Medical Communication a la Burke Edappel8 at
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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