This is a draft record of what we said, noticed and argued about on 19 October, drawn from the Teams transcript, both shared boards and the conversation in the room. Participants are reviewing it, and it will be updated as they respond. It is not the research agenda or the position paper; those build on it.
1. Why we gathered
Listening Across was a one-day working symposium. Its job was to stress-test Endarkened Co-Composition as a methodology for clinical research across gynaecology, obstetrics and reproductive justice. It sits within One Long Thread, funded by a UKRI Arts and Humanities Research Council Curiosity Grant, and is the first activity funded through Southampton’s Interdisciplinary Research Pump-Priming award.
Gre named two hopes for the wider project. The first is a new, co-developed research agenda. The second is an opera told from two lanes. One asks what happened to Anarcha after she was labelled “cured” (a word used deliberately, as there is no evidence she was). The other is research-driven: it would be co-composed with communities still living with disproportionate Black and Brown maternal and infant death, and their stories would shape the libretto of its second part.
The ask of the room was explicit: not praise but friction. Gre asked us to determine “if, when, and how” a method like Endarkened Co-Composition could work in clinical application.
The day was built toward two co-authored outputs:
A mapped interdisciplinary research agenda. This will shape the next AHRC application, with contributors cited.
A critical position paper on the methodology. The target is BMJ Medical Humanities, with a Springer Nature medical humanities journal as the fallback. Everyone who contributes will be a co-author.
2. Who was there
| Participant | Field and focus (as introduced) | Joined | Initials |
|---|---|---|---|
| Dr Nik Gre Lassiter (convenor) | Composition and fine art, University of Southampton; lead researcher, One Long Thread; developer of Endarkened Co-Composition | In room GL | |
| Dr Chisomo Kalinga | Social anthropology, University of Edinburgh; narrative, ethnography and medical humanities in Malawi and across the African diaspora | In room | CK |
| Dr Lucy Lowe | Social anthropology, University of Edinburgh; reproductive and migrant justice; perinatal health of people with insecure immigration status in Glasgow; birth companion | In room | LL |
| Dr Michelle Meinhart | Musicology, Trinity Laban; British music, narrative, memory and trauma; maternity and relationality | In room | M Meinhart |
| Dr Erin Johnson-Williams | Music, University of Southampton; music, colonial violence and resistance; co-founder, Music, Sound and Maternity network | In room | EJW |
| Dr Chi Ying Lam | Music, University of Southampton; community music; live-music project in a neonatal intensive care unit | In room | CYL |
| Dr Mary Mbuo | Faculty of Medicine, University of Southampton; global maternal health; maternal and perinatal death surveillance in Ghana, Uganda and Ethiopia; UK maternity disparities | In room | MMb |
| Dr Lucy Green | Faculty of Medicine, University of Southampton; developmental physiology; public engagement in the science of pregnancy | Online | — |
| Dr Christina Baade | Historical musicology, McMaster University; Hearing Maternity; caregiving, creative industries, queer and trans identities; prison education | Online | CB |
| Dr Catherine Medici-Thiemann | History and interdisciplinary medical humanities, University of Nebraska Medical Center (UNMC), Omaha; gender, sexuality and chronic illness | Online | CM |
| Princess Banda | PhD candidate in socio-medical anthropology, supervised by Lucy Lowe; obstetric anti-Blackness and Black maternal mortality | Online | — |
3. How the day moved
Arrival and grounding. The day opened over lunch, then Gre welcomed everyone and defined Endarkened Co-Composition. (The welcome itself was not captured by the recording.)
Introductions. Each person gave their name, field and one thing they were bringing into the room.
Screening of Three Gold Threads.
Three interlocutor provocations, from Lucy Green, Lucy Lowe and Chisomo Kalinga.
A cosmogram walk. Three Endarkened Co-Composition provocations were read facing East, North and West, adapting the BaKongo cosmogram. Each was followed by silence. Those online did the same at home. Afterwards everyone answered one question: what did you notice in your body?
Working session 1, the research agenda.
Working session 2, the critical position paper. This flowed into a longer conversation about the opera as an output.
Close and next steps.
4. Endarkened Co-Composition as defined on the day
Participants had received the draft first chapter of Gre’s book. Gre condensed it so that we could stress-test the method using shared language:
A collaborative, non-linear sound and storytelling methodology. It works with sound, music, oral histories, field sounds, utterances (a term drawn from Fred Moten’s language and lineage) and shared experience. These are treated as qualitative research, not as extracted data.
Rooted in Black and Indigenous storytelling epistemologies, where memory and imagination exist on the same plane. It challenges the Enlightenment paradigm in which more knowledge means a people has been “enlightened” about their own lives.
The participant is the expert. The composer is one co-composer among others, making meaning and work together.
Listening as an act of resistance. Listening here is active, ethical and relational. It means bringing one’s whole positionality into what Gre calls endarkened co-presence.
Opacity and refusal. This means non-clarity on purpose, and the right to refuse. Gre named opacity as the hardest principle for researchers to hold, including for Gre.
A reimagined compositional hierarchy. In practice this means graphic rather than Western notation, a large role for improvisation, and participant input on how the work sounds.
In the afternoon Gre also traced the lineage of “endarkened”. The term comes through S. R. Toliver’s application of Cynthia Dillard’s endarkened feminist epistemology. Toliver is editing a collection on how others have applied and extended endarkened storywork, to which Gre is contributing.
Three Gold Threads
Three Gold Threads was made with seven women from Afghanistan, Syria, Turkey, Pakistan and Palestine who had made new homes in Stratford-upon-Avon. It was commissioned as a response to Shakespeare’s First Folio. Together the group wrote new questions modelled on the Folio’s organisation, then the women interviewed one another, their families and their children using field recorders. Those recordings became the set text of the piece.
Nothing was translated from Arabic or Farsi. Gre presented this as opacity in practice: protection and care for the participants, away from “the almost consumptive ear of an English speaker.” When the participants later heard the piece, they said their stories felt “more real to themselves.” They had grown used to shaping their stories so that they would be legible enough to earn a listener’s empathy, and here they did not have to.
5. The provocations
Lucy Green: can I resist the urge to analyse?
Lucy Green opened from developmental physiology. Her starting point was the idea of a “best start in life”, which runs from preconception through pregnancy. She noted that pregnancy journeys in the UK are more complicated for some than others, with up to two-and-a-half times poorer outcomes for mothers of Black and South Asian background. Medical research, she said, is data-driven by design. Patient and public involvement and engagement (PPIE) has improved, but drawing people into that space is hard, and holding a quality interaction there “is an art form in itself.”
She described her own arts-based work. This included the Art of Creation exhibition from McMaster, which she brought to the John Hansard Gallery, and creative workshops on pregnancy journeys with Black and South Asian women, run with the Maternity Disparities Consortium. Some of those women went on to co-design an activity at the British Science Festival in September. Sound kept surfacing in what they shared: music as companionship in early parenthood, and glass bangles at a traditional baby shower whose sound reaches the baby in the womb. Lucy Green also played a recording of the womb’s own soundscape.
Her confession was that her instinct is always to analyse. Her question for Endarkened Co-Composition:
How can we position this kind of co-creation within the numbers-heavy medical research cycle so that it creates the bravest and most honest space in which patient and public involvement can happen, even with all the numbers and the measures?
Lucy Lowe: what clinical research misses
Lucy Lowe’s answer to her brief was an absence of listening, and especially of listening over time. Clinical research tends to frame narrow, bounded problems, and this shapes who gets invited in. She gave the example of gestational diabetes studies that recruit mostly white, middle-class women, while the women she works with in Glasgow live in asylum accommodation, cut off from their kin and their food. Such people are labelled “hard to reach”. She credited Princess Banda’s thesis for showing why people may choose not to make themselves reachable: failures to listen, and distrust of medical institutions. When research does focus on racialised communities, it tends to fixate on barriers or on pathologised body parts, as J. Marion Sims did with fistula. What gets lost is the trace of sexual and reproductive lives in bodies and memory.
She described the Home Office as an institution that demands visibility, in which bodily evidence is trusted over a person’s own narrative. She also turned to obstetric ultrasound, developed in Glasgow, which uses sound we cannot hear and has reshaped who holds authority over pregnancy. Women on Glasgow’s obstetric-led “red pathway” get more scans, and size predictions are often racialised: West African women were told their babies were too big, East Asian women that theirs were too small. These predictions led to inductions and caesareans that sometimes felt coercive, and were sometimes simply wrong.
Chisomo Kalinga: listening is culturally constructed
Chisomo shared a short clip from fieldwork in northern Malawi. It showed a group of elderly church women who visit sick members of their congregation. They begin singing before they reach the house, so that the patient knows they are coming. Being heard is the first step of care.
She described Chewa storytelling as a system with four kinds of story: narrative, song, performance and games, and instruction (how to weave, make pottery or wrap a wound). Dreams also count as story. Colonial knowledge hierarchies deliberately treated oral forms as inferior to text. Her interlocutors, though, did not describe their practice as decolonial. They said they did not care what outsiders thought: listening is simply vital to their way of being.
She also asked why Africa has been taken out of the conversation about Black maternal death and filed under “development”. Her call was to understand what is shared across Black storytelling and listening cultures without collapsing their differences, and to locate the disruptions and connections for what they are.
6. Embodied noticing
Gre introduced the cosmogram walk in these words:
To consider this work, I’ve rooted my understanding in an adapted understanding of the Congo cosmogram.
The Congo Cosmogram, an ancient symbol of the Bakongo spiritual realm, is known to have been used as a site for oath-taking between the Living, God and the Ancestors.
Its cross-like shaped core transposes, vertically, the relationship between the world of the Living, located above, and the land of the Dead, situated below. The latter, which embodies a spiritual dimension, is understood as the place where Ancestors and their wisdom lie, once they have departed from the physical realm.
The horizontal line known as «Kalunga», separates both worlds. Also symbolically interpreted as a water current, it is the area that Beings cross to get to the other side of life.
The lines of the cosmogram lay between tracings, sometimes represented as arrows, that form a circular structure. This shape evokes the eternal continuity of life, regardless of physical death.
Read counter-clockwise, the Dikenga dia Kongo sustains the belief that each individual or community follows a life cycle that is comparable to the different positions of the Sun within a day. These different phases of life are symbolised by four cardinal points. The journey starts at the southern point, Musoni, which represents the moment of conception – not birth – of an individual or community. It then goes on to the eastern cardinal point, Kala, where the individual or community is birthed into a society where the learning of social rules occurs. Tukula, the northern point, is the period of adult maturity, of knowledge and experience, which flourishes through the exchanges that occur between the different members of a community. Luvemba, the western cardinal point, represents the phase where knowledge is passed on to the next generation. It is also the final point before the cycle begins anew, departing again from Musoni, now place of rebirth.
Adapted from Maria-Gracia Latedjou and Mwana Pwo, Dikenga, Affect and Colonialism exhibition. The primary source for this thinking is K. K. B. Fu-Kiau, African Cosmology of the Bântu-Kôngo: Tying the Spiritual Knot, Principles of Life & Living, 2nd edn (Athelia Henrietta Press, 2001).
The cosmogram walk was there to bring the non-pathologised body back into the room where research and methodology are built, rather than lecturing on the method. The three Endarkened Co-Composition provocations read aloud were:
East: opacity as ethic and aesthetic
North: listening as an act of regard
West: endarkened co-presence as a research praxis
What people reported afterwards:
Stillness. Several people felt it, along with a shifting sense of heaviness. One person observed how rarely academic spaces allow time to sit with what has been said.
A split between mind and body. Princess Banda described a fragmentation between taking notes and staying present enough to feel. Others felt it as a pull between being moved and wanting to make the experience useful. Mary named the assumption she had walked in with: that one listens in order to collect data and solve a problem. Gre picked this up: when listening is a means to an end, “the listening part is a bit quick.”
Resistance and choice. Michelle described her musicology-trained mind resisting opacity, given how much the academy rewards clear argument. She also asked whose listening counts in storytelling: the teller’s, the listener’s, or both. Another participant noticed that although refusal had been explicitly permitted, everyone turned together, and that choosing to participate felt powerful.
Memory in the body. Chi Ying, who had not introduced herself as a mother, found the turning brought back the feeling of carrying her daughter.
Online. Christina found the exercise re-centring amid the distractions of joining online, with a sunrise outside her window in Hamilton.
“A drizzle of medical authority.” One participant described their excitement for the work and their worry about how clinicians respond. Clinicians want things they can grab hold of, grow uncomfortable when things get blurry, and often treat patient engagement as an add-on. Their phrase for what hangs over the whole enterprise was “a drizzle of medical authority”, meant in the Scottish sense: constant, fine and everywhere.
Refusal in the plural. Chisomo said her interlocutors’ stance was not refusal against anything. It was closer to “you’re not going to interrupt my presence and way of being.” Ethnography’s existing accounts of refusal are not comprehensive enough for that. Gre responded that endarkened co-presence has to make room for the full vastness of refusal.
7. Threads that ran through the day
7.1 Listening as method, not means to an end
This was the spine of the day. Clinical and applied health research usually listens in order to do something. Endarkened Co-Composition asks what happens when the listening comes first and is not hurried toward an output. Lucy Lowe framed what clinical research misses as listening over time. Chisomo showed that listening is itself culturally constructed and multifaceted. Lucy Green asked whether she can resist the urge to interpret without fearing that important data will be lost. Mary named the problem-solving reflex in her own field.
7.2 Opacity under institutions that demand visibility
Several contributions described institutions that demand legibility: the Home Office, the ultrasound screen, the consultation note, and the funder. Against these, Three Gold Threads offered untranslated speech as protection and care. Catherine wrote that Endarkened Co-Composition challenges the idea that transparency is always the objective of good practice with communities that have been systematically disempowered. Christina added a limit: translation can sometimes be an act of inclusion or a route into care, as with sign interpretation. Consultation and consent are what decide which case applies, especially in a world of generative AI that insists everything is knowable and datafiable.
7.3 Data, numbers and what counts as evidence
Erin’s methodological question, what is the role of data and facts?, ran through both sessions. Funders such as the AHRC say they privilege lived experience but still ask “what is your data?”, and a busy civil servant listens for the number. Erin wanted to move beyond data while speaking its language well enough to widen what counts as data. Archival absences, for example, can also be knowledge.
Mary added that measurement is what brought maternal disparity onto the policy table. The same measurement risks turning it into “a marketing campaign” and flattening the whole story into a ratio. Catherine reported from Nebraska that, in practice, individual stories are what move policymakers to act. Advocacy organisations there are now running storytelling training for people with lived experience.
Gre’s position was not to discount the numbers but to present them alongside people telling their own stories, undistilled and untranslated, with sound as the vehicle. Gre offered two examples of knowledge emerging this way:
At the project’s retreat in Alabama, the team journalled independently in a speculative storytelling workshop led by librettist Deborah Mouton. Without conferring, every person placed Anarcha’s leaving of the hospital in winter, in snow, with her breath visible. In Black storytelling tradition, speculation is a formal way of making knowledge.
The women of Three Gold Threads found shared themes across interviews conducted separately, as happens in qualitative research. Heard back in their own languages, their stories felt more real to them.
7.4 Where authority and expertise sit
Lucy Lowe put it most simply: what Endarkened Co-Composition contests is where authority and expertise sit in sexual, reproductive and maternal health. Mary named the knowledge hierarchy in maternity care as the thing Endarkened Co-Composition would have to contend with most. She described bereaved families who return for another pregnancy carrying loss that is read as anger or trauma, when it is also knowledge about how services failed. In her account the tension has at least three sides: clinicians and policymakers, researchers and bereaved families, and a legal sector for whom the NHS is a litigation market.
Erin brought in music education’s critique of the “deficit model”. It asks increased access to what? Endarkened Co-Composition could resist a colonial deficit model of gynaecological knowledge by hearing alternatives. Michelle located the same move inside music: Endarkened Co-Composition unsettles the hierarchies between composer, performer and listener, and the Eurocentric idea of the finished musical “work”.
7.5 Clinicians, training and moral injury
Catherine proposed Endarkened Co-Composition-informed arts and humanities training for students and early-career clinicians, before habits harden. The aim would be to cultivate belief in birthing people’s accounts of their bodies without triggering the defensiveness that shuts learning down. She framed this as “yes, and”: traditional knowledge has not solved this problem, so what else could we do?
Christina extended the point to clinicians themselves: burnout, minute-by-minute measurement and the moral injury of knowing a problem without being able to fix it. Catherine noted that preventing burnout and retaining expensively trained staff is something funders already pay for. Christina also questioned the “additive” model of medical humanities, in which health sciences decide in advance what “the arts” are for. She suggested Endarkened Co-Composition might model more equitable conversations between disciplines, not only between researchers and communities.
7.6 Legitimacy, politics and “good science”
One participant raised the worry carefully: how does the method stay looking like good science rather than being dismissed as “wokeness”?
The response from the room was that this framing cannot be avoided. Work by Black scholars challenging orthodoxy will be labelled that way regardless. The task is to defend the work and build a safety net for it, not to hide from the label, while respecting anyone who temporarily sanitises keywords in order to survive.
Catherine, working at an academic medical centre in a conservative US state, made a pragmatic case. People and babies are dying, and that is the problem to address. Severe morbidity, poor outcomes and lost staff all carry long-term costs, which can be made visible even to those who do not lead with care. Sometimes the work has to name eugenic logic directly.
Gre heard in the concern a familiar hierarchy that places “hard” science above the humanities. Gre took it as a call to ground Endarkened Co-Composition’s claims explicitly in sound theory, as rigorous scholarship on sound as world-building and political, and asked the room to consult colleagues on how to keep the science visibly good.
7.7 Time, depth and keeping Endarkened Co-Composition ethical
Lucy Lowe asked how Endarkened Co-Composition builds the trust and depth that ethnography earns through years of relationship. How would participants experience it as different from an NHS focus group? Gre agreed that Endarkened Co-Composition was never meant to be quick, and that this is one of its biggest challenges for composers. The method replaces solitary composition with a protocol. Even the three days in Alabama were what made Deborah Mouton’s workshop possible. Gre estimated the opera at five to six years, against hopes for a 2027 premiere from partners in Alabama.
Gre also described practices that already keep participants in the loop, though they are not yet written into the methodology:
Groups of no more than seven people.
Full transcripts returned before any text is set.
Participant input on the sound itself (“if you hate the cello, let’s do something else”), so that people own what houses the text as well as the text.
The home key of a piece set from the speaking voices of the interviews.
Hesitations and “ums” left in rather than cleaned out, because “the sound of hesitation is different than someone alluding to hesitation.”
Erin, Chi Ying and Lucy Green all raised dilution. If everyone starts calling their work Endarkened Co-Composition, how do we tell meaningful collaboration from tokenism? Erin’s worst case was a composer who engages with the method for ten minutes and then claims it. Lucy Green compared this with how lightly “co-production” is used in medicine, and wondered whether partial adoption still inches people forward. Ideas from the room included insisting on the full name, Endarkened Co-Composition, in place of shorthand; requiring the kind of critical positionality expected of good ethnography; and articulating the method’s lineage clearly. Gre added that Endarkened Co-Composition removes some of the composer’s autonomy and redefines success. The integrity of participants’ contributions comes before clean scores and good production values.
7.8 Outputs, audiences and the opera
The afternoon’s liveliest exchange was about the opera:
The case against. Michelle asked whether an opera, a work written by a composer, can reflect Endarkened Co-Composition beyond drawing attention to its subject, and what reach it will have beyond people who already attend opera. Erin asked whether genre hierarchies (opera versus hip hop) shape how funders perceive Endarkened Co-Composition. Another participant named opera’s inscribed misogyny.
Gre’s response. Gre named the tension of making work for institutions shaped by the white gaze without resolving it. The opera will be experimental, sonically expansive and accessible, and will hold beauty and dissonance together because the subject requires it. Gre’s strategy is to fund the research, writing and musicians institutionally up to the point of production. Companion forms are planned: a documentary, a possible companion book, gallery installations and a song cycle.
Catherine. She described how community-engaged opera companies, including Opera Omaha, are opening the form. She also noted that the opera audience may include exactly the people, clinicians among them, whom the message needs to reach.
Christina. She spoke as an opera lover. Anarcha’s life deserves monumental treatment, and claiming a prestigious form is powerful. Opera has always been modular (piano reductions, sing-it-yourself versions, storybooks), so it could travel into community spaces with facilitated conversations afterwards.
Lucy Green and Gre agreed that Endarkened Co-Composition has not yet theorised the role of the audience. If the aim is that fewer Black people die in hospitals, there has to be an audience-response element, and it is not yet clear what that is. Ideas included audiences contributing to the sound or singing along, staging in hospitals, and making space for creative responses that do not feel like a feedback form.
8. Tensions to carry forward
These come from the tensions written up on the day and from the discussion. They will become limitations, risks and design questions in the agenda and the paper.
| Tension | Who holds which side | What might help |
|---|---|---|
| Knowledge hierarchies and measurement | Clinicians and policymakers; us and bereaved families; the legal sector (MMb) | Ways to present numbers alongside self-told story; evidence of how lived experience moves policy (CM, US context) |
| The role of data and facts | Funders and civil servants who listen for data; researchers seeking to widen what data means (EJW) | Speaking data’s language fluently enough to redefine it; framing statistics for what they do and do not tell us |
| Explanations from science with or without the context of race and gender | Raised in discussion | To develop |
| The arts as an add-on versus the arts as a research method | Medical humanities as commonly practised; Endarkened Co-Composition (CB, CM) | Pitch Endarkened Co-Composition as research method, and as a way to foster interdisciplinary conversation |
| Moral injury: we know the problem but not how to address it | Clinicians; funders (CB, CM) | Evidence on arts engagement, wellbeing and retention |
| “Good science” versus “wokeness” | Concern for credibility; the view that the label is inevitable (CK); “yet and still, people are dying” (CM) | Ground Endarkened Co-Composition in sound theory; consult clinical colleagues; make the cost argument; name eugenic logic |
| Ethnographic time versus project time | Anthropology (LL); funders and commissioners | Write time, feedback loops and relationship-building into the protocol |
| Dilution and tokenistic uptake | Raised by EJW, CYL and Lucy Green | Positionality requirements, a clear lineage and the full name |
| Opacity versus translation as access | CB | Consultation and consent, decided case by case |
| Opera’s reach and elitism versus monumental reclamation | M Meinhart, EJW; CB, CM | Modular forms, community venues and a theory of the audience’s role |
| Why centre clinical research at all? | LL | Articulate who Endarkened Co-Composition is for, where, when and why |
9. What remains open
Who is the audience for Endarkened Co-Composition research, and what is the audience’s role in the method? Do you want to bend Endarkened Co-Composition toward an audience “that fetishises stats”, and if so, why? (LL; Lucy Green; GL)
What safeguards prevent collective harm when creative methods take on sensitive and taboo topics? Endarkened Co-Composition’s universalism is its beauty, but whose voices does it not represent? (CK)
How does Endarkened Co-Composition sit between measurable, translated evidence and embodied, sonic knowledge? (MMb)
How do we keep trust in human relationships from becoming uncritical trust in health systems? When technology makes mistakes, can collaboration make them occasions for dialogue? Can collaboration also reproduce power inequalities or pressure people to take part? (CYL)
How is success defined when co-composition reduces the composer’s autonomy? (GL)
How do endarkened listening, co-presence and storytelling relate to fugitive anthropology? (LL)
When is translation needed or wanted? (CB)
Can birthing people’s own sound-making be a source of agency in medicalised spaces? What would better birthing environments sound and feel like, and could something as modest as a checklist help? (M Meinhart; CB)
The Commitments and Refusals columns of the research agenda board were left empty on the day. They are still open, and contributions there will directly shape who is named, and how, in the next application.
10. What happens next
Gre will work from both boards and the transcript to produce, in turn, this synthesis, a mapped research agenda and a first draft of the critical position paper.
The research agenda will most strongly shape the next AHRC application, and contributors will be cited. Anyone who wants a more committed role can talk to Gre about a formal partnership, whether through their institution or as an independent researcher.
The position paper will set out how Endarkened Co-Composition works and what positions we take in applying it more widely. It will also inform the application. The target is BMJ Medical Humanities, with a Springer Nature medical humanities journal as the fallback. Everyone will be a co-author. There is no deadline yet; the aim is to have it drafted and submitted around this time next year.
Everything will be shared for feedback before it goes anywhere. Anyone can step back at any point.
Corrections
If you were there and something here doesn’t represent you fairly, please tell Dr Nik Gre Lassiter and it will be corrected.