Van De Mieroop, D. (2012) The quotative “he/she says” in interpreted doctor-patient interaction

Van De Mieroop, D. (2012) The quotative “he/she says” in interpreted doctor-patient interaction. Interpreting 14:1.

This study looks at data from 4 interpreted medical encounters (Dutch/Russian; Dutch was the providers’ native language, while not all the Russian speakers were native speakers), all interpreted by the same interpreter.  The author discusses the fact that third person (“he says/she says”) interpreting is frequently attested in the literature and in her data, despite scholarly consensus in re the use of the first person in dialogue interpreting, as well as the injunction to use first person in the Flemish government’s Code of Ethics for interpreters.  She points out that use of the third person has been found to serve as a distancing strategy or to mark changes in footing in other settings (such as media interpretation), and seeks to determine what function(s) it serves in medical discourse.  Referencing Goffman’s (1981) notion of participation frameworks, she highlights the interpreter’s dual role as listener (within the provider’s framework) and speaker (within the patient’s framework).

In describing the interpreter whose work is the subject of the study, the author says that the interpreter works full-time as a healthcare interpreter, and that she “had not been professionally trained as an interpreter but, having taken several courses in community interpreting, could be regarded as a semi-professional interpreter.”  The author goes on to point out that, in comparison with other studies of ad-hoc interpreters, this interpreter seems to have attained a greater level of competence.  I appreciate the author’s detailed description of the subject’s training and experience, given that the data must be interpreted in light of this information.

It’s interesting to note that the author discusses interpreters’ reframing of others’ speech–which is to say, the provider often addresses the interpreter, or speaks in the third person, which speech is then recast into the first person by the interpreter.  In my experience, this is a fairly common practice (I plead guilty to it…); the author explores the implications of this kind of reframing. She finds that the providers in her data are more likely to address their remarks to the interpreter (ie in third person) than the patients; she also finds that the providers tend to switch back and forth between 1st and 3rd person frequently and unexpectedly.

The author’s main focus is the interpreter’s use of “he says/she says” in the data, which is analyzed at length, with many examples.  In summary, the author finds that “he/she says” has the following functions in interpretations of the doctor’s turns:

“1. an interaction-related function which

a. facilitates the switch in participation frameworks and the segmentation of

information;

b. accounts for the interpreter’s extensive floor-holding rights when she is

translating a long discourse unit;

2. a content-related function in which distance is created between the interpreter

and the words she is interpreting. By explicitly stressing that she is merely

animating the words, she effectively absolves herself of the responsibility for

the content and indicates that the responsibility lies with the doctor. These

quotatives occur in face-threatening situations, such as delivering bad news,

providing information that does not conform with the ‘voice of medicine’, giving

dispreferred responses, or refuting the patients’ words.” (p. 110-111)

And in interpreting the patient’s turns:

“1. a content-related function in which distance is created between the interpreter

and the topics initiated by the patient, thus emphasizing the animator/reporter

role of the interpreter as a mere ‘sounding box’ (Goffman 1979) of the words,

which may be related to:

a. the interpreter’s anticipation of the following dispreferred response by the

doctor;

b. the interpreter’s confirmation of the doctor’s dominant conversational position;

2. a disambiguating function aimed at identifying the principal of the words, and

the status of a translation as:

a. a literal translation of a patient’s lack of knowledge;

b. an additional, more detailed rendering of a previous monolingual interaction.” (p. 111)

In the conclusion, the author notes that the interactions studied did not contain long segments of discourse (“discourse units”) produced by patients–in general, medical interactions (and these interactions in particular) are not characterized by long stretches of patient-produced discourse–the doctor is generally the person who speaks longer, and with authority.  The author notes that the distancing technique of using third person is applied differently for each party’s turns. The interpreter tended to use the third person to distance herself from bad news being given by the doctor (but in doing so, did not maintain the doctor’s discourse strategies for softening bad news). The distancing strategy was employed in interpreting patients’ turns was found to be related to the doctor-patient power asymmetry–that is, interpreters used “he/she says” in interpreting the patient’s attempts to introduce a new topic, or to ask a question that was perceived likely to receive a less-than-favorable response from the provider.

The author concludes that “he/she says” can be used as a meaningless marker to indicate change of participation framework (for example, from listener to speaker), to clarify that the words spoken are a translation, or to distance the interpreter from the content of the message.

The author recognizes that the data set was limited, and therefore general conclusions cannot be drawn from it. She does note that other studies have reported similar findings.

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