Genre of Going to the Doctor

“Going to the Doctor” is a common lesson theme in EFL textbooks. They tend, however, to have either a grammatical focus, e.g. practising ‘should’, or a vocabulary focus, illness vocabulary. Usually, of course, it is a combination of the two. However, the genre of the Doctor Consultation varies greatly from culture to culture and these differences and the genre expectations that are involved in visiting the doctor are not generally treated much in textbooks.

Even before the consultation, there are differing cultural expectations of where and when to seek help. Japan, for example, does not have the equivalent of a General Practitioner or family doctor. Every doctor specializes in a particular area, like internal medicine, or ear/nose & throat. So rather than visiting a G.P. who then refers you to a specialist, you effectively diagnose yourself and then go to the appropriate specialist. It is also much more common to go straight to the hospital, even for a cold. In England, on the other hand, you are required to register with a local practice and would be turned away from a hospital without a referral. It would be important, therefore, to explain the wider medical system in which the consultation takes place, something that textbooks rarely if ever take into account.

The basic genre stages of a medical consultation, as usually presented in textbooks, could be summarized as:

1. opening
2. complaint
3. examination or test
4. diagnosis
5. treatment or advice
6. closing

(http://www.paultenhave.nl/genre.htm)

Yet this has always felt somewhat too perfunctory. So based on the British Corpus it could in fact be extended to include:

• GREETING
• EXPLAIN PROBLEM (GENERAL)
• EXPLAIN SYMPTOMS (DETAILS)
• PAST HISTORY
• PLEA FOR HELP/ESTABLISH AUTHORITY
• EXAMINATION
• DIAGNOSIS (GENERAL)
• DIAGNOSIS (EXPLANATION)
• ADVICE/RECOMMENDATION
• JUSTIFICATION FOR RECOMMENDATION
• CONFIRMATION
• TREATMENT PROCEDURE
• WARNINGS
• RECONFIRM/REASSURANCE
• WRITE PRESCRIPTION
• CLOSE

Here is a Powerpoint (GOING TO THE DOCTOR’S) I use to demonstrate the differences between the stages.

 

Generic Structure Potential (GSP)

When you go to buy something in a convenience store you can be reasonably certain of what’s going to happen in that situation. First, you’ll walk in and you might say ‘hello’. Then you’ll ask for some batteries and then pay. We can guess this sequence due to our previous experience with these kinds of situations and the fact that they are nearly always the same. Some parts may change (you might not say hello) but you always have to pay.

Within certain recurring sets of texts then, coherence of structure is formed through obligatory and optional elements, the totality of which forms the Generic Structure Potential (GSP) (Halliday & Hasan, 1985) for that set. For example, the GSP for ‘service encounters‘, is:

In other words, there are certain obligatory elements that characterize the genre, in this case the ‘Sale’, ‘Purchase’ and ‘Purchase Closure’, and other optional ones that add elaboration but are not necessary. There is thus a ‘structure’ to social interactions. We can call it ‘Potential’ because it has a predictive quality that allows us to navigate these social situations almost unconsciously.

Genre of cooking classes

Further to my last post on recipes, I’d also highly recommend an interesting read on similar differences between American and Japanese cooking classes in:

Mayes, P., 2003, Language, Social Structure, and Culture: A Genre Analysis of Cooking Classes in Japan and America, John Benjamins

As she states: “…in the Japanese classes, the teacher was expert and the students were relative novices [and] would focus on task-oriented content and on giving precise procedural instructions. On the other hand, though the American teachers might be considered experts relative to the students, there was less focus on this professional relationship and more on creating a friendly relationship” (pp. 14-15). The Japanese classes were serious and focussed on ‘following the rules’ whereas the American classes were characterised by a relaxed individualism and creating original recipes.

I have noticed, however, a slight shift in Japanese cooking classes that I’ve noticed on TV. Traditionally, cooking in Japan was a female domain (ALL of the Japanese participants in the study above were women while the Americans were a roughly equal mix of men and women). Recently, more cooking shows featuring male celebrity non-professional hosts. These are decidedly more slap-dash affairs and often don’t even feature measurements at all (and lots of salt in one case). I do wonder if this in some way reflects on-going social changes occurring in Japan due to the ways in which economic pressures over the last twenty years have affected the traditional (conservative) boundaries between male and female domains and also those between older generations (full-time stable ‘job-for-life’) and younger ones (part-time non-stable careers).

 

Hemmingway, genre and metaphor

In the 1920’s, Hemingway was bet that he could write a story using only six words and came up with the famous:

For sale:
Baby shoes.
Never worn.

The story works on many different levels, with the pathos of the image contrasted brilliantly with the banality of the language. Beyond that, however, it got me thinking about just how it manages to achieve this.

On the surface, it appears to belong to a genre of ‘For Sale’ classifieds as might be found in a newspaper or, these days, on Craigslist type websites. A closer look at this genre, however, shows that it is missing a number of features. There is no price or contact name/number. There is also no listed size or colour for the shoes. You could say that this is just because of the nature of the bet, only to use six words, and so these features were omitted. That, I think however, is the important point here: The text only looks like a ‘For Sale’ genre but in fact functions as a story genre. If it were actually posted in the classifieds it would fail as a text but it succeeds as a story.

I wonder, then, if there isn’t a generic metaphor, similar to grammatical metaphor, where a text takes on the surface features of one kind of genre but, in fact, functions as something different?

Daily Routines as a genre

We often use ‘Daily Routines’ lessons to introduce or practise the simple present. Recently, however, I’ve tried looking from a genre perspective and asking what, exactly, is the purpose of these kinds of text. Who, also, is the audience? They are, I think, a kind of report genre with evaluative lexis. You can find these kinds of texts in, for example, city guides for expats (“What’s it like living in …?”). A good site is matadornetwork which has a whole series of “A day in the life of an expat in…” texts. They’re great for higher level students. Another idea is university career guides that often have overviews of different kinds of jobs and what they involve.

For lower or beginner level students I’ve found the genre approach particularly useful in enabling the students to think about the purpose of their writing. A simple GSP for a report is a General Opening followed by a Sequence of Related Statements. To adapt this for a Daily Routines text I tell the students they are writing a letter to a foreign pen-pal, explaining their daily life. The opening then establishes the evaluative mood (I am busy everyday) while the sequence expands on and explains the opening (I get up really early at 6am and rush around getting ready for work). We also group the sequence (into morning, afternoon, evening, etc) and show how changes in Theme can highlight the change from one group to the next.