METODOLOGÍA 1 Participantes:

A number of contextual factors manifested in the interactions. Contextual factors such as setting, religion, linguistic background, power and social distance, and culture were examined and discussed. The study examined the effect of the status of the interlocutors,

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location, language choice, religious belief and health practices of the interlocutors on the interactions.

The face-threatening acts analyses in 4.3 and 5.3 manifested an interplay of power and social distance as the doctors exclusively employed face-threatening acts with redress (positive politeness) and face-threatening acts without redress through the deployment of declaratives, interrogatives and imperatives involving frank talk, courteous expressions, direct and indirect expressions. The purpose was to upbraid the patients over some harmful health practices, enlighten them, emphasize the importance of certain medical procedures or make them cooperate fully with the doctors to make accurate diagnoses.

The discourse device was also deployed to make them comply with treatment as a result of the doctors‟ position as +higher role occupants. The patients did not use any of the face-threatening acts as any attempt to do so would have been felicitously inappropriate, given their position as non-medical practitioners (–higher role occupants).

The religions of the interlocutors (Christianity and Islam) also played significant roles in the interactions as they somehow influenced some of their actions as evident in 4.16 and 5.2.7. The following extracts were considered:

Extract 98 (104) (Interaction 14) Doc.: Do you feel abdomin- stomach pain.

Pt.: Yes. During Ramadan fast.

Doc.: Is it a mild stomach ache?

Pt.: No. It‟s always very painful.

Doc.: And you don‟t break the fast.

Pt.: No. Ramadan fast is a must for every true muslim.

Doc.: Madam, as a fellow muslim, I know The Quran exempts the sick from fasting. So, it is not right to fast when you are sick, when affects your health negatively like you explained. God knows more than we do about everything

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concerning us, even our health. It is allowed in the Quran to provide food for those fasting if your health does not permit you to fast.

Pt.: I didn‟t know this before. Thank you.

Extract 99 (105) (Interaction 38)

Doc.: Mr. Nzeribe, do you think it‟s a sin to have told me you are fasting? Tell me your faith so that I should know how to counsel you appropriately.

Pt.: You know it is not right to fast and go about telling people.

Doc.: See, we have the same faith. I am also a Christian. When Jesus was teaching us about fasting, he said we should not let our fasting be like that of the Pharisees who will put ash on their heads and wear poor clothing, and then they would wear a long face that people might know they are fasting. You understand?

Pt.: Yes.

Doc.: You have not done that. The reason why you have told me you are fasting is because of your drugs. Is it not? It has not even shown on your face that you are fasting. So, it is not known to others except to me. And some people say doctors are next to God, I don‟t know about that. But I know we are working together. God is the one that heals but doctors try to take care of patients. How can I take care of you appropriately if I don‟t know the current situation that you are in? Now that you have told you are fasting, it has not stopped your fasting.

You have not told me so that I should hail you, saying –this is a spiritual giant.

You have not told me so that I would feel condemned or that you are a good Christian. No. The purpose of telling me is that I will be able to intervene in how you will be able to comply with your drugs so that you will not compromise your faith.

The extracts above revealed that Christianity and Islam practised by the patients made them engage in certain practices that were detrimental to their heath, but the doctors who were also adherents of the religions used their knowledge of the concerned religions to

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guide the patients aright and educate them appropriately in areas where some misconceptions about their faiths impacted negatively on their health. Therefore, the religious backgrounds of the interlocutors aided the discourse as they enabled them to resolve certain challenges posed by religion in relation to the patients‟ health.

The culture of the interlocutors also manifested in the interactions as they employed both their indigenous languages (Yoruba and Pidgin English) in addition to English in the interactions. The following extracts were considered.

Extract 100 (106) (Interaction 1) Doc.: Good morning, madam.

Pt.: Good morning.

Doc.: What are your complaints?

Pt.: Some years back, I had holes in some of my teeth, may be like three or four and they were filled and since then I have not been coming except when I come for scaling and polishing but of recent I realized that when I take cold water or sweet things, I started feeling some kind of mild pain. So, I started thinking may be the teeth that were filled have started giving way again. That‟s my complaint.

Extract 101 (107) (Interaction 31)

Doctor: Kin l‟oruko nyin? [What is your name?]

Patient: Adijatu Olamide.

Doctor: Se e ti se ifunpa? [Have you done blood pressure test?]

Patient: Beeni. [Yes.]

Doctor: Kin lo n se nyin? [What complaints do you have?]

Patient: Mo kan waa mo boya nnkankan ko se mi ni. [I only came to know whether I am medically fit now.]

Extract 102 (108) (Interaction 34)

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Doc.: Where did you get it? Did you buy it off the counter?

Pt.: Yes

Doc.: Those two weeks when it started, what were you doing?

Pt.: Nothing.

Doc.: Mo mean pe nigba to bere, kin le se? Se laaro ni, l‟osan ni abi ale? [I mean what did you do when it started? Did it happen in the morning or afternoon?]

Pt.: Mi o take note. Mi o kan saa mo. [ I didn‟t take note. I just don‟t know.) Doc.: Okay time wo le notice? [Okay. What time did you notice it?]

Pt.: Two weeks ago.

Doc.: Kin le n se lowo? [What do you for a living now?]

Pt.: I am a civil servant.

A close look at the extracts above revealed the linguistic choices made by the interlocutors during the consultations. Depending on the status, area of language competence, level of education and preference of the interlocutors, English Language, Pidgin English and Yoruba Language were used during the consultations. The codes were also switched intrasententially and intersententially. In addition, the clinical interviews took place in hospitals, which can be categorized as a formal setting. Thus, English Language was employed in most of the interactions.

The culture of the interlocutors also reflected in the interactions. In Nigeria (the location of this study), as in other African nations, salutation is expected at the beginning and end of every conversation. The doctors, patients and patients‟ relatives demonstrated awareness of this cultural incidence as they exchanged greetings at the beginning and end of every conversation. The following extracts were considered:

Extract 103 (109) (Interaction 6) Doc.: Good afternoon.

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Pt.: Afternoon, ma.

Extract 104 (110) (Interaction 19)

Pt..: E see. [Thank you.] O dabo. {Bye bye.]

Doc.: O dabo. [Bye bye].

Extract 105 (111) (Interaction 29) Doc.: E kaasan. [Good afternoon.]

Pt.: Yes, sir.

Extract 106 (112) (Interaction 35) Doc.: Bye bye.

Pt.: Bye bye.

A perusal of the extracts above revealed that the interactions were opened and closed with greetings. In Extracts 103 and 105, the doctors opened the discourses with salutations, while Extracts 104 and 106 were also concluded with salutations. This therefore showed that the interlocutors observed this cultural ethic.

Extract 107 (113) (Interaction 27) Doc.: Razak Bimbo.

Pt.: Ma.

Doc.: E pele. [Sorry.] Bawo lara yin? [How do you feel?] Se alaafia ni? [Are you alright?]

Pt.: Daadaa ni. [Fine.]

The expression „Sorry‟ is culture-bound. As Nigerian English, it has taken on another meaning which is different from the meaning it has in places like USA and England.There, it is used to appease someone that has been affected by one‟s action.

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However, it was used in the interactions under study in situations where the users had not caused the hearer any harm but only intends to show sympathy for and avowal of the patient‟s health challenges. In effect, the deployment of the rapport expression enabled the doctors to demonstrate empathy, sympathy and emotion to the patients, thus engendering cordiality with the patients for the medical objective of eliciting all the needed information to proffer appropriate solutions to the patients‟ medical challenges.