Small stories, big dilemmas: some thoughts on method

In my last post I touched on the concept of ‘small stories’, the brief, fragmented, conversational narratives that arise naturally in our everyday interactions. Small stories are everywhere: doctor-patient encounters, business meetings, phone calls, talk in the car, and conversations between friends are just some of the interactional contexts where small stories emerge. The question that continues to pulse is how to capture these spontaneous and fleeting snippets of talk in action.

One issue with collecting small stories is the inevitable influence of the researcher’s involvement. For data to be considered ‘naturally-occurring’, Potter (1996, p.135) says that it must pass the ‘dead social scientist test’: that is, the data used should be based on an interaction that “would have taken place in the form that it did had the researcher not been born or if the researcher had got run over on the way to the university that morning”. But the ethical requirement that one must first obtain the informed consent of participants makes it hard to see how any data could be collected had the researcher “not been born”.

The famous sociolinguist William Labov used the term “observer’s paradox” to describe the difficulties of obtaining natural speech in research situations. As he puts it: “The aim of linguistic research in the community must be to find out how people talk when they are not being systematically observed; yet we can only obtain this data by systematic observation” (1972, p.209). While it is widely accepted that the observer’s paradox can never be completely overcome, researchers across the social sciences have sought to obtain data that is as close to naturally-occurring as possible (Gordon 2012). To do this, they have used research methods such as audio or video recordings and participant observation of some form or other. But for those of us who are narrative inquirers, gatherers of, and listeners to stories, these methods set off all sorts of alarm bells.

Narrative inquiry is a relational inquiry. Clandinin and Connelly (2000, p.189) tell us that “relationship is key to what it is that narrative inquirers do”. As narrative inquirers, we do research with rather than on our participants. We step out from behind the bushes and walk alongside them. We treat stories as gifts that are shared with us through the generosity of those whom we want to learn more about. It is precisely for these reasons that the thought of using recording devices or mechanically observing interactions troubles me. Like Blix (2016, p.29), I worry about becoming an “academic parasite”, intruding into people’s lives only to extract their stories away from them and scramble out post data collection.

I ask you, then, how do we approach studying small stories narratively? What kinds of methods should we use if we are to maintain a relational ethical stance in small story research? I’m drawn to Ron Pelias’ (2011) description of leaning in during everyday life encounters as a way to think about the study of small stories. Is it possible to “lean in” as Pelias suggests, to engage in the everyday life worlds of our participants without creating a sense of surveillance and eavesdropping?

One might say that I am caught in what Derrida (1993, p.12) calls aporias, moments of “not knowing where to go”. But as Caine (2010) reminds us, narrative inquiry is a fluid form of investigation; it is like travelling to and within unfamiliar landscapes without a map. What compels me to think carefully and critically about my choice of methods is that the participants I will be working alongside are in a vulnerable space. I will be entering the lives of families at a time of great disruption when serious illness calls forth important and sometimes difficult stories. This kind of research demands methods that build the highest level of sensitivity into their core.

References

Blix, BH 2016, ‘The Importance of Untold and Unheard Stories in Narrative Gerontology: Reflections on a Field Still in the Making from a Narrative Gerontologist in the Making’, Narrative Works: Issues, Investigations & Interventions, vol.6, no.2, pp.28-49.

Caine, V 2010, ‘Narrative Beginnings: Traveling To and Within Unfamiliar Landscapes’, Qualitative Health Research, vol.20, no.9, pp.1304-1311.

Clandinin, DJ & Connelly, FM 2000, Narrative inquiry: Experience and story in qualitative research, Jossey-Bass, San Francisco.

Derrida, J 1993, Aporias: Dying – Awaiting (one Another at) the “Limits of Truth”, Stanford University Press, Stanford.

Gordon, C 2012, ‘Beyond the observer’s paradox: the audio-recorder as a resource for the display of identity’, Qualitative Research, vol.13, no.3, pp.299-317.

Labov, W 1972, Sociolinguistic patterns, University of Pennsylvania Press, Philadelphia.

Pelias, R 2011, Leaning: A poetics of personal relations, Left Coast Press, Walnut Creek, California.

Potter, J 1996, ‘Discourse analysis and constructionist approaches: Theoretical background’, in J Richardson (ed.), Handbook of qualitative research methods for psychology and the social sciences, BPS Books, Leicester, pp.125-40.

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Stories from the other side of healthcare

The scream that goes through the house is the heartbeat that makes audible, at last, who we are, how resonant we are, how connected we are.

— Arnold Weinstein (2003)

Over the past few weeks I’ve been closely following The Haunted One on Twitter. This account has been set up for healthcare professionals to share difficult stories, specifically the traumatic, painful, and hard stuff they witness every day at work and that stays with them long after their shift is done. It interests me how these fragile stories are piling up and circulating through a space in which they do not comfortably reside. There have been several concerns raised about patient privacy and confidentiality, with some users questioning whether it’s appropriate to bring these stories into the public domain.

In her book Other People’s Stories (2005), Amy Shuman writes that stories need to travel beyond their owners to accomplish cultural work. We can see this in Patient Opinion, which focuses on making patients’ stories of healthcare experiences travel for improving services. The Haunted One does cultural work by providing a safe place for healthcare professionals to expose their vulnerable selves, something which is not typically encouraged in the culture of medicine.

Shuman also talks about the fault lines that crack open when stories travel. By fault lines, she means the sorts of ethical quagmires that stories can fall into on their paths. For example, Patient Opinion has been criticised for its slicing and dicing approach to moderating the stories that pass through its feedback system. The privacy and confidentiality issues that The Haunted One has been wrestling with are essentially a question of who has the right to tell which stories under what circumstances, issues of what Shuman calls entitlement to acts of narration. Claiming entitlement to the stories posted on The Haunted One is complicated because they are each, as Cathy Caruth (1996) puts it, “the story of the way in which one’s own trauma is tied up with the trauma of another”. This places storytellers in a catch-22 position: telling hard stories might make a better world, but they are never just our own to tell.

The Haunted One is a powerful reminder that patients, families, and healthcare professionals are not separate storytelling entities, even though much research treats them this way. The storytelling that takes place in healthcare is a product of the intersections of lives and the entanglement of experiences that brings patients, families, and healthcare professionals together in a storied web. This is why it’s important to be mindful of our responsibilities when telling stories about health, illness, and care that are inevitably entwined with the lives of others.

What I also find appealing about The Haunted One is that it challenges the way we see healthcare professionals. As Paul Atkinson (1997) has said of illness narratives, patients are typically represented as the victims, and medical staff as the villains. In many of the academic papers I’ve read, patients’ storylines are analysed to reveal the absence of compassion, sensitivity, and respect in clinical environments. Often, healthcare professionals are viewed as uncaring and disengaged and are found to ignore and dismiss patients’ suffering and keep families at arm’s length. However, The Haunted One presents a completely different picture. It unveils the basic humanity of healthcare professionals as people who care about the patients they care for, whose hearts bleed and eyes weep for them, and who carry their wounds and losses with them.

The Haunted One is a small but significant step towards humanising healthcare because it facilitates, in the words of literary scholar Arnold Weinstein (2003), “a world that is linked and meshed, a world in which pain and feeling bind us rather than divide us, an ecosystem that flaunts the primacy of emotion itself as a human bridge.” And, as a growing researcher trying to learn my way around this vast field, it has shown me the importance of understanding what it means to experience healthcare from both inside and outside the clinic doors.

References

Atkinson, P 1997, ‘Narrative Turn or Blind Alley?’, Qualitative Health Research, vol.7, no.3, pp.325-44.

Caruth, C 1996, Unclaimed Experience: Trauma, Narrative, and History, Johns Hopkins University Press, Baltimore.

Shuman, A 2005, Other People’s Stories: Entitlement Claims and the Critique of Empathy, University of Illinois Press, Urbana.

Weinstein, A 2003, A Scream Goes Through the House: What Literature Teaches Us About Life, Random House, New York.