PHD, Kent State University, 2014, College of Arts and Sciences / Department of English

The following study investigates a basic premise that the manner in which a doctor responds to a patient's emotions and thoughts affects the way a patient feels about telling more of his/her illness experience. This dissertation investigates how a doctor and his patients conceptualize addiction, use language to express his/her conceptualization, and respond to each other in the context of their conversational illness narrative. I conducted a case study at a methadone clinic in the Midwest. My participants were a random selection of twenty patients and their doctor. After signing a release, I audio-recorded one conversation per patient with their doctor and immediately following transcribed their discourse. Using George Lakoff and Mark Johnson's Conceptual Metaphor Theory (CMT), I analyzed the conceptual metaphors within these conversations. I found that patient's predominant structural metaphor is addiction is illness experience, and the doctor's predominant structural metaphor is addiction is disease. Additionally, my study conceptualized each conversation as a single narrative through which addiction is socially constructed by the doctor's and patient's rhetorical patterns of response to the other's structural metaphor. Each responds with utterances that I code as particular attributive metaphors, and these expressions give rise to the concept disease and/or illness, in accordance with CMT. Of these attributive metaphors, patients have the most utterances of thought and emotion, and the doctor has the most utterances on the body. This provides linguistic evidence to demonstrate that the doctor's focus is diagnostic, in that he wishes to explain the functions of the body and find a way to control the body, and patients' focuses are on expressing their illness experiences, their thoughts and their emotions related to the painful experience of addiction. Taken together, the doctor's and patients' responses within their conversational illness narratives produces resi (open full item for complete abstract)

Committee: Sara Newman (Advisor) Subjects: Cognitive Psychology; Communication; Health Care; Language; Medicine

Doctor of Philosophy, The Ohio State University, 2024, English

This dissertation project is focused on a narrative medicine approach to the comics written during the pre-vaccine period of COVID-19. By analyzing these texts from a narratological perspective, informed also by various approaches in comics studies, its aim is to identify the affordances of the comic medium in order to understand its efficacy when artists choose to utilize it. The selected narratives range from fictional narratives, autobiographical accounts from “frontline workers” at the height of the pandemic, and comics utilizing reportage and informative style of writing. The goal for this project is to learn as much from the selected stories as possible in order to identify its applications towards COVID-19 and pandemic discourse, potentially contributing insight into surviving a pandemic.

Committee: James Phelan Dr. (Committee Chair); Julia Hawkins (Committee Member); Frederick Luis Aldama Dr. (Committee Member); Jared Gardner Dr. (Committee Co-Chair) Subjects: American Literature; Medical Ethics

Doctor of Philosophy, Case Western Reserve University, 0, English

In this dissertation, I consider a range of texts from the nineteenth century including novels, personal essays, and diaries in which authors attempt to narrate experiences of illness in light of the shifting cultural perceptions of how the physical body and the concept of “self” relate to each other. The Diary of Alice James, Robert Louis Stevenson's “Ordered South,” Harriet Martineau's Life in the Sick-Room, and Henry James's The Wings of the Dove are the main texts analyzed. In each of these examples, I examine the ways that authors compose texts to understand the self alongside the “nerves and fibres” of bodily lived experience. Of primary interest to this dissertation is considering how the texts I examine can be fruitfully analyzed when concepts gleaned from the realm of medical humanities are applied to illness stories. This is a necessary intervention because much of the recent work in the broader field of medical humanities seeks to present illness narratives as artifacts of patient experiences that can be approached as acts of testimony or as evidence of therapeutic exercises. The primary concept that I rely on throughout my dissertation is the “corporeal gap” taken from the work of one of the founders of the practice of Narrative Medicine, Dr. Rita Charon. I use this concept as my way of accounting for some of the ways the texts I examine invent approaches to the difficult work of talking about how sickness disrupts the relationship between bodies and selves. The “corporeal gap,” functions as both feature and analytical tool throughout my dissertation. Primarily, I use the corporeal gap as an interpretive tool that allows me to attend to the various ways the texts I examine deal with the interruptive and disruptive experience of illness.

Committee: Kimberly Emmons (Committee Chair); Erin Lamb (Committee Member); Athena Vrettos (Committee Member); Kurt Koenigsberger (Committee Member) Subjects: British and Irish Literature; Literature; Rhetoric

Doctor of Philosophy, The Ohio State University, 2023, English

Interaction between patients and healthcare clinicians comprise a central aspect of American medical practice. This feature of medicine—patient-clinician communication—has received attention from various fields of study that aim to improve communication between these parties. One oft-cited aspect of this communication is the imbalance in authority that favors clinicians over patients; policies such as patient-centered care and shared decision-making have been advocated for as ways to balance these relationships. This dissertation takes up this asymmetry and identifies the ways in which patients and clinicians negotiate their authority in the course of interaction. Bringing together diverse data sets, Constructing Empowerment: Epistemic and Deontic Authority in Patient-Centered Care Interactions delineates ways that patients and clinicians negotiate authority while working to achieve patient-centered care. The data sets range from recordings between actual patients and their primary care clinicians to focus groups gathered with practicing physicians, current policy documents, and a fictional medical drama. Each chapter identifies key linguistic features that play a role in the negotiation of authority that patients and clinicians are engaged in as a part of medical practice. Starting with an extended analysis of one interaction between a patient and clinician, subsequent chapters expand the context to include the ways that institutional and cultural constraints shape and are shaped by these interactions. Chapter one demonstrates the role discourse markers and imperatives play to manage competing territories of knowledge and create empowering positions. Chapter two focuses on the ways that issues regarding health insurance emerge in the course of patient-clinician interaction; here, health insurance itself is seen to provide an additional set of assumptions that lie outside of traditional notions of what patients and clinicians are expected to know and functions t (open full item for complete abstract)

Committee: Gabriella Modan (Advisor); Seuli Bose Brill (Committee Member); James Phelan (Committee Member); Amy Shuman (Committee Member) Subjects: Health; Health Care; Language

Master of Arts, Miami University, 2022, English

This thesis explores the epistemic injustices Hmong Americans have suffered within Western medicine in the late twentieth and early twenty-first century. In contrast to medical and academic discourses, which blame “cross-cultural differences” as the cause for these health disparities, I contend Western medicine and society dismiss Hmong individuals' knowledge and experiences, which is particularly damaging to them as survivors of genocide, forced migration, and racial oppression. In the early twenty-first century, American hospitals attempted to improve their treatment of Hmong patients by designing “cross-cultural” trainings for shamans and physicians. Although these trainings aspired to welcome shamans into hospitals, they were not an example of cross-cultural exchange and instead prioritized Western practices, ignoring the curative value of shaman rituals. I analyze memoirs, ethnographies, and research materials from the Hmong Archives in St. Paul, Minnesota, to consider how shaman performances and behaviors redress epistemic injustices by acknowledging Hmong suffering, remembering communal losses, and resisting the scriptocentric expectations of Western medicine. With this interdisciplinary project, I investigate the synergies and tensions between Hmong literature, performance studies, and the medical humanities. My primary aim is to speak beside Hmong Americans and recognize how their practices provide a crucial method for countering medical inequality.

Committee: Katie Johnson Dr. (Committee Chair); Cynthia Klestinec Dr. (Committee Member); Andrew Hebard Dr. (Committee Member) Subjects: American Literature; Asian Literature; Health Care; Medical Ethics; Performing Arts; South Asian Studies

BA, Oberlin College, 2022, English

This thesis examines the intersections among gothic literature, empire, and contagion, and traces the emergence and evolution of a yet unexplored subgenre: the Imperial Gothic. Where early American Gothic narratives express anxieties about national stability and the republican subject, the Imperial Gothic explores anxieties that emerge when imperialism brings white Americans into contact with foreign commodities, environments, and bodies, ranging from foreign nationals, immigrants, and enslaved peoples, to Martians. It demonstrates how viral threats to the body correspond to the nationalist conception of foreign threats against the imagined white body politic. What emerges from this body of global and interplanetary literature is an “epidemiology of American imperialism.” While dark passageways, imprisoned heroines, and duplicitous patriarchal villains are staples of the classic Gothic genre, several additional tropes recur in the Imperial Gothic: trade and capitalism gone wrong, uncertain, or blurred identities, unknown deadly illnesses that spread through spatial contact zones, and the failure of both biological and national defense mechanisms. I explore these tropes through seven primary sources with publication dates ranging from 1799 to 2018. These works include: Charles Brockden Brown's Arthur Mervyn (1799), Herman Melville's Redburn (1849), Frances Harper's Iola Leroy (1892), Katherine Porter's Pale Horse, Pale Rider (1939), Ray Bradbury's The Martian Chronicles (1950), Michael Crichton's The Andromeda Strain (1969), and Ling Ma's Severance (2018).

Committee: Danielle C. Skeehan (Advisor) Subjects: American Literature; Epidemiology; Literature

Doctor of Philosophy, Case Western Reserve University, 2022, Musicology

Many of today's vocal techniques and ideas about vocality originate at the turn of the previous century. Over the course of the nineteenth century, science and aesthetics, theory and practice, the medical and the musical came together. Arthur Chervin exemplifies the nineteenth-century impulse toward blending theory and practice in his journal La Voix Parlee et Chantee, published from 1890 through the end of 1903 in Paris. From 1848 onward, doctors and medical practitioners in France began to infiltrate many aspects of politics, social life, and art. As an acknowledged expert in stuttering and a state-appointed physician and the Paris Opera, Chervin was well positioned to facilitate a multi-disciplinary publication that merged medical perspectives with those of performers and pedagogues. His journal is unique in its interdisciplinarity and its wide-ranging arguments about vocal health and aesthetics. A close reading of La Voix enables an exploration of the many sociological, cultural, and artistic implications of voice, health, and pathology in 1890s France. In the early chapters of this dissertation, I show how physicians' interventions into the bodies of ailing singers both constricted the timbres available for expressive singing and contributed to the idea that vocal anatomy determines vocal sound. And, moving beyond the physical, I investigate the relationship between mental interiority (sanity, trustworthiness, identity, etc.) and vocality, showing that contributors to La Voix believed they could evaluate an individual's innermost feelings by listening to the sound of their voice. Later chapters examine pedagogies designed to shape children's voices, and finally an exploration of timbral practices in three distinct groups of voice users—amateur choristers, professional orators, and singers/actors. Throughout, I synthesize contents from La Voix and other period sources, as well as from contemporary scholarship on vocality, contemplating how fin-de-siecle vocal (open full item for complete abstract)

Committee: Francesca Brittan (Advisor); David Rothenberg (Committee Member); Peter Bennett (Committee Member); Andrea Rager (Committee Member) Subjects: Medicine; Music

PhD, University of Cincinnati, 2021, Arts and Sciences: English

This dissertation uses methodologies and frameworks from disability studies, literary theory, sociology and medical historians to argue that representations of facial difference across several genres of texts hinder the social acceptance of facial differences and influence how we respond to them, as well as expectations about reconstructive surgeries. Each chapter analyzes the specific narratives and portrayals of surgeries and facial difference most common for each genre, and how the format of the genre influences these portrayals. By working through these various representations and their specific nuances and narratives, this dissertation aims to suggest a better way forward for how we think of facial differences culturally and socially.

Committee: Jennifer Glaser Ph.D. (Committee Chair); Lora Arduser M.F.A. (Committee Member); Julia Carlson Ph.D. (Committee Member) Subjects: Literature

Doctor of Philosophy, The Ohio State University, 2019, French and Italian

At the crossroads of French Studies, Visual Studies, and Queer theory, my dissertation seeks to confront notions of risk and responsibility to argue that society's perceptions of risk have changed in relation to a pre-AIDS world and the onset of AIDS and that contemporary treatments such as PrEP (Pre-Exposure Prophylaxis) continue to refine our definition of risk. While much recent scholarship has been written about AIDS in the 1980s and 1990s, I would like to address contemporary AIDS narratives that respond to advances in medication and a shift in our understanding of AIDS from a death sentence, to a chronic disease, and now to a preventable illness. In order to explore how gay men's relationship with risk has been articulated in artistic production and has evolved with the availability of PrEP in France, my dissertation confronts cultural production throughout the epidemic. Film and literature analysis of Herve Guibert's work establishes a relationship between taking risks with one's health and the feelings of shame often felt in the early days of the epidemic, while a critical look at Cyril Collard's Les Nuits fauves in tandem with public health campaigns demonstrate how beauty is manipulated in times of epidemic. Engaging with Erik Remes's allows for further nuancing of the question of responsibility, and suggest that the epidemic resulted in a vilification of behavior that was not only deemed risky, but also irresponsible. Finally, I explore contemporary notions of risk through a study of prevention campaigns, film, newspaper articles, and interviews. The HIV/AIDS narrative in contemporary France is one that is marked by new modes of communication, the creation of a digital queer space, and a revisiting of the trauma of AIDS. The first three chapters are in the tradition of medical humanities and film studies approach, and the fourth chapter requires a shift methodology to one that emphasizes cultural studies and oral testimonies, necessitating onsite rese (open full item for complete abstract)

Committee: Lucille Toth (Advisor); Margaret Flinn (Advisor); Dana Renga (Committee Member) Subjects: Film Studies; Foreign Language; Gender; Gender Studies; Health; Modern Literature; Public Health

Doctor of Philosophy, The Ohio State University, 2015, Germanic Languages and Literatures

The end of the nineteenth century marked the slow shift from home births towards an increased hospitalization of birthing, which became a firmly established practice in twentieth-century German-speaking countries. In this project, I analyze and contextualize representations of birthing, birthing assistants, and the medicalization of the female body in the late nineteenth and early twentieth centuries in Helene Boehlau's Halbtier! (1899), Ilse Frapan's Arbeit (1903), and Gabriele Reuter's Das Traenenhaus (1908). Boehlau, Frapan, and Reuter wrote their novels at the cusp of a new approach to birthing, and their protagonists grapple with the transition from giving birth at home with minimal medical intervention to viewing birth as a pathological condition that requires support from medical personnel. By bringing together theoretical discourses on the body and on medicalization, I examine what effect the restructuring of birthing assistance, and later the development of the medical specialty of obstetrics, had on women in the late nineteenth and early twentieth centuries, and how women perceived these changed birthing conditions. I argue that each of these literary works challenges the medical history narratives that have portrayed medical advances in obstetrics as a positive change for women across the world. Rather, these works take up questions of female agency and the human cost resulting from medical advancements. I identify the three authors' preoccupation with unwed mothers' birthing experiences and the socio-economic and moral factors that influence their patient care and access to health care as a crucial commonality between the works examined. The project begins with a historical overview of the medicalization of birthing in German-speaking countries and of the changing discourses about the female procreative body from the 1750s onwards. The subsequent three literature chapters focus on the portrayal of women's perceptions of the birthing experience, the loc (open full item for complete abstract)

Committee: Barbara Becker-Cantarino PhD (Committee Co-Chair); Katra Byram PhD (Committee Co-Chair); Anna Grotans PhD (Committee Member) Subjects: Germanic Literature

Master of Arts, Miami University, 2013, Theatre

This thesis uses practice-based research to explore possible interventions into the traumatic impact of illness upon breast cancer survivors' voices and the role of neoliberal pink ribbon culture in compounding their silencing. The interdisciplinary research pulls from the fields of applied theatre, critical pedagogy, materialist feminism, narrative analysis, social movement theory, medical sociology, and dialogue, disability and performance studies. Reflecting upon process and praxis relating to a regional tour of Susan Miller's My Left Breast as a means to engage a community of survivors, advocates and the general public, this thesis asks: Can a community-based theatre event focused on exploring breast cancer counternarratives provide both a therapeutic space for survivors to tell their stories as well as encourage the audience to think more critically about how culture works to influence narratives emerging from breast cancer culture?

Committee: Ann Elizabeth Armstrong (Advisor); Paul Jackson (Committee Member); Ann Fuehrer (Committee Member) Subjects: Fine Arts; Medical Ethics; Pedagogy; Performing Arts; Theater; Theater Studies; Womens Studies

Doctor of Philosophy, The Ohio State University, 2008, English

This dissertation explores different discursive spaces (memoirs, online magazines, local art galleries) in which women and men narrate their recoveries from various mental disorders. I argue that these narratives, and the discursive spaces in which they are told, are rhetorically strategic, and ultimately allow the authors agency within a broader climate of surveillance, oppression, and stigmatization. These writings resist, transgress, and at times, (re)construct the medical model of recovery and sociocultural expectations of people, particularly women, with disorders. Their narratives also complicate our current understandings of writing spaces, especially those coupled with the power of digital technology. Memoirs and online discursive spaces mark a shift in the voices of women with mental disorders, from persons oppressed by their illness, doctors, and society at large, to women challenging the medical model of mental illness, and ultimately creating their own models of recovery. These recovery narratives engage the medical model in interesting ways, such as by resisting it from within, as with those medical practitioners diagnosed with mental disorders themselves (Jamison, Slater) who write about their experiences in very public spaces (memoirs). Other narratives are seemingly compliant with conventional modes of treatment prescribed by the medical model, such as the Fresh A.I.R. Gallery artists who exhibit their works in a space funded by a comprehensive mental healthcare organization. Still others construct their own models of recovery by navigating through contradictory medical information (Reader's Digest) and voicing their opinions against medical authority in online spaces. I call upon Adrienne Rich's notions of revision and recovery as the theoretical framework I employ throughout my dissertation project. My project seeks to open a dialogue between rhetoric, feminisms, and disability studies so that an enabling theory of mental health discourse will emer (open full item for complete abstract)

Committee: Brenda Jo Brueggemann Professor (Advisor); Nancy J. Johnson Professor (Committee Co-Chair); Cynthia L. Selfe Professor (Committee Member) Subjects: Health Care; Literature; Mental Health; Psychology; Public Health; Rhetoric; Social Research; Womens Studies