“An acoustemologist, that’s probably the best professional description for me” – Tom Rice is a Senior Lecturer at the Department of Sociology, Philosophy and Anthropology at the University of Exeter, with a research focus on the anthropology of sound. Ever since childhood, sound has been important to him, but working as a volunteer for Red Dot Radio (the Edinburgh Hospital Broadcasting Service) as an undergraduate student, Tom was intrigued by the intensity of patient feelings about the sonic environment of the hospital wards. One thing lead to another and he decided to do an ethnographic study of the auditory culture of a London hospital for his PhD thesis. In the subsequent book, Hearing and the Hospital, Tom illustrates how sounds shape and reinforce relations between doctors, caregivers, medical students and patients (Rice 2013). He attends to the different modes of listening present on hospital wards and uncovers the ways in which medical knowledge and skills are learned and employed inside these health care institutions.
One autumn morning I met Tom on Skype for an interview about the craft of writing in social studies of medicine. Leaving the video option turned off, our questions and answers were mediated by the acoustic sensors and speakers of our laptops. Tom selects his words carefully. With his engaging voice, the listener can vividly experience his passion for the sonic and without noticing, the conversation quickly spans two hours. The following text is thus only a shortened and edited version of the original conversation but invites its readers to think through some of the sonic layers of academic writing. In his BBC radio productions, Tom experiments with replacing the written form of academic publishing by transmitting ethnographic insights through the medium of sound.
CARLA GREUBEL (CG): When you started your hospital research in 1999, what were your writing utensils and what sounds did they make? How have the sounds of your writing changed over the last almost 20 years?
TOM RICE (TR): Oh, the sounds of writing, that is fascinating! There is nothing more intimidating than when you’re sitting opposite someone at a computer who is really rattling the keys at an extraordinary rate and you are terrified by the productivity you can hear. I think the sound of the key strike is so important in life now. It is often unobtrusive, but it’s everywhere. When I was a child I used to really enjoy writing with a fountain pen because of the rhythm and the sound that the nib makes in contact with the paper, and then, you know, when you cross a t for example. A really satisfying kind of sound. While I was doing hospital research both as an undergraduate and during my PhD I used notebooks. But I didn’t do anything fancy with them, I just wrote in them with a biro. I think there is, or has been anyway, a tendency to respect the craft of writing a bit too much and to be a bit precious about it, so I quite like just scribbling and the disposability of pens and notebooks and that kind of thing. I know a lot of people take stationary really seriously, but I tend to do the opposite. For my PhD fieldwork I used about 20 A4 hardback notebooks with sepia brown covers, just because I needed something hard wearing. My handwriting is really bad and that was actually really useful because no one else could read the notebooks. So even if I left them lying around, they were useless to other people. And sometimes the students I was working with would ask to see them and I would say, “sure, go ahead” and they would glance at them and then just hand them back; they couldn’t read them, the handwriting was so hopeless [laughing]. Bad handwriting was a blessing in disguise. There is a really good line from William Carlos Williams, who was a doctor and also an author, about the typewriter replacing the stethoscope in the evenings as his major professional instrument (Coles 1984). In the fieldwork for my PhD it was often the question of putting down the stethoscope and picking up the computer keyboard. I think there was a kind of feeling of interchangeability between those instruments for me then.
CG: In which way do they express something related?
TR: Yeah, exactly, what is it? I think both of them are ultimately, to my mind anyway, instruments to help you listen. I see writing all the time as a way to direct attention towards sound. The keyboard is a way of producing text that directs attention to sound, and a stethoscope also focuses attention on sound. A text is also a technology for bringing you closer to those about whom you are writing and the stethoscope does have this way of bringing you close to people because you have to get physically close to them in order to listen. So there are parallels there.
CG: That is so interesting to see writing as an attention to listening. Sounds and wellbeing are two things that are obviously closely related although, as you also show in your work, often not in such a straightforward manner as we tend to assume in the connotation of noise as unwanted sounds. I was wondering, is there a healthy sonic environment you try to establish for your own writing sessions?
TR: I think, much like our food, we need a varied sound diet and so, as is probably ideal for the human condition, we need bits of lots of things but not too much of anything. I am lucky, I live in a pretty quiet house and I am able to work in a room that is quiet much of the time. But actually, I find recently that that isn’t helpful all the time and so now I’m trying to work some days in a shared office space where there is a proper kind of the hum of activity around me, basically people on the phone, people having meetings. I find that kind of sound also is helpful, and it reminds me to try to be industrious! That said, you know, the eavesdropping potential is absolutely huge in the office space and so you can easily get distracted by an interesting conversation about I don’t know, whatever a particular business is doing, selling organic cakes or running a cleaning service, – you wouldn’t believe some of the funny things that arise through running a cleaning company! All this is going on around and it is really funny. But you need some of that energy sometimes, I feel.
CG: So it is more the variety that makes the healthy sonic environment for writing?
TR: Yes. It’s interesting, yesterday I really felt there was no kind of emotion or feeling in what I was trying to write and it just felt very uninteresting to try to write that way. So I listened to a group of songs, some of Tom Waits’ most famous songs which I find very moving. It really helped with that particular section I was writing. I don’t think it is always helpful to write even academic work without any kind of feeling. I suppose having that music was an important part of my sound diet that day.
CG: What is your first memory related to healthcare and illness?
TR: Good question. Well, when I was about 7, my family was in a car crash, quite a serious one involving somebody coming the wrong way down a motorway slip road. It was awful. We were taken in an ambulance to the hospital and that was my first conscious sort of connection with healthcare. Actually, come to think of it there was a sonic component because we were sitting in a corridor and we could hear somebody in pain and my dad said that it was a good sign that they were shouting because it meant they were conscious and reacting. I think he was just trying to make the noise a bit more palatable for the rest of us. The whole drama of the incident kind of struck a chord because – and this has been remarked upon by several people before – hospitals are very dramatic places. We were picked up from this crash by an ambulance, there were lights, there were medical kind of smells, I was given this huge shiny metal bowl in case I needed to be sick, and there were high visibility jackets everywhere. It just seemed so vivid somehow, I suppose so colourful in a funny kind of way.
CG: Triggering so many sensory experiences —
TR: Yeah really! So I think that is my most powerful early memory of healthcare. But I’ve never thought about it as a formative experience before so it’s interesting framing it that way.
CG: You not only write academic texts but also engage in other, sonic forms of publishing in your work. What is for you the difference between writing a text and producing your broadcast of the Delhi slums?
TR: I have done quite a bit of sound editing and I do feel that there are almost always direct parallels in the writing process. Which voice am I going to fade up for this section and which fade down? Where am I going to cut this voice or switch to different material? And okay, so in writing the voices are not audio, but basically quotations from books and articles are like clips of the voices of people who may be living or dead. I mean, you can imagine them as audio clips. And in editing for a radio programme, for example, you never just have the voice but you also have a track of the audio of the room otherwise it sounds very flat and dead, there is no atmosphere of the room. And so, I think in a piece of writing you can have a sense as well of the atmosphere that needs to be kept going underneath a section. How do I create atmosphere? How do I establish there is an atmosphere? So there are real similarities between writing a text and producing an audio piece I feel.
I often wonder why, in ethnography, a writer might quote a participant at length, say five or ten lines but then no one asks for evidence: How does anybody know the participant actually said that? OK, so the writer has listened to a person, has annotated carefully and written up the notes, but I sometimes feel there ought to be a recording. A reader ought to say or be able to say to the writer: “Where is your recording? I want to hear this person actually saying this stuff.” As readers we don’t really do that, we don’t really seem to demand it. I can see there are obstacles to including sound recorders in all kinds of research contexts and people don’t want go on tape in many situations, or, you know, they might behave differently when a microphone is present and won’t speak about certain topics or they might not want to be identified by their voice. But all the same it’s odd I think that the recorded voice isn’t more valuable in medical humanities, or isn’t considered a kind of a standard.
CG: Similar to a written academic text, in your BBC program you also engage with the literature of other relevant authors, in this case for example the sound researcher Steven Feld. As a podcast listener I heard a voice that was different from yours, it was a lower voice. Was it Steven Feld talking himself?
TR: Yes, it was. I emailed him and explained what I was doing. I said I wanted to draw some kind of comparison between the sounds of the rainforest and the Delhi slums, you know, there seemed to be many parallels and he said “Yes I agree”. And I said: “Could you provide me with a couple of minutes of audio of you speaking about that?” And he did that more or less immediately, he just went to record it himself and then sent it to me as an attachment. His work, particularly his work on the Kaluli(Feld 1996) has been really important in my life. When I was writing my undergraduate dissertation about patients’ experience of hospital soundscapes, my supervisor was frightened because he said: “There is no anthropology on sound. What are you going to use for your academic sources?” We had a departmental library at that time and when I went in one day the departmental librarian said: “Oh Tom, I found this book. It has got a piece on sound in it. You might want to read it for your dissertation.” That was an amazing thing for her to remember, I think. Very thoughtful. And so I read that piece and obviously it blew my mind. That chapter really changed my life because it made me see that you could treat sound in this ethnographic and analytical way. I also found it very beautiful. In my head I often drift away to Papua New Guinea and think about that sound environment, what it must have been like, whether it still exists, how it is listened to now. I spend a lot of time in Papua New Guinea in my mind because of that text. And obviously the idea of acoustemology was/is important for me. I am an acoustemologist basically. That is probably the best professional description for me.
And so it seemed quite natural for Steven to fit into that radio piece. You know, I was conscious, although I don’t make it explicit to the audience, that I wanted it to be a piece of ‘anthropology in sound’ where we move away from textual representation. That is something Steven Feld and Don Brenneis advocate for(Feld 2004). So I was trying to respond to the call to produce anthropology in sound with that piece. But also, I was really conscious of how aesthetically interesting it would be to do this switch from the urban slum soundscape to the rainforest soundscape. The sounds sources are different but they both are dense, busy, layered sonic environments so I thought it would make a lot of sense and I think it really works in the programme.
CG: I found it really fascinating how you play with different sonic layers also allowing the soundscape of the slums to go on in the background of your own voice or your interlocutor’s voice.
TR: That keeping of the background sound, the slum soundscape under my voice, editorially it was difficult and required quite a lot tweaking and the skill of Simon James, who is a really experienced sound editor. But I think it makes so much difference and I really love the way it pops up and is never entirely absent from the whole piece. You know, we had all these recordings of ambient sounds, OK they didn’t all merit being foregrounded, but I felt it was important to find ways to include them. And they meant we could add a kind of satisfying sonic density to the programme throughout.
CG: To end the interview, I would like to come back to another aspect of writing itself: co-authorship. What do you see as the pleasures and challenges of co-authored writing in the social studies of medicine?
TR: Well, there are huge benefits in terms of drawing on the knowledge, the skills and the expertise of other people and I find that just the scale of what is achievable magnifies so much when you co-author something. That alone is a good enough reason to do it. In terms of the frustrations, well, you know, life gets in the way. If you and I could sit down together and have time and space to work on something every day for three months we’d get a lot done, but the chances of that actually being possible are pretty much nill. And so those difficulties can be a problem because you are so rarely concentrating on the work at the same time together. That said, when it does happen, it’s magical. Working on a Google doc or on Sharepoint, for instance, and seeing somebody edit and work in real time with you working alongside them, that’s really powerful. I would happily watch a video of a Google doc of an author writing a story. I would be really interested to see what comes first, how do they build the story, where they stop and start, how many breaks they take and how often, all these kind of things. So it might be a video six months long but I would still like to see it!
Carla Greubel is a PhD student in Science and Technology Studies (STS) at Utrecht University. Her dissertation investigates how ‘good ageing’ is thought of and done in different contexts, including policy discourses, pilot digital innovations for ageing-in-place, and the everyday lives of older people in Spain and the UK.
Tom Rice is a Senior Lecturer in Anthropology at the University of Exeter. His book, Hearing and the Hospital, is an ethnographic study of the auditory culture of a London hospital, and he has since written about sound environments of prisons and zoos. He also makes documentaries about sound for radio.
Coles, R. 1984. Introduction. In William Carlos Williams: The Doctor Stories (ed.) R. Coles, vii-xvi. New York: New Directions Books. P xi.
Feld, 1996. Waterfalls of Song, in Steven Feld and Keith Basso, eds., Senses of Place. School of American Research Press, pp. 91-135.
Feld, 2004. Doing Anthropology in Sound (with Don Brenneis), American Ethnologist 31(4): 461-474.
Rice, 2013. Hearing and the Hospital: Sound, Listening, Knowledge and Experience (Introduction). Canon Pyon: Sean Kingston Publishing.
About the series
Writing Life focuses on the craft of writing in the social studies of medicine. Amidst the current challenges to making texts, this series invites scholars in our field to take time to reflect, in conversation with each other, on how to navigate and nurture their craft.
Each post in Writing Life delves into the black boxes of writing life, exploring the specificities of producing texts about the lives of those entangled in illness, care, pain, diagnosis, experiment, research, suffering, and recovery. The spirit of the contributions is collaborative — an exploration through dialogue. In crafting the posts, authors also explore a research practice central to our fields – interviewing – and the work and art of transcribing and editing other people’s words.
The first installment of this series is composed of 8 interviews which will appear weekly in Somatosphere from early December. We openly invite further contributions to the series to appear in 2021. Please contact series editors Anna Harris (firstname.lastname@example.org) or Denielle Elliott (email@example.com) to express interest. You may already have someone in mind to interview or be interviewed by, but we can also make recommendations.