Second Visit

diagnoses. This, therefore, makes question and answer inevitable in diagnostic interviews as diagnosis relies partly on elicitation and supply of information to unravel patients‟

medical challenges. Thus, the doctors in this study had to seek relevant information from the patients through the use of question, and the patients also had to supply them by using answer in order to assist the doctors in their investigation and treatment of the patients‟

medical challenges. Inappropriate responses to doctors‟ queries pose a challenge to obtaining critical information needed for diagnosis. This section, therefore, analysed and discussed how the doctors in this study elicited information through direct and indirect questions from the patients and how the patients answered to supply them.

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5.2.8.1 Direct Questions with Answers

The direct questions in the interactions were realized by interrogatives beginning with wh-elements while answers were realized by declaratives to investigate the patients‟

ailments. The following extracts were considered:

Extract 70 (Interaction 29)

Doc.: Kin lo sele? [What‟s the problem?]

Pt.: Apa yii lo n ro mi. [I feel pains in this arm.]Mo de lo si hospital kan nibi ti nwon ti fun mi labere sugbon o si n ro mi.[I attende a hospital where I was given an injection but the pain persists.]

Extract 71 (Interaction 32)

Doc.: What school do you attend?

Pt.: Oritamefa Baptist….

Doc. Whao! Oritamefa. Are you the last born?

Pt.: Yes.

Doc.: Out of how many children?

Pt.: Four.

Doc.: Your mum, what does she do?

Pt.: She is a nurse.

Doc.: Your mum is a nurse. Whao! What of dad?

Pt.: A lecturer.

Doc.: Where?

Pt.: LAUTECH

Extract 72 (Interaction 26)

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Doc.: Were you ever diagnosed with diabetes or hypertension?

Pt.: Diabetes.

Doc.: Where do you treat it and what drugs are you taking to cure it?

Pt.: The drugs I was given are in my bag.

Doc.: Go bring them.

Pt. (Hands over the drugs to the doctor)

Doc.: So, these are the drugs you were given. Where do you treat yourself?

Pt.: Sadiku.

Doc.: When was the last time you went there for treatment?

Pt.: About two months ago.

Doc.: Then why did she change to this hospital.

Direct question was one of the oral diagnostic tools employed in the study to investigate the patients‟ medical challenges. Its deployment enabled the doctors to know how to intervene professionally in the patients‟ ailments. Looking carefully at the extracts above, one sees how the doctors employed direct questions in each of the extracts to obtain information on the patients‟ family history (FH), social history (SH) and history of present ailment (HPI) for the purposes of making diagnoses. In response to the questions, the patients supplied the needed information, thus making the discourses resulted-oriented.

The directness of the questions served the communicative purpose of tacitly informing the patients that the information being sought were crucial to the diagnosis of their ailments and eventual recovery. The questions, therefore, enabled the patients to actually state their health challenges. In sum, the direct question performed the discourse function of eliciting information to make diagnoses. They were grammatically realized by wh-elements.

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5.2.8.2 Indirect Questions with Answers

Indirect questions were realized by statements. They have the appearance of declaratives but are fundamentally interrogative. The following extracts were considered:

Extract 73 (Interaction 32)

Doc.: Was his immunization complete?

Pt, Rel.: Yes.

Doc.: And he doesn‟t fall sick from time to time.

Pt. Rel.: Not at all.

Extract 74 (Interaction 34)

Doc.: Eje to n wa yen, eemelo loti wa ko toodi pe ko wa mo? [How many times did you bleed before it stopped?]

Pt.: A a to bii eemeje. [About seven times.]

Doc.: Ko de waa wa mo nisen. [And it has stopped now.]

Pt.: Bee ni. [Yes].

Extract 75 (Interaction 38)

Doc.: The last time you came was in April.

Pt.: Yes. April.

Doc.: You are being treated for diabetes and hypertension according to these test results.

Pt.: Yes. Diabetes and hypertension.

Doc.: Do you have any prescription list with you.

Pt.: Yes. I have numerous of them but I want to look for the most recent of them,

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A careful look at Extract 73 - 75 revealed that the main instrument in clinical interview is seeking and giving information. Evident from the doctors‟ contributions above is the deployment of indirect questions to obtain information on the patients‟ history of present illness (HPI), social history (SH) and family history (FH). On the other hand, the patients‟ contributions supplied answers to the doctors‟ questions. The indirectness of the questions is confirmed by their interrogative status, even though couched in declarative forms, and the answer status of the accompanying responses from the patients, thus forming a question-answer sequence. Here, the elicitation and supply of information provided insights for the doctors into the likely causes of and the real nature of the patients‟ health challenges and, consequently, offered them the opportunity to intervene professionally. The doctors mostly sought information about the patients‟ health challenges while the patients provided them, thus revealing that they worked dependently in matters of oral diagnosis.

All the instances of the direct and indirect questions were emboldened. In Extract 70 – 72, there were instances of direct questions while in Extract 73 – 75, there were instances of indirect questions. The communicative function of the indirect questions was to make the interviews appear less interrogative to enable the patients who were obviously sick find the exercise less stressful and, consequently, be encouraged to cooperate in releasing all the information needed to unravel and solve their health challenges. The direct questions, on the other hand, served the discourse function of making the patients know the particular information being sought from them were crucial to unraveling their health challenges so that the doctors should be able to treat them. Unlike the direct questions, the indirect questions were realized by declaratives, but yet have the illocutionary force of question.

The answers naturally followed the questions and they performed the communicative function of presenting the information needed for diagnosis. Their deployment was inevitable as the discourse was purely investigative; they generated the raw materials for diagnosis. As the extracts above revealed, the answers were what the doctors needed to make good diagnoses, without which it was impossible for them to gain insights into the patients‟ medical challenges, except the doctors were going to conduct laboratory tests on

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them. Question and answer are very important diagnostic tools in clinical interviews in view of the fact that there are some medical conditions that can only be investigated through questions and answers.