Health and the Rhetoric of Medicine

Conclusion: The Usefulness of a Rhetoric of Medicine

153 Conclusion Conclusion: The Usefulness of a Rhetoric of Medicine Each of the foregoing chapters has used a rhetorical principle as a means of probing something puzzling or problematic in health and medicine . Each chapter was meant to be useful in a variety of ways and for a variety of readers. A historian, for example, might be interested in a rhetorical account of recent medical history for what the principle of fitnessto -situation, kairos, suggests for a history of patienthood. A physician might be interested in a critical view of “compliance” for what the principle of trust in the speaker, rhetorical ethos, suggests for treatment adherence in clinical practice. These are sample pairings of disciplinary positions and chapter occupations. A case could be made for a philosopher and the topic of death, approached through the principle of preconditions for rhetoric—or for a health-policy analyst and the topic of public debate, approached through the principle of metaphor. We are, in any case, all of us, patients or were or will be, and we are the family members and friends of patients. We do not have to be sick to be patients, either : We are patients when we appear for cosmetic surgery, for example, and we are patients when, sometimes healthy as can be, we present ourselves for diagnostic or, increasingly, predictive tests. The analyses were purposeful individually, but one purpose of them collectively was to indicate some ways in which rhetorical theory can be mobilized to increase understanding in the realm of health and medicine. 154 Conclusion While there is no single way that rhetorical criticism does its work (as my introduction sought to explain), a “principled” approach has, I hope, shown itself to be productive. Three tasks remain in conclusion: to indicate , retrospectively, the scope of the usefulness of rhetorical criticism in health and medicine; to suggest some further research questions for the rhetorical critic working among other disciplinary and interdisciplinary scholars; and to say something in general about rhetoric as a strategy for studying and for living with complexity. Rhetoric is useful as a means of studying health and medicine as a discourse-in-use. Consider the complex tropology of hospital life, of treatments “withheld” and “withdrawn” and “refused,” of people said to be in “vegetative states,” a phrase that evokes nothing so much as cauliflower or broccoli. We converse in this discourse and are persuaded by it into some things and out of others. The discourse, too, captures us; there is a way in which it is sexy, because it is a language of power. But “withdrawing ” treatments can offend by seeming a little mean-spirited; “pulling the plug” makes death sound like it happens at an electrical outlet. Rhetorical study helps us attend to what language does. Rhetoric is useful as a means of studying health and medicine as a public discourse, remarkable for its ubiquity and its increasing daring. Following closely the life course of baby boomers, the public was interested in birth control in the 1960s, then pregnancy and childbirth in the 1970s; now we are interested in menopause, sexual dysfunction, eldercare —and death. We care about the quality of our deaths and, perhaps reluctantly, about euthanasia and assisted suicide, not least as alternatives to the high cost of end-stage health care. While differences in laws concerning death options in different jurisdictions threaten to create an industry in death tourism (suggesting the possibility of Club Dead1 and other last resorts), one thing we know is that how we frame death talk now will be important to how we actually die later, just as how we framed birth control gave us an inescapable politics of pregnancy. Rhetoric is useful as a means of studying health and medicine as a commercial discourse. I have logged over the course of these chapters cases of health and medical advertising for products from eighteenth-century amulets and nineteenth-century nostrums to twentieth-century “designer drugs” and twenty-first century body-scan packages, and I have cited many authors and critics who have applied themselves to the study of these products and their marketing. Roy Porter (Health), for example, gives us an account of quackery; Barbara Mintzes (“For and Against”) holds direct -to-consumer advertising responsible in part for “medicalising normal 155 Conclusion human experience” (908). As chapter 6 suggests, health is a business is an idea of enormous scope, including more than what is essentially...