Massoot Mohammed
7260965
HSS 2102
Faculty of Health Sciences
November 24, 2014
Dr. Tien Nguyen
Introduction
John Patrick Shanley’s “Joe Versus The Volcano” tells a story of Joe Banks, a man suffering from an incurable disease, given only a few months left to live. With his impending demise in mind, he sets out to live out the rest of his life how he sees fit. The selected clip is from a scene in the film where Banks is told by his doctor, Dr. Ellison, about his terminal disease. Banks walks into the doctor’s office, after being called in repeatedly by the secretary, and sits down to speak about his ailments and possible causes. Ellison then reveals to him …show more content…
the results of his medical tests; a terminal disease. Ellison then advises Banks to live out the rest of his life to the fullest.
Health Communication Models: Leary Model
The scene portrayed a pure encounter between a doctor and a patient, following Leary’s model of two dimensions regarding the dominance-submission roles assumed by Banks and Ellison.
At the beginning of the encounter, Banks is anxious to discover the source of his ailments, assuming a submissive role. Ellison strengthens his dominant role as he allows Banks to take guesses at the diagnosis, as if toying with his patient like a game of cat and mouse. When the diagnosis was delivered, Banks attempted to take dominance by claiming that he did not feel well at all despite the terminal illness’ lack of symptoms, attacking the doctor’s diagnosis with skepticism. Ellison returned the submissive role back to Banks by explaining the gravity of the situation, to which Banks settled down and asked “What am I going to do?”. Leary’s model proposes a rule that states that dominant or submissive behaviour stimulates opposite behaviour in others, and the rule suggests that the roles can be reversed if one party chooses to do so. After learning his fate, Dr. Ellison suggests that Joe go on a vacation. Enraged at his lack of options Banks begins to lash out while approaching the doctor’s desk, forcing Ellison to submissively suggest Banks to seek a “second opinion” as if to free himself out of the corner he had been backed into. The scene portrayed a constant power struggle, a form of tug-and-war, between doctor and …show more content…
patient.
Non-verbal Communication + Interviewing and Counselling
The very beginning of the scene depicts Joe Banks sitting in the waiting room outside of a doctor’s office, covering his face in his hands, as if to hide from reality. The secretary moves and speaks to him slowly and carefully, as one would with a mentally unstable individual. The facial expressions of both Banks and secretary are polar opposites; one is tired of life, and the other is cautious for the safety of her own. The camera is placed right behind the secretary, while Banks is situated in the relative distance to further simulate the polarity.
What seem like insignificant details are in fact important in examining the encounter in terms of patient-professional attentiveness. Holding the results to the tests, proven facts about a patient’s health, the doctor still asks Banks how he is feeling at the moment. When Banks mentions his time in the fire department, the doctor, despite his extensive medical education and expertise, asks questions about what one does in the fire department and if it was dangerous. A well experience physician should know what a fireman’s job entails, but Ellison asks anyway to show greater sensitivity for his patient’s situation. After a minute of small talk, Ellison proceeds to give the diagnosis, and a careful and concise explanation. Banks also takes part in the attentive etiquette by asking for clarification for omitted information on the disease’s symptoms and curability.
Aside from verbal cues, the nonverbal cues can be seen through Banks’ reaction to his diagnosis: standing from his seated position, moving away from the doctor from a personal/social distance of less than 2 meters to a public distance of greater than 3 meters, as if to distance himself from the situation. The doctor’s speed of speech changes from a slow tempo, when reading the diagnosis, to a quicker tempo, when explaining the prognosis. It can then be seen that Banks’ facial expression changes from a smile to a concerned stare into the distance, portraying his coming to terms with his fate.
Therapeutic Communication + Ethics
Ellison, as a health care professional, found himself in a position in which he was obligated to act not only as a physician, but a therapist. A patient that has just been given a death sentence needs immediate therapeutic care, as they are most vulnerable when the wound, or diagnosis, is fresh. Throughout Banks’ reaction, the doctor remains calm and seated to avoid alarming him. He only elaborates on the diagnosis when Banks asks for clarification, practicing contractual honesty to give Banks a bit of perceptual autonomy over the situation; Banks is the one who asks for his estimated remaining lifespan, his disease’s incurability, and possible courses of action. When Banks asks for an explanation on why he does not feel well at the moment, Ellison focuses of Banks’ preoccupation with his symptoms with unmitigated honesty, branding him as a hypochondriac and reassuring Banks that his symptoms were not caused by a physical illness, but by his experience as a fireman. Ellison then guides his patient towards a course of action, two options: a second opinion, or a possible vacation to enjoy his remaining life.
Conflict
The scene in the doctor’s office portrays two cooperative parties with mixed levels of assertiveness. Both Banks and Ellison nonverbally agree to a patient-physician contract once they begin speaking. Both men understand their role in the relationship, and cooperate to deal with the situation as effectively as possible. Although Ellison remains calm and neutral, Banks transitions from an assertive position to a more timid position. Before the doctor reveals the diagnosis Banks guesses at what it may be, somewhat attempting to dictate his own fate by confidently proclaiming possible answers. When Ellison pauses to read the tests, Banks says to Ellison “Tell me” in an assertive tone in order to affirm his own autonomy. Once told, Banks begins to retreat and ask simple questions in a quieter tone, giving Ellison the choice to act out of beneficence. The conflict is a relationship conflict in terms of an issue of control.
Interviewing
The scene played out like an interview, with Banks as the client and Ellison as the clinician.
Banks asked closed questions, searching for short answers for question pertaining his condition (ex. Curability of his disease, length of remaining lifespan), while Ellison asked open questions, attempting to collect thoughts from his patient to provide the appropriate therapeutic and medical care. The encounter also followed the phases of an interview, beginning in the preparation phase. As he sat in the waiting room, Banks seemed to be dreading the diagnosis; being a hypochondriac, he expected the worst. In the initiation phase Ellison made first contact by asking Banks about his current health state, and a little bit of background information. In the exploration phase Ellison informs Banks of his condition a prediction of what his immediate future holds. In the termination phase Banks asks about what his next move should be, to which Ellison closes the interview with a final piece of advice.
References
1. Adler, R., Rodman, G. & Sevigny, A. (2011). Understanding human communication, 2nd Canadian ed., Don Mills, ON: Oxford.
2. Devito, J., Shimoni, R. & Clarke, D. (2012). Messages: building interpersonal communication skills, 4th Canadian ed., Toronto, ON: Pearson Canada Inc.
3. Dubrin, A. & Geerinck, T. (2012). Human relations: for career and personal success, 4th Canadian ed., Toronto, ON: Pearson Canada Inc.
4. Joe versus the volcano [Motion picture]. (2002). United States
of America: Warner Home Video.
5. Northouse, L. L. & Northouse, P. G. (1998). Health communication: strategies for health professionals, 3rd ed., Upper Saddle River, NJ: Prentice Hall.