The Future of Medical Research


About a year and a half ago, as I began to read into the long history behind the Epidemiology movement and the Evidence-Based Medicine debates, I told my husband that the real problem was not that we were too empirical (which is what many argue is wrong with EBM philosophy). I argued that our problem was that we have been ascribing god-like powers to a test, which in all actuality, tells us almost nothing about the human body, the way it works, and how it’s affected by intervension. The test I’m referring to is the Randomized Control Clinical Trial (RCT).

Although Epidemiology was not in any way founded on RCTs, the field quickly moved to argue that, for clinical and policy purposes, decision making should be primarily informed by double-blind epmirical trials in which a large, diverse group of people (think thousands) takes a particular drug and is monitored over a long period of time for particular results; that group is then compared to a large contol group, who takes a plecibo. The results of these studies indicate the general effects of a drug, what it does and doesn’t accomplish based on its goals, and weather it’s safe enough to hit the market. The trial also shapes how the drug will be marketed, to what group, and with what exceptions, potential side effects, etc. The same process applies to new forms of medical technology, tests, treatments, and interventions.

The long standing criticisms of RCTs are fairly consistent:

1) They can only measure what they set out to measure. If they want to see if a drug lowers blood pressure, they measure blood preassure. They don’t measure how blood pressure and the drug, interacts with each patient’s diet, their history of  smoking, the fact that they mothered x amount of children, or have a predisposition to breast cancer.  That would take way too much money and more data collection than is reasonable a trial. As a result . . .

2) Trial results have to make massive generalizations which don’t account for the innumerable varieties of reactions and interactions people experience physiologically and otherwise while on the tested drug, and dozens of other drugs.

3) Most tests are conducted by companies trying to sell a product; this means that pharmaceutical companies conducting studies have an incentive to ignore unfavorable information and isolate data and results which will ensure their product sells.

4) They test interventions; they don’t actually study how the body works. Yes, taking a pill is one way to fix something. But figuring out how complex systems interact to predispose a person to a disease might be more productive. caveat: Although much research is dedicated to how the body works, at the moment, RCTs only allow us to test a few correlations at a time–eg: the correlation between sodium intake and obesity; NOT not all the various factors which have contributed to various individual’s obesity throughout the nation.

5) Clinical Trials don’t help doctors make decisions. This has been the major complaint of those who founded the field of epidemiology in the first place (Daly). The incredibly generalized results of RCTs don’t necessarily help a doctor decide if a particular drug or test will help their particular patient. They DO help narrow the playing field (75% of the time, Drug x works better than Drug y; but Drug y is much cheaper); but the complexity of each patient is so extreme, that doctors really need more detailed information than RCTs can offer–and that usually only comes with experience (eg: historically, I have found that patients who take drug x and are also on antidepressant y, have problems with impotence, which causes them to stop taking drug x after so many weeks, before the treatment takes effect. Therefore, treatment z will probably be better for them because they’re most likely to complete the treatment).

Back to my story.

What I told my husband that day when I was beginning to process all this information was this: we need to revolutionize the way that we’re doing medical research.Rather than isolating particular questions and testing for a few correlations cut off from all other factors, we should be finding ways to do massive data collection about the detailed intricacies of the body, and mapping that data for patterns and coorelations within particular patient populations.

We need to use complex, convenient monitoring systems which will track hundreds of thousands of minor reactions and systems in the human body on a moment by moment basis, as people function within their own environments; and then–utilizing the storage and data-analysis technologies used by search-engines to navigate oceans of information on the internet, and the super computers which perform calculations humans can’t even attempt–we should be looking for patterns in that data which explain how individual’s physiological system’s work, how diseases develop, and in what conditions.

We cold take a huge sample of subjects form a single population with a disease like prostate cancer, or living in a particular area, or with a particular medical history, and monitor their physiology for however long seemed necessary, looking for what they have in common, and what they don’t. That’s how we should be doing research.

Considering what technology has accomplished over the past few decades, and looking to what potential the future holds, RCTs honestly look like something out of the stone age. We could be doing so much better. The key is combining complexity, technology, and, well, lots and lots of money.

I was thrilled, today, to find that there is a doctor who has been making the exact same argument. 

One of the top ten most cited researchers in medicine, and Professor of Genomics, the Scripps Research Institute, Cardiologist and Geneticist Eric Topol has the support of medical institutes, philosophers, medical educators, policy makers, research laboratories, technicians, politicians, clinicians, and me. His book, The Creative Destruction of Medicine: How the Digital Revolution will Create Better Health Care(Jan 2012) imagines a future in which the technologies we have devloped for personal and commercial use will be used to understand physiology in a way “that will make the evidence-based state-of-the-art stuff look” primitive,

“. . .by bringing the era of big data to the clinic, laboratory, and hospital, with wearable sensors, smartphone apps, and whole-genome scans providing the raw materials for a revolution. Combining all the data those tools can provide will give us a complete and continuously updated picture of every patient, changing everything from the treatment of disease, to the prolonging of health, to the development of new treatments.”

He specifically suggests how existing medical and information technologies can be used and further developed to achieve a new level of health research:

“At home brain-monitors helping us improve our sleep. Sensors to track all vital signs, catching everything from high blood pressure to low blood sugar to heart arrhythmia without invasive measurements to inconvenient and nerve-wracking—or even dangerous—hospital stays (which kill some 100,000 every year, due to infections caught there, or patients getting someone else’s medicine). Improved imaging techniques and the latest in printing technology are beginning to enable us to print new organs, rather than looking for donors. Genetics can reveal who might be helped by a drug, unaffected by it, or even killed by it, helping avoid problems as were seen with Vioxx.”

I was also pleased to find that Topol addresses some of  the major problems that will accompany future technologies, such as privacy and protection issues, genetic planning decisions, and the potential for depersonalized care. However, he also emphasizes the potential for individuation and personalization that these technologies could bring to clinical care, as well.

A few prememtive clarifications

Many in the medical and scientific humanities would point to my enthusiasm as reinforcing the, “science just needs to be better” philosophy in which empiricism is the answer to everything; the belief that if we just measured a little closer, controlled nature a bit better, we could master it and all our problems. That is not what I believe. On the contrary, I believe that the more humans stand in awe of natural creation–in which we ourselves beautifully and mysteriously embedded–the more we will realize that we can never control it, and the more we will desire to understand  it better. As a vitalist, new materialist, and complexity theorist, I believe that empiricism has been based on the concept that our world is linear, strait forward, simple, and masterable. I believe that methods such as the ones I’ve described here acknowledge the fact that this is not the case–that there more more connections, interactions, and vital processes than we could ever imagine or count, but that they are worthy of our attention and investigation all the same.

Lastly, and perhaps most importantly, I don’t want to ignore the serious ethical and social problems that litterally flood my mind as I consider future directions in medical technology. The fact that technology, medicine, and research are so largely privatized and commercialized obviously has difficult implications. History suggests that human social complexity necessarily includes corruption, error, over-confidence in human ability, greed, race, class and gender stratification, and oppression; innovation and power, network into nodes which disadvantage the majority of the human population. I don’t believe that science has the power to, or will solve, all our greatest needs and problems. I do think, however, that human innovation is remarkable and should be developed–with as much ethical contemplation, caution, and will toward justice as possible. Even philosophers have a part to play in the network formations of the future.

Cultural Studies in the Future Tense: Pressure Points For the Present

One of the major weaknesses of Grossberg’s book is the fact that, although it was published in 2010, it continually felt, while reading it, as though it were written in a pre-9/11 world. Many of the authoritative quotes he used to describe the changes which have taken place in our world, our present moment were in fact written in the 1980s and 90s. While that does not make these statements any less valid, they often revealed the kairotic context and were not followed by Grossberg with any addendum filling in or modifying the concepts to apply to the current state of cultural studies (see for example his use of Readings on 178-181, or his use of Harootunian on 288).

However, this weakness is compensated by the heroic new paths Grossberg blazes for the future of CS work, providing scholars with an arsenal of methodological tools for considering “[q]uestions about what’s going on and our possible futures [which] remain paramount” (288).


I’d like to suggest three present pressure points, as Gossberg might call them. Three places in the complex networks/conjunctures of society where tension has becoming so strained that, we might say, “something’s gotta give.” Emergencies, crises, or ruptures where Cultural Theorists should should obviously report. I feel some of the particularly difficult questions that are born at these cites, deserve serious efforts, and our current pattern of only skirting the edges of these issues (particular the last two which I suggest) evinces our discomfort with the complex dissonances therin. I’m not going to flush them out at length here, only briefly attempt to make visible the kinds of difficulties present. The major pattern linking these events is that all of them were organized through social media, all of them involve complex convergences of economy, politics, culture, ethics/religion (largely missing from Grossberg’s methodological tools), and they all happened within the same time frame. Most importantly, they all constitute wars over various definitions of Modernity.
1. Democracy in the Middle East

It may be safe to say that the sort of wide-scale revolution and restructuring that is taking place in the middle East has not happened since the usually named “Democratization Era” refering the Europe and Aemrica’s own . . . rebellion. And, it may also be safe to say that, in a more time-space-collapsed economy, this rupture will have an even more monumental and immediate effect on the global state than the Western one did. If the first generation of CS scholars looked at the Peace Movement, Civil Rights movement, Hippy Movement, Sexual Liberation movement, and so many other large-scale ideological ruptures and said, “What does this mean . . . (for us)?” you can bet the my generation of scholars is looking at the Middle East asking the same question, with just as much awe-struck wonder.

Oriantalism scholarship has done a brilliant job of showing us (Westerners) that we are incapable of analyzing and evaluating and interpreting the East in a way that is beneficial, ethical, or even useful. So where does that leave Western scholars in the midst of the Middle Eastern revolution? I’m not sure that we can be much more than spectators, peering into the stadium from holes in the fence, unless a person has specific ties to that area of the world, and even then, we may be considered liminal at best. It may be a case where we can only, in fairness, wait quietly, or ask questions humbly, because the difficulty of our relationship.

On the one hand, Egypt has written their own, effective “Declaration of Independence;” On the other hand, they oppose much of the ideology we generally accept (like, say, post-structuralism). On the one hand, we are in economic cooperation with them; on the other we (whoever “we” may be) have been exploiting them (in a materially real but also wider ideological sense) for decades. On the one hand, They demand the support (in so many ways) from the West; on the other, there is a clear political agenda which America simply will never be able to agree with, no matter how much the financial benefit from it–some of these facts are (rightly) ignored in the moments where we cheer. But at some point we need to think about the difficulties. Also, while postmodernists love to see the oppressed revolt, these are states ushering in so many of the very economic and ideological structures which, in the Western forms, postmodernists have fought to expose as untenable in the long-run.

Scholars, no matter how much we (want to) image we are above politics, and economy, and bias, and ignorance, and all the other buzz words, are truly just human. And to approach these questions will have to deal with a TON of self analysis, to even begin to touch the kind of economic, philosophical, theoretical work the Grossberg Demands. Nevertheless; to ignore this issue would be to pretend that the largest volcanic eruption of our time doesn’t exist, while studying plate tectonics.

2. The Riots in London

I am not a British Subject. However, listening to the BBC cover the teen-age riots in London left me shaken, disconcerted and affect-ively defeated–I felt at a complete loss that a culture could expreience such an outburst, such a unmistakable and un-ignorable break in human forms of social control, and simply turn away in stoic obdurateness, as if this meant nothing. The public debates immediately following the event were heated, but quickly faded into the background in the US news. I’ve found some analysis online, but many exclude conjectural complexities that made this even different in the historical plane (see for example this psychological analysis, which never mentions social media). I am not in a position to analyze what led a generation of youth (most in their very early teens) in one of the most acclaimed cities of the world, in one of the traditionally conceived of as “civilized” nations in the world, to overturn cars, set fires to the streets, rob and pillage. But I believe someone needs to. And, possibly even more urgently, I’d like to know if this is libel to happen anywhere else.

3. Flash Mob Crimes

Moving to our own continent, and to something akin to the events in London, I can’t help but feel that we should consider the flash mobs that became a trend this year, which were particularly mobilized through social media, and were contemporaneous with the London Riots (no coincidence, obviously). I believe that instances of collective law-breaking and crime should be considered one form of pressure point because (like revolutions and riots) they constitute a form of rupture or outburst within a culture and often point to deeper conflicts within the particular kairotic moment. There are so many issues at stake in this particular conjectural analysis, when it comes to how people have responded to these events. Discussions surrounding social, racial, economic, technological and generational conjunctures quickly sprang up in the public sphere, providing plenty for the Cultural theorist to analyze, just in the way of perception, much less in the original material events. The climate which both fostered these moments, as well as the changing pressure zones which have followed, may give us an interesting forecast of the affect-ive changes taking place in our country, and how those changes are linked/converging with affective states of various groups around the world.

On Cultural Studies in the Future Tense

Reading Lawrence Grossberg’s Cultural Studies in the Future Tense, I find myself seeking answers to questions which, as an North American PhD student reared up in the intellectual house of Cultural Studies, have plagued me for many years of my philosophical development:
Why did I always feel so trapped within the critical theory classroom? Although I loved and reveled in the feast of philosophical premises set before me, at that dinner table I often felt like the child being taught a catechism to which there was only one right answer. And this, so confusing to one being told, daily, that there were no right answers. Why did I feel that if I did not share the particular critical views toward specific cultural institutions, that I was a shameful person? And why did I feel that if I did not take up a negative attitude toward the world, that I would be a failure to my academic family? Why did I find freedom in many of the premises, but bondage in their bearing out? Why did I tire of the arguments I read over and over in prestigious journals, feeling that I was listening to the same lecture from an older family member, time and time again? And why is it that I came to the conclusion that if I wanted to fulfill the vision held by my house, I would first have to leave it, and find a new home all together?
I believe that Grossberg answers many of these questions for me:
“Cultural studies is . . . a project that reshapes itself in and attempts to respond to new conjunctures as problem-spaces” (1)
“It is about the contemporary struggle over thought, imagination, and the possibilities for action as a part of the larger contextual struggles over modernity itself. The book tries to lay out some of the work we need to do–ultimately, collaborative, and collectively–to produce a cultural studies capable of responding to the contemporary worlds and struggle constituting them.” (3)
“The [Burmingham] Center was a response to significant social and cultural changes characterizing postwar British life . . . and the political challenges they posed. . . . which seemed to call for a reconsideration of at least a part of the function of the intellectual. . . . cultural studies [was] a response to a series of frustrations with the criticisms of existing academic practices and as an attempt to do work differently.”  (emphasis mine) (11)
“Cultural studies . . . assumed that . . . intellectual work mattered, both inside and, even more importantly, outside the academy. . . . an attempt to make the academy listen to the demands of . . . the world outside of (or intersecting with) the academy . . . the Center was not trying to create a new academic norm or field, but to articulate a different kind of intellectual project, a different way of asking and answering questions. . . . it was propelled by a sense of the inability of the dominant academic norms to provide adequate answers to the compelling and important questions of the age . . . the failure of the dominant academic norms to even ask the questions that mattered to students and the population more broadly . . . changes that were visible “out on the streets,”  . . . the project was lived more as a sense of discomfort and dissatisfaction, and it was articulated as a critique and a quest rather than as a completed and positive vision of coherent alternatives.” (emphasis my own) (14).
So to summarize: “demands, inability, failure, discomfort, dissatisfaction, critique” AND  NO “POSITIVE VISION OF COHERENT ALTERNATIVES.”
And that’s the dilemma which my generation has inherited from North American cultural studies today. And I would wager that significant number of Humanities students today feel the exact same dissatisfaction, not only with the traditionally “dominant” academic norms and answers…but with those provided by the generation which founded cultural studies: we are struck by the failure of this movement to provide a “positive vision of coherent alternatives.”
However, we have a choice. We can adopt the same sour, angry, disgruntled attitudes that our fathers and mothers did toward their elders…or we could thank them for the hard work they did in paving the way for change, for having the courage to call the world into question and not take for granted the answers they were given, and continue by moving forward into the future, taking their work a step farther, and accomplishing what they–in their historical-culturally-contextual moment–were restrained from accomplishing. We perhaps can attempt to provide a vision, even if it requires us reject certain aspects of our parents’ own suggested alternatives. While all children will bear the scars of their imperfect parents, any child who does not acknowledge that their parent gave them life, and worked hard to provide for them, is a foolish person, who will be taught the painful lesson of imperfection themselves, when they harm their own children and are hatefully accused by them. Therefore, our duty is to remember, “judge not and you will not be judged; condemn not, and you will not be condemned…give and it will be given to you; for with the measure you use it will be measured back to you” (Luke 6:37). In saying this, I self-consciously practice what I preach.
We now find ourselves, as a generation, back at what Grossberg calls “the heart of cultural studies”:  “a project that reshapes itself in and attempts to respond to new conjunctures as problem-spaces” (1). For our generation, the problem space is not only the academy, our present global economy and political situation, nor even the daily lives we experience outside the academy, but we also inhabit the problem space of what cultural studies is at the University, and how it has impacted our relationship to other disciplines and publics now. Our generation wants to “change the world” as Gossberg says; we want to make a difference too, just as our mothers and fathers did. But in order to begin this process, we will have to re-forge relationships with other intellectuals which have in large part been severed or disjointed because of old offenses, pride, and bad feelings.
This task, however, is not beyond us, I think, because just as is the case within our discipline, the other fields also teem with fresh young minds and new blood. As a part of a budding generation in a global world, the youth of other disciplines are also becoming more and more aware of our need for connectivity and cooperation in order to get things done–an awareness which time and history has brought to bear, justifying our parent’s original claims and critiques–that a new order of thinking and inquiry was required of a changing world.
And perhaps, most hopeful of all, is the reality that–just as in all other places and times where blood feuds have held strong–youth and the spring time of love do have a tendency to win out, and in part, triumph over long standing hate. The incredible intermixing and inter-breeding, as it were, which our nation (and others) on every level, including the University, has hosted in the last 30 years, has meant that many relationships, partnerships, even marriages are forming between vastly diverse individuals, and a case could be made that these small and isolated ties collectively, may prove to be the most powerful cords intellectually, that may constitute a driving force for collaborative movement within the academy and beyond. That the marriage of the scientist to the Sociologist, the medical doctor to the English professor, the Women’s studies teacher to the Business professional, the Musician to the Lawyer, and the academic to the blue collar worker, not to mention the European to the Middle Asian, will be the true, underlying, and foundational hybridity that will transform the academic scape of the next century.
It may be that, after a century in which our fore-bearers fought against the domination, oppression, abuse, and bondage that the social tie of marriage can bring when coupled with ideologies of discrimination and prejudicial favoritism–that their children of the new millennium will rediscover the power of this corporal, physical, sexual, legal and intellectual bond between peoples which for all of human time has tied together nations and cultures, religions and creeds, races and classes, in order to mingle and evolve the people, ideas, and practices of the world–weaving together new ways of living and life on earth. Perhaps in our time, some aspects of this truly miraculous force may be rediscovered and reinvented in a way that redeems the problems which, through severance, our parents endeavored to protest, fight, and bring to light. By the mercy of God, may it be.

Semester Reflection: Research Requires Risk

As hard to believe as it is, the semester is over. Almost. And lots of studies show that reflection is a beneficial method for transfering knowledge. Soooo, Here we go for transfer: Three global principles I learned from this class.

1. Scholarship works with texts, scientific research works with numbers, and qualitative research works with faces. Now, this is a huge generalization–but I think it works. If we put these three on a continuum, qualitative work would be in the middle (obviously), and can include either of the other two.

2. I have developed a pragmatic definition of research that is situational and rhetorical, but which I am still devleoping, and would like feedback on.

According to IRB, research can be generalized to larger populations. What it doesn’t specify is, to how great of a larger population? I think that any larger population will do, but the size of that generalizable population will effect how much respect/clout/funding the research will get. For example, a study which claims to be applicable to all college students in the nation (Academically Adrift) will necessarily get more attention, funding, and respect than a study by a WPA which will benefit the six other writing teachers in the nation who are seeking to create an honors composition course in collaboration with a musicologist. Both studies ask valid questions (what works?) both may use controlled environments and methods to seek an answer to that question through various complexities of coorilations, and both will produce data that will in turn (when interpreted) create knowledge which can be put to use by others.

The amount of people the research serves doesn’t necessarily determine its innate value or validity…to those for whom it is useful. One helps more people, but the other helps people that could never be helped by a gigantic study of large populations. The later need a study which examines the nuances of “how things work” (to use Stakes’ definition of qualitative research). And, there are also many types of quantiative or scientific research which deal with qualitative information/data before working the numbers. So, there is a place for them both. But, incase you thought I was being too accepting:

3. I do not believe that what Rhodes calls “psychography” (proto-ethnographies which are more interested in telling a narrative which proves a hypothis than they are in conveying longitudinal experiences had in immersive evironments) I don’t believe that psychographies are research. I believe they are scholarship. Scholarship looks at texts and works to determine their meaning by comparing them with other texts and theories of texts–including critical/cultural theory. As a student of literary, cultural, and textual studies, I love scholarship, and do not contest it’s value. But there’s something research has which scholarship doesn’t, and that’s risk. At the end of the day, the worst thing that can happen in scholarship is that you can miss your deadline, or not get published (maybe loose tenure). However, in an inquiry based study, your hypothesis could be proven wrong, you could not find the answer, or your data could contradict the theoretical framework you set out to prove. And you would still report these findings. That doesn’t happen in scholarship. In scholarship, you can simply write about your topic from a different angle or use a different theorist, or just not publish. This may not be a good way to divide up types of knowledge-formation, but something in my gut tells me that this is an important factor. The rhetorical risk of inquiry matters in the way that it is composed–that’s my hypothesis. Thoughts?

In other news . . .

Because I really like longitudinal, qualitative research, I had felt at the beginning of the semester that immersive ethnography was the only type of qualitative research I could do. But hearing Hiedie McKee say, over skype last week, “why would I be reading about this, when I could be talking to these people?” made me realize that I didn’t have to do a full-scale ethnography to find valuable information, and I didn’t have to do my research all at once. I can begin by “talking to” some of the people I respect and want to understand. I can begin exploring without being Ms. Mega-Awesome, and Perfect Super-Researcher (and yes, I do feel that we read a few of those: Heath, Boyd, Caroll, etc). This was an exciting and refreshing revelation.

Top Readings:

Robert Brooke, “Ethnographic Writing” from Voices and Visions

Digital Writing Research: Technologies, Methodologies, and Ethical Issues edited by McKee and DeVoss

Jerremy Tirell’s dissertation, “Mapping a Geographical History of Digital Technology in Rhetoric and Composition.”

Dana Boyd’s dissertation, “Taken out of Context”

Other’s favorites: Stake’s Qualitative Research, Lee Ann Caroll’s Rehearsing New Roles, Heath (how can you not?) ,

Favorite Skype Visiting Author: Katherine Kelleher Sohn

Digital Ethics in Quasi-Public Places: McKee and Porter

McKee and DeVoss‘s edited collection, Digital Writing Research: Technologies, Methodologies, and Ethical Issues, provides an array of technological tools and methodologies which may be used to study writing. The section we looked at last week, Part Three: Researching the Activity of Writing, covered time-use diaries, mobile technologies, and video screen capture. Some of the chapter authors, such as William Hart-Davidson, focus on the practical use of a technology: time use diaries to examine the integration of certain writing devices, like texting, into daily practices, via when and for how long a device is used. Other authors, such as Joanne Addison, focused on theoretical basis for using technology: mobile technologies as a way to investigate phenomenological experience.

This week’s section, Part Four: Researching Digital Texts and Multimodal Spaces, was highly related to our other readings by McKee and Porter this week. All the sources dealt with the differences between static and authors and published texts, vs. fluid online texts, spaces, and speakers.

Stuart Blyth points out the difficulty of coding online data, because it is not static, but fluid, with particular texts often changing over time. His suggestion is to collect copies of the web page at a particular point in time, and make notes using an HTML tag. His was the most detailed account of coding methods I have read thus far—providing protocol for tagging words, rhetorical moves, images, and even spaces and time-laps editing.

What I found interesting was the fact that, when this book was written, authors were still trying to find ways to freeze texts, rather than develop tools to track their development. Blyth does a good job of borrowing from film coding practices, in order to find ways to code online videos or animations, and comic practices for narrative, in order to enable time-laps analysis. However, this is not quite the same as looking at verbal/alphabetic texts changing over time.

Attending CEA this month, in St. Petersburg Florida, I met Chris Friend from the Texts and Technology program at UCF. He did a presentation about the application, Google Wave—which is slowly being phased out in favor of Google Docs. The premiere feature of this composition tool, however, which Christ drew attention to, was its ability to record the collaborative writing process performed on/in a document. It worked in real time, and at any point you could “rewind” so to speak and watch how different writers had edited and added to the document. There was also a chat feature which allowed people to talk about their changes as they worked. This feature was also time stamped to be replayed with the document recording.

Digital Writing Research was published in 2007, however many of the chapters would lead you to believe otherwise. Out of the two sections we  read, Google is only named once—in one paragraph. I think that Chris’s work is a great example of where composition methods of research might be going in the next few years.

McKee and Porter’s CCC article, “The Ethics of Digital Research: A Rhetorical Approach” was incredibly enjoyable read. Published in 2008, the article addresses the need for IRB and ethical guidelines, to be tailored for online environments. At the moment, IRB’s qualifications for review are based on 3 things—two of which the article deals with 1) whether the study looks at humans or texts, 3) whether the human data is public or private, 3) and whether the data is “individually identifiable” (“the identity of the subject is or may be readily ascertained by the investigator”).

To simplify: human subjects research needs review if it is: of people, private, and identified. It does not need review (is not human subjects research) if it is: of texts, public, and/or unidentifiable. McKee and Porter problematize all three of these binaries using real examples of ethical dilemmas in online research. They provide suggestions for how researchers may make ethical choices in their studies; in particular, they propose the deliberative process of casuistry, with special attention to the rhetorical situation of various web texts (purpose, audience, environment, expectations).

This work is supplemented in “The Ethics of Conducting Writing Research on the Internet: How Heuristics Help,” in which McKee and Porter provide a more detailed set of diagrams, which take the many fluid factors of online writing into account: degree of interaction, data ID, topic sensitivity, subject vulnerability, etc.

My favorite thing in this article was the below diagram, tracing the continuum between “Space” and “Place.” Something I inferred from this distinction was the difference between static, (two dimensional) texts, versus fluid (four dimensional?) digital texts. One can be tagged and coded easily, while the other requires something as complex as Google Wave/Docs.

In their CCC article, McKee and Porter discuss the difference between an author/person binary, versus a continuum. They quote Amy Buckman who says that “Most work on the Internet is semi-published” (qtd on 734).  McKee and Porter set this concept up against the idea of online texts as published documents which may be quoted and cited at will, within reason of fair use, without permission of the author. “In this respect” the authors continue, “the ethical guidelines governing fair use of others’ writing always apply, and the ethical guidelines of securing informed consent may also apply” (734).

The basis for their argument is very similar to one of Bruno Latour’s in We Have Never Been Modern, where he argues that there are no such things as concrete subjects or objects (people/texts), or essence and representation. Rather, he says that there are quasi-subjects and quasi-objects (like, semi-published), all of which have a subject or object identity, depending on what they are are in relationship to. In the case of online texts, McKee and Porter ask that we consider online texts relation to their writers, the writer’s intended audience, and their relationship to the researcher. Is the researcher part of that original, intended audience? Or would the author be disturbed to discover that their work was being analyzed and published by the researcher? That, ultimately, is the question, regarding informed consent.

In the CCC article, “Writing in High School/College: Research Trends and Future Directions,” Addison and McGee review the results of ten educational institutions (three high schools, two community colleges, two four-year public institutions, one four year private institution, one public MA granting institution, and one doctorate-granting, flagship institution) to aggregate data regarding student writing and teacher pedagogy.

One of the most interesting points to me was the data showing that faculty favor personal and in-class writing tasks, but they don’t  value workplace genres. While I understand not teaching something you aren’t yourself familiar with, and the need for personal reflection, I can’t help feel that college writing should include some preparation for disciplinary writing. This is why I favor the Writing About Writing approach (Downs and Wardle) –also discussed at CEA–because it teaches students about how writing works within particular discourses and ecologies, without setting out to teach in the disciplines themselves.

Food Lables to Indicate Nutritional Value? What Kind of Value?

So, it is a lot of work to read food labels. And it’s depressing. Did you know that 17 out of the 18 barbeque sauces that Walmart carries contain two main ingredients: tomato paste, and high fructose corn syrup? That’s right. And, yes: I’m that obsessed with reading labels. And yes, that particular brand which did not contain HFCS as the #2 ingredient did cost more per ounce than the others. You start to feel my pain. So many Americans have no choice but to buy the foods which fail to provide them with adequate nutrition, or satisfy their appetite. And just as many are not aware, that is what they’re buying. nutritional Reformers are trying to make changes, but it’s been difficult, since industry is addicted to cheap ingredients . . . and who isn’t trying to save money these days?

I was intrigued to discover a couple months ago that Michelle Obama has actually staked a major claim in this particular national issue of concern. I found out, through this article in the NY Times, discussing a deal she’s orchestrated with Walmart, who has agreed to run a new line of healthier foods, and to print labels clearly marking the nutritional value of various canned goods.

The measure are, of course, not without controversy, since Walmart has developed such a bad reputation in regards to local ecologies, economies, and business. However, Mrs. Obama seems to understand the underlying socio-economic issues at play in national health by going after the number one grocery seller to low-income families, as well as the number one competitor when it comes to American retail. The hope is that Walmart’s changes will put pressure on other big companies such as Kraft who, up to this point, have refused to budge regarding their nutritional content, or even honest communication thereof through labels. This article on eatingwell.com‘s blog outlines the debate surrounding the deal.

I was interested to learn, that England had a heated debate last summer about whether or not to implement their own form of a nutritional labeling system, which involved a metaphoric traffic light shining green, yellow, or red to indicate health value. The system is used voluntarily by other countries in the UK As one can imagine, food companies did not like the idea of customers seeing a red flashing light when they encountered their products. Imagine, knowing what you’re eating. Scandalous.

If I were to weigh into the conversation, I’d mainly like to draw attention to the fragile balance of concern between the quality and quantity of food value. Formulating, as Latour would say, “matters of fact” into “matters of concern” requires us to decide what kinds of facts concern us.  The new policies Michell Obama has worked for, focus on quantitative measures trans fat, sodium, and added sugars.  This seems like a good place to start. But perhaps, the conversation should remain open to other forms of measurement as well. Jessica Mudry’s research points to a misguided sense of nutritional measurement in western science; hopefully these new reforms will act as a forum for the re-composition of these assumptions. Many believe that particular ingredients which are known to be both harmful to most people’s health and used in excess (such as HFCS and fructose) should be flagged with a warning label (as tobacco is), taxed, or banned all together. I think that the current measures are at least a step in the right direction, articulating matters of concern in a stronger network of association.

The Linkage between Medical Rhetoric and Data Visualization

I hope to have many more posts that fall into this dual thread;  but I am very excited to present my first finds which be making my first post which connects these two great passions of mine.  Both of the scholars I am about to feature are members of TED, and Swedish.

This first video was made for BBC hour by Hans Rosling, a professor of global health at Sweden’s Karolinska Institute who is harnessing the power of data visualization to change the nature of information itself (see also, post on Jeremy Tirrell’s work). His work falls more on the side of social studies of medicine, but I find his use of augmented reality and three dimensional space to explain diachronic patterns to be particularly exciting.

This second video explores direct application of data visualization to medical practice. Anders Ynnerman holds a chair in scientific visualization at Linköping University and is a founder and the present chair of the Center for Medical Image Science and Visualization’s scientific counsel (CMIV). He is actively involved in many international and economic endeavors to apply computer graphics to advanced scientific developments. As one studying the multiple ontologies of medicine, I find this new use of interactive, three dimensional, layered graphics particularly rich with potentiality.