Burton (1) notes that persuasion, according to Aristotle, “is brought about through three kinds of proof or persuasive appeal: logos, pathos, and ethos.” Logos is an appeal based on “logic” or “reason,” pathos is an appeal based on “emotion,” and ethos is an appeal based on the “character of the speaker” (Crewell, Draper, and Mitchell 1). Rhetorical appeals can also rely on visual devices, from how the text looks on the page (font, titles, headings, etc.) and the use of color to graphics and photo images.
In Lisa Sanders’ “Diagnosis: Missed Signals” and Jerome Groopman’s “Mental Malpractice,” both authors use similar patterns of development to achieve different primary and secondary purposes. Both articles are informative but also have unique purposes which are reinforced by the authors’ respective and different use of both visual and rhetorical appeals. While both of these articles have the primary purpose of demonstrating the difficult cognitive choices a physician must make, Sanders’ “Diagnosis: Missed Signals” relies much more on visual appeals to persuade the reader than does Groopman’s more rhetorical method in “Mental Malpractice.”
Rhetoric is a form of knowledge but not necessarily one leading to absolute truths. As Register (2) notes, when rhetoric appeals to the emotions, it is by “proving the truth of an emotional judgment or by using the connection between emotional judgment and emotional desire to prove the desirability of an action. Thus emotions take their place as a part of ordinary cognitive life, with the same structure and capacity to play a role in rational argumentation as non-emotional judgments.” Both Sanders and Groopman rely on rhetorical appeals to support their respective primary purposes. Groopman’s (1) primary purpose is to show the “deficiencies” in “the way in which doctors are trained to think.” In contrast, Sanders’ (1) primary purpose is to illustrate that “practicing medicine is a balancing act—weighing immediate and long-term good.”
Despite the contrast in their primary goals, the secondary goals of Sanders and Groopman are fairly similar. Groopman’s (2) secondary purpose is to persuade readers of the need for “widespread” instruction of doctors in “cognitive psychology,” with a focus on “cognitive detours” that account for why “some diagnoses succeed and why some fail.” Increased education and awareness for physicians with respect to proper diagnosis is also the secondary purpose of Sanders. Sanders (2) argues that physicians need more education about the dangers of limiting their attention in examinations to “immediate problems” instead of balancing these “short-term needs” with “long-term” health goals.
In a similar manner, Sanders and Groopman rely on all three forms of rhetorical appeals (ethos, logos, and pathos) to help persuade readers their respective purposes are necessary and valid. Ethos is an appealed based on the character of the speaker. In this case, both Sanders and Groopman rely on ethos to help support their purpose. Sanders (1) informs us she is an “internist,” a medical professional but even she has “failed” to do her job of keeping “patients healthy” on occasion. In a similar manner, Groopman (1-2) explains that he and his wife are doctors but that, he too, has misdiagnosed patients with even worse outcome than Sanders’ case since his patient “died.” By making an appeal to ethos, both Sanders and Groopman are positing themselves as medical professionals who have committed the same types of mistakes they think other physicians need to be educated about in order to avoid. The rationale is that if even they have made such mistakes, then other professionals surely have.
In common, Sanders and Groopman also use pathos or appeals to emotion. Both of them provide heart-wrenching stories not only of their respective patients and their health troubles from incorrect diagnosis, but they also appeal to the emotions when seeking forgiveness for their mistakes. Yet, they both seek forgiveness in a different way in an appeal to emotion. When his patient dies, Groopman (2) maintains, “I have never forgotten, nor forgiven myself.” In contrast, Sanders also feels terrible for failing her patient. However, her appeal to forgiveness is more emotionally uplifting because her patient provides it to her, “He smiled his magnificent smile and squeezed my hand…Perhaps I could be forgiven” (Sanders 3). Both of these emotional appeals are used to make readers understand how genuinely painful it is for health practitioners to make an error that harms rather than heals. This supports the need for more education for physicians, which both authors advocate.
Sanders and Groopman also use logos to help support their appeal and purposes. Groopman appeals to logic or reason when he describes why he believes cognitive thinking in physicians has been undermined. Sanders (2) uses the rational argument that new technologies have eroded the physician’s need to rely on deeper thought, “Modern clinical practice has incorporated DNA analysis to illuminate the causes of disease, robotics to facilitate operations in the brain and computers to refine M.R.I.” In his view, this increasing focus and reliance on technology has come at the expense of a focus on cognitive psychology. Sanders also use logos to support her argument and purpose. Sanders (2) uses logos to rule out other causes of her patient’s illness to reinforce the frequency of misdiagnosis, “It wasn’t a drug error. The patient’s medication box showed the correct number of pills. And it hadn’t been a heart attack; a blood test proved that.”
While all of the rhetorical appeals used by both authors are capable of conjuring up visual images in the minds of readers, the biggest different between the two articles is that Groopman completely ignores the use of any concrete visual appeals while Sanders relies heavily on them. Groopman’s article is devoid of any graphics, photos, color, headings, and hot-links to other topics that might help persuade readers to agree with his argument to a greater degree. Sanders, in contrast relies on all of these visual appeals to help reinforce her argument. Her title is in large, bold text; in contrast to Groopman’s plain text and smaller title. Sanders (1-2) uses headings to provide greater visual organization that describes the components of her argument, including: Symptoms, Investigation, and Resolution. Sanders’ appeal also provides medical images that are colored graphics to help illustrate the various aspects of the body pertaining to her patient’s particular case (SEE APPENDICES I-III). Groopman provides no color or images whatsoever and his article is less appealing in contrast because of this. Finally, Sanders (1-3) also uses the visual appeal of providing “hot links” on certain medical conditions that readers may want to know more about and can merely by clicking on the following “hot-linked” terms: blood pressure, cholesterol, and cancer.
In conclusion, it is readily apparent that though Sanders and Groopman have fairly similar purposes in advocating greater education and training for physicians with respect to correct diagnosis, they both use different patterns of development and different forms of appeals to prove their arguments. Sanders’ appeal is much more effective, primarily because of her addition of numerous visual appeals that are avoided entirely by Groopman in his argument.