Daniel Schultz

ABSTRACT: This essay stages an encounter between Foucault and black thought. It examines how Foucault has become a bad object in black studies while drawing attention to the fact that many of the problems that preoccupy black critical theory were also problems that Foucault engaged with—conceptual problems surrounding historicism, absent archives, and the genesis of worlds predicated on exclusion. Although Foucault ignored blackness and while black studies is largely critical of Foucault, this article argues that at the level of method and critical ethos, there is a generative resonance that remains underdeveloped. I explore this resonance and focalize the question of critique through different styles of writing used to tell stories silenced by history. The recurrent challenge is to find writing practices and experimental methods that work against the structuring forces of an antiblack social order. The intersection between Foucault's essay "Lives of Infamous Men" and Saidiya Hartman's rebellion against historicist practice—her "critical fabulation"—provide the initial point of contact for the exploration of these issues. The article further develops these conceptual linkages and critical exchanges as they take shape in the writing of Joy James, Angela Y. Davis, Christina Sharpe, Dionne Brand, and M. NourbeSe Philip.

This paper provides a brief overview and critique of the dominant objectivist understanding and use of illness narrative in Enlightenment (scientific) medicine and ethics, as well as several revisionist accounts, which reflect the evolution of this approach. In light of certain limitations and difficulties endemic in the objectivist understanding of illness narrative, an alternative phronesis approach to medical ethics influenced by Charles Taylor’s account of the interpretive nature of human agency and language is examined. To this end, the account of interpretive medical responsibility previously described by Schultz and Carnevale as "clinical phronesis" (based upon Taylor’s notion of "strong" or "radical evaluation") is reviewed and expanded. The thesis of this paper is that illness narrative has the ability to benefit patients as well as the potential to cause harm or iatrogenic effects. This benefit or harm is contingent upon how the story is told and understood. Consequently, these tales are not simply "nice stories," cathartic gestures, or mere supplements to scientific procedures and decision making, as suggested by the objectivist approach. Rather, they open the agent to meanings that provide a context for explanation and evaluation of illness episodes and therapeutic activities. This understanding provides indicators (guides) for right action. Hence, medical responsibility as clinical phronesis involves, first, the patient and provider’s coformulation and cointerpretation of what is going on in the patient’s illness narrative, and second, the patient and provider’s response to interpretation of the facts of illness and what they signify–not simply a response to the brute facts of illness, alone. The appeal to medical responsibility as clinical phronesis thus underscores the importance of getting the patient’s story of illness right. It is anticipated that further elaboration concerning the idea of clinical phronesis as interpretive illness narrative will provide a new foundation for medical ethics and decision making