The term “layperson” refers simply to someone who is not an expert, but the word originally meant someone not admitted to the specialized practices of a particular discipline, making those practices inherently mysterious. In contemporary culture, the historical distinction between “lay” and “expert” status still has significant effects on the average person’s experience of medical knowledge, and as much as medical education programs today emphasize the importance of a provider-patient partnership, the relationship is fundamentally unequal. The layperson has no direct, privileged access to medical research: the “best” knowledge, the research and training which inform evidence-based medicine, is found in academic settings--medical schools, university libraries, professional associations--which are off limits to lay people. Both money for fees and specialized training are barriers to accessing and understanding expert knowledge.

This does not mean that lay people do not make knowledge of their own. Non-experts have access to vast amounts of medical information in popular culture: in addition to what we glean from interactions with their providers, we find health information on medically-themed television programs, wellness magazines, health information websites, and online discussion boards. From these multifarious sources, laypeople are able to construct home-made medical knowledge, which can be effective and valuable: we can educate ourselves about conditions, prevention, and treatments; a medical mystery program on tv can lead to the discovery of a previously undiagnosed condition; an online discussion thread allows contributors to share advice about negotiating the healthcare bureaucracy. These sources can also lead laypeople astray: misinformation abounds, and even when the “facts” are right, a lack of training can lead a non-expert to apply that information in inaccurate, potentially damaging ways.

In this presentation, I will analyze how non-experts make medical knowledge, focusing specifically on one example, the reader discussion forums that appear in The New York Times’ “Health” section. I argue that medical experts must be more attentive to how non-experts work with one another to make sense of their health in these sites of shared, democratic, but undisciplined, medical knowledge--not with the goal of controlling or limiting this process, but rather to demystify it and harness its potential educational benefits.