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“Diabetes and Literacy: Negotiating Control Through Artifacts of Medicalization”

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Abstract

My experience with the California Department of Motor Vehicles offers a case to explore how bureaucratic institutions monitor, classify, and control individuals. By examining artifacts created for and used by the DMV through the lens of literacy studies, I discuss the variety of rhetorical strategies used in each document and the effects and implications of those strategies, for example on subjectivity or identity, and move beyond the language of the artifacts themselves to attend to how they are invested with power in the management and control of populations.

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Notes

  1. See “Driving When Privilege Suspended or Revoked for Driving Under the Influence, With Excessive Blood Alcohol, or When Addicted” Vehicle Code 14601.2 (Sacramento: CDMV, 1999); “Driving When Privilege Suspended or Revoked.” Vehicle Code 14601 (Sacramento: CDMV, 2000); “Driving When Privilege Suspended or Revoked for Other Reasons.” Vehicle Code 14601.1 (Sacramento: CDMV, 2000); “Driving When Privilege Suspended or Revoked for Refusing Chemical Test or Driving with Excessive Blood Alcohol.” Vehicle Code 14601.5 (Sacramento: CDMV, 2000); “Impound and Forfeiture of Motor Vehicles.” Vehicle Code 14607.6 (Sacramento: CDMV, 1998); “Unlawful Use of License.” Vehicle Code 14610 (Sacramento: CDMV, 1990).

  2. D Barton, Literacy: An Introduction to the Ecology of Written Langauge, 2nd ed, (New York: Wiley-Blackwell, 2007), pp. 34-35.; see also N Fairclough, Language and Power (New York: Longman, 1989), p. 213.

  3. A Petersen, “Governmentality, Critical Scholarship, and the Medical Humanities,” 193.

  4. Ibid, 188.

  5. N Rose, Powers of Freedom: Reframing Political Thought (Cambridge: Cambridge UP, 1999), 234.

  6. J Rendell, “Introduction to Special Issue”, 3.

  7. See J Boucher, “Ultrasound: A Window to the Womb?: Obstetric Ultrasound and the Abortion Rights Debate”; L Couthard, “Visible Violence in Kiki Smith’s Life Wants to Live”; J Rendell, “A Testimony to Muzil: Herve Guibert, Foucault, and the Medical Gaze”; J Luce, “Imaging Bodies, Imagining Relations: Narratives of Queer Women and ‘Assisted Conception’”; J Rendell, “Introduction to Special Issue”, p. 4.

  8. D Barton, Literacy , pp. 35-36.

  9. See “Diabetes and Driving.” Pamphlet (Sacramento: CDMV, 1999); see also, “Driver Medical Evaluation (DS 326)” Revised Nov. 2003. 23 May 2006. http://www.dmv.ca.gov/forms/ds/ds326.pdf.

  10. C Feudtner, Bittersweet: Diabetes, Insulin, and the Transformation of Illness (Chapel Hill: University of North Carolina Press, 2003).

  11. See Diabetes Control and Complications Trial Research Group, “The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus.”

  12. Ibid, 329.

  13. B Latour and S Woolgar, Laboratory Life: The Construction of Scientific Facts (Princeton: Princeton UP, 1986), p. 45).

  14. Ibid, 33.

  15. Ibid, 245.

  16. Ibid, 37.

  17. Ca DMV “Diabetes and Driving.” Emphasis in original.

  18. Ibid.

  19. LJ Davis, “Bodies of Difference: Politics, Disability, and Representation.” In Disability Studies: Enabling the Humanities, eds. SL Snyder, BJ Brueggemann, and R Garland-Thomson. (New York: MLA, 2002), p. 105.

  20. MA Gebers and DJ DeYoung. An Examination of the Characteristics and Traffic Risk of Drivers Suspended/Revoked for Different Reasons. (Sacramento: California Department of Motor Vehicles, Research and Development Section, 2002), p. 32.

  21. Ibid, 33–34.

  22. Ibid, 35.

  23. See B Schleter, “Diabetic Man Guilty in Fatal Crash”; J Osbourne, “Diabetes to Blame for Death in Jail? Medical Examiner Investigates After Diabetic Passed Blood Alcohol Test.”

  24. MA Gebers and DJ DeYoung, p. 35.

  25. G McGwin jr, RV Sims, L Pulley, and JM Roseman, “Diabetes and Automobile Crashes in the Elderly.” Diabetes Care 22 (2), p. 220.

  26. See WL Clarke, DJ Cox, LA Gonder-Frederick, and B Kovatchev, “Hypoglycemia and the Decision to Drive a Motor Vehicle by Persons with Diabetes”; DJ Cox, LA Gonder-Frederick, and WL Clarke, “Response to Barry-Bianchi”; C McGwin, et al , 1999; C Laberge-Nadeau, G Dionne, J-M Ekoe, P Hamet, D Desjardins, S Messier, and U Maag, “Impact of Diabetes on Crash Risks of Truck-Permit Holders and Commercial Drivers”; TJ Songer,, LB Lave, and RE LaPorte, “The Risks of Licensing Persons with Diabetes to Drive Trucks”; DJ Cox, LA Gonder-Frederick, BP Kovatchev, and WL Clarke, “Self-Treatment of Hypoglycemia While Driving.”

  27. D Marrero and S Edelman, “Hypoglycemia and Driving Performance: A flashing yellow light?” Diabetes Care 23 (2), p. 146.

  28. See “Court Must Assess Safety Threat of Diabetic Police Applicant”; J Wiener Kapche v. City of San Antonio; “Kapche v. City of San Antonio”; M Payne “Diabetes Activists Take On Driving Rules”; “Diabetes Activists Fight Rules Banning Them from Some Jobs.”

  29. See D Marrero and S Edelman “Hypoglycemia and Driving Performance: A flashing yellow light?”; B Frier “Hypoglycemia and Driving Performance”; S Barry-Bianchi “‘Real-Life’ Driving Behavior While Hypoglycemic”; DJ Cox, LA Gonder-Frederick and WL Clarke “Response to Barry-Bianchi.”

  30. See N Boyce “Diabetics May Get Second Chance to Drive Big Rigs.”

  31. See D Barton, Literacy, p. 79. Further references to this work appear in the text.

  32. Ibid.

  33. See D Brandt, Literacy in American Lives (New York: Cambridge U Press, 2001), p. 19.

  34. See E Barton, “Literacy in (Inter)Action.”

  35. From transcript of taped interview. The medical form that was not sufficient refers to the first attempt my doctor and I made to complete for form.

  36. C Marvin, “The Body of the Text: Literacy’s Corporeal Constant.”

  37. D Lupton, “ Foucault and the Medicalization Critique,” p. 95.

  38. See D Brandt.

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  1. Department of English, California State University, Chico, Chico, CA, 95929-0830, USA

    David S. Martins

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Martins, D.S. “Diabetes and Literacy: Negotiating Control Through Artifacts of Medicalization”. J Med Humanit 30, 115–130 (2009). https://doi.org/10.1007/s10912-009-9078-4

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