Discrediting

Again, we see a rhetorician who doesn’t really want to be a rhetorician vilifying someone before to advance the “true” purposes or virtues of rhetoric. This time it’s Ramus. But honestly, Plato pulled a similar move. Ramus sets forth his purpose by saying, “We shall distinguish the art of rhetoric from other arts, and make it a single one of the liberal arts, not a confused mixture of all arts; we shall separate its true properties, remove weak and useless subtleties, and point out the things that are missing” (Bissell & Herzberg, p. 563). I'm just wondering when those who claim to know what rhetoric is are going to be presenting it in a way that acknowledges that the subject of rhetoric, or any subject for that matter, is what we define it to be. And this is not simply an individualistic pursuit; it has to be agreed upon in a social manner for it to be recognized, at least by a certain group, as the definition of the field that defines what is included and excluded. In the statement above from Ramus, he seems to imply universal laws surrounding what rhetoric “really” is. The claim of truth pervades many subjects. In fact it almost seems that to advance some concept, developers and authors have to claim such clarity (as opposed to simply pointing out a falsehood or discrepancy). Yet reading back on such claims of truth is almost laughable. In Bissell and Herzberg’s Renaissance Rhetoric Introduction, Descartes is quoted saying, “One can talk of persuasion whenever there is ground for further doubt. One can talk of science however only when there is an unshakable ground” (Bissell & Herzberg, p. 477). I'm not saying that this is intentional deceit. But, oh, how much we have learned about the importance of context and social constructivism.

Here's a little story to get our minds thinking about the importance of social acceptance of terms, language, and communication. Many times when we think of science, we think of the quantitative aspect (i.e. number of milligrams of X in the blood). But it is the communication of both quantitative and qualitative aspects of science that build a social understanding in smaller circles and in larger communities. I hope this story spurs some brainstorming about what virtues are most important to various people, how terms gain their solidity and social meaning, and why absolutes are easy to conjecture but difficult to defend.

Story of miscommunication and bad blood

There was a patient who'd been seeing her primary care physician for a few years now. I'll give her the name Rosie. She was going into the office to get some work done. All seem to be okay except for her long-standing heart disease and hypertension.

One day Rosie was experiencing shortness of breath so acutely that it alarmed her enough to go straight to the emergency room. Upon admittance to the hospital, the team of doctors determined that Rosie was in cardiac distress. As the doctors worked up a plan for Rosie, someone from medical team to blood cultures in an attempt to rule out endocardititis and other heart value issues. Upon analysis of the cultures, a doctor noted a common culture growth that grows on skin. A resident, practicing full disclosure, said to Rosie, “Oh, one of your blood cultures grew out this bacteria; but don't worry, it was contaminated.”

After Rosie's experience in the emergency room and subsequently a room in the hospital, she went to see her primary care physician. Arriving agitated, Rosie burst into a demand as soon as the physician entered the room. Rosie exclaimed that she wanted to know precisely what her medical records had regarding her blood. Because of Rosie's irritation, the physician was confused. This started a long series of questions and answers in an attempt to understand the demand. But Rosie wasn't interested in answering any questions for the position. She simply wanted the blood related information to be read to her. The primary care doctor still attempted to initiate further understanding of Rosie's big concern. After many conversations, and they traced the concern back to the resident’s comment.

Rosie didn't know the precise wording that came from the resident, but from the talking and tracing, the physician was able to determine that what Rosie thought had been conveyed to her was that she had syphilis. Rosie didn't actually know the term syphilis; instead, she used the common jargon of the South: “bad blood”. In Mississippi, where Rosie was originally from, bad blood was synonymous with tainted blood or with contaminated blood. When the resident use the term contaminated, it triggered an immediate connotation for Rosie that meant she was infected with syphilis. While not thought about logically in this manner, her thinking ultimately went like this: contaminated blood means that my blood is bad because it has been tainted, and tainted blood is bad blood which is that disease with rashes and open sores [syphilis] that you get from being loose [promiscuous].

The euphemism “bad blood” was how Rosie continued to refer to what she thought was on her medical record. Rosie told the doctor, “I love my husband. I was a faithful wife. Now I'm widow, but I am still a churchgoin’ woman and I fear God. How do you think this record shows on me?” She insisted that the information had to be removed from her record. The physician tried to explain to Rosie the meaning of the word contaminated in this context, and that it had actually been determined that the person taking the blood had contaminated it. And so, the doctor continued, the contamination really had nothing to do with Rosie at all. But this made matters worse. Rosie became convinced that the person taking the blood had actually inserted a contaminated needle into her, ruining Rosie's blood.

Upon reflecting about this incident, the doctor noted it as “the biggest communication divide she had yet experienced”. The doctor felt that despite her [the doctor’s] research and subsequent connection between the euphemism and Rosie's understanding, the doctor and the patient were not speaking the same language. They did not have the same social understanding and acceptance with the term contaminated. The more the doctor tried to convince Rosie by means of the credibility of the hospital and the team of doctors, the credibility of the machines determining what is in the blood, the logical explanation and research that went into tracing the blood contamination, and Rosie's own fears and emotions involved with this trigger word, the more unmovable Rosie seemed to become.

This story is also a springboard for discussing doctor-patient rhetoric and communication in the scientific medical field.