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The Paradox of Hope

The Paradox of Hope: Journeys through a Clinical Borderland

Cheryl Mattingly
Copyright Date: 2010
Edition: 1
Pages: 288
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  • Book Info
    The Paradox of Hope
    Book Description:

    Grounded in intimate moments of family life in and out of hospitals, this book explores the hope that inspires us to try to create lives worth living, even when no cure is in sight.The Paradox of Hopefocuses on a group of African American families in a multicultural urban environment, many of them poor and all of them with children who have been diagnosed with serious chronic medical conditions. Cheryl Mattingly proposes a narrative phenomenology of practice as she explores case stories in this highly readable study. Depicting the multicultural urban hospital as a border zone where race, class, and chronic disease intersect, this theoretically innovative study illuminates communities of care that span both clinic and family and shows how hope is created as an everyday reality amid trying circumstances.

    eISBN: 978-0-520-94823-5
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Prologue
    (pp. ix-x)

    In one sense, this is a book about everyone. It concerns the suffering that comes with bodily affliction and the efforts people make to create and—perhaps more important—to reimagine hope even when life has become very grim. As humans, we are all subject to the vulnerability of our bodies. We all suffer. But this book is also more specific, directed primarily to one social scene: the clinical encounter. While clinicians are important here, the main characters are African American parents bringing their children to hospitals and clinics for care. These are mostly very ill children or children with...

  4. Acknowledgments
    (pp. xi-xvi)
  5. CHAPTER 1 The Lobby
    (pp. 1-36)

    The first time I interviewed Andrena was in the main lobby of a large urban hospital. A cavernous space. Strangely dark, even formidable. Later I could see that the gloom had its comforts. A good place for quiet crying, or for staring into nothing. High ceilings, clusters of permanently fixed plastic chairs lined up in rows of three or four, or set together in L shapes. Chairs as neutral as could be, in tones of beige and practical brown, placed neatly on the wall-to-wall gray carpet. Some leafy potted plants (plastic too, but the realistic kind) helped divide the room...

  6. CHAPTER 2 Narrative Matters
    (pp. 37-76)

    What, precisely, does it mean to say hope is a practice? On the one hand, this seems obvious. For the past several decades, anthropology and the social sciences generally have shown an interest in practice. The term is now so ubiquitous it seems mere commonplace. What else could a culture, a social structure, or a local moral world be if not something somehow “practiced”? But of course, this construct has come into play because of a particular intellectual history. Aristotle made practice (or praxis) central to his political and ethical thought. Within social theory it has been most notably developed...

  7. CHAPTER 3 Border Trouble
    (pp. 77-114)

    Thus far, I have outlined (with increasing ethnographic illustration) a narrative phenomenology of practice. Although I have given a number of concrete examples to support my assertions, arguments, and taxonomies, a good deal of this discussion has been in the abstract. This chapter marks a shift to extended examinations of particular people, places, and events, centering upon the primary families that provide the focal point for this book. I open this ethnographic scene not with them or with any hospitals or clinics, however. Taking a step back, I begin with a brief historical and demographic portrait of the contexts that...

  8. CHAPTER 4 Widening the Gap: The Creation of a Conflict Drama
    (pp. 115-140)

    When a contentious relationship has emerged and embattled interlocutors have been designated by one another as troublesome familiar strangers, it is extremely difficult to circumvent conflicts or challenge these powerful designations. The case that follows reveals the struggles between a father (Ron) and a physical therapy aide (Marcia) in which the father has already been prefigured by much of the clinical staff as a “noncompliant dad” who “does not step up to the plate” in caring for his very ill daughter suffering from sickle-cell disease.

    What is especially interesting in this case is not the struggle itself, which is common...

  9. CHAPTER 5 Plotting Hope
    (pp. 141-174)

    I have offered a troubled portrait of contemporary health care and the intransigent and consequential practices of racial “Othering” for African Americans. But I have also suggested that this is only part of the picture, one that easily obscures the creative efforts clinicians and patients can make to connect and build trust across all kinds of race and class divides. Families and clinicians often work hard to develop boundary-crossing skills, such as the ability to “read the minds” of culturally and racially distant others and to “perform” their status as competent and caring. In doing so, they draw upon cultural...

  10. CHAPTER 6 Daydreaming: Captain Hook Gets Speech Therapy
    (pp. 175-199)

    In a borderland like the hospital, the work of culture emerges as a process of constant innovation based on “borrowing” cultural objects from somewhere else. Perhaps nowhere is this penchant for borrowing so creative as in the infusion of children’s popular culture into clinical work. This infusion is sometimes used to profound effect in creating transformative clinical moments that speak to hope. The highly narrative language of children’s mass media (films and television shows) especially offers a readily available “lingua franca” for creating not only a sense of common ground but also imaginary spaces and hopeful dreams. In turning to...

  11. CHAPTER 7 Fleeting Hope
    (pp. 200-215)

    Healing dramas may be powerful, but they may also be ephemeral, momentary bursts of life that cannot be sustained under a harsh clinical gaze. They are fragile moments that are often created, only to be interrupted, ignored, or undermined. The significance of the experiences created is easily lost not only because all lived experience necessarily has a fleeting quality but also because the cultural worlds in which these healing experiences occur do not authorize these kinds of dramas. They have no official status within clinic culture and are not acknowledged as integral to healing.

    In chapter 5, I remarked upon...

  12. CHAPTER 8 Narrative Phenomenology and the Practice of Hope
    (pp. 216-234)

    In this concluding chapter, I briefly summarize some of the overarching arguments that I have worked to make throughout the book. But I also return to two people who have served as central protagonists: Andrena and Ronetta. It seems appropriate to conclude a book in which I have insisted on the importance of the experience-near, the eventful, and the personal with an epilogue that takes us back to people’s lives.

    I have concentrated on hope as connected to one key task: creating borderland communities between clinicians, patients, and families. The cultivation of hope depends upon the politics of this relational...

  13. Notes
    (pp. 235-246)
  14. References
    (pp. 247-262)
  15. Index
    (pp. 263-268)
  16. Back Matter
    (pp. 269-269)