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For my visual anthropology class, I am assigned to do visual research

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For my visual anthropology class, I am assigned to do visual research. I have done the initial research concept, the brief and the photographic study exercise. I attached both the brief below and the exercise which includes a summary of the community I propose to work with to create my own visual ethnography. The exercise I need you to do is the Exercise 2: Photovoice & Elicitation Interview. I attached the guidelines below for the exercise. Photovoice & Elicitation Interview that I would like you to do needs to be based on my initial research concept. I attached the instructions for the exercise below. The writeup need to be 800 words.

Exercise 2: Photovoice & Elicitation Interview A. Preparing for data collection: Conduct two of the following activities. You may either conduct A & B with the same participant or conduct either A or B twice with two different participants. You may not conduct the same exercise twice with the same participant. (See readings from weeks 5 and 6 for tips.) a. Ask a participant to take photographs or share images already taken of a site and/or activity directly related to the focus of your research. (For example, you could ask your participant to create images of important routines, places, or equipment.) Interview your participant about these images. b. Take or assemble a set of about 10 images you have taken of your research site and/or activity and use them to conduct a photo-elicitation interview. These can either be your own images and/or images depicting or found within your fieldsite. (For this method, they shouldn’t be images your participant created.) You should approach your interviews as a “semi-structured” style. That means having a list of basic questions you will ask both of your participants in common, then improvising further questions based upon listening closely to and engaging with their responses. (We suggest interviews of around 30 minutes.) If you are using the “photovoice” method, ask your participant to share or allow you to make copies of their images. You should omit any images that they may be uncomfortable with anyone beside you seeing. Always move on if there’s something your participant doesn’t want to look at or discuss. B. During and immediately after your interviews: You must record your participants’ responses. You may either take careful scratch notes during the interview and elaborate these later or use video or audio recordings which you can take notes on later. We will ask you to include your notes in an appendix to get full credit. Here’s four subject your notes should always cover:: a. Beforehand you should take a quick note about your choice of participants and method. If you choose to use photovoice, for instance, write down what you are hoping to get out of it and what you anticipate gaining from the perspective of each particular participant. b. After each exercise you should write a quick summary of what happened and what you learned from each image you discussed with your participant. What was the subject matter? What stood out to them? How did they answer each of your questions? What are your initial impressions (prior to reviewing your data)? c. Keep track of the way you and your participants moved from image to image (including order). Did they take the lead or did you volunteer the next photograph? Did they suggest connections between the photographs or treat them each individually? Did you have to skip any (and, if so, why)? d. Take notes on the feelings your participants’ convey in addition to their explicit comments. These can offer many important leads for interpretation. For instance, were there moments when they got especially worked up or detached, certain images they paid more intensive attention to than others, ones where they were more concerned with conveying expert insight, or certain ones that brought up many past experiences? Keep a record of this even if you don’t yet know the significance of it. C. Once you’ve completed your interviews and note taking: Gather the images together with your notes and study them closely. Note down for yourself which of the things you learned did the most to deepen your understanding, change your mind, or raise new research questions. Select a small number of the images related to these insights to use for your write-up. D. Once you’ve analyzed your images: Write a succinct but thoughtful summary of your research activities, initial findings, and any new themes. We ask that you keep your write-up to approximately 800 words. You can include photographs in the body of the write-up if you like; otherwise you can refer to them by the name or number you assign them in your first appendix. Remember, while this is an assignment for course credit, you should write as if you’re the expert informing a wide audience of your ethnographic subject matter, approach and initial findings. Here are the 4 tasks your write up should complete: a. Task 1: Give your readers a brief narrative introduction to your research activities and participants. What methods did you choose and what were you hoping to learn? Who were your participants, what is their position within the community you study or relationship to the site you study? How did these research relate to your first exercise and the emerging topic of your research? [3pts] b. Task 2: Write up your key findings (as you determined them in step C). What were the most insightful things you learned? How were they revealed in the images and the participants’ responses to the images? Describe this in some detail if you can. What are your major takeaways and new questions? You should do this twice: once per activity. [5pts] c. Task 3: Be sure to relate your observations and chosen techniques to at least two class readings or research covered in lecture. (To give a couple examples: if you used “photovoice” you may want to highlight some of Gubrium and Harper’s points about what makes it a useful method; if you want to discuss how images can help you understand another person’s embodied experience, you’ll likely want to make a connection to Lorenz.) These connections must be substantive, meaning you must have briefly explained the relevant concept, method or argument, then show how it pertains to your work in order to receive full credit. (Note: being able to do this is a major mark of professionalism, so it will add a lot of value to your visual portfolio.) [3pts] d. Task 4: Create two appendices: the first should feature a selection of key images (named or numbered so that they can be referred back to later); the second appendix should contain your full notes. (Note: if you wrote notes by hand don’t type them up: you can just photograph them and turn those photos into a PDF to include with your write-up.) [4pts] You do not have to complete tasks 1-3 in order. Feel free to spread these across your write up however you see fit. This assignment is due Sunday, May 9 by 11pm (PST) UCLA School of Law UCLA School of Law is the site for my visual ethnography. UCLA School of Law is located in Los Angeles, specifically on the UCLA campus, however, I am going to do my visual ethnographic research virtually. UCLA Law has been rated among the top 20 law schools in the United States. The school has created a virtual platform where one will be able to explore the campus virtually. The virtual tour helps anyone to explore the UCLA law building from anywhere. The virtual tour includes the front of the Law School, main hallway, library, student affairs, courtroom and courtyard. These are the most important places and buildings available in the law school. I am going to base my study around specific locations; the main hallway, the library, and the physical navigation. This context suits visual research due to the fact that with pictures of the above-mentioned places that will be taken which then will help me to find out what people are doing in space, if the creators of the virtual tour are trying to use all the little things to make visitors use the space like they will use when physically going. Also, what are the similarities and differences of the visual space versus the physical? I am a relative insider of UCLA School of Law. I am currently doing my undergraduate program at UCLA thus, and I am proud to call myself an insider because UCLA Law School is located on the UCLA campus in the Westwood district of Los Angeles. Furthermore, I have visited the law school campus many times and physically explored the region; however, for my visual research, I want to research the area and dip dipper virtually. I decided to use this site primarily for my visual research and choose to study this location because I want to apply to this law school and want to learn more about the location. The concentration of the research is the interior of the school virtually. My entire focus is that they are attempting to create a virtual equivalent of the school campus and they're attempting to convey something about what it's like to be in school in the visual space. I’m interested in studying how similar and different the campus tour could be for students and for visitors, specifically how virtual space differs from the physical space from a visitor's perspective. I will be able to conduct all the needed exercises by using the “virtual tour” website of the UCLA school of law. Consent is not necessary because the website is open and free to anyone interested to explore the site and permission is not required for conducting the exercises. In terms of technological means, the laptop is the only source necessary. The virtual tour website itself is created in such a way that allows the viewer to do photographic study, for example; taking screenshots of the space to capture core aspects of my research community. Furthermore, the tour allows the visitor to have a live season with a current UCLA law school student which will help me to successfully complete the participatory methods and elicitation Interview. The website is specifically created for students who cannot attend campus physically thus, the online experts available on the website are willing to answer any school and tour-related questions. Arustamyan 1 Photographic Study Exercise Task 1 During my days of research, I went to the UCLA law school website to collect data for the project. I am doing my research virtually because I currently have positive Covid-19 test results. Having visited the institution before, I was hoping to take screenshots that would help me understand the school better. I was trying to differentiate between a virtual tour and a physical tour by taking pictures to study later. Thus, I visited the school’s website to view the virtual tour and get an insight of what it feels like. I chose to focus on the main features of the school which are noticeable for both students and visitors. I took screenshots of the hallway with students in it. The hallway is branching towards other parts of the school. The school hallway leads to other places in the school like the library and classrooms. The picture will help me differentiate between a student's experience and the experience of other visitors when touring the school either physically or virtually. Photographic inventory will help the reader notice some features of the school that they might have missed or can miss during a physical tour. The students are some of the important participants I saw in the virtual tour. I was hoping to learn about the school’s culture and the structure and arrangement of important places like the library. I also took screenshots of the library including the bookshelves and the lights. The picture of the library is important since I want to do a comparison between my physical trip to the law school and my virtual tour. My experience while physically touring the school might not be enough for my research since I am applying to the law school. Additionally, I want to study the location especially the library since I will be using it regularly. Using the photographic inventory, I would like to understand the location including the suitability of the Arustamyan 2 school. The main activity I noticed in the school using the visual study was the intensive studying atmosphere of the school. Most students were in the library more than any other place in the school. Task 2 First, the creators of the website put the information on the page in a way that everyone has access to it. I noticed that the virtual tour makes it easier for students to navigate through campus by providing a table of all the departments as well as the map (see Appendix 3,4,5). Fascinating thing about the map is that you are able to click on things and choose a standing point position and then it navigates you to your desired department (see Appendix 5, 16). One of the key patterns I noticed was when I am far back, the information on the shelves or on the walls do not appear, technically I can't see the information until I walk into any of the rooms. Therefore, they are trying to use these little things to make me use the space like I will use when physically going (see Appendix 12, 14). I observed the routines of the school, like students studying silently in the library and some walking in the hallway (see Appendix 6, 7). The students were always in motion to and from different places in the school. I also took action shots outside the LuValle commons and the schools hallway. I decided to focus on these shots because they showed the most noticeable patterns in the institution (see Appendix 16, 17) . These action shots will give life the photographic inventory. A picture of the hallway will seem more real if there are students walking in it. Photos showing people in their context in the school will also help me remember important features of the school. They will help determine the difference between a virtual tour and a physical tour of the institution. In the photograph showing the hallway, I focused on the length of the hallway and the features on the walls. It is very long and wide and has proper lighting all the way (see Appendix 6). The different corridors branching from the main hallway are Arustamyan 3 also very noticeable. As I was taking the screenshots, I captured students converging at the hallways. The students were from the different corridors branching from the hallway. I saw students making meetings in the hallway and having small group conversations. This image is represented in my visual data in a photo showing the hallway (see Appendix 6). Task 3 In his article, Pink et al. (2013) went in depth discussion on multi-sensoriality. The idea of multi-sensoriality argues that our sensory perceptions are part of a more dynamic structure of human sensory processing in which they cannot be isolated, rather than being divided into the modern western categories of sight, sound, touch, taste, and smell (Pink 201,8). “When we use desktop monitors, laptops and mobile devices to access the Internet, we are always participating in a multi-sensory environment” (Pink 2013, 8). Thus, in his article Pink proposed theories of location, action, and multi-sensoriality to frame our perception of visual Internet ethnography. I mainly chose this article due to the fact that I am also doing virtual research and because Pink et al. also did visual research about the Cittaslow (Slow City) movement in the UK. I used campus maps in my research to better understand the location, which Pink also discussed in his article. Further, according to Collier and Collier (1986), photography can and is used as a method to collect unchanging data that is more reliable compared to data collected using other methods. My chosen technique is drawn from Collier and Collier. My observations are to be used in research to determine the difference between virtual and physical tours in the school for students and visitors. The method I used allowed me to collect a photographic inventory. A photographic inventory records not only the range of items but also their relationship and all the other aspects that determine how people use their space. My photographic inventory showed photos of different places in the UCLA school of law. For example, the relationship between the hallway and the Arustamyan 4 students and the placement of bookshelves and desks in the library. According to Collier and Collier, the arrangement of items in a photo may express patterns and values of a certain cultural group. The content and arrangement of a home is a reflection of the inhabitants and if read properly may give understanding of the people who live there. Consequently, the photographic inventory of the school gives the reader an insight about the culture, patterns and the people that study and work in the place. For example, the front of the law school is green and neat. This image talks a lot about the culture of the school. Task #4 First Appendix 1. Arustamyan 5 2. 3. Arustamyan 6 4. Arustamyan 7 5. 6. 7. 8. Arustamyan 8 9. 10. Arustamyan 9 11. 12. 13. Arustamyan 10 14. 15. Arustamyan 11 16. Arustamyan 12 17. 18. Second Appendix Notes I am going to take a picture of the UCLA school of Law hallway with students in it. The hallway is branching towards other parts of the school. The school hallway leads to other places in the school like the library and classrooms. The picture will help me differentiate between a Arustamyan 13 student's experience and the experience of other visitors when touring the school either physically or virtually. Photographic inventory will help the reader notice some features of the school that they might have missed or can miss during a physical tour. They put the material on the website in such a manner that it is accessible to all. The material on the shelf does not show until I am far out. Technically, I won't be able to see the details until I enter. They're attempting to get me to use the room in the same way as I would if I were physically moving. Navigation on a physical level. I may select a standing point location by clicking on items. I am taking a picture of the library including the bookshelves and the lights. The picture of the library is important since I want to do a comparison between my physical trip to the law school and my virtual tour. My experience while physically touring the school might not be enough for my research since I am applying to the law school. Additionally, I want to study the location especially the library since I will be using it regularly. Using the photographic inventory, I would like to understand the location including the suitability of the school. As part of my research to understand the location, I am also going to take a picture of the tower reading room. It is part of the library since it is in the same building and has bookshelves. However, the tower reading room is structured differently with single seats for individual students. It will also help me distinguish between my graphic and physical tour of the school. Additionally, the pictures will help improve my memory. Consequently, I will be able to navigate my way around the school once I apply. I am also going to take action shots outside the LuValle commons and the schools hallway. These action shots will give life the photographic inventory. A picture of the hallway will seem more real if there are students walking in it. Photos showing people in their context in the Arustamyan 14 school will also help me remember important features of the school. They will help determine the difference between a virtual tour and a physical tour of the institution. In the photograph showing the hallway, I focused on the length of the hallway and the features on the walls. It is very long and wide and has proper lighting all the way. The different corridors branching from the main hallway are also very noticeable. As I was taking the photograph, I captured students converging at the hallways. The students were from the different corridors branching from the hallway. The photographs from the library were meant to show the bookshelves and the arrangement of the seats. Additionally, the lighting in both the library photograph and that of the tower reading room can be seen clearly. The library and the reading room are very well organized and also have perfect lighting. While taking photographs of the library, I noticed it had another floor which after following led me to the tower reading room. In the photograph showing the library, the view of the bookshelves and the students studying is what made me take the photo. I wanted to display the well-organized bookshelves and the students calmly seated studying. The photo clearly shows the intended features with shelves and students appearing at the center of the image. When taking a photo of the front of the law school, I was captivated by the layout and the seats. In addition, I also wanted to capture the school’s entrance and its name. The seats are brought out clearly in the photo and the green background. I also got a good shot of the school’s entrance. However, the name of the school appears a bit too far and is not that clear. The third photo of a student walking into the LuValle commons was meant to show the entrance and the direction of the student. The photo clearly shows the student going in through the entrance. The common’s big compound and the pattern on the floor is also noticeable. The Arustamyan 15 patterns are so clear although they were not in my mind when I was taking the photo. They will assist in remembering the school's features. Doing the Snap: Storytelling and Participatory Photography with Women Porters in Ghana LAURIAN R. BOWLES This article describes the use of participatory photography to examine the lives of women migrants who work as head porters in urban Ghana. African markets are one of the few public spaces dominated by women, and this article analyzes how visual methodologies can successfully interrogate hierarchies of labor and the social marginalization of head porters known as kayayoo. Focusing on the sensory storytelling with photographs, this essay demonstrates how porters use photo-­narratives to situate their notions of industriousness, resilience, and embodied transportation. Storytelling with photographs analyzes how everyday habits reflect the marginalizing structures of Ghanaian markets and the way migrants assert their presence despite their outsider status. [Ghana, head porters, participatory photography, storytelling] Introduction A ccra, Ghana, is a popular hub for West African migrants, many of whom seek wages at one of the two dozen markets that operate in the capital. Makola Market is the largest open-­air market in the city’s central business district and the most central location to find a wide array of consumer goods. During an Accra fieldwork visit in December 2005, I took daily trips to Makola Market to accompany a friend as she made purchases for her tailoring business. The market swelled with Christmas imports to entice holiday shoppers, and I impulsively bought more food than we could carry. Fortunately, I was near a neighbor’s grocery stall and decided to visit while I sorted my overload. As I approached “sister”1 Akosua, she whistled and shouted, “kayayoo”2 in the direction of a group of women porters who sat on the roadside. Head loading is the most efficient means to transport goods at crowded markets, and Rahida, a porter I would later befriend during my yearlong fieldwork, approached balancing a large basin on her head. I quickly loaded my purchases, said goodbye to Akosua, and walked toward a taxi rank with Rahida closely behind. With the taxi packed, I turned and asked Rahida her price. In customary fashion, Rahida lowered her gaze, cupped her hands, but did not state a price. When I handed Rahida three cedis (US$1.20), she smiled with approval, and I took out my camera and asked for her photograph. Shaking her head, Rahida swiftly disappeared back into the market. I was formally introduced to Rahida a few weeks later when she approached with a small curtsey, pointed to my 35 mm camera, and said, “I am ready.” Gone were the worn-down flip-­flops and faded T-­shirt dress worn when she carried my groceries. Rahida was on her way to meet friends and asked for the picture so that she could send it to her family in northern Ghana. Obliged, I took the photograph (Figure 1). When I returned to Makola with the portrait, Rahida fondly touched the edges of her face in the print. Before then, the only photo she had of herself was the leftover passport pictures from a primary school application. Rahida said this would shape a more reassuring narrative to her family than the handwritten letter she originally planned to send. Like most of her relatives, Rahida attended school but did not read or write, so she would have paid a scribe to pen her letter. Once her cousin delivered the correspondence, a reader would be called to share her news. For Rahida, a letter had diminished social currency because as she explained, “a storyteller never wants to disappoint their audience.” The reader would downplay hardship and embellish good news. In this photograph, Rahida wore clothes no one in her family had seen, and she felt the inventive power of the Visual Anthropology Review, Vol. 33, Issue 2, pp. 107–118, ISSN 1058-7187, online ISSN 1548-7458. ? 2017 by the American Anthropological Association. DOI: 10.1111/var.12129. 108    VISUAL ANTHROPOLOGY REVIEW Volume 33 Number 2 Fall 2017 FIGURE 1. Rahida, 2008. Photograph by author. [This figure appears in color in the online issue.] photograph could defend against her family’s anxiety about her well-being. The bright stripes of Rahida’s shirt and scarf were not yet faded from frequent washes, and her updated outfit is what prompted her to ask for the picture. Rahida hoped her attire would convey a measure of success because a photograph, like a letter, can gloss some of the challenging aspects of migratory life. The day Rahida declined my request for a picture, she wore one of two shirts she brought from home and a tattered black headscarf she wore for Islamic modesty. As the self-­described “belly of the family,” with relatives who relied on her remittances, Rahida wanted this portrait to proclaim her presence in the city, substantiate her own claims to well-being, and mask her occasional choice to go hungry to send money home (Bayart 1993). Keenly aware of the way the physicality of her work undergirds her family’s worries about her health, Rahida expected this picture to provide her with a modicum of control over the stories that circulate about her back home. There is no shortage of scholarship about the challenges women porters face as rural to urban migrants,3 but I begin with Rahida’s story because of the way she incorporated a photograph and, therefore, rich sensibilities into the common pastime of storytelling. As a formal or leisure activity, African storytelling is a well-­ established art form that is regularly used to assert the ethnographic authority of a griot, circulate folktales, and as a way to teach life skills to young children (Ukaegbu 2010). Stoller (1997) describes stories as a “power object” that fosters the sensory analysis of experience in ways that preserve oral tradition and challenge the Cartesian mind/body dichotomy. Among porters, stories express tensions between farm and city, the individual experience and the imagined collective narrative of head loading. Coming-­of-­age tales and the “bright lights-­big city syndrome” are part of women’s storied aspirations about wages in ways that regularly compel young women to leave agricultural communities to work as head loaders (Bucken-­Knapp 2003). Fascinated by the “social life of stories” and what orally received events reveal about the relationships between women porters, Rahida’s incorporation of photographs into her narrative caused me to consider how photography might deepen the ethnographic insight of Ghanaian market life (Cruikshank 1998). The encounter with Rahida prompted me to consider the usefulness of photography to witness the storytelling sensibilities of women porters, and in this article, I detail how photographs present a visual literacy porters have about market labor through a shift away from women as subjects of someone else’s photographs to image producers with storied lives. Stories reveal women’s awareness and knowledge about the constraints on their labor, and their pictures document their narrative distillation of social events at the market. Photographs and conversational storytelling attend to the tangible struggles of women porter’s lives and locate their hard work as an embodiment of creative resilience within sensibilities of migration. Since early anthropological accounts of African markets, attention has focused on the women traders who are the tough negotiators and staunch matriarchs who control the daily commerce.4 In the deeply insightful ethnographic film Asante Market Women (Milne 1982), traders explain the complexity of the market through ruminations about gender roles, the constraints of matrilineality in polygamous households, and the way trade maintains financial independence. The rapport Laurian R. Bowles is a visual anthropologist who uses photography to study women’s migration in Ghana and mobility in the African Diaspora. She is an Assistant Professor of Anthropology and core faculty member of the Africana Studies at Davidson College. She earned her Ph.D. in Anthropology from Temple University. Participatory Photography in Ghana between filmmaker and participants brings to light the vulnerability traders feel about their work in one of the few occupations readily accessible to Asante women and both the camaraderie and kinship that exist in one of the rare public places dominated by women. While the film Asante Market Women affirms the irreducible power of women who wield public authority with little influence in their households, here I consider how photography can help assess the sensory knowledge women bring to their lives as porters. In the way that Asante Market Women witnesses, engages, and opens up the challenges of traders’ lives, I argue that photography can also have a generative role for the women porters who also work at markets. In sensory anthropology, there is a growing focus on the way visual methods can help us understand perceptions of the body, ways of being-­in-­the-­world, and vision as a pathway to embodied sensibilities (Pink 2009). Such an embodied sensibility of vision was evident in my research, as when participants in the photography practice I initiated entered a group setting, someone might snap her fingers while holding a photograph in the air. The term doing the snap became a verbal cue photographers used to request that I write down specific details of a story. Snaps are performative disseminations of market commentary where the effect of storytelling and the sensory value of photographs become part of already given social practices (Edwards 2012). Without the photographic praxis, it was easy to miss the subtleties of porters’ sense of not belonging and of the crafting of women’s stories about marginalization and the gender inequality of informal transportation. Finger snapping signals the interrelatedness of feeling and habituated gesture in storytelling habits, which invokes the porter’s sense of “being in the world.” As a relational medium, photographs drew porters into commentaries that allowed both storytellers and listeners to interpret market politics and contribute personal reflection into the photographic moments they discussed (Jackson 1989, 9). Studio portraits are the oldest and most popular form of photography in Ghana, and porters harnessed the “sensory registers” of portraiture with their own candid photographs in public spaces connecting to embodied emotion (Buckley 2006, 62). Photographs provided women with new routes of awareness about their daily routines, the curve of learning how to work in urban markets and their interaction with strangers; this is particularly important for women from areas with small numbers of newcomers where modes of sociality are centered on the extended family. The value of photographs lies in their tangible capture of women’s knowledge about efficient ways to find accommodations, the Bowles   109 prices of renting pans, and where to secure water and charcoal to avoid theft while at work, whereas “snaps” legitimate the storyteller’s authority and offer nonliterate porters an invaluable, yet familiar way to assert their role as producers in the project. During research visits to Accra from 2005 to 2007, I piqued women’s interest in learning photography by building on my preexisting relationships with women workers like Rahida. Because porters are wary of people taking their picture without permission, particularly by tourists just visiting the market as part of excursions, I spent most of my time with porters I already knew, offering to take photographs of them and their friends. By late 2007 when I arrived in Accra with fourteen 35 mm cameras, two digital cameras, and over 300 rolls of film, 12 of the 60 women I met over the previous two years asked to learn how to use cameras. They were Dagbamba migrants from the Northern Region who had lived at Agbogbloshie for less than two years,5 and among them were several long-­standing friends who coordinated their Accra with each other and with their photography. Three of the participants had toddler-­aged children with them in Accra, and another was visibly pregnant during the last two months of my fieldwork. Half the group were unmarried, and the remaining women were a second or third wife in their households. Few of the women had any formal education, none were literate, but all were fluent in at least two languages. The women described themselves as “circular migrants” and regularly discussed plans for a return to their hometowns, although privately several admitted to having no desire to go back to agricultural livelihoods. After I gave each participant a 35 mm point-­ and-­shoot camera with the film preloaded, we spent three weeks learning camera functions (Figure 2). My method was similar to participatory methods like photo-­ voice6 and “talking-­pictures” (Bunster 1977), designed to examine porters’ social relationships through the study of the stories that are told during the production, consumption, and exchange of photographs. Photographs proved useful to analyze how nonliterate people use images to tap into interior feelings and the significances they made that were similar in ways to writing. Situating Porters at Makola Market Accra is a popular hub for migrants throughout West Africa. Rural Ghana has historically served as a male labor reserve for mining and forestry sectors and female migrants typically rely on fostering traditions, where urban relatives pay their school fees and provide accommodations, in exchange for household labor. 110    VISUAL ANTHROPOLOGY REVIEW Volume 33 Number 2 Fall 2017 FIGURE 2. The author (bottom right) with several head porters learning camera functions. Photograph by Rahida, February 2008. [This figure appears in color in the online issue.] Porters are “out of place” strangers (Lentz 2006, 118). in the city because they do not follow the feminized fostering traditions (McKinley 2011, 106). The movement of women into the city to work as porters in Makola Market is the result of structural adjustment and the privatization of state enterprises, as well as cuts in agriculture and education subsidies. These have all fueled the downward mobility of most Ghanaian households who draw on multiple strategies to respond to these economic pressures (Clark and Manuh 1991). With the implementation of the Alien Compliance Order of 1969, the state expelled 100,000 foreign nationals, including the Nigerian men who dominated the porter and indigo trades (Eades 1993). This “depleted landscape” created an employment niche for women from northern areas who have quickly adapted rural tasks like fetching water and carrying firewood to human transportation in cities (McKinley 2011, 106). Head loading is a popular wage strategy for rural households because porters require little start-­up money and women can regularly return home to farm because they do not secure long-­term accommodations (Adepoju 2004). To prepare for work, women rent large aluminum basins against their daily wages or buy planks of plywood. Porters then spend the growing seasons in the south while they await the harvest of groundnuts, okra, sorghum, and yams on family farms. Some women leave with the blessing of their parents, who expect regular remittances, whereas others hope to earn enough money to purchase the household goods necessary to be considered marriageable. The younger married porters are usually junior wives in polygamous households who come to Accra with their toddlers because the children are too young to be useful in farming and use their porter wages as leverage against a venerated first wife (Bacho 2004). Upon arrival in Accra, porters share accommodations at Sodom and Gomorrah, the colloquial name for the Old Fadama/ Agbogbloshie shantytown where regional migrants rent weekly space in wooden shacks without water or regular waste removal. Muslim migrants from the Sahel comprise the bulk of the area’s ethnically heterogeneous neighborhood, and long-­standing antagonisms between slum residents and the state escalate when the government initiates forced removals to raze the settlements on the premise of an ecological restoration of the area’s wetlands (Boadi and Kuitunen 2002). Makola Market originated in the 1920s when the Accra Town Council constructed a one-­story market adjacent to the railroad line to expedite the transport of goods from the interior (Darkwah 2007). Makola is a broad term that describes an array of buildings and specialty markets in Accra’s central business district where thousands of women hawk goods from secondhand clothes and food to raw materials. Since the colonial administration, the state has used government-­owned stall rentals as surveillance of trade activities and to streamline tax collection (Chamlee-­Wright 2002). The growth of Euro-­American-­ style shopping malls has not diminished Makola’s impor- Participatory Photography in Ghana tance as a shopping district for the city’s two million residents (Yeebo 2016), and informal trade continues to transform a pedestrian “space on the side of the road” into brisk sales areas for women without the resources to rent government stalls (Stewart 1996). Rawlings Park is a monument square that was the original home of Makola Market No. 1 and was the meeting place porters and I agreed upon for our discussions. The park is one of three areas where a substantial number of porters congregate to compete for wages from the regular stream of delivery trucks that terminate in the square’s parking lot. Late mornings are ideal to spend time with porters, as there is a lull following the emptying of trucks that have arrived at dawn. Head loaders intermittently roam the park’s perimeter to hawk for customers, but women must weigh the prospect of a shopper in need of assistance against the surety of a delivery truck that requires unloading. It was moderately easy to make time for group conversations since porters placed importance on storytelling to stave off the listlessness of waiting for work (Jeffrey 2010). In addition to practicing Pidgin English together, I occasionally babysat children while porters worked so they could avoid the fees at market crèches. At the end of the 2007–2008 period of fieldwork, each participant kept her 35 mm camera, and as a small gift, I gave the group the remaining unexposed film and prepaid the processing fees at a studio walking distance from the market. After one month of training, porters began to take portraits of themselves and their friends, and some sent pictures to their hometowns or used the photographs to decorate their gloomy accommodations. Porters and I held biweekly meetings to exchange film and discuss the photographs. There was no organized system of distribution when the women were having the first look at the pictures, but we always sat in a circle where women spread their prints on the ground or handed them out one by one for review. On one February afternoon, Kisu, a slight-­build porter who had spent three years working in two coastal cities, announced to the group that the photographs were “too scattered.” Kisu was unconcerned with the quality of the photographs but wanted to position the images within a story that was being shared. Aware of the evaluative value of photographs, Kisu asked each participant to “tell the stories” of the laughter or heaviness they felt from the pictures (Figure 3). In her own case, Kisu’s carefree optimism caused her family doubts about her success as an Accra porter and coupled with an increasingly nagging neck pain, Kisu worried about the possibility of a short-­lived career as a porter. Kisu considered photographs to be an organizing repository of feelings reflecting her own experiences. She strove to blend the performativity, Bowles   111 FIGURE 3. Tania preparing to lift a load at Rawlings Park. Photograph by Lahiri. [This figure appears in color in the online issue.] materiality, and sensoriality of images to her commentary about being a porter (Edwards 2006). Kisu pointed to this picture of Tania and said, “We are so very hardworking and so strong, but they just don’t know. They should.” Kisu’s context of “we” included the women in our conversation and the imagined similarity and solidarity with every other porter at the market. “They” included family 300 miles away and the traders who hire head loaders. For example, the endurance of body pains as an essential part of their work-­ life demands improvisation and produces constant worry. Kisu had boyfriends in two of the cities she porters in, took frequent portraits of the one in Accra, did not purchase household wares to prepare for marriage, and infrequently sent remittances to her family. But for Kisu, the narrative focus is on the “body aches” that contained her frustrations over low wages and contradictions of her status, expressed through the relationships with her boyfriends and her family obligations. The crowded market, her regular mishaps, and the frequent physical collisions that cause bodily harm and have repercussions to her daily life are all incorporated into the narrative arc of “bodily aches.” In the top left of the photograph (Figure 3), Tania has a yard of yellow cloth resting on her head atop her green scarf. The photograph is “both constitutive by and constitutive of” an experience and presents porter modalities with material and relational purpose (Edwards 2012, 221). The cloth folded into a donut shape on Tania’s head cushions her head for the load she is 112    VISUAL ANTHROPOLOGY REVIEW Volume 33 Number 2 Fall 2017 about to lift. The photograph freezes a present moment of the necessary improvisation of head loading. Tania is unable to balance the cushion and ­simultaneously bend to place the plywood on her head; nearby porters will secure the bundle atop her head. The photograph shows the stakes of physical labor, the near-universal habit of head cushioning for loading and the importance of a seemingly insignificant resource. In artful response to Kisu’s concern about “scattered” photographs and the lack of recognition for the strenuousness of porter work, Ahjara and Hanifa take action photos of Kisu (Figures 4 and 5). Ahjara and Hanifa explain that what prompted these photos was Kisu’s whistling to clear walkers from her path. Some complaints before, Kisu had complained about the smell of the camphor salve she was using for her pained limbs. Ahjara and Hanifa were drawn to the contrast of Kisu’s complaints and their witnessing of her work the next few days. Each photograph (Figures 4 and 5) juxtaposes Kisu’s stature in relation to the load that she carries. The pictures have a “creative correspondence” where porters all agree that Kisu is a “force,” an expression used to affirm the qualities of a certain grit and perseverance in the sensory order of head loading (Okely 1994). Hanifa and Ahjara were drawn to take photos of Kisu because she whistled as she crossed the market. Unaware of her friends’ photographs, Kisu whistled to distract herself from her neck pain while Hanifa considered the sound as an affirmation of labor and created a photographic index of the moment. This attention to the sound through images is a “congealed residue” of FIGURE 5. Kisu carries a heavy solid-­wood table for a trader. Photograph by Ahjara. [This figure appears in color in the online issue.] the relationship between Hanifa, Ahjara, and Kisu (Gell 1998). During conversations about pictures and whistling, women’s intentions about photographic display are clarified, to reiterate Kisu’s affinity for stories that addressed the “scattered” nature of the photographs. The photographs signified relations between the photographers and the work they undertake in spite of terrifying body pains, and whistling is the habituated routine that situated sound in the efficacy of labor (Figure 6). Affective Snaps and Storytelling FIGURE 4. Kisu carrying a load across Rawlings Park. Photograph by Hanifa. [This figure appears in color in the online issue.] When these women photographers described an emotion or action they associated with a picture, they snapped their fingers in rapid succession. These aural gestures interrupt the quietness of head loading in the densely packed market where porters are hypermobile. This is most notable in the gestural interactions women have with their carrying materials, whether pans, plywood, or pans, and the way they integrate them into the photographs. Aural gestures intervene in the temporality Participatory Photography in Ghana Bowles   113 FIGURE 6. A group of porters at Rawlings Park. Kisu (center, striped shirt) and Sakina (far right) are two of the participants in the photography project. Ahjara took this photograph the same day as the photograph showing Kisu working (Figure 5). Sakina (right) holds their cameras. Photograph by Ahjara. [This figure appears in color in the online issue.] of waiting, photographs blend sociality and sound, and these activities demonstrate the sensibilities of integrity brought to work tasks (Feld 2012). Sensing the market is snapping fingers while absentmindedly tapping on the sides of pans, and the awareness of this comes during picture-­related conversations. The multisensory characteristics of porters’ perceptual experiences are also visualized with pans that are nestled into the frame of many of the pictures women take at work. Rahida could not afford to purchase an aluminum pan to work and snapped her fingers when she describes buying a pan as a “waste” because there are few sureties against theft. Yet, pans feature in several photographs in ways that are illustrative of the embodied labor of head loading. The distracted motion of talking with their pans also announces the presence of the person in the space—who is snapping and whistling—in synchronous ways. Feld’s (2012) work on “acoustemology” as a way of knowing the world through sound as demonstrated by the honk-­ horn sociality of Ghanaian truck drivers bears similarity among porters who blend the materiality of pans with snapping gestures and storytelling. When someone shared important news or ideas during conversational gatherings, she snapped her fingers. Listeners also snapped their fingers as a gestural exclamation and affirmation. As a bodily technique, snapping fingers demands attention and when someone snaps her fingers, conversations stop. Snapping one’s fingers in the group positioned the finger-­ snapper as the primary storyteller, and listeners quieted their conversations and leaned their bodies inward. The images connect dimensions of porters’ livelihoods with their feelings and action (Csordas 1990). If anyone anticipated that their work might distract the group, they left before the story began to minimize distractions. The storyteller sometimes moved herself to the middle of the group and snapped her fingers to punctuate a suspenseful moment. On one of these occasions, Hanifa was looking at a photograph she had taken of her friend Shani (Figure 7). Hanifa snapped her fingers, waved the picture in the air, and said, “Everything about the market is there.” About five of the participants were idling nearby, some standing in conversation, others sitting, having turned their work pans into makeshift seats. Hanifa snapped her fingers, waved the picture, and pointed to the signboard in the photograph. Hanifa said, Before I raised the camera, I saw the snap and Shani adjusting her scarf. When I put the camera to my face, I saw the picture inside this picture. Everything about the market is inside this picture. The snap is inside the snap! I don’t read words, but the snap is there. Look at all these people around this girl. None of them are minding her. None of them are minding me. Only Shani sees me. I am like the tro-tro [minibus]. When the mate shouts from the tro-tro, people mind him [pay attention]. When the taxi driver presses his noise [horn], people mind him. As for me, the only person who minds me is Shani. She was ready to curse me, until she saw it was me, with my camera. 114    VISUAL ANTHROPOLOGY REVIEW Volume 33 Number 2 Fall 2017 FIGURE 7. Shani. Photograph by Hanifa. [This figure appears in color in the online issue.] The audiovisual literacy in this reading of photography as “the snap inside the snap” supports how women understand photographs as a repository of acquired sensory knowledge. First, Hanifa uses the image to take note of the word snap on a signboard. When I first observed the porters snapping their fingers, I wrote the word snap in the margins of my field notebook. Observing me, Hanifa then noticed the word in the signboard, saw her friend in the shot, and felt moved to take the photograph. As she spoke, we all snapped our fingers in encouragement. This encouraging gestural exchange was made visible through pictures. When I then asked Hanifa about “everything at the market,” Hanifa said the picture “sharpens” about what it means to “be kayayoo.” This sharpening is Hanifa’s understanding of photography as an integrative experience that offers a breadth and depth to her creative energies as storyteller. A single photograph like this exposes the layered characteristics of Accra’s informal transportation networks and they sensorially underpin social interactions. Although her work is sanctioned as a market necessity and is a common practice, Hanifa focused on the particular body politics and modes of visibility in her work. The camera allowed Hanifa to read the market in a new way where she connected the yellow advertisement for a passport photography studio at Makola Market. Hanifa intentionally deploys the word snap to document her word recognition in a way that was powerfully affirming for her as a nonliterate person. The word snap inside the frame helps Hanifa to normalize her photography because Super Snaps Studio suggests the place for photography is in registered habituated routines at the market. Hanifa’s feelings come into the conversation through taking pictures of Shani, and the ordinariness of snapping fingers unpacks Hanifa’s own embodied observations about daily life as a porter. The photograph represents the porter’s intuitive literacy of the labor of informal transportation. The particular navigability of head porters—because they work on foot and can easily slip through narrow spaces—allows women to move within the tightly packed market in ways that other forms of transportation cannot. When Hanifa pointed to the barely noticeable carrying pan in the bottom left of Figure 7, she noted how the picture fixes a moment of action where a man enters a minibus taxi and Shani adjusts her scarf. Both of their bodies index transportation in different ways. Looking at the photograph of Shani, Hanifa absentmindedly tapped the top of the aluminum carrying pan that she sat on as an aural reference. She adds, “No one makes my price. I don’t get to call like a mate. I am just here. The only person who can really see me is another person who does not call. I am here to quietly make money. But not making noise costs.” Shani’s gaze into the camera is a mutual recognition of a shared kinship expressed through gender and migration labor. Shani acknowledges Hanifa’s presence and distinguishes their connection from the other markers of transport at work in the picture. The centrally foregrounded taxi is the antinome of the haggling that occurs in most Ghanaian transactions because everyone who enters the minibus will pay a set fare to the male driver’s assistant. In the left are coconuts that men sell from carts they have pushed to the market. Hanifa’s reflexive attempt to make sense of the way gendered expectations buttress her earnings comes through in the suggestion that “no one minds” porters and captures how women make sense of having too few tools to announce their presence and no machine-dependent parts to their labor needing maintenance (Grosz 1994). Porters may not be the wealthy subjects or producers of studio photography popular in Ghana since the late 19th century (Wendl 2001), but the proliferating ownership of cell phones with cameras has popularized street photography in Ghana (Shipley 2015). By subjecting the market to their gaze and valorizing their peers as subjects, porters create critical interventions about human transportation and the Participatory Photography in Ghana industriousness of women market laborers in ways that add another dimension to the discourses about class and access in Ghanaian photography as well as unique reflections on the authorship and popular photography (Schneider 2010). The emotional toll of being marginalized yet socially aware is enacted through sensory aspects of photographs because they present women’s stresses and uncertainties. Porters may be part of the “commercial vocabulary” of market transportation in Ghana, but the degradation of porter work is common throughout social discourse (Yeboah and Yeboah 2009). The state describes porters as a “disruption to the tourism industry” of Accra because of the way porters are clearly marked in the public by their carrying pans (ADM 2005). Recently, regional authorities proposed that transportation levies for market tolls and taxi licenses extend to women porters (Tawiah 2016). Traders express affinity for women porters because they are viewed as less capable of running away with goods and therefore “more trustworthy” (Argawal et al. 1997). Male porters use dollies, hand trucks, and wheel barrels to transport and haggle with customers for their wages to compensate for the wear and tear on their mechanical technology, sometimes leaving wobbly wheels on their barrels to negotiate for better rates (Figure 8). With photographs that record elements of reality and simultaneously engendered embodiment of stories (Pinney 2016), women’s photographs lay bare the narratives of laborers who are highly visible yet rarely represented in ethnographic accounts of markets (Achebe and Teboh 2007). Women’s heads and limbs are less effective resources to leverage as negotiation tools (Amponsah et al. 1996). The use of plywood and metal basins, rather than assistive Bowles   115 technology like barrels and carts, fuels a tacit ghettoization of women’s physical labor, especially when women experience income losses due to injury or illness (Opare 2003). The digital circulation of images has jettisoned some of the scholarly attention away from photographs as material objects (Edwards 1997, 2002), but storytelling and photography proved useful for parsing embodied sensibilities of labor at Makola Market. To be sure, I did not conceive of participants as being empowered by photography, but instead, I suggest here that the photography project did enable women to disrupt some of the common tourist or journalist photographs that show an African woman with a load on her head and a baby tied to her back. The way women distinguish between the images to circulate among peers in Accra, photographs as keepsakes, and photographs to be sent home resonates with women’s own sensibilities as narrator within the aspects of porter work that mattered most to women: being perceived as industrious, by their peers in equal measure as their families, and how the value of that perception is relative to their overall lived experiences as workers. With photographs, porters interpret the market for their own use in ways that “may or may not be legible to a broader public” but nonetheless bring visibility to the complexities of women-dominated spaces (Shanker 2016, 164). The location where porters work inside of the market, how women migrants secure accommodations, and the way porters arrive in the city are forms of knowledge acquired and expressed through stories. Women’s photographs did not so much visualize these contingent uncertainties of market life but rather added an embodied visuality to narratives about the way women counter their marginality. Porters leveraged the FIGURE 8. Male porter. Photograph by author. [This figure appears in color in the online issue.] 116    VISUAL ANTHROPOLOGY REVIEW Volume 33 Number 2 Fall 2017 sociality of their work within the “potentialities intrinsic” to West African markets because market women are heralded as the archetypes of economic acuity (Wittekind 2016, 188). Photographic stories, such as I have presented here, can account for the shared aspirations and body pains of head loading as well as affirm the recurrent improvisations of self in everyday life. While the photography project created space for women to engage in emotionally supportive processes, these narratives cannot shift the structural violence associated with women’s labor in Ghana. What stories and photographs do offer instead is a self-­generative analysis of women’s lives that are not often articulated or imagined. Acknowledgments I thank my colleagues in Anthropology and Africana Studies at Davidson College for their close readings of earlier drafts of this article at the Africana Studies Department Roundtable in 2014. I would also like to thank Beth Uzwiak, editors at VAR, and the anonymous reviewers for their attentive feedback. Funding for this research came from the Faculty, Study and Research grant at Davidson College and the Woodrow Wilson Career Enhancement Fellowship. Notes 1 ecause we are close in age as well as neighbors, Akosua B and I use the moniker of sister as a sign of friendship. This is a common practice among Ghanaians, although Spencer (2008) also describes the sibling moniker as a marketing strategy used by hawkers toward African American ­tourists. 2 Kayayoo (kayayei, plural) are the female head porters who transport goods across Ghanaian markets by foot (Opare 2003). 3 Grieco, Apt, and Turner (1996) offer a sociological study of Ghanaian female traders and the porters who support trade in Ghana. Awumbila and Ardayfio-­Schandorf (2008) as well as Anarfi (1997) detail the housing insecurities and socio-­ economic vulnerabilities porters face. Opare (2003) also addresses the ways in which circular migration connects to agriculture in Ghana. 4 For a rich treatment of Ghanaian market women in Kumasi, see Clark (1988, 1994). Robertson and Berger (1986) focus on market women in Accra, whereas House-­Midamba and Ekechi (1995) examine the economic power of market women across West Africa. 5 Reliable estimates about the number of women porters prove challenging. Bayor (2007) suggests that 25,000 female porters work in Accra daily, with the Northern Region accounting for more than 70 percent of porters. 6 Wang (1999) and Wang and Burris (1997) initially employed photo-­voice as a method to engage women’s health in China as part of a public health initiative. Harper (2002) assessed the practical considerations of photo-­ elicitation studies. Photo-­ voice has since become a more widespread methodology for research with children and youth (see Johnson 2011). Davis (2003) describes photo-­voice as a methodology that facilitates descriptive sensibilities of well-being in feminist ethnography. 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Yeebo, Yepoka. 2016. “Ghana’s Market Women Were Once So Powerful They Were Targeted by the Military.” Public Radio International, The World. January 5. http://www.pri.org/ stories/2016-01-05/ghana-s-market-women-were-once-sopowerful-they-were-targeted-coup. Accessed February 29, 2016. A way into empathy: A 'case' of photo-elicitation in illness research Author(s): Laura S. Lorenz Source: Health , May 2011, Vol. 15, No. 3, Special Issue: Another way of knowing: Art, disease and illness experience (May 2011), pp. 259-275 Published by: Sage Publications, Ltd. Stable URL: https://www.jstor.org/stable/26650209 JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at https://about.jstor.org/terms Sage Publications, Ltd. is collaborating with JSTOR to digitize, preserve and extend access to Health This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms healtti: Article Health A way way into into empathy: empathy:A'case* A'case* of of photo-elicitation photo-elicitationininillness illness 15(3) 259-275 ©The 20112011 ©TheAuthor(s) Author(s) Reprints and permission: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1363459310397976 research hea.sagepub.com DSAGE Laura S. Lorenz Brandeis University, USA Abstract Brain injury patients often face a lack of empathy that leads to feelings of being disrespected and powerless. This article explores the use of photo-elicitation as one way to generate empathy in research (and clinical) relationships with acquired brain injury survivors through a re-examination of the process and products of photo elicitation research conducted several years ago. The 'case' starkly illustrates the limits of researcher empathy and analysis even as the ethics of visual methods create opportunities for participants to share research power, contest research analyses, and present an alternate view that displays health and strength as well as illness. The 'case' prompts us to remain vigilant of the ways in which our personal lenses and histories affect what we see and shape our production of knowledge. Practicing empathy by using photos to create discursive spaces in research relationships may help us to learn about ourselves as we learn with patients. Keywords lived experience, narrative, participatory visual methods, patient-provider relationship, storied accounts Background Clinicians have long advocated for gaining an insider perspective on patients' experiences (Prigatano, 2000). With traumatic brain injury, caused by a blow or jolt to the head, patients do most of their healing work at home, increasing the urgency to understand their daily lives, outside the rehabilitation setting. Traumatic brain injury is a global public health problem (Langlois et al., 2006) and a major source of disability. Corresponding author: Laura S. Lorenz, Institute for Behavioral Health, Heller School for Social Policy and Management MS035, Brandeis University, 41S South Street, Waltham, MA, 01752, USA. Tel: +1 781 736 3847; fax: +1 781 736 3985 Email: llorenz@brandeis.edu This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 260 Health 15(3) Yet brain injury patients consistently experience lack of recognition and support for what they are going through and must contend with misdiagnosis, negative attitudes, lack of respect, and feelings of powerlessness (Jumisko et al., 2005; Nochi, 1998; Sherry, 2006). Providers may focus on the empirical knowledge they bring to the clinical encounter and feel challenged in comprehending the social environment impacting their patients' self-perceptions and health decision making (Rich et al., 2002). Physicians may not have the capacity to recognize what their patients are going through or have empathy for their suffering (Charon, 2001). The 'case' of photo-elicitation research described in this article provides insights into the value and risk of empathy in working with participants with invisible injuries and portraying their lives for others. Broadly defined, empathy is the ability to understand another's perspective, stand in their shoes, or see through their eyes. It is both a personality trait, which some people have in greater proportion than others, and a momentary emotion that results from viewing another person experience suffering. Empathy has both emotional and cognitive aspects (Eslinger, 1998): cognitive empathy is the act of adopting the mental perspective of another person, or thinking with patients or participants instead of thinking about them (Frank, 2004). Emotional empathy is the vicarious sharing of an emotional state with another person and helps in 'building true intersubjectivity with sick people' (Charon, 2006: 179). Together, emotional and cognitive aspects of empathy engender what Charon (2006: 179) calls 'bearing witness to sickness' or both thinking and feeling with a patient. Empathy creates links that enable patients to reveal not only their illness but the ways in which 'they are still healthy' (Katz and Shotter, 1996: 920), an example of restoring 'power or control to those who have suffered' (Charon, 2006: 181). In this article I will reflect on empathy and power in a 'case' of photo-elicitation research on lived experience with brain injury. My 'discipline' is social policy; empathy in clinical settings is a social policy issue when lack of empathy on the part of clinicians (and health-service funders) results in care that is not patient-centered. In the United States, clinicians are under tremendous pressure to provide 'efficient' care. Time pressures inhibit the taking of a 'dialogical invitational stance' that fosters 'living moments of talk' (Katz and Shotter, 1996: 921) where patients communicate their lived experience with health and illness and clinicians can empower through bearing witness. Policy is made and implemented at many levels, from national governments to individuals living out their daily lives. At all levels, we need to consider evidence from real lives as we seek to provide better care to more people in a context of shrinking financial resources. One way to develop evidence on and empathy for lived experience with health and illness is to create 'discursive spaces' (Katz and Shotter, 1996; Radley, 2009) by putting cameras in the hands of patients and talking with them about their photographs. Following the lead of Riessman (2003) I return to a 'case' first reported on several years ago to re-interpret the photographs, conversations, and analysis and explore the implications for illness research and care. Using photo-elicitation to explore lived experience Photography has served as a powerful tool for illuminating human experience. Photo elicitation, or inserting a photograph into a research interview, unlocks subjectivity, perspective, and emotion (Collier, 1957; Harper, 2003), surfaces information which This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 261 Lorenz might otherwise remain 'invisible', hidden, or submerged, and encourages participants to see their communities, experience, and daily lives with fresh eyes (Collier, 1957; Frith and Harcourt, 2007; Harper, 2003; Radley and Taylor, 2003). With photo-elicitation, research photos may be historical or current, from a range of sources. For my study of lived experience with brain injury, participants took the photos. Putting in participants' hands the power to produce unstructured research data can lead to a shift in the power differential between researcher and respondent (Worth et al., 1997) as participants' photos generate discussion and invite them to lead the conversation (Hagedorn, 1996). Self-generated photographs can provide a means for respondents to allude to trauma and recovery or community challenges in a safe way (Lorenz and Kolb, 2009; Radley and Taylor, 2003). Further, the resulting data are different as researchers gain 'a more direct understanding' of people's life experiences than is possible with researcher-controlled data (Rich et al., 2000: 156). Methods that combine self-generated photos and interviews or discussion have proven useful in research with children, young mothers, and adults with cognitive challenges (Booth and Booth, 2003; Dyches et al., 2004; Lorenz, 2010c). Slowed processing speed in the brain can challenge a participant to respond quickly to a question, and short term memory issues may impede participation (McCullagh and Feinstein, 2005). Using photo elicitation with adult brain injury survivors facilitates knowledge generation by providing participants with something to talk about and a way to remember. Generating and analyzing the data of this case From 2006 to 2007, I carried out a study of lived experience with brain injury that used photo-elicitation with brain injury survivors accessing outpatient services in a rehabilitation hospital in the northeastern United States. A primary study purpose was to 'understand a larger world of suffering beyond the consultation room' (Katz and Shotter, 1996: 924). Patients were asked to use their cameras to show their point of view on living with brain injury and the things that help or slow down their recovery, and to discuss their photographs with me. The protocol was approved by the hospital's Institutional Review Board, and informed consent was obtained through a three-step process that involved an informed consent interview, periodic reminders that participants were free to withdraw from the study at any time, and written permission to share any photographs outside the research interview. Participants used disposable film cameras to take between 12 and 54 photographs each and spoke with me for at least one hour. Analysis methods I analyzed study photographs and interview text using several narrative analysis methods: thematic; structural; visual; and dialogic/performance analysis (Riessman, 2007). My thematic analysis involved identifying a theme in a participant's photographs and what they said about them. Structural analysis included looking at structural elements (the 'how') of what was said as I parsed the interview text into lines and grouped the lines into parts (Gee, 1991:22). Dialogic analysis involved exploring my feelings in working with participants the 'living moment' of the relational process that 'can only be made visible from within the This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 262 Health 15(3) practice itself' (Katz and Shotter, 1996: 920). Dialogic analysis also involved sharing my analysis with my participants and asking them to respond to, perhaps contest my findings. And finally, visual analysis methods included looking at a photograph's details (Becker, 1986), and reflecting on its production and audiences (Rose, 2007). In this article I will focus on the structural and dialogic/performance aspects of the case of focus, and the limits of 'one reading' (Walkerdine, 1986: 192), at one point in time. I hope that my reflexivity will help to bring you, as practitioners and consumers of research and medicine, 'into the presence of the same conditions that provoked' the data and analysis presented here (Radley, 2009: 100). I also hope that my reflexive effort at transparency about my research 'practice' (Katz and Shotter, 1996) will prove helpful. And finally, I am using this writing opportunity to better understand how my positioning shaped 'the production of knowledge' in the research presented in these pages (Riessman, 2003:6). Cose study selection Narrative analysis is a case-based method that 'relies on extended accounts' (Riessman, 2007:12). Narrative scholars often keep large chunks of participants ' spoken or written data and 'theorize from the case rather than from component themes across cases' (Riessman, 2007: 53). Patients can 'illustrate a disease category' while also being 'unique' in how they are affected by their disease (Radley and Chamberlain, 2001: 323). In selecting individuals as a case, the 'context of their lives 'needs to be an expressive portrayal that is ... meaningful to the person' and to me as witness to their illness performance, be it visual, text, or in this case, both (Radley and Chamberlain, 2001: 329). Using Radley and Chamberlain's definition of a case brings up two points of consideration relevant to this article: What constitutes an expressive portrayal? And what details will help audiences 'to enter into the context of the illness situation so defined' (Radley and Chamberlain, 2001:330)? Works of illness or artworks (including photographs) by patients have clear potential to portray 'meaning in an expressive way' (Radley and Bell, 2007: 371). A strength is their ability to gesture, to call attention as if by pointing, to 'what should be the focus of concern' from the perspective of the patient (Radley and Bell, 2007: 371). The act of pointing can be subtle - a word (Katz and Shotter, 1996) or more overt, as in a photograph, a tattoo, or a drawing (Prigatano, 2000; Radley, 2009; Radley and Bell, 2007). The participant-generated photographs included in this article point us toward issues of concern important to a man and former professional whose brain injury was relatively new and who used the opportunity to call attention to the suffering he felt in the loss of former abilities and roles. In the context of our interview, he expressively portrayed the meaning of living with brain injury to me, his research co-conspirator, in his photographs and words. He questioned the policy relevance of our conversation and his artworks. He also questioned the validity of my portrayal of him and challenged me to see him through a broader lens than my narrow one of the frustration and confusion of living with brain injury. In part this article is an attempt to explore the policy relevance of conducting - or failing to conduct - patient-centered research and providing - or failing to provide - patient-centered care. This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 263 Lorenz Setting the stage My clinician collaborator recruited the man of focus in this article because of his intelligence and reflectivity. My respondent chose for himself the pseudonym 'Subject D', which reveals an ironic, self-deprecating sense of humor and perhaps a sense of low power in the research context. His pseudonym is 'arresting' (Katz and Shorter, 1996) for postmodern qualitative researchers, who conceptualize those who take part in research as 'respondents' or 'participants', not 'subjects'. The dissonance between his name and our perceptions of our research identity reminds us that no matter how hard we try, we cannot erase the power inequity endemic to research settings. In 'allowing' him to choose a name that discomfits I am choosing to share power with him. His pseudonym is thus symbolic of both his power and his powerlessness in our research. At the time of the study, Subject D was in his late 50s, with thick hair and a thick mustache. His voice hinted at a life-long habit of smoking cigarettes. He was injured falling down his basement stairs as he descended to fix the water heater. He was in a coma for a month. We spoke about a year and a half after his injury. We talked in Subject D's kitchen, sitting across the table from each other, in a suburb of a major city in the eastern United States. At that time he spent much of the day in his kitchen. It is where he read the paper, ate and cooked, kept his organizer, and managed his day. He smoked cigarettes while we talked. Listening to the recording of our interview, I again heard the flicker of Subject D's lighter, the silence of his inhalation, and my dry cough as I inhaled the secondhand smoke. I said yes when he asked permission to smoke, and, as I find in my field notes, the smoke did not bother me. He offered me a glass of water, which I accepted. We sat near an open window, which let in the sounds of gulls, song birds, carpenters working nearby, and a heavy summer rain that interrupted our conversation when he went outside to close the windows of his wife's car, which he had been detailing when I arrived. In sum, the circumstances of our conversation felt more intimate than those that took place at the rehabilitation hospital, perhaps reinforcing my sense of empathy with this man - and perhaps contributing to the creation of a discursive space where he felt more comfortable contesting my perspective compared with participants who spoke with me at the hospital, where, though peripheral to the setting, I was by association powerful (Katz and Shotter, 1996). Subject D as photographer At first Subject D did not think he would have many things to photograph. The excerpt below, like the others in this article, is parsed into separate lines, each one about 'one central idea, or topic' (Gee, 1991:22). My words and sounds are italicized; all other text is Subject D's. A period indicates a full stop, and a comma indicates a brief pause. I don't have a very complicated life. There's not too many things I can think of to take pictures of. No? I hang around the house most of the day, And I go walk the dog in the afternoon. This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 264 Health 15(3) And I come back and cook dinner and watch the baseball game, go to bed. That's what I do every day. Well, even documenting your day, I mean that s part of living with brain injury, the things you do in your day. You could just take photos of those and talk about them if you want. It's kind of hard to take pictures of myself taking naps. The excerpt immediately grounded us in the boring, repetitive nature of his life with brain injury. He questioned whether his day could possibly be of interest to me. The exchange again demonstrated his ironic sense of humor - which amused as it deprecated my choice of research topic, method, and 'subject'. In our informed consent interview, Subject D expressed concerns that pictures of people would pose a risk to confidentiality because they might be tied to him: 'I don't want my disease, my problem to have any record in government projects.' Thirty years as a federal government contractor had given him a healthy skepticism about the power and intent of government. After our interview, I immediately drove to the hospital to speak with a research administrator, who assured me that a government review of this small study was highly unlikely. I reported back to Subject D, and he agreed to participate choosing not to exercise his power to refuse. I felt relieved. Subject D took to his research assignment with intent and enthusiasm. He completed his project-provided camera in one day and immediately purchased a second camera. His two cameras were in the mail to me within three days. With the first he took 24 (of 27) photos in and around his house and yard, including 12 in his kitchen. With the second he took 22 (of 27) photos outside his home: at the grocery store, municipal center, and the park where he walks his dog. He took photos to show a non-brain injured person what it is like to live with brain injury. The photo interview Subject D and I spoke for about two and a half hours about his photographs. I picked the first photo we discussed, and he chose the rest. The pictures were in two piles, one for each roll of film. Once we got going, they were spread out on the table, some photos covering others. He picked out ones that caught his eye. Generally speaking, we focused first on his house, and then on a restaurant, grocery shopping, and the dog park, similar to the order of his picture-taking. Some of our conversation touched on our shared experiences living and working overseas. Subject D had many stories about his life stories that he had told many times and which still entertained a fresh listener. Researcher reflexivity My impressions of and feelings about Subject D inevitably influenced our conversation and my analysis of his visual and interview data. For example, when we first spoke on the phone, I wrote in my notes that his voice sounded 'deadened', not a 'natural sound', and that he sounded a little 'confused and angry'. I felt some trepidation about what lay ahead as I drove to his home to ask him to participate in the study. Later I learned that this deadened sound is a common symptom of brain injury (and is called flat affect) and This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 265 Lorenz anger is common after brain injury. Subject D was the third person I interviewed for my study, and I was relatively naïve about the symptoms and consequences of living with brain injury when we spoke. Second, Subject D reminded me of my grandfather, who also smoked cigarettes and was heavyset with a permanent tan and a rich voice. Like my grandfather, he moved slowly, as if under water, which in my grandfather's case was caused by alcohol consumption and medication. The daily life that Subject D described reminded me of my grandfather in his later years - not much change from one day to the next, each day repeating itself in what appeared to me to be an endlessly dull routine. It also seemed lonely. In West Africa, where Subject D and I had each lived prior if unconnected lives, there is no word for alone that does not also mean lonely. Subject D's life post-injury struck me as a sad contrast to his past, when a beer, meal, or tennis game with fellow expatriates was likely a daily occurrence. In putting myself in his shoes as I looked at his photographs and discussed them, I inevitably filtered his experience through my own, and there were things about Subject D that reminded me of myself. After college I lived for three years in the eastern city where he grew up - a city where immigrants fueled industries that blackened the skies and held on to their identities as they became Americans. Subject D and I both lived and worked for years in West Africa, where we fell in love with cultures and people who welcomed our technology and money and tolerated our presence. We spoke of feeling comfortable surrounded by a culture alien to our own. We expressed a sense of service to others and a desire to make a difference in the world. I felt an affinity with Subject D for our shared life experiences and values. Seeing and talking about his photos helped me to have empathy for - if not complete understanding of - his current situation. Re examining my reaction to Subject D from my 'position' today, is an exercise in 'caring for the self-who-listens' and who looks (Charon, 2006: 181) and a humble attempt to deepen my understanding of my research practice and myself. A lived experience narrative Nineteen of Subject D's 54 photographs overtly related to food, and food was a major theme in our interview. Food is such a basic part of daily life. If food became a source of frustration, then it seemed to me it must be a daily and unavoidable feeling. In turn, he made me feel frustrated. He did not seem to recognize his residual strengths, from my perspective: a curious mind; strong intellect; caring nature; and good sense of humor. My perception at the time was that he seemed to see no hope in his situation and he appeared adamant at sticking with his trope of frustration and confusion. For my thematic analysis, I selected four of Subject D's photos and what he said about them as a narrative of the frustration and confusion of living with brain injury. Terms he used to describe these feelings and states of mind included: 'frustration'; 'confusion'; 'constant disorder'; 'chaos'; 'drives me crazy'; 'flips me out'; and 'freaks me out'. These words figured prominently in Subject D's explanation of why he captured the four photographs I included in his visual illness narrative. The theme that emerged was food and related everyday tasks: shopping; storing; cooking; tasting; and cleaning up. For this article, I focus on one photo - of cans in the sink, which he took to depict the 'disorder' he lives with. This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 266 Health 15(3) The photograph (Figure 1) and its accompanying text have a title that describes the photograph and places it in context. The photo is followed by the title and the interview text is parsed into lines and grouped into parts, each with a title using Subject D's own words (Gee, 1991: 22). Anything I said is italicized; all other text is Subject D's. A period indicates a full stop. A comma indicates a brief pause, and two dots indicate a longer pause. A discussion follows the excerpt. Figure I. Cans in the Sink,'The disorder that I'm living with right now' Preamble: It was supposed to make a point I think this is beautiful. This is a beautiful photo. That's an accident I know, but it s Just the way the light was I know, but it's, it came out, it's almost like a cartoon Well, it is. It was supposed to make a point. Was it?.. What point? Part 1:1 keep getting confused and lost The disorder that I'm living with right now Uh huh A lot of it's my fault, because I can't organize things any more, Like I go to a store, and I'm supposed to buy maybe ten things. It takes me an hour and a half. And I keep getting confused and, lost in the store, and,.. I get panicked sometimes if I go to a new store and it's too big hm hmm. This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 267 Lorenz Part 2: Now everything is disorganized But the house is the same way. I can't get my wife and daughter to put anything where it belongs, you know, just., hm hmm They put everything on a, table top someplace. Which they've always done, and I just yell at them and not pay any attention, just go on out. But now it, it, it freaks me out Everything is disorganized, you know, I can't find anything hm hmm Then, they keep putting things, you know just, stockpiling things on the front porch for example, And then they throw it all in the garage, So the garage is so fall now I can't get in there to get my tools. Part 3:1 feel like I'm living in chaos and it's hopeless Now I'm talking about something that every family has to deal with, especially if you have a teenage girl and a, um, a disorganized wife, but, um.. It drives me crazy now, I mean, just, the way my brain's operating, hm hmm Your reaction, is different from how it used to be. I feel like I'm living in chaos and it's hopeless, I can't do anything about it hm hmm. Coda: These are appropriate pictures These are appropriate pictures. These are all the chaos. Discussion of'Cans in the Sink: The disorder I'm living with right now' The photograph and its text grounded us immediately in two common if understudied brain injury survivor concerns: feelings of frustration and confusion. It was the first photograph we discussed. It set the tone for our interview. The photo functioned as a 'crucial poetic moment' that 'struck' me without my knowing quite why (Katz and Shotter, 1996: 920), and I followed my instinctive attraction to the photo when I picked it up as we started talking. My experience with this photograph appears similar to the experience of Arlene Katz when she heard a Haitian patient speak of 'home' (Katz and Shotter, 1996). As I said in the Prelude, the photo seemed beautiful to me - the colors, the play of light off the steel sink, the cartons, cans, bottle of dish detergent, even the plastic containers in the dish drainer - they seemed luminous, unreal, like a 'cartoon'. Subject D said that the beauty of the photo was an accident, but that the image itself was intentional: 'it was supposed to make a point'. The photo was thus a 'work of illness' that created an opening, a 'crack in the discourse', a 'space' (Radley, 2009: 99-101) where we began to talk about the photo and, in so doing, talked with each other (Frank, 1995). Our interplay as we began to talk about the photo is an example of what Radley (2009: 101) calls an invitation to a 'response that is participatory' as we entered the 'moment or the space' that the photograph - the 'display' of his experience - made possible. Subject D said that his intent here was to show the 'disorder' that he lived with every day. In Part 1, he blamed himself for 'a lot' of the disorder, due to his inability to organize 'things', exemplified by the task of grocery shopping, which not only took longer than it used to but This content downloaded from 131.179.222.3 on Mon, 22 Mar 2021 23:03:32 UTC All use subject to https://about.jstor.org/terms 268 Health 15(3) which induced panic when he had to shop in an unfamiliar store. In the 'crucial moment' of the interview, we were not seeking facts; it was emotion and meaning that mattered: feeling confused and lost in formerly familiar places. He used his photo to show confusion in the sink, but he talked about not just the environment...