Part III.1 - On the hierarchical organization of consequentiality

The phrase “hierarchical organization of consequentiality” is intended to deal with trying to account about the relationship between “chitchat,” “contraction,” and “medical visit.” The structural features of the last two were obvious. The process through which one moved from one to the other was less obvious even though all performed the shift with little problem. That Contraction would stop chitchat (to simplify) seems easy. That Medical Visit would stop Contraction (but not contraction) was what made me think in terms of (and I am coining something here again) “moments of authorized interruption.” In other words, the onset of a physical contraction authorizes Lonnie to interrupt chitchat and to request that all shift to Contraction. This request is not always heeded right away but it is never ignored. Medical Visiting is of the same order: that which authorizes medical personnel to interrupt Contraction is not as such inscribed in the structure of the Contraction positioning, but not to mention this authority is to ignore most of what is consequential when doctors enter the room as Doctors (rather than as patients or friends) and what I think you would say all “align” themselves towards.

Then there was the question of the “absent” child. The monitor of the child’s heartbeat was mostly off during this labor, and the child never surfaces as the specific focus of medical attention. I just can’t believe that the child is at all absent in such a setting! This could in fact be discussed as a serious problem in the sensitivity of our recording equipment. Theoretically, it poses other problems if we assume that, at any time, the child could have been made present in an authoritative medical manner that would have swept all other temporarily established patterns. As had in fact happened twice in Lonnie’s preceding labors, the Doctor could claim the right to interrupt chitchat, contraction, and even routine medical visits, that is the whole labor in the name of “saving the child.” This would also be true of “saving the mother.”

Chitchat does not interrupt Contraction though it can leak into it as it can even during the off-times that are in fact allowed within Medical Visit. Contraction does not interrupt Medical Visit (in this case the epidural), though it may leak into it as specific signs can be performed that Contraction is NOT being done (e.g. grimaces, groans, etc., by Lonnie as she does not ask for recognition). This phenomenon is what I am trying to capture through the word “hierarchy” which I believe I am using in the sense that Louis Dumont used it in his work on the individual and the social in India and Euro-America. The reference may now be obscure and another word may be necessary, but this is the best one I have found so far.

In other words, it might be possible to argue that the structure of authorized interruption is characteristic of “Hospital Labor” that we could model as a sequence of sequences hierarchically organized by their interrupt qualities.

As I was thinking about this, I got to wonder whether we could reinterpret some of the work in turn-taking in terms of “authorized interruption” which might allow us to move more completely away from consensus or knowledge models of interactions. Specifically, I am thinking about your work on the recipient role in the shaping of an utterance. If I understand it right, your point has been that, in certain (all?) circumstances an utterance is dependent on the work of the recipient acknowledging in various ways how he is taking this utterance, with the consequence that speakers may have to change their utterance in mid-stream in ways that are all the more complex that there are more possible recipients in the setting. I wonder whether this “power” of the recipient to transform a speaker’s utterance in mid-stream might not be understood as an “interrupt”: everything I say to you can be interrupted at any point, with non-interruption being but a limit case: a particular case of non-interruption would thus always be understood specifically as an act of the recipient actively not exercising his authority to interrupt. We could then move to an examination of hierarchies of interrupt, with the case of exact balance between speaker and recipient being but a limit case: there is always a Doctor in the house, ready to interrupt everything else

One of the thing I like about this is that it allows the analyst not to have to assume that either speaker or recipient have to be aware of the exact authority of any of the others whom they are facing (nor of whom these people might be). Thus we do not have to invoke consensus, sharing, of even “contract” among the participants even as acknowledge that the plan for all social constructions (scripts for all scenes?) are rarely if ever drawn locally. Local scenes like Hospital Labor would then be understood as the product of hierarchical processes enforced through the accountability feedbacks of all participants stating, challenging, resisting, rephrasing, etc., with heavier and heavier corrective interruptions being invoked by those thereby revealed as having authority. (I am thinking here of a case from a dissertation about a birthing center in the Bronx when a woman in labor became so loud and extreme in her behavior–e.g. lying on the floor of the corridor screaming–that the staff decided to shift the woman to a hospital for no medical reason besides her refusal to accept their suggestion for allowable behavior).