Glossing controversy: the role of facework in navigating trauma

Against the backdrop of an established literature on medical professional/patient relationships and intercultural health consultations, this presentation explores communicative practices in a superdiverse hospital setting. The individual repertoires of both staff and patients can be seen to index diverse biographies and migration trajectories and there appears to be a willingness to employ a range of linguistic and multimodal resources to ensure mutual understanding. Nevertheless, it becomes apparent that, on occasion, dynamic populations can present the conditions for unpredictable encounters which may challenge interactive norms. 

This session documents an antenatal consultation with a woman who is a victim of trafficking and examines the contrasting communicative strategies employed by her interpreter and consultant gynaecologist, who seem to conceptualise patient experience through the frames of lifeworld and the biomedical respectively. As they explore and elucidate the series of events that have preceded the patient's visit, and which may have a material effect on her current pregnancy, linguistic, cultural and ethnic differences are alternately introduced and then marginalised, as the professionals work to piece together medical history. Although traumatic incidents take a back seat to the practical goals of achieving positive health outcomes for mother and child they must be tackled, and a consistent, close attention to the patient's face needs, particularly by the community interpreter, is striking. As such, this observation offers the opportunity to reflect on some of the unsettling realities of 21^st century migration and consequences for contemporary healthcare interaction: this may prove useful in medical training.