This essay examines the “dirty margins” where HIV/AIDS, cancer, and academic life intersect. Drawing on Paula Treichler’s concept of AIDS as an “epidemic of signification,” it traces forty years of living with HIV, including a near-fatal episode of Kaposi’s sarcoma (KS) in 1994 and over a decade of anal dysplasia—conditions rendered culturally legible through AIDS-era moral panic as much as through oncology. I write as autopathography, treating autobiography not as confession but as method, following Arthur W. Frank’s understanding of pathography as knowledge produced from embodied experience. Although KS did not recur, its long shadow shaped the temporal and affective terrain of survival. Moving from the whispered moralization of illness to the clinic’s production of the clinical self—the version of the body produced in medical records, and from academic domestication and erotic counterpractices to quantification, pharmacological society, and the social mirror, the essay traces how a misbehaving body is repeatedly threatened, written down, fragmented, managed, and measured—yet continues to theorize back. In these processes, minoritized bodies become hypervisible as research objects yet remain marginal as knowledge producers. Against triumphant scripts of biomedical progress, the essay assembles a counterarchive of resentment, erotic improvisation, and delayed care. The “dirty margins” of cancer, it argues, reside not only in diseased cells but also in the epistemic and institutional systems that metabolize marginalized bodies as spectacle, evidence, and compliance while refusing their authority as theory.

Pathographies of cancer illuminate what biomedical discourse overlooks. Minoritized scholars illustrate how bodies and knowledges at the margins are both cared for and silenced. As a gay academic who came of age during the AIDS epidemic and now lives with Stage 4 metastatic cancer, I write from oncology’s “dirty margins”: outside cure and within institutions where marginality has long shaped my labor and leadership. I examine how sexuality, pleasure, and ambiguous grieving intersect with advanced cancer, and how these embodied knowledges can queer and crip the clinic. By foregrounding erotic life, loss, and resilience in an autopathography, my narrative praises exemplary care while critiquing medicine’s discomfort with ambiguity. Methodologically, I draw on autobiographical reflection informed by queer theory, poststructuralist feminism, and crip theory to explore three sites: the erotic body as an archive of vitality and ambiguous loss; insider–outsider tensions across academy and clinic; and a shift from seeking positional authority to being—servant leadership and pedagogical legacy. In this minoritized pathography, I explore tensions between gratitude and critique as a generative queer gesture. Offering praise while unsettling biomedical silences queers the binary of “good” versus “bad” care. For biomedicine, this entails greater tolerance of ambiguity and integration of sexuality and grieving into care; for the humanities, recognition of embodied, erotic, minoritized knowledges as central to reimagining illness and work. Ultimately, such narratives transform suffering into meaning, legacy, and pedagogy—acts of queer resistance that teach how to live and die with authenticity and love.

This article engages health humanities scholarship that approaches biomedical knowledge as cultural and pedagogical, and that treats patient experience, clinician reports, medical images, and other quotidian patient and/or health-provider texts as interpretive sites. This work fleshes out the intelligibility of patient voices as constitutive of a cartography of presence. Drawing on queer theory and the onco-humanities, I argue that clinical cancer settings operate through choreographies that both organize bodies and feature tactical refusals. Autobiographical experience rendered as pathography—often dismissed as anecdotal—is approached here as research evidence and as animating practices of resistance within regimes of biomedical authority. Methodologically, the article juxtaposes close readings of two sets of artifacts: (1) Tactic, the first widely broadcast cancer-focused educational television series (produced by the American Cancer Society and NBC) and (2) a hauntological archive summoned from my 2025 to 2026 Stage IV lung cancer documents; a constellation of clinical and autobiographical traces—fieldnotes, clinical care-provider reports, and medical images. Read together, these materials reveal how cancer—reimagined as an “epidemic of signification”—has long functioned as a pedagogical project aimed at managing uncertainty, disciplining affect, and sustaining optimism as a mode of governance. By placing a contemporary patient-curated archive in dialogue with mid-century public cancer pedagogy, the article traces queer pedagogical practices that rewrite the normative from cancer’s margins. It advances the concept of tactical choreographies to name how cancer patients inhabit, reroute, and on occasion, refuse the pedagogical demands of medicine under conditions of institutional invisibility, necropolitical abjection, and state violence.

Mothers of Sierra Leone leverages the power of filmic storytelling to improve maternal health outcomes in Sierra Leone, a country with one of the planet’s highest maternal mortality rates. Since 2019, we have operated as part of Lehigh University’s Global Social Impact program, working with a team of interdisciplinary students to amplify the voices of Sierra Leonean women rather than transmit Western medical expertise. Our project is based on two premises: (1) we will not solve the healthcare crisis in Sierra Leone through technology and (2) women experience better healthcare outcomes when they are confident and comfortable to advocate for themselves. Our focus group and survey data indicate that our filmic storytelling improves women’s confidence to advocate for themselves and increases their knowledge of available health services. Maternal mortality may be one of the most expansive health challenges facing our planet today because we struggle to comprehend or delimit its parameters, including structural and systemic racism, networks of capitalism, insufficient infrastructure, disparate access to medicine, and patriarchal violence. Our failures to tell public, accessible, and equitable stories about maternal mortality exacerbates and often exoticizes this crisis.

Viewing difficulty as an opportunity for learning runs counter to the common view of difficulty as a source of frustration and confusion. The aim of this article is to focus on the idea of difficulty as a stepping-off point for learning. The literature on difficulty in reading texts, and its impact on thinking and the interpretive process, serve as a foundation for the use of poetry in healthcare ethics education. Because of its complexity and strangeness compared to the usual scientific and clinical texts health science students encounter, poetry is an excellent means to achieve the aim of thinking through difficulties in ethics. Specific examples of teaching and learning strategies for turning difficulty into opportunities for learning are presented, including the difficulty paper and the triple mark-up method. Both methods require students to examine their process of working through difficulties, reflect on how they make sense of difficult texts and then share their process and interpretations in a collaborative manner with peers. The importance of framing difficulties as a public, visible, collaborative process rather than a personal process is emphasized. Working together to hypothesize reasons for difficulty and map out plans to come to terms with difficulty are equally relevant for reading text as they are for reading complex ethical situations. Finally, I argue that transference of this kind of personal and collaborative learning about difficulties benefits interprofessional clinical practice, particularly when dealing with ethical issues.