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в русском языке, с другой - трудности с выделением темы-ремы в предложении, что и является решающим в русском языке. Следующий подтип ошибки заключается в построении предложения со всеми элементами в правильной форме, но в несоответствующей позиции. Например, «У меня есть семья хорошая». Если мы переведём данную фразу на родной язык пишущего, то есть на персидский язык, то получаем: ¡¿з 4 —¿и С» [ман ханевадеи хуби дарам]. Здесь наглядно демонстрируется характерный для персидского синтаксиса твёрдый порядок слов с фиксированным местом прилагательного после существительного.
Проведённый анализ письменных работ позволил выявить частотные языковые ошибки содержания, причины возникновения которых носят комплексный характер. Это, с одной стороны, влияние родного языка на изучаемый, с другой - расхождения в семантических значениях слов русского и родного персид-
Библиографический список
ского языков, недостаточная сформированность речевых и языковых навыков. Наиболее частотные и типичные ошибки возникают в разветвлённых языковых явлениях, часто не имеющих прямых аналогов в персидском языке.
Результаты анализа, проведённого в системном порядке, показал, что ошибки содержательного характера, совершаемые студентами Ирана могут быть представлены двумя видами: ошибки лексические, которые мы подразделили на категории коммуникативно значимых и коммуникативно незначимых, и языковой интерференции - иранизмы. Работа по выявление ошибок содержания в письменной речи учащихся направлена на возможность прогнозирования появления ошибок данного характера в письменной и устной речи, осознания их причины, а также разработки рациональной системы и оптимальных форм подачи материала, нахождения действенных приёмов предупреждения и устранения ошибок.
1. Латышев Л.К. Технология перевода: учебное пособие для студ. лингв. вузов и фак. Под ред. Л.К. Латышева. 4-е изд., стер. Москва: Академия, 2008.
2. Азимов Э.Г, Щукин А.Н. (1999). Словарь методических терминов (теория и практика преподавания языков). Санкт-Петербург: Златоуст, 1999.
3. Львов М.Р Речь младших школьников и пути её развития. Москва: Просвещение, 1975.
4. Цейтлин С.Н. Речевые ошибки и их предупреждение: пособие для учителей. Москва: Просвещение, 1982.
5. Ладыженская Т.А. Методика развития речи на уроках русского языка: кн. для учителя. Москва: Просвещение, 1991.
6. Захраи С.Х., Сиями Х. Типичность лексических ошибок межъязыковой интерференции на русском языке у студентов Ирана. Приволжский научный вестник. 2016; 2 (54): 133 - 138.
References
1. Latyshev L.K. Tehnologiya perevoda: uchebnoe posobie dlya stud. lingv. vuzov i fak. Pod red. L.K. Latysheva. 4-e izd., ster. Moskva: Akademiya, 2008.
2. Azimov 'E.G., Schukin A.N. (1999). Slovar'metodicheskih terminov (teoriya ipraktika prepodavaniyayazykov). Sankt-Peterburg: Zlatoust, 1999.
3. L'vov M.R. Rech' mladshih shkol'nikov iputi ee razvitiya. Moskva: Prosveschenie, 1975.
4. Cejtlin S.N. Rechevye oshibkiiih preduprezhdenie: posobie dlya uchitelej. Moskva: Prosveschenie, 1982.
5. Ladyzhenskaya T.A. Metodika razvitiya rechi na urokah russkogo yazyka: kn. dlya uchitelya. Moskva: Prosveschenie, 1991.
6. Zahrai S.H., Siyami H. Tipichnost' leksicheskih oshibok mezh'yazykovoj interferencii na russkom yazyke u studentov Irana. Privolzhskij nauchnyj vestnik. 2016; 2 (54): 133 - 138.
Статья поступила в редакцию 22.04.19
УДК 81
Agadzhanian S.A., Cand. of Sciences (Philology), teaching assistant, Lomonosov Moscow State University (Moscow, Russia), E-mail: medicalenglish17@mail.ru
THE USE OF SPECIAL TERMS IN THE PATIENT'S SPEECH IN THE ENGLISH-LANGUAGE MEDICAL CONSULTATIONS. The article studies characteristics of the use of terms in the speech of patients. The topicality of the study is attributable, firstly, to the growing interest in the problems of medical communication and, secondly, insufficient knowledge of the specificity of patients' speech. Authentic dialogues between doctors and patients (native English speakers) are used as the research material. In general, cases of proper use of medical terms by patients can be singled out, although these cases are rare and are explained, presumably, by the high level of education of these patients. Much more often improper use of terms can be observed, in particular, a distortion of their semantic meaning, the omission of one or more words in terminological phrases, and phonetic distortion. The cases of replacing special terminology with non-terminological phrases, as well as the use of various non-verbal means are even more common. By and large, it can be assumed that the trend towards an increase in the incidence of use of special medical terms will become more and more stable as the degree of medicalization of the population grows due to the development of mass media and popular science literature.
Key words: doctor - patient communication, special terms, lay terms, terminologization, determinologization.
С.А. Агаджанян, канд. филол. наук, преп. факультета иностранных языков и регионоведения, МГУ имени М.В. Ломоносова,
каф. английского языка для естественных факультетов, г. Москва, E-mail: medicalenglish17@mail.ru
СПЕЦИАЛЬНЫЕ ТЕРМИНЫ В РЕЧИ ПАЦИЕНТА В АНГЛОЯЗЫЧНЫХ МЕДИЦИНСКИХ КОНСУЛЬТАЦИЯХ
Статья посвящена особенностям употребления терминов в речи пациентов. Актуальность исследования обусловлена, во-первых, возрастающим интересом к проблемам медицинского общения и, во-вторых, недостаточной изученностью специфики речи пациентов. В качестве материала исследования были использованы аутентичные диалоги между врачами и пациентами, носителями английского языка. В целом, можно выделить случаи правильного употребления медицинских терминов пациентами, однако эти случаи встречаются редко и объясняются, предположительно, высоким уровнем образования данных пациентов. Намного чаще наблюдается неправильное использования терминов, в частности, искажение их семантического значения, опущение одного или нескольких слов в терминологических словосочетаниях, фонетическое искажение. Ещё более распространены случаи замены специальной терминологии на нетерминологические словосочетания, а также использование различных невербальных средств. В целом, можно предположить, что тенденция к увеличению частоты использования специальных медицинских терминов будет становиться всё более устойчивой по мере того, как растёт степень медицинской просвещённости населения благодаря средствам массовой информации и научно-популярной литературе.
Ключевые слова: коммуникация «врач - пациент», специальные термины, общеупотребительные термины, терминологизация, детерминологизация.
In the recent decades, attention to the problems of medical communication has increased significantly. This is due to factors such as the high availability of medical services, the improvement of treatment methods, and the growing awareness of people about various aspects of medicine due to the development of the mass media. Medicine is a field of knowledge that constantly comes into contact with everyday life, its concepts spread very quickly in a non-professional environment. With increasing interest in the features of medical consultation, it became obvious that a correct diagnosis and medications prescribed in accordance with it do not guarantee a full recovery. The level of trust between the medical specialist and the patient has been recognized as one of the main determining factors of compliance, that is, the patient's voluntary readiness to comply with the prescriptions. Moreover, it became obvious that to under-
stand the rules of medical consultations, it is not enough to take into account only their psychological component. An important role is also played by the search for the most appropriate language means for any given situation for establishing contact as well as for the correct transmission of important data.
Several factors at a time determine the relevance of studying the features of medical terms in the speech of patients. First, in the recent decades, one can observe a gradual decline of the so-called paternalistic counseling model, in which the authority of the doctor was recognized as primary and unquestionable. This can be explained by the fact that the modern patient is more educated, informed, has a larger choice in medical services and specialists providing them. Secondly, linguists have been able to collect a lot of data about the characteristics of the language that medical specialists
use in doctor-patient communication. At the same time, it is worth mentioning that many features of patient's speech remain unexplored. Thus, in a number of works we can find a comparative analysis of medical terms from different languages [1; 2], specific features of English texts on medical subjects [3; 4], characteristics of the terminology of various fields of medicine [5; 6; 7; 8; 9; 10]. Some studies [11; 12] are devoted to the sociolinguistic analysis of English medical texts.
At the same time, a very limited number of researchers concentrate on the details of the language used by patients during medical consultations. So, in her doctoral dissertation V.V. Zhura [13] considers the dialogues of doctors and patients in both English and Russian languages through communicative approach, highlights a number of communicative characteristics typical of oral medical speech, but the focus is only on those strategies that the doctor uses. M.I. Barsukova [14] in her study also placed particular emphasis on the study of the ways of the doctor's behavior when communicating with the patient. S.I. Madzhayeva [15] in her scientific work singled out a special section in which the speech features of doctors were examined in the consultations in Russian.
In general, the study of this topic is also hindered by various obstacles in the selection of linguistic material: for ethical reasons, the dialogues between doctors and patients are confidential, and all the participants of the communication should give their consent to make the recording possible.
As for the foreign scientists who have studied doctor - patient communication, they in their works mostly refer to the specific features of interaction between an English speaking doctor and representatives of other countries and cultures [16; 17], to the situations that may cause difficulties in establishing contact between speakers [16], gender characteristics of the language of medicine [18; 19], etc. The manuals aimed at native English speakers contain a lot of information on psychological strategies and language tools that a doctor should employ, but very few facts are presented about the language used by patients. The main focus is precisely on the figure of the physician as a person who provides guidelines and instructions. In general, a large number of gaps and questions remain in the description of the features of the "patient part" of medical consultations.
To analyze the characteristics of the terminology used by English-speaking patients in the process of medical consultation, authentic English-language dialogues between doctors and patients were collected and presented in the form of scripts with a total of about 2000 printed pages. Among them, there were consultations carried out by physicians, gastroenterologists, nephrologists, cardiologists: a total of about 60 doctors and 60 patients. Most of the dialogues were recorded over the last 10-15 years. The materials were provided mainly by general practitioners living in the United States of America.
Recently, the role of the patient in the treatment as a whole and during the consultation in particular has risen significantly. Nevertheless, there are still linguistic stereotypes associated with the features of the patient's speech. A strong proof of the existence of such stereotypes is the division of the language of medicine into two categories: the "language of doctors", which includes special terminology, and the "language of patients", where, according to the existing stereotypes, only common analogs of special terms can be found. Such differentiation can be found in a number of textbooks written both for native English speakers and for those medical professionals for whom English is not native. However, taking into account such natural and constant linguistic processes as permanent interpenetration and mixing of special and non-special layers of vocabulary, the assumption that patients' terminology is simplified as much as possible and its lexical composition is homogeneous does not correspond to the reality. It also been proved through the analysis of the collected linguistic material.
In addition, currently there are quite a lot of contradictory data and judgements about the level of medical education of patients. On the one hand, the medical sphere and various information related to it has long ceased to be closed to non-specialists with the emergence of popular science medical literature, radio and television programs on medical topics, etc. On the other hand, theoretical works of foreign researcher often report a low level of medical literacy.
It seems that in the context of the existence of such conflicting points of view and data, it makes sense to describe specific trends singled out on the basis of a study of patients' replicas. In the course of the analysis, it became possible to classify both the cases of the use of medical terms and a number of ways to replace special terms with lay terms and phrases on the part of patients.
During the consultation, patients use far less medical terms than doctors. The analysis showed that the special terms in the speech of doctors and patients are only about 15% of all the medical terms found in dialogues. It is also important to note that the quantitative distribution of special terms in the speech of various patients is uneven: in the speech of a limited number of patients almost all cases of the use of medical terminology are found, whereas other patients are more likely to resort to different ways of replacing terminological units. There errors in the use of terms are quite frequent: patients distort them either phonetically or semantically. All these data allowed us to propose the following classification of the use of medical terms in patient's speech:
1) Proper use of special terminology
The use of the term is proper, firstly, when it is pronounced correctly (since the scripts are based on audio recordings, the words that are mispronounced are specially marked), secondly, when they are used correctly in context (preserving the lexical
meaning, with the correct lexical and grammatical collocations). The following excerpt demonstrates proper use of terminology on the part of the patient:
(1) - ...several changes of blood in a 3 and 4 hours period....., from what I've
read, I understand there is some damage to the red corpuscles. My platelets and red corpuscles really aren't... the way they should be anyway...
- Were you having trouble with your blood count since the surgery?
- Yes...First and only, so far, was two Sundays ago...no, last Sunday. I, uh, had my first case of peritonitis...I've gone through literature and looked at things about kidneys and stuff...
In the patient's speech a proper and free use of such medical terms as red corpuscles, platelets, peritonitis can be observed. This case seems interesting not only because of correct presentation of speech, rich in terms, on the part of the patient, but also because of the demonstration of correct perception, understanding of terminology. So, the patient in his last remark in response to a question from a doctor, where the latter used the term blood count, shows an understanding of both the term and the question as a whole. In this passage, the proper use of medical terms can be attributed to a noticeable influence of an extra-linguistic factor, such as the high level of education and general knowledge of the patient (from what I read, I have gone through the literature).
2) Improper use of special terminology
The cases when the patient uses medical terms incorrectly can be found much more frequently. Depending on the nature of these inaccuracies, we can suggest the following classification of the misuse of medical terms by patients:
a) Distortion of the semantic meaning of special terms.
Most often, in various contexts, patients confuse medical terms that are similar in meaning, refer to the same disease or area of medicine:
(2) - Is it [Turner's syndrome] hereditary?
- No...What do you mean by hereditary?
- From birth.
- Then yes.
In the example given above, the patient asks whether Turner syndrome (a chromosomal disease that is accompanied by abnormalities in physical development, short stature, sexual infantilism) is congenital, using the term hereditary. The doctor asks a follow-up question to find out if the patient understands the term. Thus, the patient is replacing the term congenital with the term hereditary which is similar in the meaning.
b) Omission of one or several words in terminological phrases
For example, quite often the term blood pressure is reduced to pressure, the term exercise tolerance test to exercise test.
c) Phonetic distortion of medical terms by patients.
It is well known that most of the medical terms have a Greek or Latin origin, as well as a structure that is difficult to memorize and pronounce. In this regard, patients often distort the terms from a phonetic point of view, thereby showing a lack of knowledge of the terminology of various medical terminological systems:
(3) - When I was 30, I had that...[paienefritis]
- Pyelonephritis?
This excerpt suggests that the patient has already heard the term pyelonephritis, but pronounces it incorrectly, partially reducing it. The resulting nonce word is phonetically similar to the original term, which allows the doctor to guess what the patient has in mind and thus avoid misunderstanding.
In all the examples discussed above, patients showed various degrees of proficiency in medical terminology. The results of the analysis confirm that in medical communication in most cases patients try to avoid the use of special terms either because of not being sure in their meaning or because of not knowing them. The replacement of medical terms with lay words or expressions are very common in this regard.
The following examples illustrate the above mentioned phenomenon:
(4) - When I was 33, I spent 3 weeks in the hospital because I had...water in the lungs...
- Ah, edema.
(5) - Your grandparents, probably they had some history of cancer, coronary heart disease...
- My grandfather, he died of high pressure, brain problem...I don't know how to say that...
- A stroke?
- Yes, yes.
In the first dialogue, the patient uses a non-terminological phrase water in the lungs instead of the term edema. Interestingly, this phrase is transformed into a term in the speech of the doctor. Thus, it can be concluded that in some cases, the doctor's speech is characterized not only by the tendency to use special terms with their further explication through commonly used words, but also by "translating" the patient's simplified speech into the terminological language of medicine. Perhaps these two opposing tendencies of terminologization and determinologization in the doctor's speech are aimed at, on the one hand, making the information as comprehensible to the patient as possible, but on the other hand, maintaining their own professional authority.
The first dialogue illustrates the simultaneous use of distorted terms by the patient: the patient describes not the disease itself, but its symptom with the help of the phrase high pressure, while distorting it (the correct term is high blood pressure). In the second example, since the patient does not know the term stroke, he uses the phrase brain problem in his speech, which, in fact, is a hyperonym for a number of
