interestingly, reading bloomaert's "discourse" for my discourse analysis class has helped me to think deeply about various issues surrounding my eye illness. i was particularly moved by the chapter on ideology. i couldn't help but think about the various ways in which i interact with dominant ideologies in my own life, especially in relation to health and wellness and the healthcare system. here are some connections to healthcare i made while reading bloomaert's chapter on ideology (he makes lots of references to gramsci, by the way, who i was completely enamored with when i was 18 or 19... just a random fact):
- "... when it comes to explaining how ideologies become ingredients of structures of power and control, van dijk's solution is straightforward: people control themselves by means of the ideologies they have in their heads, and they do so as a group because the ideologies are group ideologies" (162). i've been thinking about this a lot in the context of medicine and food. one thing i've found in my interactions with my doctors, with family members and friends, and with people in general (including co-workers) is that people just don't seem to see much connection between the food they eat and their health. now that i'm dealing with this major inflammation in my eye (and potentially elsewhere in my body), i've changed my diet and begun eating tons of anti-inflammatory foods. i've also given up alcohol, gluten, certain meats, dairy, and certain inflammatory produce (including tomatoes, peppers, eggplant, and potatoes). yes -- it's a major transition, but i've seen major improvements in my health since making these changes. this dominant ideology of medicine as not linked to food controls people's decisionmaking about their own health. for example, people who are sick don't necessarily feel the need to change their diets to get healthy. and even though i told my doctors that changing my diet has helped me heal faster, they don't really have an interest in researching anti-inflammatory foods, suggesting these things to other patients, or even acknowledging how important it is! the ideology is so ingrained that people can't see past it or through it or whatever. even though my co-workers and family members know that these changes are helping me, they still say things like, "well, one sandwich won't kill you!" and i have to reiterate, "you're right -- it won't kill me, but it might make my eye take longer to heal and frankly, i'm ready to have my vision back!" i think those two things seem so separate to people that they can't really fathom such a direct connection.
- "no idea is in itself 'ideological;' it may become ideological as soon as it is picked up by power-regulating institutions such as the media and inserted into the ideological reproduction system they organize. thus, the media seem to have the power to construct deep ideological messages out of trivial, sociologically insignificant events or phenomena" (163). i guess for me, the institutions i kept thinking about when reading this are the food and health care industries. another way i'm thinking about this is specifically in the context of insurance. the ways that we often think about ourselves as healthy (and ailing) people are within the confines of our health care plans. if you don't have health care, your options becoming exceedingly limited. and at the same time, if you have an HMO plan like me, everything is parsed out by your PCP's office -- they are the deciding authority on whether you can go to certain specialists and if you decide you want to go to an alt med professional like a chiropractor or acupuncturist, you actually have to convince your doctor that this is, in fact, your body and that it doesn't matter what their belief system about these things are because you are both working in a system that unfairly gives them a certain power over your health decisions. i often find myself thinking about my own health within the boundaries of what is allowed by my health care plan; i think of specialist visits in terms of co-pay and so on. and then we're surrounded by all these public discourses that reinforce those ways of thinking and being.
- "at the end of the day, hegemony may be what it is because there is a real price to be paid for being anti-hegemonic. the price may be that one is not understood, not heard, not recognised as a subject, but it may also be that one is ostracised, exiled, killed or jailed, made unemployable, or declared insane. as foucault has shown, the boundaries of hegemony are well guarded by coercive institutions" (167). at a lesser level, i find that regardless of what i do with my body (for example, my change in diet to heal inflammation), the health system is still primarily concerned with its own set of standards. when i come into my doctor's appointments, i can mention how much the anti-inflammatory diet is healing me, but my doctor's interest is specifically in whether i'm following my medicine plan, whether i'm taking my pills and drops at the recommended doses, and so on. so i'm allowed to be counter-hegemonic on my own time (for example, i'm sharing my knowledge with others who are dealing with inflammation and with friends, family, and coworkers online), but those practices are still seen as completely separate from who i am in the medical system and it's expected that i don't voice those particular practices in my doctor's visits because they're seen as irrelevant to the issue at hand. in that system, i am represented by a series of charts and blood test results and logs of each visit and all those things, but it's unlikely that they will ever include any notes on the things i'm doing on my own to heal my body.
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