Phlebotomic pedagogy: a thought experiment

Back in September 2017, my first semester of teaching first-year writing, I wrote a piece about phlebotomy and its queer intimacy. As I write this essay, I have a little more teaching experience under my belt. And unsurprisingly, while I teach I am still thinking about blood draws.

My pedagogical habits of mind have been fundamentally shaped by my tenure as a phlebotomist. My attention tracks others’ emotions, particularly when they are uncomfortable, afraid, or guarded. And sometimes in my students I see a resemblance of what people feel when getting blood drawn. A writing classroom has dynamics closely associated with the blood draw setting: asymmetrical configurations of power, a closeness or intimacy generated by one party’s personal disclosure (be that blood or writing), and fear. This phlebotomic installment explores the similarities between writing classrooms and blood draws, and considers how, through this lens, writing teachers can better attend to students’ fear.

I’ve closely studied the sort of vulnerability and fear wrapped up in the space of a blood draw. This particular fear is a result of two people unequally positioned in power where one actor is necessarily vulnerable. The social configuration of the blood draw is anxiety producing in several ways: the anticipation of the draw; the ritualized physical preparation (applying a tourniquet, pressing into flesh to locate veins, disinfecting the elbow crook with alcohol); and the actual needle bite and removal of blood. This kind of fear, especially marked by an unequal power balance with one-sided personal disclosures, can also be found in first-year composition classrooms.

Composition scholarship confirms that, indeed, first-year writing classrooms make students nervous. Sally Chandler’s “Fear, Teaching Composition, and Students’ Discursive Choices: Re-thinking Connections between Emotions and College Student Writing” details student interviews about their emotions in her writing course. She writes about one student who described “his internal physical and emotional anxiety as he contemplate[d] his [writing] responsibilities,“ and she explains “even though different students noted different details of the [classroom’s] physical context, the feelings remained very much the same: fear, anxiety, and suspenseful anticipation” (56).

It isn’t very surprising that writing classes can make students uncomfortable; writing is a personal act, and being required to share and change it can make anyone feel vulnerable. But it’s notable that writing students’ feelings mirror those experienced by many people getting their blood drawn: “fear, anxiety, and suspenseful anticipation.” And it doesn’t stop there. Chandler explains that

< Student fear and loss of confidence are perennial issues in composition < classrooms. Because writing is bound to conceptions of self, pressure to change

< the way students write challenges the self engendered by the discourse marked < for correction. As a result, students required to change the way they write often < encounter intense internal conflict… (60)

In various ways, composition teachers do try to change how students write. Therefore, it follows that a kind of subtle pressure might be felt by students to change themselves; how one writes is thoroughly bound up with conceptions of self. Furthermore, classes that enact critical pedagogy, where interrogating identity is common, often explicitly encourage a rethinking of self through writing. Although Chandler’s study focused on mostly white students -- where part of the students’ anxiety and fear is linked to re-seeing their subjectivities and place in privilege -- I think all students in first-year writing classrooms are being asked, in some way, to revise their writing, and thus themselves. So there are always already multiple and varied anxieties present depending on the student, classroom, and teacher.

One root of these precise, but related, vulnerabilities of students and blood draw patients can be thought through (and furthered!) with the help of Jacques Lacan.

A significant amount of Lacan’s intellectual contributions stem from his work on the three registers of “psychical subjectivity,” or, the human psyche and mental processes (Johnston). The Imaginary, the Symbolic, and the Real are mutually dependent on each other, and make up how speaking subjects exist in the world. Here’s a quick and dirty breakdown of these registers: the Imaginary is what people project outward, like imaginings, fantasies, and illusions. The Symbolic is sort of like discourse: the language that constructs and binds subjects, as well as society, culture, norms, and social rules. Lastly, and most relevant to this piece, is the Real. This register is tricky. Lacan has described the Real as “whatever is beyond, behind, or beneath phenomenal appearances accessible to the direct experiences of first-person awareness” (Johnston). Adding to that, the Stanford Encyclopedia of Philosophy relates it to “traumatic events, unbearable bodily intensities, anxiety, and death.”

I think of the Real as that which is outside the Symbolic -- outside of or before language and the social order all people exist in. The Real can never be touched or seen, but it can be traced by delimiting the Imaginary and the Symbolic. The threat of the Real can be felt when there is disruption in the Symbolic -- a disruption that suggests that what enables people to make sense of themselves and the world is at risk. Perhaps, for now, the Real could be thought of as dissolution, or the threat thereof.

Armed with Lacan, the vulnerability of the blood draw and writing classroom can be better contextualized.

During a blood draw, the threat of the Real lurks pointedly. Perhaps blood draws are so nauseating, upsetting, and hated by people because of what they stir up. When someone sees or feels a needle in their vein taking blood from their body, Lacan’s symbolic register sustains a small rupture. This literal vein rupture and taking is, in my mind, intimately connected with the terrifying Real, signaling one’s fragility, materiality, and future death. This moment of jarring unconscious awareness is often too much to consciously bear, and causes a visceral physical response to distance oneself from the sense of the Real. As is said, perish the thought.

What might be made possible if first-year writing classes were thought of as another site of potential symbolic rupture, where writing teachers ask students to fundamentally revise the ways they understand themselves? In a sense, writing teachers are asking for a kind of dissolution so that self reflexivity in writing may emerge. I imagine the Real in this context as the threat of unmooring, of finding oneself away from familiar ways of knowing, and from past conceptions of self.

I don’t mean to suggest that the Real is always at work in writing classrooms, and that by asking students to re-see themselves they will be lost in a terrifying space without language from which they will never return. I am suggesting that there might be something useful in this thought experiment. Viewing students' vulnerability through the double lens of Lacan’s Real and the comparison to blood draws might make writing teachers more sensitive to the reality that first-year writing classes ask a lot of students, whose fear might include the loss of who they’ve known themselves to be through writing.

Being a phlebotomist reminds me that I am not asked to be vulnerable the way my students are; they don’t grade my papers, and my patients didn’t draw my blood. It reminds me of the positioning differences between us. Lacan helps me imagine how unmoored those in my first-year composition class might feel, how I can better attend to their restructuring of self. I wonder if they feel the threat of dissolution, or that something personal is at stake. Perhaps writing teachers could choose to see their students as beginning a necessary re-assembly, attempting to make new sense of a world intellectually and emotionally. And when their teachers can attend to their revision, within and beyond their words on a page, perhaps it could lessen their fear.

Works Cited

Chandler, Sally. "Fear, teaching composition, and students' discursive choices: re-thinking

connections between emotions and college student writing." Composition Studies 35.2

(2007): 53-70.

Fink, Bruce. The Lacanian subject: between language and jouissance. Princeton University

Press, 1997.

Johnston, Adrian. "Jacques Lacan." The Stanford Encyclopedia of Philosophy (Winter 2016

Edition), Edward N. Zalta (ed.), URL


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#phlebotomy #pedagogy #Lacan #criticaltheory #AnneJohnson

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