Page 276 - Handbooks of Applied Linguistics Communication Competence Language and Communication Problems Practical Solutions

254 Celia Roberts

Data example three

D come in come in please come in [ ] good morning
P good morning
D have a seat
P thank you
D how are you today
P oh: {[dc] [creaky voice]not very good}
D not very good (.) what’s happening
P I *pain here (.) *too much (.) I can’t cope you know
D right
P *yesterday (.) *whole day
D right
P and I eat (.) *three times (.) paracetamol
D right
P two three hours it will be *all *right and then (.) *come *pain again (.) I
*can’t cope (.) pain like
D you can’t cope with this pain
P yeah very very bad (.) I don’t know what’s the wrong with me
D sure how * long you have this
sure h/w * lo n\

The patient slows down her speech with “not very good” and speaks in a creaky,
tremulous voice. It as if she is as acting out the pain in her talk. The rest of her
initial self report is delivered in short quite sharply contoured units with little
distinction made prosodically between the description of the symptoms, the
context, the self-treatment and her stance. The doctor does not immediately ask
her about her symptoms but instead repeats what she has said, “you can’t cope
with this pain”, which elicits more affective talk. And when he does ask about
the symptoms, the question is, prosodically, more like a comment than a ques-
tion and does not seem to function as directing back the patient to the facts of the
condition. One reason why this example may be different from the previous one
is that the doctor is also of South Asian origin, a Panjabi speaker, and is willing
to stay with the affective stance as the focus of this self report, rather than mov-
ing immediately to the question about how long she has had these symptoms.
Both the English mother and the Gujarati patient were able to create the con-
ditions for shared negotiation and appropriate presentation of self and symp-
toms because they shared linguistic and cultural resources with the doctor.
When this is not the case, the orderliness of the opening stage of the consultation
is challenged. Unexpected aspects of self-reporting are put in the foreground
and the expected focus is lost. Sometimes, patients cannot combine symptom
telling with a stance which tells the doctor what kind of patient they have sitting