The Absent Breast: Speaking of the Mastectomied Body

Manderson, Lenore; Stirling, Lesley

doi:10.1177/0959353507072913

Cited by 96 publications

(32 citation statements)

References 50 publications

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“…One aspect of the language of actual cancer patients which has received attention is the choice of lexical items used to refer to the disease, the afflicted part, and to the disease site post-surgery (for discussions of these issues in relation to breast cancer see Langellier and Sullivan (1998); Manderson and Stirling (2007)). …”

Section: Responding To Emotionally-charged Wordsmentioning

confidence: 99%

Oral communication skills of international medical graduates: Assessing empathy in discourse

Cordella¹,

Musgrave²

2010

Communication & Medicine

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We examine a dataset consisting of 11 International Medical Graduates (IMGs) performing an Objective Structured Clinical Examination (OSCE). Our aim is to address questions about the linguistic realization of empathy in the clinical discourse of IMGs and the extent to which OSCE examiners are sensitive to relevant features of the discourse. We analyse three aspects of the dataset as manifestations of empathy: sequential organization to provide reassurance; responsiveness to the simulated patient's lexical choices for emotionally charged words; and the organization of turn-taking in the interaction. Our analysis suggests that in each of these areas it is possible to identify discourse strategies which realize empathy. These strategies are used by IMGs who are good communicators and not used by poor communicators. Our evidence suggests that of the features we examine, the most salient for the examiner is a greater than normal occurrence of transition pauses. We argue that it is only in the area of the organization of conversation that the problems displayed by some IMGs are due to differences in cultural background, and it is therefore significant that the feature we identify as salient comes from this area.Keywords: empathy; discourse analysis; reassurance; division of work; International Medical Graduate (IMG); OSCE BackgroundAustralia, like many other Western countries (Birrell 1996;Birrell and Hawthorne 2004), relies heavily on international medical graduates (IMGs) to provide medical care to its growing population (Han and Humphreys 2006). These IMGs bring to Australian medical institutions a considerable diversity in their background training, clinical skills, understanding of the health system and communication skills (McGrath 2004;Whelan 2006). IMGs' professional knowledge, lay-cultural knowledge, socio-cultural assumptions, institutional norms and values, and personal experiences are all in full display in medical events (Sarangi and Roberts 1999;Roberts and Sarangi 2002;Candlin and Candlin 2003;Roberts et al. 2003Roberts et al. , 2004. A lack of commonality in the participants' inferences and contextual cues may affect the interpretative schema and therefore the comprehension of speech (Gumperz 1971(Gumperz , 1982(Gumperz , 1999 between IMGs and their patients, potentially causing miscommunication in medical visits. Such communication difficulties can have a negative effect on patients' satisfaction in the consultation. 1 This paper addresses some of the communication difficulties that IMGs face during medical consultations by examining how diverse discourse features were used by IMGs to articulate an empathic stance during an OSCE (objective structured clinical examination) and the extent to which the assessor's rating seems to be sensitive to these discourse features. The data we consider here was taken from a training session for IMGs preparing for the actual Australian Medical Council examination. In this case a medical practitioner played the role of the patient. The OSCE scenario assess...

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Section: Responding To Emotionally-charged Wordsmentioning

confidence: 99%

Oral communication skills of international medical graduates: Assessing empathy in discourse

Cordella¹,

Musgrave²

2010

Communication & Medicine

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“…A mastectomy scar, similar to other amputation scars, thus produces both physical change and physical loss. It is rather common for women who have undergone mastectomy to use the word ''scar'' to refer to both the visible scar tissue and the absent breast (Manderson and Stirling 2007). In my analysis I will address both aspects by exploring what it means to grow familiar with physical change and physical loss.…”

Section: Introductionmentioning

confidence: 99%

Is It Possible to “Incorporate” a Scar? Revisiting a Basic Concept in Phenomenology

Slatman

2016

Hum Stud

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Although scars never disappear completely, in time most people will basically get used to them. In this paper I explore what it means to habituate to scars against the background of the phenomenological concept of incorporation. In phenomenology (Husserl, Merleau-Ponty) the body as Leib or corps vécu (lived body) functions as a transcendental condition for world disclosure. Because of this transcendental reasoning, phenomenology prioritizes a form of embodied subjectivity that is virtually dis-embodied. Endowing meaning to one's world through getting engaged in actions and projects is most successful indeed when one's body is ''absent,'' ''transparent,'' or, at least, if it is not in the center of one's attention. This taken-for-granted nature can be disturbed by discomfort, disability, and disfigurement. Incorporation, so I explain, aims at maintaining or restoring the body's taken-for-grantedness. My analysis of the case of a woman who successfully habituated to her mastectomy scar demonstrates, however, that habituation to a perceptible scar can only be understood partly in terms of incorporation. Next to a decrease of explicit attention for the scar and the discomfort it produces (i.e., incorporation), the scar should also stop being a sign that refers to something else than itself. This is only possible, I argue, by taking the body's materiality seriously, rather than it being wiped out as a result of transcendental reasoning.

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“…I pay particular attention to how these might illuminate inter-corporeality that encompasses the "specificity and particularity" which Grosz notes "remains obscured" in much of Deleuze and Guattari's work and its subsequent application by other authors (Grosz, 1994, p. 182). I also draw together the post-constructionist work of Lam (2015) and the early and more recent writings of Haraway (1987Haraway ( , 2015, discussing this as well as contributions by Manderson (2011;Manderson & Stirling, 2007;Warren & Manderson, 2013) and Shapiro (2015).…”

Section: Conclusion: Comprehending Bodiesmentioning

confidence: 99%

“…As noted above in the review of literature in Chapter 1, Manderson's anthropological analyses of illness and disability focus on people's (re)conceptualising of their bodies following radical changes to physicality -for example, mastectomy (Manderson & Stirling, 2007) -and how bodies which challenge prevailing norms might be (re)contextualised (Manderson, 2011;Warren & Manderson, 2013). Manderson's work with amputees and their uses of and perspectives on prosthetics also contributes to exploration of the technologically-mediated aspects of body practices.…”

Section: Corporeality: Prosthetic Mediated and Misfittingmentioning

confidence: 99%

“…Additionally, Manderson's anthropological analyses of illness, disability, and bodily lack discuss the (re)conceptualising of bodies following radical changes to physicality (through mastectomy, for example (Manderson & Stirling, 2007)) and the contextualising of bodies which challenge prevailing norms (Manderson, 2011;Warren & Manderson, 2013). Manderson's work also contributes to my exploration of the technologically-mediated aspects of milk sharing, such as the disconnection of breastmilk from the donor/recipient body via breast pump, and the potential for use of various vessels including at-breast supplementing systems reminiscent of prosthetic devices.…”

Section: Shared Bodies: Milk Sharing As a Response To Insufficiencymentioning

confidence: 99%

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Becoming-(breastfeeding-)woman: women’s body practices and experiences at the intersection of breastfeeding, milk insufficiency, and milk sharing

Smith¹

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The breastfeeding body is a site of complex, contested, and conspicuously moralised practices that has long been a focus for research in the social sciences through to the arts and humanities. Often too the maternal, lactating body is situated within a biomedical frame that marks the milk-producing body as problematic, failing, and subject to and object of expert knowledges. In this frame, women who identify as producing "not enough milk" to feed their babies have been a significant focus.Despite this extensive attention, however, there is little research that has explored women's experiences of and body practices enacted in relation to continued breastfeeding alongside ongoing milk insufficiency, nor the act of milk sharing as a specific response to this bodily insufficiency.In this thesis, I describe and discuss my research with 13 women who have faced difficulties in breastfeeding based on a shared experience of 'chronic milk insufficiency'. I also focus on the act of milk sharing as one response to this insufficiency. Through analysis and discussion of in-depth interviews and observation, I explore how women enact and experience body practices at the intersection of breastfeeding, milk insufficiency, and milk sharing.My critical exploration of breastfeeding, milk insufficiency, and milk sharing as interrelated body practices and modes of meaning-making is informed by, and also informs, the use of a conceptual frame developed through articulation with corporeal and post-constructionist feminism, and ideas from Deleuze and Guattari's work such as deterritorialisation, complex assemblages, flows, desire, and (inter)corporeality. I employ this rhizomatic, cyborg conceptual frame to analyse women's body practices with reference to a number of Deleuzo-Guattarian thematic strands including expectations and beginnings, incorporation and avoidance, the fragmenting body and complex assemblages, creative corporeality and body extension, and becoming-(breastfeeding-)woman.In situating embodied knowledge relative to creative body practices, and highlighting the spaces between bodies and the tension between normative and resistive body practices, I disarticulate and reterritorialise a range of ideas about maternal, lactating bodies. Taken together, these support the conceptualisation of continued breastfeeding in the context of ongoing insufficient milk as a creative, resistant (inter)corporeal act. I further discuss this creative (inter)corporeality in terms of its pragmatic and conceptual implications for anthropologists and social scientists more broadly, as well as for health professionals and others working with pregnant and breastfeeding women.ii Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis.

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The Absent Breast: Speaking of the Mastectomied Body

Cited by 96 publications

References 50 publications

Oral communication skills of international medical graduates: Assessing empathy in discourse

Oral communication skills of international medical graduates: Assessing empathy in discourse

Is It Possible to “Incorporate” a Scar? Revisiting a Basic Concept in Phenomenology

Becoming-(breastfeeding-)woman: women’s body practices and experiences at the intersection of breastfeeding, milk insufficiency, and milk sharing

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