Blogs as Dialogical Reparatory Work: A Theoretically Informed Analysis of Online Cancer Narratives

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

I am pleased to have had the opportunity to review this analysis of first-person cancer blogs which the authors read through the lens of Ricoeur and Bakhtin as narratives that serve as a way to make meaning out of the disruption, sorrow, fear, and isolation of serious illness. Overall, the article is well-written and worthy of publication with revision.

Addressing the following big-picture points will strengthen and enrich your overall premise and presentation.

1. I suggest making the first couple sentences of your introduction and abstract more specific. Cancer cases are not countless. Consider looking at some of the epidemiology and using a citable fact or two to catch your reader and anchor your premise to some facts about cancer. Doing so will also bolster your authority and broaden the appeal of your article for readers in adjacent disciplines: public health, science, and social science.
2. Also in those early sentences, I suggest avoiding the outdated phrase: Western world. Are you referring to high-income countries? Countries where patients can access high-quality cancer care?
3. In your methods section you note that you asked the blog writers for permission to analyze their work and publish a manuscript that references their work. I applaud that. I am unclear, however, about the decision to anonymize the publicly available blogs. You say that you have done so to comply with privacy regulations. I’m not sure what those regulations are and how they apply to work in the public sphere, indeed one of the blog authors turned her online narrative into a book and two of the three have a broad readership. Not being able to look search for a look at the blogs (if they are still online) reduces the richness of your analysis. When I read an article about a novel or poetry that has been copyrighted, I usually know or can find the text. I found myself wanting to do that here. I suggest either being more explicit about the privacy regulations you are adhering to or replacing the pseudonyms with real citations. My guess is that you will not want to do the later or (that you have promised the blog authors that you wouldn’t). So being more explicit about your reasons for not citing the primary text (and maybe noting it as a limitation of your analysis) is the next best option.
4. I was intrigued early on when you described the blogs as Norwegian. Were they written in Norwegian and translated or were they written in English by Norwegian authors? If they were translated, then that merits some explanation in your methods section.
5. Continuing to follow the Norway connection, I wanted to hear a bit more analysis about culture and context. You very briefly reference cancer awareness/advocacy campaigns and celebrities. And you make a general reference to cultural expressions of disease at the top of page 2. But you don’t take that line of inquiry any further. Did you find cultural expressions of illness? Were there aspects of the blogs that made them distinctly Norwegian / Nordic / Scandinavian in terms of cultural ways of thinking and talking about cancer specifically and chronic illness more generally? Or were there aspects of the texts that reflected the healthcare or social context in which they were written? For example, a blog by a person with cancer written in the US might make frequent references to the cost of care or the many obscure steps and insurance details needed to access care. In a system with universal health care, I’m assuming that the logistical concerns about care might be quite different (or less present). This particular theme may not be relevant, but I'm wondering if there are any aspects of the Norwegian social context that stood out, particular ways of expressing stigma, hope, or other cross-cutting themes?

Author Response

Dear Editor-in-Chief and Reviewers,

Thank you for considering our manuscript and for providing us with the opportunity to revise it. We greatly appreciate the insightful comments from both reviewers, which have been invaluable in helping us refine and strengthen our work. We have revised the manuscript accordingly, with significant changes highlighted in red. In addition, we describe the revisions and address each point raised in the response. Please see the attachment, ref. Reviewer 1.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This is an attractive paper, which makes excellent use of Ricoeur's idea of 'concordant discordance' and Bakhtin's 'addressivity'. It is suggestive and could easily have been longer, so that these themes could have been further developed. Just three aspects, it seems to me, could have been extended:

1. The central feature of the blog is that it allows the blogger relief from the need to produce an overarching narrative at a time of narrative disruption or disintegration, even as they attempt to construct a fresh one - its episodic nature matches the fragmentation of their experience. This is there throughout the paper but maybe could do with an additional sentence or two in summing up.
2. I would have liked a little more on the ways in which cultural discourses have helped shape these blogs: the subject is raised but then barely returned to. Do the rules and conventions around personal disclosure, for example, differ in Nordic countries, compared, say, with Anglo-American or Mediterranean ones, and how might these have impacted upon the blogs?
3. I liked the rejection of a 'hermeneutics of suspicion' in the analysis of the blogs, even though, just occasionally, it leads to a slightly bland and simplistic reading of them. It is clear that such blogs operate on many different levels, as the authors here recognise: might the inclusion of discussion about some of the meta-material around the blogs (eg the ways in which they're presented and publicised) have helped bring out more the ways in which they also function as a defence against annihilation and a way of taking control over the condition? I appreciate, thought, that this latter suggestion, might stray too far from the authors' original intention of applying Ricoeur and Bakhtin and too much into psychoanalytic discourse. Overall, though, a really interesting paper.

Author Response

Dear Editor-in-Chief and Reviewers,

Thank you for considering our manuscript and for providing us with the opportunity to revise it. We greatly appreciate the insightful comments from both reviewers, which have been invaluable in helping us refine and strengthen our work. We have revised the manuscript accordingly, with significant changes highlighted in red. In addition, we describe the revisions and address each point raised in the response. Please see the attachment, Reviewer 2. 

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The revision looks great. I vote to publish. 

I did find one typo in line 217 on page 5. The verb should be plural.