'Fascinomas' and 'horrendiomas': The occupational language, humor, and speech play of American physicians.

摘要

This dissertation concerns the occupational language, humor, and speech play of American doctors. It examines etymologic, thematic, and sociolinguistic patterns in the occupational speech register; how doctors playfully manipulate this register; structural patterns in biomedical humor; how this material articulates concerns normally disallowed by the profession's emphasis on the instrumental; and the manner in which generic conventions traditionalize (and thereby order) ongoing, unique experiences in a rapidly changing occupational setting.;This study is based on ethnographic fieldwork on the inpatient pediatric unit of a university hospital.;Biomedicine incorporates rigid splits between mind and body, subjective and objective in its intellectual foundations and stresses the instrumental over the expressive in its culture. However, this emphasis is not maintained in the profession's speech play and folklore. Mishler describes the alternation of the voices of biomedicine and the patient's lifeworld in doctor-patient communication. A similar process occurs in doctor-doctor discourse. This process is seen most clearly in the narrative genre of the case presentation, in which the voice of scientific biomedicine alternates with other biomedical voices which rely on humor and speech play. The former voice, in conjunction with the conventions of the genre, aids in transforming person to patient, while the latter undermines this transformation by emphasizing sociocultural concerns outside the purview of "scientific" biomedicine.;Speaking in these alternate voices, biomedical humor turns on blurred boundaries, oppositions, reversals, inversions, transformations, rule violations, broken expectations, contrarian statements, and worst possible case scenarios. It depicts a world very different than the idealized version of biomedical reality dictated by professional goals and ideology. Terminologic paradigm play, terminologic usage violations, alternating register play, and non-terminologic occupational speech play wreak havoc on the biomedical register. The voice embodied in this material draws on its own universe of meaning to become a kind of anti-language by which sentiments and ideas outside the range of the normal instrumental occupational register are expressed.