engleski

Some metaphorical and metonymic effects in health communication: from the epistemic to the metacommunicative1

Health practitioners and patients alike make ample use of figurative language, especially conceptual metaphor and metonymy, while discussing all kinds of medical conditions and treatments. Metaphors and metonymies are often said to have different functions. According to Lakoff and Johnson (1980: 36f) metaphor is “principally a way of conceiving of one thing in terms of another, and its primary function is understanding ; ” while metonymy “has primarily a referential function, that is, it allows us to use one entity to stand for another.” However, we could distinguish a number of more specific functions of both metaphor and metonymy, where they do not differ much from each other in terms of their effects. Metaphor can indeed play a significant epistemic role in bridging the knowledge gap between health practitioners and patients. I illustrate this on the example of the alternate use of two metaphors in endocrinology, specifically in talking about the endocrine system and the role of the pituitary gland, as well as on a cluster of conceptual metaphors used in transplantology. Figurative expressions can, however, also exhibit some social, i.e. metacommunicative functions. They can be used euphemistically, to cover-up some unpleasant facts, and in that case metaphor can hardly be said to make possible new insights—it actually comes quite close to metonymy in providing alternative means of referring to a phenomenon in a more or less offensive or palatable way. But even more importantly, both metaphor and metonymy can have an even more important social function in helping forge closer links between health practitioners and patients. As can be observed on the same pair of metaphors used in endocrinology, health practitioners can (consciously) modulate their metaphorization patterns in order to accommodate patients, while patients on their part can also over time adopt some non-layman metaphors. All this “metaphor sharing” shortens the distance between the two groups on the institutional ladder. A similar process can be observed in the use of various medical eponyms, where full eponymic expressions tend to characterize formal encounters, while the use of elliptical, metonymic eponyms, is indicative of informal exchanges of equals or near-equals. While metaphor and metonymy can apparently both fulfil this social function, I show in the last part of my presentation, where I return to the use of metaphor and metonymy in transplantology, specifically in preparing juvenile patients for the surgery, that the two types of figurative expressions can differ with respect to how successful they can be. Studying such patterns of the effects of figurative expressions in the interaction between health practitioners and patients is not only intrinsically interesting, but is of immense practical value as its better understanding can remove communication barriers and increase patient compliance and adherence to therapy and thus enhance the efficiency of health systems.

health communication ; language effect ; figurative language ; metaphor ; metonymy ; eponym

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