Summary

In the present study, initial observations in the head and neck cancer outpatients' clinic led me to my decision to combine an ethnographic approach with linguistic analysis, to understand the ways patients and professionals navigated the clinic's geography. Had my data only been recordings of consultations, or only interviews with the research participants, I would have missed crucial parts of the process through which patients' concerns are expressed. Furthermore, combining both approaches invites re-appraisal of interpretations and analyses from the respective sets of data. The clinic brought its own constraints to bear on the consultation; its environment was in many respects at odds with patients' care, and could exacerbate the patient's feeling of being 'mind-boggled'. At the same time, patients and professionals relied on the environment to interpret the significance of an event, or to prepare for the consultation. Patients' experiences of the clinic environment gave them insights into the progression of illness and the effects of treatment. Patients would modify their own communication with professionals accordingly, voicing concerns and questions in the corridor. Sitting in the waiting room presented patients with new concerns and experiences of others' illness and treatment. There they would see the progression of disease and recovery, and share experiences with others; and when the waiting room was busy, or at the end of the day, they would edit their talk with the doctor accordingly.

 
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