Culture Influences on Context: The Medical Settings
文化影响环境:医疗情境
Zhang Jing,Associate Professor from Shandong University,
was giving lectures and tutorials to ICC students.
Pre-task: Case Studies
以下的十五段对话为在中国的涉外医院对真实医学情景跨文化医患会话进行录音并利用转写符号进行转写的文本。请大家在上课前把每一段对话都看一下。上课的时候每组将分析其中的一两段对话,利用跨文化交际的知识分析对话中的中国医护人员与外籍患者交际中的问题。我已经按你们的组分好,下面的每一页开头我写明了分别是给哪个组的。上课的时候我会先给大家约五分钟的时间以组为单位讨论你们的分析结果,然后我会随机叫组里的某个成员汇报你们的分析结果。
录音转写符号
D doctor
P patient
R relative
[ 表示重叠话语起始的地方
] 表示重叠话语终止的地方
= 表示两句话中间没有停顿
(.) 表示极短的停顿,一般少于 0.2 秒
(0.0) 表示以秒为单位停顿或沉默
(:) 表示前面语音的延长,冒号越多语音延长越多
- 表示突然中断
xx 下划线表示语音加强和重读音节
>xx< 表示语速较快
↑↓表示音高的突然上升或下降
→ 表示提请注意,为讨论的相关部分
(……) 表示录音根本听不清楚的话语
((laugh)) 表示语境的说明或难以转写的声音
For Group 1
案例1:“stop the teeth”
<1>
P: I’ve got an awful toothache; I want to stop my tooth.
<2>
D: >stop your tooth? < Let me see what’s wrong. Open your mouth, please.
Oh, It is a deep cavity, it should be filled, and does not need to be
extracted.
<3>
P: Yes, what I mean is to stop the tooth. It’s too far
gone.
<4>
D: Er, Although your tooth is decayed seriously,I’m going to scrape your teeth and then
polish them, This tooth will have to have a permanent filling. And we need not stop
the tooth.
<5>
P: Doctor, maybe you have mistaken my meaning,
maybe you think stop the tooth means pull out the tooth. But actually it means
<6>
D: Oh, sorry, I got the wrong meaning.
案例 2:“morning sickness”
<1>
P: Doctor, I always feel sick.
<2>
D: It comes slowly or quickly?
<3>
P: Quickly.
<4>
D: It appears only a very short period of time or it last long time?
<5>
P: It appears only a short time.
<6>
D: When did it come?
<7>
P: In the afternoon.
<8>
D: Do you have (2s) <morning sickness>?
<9>
P: Doctor; only women have morning sickness when they
are pregnant.
<10>
D: I’m sorry, what I mean is do you feel sick in the
morning?
<11>
P: No, usually in the afternoon, about 5 o’clock, before supper.
For Group 2
案例 3: “Doctor Liu”and“Director Liu”
<1>
D: We are going to do the operation on you tomorrow.
<2>
P: Does the operation safe? I am so scared.
<3>
D: There is nothing to worry about. Director Liu
will operate on you. He is very experienced and considerate.
<4>
P: Director Liu? Does he
administer the hospital? Why does he operate on me?
<5>
D: Oh, he is <Doctor Liu Qiang.> you have
ever seen him.
<6>
P: But why you call him Director Liu?
案例 4:Let auntie see your throat
<1>
R: My child is coughing, sneezing and has a running nose.
<2>
D: How long (2s) has he been ill?
<3>
R: For two days.
<4>
D: Does he have a temperature?
<5>
R: Yes, it’s
<6>
D: How much has he been coughing? Has he any sputum?
<7>
R: He has a bad, dry cough. Sometimes, he has vomited after coughing.
<8>
D: Has he a sore throat?
<9>
R: Yes.
<10>
D: Ok, honey, let auntie see your throat.
<11>
P: Mum, why she says she is my auntie.↑
For Group 3
案例 5:He is just hard of hearing
<1> R: Doctor, my son is <hard of hearing>. Can you cure him with
acupuncture?
<2> D: He completely couldn’t hear anything?
<3>R: Yes.
<4> D: How old is he?
<5> P: Five, five years old.
<4> D:
<5> R: Yes.
<6>D: I’m sorry, because she has been (2s) stone deaf since birth. Acupuncture is not always
helpful for deafmutism; it’s only effective in
cases of early and mild deafness.
<7> R: Oh, it’s a pity, anyway, thank you. But my son is not deaf↑ , he is just hard
of hearing. His hearing is not performing very
well.
案例6:Do you suffer from Constipation?
<1> D: Do you suffer from Constipation?
<2> P: Yes, I haven’t been for four days.
<3> D: What?
<4> P: I mean I haven't
had a road through me for four days.
<5> D: Oh, I know, I know.
<6> P: Could you give me a dose of salt?
<7> D: Salt has nothing to do with your cons- er (2s) your trouble. I can give you some cathartic.
<8> P: A dose of salt is
another expression of cathartic.
<9> D: Oh, (laughing), now I give you the
prescription.
For Group 4
案例 7:I’d like to make an appointment to see the doctor.
<1> P: Excuse me, I’d like to make an appointment to see the doctor.
<2> N: Sorry, in our country we usually do not
make the appointment, but queue up to register?
<3> P: (.)Where should I register?
<4> N: The registration office is on the first
floor. You can see the sign.
<5> P: > it’s so busy, if I queue up here, it
will waste me a lot o f time.
<6> N: I’m afraid not.
<7> P: oh, > it’s so inconvenient,↑ < will it be ok
if I come back later?
<8> N: Hm, you’d better wait, because the
registration time is between 8 and 11:30o’clock. And now it’s nearly 10:30.
<9> P: Can I register now and see the doctor in
the afternoon.
<10> N: Yes, you can. (2s)But if you don’t wait,
a lot of patients will be ahead of you, and you won’t be able to get the chance
to see the doctor today.
<11> P: Your habits are
not good.↑ So many people crowd here
(shaking the head) may I ask a certain doctor to treat
me?
<12> N: No, you should
register for a certain department. If you want to find a better doctor, you can register specialist to treat you. It’s more expensive.
<13> P: Specialist? In my country, we haven’t
this kind of distinction, it’s so strange.
案例 8:Why I can not make checks before I come into hospital.
<1> D: The only way to treat your column is by
an operation. I’d like you to come into hospital for a few days.
<2> P: When shall I make the operation?
<3> D: Perhaps 3 or 4 days ago.
<4> P: Why do you
suggest me to come into hospital now?
<5> D: You should come into hospital, we’ll give
you some other checks, and if your conditions are good, we’ll give you the
operation.
<6> P: > what kind of check, why I should make checks after I come into hospital. ↑ <Why not now?
For Group 5
案例 9:Please take care of my son.
<1>
R: Doctor, my child is being admitted. I’ll go to work now, please take care of him.
<2>
N: Who will stay with him?
<3>
R: Nobody, My husband has gone to
<4>
N: But your family must have a member staying in the
hospital and take care of him.
<5>
R: why? Taking care of the patients is your work.↑
<6>
N: My work only includes giving the patients medicines,
IV and etc.
<7>
R: It’s unbelievable. Then you mean I must take
care of the patient by myself?
<8>
N: Yeah.
<9>
R: But it should be your service.
案例 10:You do not provide it for me?
<1>
P: Excuse me, can you give me the towel, toothbrush and toothpaste?
<2>
D: Sorry, you should buy them by yourself. We’ll provide bedding and clothing in the ward; you must
bring your personal articles.
<3>
P: But our insurance agent will afford them. It’s your task to provide them for me.
<4>
D: Sorry, in our country, we have never done that.
<5>
P: It’s troublesome. My teeth are not good. Will you please give me soft food
and tender meat?
<6>
N: You can buy food by yourself in the first floor.
<7>
P: You do not provide it for me?
<8>
N: No. You can make your relatives buy it for you; we do nothing about your
food.
<9>
P: The clinical dietitian should advise my special
diets, it’s my right.
<10>
N: The clinical dietitian is not available here.
<11>
P: I couldn’t bear it. I couldn’t stay here anymore.
For Group 6
案例 11:Call a Catholic Father
<1>
D: Mrs. Smith, I’m sorry for telling you this, but your husband’s condition has
changed.
<2>
P: Oh, it’s- (crying)
<3>
D: Is there anything else we can help you?
<4>
P: We are Catholic. Will you please call a Catholic
Father right away?
<5>
D: Sorry, but we do not believe in God…
案例 12:I don’t eat meat on Fridays
<1>
D: In order to provide better service for you, I would like to ask you some
questions for our records, Mrs. Wood.
<2>
P: What about? What kind of questions?
<3>
D: Well, personal things (2s) such as your eating habits.
<4>
P: All right.
<5>
D: Do you have a good appetite?
<6>
P: Yes, I have.
<7>
D: What kind of food do you dislike? Please tell me if there is something (.)in
particular that you do not like or can not eat.
<8>
P: Oh, I eat everything but I prefer fish rather than meat.
<9>D:
What is your religion? Is there any food you don’t eat for religious reasons?
<10>
P: Yes, I don’t eat meat on Fridays.
<11>
D: All right, I will inform the dietitian about this.
For Group 7
案例 13:I don’t want to try the cups, please give me some medicine
<1> P: I feel painful in my lower back. My lower
back has bothered me for a long time. Is there anything you can do to relieve
my pain?
<2> D: Yes, but let me examine you first. I’ll
try acupuncture and see what happens. Are you afraid of needle?
<3> P: Acupuncture?
<4> D: “Acupuncture” is a ancient system of healing developed over
thousands of years as part of the Traditional Chinese Medical Science. It is
the insertion of very fine needles into acupuncture points just beneath the
body surface in order to influence physiological functioning of the body. Have
you got the idea?
<5> P: You mean it can use needles to cure the
disease.
<6> D: Yes. people with
pain, anxiety, sports injuries, high blood pressure, and so on can all get help
from acupuncture treatment.
<7> P: That sounds
incredible.
<8> D: Acupuncture is effective in helping
people with such conditions;
it does more than simply relieve symptoms.
<9> P: You mean acupuncture can cure people?
<10> D: It treats the
whole patient and (3s) restores the balance between the physical, emotional and
spiritual aspects of the individual.
<11> P: I can’t follow
you.
<12> D: I mean an illness is considered the
result of an imbalance of energy. It can restore the balance. I suggest you
have a try. It’s 插入
<13> P: But I think it’s awful, it may hurt my body.
<14> D: If you don’t want to receive this
therapy, I’m going to try cupping therapy. You’ll only feel a little (.) heat
but no pain. In addition, I’d like to give you some massage which may be
helpful. Then how do you feel now?
<15> P: The cup can
relieve my pain, I’m doubtful of this. Please give me some medicine.
For Group 8
案例 14:I can decide by myself
<1> D: Okay, I have already looked your check
result, and understand your illness, < now you can go back to your ward and
have a rest.>
<2> P: But why don’t you
tell me the result?
<3> D: Er (2s), please
tell your husband come to my office.
<4> P: Why?
<5> D: Er (3s)…
<6> P: You want to tell my husband my diagnosis?
↑
<7> D: Yes. I think your
task now is rest, and I will talk over your treatment plan with your husband.
<8> P: But it’s my
illness, I should know my illness conditions and my treatment. I can decide by
myself.
<9> D: er (:::) I diagnose your illness as, er
(3s) lung cancer.
案例 15:It’s my privacy
<1> D: Do you feel better today?
<2> P: I feel better.
<3> D: how about your pain?
<4> P: no pain at all.
<5> D: Okay, that’s good. If you don’t feel
anything wrong, you can leave the hospital this afternoon.(Turn to the medical
students)
<6>D: This patient came to the hospital
yesterday, he got an awful pain in his belly, feellike vomiting. He had high
temperature of
<7> P: How could you
tell my illness so detailedly to them, it’s my privacy.↑
<8> D: They are interns
in the hospital, it doesn’t matter telling them your things.
<9> P: You are wrong;
you encroach too far on my privacy. You should ask for my permission beforehand.↑
<10> D: But they are all doctors (::::)