Deliberations

Our family has had a tough week. My 5-yr-old daughter was admitted to Royal Children's Hospital in Melbourne with a severe kidney infection. For four days my wife and I played tag team as she recovered. Allison is doing well now, back to normal activities with no permanent damage, although it will still take several weeks for optimal renal function to return.

To advance my research while at the hospital, I read the many contributions to the Handbook of Constructionist Research (2008), edited by Holstein and Gubrium. Constructionism is an approach to understanding human activity, learning and experience that presumes that they are ongoing accomplishments and evolving social practices. Constructionist research is a qualitative endeavour that reveals how participants (and researchers) build their coherence of complex life situations.

This is in contrast to the predominant view that life is merely the inevitable consequence of either individual cognition, of competing preferences or of institutional or cultural forces (as with constructiVISM). Constructionist research rarely seeks to prove hypotheses of predictable, universalised truths. Instead, it examines real life situations in appreciation of the multiple and changing perspectives of participants. Constructionists view knowledge as socially created through interaction. Constructionism is a postmodern approach that celebrates subjectivity and particularity in context. There are strands of constructionist inquiry in sociology, social psychology, anthropology, communications studies, educational research, linguistics and political science. Each discipline brings its own nuances to the approach. I could write a great deal more here, but I should leave that for my thesis.

Every young patient in the hospital ward had a medical situation that was more dire than that of Allison. I couldn't help but notice how many in the ward acted in ways that ameliorated their situation, that constructed optimism. For young Allison, it was about making friends with the others. One teenage patient, who I believe was battling the complications of a kidney transplant, was very kind and enjoyed her company, playing her games and asking her questions. They both appeared to benefit by that interaction.

It was apparent that the young man had taken ownership of the medical procedures he had to endure. He (and his father) spoke as equals to the medical staff, correctly pointing out errors made in the treatment. The staff promoted this transformation by speaking to them without condescension. The medical outcome is directly influenced by the constructed social situation.

One morning, while walking down the corridor, I passed a conversation between a registrar and some parents. The doctor was visibly unfit, standing with one hand on his hip and the other leaning on a door frame. He spoke at the parents, at a distance from them. I heard him say "You MUST ...". He was stamping his authority on the situation, in no uncertain terms. When the registrar had finished, he shuffled quickly off to the lift, where I was, checking his mobile phone (which should not have been switched on in the ward). He needed to be somewhere else.

When Allison's two renal specialists (one on the weekend, one during the week) spoke to us and to Allison, they were open and friendly and preferred to be addressed by first name. They both appeared fit and their body language was at ease. They sat close on the bed. They started every conversation with questions and it was clear by their responses that they had listened to the answers given, including Allison's. Their recommendations to us about the appropriate conditions for discharge and for subsequent diet at home emerged as a collaborative endeavour between us all. I am sure that both specialists were well trained to talk effectively to parents and patients, but I am equally sure that they were naturals at it. Their conversational turns, especially with Allison, showed that they enjoyed the interaction and valued all perspectives related to their work. They were not compelled to try to impress us. For all the downplay of their authority, I view them with greater respect than the I do the registrar.

A common thread in constructionist study is its focus on language, narrative, discourse and performance. It is quite literally a natural fit for my study of deliberation and deliberative processes.