Research in Conversation Analysis has demonstrated how patients' storytelling in medical interactions can be constructed in different ways and with various purposes. Halkowski (2006) illustrates how one common way for patients to introduce a narrative sequence justifying their visit to the doctor is the formulation "At first I thought X, but then…". Through this device, patients present themselves as reasonable by highlighting their initial interpretation of their symptoms as something not worthy of a doctor's visit, before adding information explaining why they did seek medical care in the end. Moreover, Gill (1998) shows how patients' attempts to explain the causes of their condition tend to be downgraded through uncertainty markers. As Drew (1991) points out, this does not necessarily imply a lack of knowledge on their side, but it could also be a question of not feeling entitled to the concerned knowledge and leaving space for the doctor's evaluation. One way of doing this is through what Gill calls "speculative explanations", where the patients "sound as if they are doubtfully conjecturing aloud" (1998, p. 346).
The syntactic structures involved in these pronounced conjectures have been studied by Floquet (2019) who refers to them as monologues intérieures, interior monologues. She illustrates how these can be reported not only through explicitly communicative verb constructions such as "say to oneself", but also through mental activity verbs such as "think", which then is capable of both covering a simple thought, and of reporting a formulated piece of discourse, according to the syntactic structures in which it is inserted.
The aim of this presentation is to propose a conversation and syntactic analysis of patients' use of the English verb think and one of its Swedish equivalents tänka in storytellings in medical consultations: how and why are these verbs employed? The corpus consists of English audio recordings of medical consultations with a general practitioner, collected for the British National Corpus in 1993, and Swedish video recordings of medical consultations involving rheumatic patients, collected by Ulla Melander-Marttala between 1989 and 1992.
We will show how think and tänka both appear in different (micro and macro) syntactical structures as epistemic hedges and reporting verbs introducing different forms of thought processes. Accordingly, we want to demonstrate how these verbs allow the patient to downgrade their epistemic authority and justify their choices, thereby contributing to the construction of a certain patient identity.
References:
Drew, P. (1991). Asymmetries of knowledge in conversational interactions. In I. Marková & K. Foppa (Eds.), Asymmetries in Dialogue (Harvester Wheatsheaf, p. 21‑48).
Floquet, F. (2019). Monologue intérieur et discours rapporté : Une union problématique ? E-rea. Revue électronique d'études sur le monde anglophone, 17.1, Article 17.1. https://doi.org/10.4000/erea.8664
Gill, V. T. (1998). Doing Attributions in Medical Interaction: Patients' Explanations for Illness and Doctors' Responses. Social Psychology Quarterly, 61(4), 342‑360.
Halkowski, T. (2006). Realizing the illness: Patients' narratives of symptom discovery. In J. Heritage & D. W. Maynard (Eds.), Communication in medical care: Interaction between primary care physicians and patients (1st ed., p. 86‑114). Cambridge University Press.
