Rhetoric of Health & Medicine
Vol. 3, No. 4, pp. iii–xiv
Continuing our Speculative Study in the Present: Critique as Provocation
J. Blake Scott, Lisa Melonçon and Cathryn Molloy
When we began drafting this issue introduction, extending from a previous introduction in which we committed “to do more and better in cultivating, sponsoring, publishing, and promoting scholarship that addresses racism and interlocking systems of oppression as public health (and/or other health or medical) issues,” we knew we wanted to continue to foster a space in which RHM scholars could ask new and newly exigent questions born out of the rupture of our current moment of swirling, interconnected crises, some longstanding and others novel.
To situate what we imagined as our “call” for a (self) critique of the present, we first turned to Bruno Latour’s (2004) reorientation of critique from “matters of fact” to “matters of concern,” as a way to understand our editorial commitments to hospitality, community-building, care, generosity, and other priorities articulated across our previous editors’ introductions. In his call for reimagining the purpose of critique, Latour (2004) contrasted matters of fact, focused on attacking, criticizing, exposing, and historicizing “beliefs, powers, and illusions” and the conditions that make them possible (pp. 245, 232), with matters of concern, focused on “a multifarious inquiry … to detect how many participants are gathered in a thing to make it exist and to maintain its existence” (pp. 245–246). Latour (2003) connected matters of fact to a predominant mode of critique that “lifts the rugs from under the feet of the naïve believers” (246).
“Although matters of fact are excellent for debunking,” Latour (2004) warned, they themselves can become “eaten up by the same debunking impetus” (p. 232). Karen Barad (2012) elaborated how this mode of critique has not been a productive practice but a destructive one “meant to dismiss, to turn aside, to put someone or something down.” To replace this version of critique, Barad explained, Latour drew on Alan Turing’s concept of “critical,” “where going critical refers to the notion of critical mass.” Latour (2004) recast the critic, in our case the rhetorician, as “one who assembles” and “one who offers the participants arenas in which to gather” (p. 246).
We were drawn to Latour’s reformulation for several reasons. First, it gave us another way to think about the journal and field as a sustainable and sustained dwelling place, or a gathering “of ideas, forces, players and arenas in which ‘things’ and issues, not facts, come to be and to persist, because they are supported, cared for, worried over” (Neil, 2017). And, like Latour, we value an inter- and multidisciplinary assembling, though with a strong rhetorical orientation. This value has guided the genres and forms supported by the journal. It has shaped our open and targeted calls for submissions (including in such underrepresented areas as racial inequities in healthcare), our special issues driven by the field’s reported interests, dialogues assembling an array of stakeholders around issues of concern, persuasion briefs aimed at connecting rhetorical scholarship to the research and practice of others, and the ethical exposure essays featured in this issue.
We also share an emphasis on co-constructing and caring for—as opposed to deconstructing and debunking—rhetorical scholarship, through supporting new enactments of this work (e.g., methodological experimentation, theory-building) and through the care we take in our modes of assembling, such as our review and other editorial processes or our attention to practice-level methodological tensions and responses. For us, as for Latour, attending to matters of concern entails a productive responsiveness to, rather than hermeneutics of suspicion toward (Ricœur, 1970), the phenomena we engage (in), guided by a humbler and more caring attunement to our roles in such phenomena. As Thomas Rickert argued, “rhetoric cannot precede its constitutive entanglement in worldly relation and iteration; rather, it is emergent from within such entanglements, being the incipient motivation within iteration” (Walsh et al., 2017, p. 453). Our critical practices, then, must be attuned and responsive to their entanglements.
Despite the usefulness of this Latourian concept for reinforcing key values of the journal, we became increasingly discomforted by the direction of our introduction as primarily engaging the “usual suspect” of a canonical white male theorist drawing on other white male theorists, including a racist one (Heidegger, whose idea of “gathering” Latour adapted). And we questioned why we were drawn to Latour in the first place. Sure, he has had an undeniable influence on the rhetoric of science, technology, health, and medicine, but are more familiar conceptual frameworks adequate for the current moment? This self-questioning also led us to question, though not completely give up on, the goal of creating a dwelling place. To what extent might the metaphor of dwelling reinforce a mostly community-affirming, community-reinforcing enterprise, and what are the limitations of this in a time of crisis and beyond? To what extent might dwelling privilege engagement and alignment over imagination? What other metaphors for assembling and collectively supporting, caring, and (re)imagining could we consider at the same time?
Instead of (only) a dwelling place, we see the need for a place of provocation, guided by an attunement to crisis. Alignment is important, not as re-affirmation but instead as taking ongoing matters of concern as points of departure. But we’ve come to view imagination—as an ongoing, self-provoking, and reinventing process—as even more important than alignment. In addition, instead of or alongside our field’s “nesting” in dwelling places like RHM, we might conceptualize our collective endeavor in alternatively sustaining terms of (re)assemblage and co-journeying, guided by emergent and new questions about what we are doing and becoming. In exploring these possibilities, we turned to two less familiar (at least to RHM) sources.
We turned to Chilean sociologist Rodrigo Codero (2017), whose book Crisis and Critique is informed by some canonical social theorists but, more importantly, by crises in the world and the critical practices of engaging it. In theorizing the potential interconnectedness of crisis and critique, Codero postulated that both are located in moments of rupture and fragility and that each can provoke the other. (We might liken this mutually influencing relationship to a notion of exigency that merges accommodation and creation models of the rhetorical situation.)
“Crisis provokes critique,” Codero (2017) explained, in that “critique appears as a subjective response to the contradictions and problems that the crisis situation reveals” (p. 2). In pointing to the importance of attunement to crisis, Codero wrote that “crisis is the moment where we are compelled to ask questions: where are we, what is going on, what went wrong, how can we get out of here?” (p. 1). It has been in this vein that a number of groups in and related to the field have raised questions and proposed actions around our roles and responsibilities in responding to ongoing crises of racial injustices in law enforcement and in pandemic conditions and responses. We were also thinking about the fragility around our relationships with more vulnerable stakeholders of our scholarship when we developed the idea for the ethical exposure essays.
Simultaneously and conversely, “critique provokes crisis” in that “crisis is produced by an active involvement of critique in opening up and challenging the conditions that sustain a conflictual and intolerable social reality” (Codero, 2017, p. 2). We see this as a productive crisis, to be sure. We also share Codero’s recognition of the “crisis of its [critique’s] own position as critique” (p. 2), and, consequently, the importance of throwing our critical practices into relief and asking what possibilities they enable and foreclose rather than fetishizing them (see Butler, 2001). This is why we strive to help scholars unpack the various dimensions and functions of their methodologies. This is why we hope the field will continue to ask critical questions about our modes of critique and the types of questions they ask, as well as our modes of assembling and corresponding forms of scholarship.
Codero (2017) pointed out that this mutual provocation is not automatic, as crisis can lead to responses of meanings and actions that reinforce the status quo, and as critique can disconnect itself, sometimes by turning inward, from the exigencies brought by crisis (p. 2). We have to work actively to remain attuned to the possibilities of the crisis-critique relationship, to foster the issues, questions, methodologies, alliances, modes of assembling, and other forms of engagement that can help us provoke and be provoked.
A second source we engaged to rethink and to expand our goals is The Undercommons by Stefano Harney and Fred Moton (2013), which offers additional ways to be skeptical of critique but still engage in it, albeit differently, in part by suspending our impulse to solve, correct, or normalize. Harney and Moton called the alternative critical practice they advocate the “study,” which Jack Halberstam, in the foreword, described as moving away from an antagonistic stance of being for or against and instead learning “how to be with and for, in coalition, and on the way to the place we are already making” (Harney & Moton, 2013, p. 11). Instead of taking a removed stance, Halberstam explained, the “study” entails engaging in the present with others with the recognition that “you are always already in the thing that you call for and that calls you” (Harney & Moton, 2013, p. 7). As Moton described it in an interview in chapter seven of the book, “study is what you do with other people … held under the name of speculative practice. The notion of a rehearsal—being in a kind of workshop, playing in a band, in a jam session, or old men sitting on a porch, or people working together in a factory—there are these various modes of activity. The point of calling it ‘study’ is to mark that the incessant and irreversible intellectuality of these activities is already present” (Harney & Moton, 2013, p. 110). Like others, we think of the biennial RHM Symposium as an un-conference that enables this type of engagement, through the working paper groups and discussion hubs at the symposium itself, and also through providing a site to (re)activate ongoing networks for supporting our work-in-progress. Indeed, when at the recent 2020 symposium Lisa posed the question about how to organizationally sustain RHM work going forward, one of the consensus responses was that, whatever mechanisms we use or create to engage one another, we should take good care to ensure that they can continue to support the informal, in-progress, improvisational, and inclusive qualities of our coming and journeying together.
For us, one takeaway from Harney and Moton’s (2013) notion of “study” is that our modes of coming together and engaging one another and other stakeholders of our scholarly practices are the best places to locate critique as a “speculative” (that is, questioning, pondering, curious) practice—that we can, in part, locate threads of the futures we want to build together in the present. This is why the special issues sponsored by the journal have come out of what scholars in the field are already interested and engaged in, what we are already building through our collective activities. This is why our submission development work is so closely tied to the RHM Symposium and other forums for supporting and learning from a wide range of scholars’ work-in-progress. For another, more specific example of being in the study, we could turn to John Lynch’s (2020) questioning of the value of an RHM-specific ethics statement. In response to Raquel Baldwinson’s (2018) well-reasoned call for such a statement, Lynch argued that the best guide for and enactment of our ethics is our scholarly practices themselves: “One can see our ethics on display in our work, and the value of those rhetorical insights will make it clear why we deserve a place at the interdisciplinary table” (p. 256).
We see another, related connection between Lynch’s (2020) argument and that of Harney and Moton (2013): a resistance to overly prescribing our speculative practices. Harney and Moton discussed this through their distinction between “policy” work and “planning” work. Often promoted by our institutions, policy entails “correction, forcing itself with mechanical violence upon the incorrect, the uncorrected, the ones who do not know to seek their own correction” (p. 78). Harney and Moton likened it to “thinking for others” (p. 112) and also described it as a “disposition toward display” (p. 80). We can see this in the field’s resistance to a “call to order” that closes off our future possibilities, through the journal, an organization, or other fora (Harney & Moton, 2013, p. 126). We can also see it in ongoing concerns about organizational/ institutional statements about racial injustice that aren’t connected to already underway activities. In contrast, planning resists prescription (for others and self) and entails not only acts of engagement but the “the ceaseless experiment with the futurial presence of the forms of life that make such activities possible” (p. 75). Again, we are already experimenting with our futures. In place of the typical metaphor of a critical toolbox, Harney and Moton propose that of the toybox as a way to capture the play and experimentation of planning together. Toys are the “props” for our reimagining, as in hitting a ball with a sword or playing music with a bat—“if you pick them up you can move into some new thinking and into a new set of relations, a new way of being together, thinking together” (p. 106). We like this metaphor, as it recasts criticism as enjoyable rather than vexed and immobilizing, emphasizes the importance of activities and relations over mechanisms, and encourages a careful but inventive play with methodology (including theory building).
In another section of the book, Moton described the work of the undercommons as “an improvisation that proceeds from somewhere on the other side of an unasked question” (Harney & Moton, 2013, p. 96). Thus, while we are actively experimenting with our future forms and identities, we are not working from a prescription of what these should be, and we have already begun to answer questions about them before they are asked. For us, avoiding prescription is not the same as avoiding or abandoning judgment—as the latter is inherent to rhetorical practice. The shift away from prescription and from matters of fact does mean, however, a practice of playful expansiveness and an emphasis on “generating more ideas than we have received” (Latour, 2004, p. 248). The community-building practices of engagement and imagination may well be more important than that of alignment. As we read them, even calls by fellow rhetoricians of science, health, and medicine for post-critique have not required abandoning judgment but instead have focused on its generative possibilities. In arguing that topologies “adhere to post-critical ideals,” Lynda Walsh and Casey Boyle (2017) also emphasized that they are concerned with generating heuristics for alternative political dynamics” (p. 10). In her argument for reading “the rhetorics of choice surrounding BRCA risk productively,” Kelly Pender (2018) still critiqued the “habitual grooves” that limit the ways her stakeholders engage with and are engaged by risk (p. 141). Thus, post-critique can still utilize judgment, particularly of the present activities and the “futurial forms of life” they make possible—as vehicles for imagination (Harney & Moton, 2013, p. 75).
As we are moving through the process of bringing in new stewards for the journal, symposium, and other mechanisms for assembling, we remain grateful for our many co-stewards and companions—from our editorial team and board to the various submitters and authors to those active in Flux and other forums to the various other stakeholders who we follow and engage—for inventing, caring for, and sustaining our “dwelling journey” of RHM. And we’re counting on all of us to continue (re)imagining RHM by asking new questions but also by recognizing in our ongoing, improvisational practices ways “we can get out of here” (Codero, 2016, p. 1) from “somewhere on the other side of an unasked question” (Harney & Moton, 2013, p. 96). Critique and crisis can provoke each other in productive ways, and this moment of rupture and fragility highlights, perhaps, how such provocation is generating, and will continue to generate, the speculative forms of study and identities that will continue to be RHM.
Overview of the Issue
The set of articles and dialogue in this issue illustrate aspects of our observations above, including the mutual provocation of crisis and critique (particularly if we conceptualize critique in terms of methodology more broadly) and the speculative practice of planning work.
The lead article of this issue, by Kim Hensley Owens, locates a practice of distributed agency in the cascading rhetorical responses to a rape accusation and their effects on the survivor and related network of social justice activists. Importantly, Hensley Owens’ study of these events was improvisational, a shift in her original study (requiring a new, retrospective IRB approval) based on her ethical attunement and changing sense of what was important to attend to. Her study came out of a question she didn’t initially ask or anticipate but that was nevertheless embedded in the discourses and people (especially the survivor) she engaged, and that was informed by her own positionality vis-à-vis this rhetorical ecology. In “tracing first the thwarting and later the amplification of Desirae’s [the survivor’s] rhetorical agency after the rape accusation,” Hensley Owens identifies a sense of “distributed feminist rhetorical agency” grounded in rhetorical listening. This agentive practice, she argues, can enable a “rhetorical resilience” for survivors and guide “continuing public health education about what sexual assault is and how its survivors’ stories can be empathetically and trustingly received by friends, mentors, police, and communities.”
The second piece in this issue is a dialogue, coordinated and led by Lisa DeTora. The dialogue’s six medical journal editors and publications professionals, along with a philosopher who spoke at their national meeting, respond to DeTora’s questions on authority and authorship in biomedical research—a topic for RHM researchers as both a matter of concern and matter of practice. Although its topic might not seem readily relatable to the topic of speculative practice, this dialogue highlights a collective stance by the participants that thoroughly locates authorship and authority in “scientific practice” and knowledge-making. Putting RHM researchers in conversation with observations by experts from the allied field of biomedical publishing, the dialogue offers new (to many of us) meanings of authorship, understandings of boundaries between fields, and considerations for our own field-specific practices.
We also want to call our readers’ attention to a new book review of Robin E. Jensen’s Infertility: Tracing the History of a Transformative Term, written by Megan Donelson and published online on the journal’s companion open access site [LINK TO FOLLOW]. Donelson’s helpful review includes a discussion of the book’s connection to other recent interdisciplinary RHM histories of medicalization and women’s healthcare.
SPECIAL SECTION ON ETHICS
This issue also includes something that we hope will become a regular feature: a special section with shorter essays that build on critical threads or matters of concern of ongoing RHM work. For our debut special section, the essays discuss ethical conundrums encountered in practice-level enactments of methodologies. The essays extend Baldwinson’s (2018) and Lynch’s (2020) published arguments about the need for an RHM-specific statement of ethics. The “ethical exposure” essays both point to the potential usefulness of ethical principles to guide researchers through uncharted methodological territory but also to the idea that our ethical principles are best revealed through their enactments in scholarly decision-making, and that these write-ups of research-in-practice offer us a kind of unfolding guide (or at least parts of one).
Opening the special section is Melissa Carrion’s discussion of lessons learned in her research with mothers who have refused vaccines. Carrion describes unanticipated challenges that she experienced during her mixed-methods project, and she brings to the forefront the need for RHM to continue its reflective stance about ethical considerations that arise during the practice of research. Carrion’s reflective positionality on recruitment techniques in online environments offers RHM some specific ways to address ethical issues in and around recruitment. One of the strengths of Carrion’s entry lies in her including excerpts from her research journal. These first-person accounts reflect her experiences at the moment of the ethical challenge during research and enable her to pivot to explaining important lessons learned for other RHM scholars.
In her ethical exposure essay, Amy R. Reed takes up the issue of conflicting researcher obligations to different stakeholders when engaging participants who are medical professionals. Based on her research involving communication around a Down syndrome (DS) prenatal diagnosis, Reed located sometimes diverging interests (all of which could be important) and inequitable power dynamics among obstetricians and genetic counselors, more constrained parent advocates in the DS community, and more vulnerable patients. This divergence and power differential presented her with conflicting obligations to the different stakeholders of her research, particularly given that patients receiving such a diagnosis have reported being given inadequate information and pressured by a clinician to terminate. In addition to offering RHM scholars several important ethical considerations, Reed argues that “we need to reconsider how human research subject protections are offered to medical professionals.”
Next, Sommer Marie Sterud engages the under-considered (in RHM) conundrum of oppositional research, that is research involving participants and groups whose work the scholar ethically or morally opposes. Sterud couches her observations in her ethnographic study of a pro-life organization, as a pro-choice scholar disturbed by the increasing legislative abortion restrictions and waning access for which her participants advocate. She argues that an ethics of care made possible through rhetorical listening should “not be reserved for the vulnerable and agreeable alone,” also illustrating through concrete examples how she enacted this with her participants in a way that provided space to reflexively examine struggles with data collection and analysis and that ultimately “yielded a common outcome”.
Finally, in their essay, Kristin Marie Bivens and Candace Welhausen explore a different type of ethical concern related to data access. Through the lens of their content analysis of consumer reviews of PulsePoint Respond—a crowdsourced, emergency response app that connects people experiencing sudden cardiac arrest with nearby responders—Bivens and Wellhausen consider the issues around the app users’ expected privacy and confidentiality in relation to the benefits of making data (even if redacted) from one’s research available to other researchers. Making available databanks of derived, complied, and/or designed data, they argue, should entail additional efforts to ensure informed consent and ethical “custodianship.”
Changing of the Guard
From the beginning of this endeavor of RHM, we (Lisa and Blake) have remained committed to the goal of handing off the journal’s editorship to a new set of stewards after five years or so. Because of Lisa’s new responsibilities as department chair in summer 2020, we had to accelerate this process a bit, inviting Cathryn Molloy to join us as a co-editor. In addition to being a dazzling scholar of RHM and especially mental health rhetoric research, Cathryn was already a proven member of our editorial team, having led the journal’s assistant editors for the past four years, as well as co-editing a special issue of the journal (vol. 3, no. 2).
With Lisa still on board and overseeing the completion of documentation of the journal’s various processes, Cathryn has quickly learned the ropes as editor, gradually taking on more and more of Lisa’s duties and the day-to-day oversight of the journal’s management. After Lisa fully transitions to a new role as consulting editor emeritus, Blake will continue as co-editor through the summer of 2021 while a committee of the editorial board searches in the fall and early spring for a second co-editor to join Cathryn. Through this timeline, we have created staggered terms for the two co-editor positions, ensuring continuity of stewardship and working knowledge during each five-year transitional period going forward.
We also have another transition in fall 2020. Carolyn Gubala, a PhD student at the University of South Florida, has been the primary copy editor of the journal since our second issue. Leveraging her past workplace experience as an editor, she has worked steadfastly and capably in ensuring our editorial style, but she has also been instrumental in creating RHM’s internal style guide, as well as documenting many of the journal’s processes. The latter made it possible to train Cathryn on the managing editor duties so quickly! We want to extend our gratitude and heartfelt thanks to Carolyn for her eagle editorial eye, good humor, and hard work. She played a vital role in the development and success of RHM, and we wish her all the best for the next steps her academic career.
References
Baldwinson, Raquel. (2018). Ethics for rhetoric, the rhetoric of ethics, and rhetorical ethics in health and medicine. Rhetoric of Health & Medicine, 1(3–4), 213–238.
Barad, Karen. (2012). “Matter feels, converses, suffers, desires, yearns and remembers”: Interview with Karen Barad. In Rick Dolphijn & Iris van der Tuin (Eds.), New materialism: Interviews & cartographies (pp. 48–70). Open Humanities Press.
Butler, Judith. (2001, May). What is critique? An essay on Foucault’s virtue. Transversal Texts. https://transversal.at/transversal/0806/butler/en#_ftn1
Codero, Rodrigo. (2017). Crisis and critique: On the fragile foundations of a social life. Routledge.
Harney, Stefano, & Moton, Fred. (2013). The undercommons: Fugitive planning and black study. Minor Compositions.
Latour, Bruno. (2004). Why has critique run out of steam? From matters of fact to matters of concern. Critical Inquiry, 30 (Winter), 225–248.
Lynch, John A. (2020). The ethics of rhetoric is the rhetoric of ethics: Refusing the call to codification. Rhetoric of Health & Medicine, 3(3), 249–257.
Neil, Jonathan T. D. (2017, March 17). When facts become concerns. ArtReview. https://artreview.com/ar-march-2017-pov-jonathan-td-neil-when-facts-become-concerns/
Pender, Kelly. (2018). Being at genetic risk: Toward a rhetoric of care. Pennsylvania State University Press.
Ricœur, Paul (1970). Freud and philosophy: An essay on interpretation. Yale University Press.
Walsh, Lynda, & Boyle, Casey. From intervention to invention: Introducing topological techniques. In Lynda Walsh & Casey Boyle (Eds.), Topologies as techniques for a post-critical rhetoric (pp. 1–16). Palgrave Macmillan.
Walsh, Lynda, Rivers, Nathaniel A., Rice, Jenny, Gries, Laurie E., Bay, Jennifer L., Rickert, Thomas, & Miller, Carolyn R. (2017) Forum: Bruno Latour on rhetoric. Rhetoric Society Quarterly, 47(5), 403–462.