How do Doctors Use Language to Shape, Challenge and Form Relationships?

This month we published Reflective Writing in Medical Practice by Miriam A. Locher. In this post the author explains the focus of the book and how it came about.

This book is about the linguistic analysis of written reflective writing texts that were produced in the context of medical education and medical practice. The texts were collected from medical students from the University of Basel and the University of Nottingham (in connection with courses on communication skills in doctor-patient interaction), and are supplemented by a corpus of texts written by doctors for columns published in medical journals.

The genre of reflective writing has several purposes: it invites the writer to learn from a past experience and to reflect on potential future behaviour. In its focus on a past experience it involves narrative elements and in its trajectory on learning it involves reflection and projection. As a practice, the value of reflective writing has long been established within the medical humanities and medical professionals are encouraged to make reflective writing a life-long habit.

My own expertise in online health communication and (im)politeness studies led me to ask how medical students and doctors use language to shape, challenge and form relationships (a process for which I use the term ‘relational work’), and thus to study the texts in the reflective writing corpus from an interpersonal pragmatics perspective. In addition, the texts are explored with respect to topic, composition, and genre. In the book, we explore:

  • what topics and communication skills the authors write about
  • how the narratives develop
  • how these texts are shaped
  • what genres influence their composition
  • how relational work surfaces in them
  • how the writers linguistically create their identities as experts or novices

The medical humanities have long played an important role in medical training at the University of Basel. When I joined the staff of the English department in 2008, two important scholars on the medical humanities committee, Prof. Alexander Kiss (psychosomatics) and Prof. Franziska Gygax (English literary and cultural studies) approached me and we developed a joint interdisciplinary project entitled ‘Life (Beyond) Writing’: Illness Narratives, (funded by the Swiss National Science Foundation). This project joins the study of life writing, reflective writing and medical education. During the years that the project was funded, we have learnt from each others’ different ways of developing questions and approaching data. We also organized an interdisciplinary conference, which resulted in an edited collection (Narrative Matters across Disciplines in Medical Practice, Benjamins, 2015).

The current book is the result of the linguistic branch of the project, which deals with the reflective writing corpus as outlined above. Our collaborator Victoria Tischler (Nottingham) and the linguistics project member Regula Koenig were important team members throughout the genesis of the book. While bringing the ideas together as a whole and writing it up was a single-author experience, I feel indebted to both and therefore use the authorial “we” when writing. Without their help in obtaining data, coding and feedback, the completion of this project would not have been possible.

More information on the author can be found on her website.

More information on the interdisciplinary project can be found on the project website.

For more information about this book, please see our website. If you found this interesting, you might also like Medical Discourse in Professional, Academic and Popular Settings edited by Pilar Ordóñez-López and Nuria Edo-Marzá and English in Medical Education by Peih-ying Lu and John Corbett.

 

How can we overcome language barriers in health care?

This month we published Providing Health Care in the Context of Language Barriers edited by Elizabeth A. Jacobs and Lisa C. Diamond. In this post the editors tell us about the inspiration behind the book and what we can expect from reading it.

Have you ever had to seek health care in a country where you did not speak the language? Have you ever thought about what the experiences of the patient, care provider and, if present, interpreter are?

As immigration continues and grows across the globe, this has become a frequent experience for patients around the world. Many patients and their health care providers have to communicate across a language barrier, often in collaboration with an interpreter, formal or informal. In this situation, patients’ needs may not be understood or met because of lack of adequate communication. The nature and complexity of language barriers in health care vary within and across nations due to the culture and political nature of the nation and/or the linguistic groups seeking health care in those countries. With this diversity of contexts comes a need for diverse approaches to overcoming language barriers in health care. The goal of our book is to provide a collection of chapters describing these different approaches, their advantages and disadvantages, and special issues which need to be considered in particular contexts or linguistic groups.

This edited volume provides an excellent overview of the global challenge health care providers and linguistically diverse patients face when they seek health care in settings where it is delivered in a language other than their own. The contributing authors provide a diverse set of insights into these challenges and means for overcoming them and highlight how the likely best solutions to the problem of language barriers in health care vary depending on where you are in the world, what means of overcoming them are available, how policy shapes or does not shape these solutions, and the culture, language, and language abilities of the patients being served. They also provide a number of practical ideas and recommendations as to how to address these challenges, from how to work effectively with informal interpreters to developing a means for measuring physician language proficiency. These recommendations sometimes conflict, indicating that, while the challenge is consistent and global, the means for addressing language barriers in health care settings are varied and context-dependent.

We hope you find valuable evidence for the diversity of linguistic needs in the health care setting around the world in this book and that it serves you as an important resource for understanding this increasing global challenge, the different means for addressing it, and issues that must be addressed when developing solutions.

Patients worldwide deserve to be heard and understood and we hope this work helps make this happen.

For more information about this book, please visit our website. If you found this interesting, you might also like Medical Discourse in Professional, Academic and Popular Settings edited by Pilar Ordóñez-López and Nuria Edo-Marzá and Ideology, Ethics and Policy Development in Public Service Interpreting and Translation edited by Carmen Valero-Garcés and Rebecca Tipton.

The start of a busy conference season for Multilingual Matters

Laura at NABE 2017Last month I kick-started our 2017 conference attendance with a trip to the National Association of Bilingual Education
conference. Last year’s conference was in Chicago and this year the gathering moved south to the warmer climate of Dallas, Texas. Fresh off the press (so much so that I had to take them in my suitcase!) and highlights of the Multilingual Matters’ stand were Mahoney’s new book The Assessment of Emergent Bilinguals and the 6th edition of our bestselling textbook Foundations of Bilingual Education and Bilingualism, which is now co-authored by Colin Baker and Wayne E. Wright (you can read more about that collaboration on our blog here).

Click to enlarge

Next up on the Multilingual Matters conference schedule come the American Association for Applied Linguistics (AAAL) and TESOL conferences and our editorial team will be heading to those gatherings which are due to take place on the west coast in Portland and Seattle later in March. We very much enjoyed our last trip to Portland for AAAL in 2014 and are looking forward to a bustling few days at the conferences. A particular highlight of the AAAL calendar will be the celebration that we’re hosting during the Monday afternoon coffee break at AAAL, to which all delegates are invited.

On return to the UK, Anna will be attending the iMean conference which is hosted right on our doorstep at the University of West of England, in Bristol. Jo Angouri is one of the organisers of the conference and also one of the series editors of our new Language at Work series. We are looking forward to introducing the delegates to the first book in the series, Medical Discourse in Professional, Academic and Popular Settings edited by Pilar Ordóñez-López and Nuria Edo-Marzá, which was published last year.

Later in the spring we’ll be exhibiting at the American Educational Research Association (AERA) conference in San Antonio, Texas and then in the summer we’ll be crossing the waters to Ireland for the International Symposium on Bilingualism, which is to be hosted by the University of Limerick.

We very much hope to see you at a conference somewhere this spring – please drop by the stand and say hello if you see us!

Laura

War – The Mother of all Metaphors in Cancer Discourse

This month we are publishing Medical Discourse in Professional, Academic and Popular Settings edited by Pilar Ordóñez-López and Nuria Edo-Marzá. This post debates whether some of the metaphors used to discuss cancer are more appropriate than others.

Medical Discourse in Professional, Academic and Popular SettingsCancer metaphors are not new. However, they still spur interest among researchers, patients, families and doctors. Are some metaphors more appropriate than others? Their use helps to create our mental image of the immensely diverse group of diseases we understand as cancer. In the same way, nonetheless, they can provide an excessively simplified or negative image of treatments.

While some studies have been critical of war metaphors for decades, others prefer to consider the validity of metaphors regarding their usefulness for the experience of each patient. While some patients can be encouraged to deal with the disease in terms of battling, others can suffer if they see themselves as the losers in a fight after doing their best. Therefore, some patients or professionals prefer to refer to cancer with other metaphors such “the disease as a journey”.

Two chapters in this new book, Medical Discourse in Professional, Academic and Popular Settings, address cancer metaphors from different perspectives. The first reviews metaphors used in a particular cancer type, lymphoma caused by human immunodeficiency virus (HIV), through the analysis of texts of different genres: research papers, science news and press articles. The most formal genre, the research article, reduces metaphor usage while press authors exploit metaphors more deliberately for discursive and argumentative purposes.

The next chapter focuses on analysing the case of the two FC Barcelona figures who were diagnosed with cancer, the player Eric Abidal and the manager Tito Vilanova. It concludes that the journalistic discourse on the disease, even in a sport context, is still dominated by the war metaphor. Although the two figures often used sport metaphors publicly (“I know I’m not playing this match alone”), as did the media (“Tito faces his most difficult match”, “Vilanova plays the hardest competition, cancer, against the worst rival, death”) war metaphors were predominant.

There are similarities between war and sport metaphors (two opposing teams, the battle/match, the winners/champions), but there are also differences. The losers in war are captured, humiliated, even killed. The loser in a football match may have the feeling of having played better than the opponent or think that they were just unlucky. The media collect different metaphors and sanction them through use. As we can see, although new metaphors are introduced and enjoy general acceptance in certain contexts, as happens with the sport metaphor, military alternatives are still the mother of metaphors when discussing cancer.

This interesting debate shows how to face the challenge of defining such a complex disease, one that scares us, a disease described by Dr. Siddhartha Mujkerhee – using a new metaphor – as “the emperor of all maladies”.

 English in Medical EducationFor further information about this book, please see our website. You might also be interested in English in Medical Education edited by Peih-ying Lu and John Corbett.