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Pain and Plain Language

Anthropologist and National Science Foundation Graduate Research Fellow Chelsea Jack ’10 hopes her podcast will both demystify and complicate our understanding of the opioid epidemic.
What do we talk about when we talk about hte opioid epidemic? The phrase itself is technical, latinate, biomedical. You can parse those words to pieces—opion (poppu juice) + epi (upon) + demos ( the people) — and still not see what Chelsea Jack '10 believes is an obvious but overlooked part of this national public health emergency: PAIN.

"I wonder if we should speak less technically and demystify the conversation a bit," says Chelsea, who is a Ph.D. student in anthropology at Yale ty and the recipient of a National Science Foundation Graduate Research Fellowship Program award to study opioid use in Appalachia. “We’re talking about uncontrolled actions to relieve pain. That’s just a different framing. I’m interested in different framings, and interrogating the language we use, and pushing boundaries in that way.”

More than 140 Americans die of opioid overdose every day, making it the leading cause of death among Americans under age 50 since 2017. But numbers alone don’t necessarily illuminate the underlying roots of this crisis.

“Public health experts study patterns of use, rates of prescription, what leads to fatal overdoses,” says Chelsea. “As an anthropolo- gist, I’m more interested in how pain, and actions motivated by a desire for pain relief, come from a diverse number of sources — diverse lives, diverse experiences — how it escapes generalization.”

To investigate this sweeping, national trend, Chelsea is zooming in on the life of one man: a rural doctor from the Shenandoah Valley who both prescribed and became dependent on opioids. She is working with the man’s 26-year-old daughter to produce a podcast that tells her father’s story and looks at how that story intersects with larger ones about American precarity.

“It’s a complicated story,” says Chelsea, “about a woman reckoning with the fact that her father — after a life shaped by trauma and pain — walked into the woods one day and disappeared.”

“Anthropologists are fundamentally writers,” Chelsea remembers her professor saying on her first day of anthro class at the University of Virginia. Instructions for employing “thick description,” an ethnographic research method developed by the esteemed cultural anthropologist Clifford Geertz, read a lot like advice to a young writer: show don’t tell; be specific; use anecdotes, examples, and quotations.

“‘Thick description’ is a phrase that inspires a lot of curiosity,” says Chelsea with characteristic carefulness in choosing her words. “It’s supposed to recognize the way that attending to people and their experiences, and the way they talk and the stories they tell, requires really good storytelling and really close attention.”

Chelsea is obviously adept at both scholarly anthropolog- ical research and astute, quick-witted cultural critique. Her writing has appeared in such pointed online pubs as The Huffington Post, Quillette, The Establishment (now under Medium), and Wiley, as well as on the Bioethics Forum hosted by The Hastings Center, the think tank where she worked for two years as a project manager and research assistant.

Before her doctoral studies at Yale or her master’s in social science at the University of Chicago, Chelsea grew up in rural Bedford County, Virginia, in the shadow of the Blue Ridge Mountains. “For as long as I can remember, I thought I grew up in the most beautiful place on earth,” she says. But she yearned for something more: “a place where I could access resources that would allow me to develop ideas, work as a writer, and encounter new parts of the world.”

Episcopal was that place. At EHS, Chelsea learned the importance of language. “I learned that there is the world, and there are also representations of the world,” she says. “Whether it was in Mr. New’s English class, or looking at classical texts with Mr. Streed, I was thinking about the ways in which humans talk about one another and construct stories about one another, and how there’s politics to that — how certain people have the right to construct history, to define genres, and to assert their voices in the world.”

Later, Chelsea’s master’s research at the University of Chicago would further underscore the importance — and power — of language when she became curious about how opioid prescription rates differed from state to state. “That encouraged me to attend not only to the way in which people were being prescribed more drugs, but how people were talking about that.”

She found that in West Virginia, the language of addiction was being used to describe issues related to the economy and labor. “In letters to the editor, people would use the meta- phor of addiction and dependency to talk about chronic unemployment in the state. They’d say things like, ‘West Virginia’s always been addicted to coal.’”

The linguistic blending of these separate narratives leads to an ingrained assumption that the two issues — the declining coal industry and rising opioid abuse — are related, when perhaps they are not. “If you imagine that the decline of coal has led to increased drug use, then one conclusion you could reach is, ‘Well, then, we should bring coal back. We should bring those jobs back.’”

Chelsea’s research revealed how metaphors could be powerful political tools, and how the ravages of the opioid epidemic could be exploited to further political agendas.

In the spring of 2017, Chelsea posted about her master’s research on Facebook and was contacted by a long-lost childhood friend who saw her post. Her friend said, “I think my dad’s story is a very odd one and might add to your research.” Chelsea didn’t know it then, but that was the beginning of an exciting new project and the exploration of a new form.

***

“The medium is the message,” the philosopher and media scholar Marshall McLuhan famously said. He meant that the form a storyteller (or advertiser or politician) chooses isn’t a blank slate. It can change the meaning of the message it communicates.

Chelsea deliberately chose podcasting to tell her friend’s story because of the message the form naturally conveys.

“What interests me most about podcasting is how the medium promotes listening — and just listening.”

Though podcasting might sound newfangled, it’s really nothing more than on-demand radio. The big difference between radio and podcasting is that almost anyone can create and share a podcast — which means so many more stories are being told. Chelsea touches on podcasting in an essay she wrote for The Establishment about women who are creating new spaces for their creative work in the digital sphere. “Podcasts, like any technology, can change the pace and patterns of a thoughtful media consumer,” she writes. “When coupled with content explicitly by and for women, the message, in the McLuhan sense, of podcasts […] is one about engaging in social practices long championed by feminists (and decent human beings): listening to one another and recognizing untold stories.”

Chelsea hopes that her podcast will be accessible and engaging enough to capture people’s attention and present an alternative narrative to the one promoted in Hillbilly Elegy, which readers have eagerly consumed since its publication in 2016.

“I think a lot of Americans picked up this book as an instruction manual to Trump country,” she says. But many, including Chelsea, find Hillbilly author J.D. Vance’s story simplistic and problematic. He misrepresents Appalachia as ethnically homogenous, patronizes his cast of colorful characters calling them “hillbillies” and “lunatics,” and basi- cally concludes that his impoverished friends and family are responsible for their own misfortune, ignoring the influence of government policies and corporate greed.

Moreover, says Chelsea, the book reinforces a decades-old trope. “People who read this book are buying into an idea that’s been around a long time, which is that Appalachia is a culture in crisis,” says Chelsea. “This is a representa- tion we’ve seen since JFK and Lyndon B. Johnson visited West Virginia and declared a war on poverty and economic distress.”

By reproducing and sensationalizing this narrative without understanding or reporting on its complexities, we further distance ourselves from this region and its people.

“Anthropology is all about this,” says Chelsea. “It’s about figuring out the ways in which conversations have been structured around division, around the idea that you can separate those people over there from these people over here — that they’re fundamentally different and there’s a hierarchy.”

***

Chelsea’s podcast is currently in development; she has completed production of a pilot and is seeking resources to produce and distribute the rest of the series. She doesn’t want to reveal too much about the plot of the story, which will be told over several episodes à la Serial, the popular series that put podcasting on the map.

Ultimately, Chelsea urges us to remember that underlying so many people’s out-of-control use of highly addictive pain- killers is pain itself, physical and psychological.

“There does seem to be, in American life, an anxious- ness. Different sources of economic and financial anxiety. Different sources of uncertainty. Who knows how those things manifest when it comes to the human body? Who knows how these things manifest when it comes to communities?”

Whatever those manifestations, Chelsea believes in using plain language to tell complex stories. “Conversations in certain spaces adopt a jargon of their own, and it becomes a mystifying thing. We could talk about this crisis in more plainspoken, non-technical language, and I wonder if we would get at its sources in a more comprehensive and creative way.”

Read, Listen, Watch Heroin(e), a Netflix Original documentary directed by Elaine McMillion Sheldon Hillbilly Hellraisers: Federal Power and Populist Defiance in the Ozarks by J. Blake Perkins Pain: A Political History by Keith Wailoo Pilgrim at Tinker Creek by Annie Dillard Ramp Hollow: The Ordeal of Appalachia by Steven Stoll Removing Mountains: Extracting Nature and Identity in the Appalachian Coalfields by Rebecca Scott What You Are Getting Wrong About Appalachia by Elizabeth Catte To learn more about Chelsea’s forthcoming podcast, or to support its development, contact Chelsea at chelsea.jack14@gmail.com.
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