times, 11 Apr. 2018, www.nytimes.com/2018/04/11/magazine/black-mothers-babies-death-maternal-mortality.html.

Nancy Mairs Strength

Katie Welsh
Anth 272

Many of the strongest people we see today experience many tragedies. This is clear in Nancy Mair’s story “On Being a Cripple.” Mair’s character is consistently empowering, yet the way she expresses her experience being a “cripple” is obviously frustrating for her. In this reading response I will discuss the complexity and strength of Nancy’s character.
At the beginning of the story Mair’s clearly tell the audience that is self aware when she discusses falling in a bathroom stall. She tells the audience that she couldn’t help but laugh at herself after falling and struggling to get up because she is crippled. Yet, begins to explain that she would not have been able to laugh at herself had she not been alone. This is an example of Mair’s complexity and strength.
Mair is complex because she realizes that her mishap is unfortunate and frustrating. Yet, she is also has enough self-awareness to not take herself so seriously. On top of not being in denial and she identifies a key issues with how society perceives disability and in her article she discusses how societies response (even though it is kind) can end up being limiting and frustrating for someone who is disabled.
At the beginning of her story she says “One may also loses one’s sense of humor. That’s the easiest to lose and the hardest to survive without.” This quote show the strength and empowerment of Mairs character. She is identifying that being crippled is not easy, and there are many things that she may not get to experience again, but she also realizes that life is short and there are many beautiful wonderful things that she still gets to experience. Therefor her sense of humor is a mechanism of strength (when used appropriately).
In this article I have argued the complexities and strengths of Nancy Mair’s character by using her example of falling in a bathroom stall and her ability to laugh at the situation.

Gentle Chaos

Nancy Maris’ self-determined narrative on MS, identifying as crippled, and living with an incurable disease lives outside of Aurther Frank’s trinary of illness narratives. There are certainly parts of each that one could pull from her story. She has her Salt Path moments, resolving to travel through the desert and California state parks, on a quest to experience life before she is no longer able. A doctor presented with Nancy Maris’ story about her life with MS could argue that her’s is a chaos narrative. Her description of periods of grief and depression, falling down, dropping cans, losing her vision and mobility, her contemplation of death and incurable disease reflect on chaos. But Maris argues that the chaos narrative is about a doctor’s fragility, not hers, “whose disease in its intransigence defeats their aims and mocks their skills.” Maris writes, “I have always tried to be gentle with my doctors, who often have more at stake in terms of ego than I do. I may be frustrated, maddened, depressed by the incurability of my disease, but I am not diminished by it, and they are.” The assertion Maris makes here is so powerful. She’s arguing that, on the contrary, doctors who seek to cure and eradicate are the ones who feel defeated in the face of illness, death, and incurability. That contradiction is reflected in her diction. The suffering, the banal, the grief that Maris describes here and throughout her story is juxtaposed by the word she chooses to describe her approach to doctors: “gentle.” An MS diagnosis does not change Maris’ will to live or her perception of herself as a whole person. She is not diminished. Doctors who subscribe to the idea that disabled or sick body is broken, or see “death as the ultimate evil” see Maris’ narrative as one of chaos and defeat. But she refuses that. The way she talks about being gentle with them, instead of the other way around is perfect irony. It’s amazing, it’s hilarious, it’s truthful, it’s dark. And it’s her own.

“On Being a Cripple” – Mairs Reading Response

Nancy Mairs, in “On Being a Cripple” writes in a complexly optimistic tone about her diagnosis, MS, while retaining a framework of realism. She expresses her preference from the get-go: to be called a “cripple” instead of any other politically correct semantic iteration. Her reasoning is as follows; “And I refuse to participate in the degeneration of the language to the extent that I deny that I have lost anything in the course of this calamitous disease; I refuse to pretend that the only differences between you and me are the various ordinary ones that distinguish any one person from another.” In this explanation, one begins to grasp one of the most important parts of living with chronic disease, being the inability and refusal to erase experiences. Mairs is unapologetically acknowledging her losses, and the weight of those losses.

Her autobiographical essay elegantly, though not-so-delicately, expresses the changes of body, mind, and lifestyle that all accompany a chronic disease; these include an inability to see friends on outings, play piano, dress herself for style instead of comfort, and other. The lack of subtlety in language about the symptoms and pain of MS work towards acceptance and even appreciation of the diagnosis at times. To me, it was striking how she was able to so honestly discuss the losses she has endured, and it seems important to recognize one’s past in order to appreciate her present and disregard the future. While she has lost the ability to do many things, she has also gained good, bad, and different. It feels almost like Frank’s chaos narrative, in which she recognizes all the sides of her symptoms and lifestyle without trying to return to her life before. She writes beautifully about the appreciation she has for new activities in her life that fulfill her, including humor and gentleness towards others. She also discusses the intense pressure to please and self-consciousness that partners itself with her diagnosis. And lastly, she notes the ways in which she can still enjoy herself in activities that perhaps are just slightly different now; she still loves to cook even though she makes a mess, and she can play bridge with her friends but has to lay the cards on the table and trust that others won’t peek.

I truly believe that her outlook on life is beautiful and poetic. She finds the light in small things, while acknowledging that it is okay for things to be dark sometimes too. It is with this complexity that she expresses a truly unique and inspiring account of living with an equally complex diagnosis.

Kleinman Chapter 1 Reading Response

Emma Kikerkov

Julio Villa-Palomino

ANTH 272

January 26, 2020

Kleinman’s reading is interesting because it delineates between three concepts that are practically interchangeable in our society.

Kleinman defines illness as “the lived experience of monitoring bodily processes…”, meaning that it is how a disease influences with the way that someone interacts with the world. Examples of subjective lived experiences of illness include not being able to get homework done because of excruciating headaches or having “distracting low back pain while we sit at work” (Kleinman 4). It is imperative to make the distinction between “sickness”, which is how society influences a disorder, from “disease”, which is the empirical diagnosis to why the body is in a state of distress, and illness because all of these three terms defines the universal experience of being unwell. However, the way our biomedical system is set up, we focus on curing the disease, even though that may not stop someone’s suffering (Kleinman 6). Kleinman refers to another problem in our biomedical system, which he calls the “…materialist pursuit of the biological mechanism of disease…”, which is the emphasis on medical training and medical devices, as opposed to social and psychological aspects of medicine, therefore illness and sickness is not being addressed (Kleinman 9).  In addition, the way disease is defined, it assigns sole blame on one person, instead of addressing other factors that may be causing the disorder, such as socioeconomic status, race, etc.  In order to adequately treat someone, we need to focus on all three of these components

Citation

Kleinman, Arthur. “The Meaning of Symptoms and Disorders.” The Illness Narratives: Suffering, Healing, and the Human Condition, Basic Books Inc, 1988, pp. 3–30.