This article revisits the mid-century medical debate over the “treatment” of transsexualism in the U.S., summarily represented in the most cited essays on transsexualism at the time. The article leverages the stasis point of those medical debates—is transsexuality a product of the psyche or the soma?—as a singularly rich site for rhetorical inquiry arguing that this case demonstrates that stasis has both substance and a rhetorical form that determines the limits of what is accepted as a legitimate argument within any debate. The ultimate aim of this essay is twofold: one, to add to the rhetorical history of transsexuality with regard to medicalization and, two, to demonstrate how the decision of medical professionals to not allow sex-change surgery as a legitimate treatment to transsexual patients had much to do with the rhetorical association of site of malady/site of treatment and little to do with scientific evidence.

Survivor’s guilt haunts countless veterans, yet little research examines how veterans rhetorically process this experience. This study analyzes poetry from post-9/11 veterans to identify a distinct rhetorical mode we term reparative ethos.  While existing Mental Health Rhetoric Research (MHRR) has identified and extensively explored recuperative ethos—strategies used to restore credibility in the face of externally imposed stigma—we propose that some veterans may also engage in what we call reparative ethos. Unlike recuperative ethos, which addresses externally imposed stigma through appeals to living audiences, reparative ethos aims to make amends to internalized representations of lost comrades. Drawing on Melanie Klein’s object relations theory and MHRR, we analyze poems from Warrior Writers anthologies that explicitly address survivor’s guilt. Our analysis reveals that veterans engage in narrative acts of reparation directed toward deceased others, addressing both the loss of external relationships and threats to internalized military ethos. This research extends MHRR by demonstrating how trauma can generate inward-facing rhetorical strategies focused on healing rather than persuasion, offering new frameworks for understanding veteran mental healthcare and creative expression.

What makes societies see, acknowledge, and constitute an issue as a crisis which should be acted upon? We address this by examining a specific instance of media attention to a creeping health crisis, namely the communication of an individual non-governmental actor, the influencer Ingeborg Senneset. We ask: What is the rhetorical agency of an individual opinion leader (influencer) in a health risk situation such as the creeping AMR-crisis? Our study demonstrates that the rhetorical agency of Senneset as an influencer rests on three interrelated communicative strategies: First, she enacts what we term a multiple ethos implying both the expertise of a professional and the authenticity of an ordinary person; Second, she uses narratives of fear with a rational grounding; Third, she establishes and works rhetorically within a diverse digital ecology where she publishes, posts, and comments on several different platforms, where the different posts and publications reinforce each other.

Using the Indiana Medical History Museum’s (IMHM) “Rehumanizing the Specimens” project as a case study, this essay explores the impact of language on rehumanizing human specimens in medical museums. The individuals represented by these specimens are often dehumanized because they are reduced to specific illnesses or injuries and/or because they are viewed as curiosities rather than representations of actual people. Further, the specimens at the IMHM were obtained from former patients of Central State Hospital, a psychiatric facility in operation from 1848 until 1994, so these individuals experienced additional dehumanization due to the stigma surrounding their mental illness diagnoses. To resist these forms of dehumanization, the IMHM launched the “Rehumanizing the Specimens” project, which used historical records and documents to develop narratives outlining the lived experiences of the 48 people represented by the specimens. Particularly, the narratives engaged rehumanizing rhetoric (Winderman & Landau, 2020) and recuperative ethos (Molloy, 2015), and I argue for the effectiveness of these rehumanizing strategies. In addition to offering suggestions for how these strategies can be adopted by other medical museums, I extend the discussion to healthcare providers, applying what was learned from the case study to the contemporary study and practice of medicine.

This study investigates infant feeding rhetoric from the Baby-Friendly Hospital Initiative (BFHI), a World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) partnership that prioritizes exclusive breastfeeding. The study approaches patient education materials as user documentation and analyzes the materials for kairos and metaphor. The author argued that the materials function as documentation for the birthing parent’s body operating within the system of the BFHI. The article concludes with recommendations for future research and for creating infant feeding resources that provide critical access to the healthcare system by rejecting the body-as-machine metaphor and reflecting families’ diverse situations, not just the situation of the U.S. healthcare system or BFHI.

Extending Sarah Singer and Jordynn Jack’s (2020) definition of illness chronicity as a complex rhetorical process of identification, this essay suggests that the development of specific temporal vocabularies (ways of defining and describing time) is an important part of this process, one that precedes and enables identification. Drawing from underemphasized temporal themes in Kenneth Burke’s work, this essay analyzes a collection of public descriptions of chronic depression to identify implicit patterns of temporal vocabulary development and to consider how these patterns relate to identification. The analysis shows that descriptions of chronic depression consistently utilize what Burke termed “directional” strategies of definition, which center permanence as the essence of the illness experience, obscuring recognition of change. While this definitional strategy enables two potentially ameliorative disidentifications, it comes at the expense of precluding kairos, which requires a dialectically-intact temporal vocabulary featuring terms of both permanence and change.

Though persistent failure of clinical trials poses a challenge for multiple conditions, traumatic brain injury (TBI) is especially difficult to study because of its heterogeneity, complexity, unpredictable outcomes, and resistance to definition and classification. This article analyzes published discourse among researchers about the failure of two large trials for progesterone as a traumatic brain injury (TBI) treatment. The analysis specifically examines how researchers respond to trial failure and how TBI functions as a diagnostic construct. I draw on theories of kairos and multiple ontologies to argue that, while evidence-based medicine constructs TBI as a coherent entity in order to study it through randomized controlled trials, this entity breaks down in practice into multiple temporalities and spaces that are not sufficiently coordinated.

Rhetoric of health and medicine (RHM) knowledge integrity is explored in the context of preparing RHM students, researchers, and practitioners to be careful curators and communicators of information from the medical literature. More specifically, the goal of this article is to provide a systematic framework for researching and citing claims, or “facts,” from the medical literature with transferrable skills beyond the academy. In this article, this framework is examined through the lens of science communication ethics and writer ethos to guide individuals while navigating between automation of literature databases and human agency. Furthermore, this article explores the proper citation of research claims from different genres that are published in the “medical literature” with attention to conserving the authors’ original voice. Collectively, this framework and discussion builds on prior scholarship on authorship and intellectual property in medicine.

The coronavirus pandemic has been widely experienced online, and the experience of COVID-19 vaccines is no exception. This article reports on a case study of social media writing authored by COVID-19 vaccine clinical trial participants as a new and innovative form of vaccine communication. Findings offer three insights about vaccine decision-making and communication: 1) vaccine refusal, confidence, and hesitancy are increasingly informed by individuals’ personal assessments of vulnerability and risk; 2) expressed vaccine hesitancy is characterized by openness to persuasion; and 3) this impressionable vaccine hesitancy can be productively addressed in spaces that bridge lived experience and medical expertise. Building on these insights, this article delineates strategies for meaningful and participatory online communication about vaccination.

Extensive evidence demonstrates that the Centers for Disease Control and Prevention’s multimedia anti-smoking campaign, Tips from Former Smokers, is an effective public health measure. In this essay, I explain the rhetorical appeals utilized in the campaign that contribute to its resonance, arguing that the campaign invokes corporeal anxiety, an emotion that emerges from societal aversion to disability. These appeals to corporeal anxiety operate as enthymemes by relying upon an unstated premise: that disability is negative and ought to be avoided to preserve one’s normalcy. This analysis treats the campaign messages as a form of bodily rhetoric and visual argument, arguing that the campaign deters smoking through graphic bodily imagery and narratives of lost normalcy that conceptualize disability as tragedy or deficit. I conclude that the success of the campaign comes at the expense of perpetuating stigma against people with disabilities.

This persuasion brief addresses medical oncologists and their teams (nurses, physician assistants, and the like) who use chemotherapy to treat cancer patients, and asks them to consider the ways that a post-chemotherapy state is itself a chronic condition, how some patients come to understand their bodies as chronically changed by chemotherapy (almost as if having a new or different disease), how patient education materials describing chemotherapy can better equip patients to face their new reality, and why practitioners should be better trained in post-chemotherapy care.

Alzheimer’s disease (AD), a neurodegenerative disease that progresses along a fluctuating course of changing capacities, affects approximately 5.7 million Americans, an estimate expected to skyrocket as the baby boomer generation ages. Adopting a rhetorical field methods approach I analyze the transcripts of qualitative interviews of 3 patients and 28 caregivers to understand how the chronicity of AD affects informal caregiving strategies as well as the lived experiences of persons with AD. Employing a new materialist framework along with rhetorical enactment theory, I posit chronicity as rhetorical action distributed not only among human and nonhuman agents but also across moments, requiring special attention to time and timing. I argue chronic illness is rhetorically enacted through three material-discursive practices: ontological practices that enact reality, alignment practices that facilitate or disrupt cooperation among entities, and mnemonic practices that enact and outsource memory among AD caregivers. Across all three kinds of practice, a material-discursive sense of kairos and chronos is advanced.

As the introduction to this issue makes clear, the ethical exposure essays we include here are the start of an ongoing initiative in the journal—to include focused sections of shorter pieces on critical threads or matters of concern in ongoing RHM work, in this case ethical conundra encountered in practice-level enactments of methodologies. In setting the tone for this special section, we now attempt to parse an “ethics in praxis” that is characterized by situational, embodied, and reflexive orientations rather thanby attributes more common in virtue ethics. This emphasis on praxis allows us to put forward an idea of ethics in and for RHM that is responsive to critique as we articulate it in the overall introduction to this issue: as kairos-driven and attuned to crises as they unfold in the present and as they anticipate and offer opportunities to “play” at various imagined futures.

The following commentary follows on and flows out of an initial response to reading “Multiple Voices on Authorship and Authority in Biomedical Publications” by DeTora and colleagues (2020), which appeared in volume 3 issue 4 of Rhetoric of Health and Medicine. This response, by rhetorician of science, health, and medicine Celeste Condit, begins by situating questions about authorship and authority in biomedicine against a classical rhetorical source, Plato’s Gorgias. In so doing, Condit identifies a messy truth—that rhetoric potentially can pose dangers when applied to health and medicine. The authors then construct a Platonic dialogue that situates authorship, ethos, and authority in the context of biomedicine. Ultimately, the two authors illustrate the messiness that results when attempting to mount a discussion of these terms across intellectual registers.

Between 1842 and 1890, 23 women wrote 33 memoirs about their time spent incarcerated in American insane asylums. While a handful of these memoirs have been studied, there has not been a recognition of how many asylum mem­oirs exist and their significance as a collective body of work. Grounded in an inductive analysis of the collective 33 works, this article begins a process of recovering a mostly forgotten moment in time when former patients took agency over their experience, ethos, and rhetoricity to break down the institutional wall of silence and give the public the first patient-centered memoirs. I argue that these women rhetors did this by foregrounding their own identity as patient and by creating a rhetorical position from which their readers would feel the trauma of asylum life. Both rhetorical moves countered institutionalization’s dehumanizing effects by placing the patient experience at the center of understanding the asy­lum experience.

This pilot study of a mental health call center clinician’s workplace tools, processes, and organizational structures proposes a preliminary theory of “distributed and mediated ethos.” A distributed and mediated ethos refers to how an organization uses various resources—artifacts, technologies, and processes—situated across dis¬parate locations in order to expand and control their identity in the service of extend¬ing their reach and capacity to render essential services. An analysis of a participant clinician’s rhetorical context flowcharts and network pictures shows how an agency’s ethos is mediated through various technologies. Findings suggest that a distributed ethos (1) projects the impression of being “always there”; (2) relies on dexterity across several human and nonhuman actors; and (3) necessitates targeted tasks from branches that extend ethos farther from the organization. This pilot study, thus, provides researchers of rhetoric of health and medicine (RHM) with a new tool for exploring the intricate and complex nature of health at a distance and other complicated 21st century healthcare delivery formats.

Using primary source materials from medical, government, and journalism archives, this study of public medical discourse reveals the role of argumentation in posi­tively shaping public perceptions of traumatized soldiers and locates the contem­porary origins of the trope of “soldier as psychological victim of war”—a perception that continues to inform public policy and medical research. Using Jasinski’s (1998) concepts of interior and exterior constitutive potential to analyze the public writ­ings, interviews, and Congressional testimony of VVAW-affiliated psychiatrists, the study finds that the radical psychiatrists’ interior (directed at veterans) and exte­rior (directed at public and medical institutions) rhetorics were (and arguably remain) mutually effective in creating an identity for veterans to occupy that exculpated them from their involvement in war, while allowing them to garner benefits for their ser­vice. The article concludes with two examples of the “veteran as psychological vic­tim of war” trope as it shapes the contemporary rhetorical ecology of former servicemembers.

To ascertain the risk assessments parents use when making vaccine decisions, I conducted semi-structured interviews with mothers of young children. Treating these interviews as texts, I rhetorically analyzed how parents talk about their chil­dren’s vaccination in order to better understand reasons for vaccine hesitancy. My analysis reveals that despite the difference in behavior between parents who vac­cinate and parents who hesitate, there is a commonality in discourse. Three topoi emerged within these mothers’ explanation of their vaccination decisions: percep­tions of diseases, perceptions of environmental threats, and assessment of their child’s vulnerability. Considering the common ground these topoi reflect, I explore possible alternative messaging about vaccines that might better encourage vaccine uptake. Ultimately, I argue a rhetorical approach to studying public and personal discourses about health issues can prove useful for identifying key topoi, which can generate communication strategies for addressing public concerns while potentially improving support for public health initiatives

In this article, we argue that Down syndrome (DS) advocates seeking to intervene in medical exigences are poorly positioned by their audiences of patients and physicians. To combat this problem, we find that some advocates, specifically mothers of children with DS, recuperate their ethos through two primary rhetorical strategies: shaping contexts and developing invitational ethos. Advocates are able to more freely draw from maternal authority when they shape the contexts of their messages, creating new venues and limiting their audiences. On the other hand, advocates can also appease medical authority by developing an invitational ethos in which they create the conditions for their own participation and offer their own perspectives. Through the use of these two strategies, advocates are able to claim their positions as mothers, while still cultivating positive ethos.

Recent work in rhetoric of science, technology, health, and medicine argues for a shift away from critique, even as some health communication scholars call for critical engagement with the situated, ideological nature of scientific claims supporting public health messages. We suggest that critique of scientific claims remains important to rhetoricians of health and medicine, but that such critique must go further in examining interactions between science, values, and public health policy. We offer an adapted version of stasis theory as a framework for pursuing this end. Using the U.S. public health nutrition policy Dietary Guidelines for Americans as a case study, we engage this framework to explore how science-based nutrition policy provides a discursive lens that influences how subsequent scientific evidence is produced, interpreted, and employed.

This persuasion brief suggests that the rhetorical concepts of techne and rhetorical work facilitate the creation of public health crisis communication. To illustrate this claim, we present findings from a case study with the Johns Hopkins Medicine Ebola Crisis Communications Team, a transdisciplinary group that collaborated with Centers for Disease Control and Prevention during the 2014 Ebola crisis. The team created multimodal documentation to support healthcare providers as they prepared to treat patients and crafted communication to alleviate the fear among health workers and the public caused by the threat of Ebola. Ultimately, we frame public health crisis communication as a rhetorical endeavor guided by a focus on failure, situated expertise, and techne. This focus pushes specialists to tend to the processes involved in creating a response, and it highlights how gut feelings factor into the process of designing and implementing a public health crisis intervention.

Patient-OBGYN (obstetrics and gynecology) communication about contraception and reproduction can be fraught with ideological pressures, cultural assumptions, and emotion-based claims and concerns. Specifically, the topic of elective sterilization for women often invokes preconceived notions of femininity and mothering. Based on medical pamphlets and online discussion forums, our analysis reveals how gendered discrepancies exist in medical information about elective sterilization. This persuasion brief aims to invite OBGYNs to understand how cultural and traditional views of gender inform medical decisions and oppress women’s reproductive autonomy. It offers suggestions for OBGYNs, women seeking sterilization, and scholars in the rhetoric of health and medicine.

Analyzing media discourse around Chris Christie’s fatness and fitness for the presidency, this essay examines how stigma constrains the rhetorical resources of individuals who transgress norms of bodies, health, and ability. To do so, I extend two concepts in the rhetoric of health and medicine: rhetorical disability (challenges to ethos precipitated by stigma) and recuperative ethos (Molloy, 2015) (efforts to rebuild ethos in light of rhetorical disability). I make two interrelated claims: 1) fat stigma is rhetorically disabling in the cultural logics of the obesity epidemic, and 2) since fat stigma in this context operates as a rhetorical disability, Christie seeks to recuperate his ethos by presenting himself as a viable leader. While scholars have theorized that “rhetorical disability” is incited by stigma around mental disability (Price, 2011; Johnson, 2010; Prendergast, 2001), I show how fat stigma similarly produces a disabling rhetorical effect: as Christie works to recuperate ethos, fat is taken up as an argument about health, morality, and individual failure.

Public health advocates often encounter the arduous rhetorical situation of championing issues assumed to be personal. One such rhetorical situation can be observed in pro-caregiving advocacy rhetoric; organizations promoting public policy attention for unpaid family caregivers. This essay argues that pro-caregiving advocates invite public action by persuasively advancing personal and public problems that impact caregivers, care-receivers, taxpayers, and businesses; however, in their policy statements, advocates undo the likelihood of public action by creating a partial solution that emphasizes the preferred location of home care and de-emphasizes the ways in which the financial and health-related caregiver problems get solved. The essay concludes with rhetorical lessons that highlight the practical applicability of argumentation methodology for scholars and practitioners of public health advocacy. In doing so, this essay offers practical tools to evaluate and reposition the efforts of health advocates moving an issue from personal to public.

In the introduction to the inaugural double issue, we presented our vision for RHM’s ethos as a dwelling place (Hyde, 2004) for those doing rhetorically oriented work in health and medicine, and as an ambassadorial site for demonstrating how rhetorical study in all of its forms can inform the work of health and medicine’s wider stakeholders and practices. In this introduction, we aim to extend this call by imagining the journal as a site for building a community of practice, which, according to Etienne Wenger and Beverly Wenger-Trayner (2015), can be defined as “a group of people who share a concern or a passion for something they do, and learn how to do it better as they interact regularly” (para 1). This theory of social learning includes the three “modes of identification”1 (Wenger, 2010)—namely engagement, alignment, and imagination—through which the journal helps shape the identity of the now-emerged community of RHM scholars.

In this persuasion brief I suggest how rhetorical-historical insights into the scientific and medical discourses of female hormones are relevant to current organizational and institutional diversity initiatives, especially those that aim to increase the number of women in leadership positions. Many of the examples I cite in the essay make specific reference to hormones, and as I argue, hormones often serve an enthymematic function in these expert arguments, both past and present. More specifically, I argue, discourses about hormones allow people who do not possess any scientific expertise to make authoritative-sounding claims that resonate with popular beliefs about women’s bodies and brains. Uncovering these historical tendencies in scientific and medical discourse offers new perspectives on the obstacles that women face in today’s workplaces. In this persuasion brief I aim to discuss these perspectives in ways that make the findings of rhetorical-historical research relevant to the many different stakeholders, leaders, and policymakers who are currently working to help women rise to leadership positions in many different fields.

Vaccinations are a notoriously difficult topic to discuss with patients, and efforts to persuade those who are most hesitant often fail. In this persuasion brief, common vaccination concerns and skepticisms are reexamined through the perspectives offered by rhetorical studies. This analysis demonstrates why current counter-arguments to vaccine skepticisms often fall short. As an alternative, this article encourages practitioners to consider how the material qualities of vaccinations contribute to their instability and make them difficult for patients to accept. This perspective suggests relationship-building and coalition-building as routes for improving doctor-patient communication about vaccines.