Monologues and Dialogues by Elizabeth Spradley

ELIZABETH SPRADLEY is an assistant professor at Stephen F. Austin State University.  Elizabeth completed her Ph.D. in health communication at Texas A&M University in fall 2013 and has embarked on an academic career aiming to blend interests in health communication, narrative, and interpersonal relationships.

ELIZABETH SPRADLEY is an assistant professor at Stephen F. Austin State University.  Elizabeth completed her Ph.D. in health communication at Texas A&M University in fall 2013 and has embarked on an academic career aiming to blend interests in health communication, narrative, and interpersonal relationships.

Driving home on the loop, I was struck by a mix of emotions as I both mourned and celebrated the replacement of a breastfeeding billboard for a different public service announcement.  The billboard once read, “Breastfeeding works for working moms,” which was one of the messages in the multi-media Every Ounce Counts Campaign in Texas. 

Why were my emotions so conflicting?  On one hand, I ask myself, am I not a champion of worksites that facilitate maternal and infant health?  Am I not enthusiastic about health promotion that enables healthy infant care practices and reduce the cost of said practices?  On the other hand, I also ponder how a working mom whose found breast pumping at work hard may feel when driving by the billboard or how a mom feels who simply did not find breastfeeding to be worthwhile or workable for her family.  The politics of health pulls my emotions in seemingly every direction – north, south, east, and west.

In Bhatia’s Fall 2011 Intima article entitled, “Medicine and Cultural Competency: What Anthropology Can Teach Us,” we are reminded that health is about much more than a biomedical concern, especially in relation to cultural competence.  Healthcare messages that are one-size-fit-all inherently fail to embrace the multiplicity of cultural and socioeconomic conditions of those receiving those messages.  Billboards, as a media choice in health promotion, may offer high visibility for thematic health content, but such media cannot replace the customized, culturally-oriented messages that healthcare providers are able to generate in the context of patient-provider relationships.

In the same way that Bhatia explains how physicians are positioned to listen to patients narrate their health stories from their unique cultural and socioeconomic statuses, healthcare providers, albeit a lactation specialist or pediatrician, are positioned to listen to mothers narrate their infant feeding experiences from their unique subject positions.  Subsequently, the content and wording of health advice constructed within those relationships has greater potential to penetrate barriers and be perceived as relevant or helpful. 

The breastfeeding promotion billboard that I described at the opening of this entry is a monologue to mothers, but monologues cannot attend to the vast array of storylines that mothers experience.  As Mario de la Cruz explains in the Fall 2011 article, “Approaching New Horizons,” narrative medicine facilitates “co-construction, the practice of collaboratively unpacking experiences and information through dialogue that enables a body of knowledge to be developed and shared equally.” 

Narrative medicine represents the promise of dialogue rather than monologue within healthcare relationships.  Such a promise breaks through the mixed emotions that pulled me in seemingly a thousand directions upon seeing the billboard come down. The promise of narrative medicine provides hope that mothers will not feel condemnation if their breastfeeding goals are unrealized or if they alter infant feeding goals to fit their personal and familial needs because maternal and infant health messages will be contextualized in relationships with healthcare providers attending to their individual storylines.


ELIZABETH SPRADLEY is an assistant professor at Stephen F. Austin State University.  Elizabeth completed her Ph.D. in health communication at Texas A&M University in fall 2013 and has embarked on an academic career aiming to blend interests in health communication, narrative, and interpersonal relationships.  In addition to working on several research projects and teaching courses in interpersonal and health communication, she is passionate about growing her own food, encouraging others to garden, and speaking about her faith.

© 2016 Intima: A Journal of Narrative Medicine

Source: www.theintima.org