Unfitting Stories: Narrative Approaches to Disease, Disability, and Trauma

Interdisciplinarity and Postdisciplinarity in Health Research in Canada

Many scholars have turned their attention to the definition of interdisciplinary studies, and to the advantages of interdisciplinary and multidisciplinary approaches to complex questions over strictly disciplinary ones.1 However, feelings of ambivalence towards interdisciplinarity pose a special problem for health and medicine; even more than those that beset interdisciplinary studies in general. The word “interdisciplinarity” itself is a god-term in health research theory, and research administrators lavishly praise the idea of interdisciplinary health research. Yet, for often understandable reasons, the medical establishment still seems to like monodisciplinary , essentially biomedical research best. In Canada, talk about interdisciplinary health research came to the fore especially during events leading up to the creation of the Canadian Institutes of Health Research in 2000. The purpose of the cihr was to shift the Canadian research agenda away from more narrowly defined medical research, and in the direction of broader-based health research. cihr’s mandate was not only to take over biomedical and clinical research, supported to that point by the Medical Research Council, but also to fund health systems and services research, and populations and public health research—including research in the social sciences and humanities. Quite suddenly, Canadian researchers and research administrators were asking what counts as health research, who does it, and how it is done.2 cihr marked its fifth anniversary in 2005, and it continues to operate, in principle, on the idea that interdisciplinary work, including the work of social scientists and humanists, is essential to improving the health of Canadians.3 Central to the ideology of the cihr is the notion that health problems are human problems, requiring study by more than traditional 11 judy z. segal Interdisciplinarity and Postdisciplinarity in Health Research in Canada medical means. Pain may be a medical matter, for example, but suffering is a personal, and social, one. Death may frequently occur in hospitals, but dying is, first, a human experience. Medical researchers may study pathology, but humanists and social scientists illuminate the nature and meaning of pathology in everyday life. Even so, the cihr was born into a research culture that made it very hard to know how to support truly interdisciplinary health research—beyond, say, the collaboration of a microbiologist , an epidemiologist, and a biostatistician. I will argue here that interdisciplinary research (which I will reconfigure in part as postdisciplinary research) is difficult, but absolutely necessary to effect changes in matters of health. My discussion is in four parts. In the first, I explain what interdisciplinarity is, from the point of view of someone who has never been disciplinary. In the second, I enumerate some of the practical problems of doing interdisciplinary research. The third section suggests the contours of postdisciplinarity in health research, and the fourth focuses on narrative as a means of doing postdisciplinary health studies. What Interdisciplinarity Is A couple of years ago, I was invited to participate in a workshop at my university on science envy. The organizers were trying to understand why social scientists seek to emulate the methods and postures of scientists, humanists try to emulate social scientists, and other scientists try to emulate physicists. Personally, however, I was, and still am, coming to terms with the realization that for the past fifteen years, as a rhetorical theorist of health and medicine, I have been experiencing discipline envy. Most of my colleagues in the English Department approach interdisciplinary work, if they do approach it, from secure places in the discipline ; they are like contented singles ready to speed-date at scholarly gatherings. I come from a branch of English studies, however, that was not quite disciplinary to begin with. For one thing, rhetoric is always rhetoric of something (politics, advertising, science), so it always works in interstices. Also, studies in persuasion are almost always at least historical, cultural, and literary at the same time: in other words, interdisciplinary. My own situation has taught me that disciplinary studies have certain structural and institutional advantages over interdisciplinary ones. Multidisciplinary studies are relatively straightforward, and are what many people mean when they talk about interdisciplinarity. In multidisciplinary research, disciplinary specialists work together. Complex health 12 narrative frames research on pain and suffering, for example, may require the cooperation of physicians, nurses, psychologists, historians, anthropologists, philosophers , and others, each ideally possessing some understanding of each other’s approaches. In such a case, the researchers are disciplinary, while their project is multidisciplinary. A multidisciplinary treatment team in...