Elizabeth Dell, "Young Women’s Diagnostic Experiences in an RVU-Driven Healthcare Market: Using Narrative Medicine to Illuminate the Unseen Girls of the Healthcare Crisis" In the cacophony of the American healthcare crisis, who falls through the cracks of policy debate? Needing to trade anecdote for answers, the care of young women struggling to be heard in doctor’s offices often hinges on storytelling. While 46% of American teenagers live with chronic illness, their stories have gone largely unstudied. This project tells the stories left behind after the clinical encounter of the young women missing school, work, and extracurricular sports as their life is overtaken by chronic illness.
This project uses an academic theory and clinical modality known as narrative medicine to document chronically-ill young women’s experiences seeking diagnosis and explores relative value units (RVU), a healthcare policy, as a contextual factor in these healthcare experiences. This research asks: What is the timeline of diagnosis for a young woman with a chronic condition, how does this diagnostic process not only impact a patient’s understanding of their illness and treatment plan but also their identity and self-efficacy, and what are the constraints on this diagnostic process that may impede timely, effective care? This research uses three methods: narrative case studies on chronically-ill young women, a literature review of physician experiences related to healthcare payment policy, and an interview with a clinician and educator in pediatric and adolescent medicine. The findings indicated that while seeking care, participants experienced disjointed diagnostic timelines which persistently damaged identity formation and self-efficacy through invalidation, scarce information, and lapses in care. The crisis in care depicted concurrently across patient case studies and physician testimony is attributed to systemic barriers in the current healthcare system. This project employs narrative medicine as a modality of study and means of action to combat the inefficiency and erasure present in the practice and study of medical care for chronically-ill young women.
Fedra Cabrera Solano, "Looking Coatlicue in the eyes: Anzaldúa on writing and emancipation" In Borderlands/La Frontera (1987), Chicana philosopher and activist Gloria Anzaldúa characterizes the process whereby members of oppressed groups acquire knowledge of the structures of dominance that marginalize them from society, and where they fit within those structures. She calls this process the ‘Coatlicue state’, referencing the Nahuatl name for a goddess representing ambiguity in the Aztec canon. At times she describes this state as paralyzing, and at others as divine and profound – as something that must be undergone in order to survive. In this presentation, I sketch an aesthetic reading of the Coatlicue state. In my view, this state should be understood as a crucial first step in the process of forming coalitional networks of insurrect action. This is because it can provide the basis for the creative act of writing, which Anzaldúa describes as crucial in making the experiences of marginalized individuals meaningful and shareable. Importantly for Anzaldúa, the task of writing requires us to rest in the paralysis brought about by the Coatlicue state. Once the agent allows themselves to process this paralysis, they can give it words, which then allows them to render their experience intelligible with the aim of finding allies and dismantling oppressive tropes and stereotypes.
