A Confession of Miraculous Mythological Epistemology for Health Communication
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A Confession of Miraculous Mythological Epistemology for Health Communication A dissertation presented to the faculty of the Graduate College of Ohio University In partial fulfillment of the requirements for the degree Doctor of Philosophy John Ryan Stonestreet December 2014 © 2014 John Ryan Stonestreet. All Rights Reserved. 2 This dissertation titled A Confession of Miraculous Mythological Epistemology for Health Communication by JOHN RYAN STONESTREET has been approved for the School of Interdisciplinary Arts, the School of Communication Studies, and the Graduate College by Vladimir L. Marchenkov Associate Professor of Interdisciplinary Arts Joseph Shields Dean, Graduate College 3 ABSTRACT STONESTREET, JOHN RYAN, Ph.D., December 2014, Individual Interdisciplinary Program, Interdisciplinary Arts and Health Communication A Confession of Miraculous Mythological Epistemology for Health Communication Director of Dissertation: Vladimir L. Marchenkov This dissertation examines health communication surrounding patient and family hopes for miraculous divine intervention in response to physician predictions of medical futility. The study presents an auto-ethnographic account of the author’s personal experience of this clinical context as a hospital chaplain. The context is then reframed from a particular chaplain’s experience to an examination of similar contexts surfacing in the prognosis-related communication between physicians, patients, and families, as revealed in the literature. The combination of first-person experience and third-person analysis of the same problem takes seriously the rationality of both immediately given reality and the work of thinking. At stake in any serious consideration of what all may be at play in this context are significant issues outside of the health communication domain, such as religion, myth, and epistemology. As such, the methodology is an interdisciplinary theoretical analysis of a practical problem in health communication. The theories used for such an analysis are theology, myth theory, and health communication theory. Eastern Orthodox theology forms the underlying theoretical substratum through which the immediate chaplaincy experience is filtered. Myth theory forms the next theoretical layer, examining such issues as the relationship between myth, symbol, and miracle, and the impact of these domains on the evolution of both art and 4 science for a historical contextualization and philosophical conceptualization of the paradigms colliding in the health communication context. Health communication theory forms the final theoretical layer. Drawing upon and building from preceding layers of theoretical analysis, problematic integration theory, hope theory, and narrative medicine theory combine to illumine the problem of interest and suggest a way forward. Teasing out the interdisciplinary aspects of the problem by interweaving multiple levels of theoretical analysis not only sheds light on this particular context, but may also suggest new possibilities for a wider range of health communication encounters at all stages of disease trajectory. 5 DEDICATION To my darling Anastasia 6 ACKNOWLEDGEMENTS Thank you to all of my classroom and clinical teachers at Duke, VCU, UNC, Harvard, Stanford, Berkeley, and St. Vladimir’s who have contributed to my educational journey. Special thanks to Drs. Austin Babrow, Karen Deardorff, Claudia Hale, and Vladimir Marchenkov. Words cannot express how fortunate I feel to be your student. And thank you to Ohio University for recruiting professors of such depth and humanity, for creating unique degree programs that accommodate the exigencies of twenty-first-century education, and for truly being, in my experience, “the best student- centered learning experience in America.” 7 TABLE OF CONTENTS Page Abstract ............................................................................................................................... 3 Dedication ........................................................................................................................... 5 Acknowledgements ............................................................................................................. 6 List of Figures ..................................................................................................................... 9 Chapter One: Surprised by a Disarming Miracle .............................................................. 10 Six Months Later: An Unsolicited Request................................................................... 12 Anna’s Coma ................................................................................................................. 17 Scott’s “Flog” ................................................................................................................ 19 Miracles as Physical Containers for Paradigm Shifts ................................................... 24 Chapter Two: Medicine, Miracles, and Mythical consciousness .................................... 28 The Protection of the Theotokos ................................................................................... 35 Myth and Symbol .......................................................................................................... 37 Myth and History .......................................................................................................... 40 Myth, Painting, and Epistemology ................................................................................ 42 The Alternative to Absolute Mythology is the Partial Mythology of Materialism ....... 44 Egocentric Space and the Physician’s Gaze .................................................................. 47 The “Miraculous” Myth of Materialism........................................................................ 50 Miraculous Mythological Rationality ........................................................................... 54 Miracle and Meaning .................................................................................................... 58 Chapter Three: The Canonical Genres of Modern Medical Myth .................................... 64 Healing as Detective Story ............................................................................................ 76 Healing as Battle ........................................................................................................... 77 Healing as Machine Repair ........................................................................................... 84 Healing as Transformative Journey............................................................................... 86 Chapter Four: The Adolescence of “Immanentist Infinitism” ......................................... 91 The Evolution of Myth as the Lifecycle Development of Humanity ............................ 94 The Childhood of Myth ................................................................................................. 96 The Pre-adolescence of Myth ...................................................................................... 101 The Early Adolescence of Myth.................................................................................. 113 New Possibilities for an Unrealized Future................................................................. 127 Chapter Five: PI Theory & Hope for the Miracle of Communicative Transformation . 131 The Basics of PI Theory .............................................................................................. 133 Probability and Meaning ............................................................................................. 134 Futility Prognostication and Miracle-hope: A Health Communication Challenge ..... 142 Futility Prognostication, Miracle-hope, and PI Theory............................................... 144 Chapter Six: Communicative Horticulture for the Flowering of Hope ......................... 161 Hope at Life’s End: Miracle Cure or Peace with God? ............................................... 164 Hope Theory: Conceptualizing the Evolution of Full-bloomed Hope at Life’s End .. 170 Modern Scientism or Premodern Spiritualism? .......................................................... 175 Miracle on 34th Ward: From Cynicism to Hope’s Loving Embrace ......................... 177 Chapter Seven: An Examination of, and Prescription for, Narrative Medicine ............. 180 8 Narrative and the Extended Adolescence of Postmodernism ..................................... 197 Postmodern Narrative and the Art of Medicine .......................................................... 200 Black Swans Consume the Carnage of Exclusively Probabilistic Reality .................. 203 The Art of Medicine, a Pro-theological Activity ........................................................ 209 Chapter Eight: Orthodox Wisdom for Uncertainty and Suffering in Health Communication ............................................................................................................... 214 Toward a Twenty-First-Century Conversation ........................................................... 220 A Philosophical Prescription for Modern Theology’s Ailment: Divine Weakness .... 226 Eucharistic Reality ...................................................................................................... 232 An Orthodox Physician’s Perspective ......................................................................... 256 Chapter Nine: Theological Reflection for the Art of Health Communication ................ 278 Modernity and