This analysis integrates Arthur Frank’s timeless revelations about woundedness within the communication context of an oncology interview. A Patient whose life is threatened by recurrent metastatic breast cancer claims personal knowledge and visibly demonstrates impacts from illness experiences. Conversation Analysis (CA) was conducted on a video recorded and transcribed case study involving a Patient, her husband, and co-present oncologists. By focusing on narratives as talk-in-interaction, grounded exemplars are provided of primary interactional achievements: How woundedness gets displayed and responded to with empathy and compassionate witnessing; Patient’s flooding out with emotion and potential embarrassment; attempting to regain control and resume talking about her condition; and the serial organization of crying and laughter when managing noticeably delicate moments. In this interview, woundedness is not discounted or dismissed but recognized as legitimate suffering meriting shared commiseration. Understanding how to enact humane and communicatively competent skills during emotionally uncertain moments can enhance medical education.
ArmanM.RehnsfeldtA. (2003). The hidden suffering among breast cancer patients: A qualitative metasynthesis. Qualitative Health Research, 13(4), 510–527. https://doi.org/10.1177/1049732302250721
2.
AtkinsonJ. M.HeritageJ. (Eds.). (1984). Structures of social action: Studies in conversation analysis. Cambridge University Press.
3.
BalintM. (1957). The doctor, his patient and the illness. Pitman.
4.
BeachW. A. (2009). A natural history of family cancer: Interactional resources for managing illness. Hampton Press, Inc.
5.
BeachW.A. (Ed.) (2013a). Handbook of patient-provider interactions: Raising and responding to concerns about life, illness, and disease. Hampton Press, Inc.
6.
BeachW. A. (2013b). Patients’ efforts to justify wellness in a comprehensive cancer clinic. Journal of Health Communication, 28(6), 577–591. https://doi.org/10.1080/10410236.2012.704544
7.
BeachW. A. (2014). Managing hopeful moments: Initiating and responding to delicate concerns about illness and health. In HamiltonH. E.ChouW. S. (Eds.), Handbook of language and health communication (pp. 459–476). Routledge.
8.
BeachW. A. (2015). Doctor-patient interaction. In TracyK. (Ed.), Encyclopedia of language and social interaction (pp. 476–493). John Wiley & Sons, Inc. https://doi.org/10.1002/9781118611463
BeachW. A. (in press). Cancer: Fears and recurrence. In HoE.BylandC. (Eds.), ICA international encyclopedia of health communication. Oxford University Press.
11.
BeachW. A.DozierD. (2015). Fears, uncertainties, and hopes: Patient-initiated actions and doctors’ responses during oncology interviews. Journal of Health Communication, 20(11), 1243–1254. https://doi.org/10.1080/10810730.2015.1018644
12.
BeachW. A.EasterD. E.GoodJ. S.PigeronE. (2004). Disclosing and responding to cancer “fears” during oncology interviews. Social Science & Medicine, 60(1), 893–910. https://doi.org/10.1016/j.socscimed.2004.06.031
13.
BeachW. A.GutzmerK.ChapmanC. (2017). Conversation analysis and medicine. In NussbaumJ.RobinsonJ. R. (Eds.), Oxford research encyclopedia on communication. Oxford University Press, Inc. https://doi.org/10.1093/acrefore/9780190228613.013.137
14.
BeachW. A.PricketE. (2017). Laughter, humor, & cancer: Delicate moments and poignant interactional circumstances. Journal of Health Communication, 32(7), 791–802. https://doi.org/10.1080/10410236.2016.1172291
CasanovaF.KnaulF. M.RodriguezN. M. (2021). Harvesting health knowledge: Breast cancer perceptions in the south Florida Latinx farmworker community. Qualitative Health Research, 31(8), 1423–1436. https://doi.org/10.1177/10497323211003542
17.
ClaymanS. E. (1992). Footing in the achievement of neutrality: The case of news interview discourse. In DrewP.HeritageJ. (Eds.), Talk at work: Interaction in institutional settings (163-198). Cambridge University Press.
18.
DrewP.HeritageJ. (Eds.). (1992). Talk at work: Interactions in institutional settings. Cambridge University Press.
19.
EliottJ.OlverI. (2002).The discursive properties of “hope”: A qualitative analysis of cancer patients' speech. Qualitative Health Research, 12(2), 173–193. https://doi.org/10.1177/104973230201200204.
20.
FisherC. L.MaloneyE.GlogowskiE.HurleyL.EdgersonS.LictenthalW. G.KissaneD.BylandC. (2014) Talking about familial breast cancer risk: Topics and strategies to enhance mother–daughter interactions. Qualitative Health Research, 24(4), 517–535. https://doi.org/10.1177/1049732314524638
21.
FordJ.HepburnA.ParryR. (2019). What do displays of empathy do in palliative care consultations?Discourse Studies21(1), 22–37. https://doi.org/10.1177%2F1461445618814030
22.
FrankA. (1995). The wounded storyteller: Body, illness, and ethics. The University of Chicago Press.
23.
FrankA. (2002). At the will of the body: Reflections on illness. Houghton Mifflin Company.
24.
FrankelR. M.BeckmanH. B. (1988). The pause that refreshes. Hospital Practice, (Office ed.). 71(9A), 62–67. PMID: 3138269.
25.
GarfinkelH. (1967). Studies in ethnomethodology. Prentice Hall.
26.
GlennP. (2003). Laughter in interaction. Cambridge University Press.
27.
GodfreyM.PriceS.LongA. (2018). Unveiling the maelstrom of the early breast cancer trajectory. Qualitative Health Research, 28(4, 572–586. https://doi.org/10.1177/1049732317746378
28.
GoffmanE. (1956). Embarrassment and social organization. American Journal of Sociology, 62(3), 264–274. https://doi.org/10.1086/222003
29.
GoffmanE. (1961). Encounters. Bobbs-Merrill.
30.
GoffmanE. (1963). Stigma: Notes on the management of spoiled identity. Prentice Hall.
31.
GoffmanE. (1967). Interaction ritual: Essays on face-to-face behavior. Anchor Books.
32.
GoffmanE. (1981). Footing. In Forms of talk (pp. 124–159). University of Pennsylvania Press.
GoodwinC. (2015). Narrative as talk-in-interaction. In de FinaA.GeorgakopoulouA. (Eds.), Handbook of narrative analysis (pp. 197–221). Wiley-Blackwell
36.
GoodwinM.CekaiteA.GoodwinC. (2012). Emotion as stance. In SorjonenM. L.PeräkyläA. (Eds.), Emotion in interaction (pp. 16–41). Oxford University Press.
37.
GoodwinM. H.GoodwinC. (2013). Nurturing. In OchsE.Kremer-SadlikT. (Eds.), Fast forward family: Home, work and relationships in middle class America. (pp. 151–173). University of California Press.
38.
HaakanaM. (2001). Laughter as a patient’s resource: Dealing with delicate aspects of medical interaction. Text, 21(1–2), 187–220. http://doi.org/10.1515/text.1.21.1-2.187
39.
HaakanaM. (2002). Laughter in medical interaction: From quantification to analysis, and back. Journal of Sociolinguistics, 6(2), 207–235. https://doi.org/10.1111/1467-9481.00185
40.
HeathC. (1988). Embarrassment and interactional organization. In DrewP.WoottonA. (Eds.), Erving Goffman: Exploring the interaction order (136–160). Northeastern University Press.
41.
HepburnA. (2004). Crying: Notes on description, transcription, and interaction. Research on Language and Social Interaction, 37(3), 251–290. https://doi.org/10.1207/s15327973rlsi3703_1
42.
HepburnA.GoldenG. (2017). Transcribing for social research. Sage.
43.
HeritageJ. (1984). A change-of-state token and aspects of its sequential placement. In AtkinsonJ. M.HeritageJ. (Eds.), Structures of social action: Studies in conversation analysis (229–345). Cambridge University Press.
44.
HeritageJ. (2005). Revisiting authority in physician-patient interaction. In DuchanJ. F.KovarskyD. (Eds.), Diagnosis as cultural practice (pp. 83–102). Mouton De Gruyter.
45.
HeritageJ. (2012a). The epistemic engine: Sequence organization and territories of knowledge. Research on Language and Social Interaction, 45, 25–50.
46.
HeritageJ. (2012b). Epistemics in action: Action formation and territories of knowledge. Research on Language and Social Interaction, 45, 1–25.
47.
HeritageJ.MaynardD. W. (Eds.) (2006). Communication in medical care: Interactions between primary care physicians and patients. Cambridge University Press.
JeffersonG. (1972). Side sequences. In SudnowD. N. (Ed.), Studies in social interaction (pp. 294–338). Free Press.
50.
JeffersonG. (1979). A technique for inviting laughter and its subsequent acceptance declination. In PsathasG. (Ed.), Everyday language: Studies in ethnomethodology (pp. 79–96). Irvington Publishers.
51.
JeffersonG. (1984). On the organization of laughter in talk about troubles. In AtkinsonJ. M.HeritageJ. (Eds.), Structures of social action: Studies in conversation analysis (pp. 347–369). Cambridge University Press.
LernerG. (1989). Notes on overlap management in conversation: The case of delayed completion. Western Journal of Speech Communication, 53, 167–177.
57.
LernerG. (2004). Collaborative turn sequences. In LernerG. (Ed.), Conversation analysis: Studies from the first generation (225-256). John Benjamins Co.
58.
MaynardD. W. (1996). On “realization” in everyday life: The forecasting of bad news as a social relation. American Sociological Review, 61(1), 109–131. https://doi.org/10.2307/2096409
59.
MaynardD. W. (2003). Good news, bad news: Conversational order in everyday talk and clinical settings. The University of Chicago Press.
60.
MaynardD. W.FrankelR. M. (2006). On diagnostic rationality: Bad news, good news, and the symptom residue. In HeritageJ.MaynardD. W. (Eds.), Communication in medical care: Interactions between primary care physicians and patients (248-278). Cambridge University Press.
PeräkyläA. (1995). AIDS counselling: Institutional interaction and clinical practice. Cambridge University Press.
65.
PeräkyläA. (1998). Authority and accountability: The delivery of diagnosis in primary health care. Social Psychology Quarterly, 61(4), 301–320. https://doi.org/10.2307/2787032
66.
PeräkyläA. (2002). Agency and authority: Extended responses to diagnostic statements in primary care encounters. Research on Language and Social Interaction, 35(2), 219–247. https://doi.org/10.1207/S15327973RLSI3502_5
67.
PomerantzA. (1986). Extreme case formulations: A way of legitimizing claims. Human Studies, 9(2), 219–229. https://doi.org/10.1007/BF00148128
68.
PriorL.LimM.WardC.FeatherstoneH.MurrayH.D’ArcyC.CrownJ.GulloG. (2017). Metastatic HER2+ Breast Cancer: A Potentially Curable Disease?Cureus, 9, e1654. https://doi.org/10.7759/cureus.1654
69.
SacksH. (1992). JeffersonG. (Ed.). Lectures on conversation: Volumes I & II. Blackwell, Oxford.
70.
SandaunetA. G. (2008). A space for suffering? Communicating breast cancer in an online self- help context. Qualitative Health Research, 18(12):1631–1641. https://doi.org/10.1177/1049732308327076
71.
SidnellJ.StiversT. (Eds.). (2013). Handbook of conversation analysis. Blackwell-Wiley.
72.
SinclairS.BeamerK.HackT. F.McClementS.Raffin BouchalS.ChochinovH. V.HaganN. A. (2017). Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences. Palliative Medicine, 31(5), 437–447. https://doi.org/10.1177%2F0269216316663499
73.
SinclairS.KondejewskiJ.SchulteF.LetourneauN.KuhnS.Raffin-BouchalS.GuilcherG. M. T.StrotherD. (2020). Compassion in pediatric healthcare: A scoping review. Journal of Pediatric Nursing, 51, 57–66. https://doi.org/10.1016/j.pedn.2019.12.009
74.
StarP. (1982). The social transformation of American medicine. Basic Books.
75.
StiversT.HeritageJ. (2001). Breaking the sequential mold: Answering “more than the question” during comprehensive history taking. Text, 21(1–2), 151–185. https://doi.org/10.1515/text.1.21.1–2.151
76.
StiversT.HeritageJ.BarnesR. K.McCabeR.ThompsonL.ToerienM. (2018). Treatment recommendations as actions. Journal of Health Communication, 33(11), 1335–1344. https://doi.org/10.1080/10410236.2017.1350914
77.
StiversT.TimmermansS. (2016). Negotiating the diagnostic uncertainty of genomic test results. Social Psychology Quarterly, 79(3), 199–221. https://doi.org/10.1177%2F0190272516658770
78.
StiversT.TimmermansS. (2020). Medical authority under siege: How clinicians transform patient resistance into acceptance. Journal of Health and Social Behavior, 61(1), 60–78. https://doi.org/10.1177%2F0022146520902740
79.
StommelW.TemolderH. (2018). Empathically designed responses as a gateway in Dutch counseling calls. Discourse Studies, 20(4), 523–543. https://doi.org/10.1177%2F1461445618754436
80.
ThewesB.HussonO.PoortH.CustersA. E.ButowP. N.McLacklanS. A.PrinsJ. F. (2017). Fear of cancer recurrence in an era of personalized medicine. Journal of Clinical Oncology, 35(29), 3275–3278. https://doi.org/10.1200/JCO.2017.72.8212
81.
ThorneS. E.OliffeJ. L.OglovV.GelmonK. (2013). Communication challenges for chronic metastatic cancer in an era of novel therapeutics. Qualitative Health Research, 23(7), 863–875. https://doi.org/10.1177/1049732313483926
82.
VrintenC.McGregorL. M.HeinrichM.von WagnerC.WallerJ.BlackG. B. (2017). What do people fear about cancer? A systematic review and meta-synthesis of cancer fears in the general population. Psycho-oncology, 26(8), 1070–1079. https://doi.org/10.1002/pon.4287
83.
WeatherallA. (2021). Displaying emotional control by how crying and talking are managed. In RoblesJ. S.WeatherallA. (Eds.), How emotions are made in talk (pp. 77–98). John Benjamins.
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
