Remembering My Hat

12th April 2011

Fiction and the cultural mediation of ageing: Final part (I promise)

Later, I gave a paper in a panel on narrativity and non-normativity and only seem to have made notes on one of the other papers:

The successful failure of narrative in Lisa Genova’s Still Alice

Sarah Falcus

Novel about psycho-linguistics prof who gets early onset dementia [want to read this one too]

(cc) quimby

‘Everything she was was about words’, one of first words she can’t remember is ‘lexicon’. Metafictional concerns in the novel. 3rd person narra but privileges PWD’s point of view. This conflicts somewhat with coherence and chronology demanded by novel form. (not experimental text, fairly trad)

Reader too experience something of Alice’s experience but not to get lost in it, as Alice is lost. Her missing words are also absent from the text, at the beginningn of novel. People’s names too ‘that man’ as she can’t remember her hus. Repeated sentences and paras. Don’t know some things because she doesn’t.

Alice is only 49 at onset – resists association of dementia with ageing. Activities of Daily Living questionnaire – is incontinence because of dementia or because of ageing? But pre diagnosis, attributes her anxiety, confusion, memory loss to menopause = natural v. monster of dementia

Nearly all fiction about ageing contains a ‘mirror-moment’ (Kathleen Woodward)

[Notes definitely getting more sparce as I got more tired]

Naomi Richards from the Look at Me project

Putting older women in the picture

Phototherapy. Working with Rosie Martin, who worked with Jo Spence in 1980s to create phototherapy! As before, using photography to heal, beyond the family album, dressing up.

Aged 47-60 women. 5 full days over 4 week period. Photo diaries to familiarize with camera, over one week. And to help them think visually. Not as a prompt to talk, they were as interested in the product as the process, unlike traditional creative methodolgies in social science which tend to focus on the process [and particularly the talk about the process] [very interesting. Think some more about the implications of this]. Re-enactment session on theme ‘transformation’ transformative visual narrative using props.

One participant’s theme was Gaga to Lady Gaga.

Photos within her grasp rather than the spectre over her shoulder [kind of literal/metaphorical thinking I’m not good at but really like. Seeing something that is literally true as well as metaphorically].

Marta Miquel-Baldellou, Univ of Lleida

From pathology to invisibility: the discourse of ageing in vampire ficture

Vampires don’t show their age and don’t age. Vampires first in fiction looked old. No longer. Repulsive, now generally attractive. Bram Stoker, foreign, aristocratic and old. Anne Rice Interview with the Vampire started trend of young vampires, and introduced vampire children. Also first to be sympathetic

Aged vampires in Vict fiction as sign of difference.As became younger, became more sympathetic, true hero of the novel. Appears in mirrors in modern novels [not in the novels I’ve read]

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27th January 2010

Conversations with my Physio: Part Two

Another interesting conversation with my Physio today. (Dear Physio, should you, by some freak of the internet, stumble across this blog, I do hope you don’t mind our interactions being scrutinised. It’s not personal, I promise).

She mentioned that she is thinking of doing a course in accupuncture for Physios. I expressed surprise at accupuncture being available on the NHS, especially within a hospital clinic, since hospitals are traditionally particularly the domain of bio-medical types of healthcare (for an introduction to this, you could go further and do a lot worse than Unit 2 of K101. Alas, this isn’t available on Open Learn, but the fuller but older version of this material from K100 is). We ended up having a conversation about the evidence-bases of conventional and alternative therapies.

(picture nicked, appropriately enough, from the NHS choices website introduction to accupunture)

Perhaps because of her previous framing of anatomy as the central knowledge of physiotherapy, I had been thinking of the discipline as quite bio-medically oriented and positivist. But she characterised it as the soft, holistic end of medicine because they don’t prescribe drugs and do things like physical manipulations. She talked about the way she feels things in her hands when she is treating someone and how hard that is to write up in her notes.

We talked about the legendary finding (i.e. neither she nor I knew the source, but we’d both heard of this piece of reserach. A quick look at Cochrane just now doesn’t find it either) that treating scar tissue with high doses of ultrasound works equally well whether the ultrasound machine is plugged in or not. Her point was that it’s impossible to properly test this sort of thing because she would never prescribe ultrasound on its own, she would always accompany it with physical manipulations, exercises etc. I recognise this as the argument that evidence-based healthcare is incompatible with the ethics of offering patients the best care. (I’m not sure that she’s correct that it couldn’t be done ethically, but I’m interested that that’s her perception of how evidence-based healthcare doesn’t work in practice).

One day, I really ought to write something proper about evidence-based care. I keep returning to it as an overarching issue, but I get daunted by how quickly it gets into epistemology and ontology.  In the meantime, here are links to the two most accessible articles on some of the problems of evidence-based care that I have found (and at a much more introductory level, there’s my material in K101, Unit 19, section 3. This was new for K101, so unfortunately there’s nothing similar in the K100 material on Open Learn). Note to self – at least do something with the swathes that were cut from earlier drafts because it was (correctly) judged to be too difficult for Level 1.

A chapter by Miles Little in a book, available on Googlebooks

An article in the BMJ, (I think that’s open access). It also features in abbreviated form as a chapter in the K101 Reader (because I chose it)

28th September 2009

For the love of three Bookstart books

My almost-toddler had a routine Health Visitor checkup today. I was trying to work out why I took him along. I have no worries about him and felt no need to have my lack of worry validated by a Heath Professional. Taking him along risked getting sucked into surveillance practices that I know from previous experience can be very unhelpful. It was quite inconvenient to attend – I had to take time off work and he missed a nap.

I have, like most parents, considerable investment in being seen to be A Good Parent, and attending routine check-ups is one of the ways modern parents can do this. But I have sufficient theoretical traction on that to give me the resources to refuse it head-on. And sufficient articulateness and socio-cultural privilege to deal with the Health Visitor had they bothered me about it. I know my Health Visitor has targets to meet about getting parents to bring children to check-ups, but I don’t care enough about her to attend just to help her statistics.

In the end, I concluded that I went because I wanted the Bookstart books you get given at this check-up, and the handy sturdy canvas bag they come in.

That set me thinking about the role of trivial incentives in health and social care settings and in recruiting research participants.

Children often get given stickers by dentists and practice nurses these days. It doesn’t seem to encourage or reward my children significantly, but I guess it must do some children, or it wouldn’t have become such a common practice. Or is it, perhaps, not an evidence-based intervention?! Is is perhaps performed just to make practitioners feel they are doing being good with children?

Pregnant women in my area get given a pseudo-book ‘Emma’s Diary’ at an early antenatal appointment. I found it too irritating and patronising to read. I wonder whether it does improve pregnancy outcomes. Then there is the whole Bounty Bag Full of Nothing phenomenon. If you have a home birth you often end up not getting the post-birth bag – serves you right for bucking the system?

It is becoming increasingly common practice when doing academic research to reward participants with something like a £10 M&S voucher. I’ve always had rather mixed feelings about this. On the one hand, yes, it’s nice to symbolically give something in return for participants’ time, energies, insights and experiences. But on the other hand, £10 seems a woefully inadequate response given how crucial people’s participation is to academic research. And as vouchers-for-participants becomes more of a norm, it becomes more difficult to undertake unfunded research. And there’s an argument from the service-user movement that participants in research ought to be properly paid for their time if their contribution is so important.

I’ve often wondered whether the £10 is significant to research participants, or just to researchers, so that they can do being a good (ethical) researcher. But perhaps my own willingness to inconvenience myself suggests that trivial incentives can work.

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