Five years ago, I read for the first time a Japanese version of an old French book, “Docteur, pour la première fois, nous avons parlé le même langage” dit Christina (“Doctor, for the first time, we spoke the same language”, Christina said).
The book tells a true story of a female in-patient, Christina, in a hospital ward in France, describing dialogues between her and her doctor, with 35 of her drawings alongside the text. She was a journalist. The book title comes from what Christina said to her doctor one year after they started talking. The title is very symbolic of the asymmetric relationship between a patient and a doctor in a hospital. Patients have their own ‘lifeworlds’ and doctors have their own professional frame of mind. As the doctor spent time with Christina, his perspectives slowly transformed from biomedical into psychosocial views. He noticed that there was something that a patient could inspire in a doctor.
The book was first published by Hachette in France in 1979, and translated into Japanese in 1985. It’s really a shame that it hasn’t been translated into English.
I was very lucky to find this beautiful old book when I was about to embark on my PhD research. The book reminds me of the starting point of my research journey.
My field of study is applied linguistics. I am researching the context of doctor-patient interactions, which also overlaps health communication studies. I look at a real-life context of clinical practice, and my view is purely based on ethnographic fieldwork for understanding and recording what doctors and patients ‘do’ and ‘say’. I analyse their linguistic patterns, hoping that the findings can inform patients’ voices, increase awareness, help health professionals to evaluate and improve actions, and also prove a theory.
I am always moved when observing their interactions and listening to their stories. Everybody has a story.
Doctors may conduct research on the exact same topic. Many doctors who were my research participants were also researching topics on patient-doctor communication as well as practising. Their views are situated within medicine, sometimes employing linguistic methods such as discourse analysis or conversation analysis, and they would contextualise the data into their medical perspectives.
Researchers always go back and forth between the ‘language in practice’, the ‘researcher’s personal view’ and ‘academic words in the field situated’. In the end, I return to linguistic terminologies, and doctors would be responsible for having gone back into the biomedical world.
If I had got stuck in any of them (linguistic or personal or medical views), relying on only one view, my research would fail as a qualitative study. To balance this, I believe that fieldwork (or carefully listening to a story) provides a profound insight into the context. Although I have currently researched online consultations during the COVID-19 pandemic, contextualising is always the crucial part. I have felt that I could do something in this particular field as a linguist.
Cross-disciplinary dialogue across boundaries
Over the last few years, the field has evolved in mixed methods for various kinds of contexts, ranging from health discourses of individuals (patients’ talks, adherence to treatment, health literacy, online support groups) to professionals’ practices (institutional talks, inter-professional communication, communication skills training, clinical reports, nursing care), and patient-provider interactions (diagnosis, negotiations, ethics).
Recently, I have seen many papers on dementia care, palliative care, and end of life care.
It is not only linguistics that has shed new light on many healthcare issues, but also health communication that has contributed to theories and frameworks in linguistics – cross-disciplinary dialogue across our boundaries, just like the conversation between Christina and her doctor. This is what I have seen through research.
Here are my dreams.
Research in the field can do the following.
- Serve as material to facilitate learning for all health professionals and non-professionals
- Teach how to research, so that professionals can learn how to evaluate and interpret data, which will help them to apply it to their own practice sooner
- Increase public awareness on issues that they didn’t even know existed
- Reveal mystery and truth in healthcare practice
- Benefit healthcare services with greater success
- Contribute to the technological advancement of online medical services
For reference, I always turn to the pages of three major handbooks of the field. These are the most comprehensive books on the area, and I have read (and will read) them over and over again.
- The Routledge Handbook of Language and Health Communication (Routledge, 2014)
- The SAGE Handbook of Qualitative Methods in Health Research (SAGE, 2010)
- Communication in Medical Care – Interaction between primary care physicians and patients (Cambridge University Press, 2006)