Metagnosis and Narrative Medicine w/Danielle Spencer

 
 

Episode description

In this episode, Élaina interviews Danielle Spencer, the author of “Metagnosis: Revelatory Narratives of Health and Identity”. Danielle explains what she means by “narrative medicine” and what the COVID-19 pandemic and the genre of physician memoirs can tell us about what still needs to happen before we can achieve more holistic healthcare.

You can reach Danielle and find her work on her website: https://www.daniellespencer.com/

You can read my review of “Metagnosis” here: https://drive.google.com/file/d/1DtWQScs-arO8Hd3T8BNVDpxFFEHgNjh4/view?usp=sharing

Texts mentioned in the episode (All links are affiliated to Bookshop.org UK and any purchases made through them will generate a small commission that helps to support the podcast):

Metagnosis: Revelatory Narratives of Health and Identity, by Danielle Spencer

Phenomenology of Illness, by Havi Carel

Recognitions, by Terence Cave

The Cancer Journals, by Audre Lorde

The Undying: A Meditation on Modern Illness, by Anne Boyer

Illness as Metaphor, by Sunsan Sontag


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Read the full episode transcripts at www.elainagauthiermamaril.com

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Follow Élaina on Twitter @ElainaGMamaril

Transcript

Élaina Gauthier-Mamaril 0:15

Hello and welcome to Philosophy Casting Call, the podcast that features underrepresented philosophical talent. My name is Élaina Gauthier-Mamaril, your host and producer. Today, it is my great pleasure to share the conversation I had with Danielle Spencer. I had the opportunity to review Danielle's book "Metagnosis: Revelatory Narratives of Health and Identity" for the International Journal of Feminist Approaches to Bioethics, and it absolutely blew me away. Not only did it speak to my philosopher soul, it also made me seriously reflect and think about my own research methodologies. So you can maybe see a link between last episode in this episode: we keep talking about methodologies. Anyway, I was thrilled when Danielle reached out to me and then agreed to come on the podcast. She really wanted this to be a bit more of a conversation, so I have a bit more of a speaking role in this episode, and I do hope you enjoy our exchange. Without further ado, here is my interview with Danielle Spencer.

Hello, Danielle, thank you for being here.

Danielle Spencer 1:32

It's my pleasure.

Élaina Gauthier-Mamaril 1:33

Would you like to introduce yourself to the listeners?

Danielle Spencer 1:35

Yes, I'm Danielle Spencer, I am the director of the narrative medicine, Master of Science programme at Columbia University in New York. And my most recent book is called "Metagnosis: Revelatory Narratives of Health and Identity". And prior to my work in narrative medicine, I was the art director for the musician and artist, David Byrne for many years.

Élaina Gauthier-Mamaril 2:00

And I first encountered your work because I was asked to review your book "Metagnosis" for the International Journal of Feminist Approaches to Bioethics. And I was really struck by how you used your methodology as part of your argument. So you were really not only talking about narrative medicine, but using that as a methodology, as you were explaining good. So could you tell us what is Narrative Medicine?

Danielle Spencer 2:29

Absolutely. Narrative Medicine was founded as a clinical methodology in which the clinician is trained in the skills of narrative interpretation. So, a physician say receiving a person's account of illness or injury is attentive, not simply to the data that they can extract from this account, but also to all the elements of the story, such as "Where does it begin? How is it told all the elements of literary analysis?", and that's still very much part of the field and the field has also broadened to become a transdisciplinary field of inquiry. That's part of the health humanities asking questions about how the humanities, literature, philosophy, and so forth, and healthcare can be in dialogue with one another, and thus help one another truly. So it's interesting in that sense, because it's, you know, started as a clinical methodology, and now it's expanded quite a bit. And so people in the field are there are a lot of clinicians and clinicians and training and also people who are trained in and working in other other disciplines, such as philosophy, literature, gender studies, creative writing, and that reflects my background as well. I'm not a clinician myself.

Élaina Gauthier-Mamaril 3:45

So it's a very interdisciplinary discipline at its core, it's basically created on the premise of transdisciplinarity.

Danielle Spencer 3:54

Exactly, yeah.

Élaina Gauthier-Mamaril 3:55

How did you come into this work? If you're not a clinician, and you've worked with a musician before? I'm curious what your trajectory has been?

Danielle Spencer 4:05

Yeah, no, that's a natural... It's a good question. I think that there's a through line in the sense that I was always drawn to doing interdisciplinary work and also hopping back and forth between academia and different types of work. So the art world and then the music industry, and David Byrne is a is a known as a musician. He's also a visual artist, and a writer and a curator, and many, many other things. And working with him was really exhilarating and generic boundaries were not respected. And then his work in a way that was that was really exciting. And so that is a through line between that chapter of my professional life and what I'm doing now, although it certainly was a very big change. And I think at the time, I wouldn't have really been able to answer this question satisfactorily. I knew I had a very deep interest in medical culture and medicine. Although I didn't really know why, I would just devour nonfiction work memoirs written by clinicians and other works about health and healthcare. I was really struck by the fact that there's such a, in the US, it seems that there's such a deep cultural and linguistic and epistemic divide between people who work in healthcare and people who don't, which struck me as odd and unfortunate, because it should pertain to all of us. And I was drawn to it with the feeling that will, perhaps it would be beneficial if there are people who can learn a bit of both languages and helped try to speak across this divide. And I think it was, I was lucky, because at the time that I entered the field, it's been a time of tremendous growth and exploration for the health humanities in general. So that there are a number of people who are in a similarly Incoloy way drawn to this intersection and want to come to it and see what tools they can bring to it to try to help facilitate more dialogue and more nuanced understanding. I also had a health experience of my own, that I talked about in my book, and I think that that informed my my stance as well, that you know, that's common in the field to people who've had some kind of experience, either for themselves personally, or somebody in their life, say they're, you know, carrying dealing with chronic illness or something like that, and maybe haven't metabolised it and they're looking for for some way to do so.

Élaina Gauthier-Mamaril 6:24

And that leads me to ask you how you define your, the role of interdisciplinarity, in your practice, that would maybe be a focus on, as you say, a lot of us kind of come into humanities or arts surrounding the medicines because of various experiences we have. And at least in my work, part of that is kind of how do I manage my personal investment? Or like when you're working on something that is meaningful to you on multiple levels, including on a personal level? And when you know, you're very frank about your own experience in your book, and you really weave that into the argument? I'm curious, how do you know how do you manage that? Just kind of how does that work into your practice your scholarship?

Danielle Spencer 7:15

Yeah, that's such a good question. I and I have to say that I there's so many other people who have very much more courageously brought their own personal lived experience into their professional work. And in times and in contexts where it wasn't as widely done. So I looked to them, people who were addressing issues of in particular race and gender ability and disability. And there are other figures in writing in the health humanities, or philosophers, writing about illness or phenomenology of illness who've who've done this. Havi Carel is coming to mind, she's a really astounding thinker and writer, and she wrote about phenomenology and her own illness experience in a way that she was wearing both hats, and which really begs the question of why should they be different hats. So I felt, I think, because other people had done it, I felt accountable for how could I defend myself if I didn't do it? In a way, I actually really did not want to speak publicly about my own healthcare journey, if you will. It's not really in my nature. I mean, I'm just, you know, a private person, as many of us are, and but to me, I think it would have been dishonest not to talk about it. Because the my interest in this topic of metagnosis, which is the revelation of a long standing, undetected condition, did come about largely because of my own experience with it. And so it was also very useful to use my own story as the starting point. And then to take off from there, what do you think, do you see many people doing this or what?

Élaina Gauthier-Mamaril 8:48

I see it in different spaces, I feel like people who are already taking risks in being you know, people of colour, or women of colour, like in academia will tend to do that, because it's, sometimes it comes from a feminist methodology as well. positionality. And of also recognising that the personal is political, all of that this kind of like how we cannot separate ourselves from the work in such a neat way, but it's still it's still challenging, and I myself, I'm working on eugenics right now. And it can be very challenging to work on that material when you have lived experience. And so that's something that I have to manage, in, I have my hat as a researcher and my hat as me and we can never separate them completely. But there are times where you have to be attuned to how you effectively react to engaging in the work.

Danielle Spencer 9:50

Yes. Well, and the way that you just phrased that, I want to connect that back actually to narrative medicine because in my brief exposition what I didn't say was one of the things that we do in the field of Narrative Medicine is we use the experience of reading, interpreting, often literary works in a small group setting in a workshop. And we don't have a particular interpretive methodology per se. I mean, it's largely hermeneutic. And it's influenced by several different fields of, you know, approaches to literary criticism and theory, but the effective response of the reader to the work absolutely has a place in the discussion, and this is enacting the role of emotion and experience, you know, in conversation with, you know, more quote, unquote, critical analysis or discourse. And part of the reason for that is, with this foundational methodology of Narrative Medicine is a lot of it is for clinicians. And so then they're, you know, take this experience back to the clinic. And part of the lesson is, well, guess what, you are actually yourself embodied and situated? How can you be aware of this in a way, right, because everything in their, in their formazione, you know, their education and training has been at least in in American medical education is to divorce them from that.

Élaina Gauthier-Mamaril 11:07

Absolutely. And that's something that I now that I'm in a position to teach future MDs, that's something I introduced to them, like, you know, you are also a person, and also means that sometimes, you're going to have to act in solidarity with your colleagues in order to change your workplace, like seeing yourself as a worker as well. And this idea that when I, in my previous research, look that shared decision making in a clinical setting, and my major argument was that we are trying to say that in order to make this exchange equal, we have to treat the patient as if they were a perfect rational agent. And but we're not paying attention to how affects inform how you receive information, how we share information, what information we believe is valuable and have has authority. And we're not paying attention to the fact that the doctor has affects as well. And so again, that's part of the thing of, you have to first recognise that you are a human and not just a vessel of biomedical information before you can have a kind of empowering relation with your patient.

Danielle Spencer 12:21

Oh, absolutely! Yeah, absolutely. And then the narrative focus of Narrative Medicine is a very efficient way of doing that, because it's like the engine or locomotive of the train, once you start talking about narrative, it pulls behind it, all of these other questions and considerations that should be unavoidable. Such as you know, who's doing the narrating who's doing the speaking, who's doing the receiving all these questions of narrative ethics and power then come into play. And it's kind of sneakiest, like a Trojan horse book, if you will, that once somebody, you make them, you know, like experience themselves as a reader, and as an interpreter, and as somebody who has ethical responsibility in that arena, then it comes back into the health care space. And those very questions are there, well, what agency do I have? Or could I have? What kind of responsibility do I have? And I'll say that, you know, this is a methodology that the goal is supposed to be to produce people who are more narratively equipped. And I would expand that not just to clinicians, but everybody, you know, there's a strong counter argument, which is to say, well, you know, a lot of the issues afflicting healthcare, you know, you know, at least, unfortunately in my country, you know, are political and economic economic. And so, is this all just a fig leaf? You know, it's all, you know, like, some kind of window dressing, and what we really need is, is deeper, systemic change? And I would say yes, and, I mean, I can't really dispute that critique, I think is valid. And also, how are we going to affect change? Well, one way is exactly as you're saying, you know, with your work in medical education is that if you put that little awareness, if somebody has that awareness, and they're working within the system, then perhaps that inspires them to think well, do we really just have to continue in the way that we have? Or can we be agents of change? And we've a lot of people will assume, right? I mean, like, that's, yeah, that's the ultimate.

Élaina Gauthier-Mamaril 14:17

It was wonderful to see them in real time their face change when they said out loud, so I can question what was put in my curriculum? Yeah, yeah. Yes. You were allowed to, you're encouraged to great. Yeah.

Danielle Spencer 14:29

Yeah. Subversive. Yes.

Élaina Gauthier-Mamaril 14:31

This is what why we educate.

Danielle Spencer 14:33

Yeah.

Élaina Gauthier-Mamaril 14:33

I had a question about... So metagnosis is, I think, a fascinating concept of kind of giving a new name or a new vocabulary or new framework to something that you've been living with or that's been part of your world. If we want to say like for a long time, but now we have a new way of approaching it. So it could be within a medical context, you get a diagnosis for something that I mean, I want to say symptoms, but in the case is some other are no symptoms, you just assume that, well, this is your reality and then someone else's like, by the way, it's deviant from this framework. So how I'm curious, how would you think about the, if we're thinking of a medical setting, like the physician side of the metagnosis? So if you're thinking about continuing treatment or offering treatment? Or if like accompanying this person through a metagnosis process, like what would that look like?

Danielle Spencer 15:34

Well, it's a good question. In the book, I don't really focus on that. But it's some perhaps that's why you asked! I think that the baseline narrative structure of diagnosis within healthcare is one which would simply say, "Oh, well, we didn't realise that you had ADHD are a visual field defect. And now we do." So the just practical questions are some treatment that could benefit you, right? In other words, the Sherlock Holmes mystery novel mystery, narrative structure is one in which there's some enigma, the diagnosis answers that enigma. And that's the end of the story, when it's a retrospective revelation of a long standing condition in which symptoms per se weren't recognised as such. And let me just pause here to say that this is distinct from the cases where somebody knows they have a problem, you know, like Megan O'Roorke, writing about her chronic illness and the invisible kingdom, recent title for many, many years and just isn't getting satisfactory diagnosis and treatment. These are cases where you might retrospectively realise that you had symptoms, but you're not aware, you're not seeking help for some kind of problem that you're aware of. So I would say that for the clinician, on the first, the first part, I would hope is that, you know, if they read my book, or listen to this podcast, or have thought about is that, that they could have some awareness that part of the help that they can offer to the person is to help them navigate the reception of this knowledge, and that it's very powerful, and that there isn't a clear map as to how it's supposed to be significant or insignificant and the medical narrative in which "Oh, now we know. And so this solves the enigma that wasn't even there before" is really unsatisfactory for somebody who wasn't even aware that they had a problem, per se. And so to enter into a partnership with them to say, Well, what's going to be the most helpful understanding of this for you and your life? You know, it could be ignoring it. And I did see that I, you know, with my own experience, I think some more enlightened physicians certainly had that, that perspective, which is to say, look, if you're functional, and this, this is your normal, then go forth and live your life, you know, don't percent rate on it, right. But it varies a lot, depending upon what the condition is. And I you know, I'm very careful not to generalise because different conditions have different stigmas attached to the diagnosis itself, and different possibilities for how you could then get treatment or accommodation. And so it's just gonna vary considerably.

Élaina Gauthier-Mamaril 18:09

Yeah, sometimes it will affect whether or not you can get insurance if you don't get it. Yeah. So yeah, it's complicated. But I noticed when I read your book, that you use a lot of different approaches, or you pull from many different scholarly cultures.

Danielle Spencer 18:26

That's a good way of putting it.

Élaina Gauthier-Mamaril 18:28

So what do you hope your reader will take away once they read your book?

Danielle Spencer 18:33

I mean, many things, I hope, but the meta, the meta lesson of metagnosis is about how what can be done when we're truly trying to bridge these different discourses, and that we can have revelations that we couldn't otherwise and to just try to empower people not to feel that they have to segment their own lived experience and knowledge and whatever discourses of knowledge they're a part of, and this is, I mean, this is a goal that's, that's shared by, you know, health humanities writ large. But yeah, to your earlier point about the work, I was very much trying to put into practice, you know, it's one thing to say, you know, it's really important to not be siloed. And it's another thing to really try to do it. And it's risky to because you're inevitably not going to really do full justice to Well, I mean, philosophy, you know, he, you know, that's, I do go into philosophical discourse, and I, you know, I have some training, but certainly not as much as many people do. And I think to myself, like, what right, do I have to explain that, you know, whatever, whatever it was, I was I was trying to talk about, but I think it's, I think it's a valuable effort, hopefully.

Élaina Gauthier-Mamaril 19:41

No, I mean, it's, it's definitely for me, it was very important to see this model then I'm reading Sami Schalk's "Black Disability Politics" at the moment, and, you know, even in the way that she builds in interludes, and sometimes after using difficult examples of police violence, will take a space on the page to be think about this reflect like, and then have a kind of a mantra almost like poetry in the middle of the academic text.

Danielle Spencer 20:12

Oh, I love that!

Élaina Gauthier-Mamaril 20:12

I think that's brilliant. Yeah. So yeah, so your book and Sami's book, like all of these things are very important to model kind of different ways that scholarship can be produced. And yes, yeah, I think, yeah, for me, it's, it's a high point to see that happening.

Danielle Spencer 20:33

Well, well, thank you. And also in narrative medicine, and in my book, there's also the medicine part of it. And I play with that by saying that I'm diagnosing this phenomenon, which is, which is really, you know, terribly hubristic of me, because I'm not a doctor, you know, but that's it was very intentional, to say, well, you know, what are we talking about here, if we can't really empower people to come into this into this dialogue? And, you know, again, it was very meta, because the subject is diagnosed, you know, certain aspects of diagnosis. And, and so, so I walked into it and said, "Well, yeah, I'm a diagnostician in that sense, right?" I'm going to name this thing and I'm going to... And that too, I felt, what right do I have? And then I looked at all these neologisms that, you know, the classissists hate what doctors do to Greek and Latin, they just create these new words. And I thought, well, they've been doing it for centuries. You know, I can do it, too. And so that's why I coined the term metagnosis.

Élaina Gauthier-Mamaril 21:31

Yeah, you've achieved what we all want: to coin a term. No, but that's great. I mean, I'm finding myself doing the history of economic policies in the UK and how they affect eugenics. I never thought I would be a historian of economics. I guess I have to now!

Danielle Spencer 21:52

Right? Right. If you think that you wave a wand and you anoint yourself, that person who's the expert in that thing, and then fulfil it.

Élaina Gauthier-Mamaril 22:01

You don't ask permission to do it. Right. Speaking of wands, you wrote an article called "Wizards, Masks and Metagnosis: Is the pandemic truly changing us?" Would you like to just give a brief synopsis of what you were addressing there?

Danielle Spencer 22:19

Oh, yes, this was a short piece that I published in literature and medicine last fall, and it's about the COVID 19 pandemic, and weaving it in with metagnosis. And I also talk a lot about clinician memoir and the figure of the mask, it makes a lot more sense if you actually read it. I was interested, you know, since the book came out, I've been interested in different ways in which the framework could be useful in different contexts. So not necessarily strictly medical, it seems like it happens in many different contexts. And so, here, the question is, so is the pandemic really changing? us know, and I wrote this, you know, earlier on when it was still more and more affecting daily life. And looked at the genre of clinician memoir, in which it seems that there's this figure of, "Oh, I'm gonna take the mask off", you know, the surgical mask off or pull aside the curtain and show you what it's really like. But that, in my view, on the whole, it's a largely conservative genre, that then the clinician has some kind of epiphany about the essential humanity of doctors and patients and, but then just folds it back into their professional identity saying, "Well, this this epiphany that I had", and they never acknowledged that there's a whole genre of other physician writers who have the same epiphany that this epiphany is going to make me a better doctor. So this sort of like de novo revelation. And so with this figure of the mask, and meta Gnosis like this is revelation of this essential humanity that's been there all along. So that's a metagnostic experience. But then the question that I ask is, well, can you allow that to actually truly change your understanding? I mean, the "meta" in metagnosis is "changed", "changed knowledge", and my appraisal of the genre of clinician physician memoir, in the US in particular, is that it doesn't you know, that it does what I just said, it folds back into itself kind of self valorizing way. But the question is, with a pandemic having revealed so many aspects of our experience of our society that have been there all long, visible to many people, but not everyone. So for example, the extent of societal inequity that gets played out in the pandemic, in terms of mortality rates and access to care and everything like that, is this a revelation that we're just going to put our masks back on and forget about? Or are we actually going to understand our knowledge is being changed?

Élaina Gauthier-Mamaril 24:33

Yeah. And I liked how you had all of the examples, including the covers, which is really cool. Yeah, if people want to read the article you can see all the covers of these memoirs that are very kind of disembodied, very impersonal. Sometimes we can't see the face at all. Sometimes people are masked, this idea of the kind of doctor as a maybe mystical entity or a superhero type thing. And then you said towards the end, will we sell during the pandemic, frontline workers and health workers who are women or women of colour, or people basically were not white men, using unmasking, taking selfies of their faces that were damaged by the PPE for wearing them for hours a day and kind of showing the flip side of like, No, we're not heroes, we are human beings that this is our job. And this is how it's affecting us and sometimes breaking us down that vulnerability. Yeah, yeah. So this kind of kind of coming full circle to when you said you were interested in doctor's memoirs, and that kind of led you into the field. And, yeah, it's interesting to see the different narratives that are forming. But my question is...

Danielle Spencer 25:41

Well, actually, just a note: if people are interested, I have the PDF of the article on my website, which is daniellespencer.com. You just go into publications. And somebody asked me that... So I have, I was able to include four pages of grids of these covers from the genre of of physician memoir. I didn't cherry pick them; there are a couple of counter examples, but these are representative of the genre, which is really striking when you see them all together that as you said, they're fragments of faces behind masks. And then there's a bunch where it's just the crossed arms of the surgeon. And then there's a bunch where they're walking away. And there's something there's some trope of hide and seek that's very prevalent in the genre.

Élaina Gauthier-Mamaril 26:23

And they have a big trend of a very pastel blue, white palette.

Danielle Spencer 26:30

That's like, oh, yeah.

Élaina Gauthier-Mamaril 26:31

So that's why it makes me think of, yeah, you know, kind of religious imagery with like, bright lights, and you have this figure standing in front of it with like, light blue.

Danielle Spencer 26:40

Absolutely, yeah. I hadn't thought about that. You're right. I can only see like one or two counter examples. Yeah, go ahead. Sorry, I interrupted, you have your head?

Élaina Gauthier-Mamaril 26:49

No, no, that's fine. So my question is, do you see metagnosis as an ongoing practice, for example, if we have now these narratives of your healthcare workers are not superheroes, they are in fact, workers, they are people who are sometimes putting their lives on the line doing this, but you know, kind of demystifying the role of the doctor or the nurse as part of our kind of hierarchy of knowledge and authority. How do we keep that going? Because what I'm seeing is that inertia is strong.

Danielle Spencer 27:25

Yeah.

Élaina Gauthier-Mamaril 27:25

And as we have narratives of going back to normal, this doesn't mean that we are investing in the healthcare system. Like during the pandemic, we're like, you are heroes, and now, it's kind of like soldiers coming back from war, you gotta be like you are you've served your country. But if you can't recover from your PTSD, then we kind of don't want you around. Right. So my question is, how do you see if we wanted to go beyond metagnostic revelation into an actual practice?

Danielle Spencer 27:54

Yeah. Well, that's the that's the key question that you just articulated beautifully. I mean, I think the kernel, the kernel of it, is there in the proper analysis of the experience. So in the book, I go back to Aristotle, Aristotle's conception of enuresis, which is, you know, like coming upon knowledge and can describe a revelation like that EPIs is the classic example, and trace through some of the literary critical interpretations of this through time and where it moved from, and I'm drawing upon the work of Terence cave, for example, his book recognition, moved from more of a conception of some revelation of an anterior hidden truth to the understanding that it's not just the information that's been uncovered, so to speak, but that once, once there's a possibility of having some kind of Revelation, something that's been there all along, you're not who you thought yourself to be, you know, it was it for Oedipus, is that the, the really significant revelation? Well, at first, it was significant enough for him, but the really significant revelation is that that can always happen. And so our knowledge and our understanding of our identities and is always always changing, and always subject to change. And that that really should be the substrate and that, if that's the case, then we have more agency because then we can ask, well, if we're always changing, what do we want to change into, for God's sake, right? And also less isolation because when somebody has a, you know, learn something about themselves, that changes who they thought themselves to be whether it's genome genetic paternity revelation or something, medical or end of life revelation, you know, when you get that existential hit on the head, where you actually have to face your own mortality, that these are such isolating experiences, but since it's it's odd, because they're they're actually quite common across across our lives, and so if we're able to see them as such, and Bring them into connection with each other, then maybe there's maybe we have more of a chance of, of actually changing our understanding rather than having each experience then just say, you know, as you just said, Oh, well, okay, we're done with that. So now I don't have to think about it anymore. I can just go back to normal. You know, the barnyard conception of normal really needs to change.

Élaina Gauthier-Mamaril 30:20

Well, I'm that I'm going to ask something I always ask my guests, which is what are you reading right now that is giving you life?

Danielle Spencer 30:28

What am I reading right now that's giving me life? I will I just reread Anne Boyer's "The Undying", which is really brilliant, and searing illness narrative. And I'm just finishing a chapter with Arthur Frank on writing, we're writing about illness narratives and reflecting on on the evolution of the genre. And, you know, in a way, it's dispiriting, because so little has changed. But in another way, it's encouraging, that the problems facing facing us have changed. I mean, we're doing this comparison between Boyer and Audre Lorde, and Audrey Lorde was, you know, writing into silence, you know, the fact that she was speaking and writing about her breast cancer was itself just such an act of incredible courage and also writing about her own situated experience as a black lesbian warrior poet, fast forward 40 years later, and Boyer, you know, different situation, she's writing into this cacophony of voices, and part of the challenges she's speaking to, and she does it also through her formal decisions, is how to resist the prescriptive cultural narratives that attend breast cancer in particular. So, there's always problems, and nobody wants to be ill. But the fact that the problems change is, I think, actually encouraging gives me hope.

Élaina Gauthier-Mamaril 31:52

Oh, I'll definitely check that out. I already put "Illness as Metaphor" on my list. Yes, it was a source in your article. Where can people find you and or your work on the internet? You've already mentioned your website?

Danielle Spencer 32:07

Yes, I think my own website is the is the best resource. So daniellespencer.com, not to be confused with Danielle Spencer, the Australian singer and actress and ex wife of Russell Crowe. But I have the URL, I have the daniellespencer.com. And if you, as I said, if you go into the Publications page, I have PDFs of all of the articles. And also, you know, a lot of people, you know, if you're interested in narrative medicine, there are links to the Columbia Narrative Medicine programme. And you can just reach out to me, there's a contact form on my website. And I'm happy to respond to any questions about the programme and the field. And, you know, really anything at all!

Élaina Gauthier-Mamaril 32:51

Well, again, thank you so much for meeting with me. This was great. I feel we could talk for much longer.

Danielle Spencer 32:57

Absolutely! Yeah, my pleasure.

Élaina Gauthier-Mamaril 32:59

Yeah, so have a good day!

Danielle Spencer 33:01

Thanks so much!

Élaina Gauthier-Mamaril 33:13

Thank you so much, Danielle, for your time and your wonderful energy. I hope you'll find this interesting. I certainly had fun. And maybe it'll inspire you to contact an author whose work spoke to you. Academia is rife with criticism, and I think we would all benefit if we generated some more mutual appreciation. So hey, have you read a really good article lately? Reach out to that person and tell them what it meant to you. As always, I will link Danielle's website in the show notes and I do encourage you to check out her work. If you want to support Philosophy Casting Call, the best way is to rate the podcast and leave a review on Apple podcasts or Spotify. I would also love it if you told me if you use philosophy guessing calling your classrooms. I know some of you have and it always warms my heart to hear that young and not so young minds are being exposed to these conversations. And if you're in a position to donate and only if you can, you can also become a monthly supporter on cofee. So that's Ko-Fi.com/philoccpod. Any amount is completely appreciated. And of course, you can follow the podcast @philoccpod on Twitter and Instagram and all the transcripts live at my website that will be linked in the show notes. So until next time, bye!

Transcribed by https://otter.ai

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Non-Ideal Theories of (Trans)genders w/Matthew Cull

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Ethics of Kinship in the Archive w/Hannah Sullivan-Facknitz