Transcript of Recording 2 (Link to Recording 2: http://clicresearch.rice.edu/caslar-authentic-spoken-language/#medical)

Scenario for role play at Activity 5

Patient Name: Zhu Guoqing;

Age: 52; Gender: Male;

Occupation: Computer Engineer

Symptoms:

dizziness, chest tightness, lack of strength, numbness of limbs, insomnia.

Lifestyle：stays up late to work、loves spicy food、doesn’t exercise

Initial Diagnosis：

Early stage of heart disease

Doctor’s Recommendation：

Get an EKG test;

Adjust daily routines and food

Jog 3 times a week, half an hour each time.

Peer Evaluation Sheets (Evaluate both of your group members)

Pair 1 Names:

Recipiency: Very Active Pretty Active Somewhat Active Not Active

Comments:

Pair 2 Names:

Recipiency: Very Active Pretty Active Somewhat Active Not Active

Comments:

Task 1:

Video record a doctor-patient role play with a Chinese L1 speaker based on the scenario below. Make sure you play the role of the doctor.

Scenario:

Patient Liu Youyu has recently been diagnosed with lung cancer, stage III. After a thorough examination, his doctor at MD Anderson Dr Yang recommended a treatment plan that includes surgery, followed by chemotherapy. However, Liu’s relatives and friends warned him that chemo does more harm than good to him because while it does kill cancer cells, it also poisons other good parts of the body. They suggest that he stay away from chemotherapy and use traditional Chinese medicines such as herbs, combined with other Chinese traditional treatments such as diet, Qigong, etc. Now, he comes to the doctor’s office and expresses his concern.

Task 2:

A). Listen to the audio. Identify and underline the response tokens used both by the doctor and the patient in this real doctor/patient conversation. (See the underlined parts for answer key)

B) Answer the following questions regarding the use of response tokens in this conversation.

1. In line 8, how many response tokens did the patient use? Do they serve the same function? Do they have the same kind of linguistic forms? Why did the patient use them during the doctor’s speaking turn?

Answer key:

He used 6 response tokens. They serve two different functions: 1. Reactive Expressions (对、是、有); 2. Backchannels （嗯）. The patient responded so richly during the doctor’s speaking turn probably because he was so eager to let the doctor know that his symptoms were exactly like what the doctor described that he couldn’t wait until the doctor finished his turn.

1. In line 13, what type of response token is “我做过那个肠镜”? Why?

Answer key:

It is a collaborative finish, because the patient was listening to the doctor so attentively that he could predict exactly what the doctor was going to ask, which is “肠镜”

Doctor: Cindy (student)

Patient: Nancy (L1 speaker)

Worksheet 1

1. 1. A Resumptive Opener (RO)

   2. A Reactive Expression (RE)

   3. A Repetition (RP)

   4. A Collaborative Finish (CF)

The Collaborative Finishes (CF) display the most active listenership because the listener is able to predict what the speaker is about to say.

The Resumptive Openers (RO) display the least active listenership because it is no more than a sound that acknowledges the understanding. Any listener can produce a sound like an RO even when he or she is not listening at all.

Worksheet 2

1. Line #	Response Tokens	Position in relation to the previous turn 1. beginning 2. middle 3. end	Functions (types of responses: use acronyms annotated on worksheet 1)
   5,7,14,18,	哦（Oh）	1	RO
   26,30,32
   16	犯困，是吧		RP
   	(sleepy, right?)	1
   13	其它（anything		RP
   	else …）	1
   19	吃东西…		RP
   	(appetite…)	1

Discussion

1. No. Even though he used many response tokens such as resumptive openers, they all happened at the end of the patient’s speaking turn and before he took the turn to speak, which means the patient didn’t receive any acknowledgement of understanding while she was speaking. While perfectly appropriate in a conversation between two Chinese L1 speakers, in many cultures, this kind of silence on the doctor’s part may result in the patient stopping to check the doctor’s response.

2. Some of the good examples of body language are: nodding, looking into the patient’s eyes, facing the patient, or slightly leaning his/her upper body towards the patient.

3. Perhaps he did not want the patient to feel interrupted and to stop to check with him. By not saying anything to interrupt, the doctor was giving the patient the space and the freedom to speak all she felt like speaking. It is a Chinese way of showing respect and exercising politeness.

4. For the same reason explained in question 3. The doctor waited until the patient finished talking so she wouldn’t feel interrupted and has the freedom to speak.

1. Types of Responses	English	Chinese
   Backchannels	3	Ø
   reactive Expressions	2	2
   Repetitions	Ø	2
   Collaborative Finishes	Ø	2
   Resumptive Opener	1	3

Discussion

While both Chinese and English speakers acknowledge their understanding in a conversation by using reactive expressions to provide an assessment of the speech, Chinese speakers favor resumptive openers and English rely hugely on backchannels. Also, while there are few cases of repetitions or collaborative finishes in English conversations as response tokens, we see quite a few in Chinese ones.

Chinese speakers’ lack of response during the prior turn does not mean they are lack of interest or understanding. It provides the speaker with the space or freedom to speak without feeling interrupted, especially when health condition is the center of the conversation. English speaker’s active responsiveness during the prior turn does not create interruption like a Chinese speaker would perceive. Quite the opposite, it actually serves as an encouragement for the speaker to continue speaking, also without feeling interrupted.

Worksheet 3

1. Answers vary. See transcript or listen to the recording.

2. 1. 头晕目眩，消化不好，已经吐了一整天。 她以前有过同样的问题。

   2. 上次头痛，一吃药就好，可是这次吃药不起作用了，头一直晕，需要一 直躺着。这次更严重，因为上次头痛一吃药就好，而这次吃药也不行。上次虽然头痛， 但可以自己开车来（诊所），可这次却不敢。

   3. 有没有发烧？感冒？吃了什么药？耳朵是否会觉得响？上次的药，吃了没有？

   4. 因为上次去了台湾。

Worksheet 4

1. See transcript or listen to audio recording

Discussion

1. Yes. He constantly acknowledged his understanding during the patient’s speaking turn by using backchannels and reactive expressions.

2. It is exactly like the “uh huh” in an English conversation, in terms of sound, function and position. Like “uh huh”, it is a backchannel serving as a “continuer” to display interest and claim understanding on the doctor’s part.

   1. See transcript or listen to audio recording

   2. Line #	Response Tokens	Position in sentence 1.beginning 2.middle 3.end	Types/Functions
      40	对 (right)	2	RE
      33	所以, 这次比上次更严重 (So, it’s more serious than last time)	2	CF See explanation at discussion question 1 below.
      7	吐了(vomited)	2	RP
      13	没有发烧（no fever）	2	RP
      21	什么药都没吃 (didn’t take any medicine)	2	RP
      23	并没有特别
      	(nothing special)	2	RP
      48	吐得比较厉害 (vomited badly)	2	CF It is a CF, because the patient says “今天没有吐， 昨天是…” then there is a little overlapping and she is heard saying “就吐很多”。

Discussion

1. It responded to “这次我连车都不敢开…”. The doctor initiated the topic about last time and the patient answered with “yes, but”, so we can say she meant to say something like “so this time it’s more serious”. The doctor jumped in before she said it, and he finished her turn by summarizing her description of her condition.

2. They all happened in the middle of the prior turn, with overlapping observed between the two speakers. This shows that the doctor was listening so attentively that he could provide various kinds of response tokens in the right places at the right times.

3. Here, the doctor played the dual roles of a listener and an information seeker. As an information seeker/recipient, he repeated those words or sentences to confirm with the patient if he understood her correctly. This was an important action for the doctor to take as his diagnosis would rely heavily on the information he received from the patient.

1. Types of Responses	English	Chinese	Chinese American
   Backchannels	3	Ø	3
   Reactive Expressions	2	2	2
   Repetitions	Ø	2	2
   Collaborative Finishes	Ø	2	2
   Resumptive Opener	1	3	3

Discussion

1. The Chinese American doctor, because throughout the whole conversation he was heard using all kinds of response tokens that are acceptable to the patient both socially and culturally.

2. The listener’s recipient style of the Chinese American doctor comprises features of both Chinese (RO, RE, RP and CF) and English (BC and RE) practices. Here we see a case of transfer of interactional practices from one’s second language to his native language, ie, adopting BC’s in his Chinese conversations with the patient. This happened probably because the Chinese American doctor has practiced in the US for a long period time and his patient happened to be a fellow Chinese American who has lived in the US for quite some time as well.

3. This shows that the Chinese American doctor has developed a strong intercultural competence as he clearly knows how to adapt to the cultural context in a “when in Rome” style (in this case, talking to his patient, a fellow Chinese American, in his US-based office), while still able to maintain the common practices of his native Chinese language.