Language and Disease

By

Obododimma Oha

There are many ways to approach this kind of open-ended discourse. One can explore the most basic, i.e. the functions performed by language in relation to disease in human society. One can also look at some configurations of a particular disease and how these relate to the pattern of attention. Anyone can examine how some groups manage language in relation  to disease. Further, somebody could examine narratives about a disease, to expose the kind of rhetoric in operation. In this essay, one simply looks at how language makes  the management of disease impossible or possible and the strange idea that language could also be a disease itself. 

The first and very simple case was what I saw at a clinic in the Out-Patients' Section at a teaching hospital in Nigeria. The country is recognised as English-speaking and this raises an assumption  that English would be used in official interactions, including open clinic discussions. But a local language was used instead. Was the hospital being stubborn and forgetful of Nigeria's linguistic status as a multilingual  and anglophone country? Indeed, many of the patients did not have English as their first language or their major language. So, being English--speaking is ruled out. And what was language essentially doing there?  Was it not to pass relevant information about behaviour and general knowledge only? In other words, was the pattern of rhetoric and language choice friendly to  the audience. The knowledge needed was not a specialized one -- which language communicates, anyway. The choice of the local language and some sprinklings of pidgin recognized the linguistic status of the audience.

Hmmmm, pidgin again. Braj Kachru classifies Nigeria in the Outer Circle of English language use, with the understanding that English was imposed on the country through colonisation and the language has been wrestling and interacting with local languages in the lives of the people. Pidgin comes in to resolve the tension between highbrow English and simple life. So, citizens that cannot just go very high in English language use only manage with pidgin. That is not to say that the High in society do not sometimes pretend to identify with the Low  through the sharing of pidgin with them. 

A closer investigation revealed that language occupies a special place in the hospital's hiring of staff for open clinics. Applicants without qualification or training in the local language are not hired. This is a good move, for it means that the hiring of staff for interaction with the public in open clinics is  focused on linguistic training on the languages of interaction, not on any sentiment about the language itself.

The health worker at the clinic is required to have the control of two forms of knowledge: expert  knowledge on the health issue at stake and the rhetoric of the language of interaction. The first is  what certification in health and experience can solve and the second requires deep knowledge of the language, having better command of the local language, and knowledge of the available  metalanguage for the clinic. Some  local languages are deficient in the metalanguage but a lot of work is going on to develop these metalanguages in Africa.

The medical concepts that feature  in the  metalanguage project may first be problematic, but  very  soon become popular  in use. The health worker should  demonstrate an awareness of the emergent concepts in the language and provide a little explanation  where necessary.

Another dimension in the  rhetoric is pathos. Health workers are sometimes portrayed as lacking emotion, lacking feelings for suffering. Patients are sufferers and do expect at least empathic and gentle treatment. This extends to clinic interactions. If the health worker  at the clinic does not express or show enough feeling of sympathy (i.e. being on the side of the patient), it is a problem and cooperation may suffer. Where else can this empathy be better expressed than in the local language? 

But can we think of language as a disease, too? In fact, a pandemic! We have approached language as a balm in human suffering, but language is sometimes used in opening up wounds. Yes, this is what humans sometimes do, and give the impression that they are only helping those that they are talking to. They may  make people suffer more, instead of removing the pains. Is that a clinic of torture?

Running the clinic  of torture involves saying the things that hurt,pragmatically speaking or making a language choice that further and deliberately complicates matters for social identity. In other words, language could be a weapon in many ways, as Dwight Bolinger argues. Paradoxically, what is used in healing is also used in killing! Is that not surprising?

So,  language calls us to realise and acquire the deep knowledge about disease. Health workers at clinics are expected to combine this professional knowledge communicable in language with some deep knowledge of the persuasive power of speech in the language of  the aim should be to use language as treatment and for  treatment.