Medical Communication a la Burke
Edappel8 at cs.com
Wed Jun 5 12:10:44 EST 2002
You may recall, or wish you hadn't, a series of rants I posted on this topic
several months ago. I focused my Burke-laden recommendations for
communicative improvement in the clinical setting on the problem of obesity,
one of the most easily diagnosed maladies a physician encounters, or a
"patient" suffers from. I built my case especially around the putative need
for a "full dialectic" in the exchange between doctor and client, namely, due
consideration to be given to agent, act, purpose, means, attitude, and scene
in their fullness. In respect to recalcitrant "scene" (or counteragent: it
depends on how you're making use of the fluid hexad), I said the "patient"
(read: agent) needs to act "in response to and against 'enemies,'
resistances, and odds (or risks) that serve as possibly dire scene,
situation, or context for the salutary actions that are recommended,
potential conditions of illness or injury that threaten to result and damage
one's life in specific ways, if the recommended regimen of correctives is not
The need for such a dialectical enjoinment in weight control--or
confrontation with a mortal "enemy," personal or impersonal, that functions
as a threat to one's physical well-being-- was underscored in a fine program
on CNN a month ago. It was called "Fat Chance" (Saturday, May 4, 2002,
8:00-9:00 P. M.). The weight guru on the show offered seven tips for
successful weight management which I won't bore you with now. What I found
most pertinent was the fact that the woman, Karen, and man, Robert, featured
as exemplary masters of their avoirdupois, were each in constant and
conscious battle with a specific "enemy" and set of odds. They "feared"
specific illnesses that they were "at risk" of contracting--if they did not
literally "shape up." For Karen, heart disease was endemic in her family.
She was fighting against potential heart failure, stroke, or some such fatal
or debilitating illness. I forget what Robert's particular bete noir was,
but he had one, also.
In weight control, medical and health issues in general, in life, "find your
enemy" and name it "correctly" and in detail. Not a human "vessel" to be
victimized and scapegoated, but rather, comedy-wise, menacing scenic
circumstances that "hold cards" that could trump your best "play," if you are
not careful. Goffman is more thorough than Burke in analyzing the risk
aspect of drama. Even Burke, though, did name HIS enemy at the conclusion of
"Hitler's 'Battle,'" implying the desperate stakes involved in ignoring this
German maniac. "Struggle," Burke says in that chapter in ATH Kastely alluded
to, is of the essence of human life and activity. Induce creative,
programmatic, and successful struggle, discover fullness of "motive," by
finding that dangerous "opponent" against which you must act to give you the
best odds in your endeavors you can possibly have.
In our seminar on ecocriticism in New Orleans, Bob Wess pointed out the human
need for "fear" of specific and deleterious consequences, if environmental
disaster is to be circumvented. "Fear" implies enjoinment, or potential
enjoinment, or inducement toward enjoinment, with a threatening scenic
"enemy" of some kind. The ecocritical problem is that today's polluters will
be long gone before the ecocataclysm occurs.
Such a postponement of the day of reckoning cannot be counted on by
individual persons in respect to their own physical health. They need to
seek, find, and elaborate a full dialectic: Now.
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