Band 4, Heft 1

This article presents a linguistic analysis of data from an ongoing research project exploring HIV/AIDS education in West African Burkina Faso. I argue that we can identify different, sometimes even competing, discourses about the disease in prevention interactions. Thus, communication about HIV/AIDS in Burkina Faso—and probably in most of the Sub-Saharan countries—might be characterized by what I will call, with reference to Bakhtin, discursive heteroglossia. There is clear evidence of such discursive heteroglossia, that is, the participants' alignment to local and global HIV discourses, deployed in the communication of health workers. In my analysis of peer educators training sessions, I draw on theoretical and methodological principles from discourse analysis and interactional linguistics. I focus on the linguistic devices and conversational strategies the participants use to indicate the relevance of the local or the global discourses. Three particular devices—namely, metaphors, epistemic and evidential markers, and word explanations—will be examined in a more detailed way. I will also show how the local and the global interweave at different levels of prevention discourse.

In this study, we investigate the use of narrative in online conversations among persons suffering from chronic opiate addiction and evaluate both its positive and negative uses. Illness narratives, as argued by sociologist Arthur Frank and psychiatrist/medical anthropologist Arthur Kleinman, enable patients to give order to life experiences and receive support from others. We wished to explore under what circumstances online support coalesces and breaks apart. The narratives we examined exemplify two topics frequently discussed on the message board: the recovery process and what it means to be ‘clean’. To better understand these narratives from a theoretically based approach, we used the work of rhetorical theorist Kenneth Burke. Burke's description of two human motives, suffering and perfection, led us to an understanding of how unification and division happened within the online community. We found that the recovery narrative primarily embodied the author's suffering and, consequently, received support from other members of the message board. The second narrative centered on what it means to be ‘clean’ through a discussion of the author's desire to court temptation, revealing what Burke calls the rotten nature of perfection. As a result, the author of the narrative provoked disagreements and did not receive support.

This paper examines the pragmatic and discourse features of a number of multimodal international healthcare insurance texts. The texts contain specialized language related to the provision and treatment of healthcare and to insurance coverage and are aimed at a fairly well-defined target readership, many of them actual or potential expatriates. They thus serve a useful function, that of providing the readership with an informed and comprehensible guide to the services and products available. Some of them have a more strictly promotional aspect, that of advertising specific insurance policies. In particular, the paper focuses on the language choices favored by these texts and the strategies they serve, noting that the distinction between their informative and promotional dimensions is not always clear-cut. It further suggests that the writers of these texts make a specific use of discourse features and languaging strategies in order to achieve their rhetorical purposes.

Most studies evaluating companion effects on medical triadic interaction focus on the doctors' part, e.g., how the companion's presence diverts doctors' attention away from the patient. In contrast to this mainstream approach, the current research proposes an alternative framework by focusing on the patient parties—especially on how companion participation reshapes the discourse sequences where patient parties provide information, and how it affects patient full turns and priority in providing complete first-hand information to doctors. By examining fifteen geriatric triadic conversations collected in a teaching hospital in southern Taiwan, this proposed framework concludes that in the companion's presence, the information providing sequences are restructured into eight patterns, among which sole information provider is preferred to joint providers. Furthermore, the more companions participate in providing information, the less patients by themselves volunteer information or respond to doctors' questions prior to companions' verbal involvement. A more striking companion effect shows that even in the triads with a low-participation companion, whenever the companion does participate, the patient rarely has a full turn or priority to complete an information unit. The patient's turns are either taken, are simultaneous with, or cut-off by the companion's participation.

This investigation examined how the interpretive practices of a speech–language pathologist (SLP) contributed to the construction of identity among adults with traumatic brain injury (TBI) during group therapy in a hospital setting. Six group therapy sessions were video-recorded and transcribed (yielding a total of 8,056 utterances). Attention was paid to patient expressions of identity and ability, the communicative functions of these expressions, and the manner in which these expressions were evaluated by the SLP. The SLP was also interviewed regarding the nature of therapy practice. Analysis revealed that the interpretive voice of the SLP dominated in ascribing a patient identity of self as damaged goods. Implications are discussed in terms of how the institutional setting, the perceived nature of TBI, the agenda of the SLP, and the interactional substrate combined to motivate such interpretive practices on the part of the SLP.

This paper explores some institutionalized visual representations of women with breast cancer and examines the rhetoric of the images in the American Cancer Society product catalogue (2000) and the Look Good … Feel Better pamphlet. I show that these cultural discourses promote notions of appearance that are ‘acceptable’, ‘desirable’, and ‘beautiful’ even when a person is sick. Suggestions and models offered for women when there is a ‘problem’ with their bodies through the frame of ‘helping’ them to cope with the effects of cancer—by managing their appearance—provide models for renewed femininity during/after cancer treatment and function to maintain the existing definitions of beauty, femininity, and gendered appearances even in times of crisis. With an emphasis on the ‘normalization’ of one's changed ‘problematic’ appearance, the images function to narrow down women's meanings and choices about their bodies and the ways in which they can manage their bodily appearance. Furthermore, this paper points to possible alternative discourses for further exploration. This study aims to enrich our understandings of cultural meanings of illness by making visual materials a significant part of our research.

Using the methodology and findings of conversation analysis, we analyze changes in the talk of a man with aphasia (a language disorder acquired following brain damage) at two points in his spontaneous recovery period in the first months post-stroke. We note that in the earlier conversation (15 weeks post-stroke) two of the turn constructional methods he particularly makes use of are replacement (a form of repair) and extension. By the time of the latter conversation (30 weeks poststroke) these methods are less prevalent, while another repair operation, insertion, is now used in a particular way not seen in the earlier conversation. We suggest that these methods are means by which the aphasic speaker adapts his limited linguistic resources to the demands of constructing a turn-at-talk in conversation in order to lessen the extent of repair and delay with the turn and thus lessen the exposure of his linguistic noncompetence and his identity as ‘different’, ‘disabled’, or ‘language impaired’. These turn constructional methods are dynamic and change as the speaker recovers. We suggest that communication disorders such as aphasia can be problematic not only because of difficulties they can cause in conveying information or producing other social actions, but also because they can create difficulties in the presentation of self in everyday life.

Few diagnoses present as great a challenge to one's life as cancer. Many men each year are confronted with a diagnosis of early stage prostate cancer and find themselves making decisions about treatment in the face of side effects that present often devastating effects, including problems controlling one's urine and an inability to perform sexually. In this paper, we explore the narratives of men who, having chosen and undergone treatment for early stage prostate cancer, are living with the consequences. Faced with what Charmaz calls an ‘identity dilemma’, how do these men linguistically construct their identities in the face of challenges to their bodily, personal, and social integrity? Drawing upon theories of social languages and Discourses, we examine how men linguistically resolve the identity dilemmas they encounter and in turn construct an identity in response to a question about the quality of their lives in the face of the adverse event of prostate cancer. We present an analysis of the interview narratives of two men and show how they ‘re-collage’ an identity in the face of fundamental changes in their functioning as men. We argue that these men draw upon alternative discourses to construct themselves as whole, competent, and ‘no less a man'.