"Sigmund Freud called his distinctive form of therapy 'the
talking cure, ' but this is the first time anyone has had the
ingenuity to figure out how it can be done with silences. Well,
maybe the second time--leave it to the Mayans That silence can kill
is a well-known fact; that it is golden is widely assumed; but that
it can be orchestrated in a socially meaningful way, that takes
perfect pitch. T. S. Harvey's landmark study of acoustical healing
may take some time for its voice to be unheard, but I am convinced
that it will come to be a classic in its field."--Roy Wagner,
author of Coyote Anthropology
The delivery of health care can present a minefield of
communication problems, particularly in cross-cultural settings
where patients and health practitioners come from dissimilar
cultures and speak different languages. Responding to the need for
in-depth ethnographic studies in cultural and communicative
competence, this anthropological account of Maya language use in
health care in highland Guatemala explores some of the cultural and
linguistic factors that can complicate communication in the
practice of medicine. Bringing together the analytical tools of
linguistic and medical anthropology, T. S. Harvey offers a rare
comparative glimpse into Maya intra-cultural therapeutic (Maya
healer/Maya wellness-seeker) and cross-cultural biomedical (Ladino
practitioner/Maya patient) interactions.
In Maya medical encounters, the number of participants, the
plurality of their voices, and the cooperative linguistic
strategies that they employ to compose illness narratives challenge
conventional analytical techniques and call into question some
basic assumptions about doctor-patient interactions. Harvey's
innovative approach, combining the "ethnography of polyphony" and
its complementary technique, the "polyphonic score," reveals the
complex interplay of speaking and silence during medical
encounters, sociolinguistic patterns that help us avoid clinical
complications connected to medical miscommunication.
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