This paper presents initial findings from a large-scale study of over thirty clinical interviews recorded in hospitals in St. Petersburg and Moscow. Results from the fieldwork, undertaken in summer 1997, include audio-recorded and transcribed data sets and extensive observational notes. In the current paper I focus on one doctor's interviews with three successive patients in order to identify several patterns of cohesion which I conclude to be language- and culture-specific to the setting of contemporary Russian medical discourse.
The framework for analysis is drawn, in part, from recent theories
on the social construction of text as viewed through referential
knowledge sets and cohesion in Russian (Yokoyama 1986, 1999, and
Zaitseva 1999) and in Hebrew (Fine 1994). I identify the
contextually- and culturally-bound shared knowledge sets (the
so-called Master Interview Rating Scale
of the US Society of
Teachers of Family Medicine (1997) to provide important cross-cultural
analyses of these professional discourse models.
A comprehensive review of US doctor-patient discourse (Ong et
al. 1995) indicates that previous traditions of
paternalistic
interviews, with doctor-dominated
behaviors, have yielded to more patient-centered
approaches with enhanced affective linguistic strategies prescribed
for the doctor. However, no empirical studies to date have been
undertaken in Russia to investigate this professional
discourse. Despite this absence of information on Russian discourse
practices, there have been many US-funded medical initiatives in
Russia to establish private clinics and provide US-based training to
Russian personnel. However, the measures of success remain
mixed. Attempts to transfer the US interview models
to
the Russian setting, for example, present significant challenges
beyond that of accurate translation alone.
My hypotheses posit the primacy of the women's speech
) and gender of the patient, shared
belief in folk medicine, shared concern about the difficulty obtaining
prescription drugs, and mutual expectations for patients'
contributions, including self-diagnoses. Against the background of
this Russian experience,
the interviews comprise a
series of