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I S S U E N O . 48 [ September 2 0 1 0]
Akin
Odebunmi
Code selection at first
meetings: A pragmatic analysis of doctor-client conversations in Nigeria
Existing studies on doctor-client interactions have mainly focused on
monolingual encounters and the interactional effects and functions of the
languages used in the communication between doctors and their clients. These
studies have neither examined the several codes employed in single
encounters and their pragmatic roles nor given attention to communication at
doctor-client first meetings. This paper closes this vacuum by cataloguing
the generic structure of the interactions at first meetings in Nigerian
hospitals and examining the pragmatic features and functions of the codes
used by doctors and clients at the different units of the generic structure.
Ten interactions were sampled from 75 audio-recorded doctor-client
interactions in selected state government-owned and private hospitals in
Southwestern Nigeria. The transcripts were analysed with insights from
theoretical perspectives on code selection, Stephen Levinson’s notion of
activity types and Skirant Sarangi’s concept of discourse types. Four stages
characterise doctor-client interactions at first meetings in Nigerian
hospitals: Opening, Diagnostic Interaction, Announcement and Closing. While
Diagnostic Interaction is obligatory, all the others are optional. Each of
the stages is characterised by sub-stages/units that are largely optional.
Two code selection types run through the generic structure of the
interactions, namely, non-strategic and strategic. Non-strategic choices are
necessitated by cultural and institutional routines, and linguistic
routines. Strategic choices are characterised by context-shaping and context
determined acts. The former acts are marked by code negotiation cues while
the latter are characterised by institutional and local contextual
constraints. Codes are selected at the non-strategic level to express phatic
communion, indicate deference and display personal styles. At the strategic
level, they are employed to accommodate dispreferred code choices, relax
tension, flaunt competence, assure, save face, joke, reformulate and warn.
Code choices, non-strategic and strategic, are very vital tools in gaining
access to the events at doctorclient first meetings. The phenomenon of code
selection reflects the multi-code nature of the interactions, shows the
culture-institution nexus that governs the meetings, reveals linguistic
flexibilities despite the dominance of English in the Nigerian orthodox
medical institution and presents a context-sensitive communicative terrain
that permits linguistic and goal negotiations. Future research can compare
codes at first and subsequent meetings, and investigate the point of contact
between first meetings in African and Western hospital interactions.
Key
words: Doctor-client conversations; activity type; discourse type;
generic structure; nonstrategic/ strategic code selections;
context-shaping/context-determined acts
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