A Natural History of Family Cancer

Interactional Resources for Managing Illness

Bibliographic Data

ID2266212
AuthorsGeraldine Leydon (0000-0001-5986-3300, University of Southampton, corresponding author), Geraldine M Leydon
Year2010
Volume32
Issue6
Pages974-975
Publication date2010-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/j.1467-9566.2010.01264_7.x
OpenAlexW1560495899
LanguageEN
Citations received11

Beach, W.A. A Natural History of Family Cancer: Interactional Resources for Managing Illness . New Jersey : Hampton Press Inc. , 2009 $89.50 (hbk ) 388 pp ISBN 978-1-57273-690-0 (hbk) . Over the last 30 or so years we have witnessed a significant rise in empirically driven research, drawing on the method of Conversation Analysis (CA), concerned to explicate and understand how a variety of health related interactions are socially patterned and organised. During a similar period, the literature on the psycho-social needs of people affected by cancer and the centrality of communication has also grown. This largely empirical volume contributes to both of these fields, by drawing on a corpus entitled ‘The Malignancy Series’. The corpus comprises 60 audio-recorded conversations involving family members of the author who have been informed that their mother’s tumour has been diagnosed as malignant. The calls were recorded over a 13 month period and commence with a call between Dad and Son in which the Dad ‘delivers the news’. The cancer journey is revealed and (in part) constituted in and through ongoing conversations with other family members (including ‘Mom’) and friends. The journey ends with the last calls as Son arranges travel home to await Mom’s death. The volume is organised into six parts comprising a full 15 chapters. Part I provides an extremely useful review of the literature on the importance of communication for cancer care and the various limitations of much of that literature, including the common (over)-reliance on self report data in the field of psycho-social oncology, and the need to open up the black box of communication to look at how communicative endeavours are realised in order to begin to verify this ‘theoretically rich and empirically underdeveloped’ field. Beach also highlights how, on the one hand, many acknowledge that a cancer diagnosis alters social relationships, while on the other hand research on families and how they interact is in its infancy. Part I also provides a useful index, timeline and chronology of the corpus (p.28-9). Transcription notation (following Gail Jefferson’s orthography) (p.30) is explained, a useful summary of two fundamental assumptions of CA provided, and validity, reliability and generalisability discussed. This makes for essential reading for the subsequent analytically driven pages. Part II focuses on the initial conversations about Mom’s diagnosis, covering the delivery, reception and assimilation of bad cancer news. Whilst the literature is laden with a range of theoretical through empirical examples of how health care professionals and their patients negotiate bad tidings, the lay-lay equivalent is much less explored. It provides excellent insights into what happens once a patient leaves the oncologist’s consulting room, and together with her family elaborates and realises bad news. Beach draws on Douglas Maynard’s extensive work on news deliveries and on a good range of other non-CA writers, referencing classic works by Susan Sontag and Arthur Frank. In Part III, Beach draws out in detail how participants in the calls interactionally ‘manage life in times of uncertainty and crisis’. This is central to so much of the psycho-social oncology field and complements the plethora of self-report studies that have asked cancer patients and their ‘carers’‘how they cope or manage’ or share news about cancer. Subsequent chapters continue to chart the unfolding of Mom’s cancer journey. Part IV focuses on the callers’ talk around reporting and assessing medical care. Chapter 8 gives real insights into how lay members report and render meaningful oftentimes complex medical information, while Chapter 9 shows how medical staff are discussed and evaluated ‘behind closed doors’. Part V Chapter 12 provides helpful discussion of hope – secular, spiritual and social scientific constructions. And, in Beach’s skilled and grounded style, he draws out discussion with the use of fragments from the malignancy corpus. Chapter 13 provides a complementary focus on moments when speakers explicitly reference hope and in other ways manage information optimistically. The volume draws to a close with a discussion of how to extend research on families, communication and cancer and the powerful implications of selected findings for lay and professional communities. The final Chapter 15 shifts gear, moving away from detailed analysis of fragments, to instead provide transcript fragments from a Family Interview (Son, Dad, Aunt), conducted 18 years following diagnosis, for readers to reflect upon. Up until now many Conversation Analysts interested in health have studied conversational practices in institutional medical settings, and most have worked with episodic data, one-off meetings. Hence, the non-institutional and longitudinal nature of Beach’s corpus is truly novel and important. The volume provides insights that are likely to be relevant across a number of audiences, both lay and professional. Sociologists, health care practitioners and health researchers in general would find this volume useful. Students of the method of CA may find this a useful demonstration of how one can skilfully and carefully use the micro-analytic tool of CA and still draw out very macro-oriented practical insights. Equally, the topic itself is novel and provides a rare insight into families and how they cope with news that is likely to alter them (on many levels) as individuals and as a family unit forever. Those versed in this style of analysis are bound to find it an easier read than those readers coming to it without such background, but it is not essential to be a conversation analyst. Beach writes in a clear and altogether un-alienating fashion. His work is thoroughly grounded, while evidenced with an impressive literature (a useful resource for researchers/students in this topic in and of itself). This is an excellent volume but, like most books of its kind, it is definitely not one to be read in one sitting (though I’m sure this was never the intention)! Indeed, readers may usefully choose to dip in and out and read individual chapters in detail. It is a real family, a real cancer diagnosis and a real series of calls analysed by a primary consequential figure to the news (‘Son’) with skill and integrity. And, as Douglas Maynard remarked in his foreword to the book, Beach’s skilled analysis is such that to read this book is ‘as close as analytically possible to being there’

Cancer · Natural (archaeology) · Natural history · Family Support in Illness · History · Internal Medicine · Medicine · Psychology

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