'If it didn't work the first time, we can try it again': Conditionals as a grounding device in a genre of illness discourse.

Abstract

This article explores the occurrence and some special patterns of conditional usage in medical discourse produced by doctors and patients. Findings are based on the Journal of the American Medical Association with its section 'Clinical Crossroads' which was founded to further the co-operation of patients with medical professionals. The analysis centers upon the concept of prediction, which is considered both a semantic concept governing verb patterns as well as a communicative act prominent in medical encounters. It is found that, in the discourse context investigated here, patients are more concerned with prediction than are doctors, but that they also produce at times unusual patterns in which they mirror their doctors' voices. The mapping of mental spaces, inherent in the conditional construction, then takes the form of a mapping of voices as institutionalized by the genre. Such uses of conditionals suggests that a classification based on content, or 'logic' from which only pragmatic types of conditionals depart, turns out to be inadequate, since the construction operates on two simultaneous levels; these are grounded in the discourse situation provided by the genre. For medical communication, this illustrates that patients engage in their own predictions but also strive for an alignment with their doctors.