PETERSO N, C. 690
Cad . Saúd e Púb lic a, Rio d e Jane iro , 14(4):671-699, o ut-d e z, 1998 Dep a rt a m en t o d e
M ed icin a Socia l, Un iv ersid a d e Fed era l d o Rio Gra n d e d o Su l, Port o Alegre, Bra sil. Da n iela Riv a Kn a u t h
Th e a u t h o r’s p r o p o sa l t o st u d y t h e ‘m e d ic a l sla n g’ u se d b y p h ysicia n s a n d h e a t h ca re st a ff in d a ily c lin ic a l p r a c t ic e is q u it e in n o va t ive. Fe w st u d ie s h a ve fo c u se d o n t h is issu e , a l-t h o u gh il-t ca lls l-t h e a l-t l-t e n l-t io n o f l-t h e ‘la y p e rso n’ wh o h a s co n t a ct wit h t h e m e d ica l m ilie u . Ac-co rd in g to th e Ac-co m m o n -sen se view, su ch sla n g p la ys t h e r o le o f m a in t a in in g a d ist a n c e b e -t we e n -t h e p h ysicia n a n d p a -t ie n -t a n d re lie vin g t e n sio n s in h e re n t t o t h e p r o fe ssio n , in c o n -st a n t co n t a ct wit h su ffe r in g a n d d e a t h . It a lso a p p e a rs a s a wa y o f p ro m o t in g ra p p o r t wit h in th e h e a lth ca re sta ff, th ro u gh a co m p licity cre -a ted by sp e-a kin g th e ‘s-a m e l-a n gu -a ge’.
Th e a u t h o r d o e s n o t a cce p t t h e se e xp la n a -t io n s a n d su gge s-t s -t h a -t ‘m e d ica l sla n g’ ca n b e se e n a s cre a t in g n e w m e a n in gs in p h ysicia n s’ re la t io n sh ip t o : p a t ie n t s, c lin ic a l kn o wle d ge a n d sp e c ia liza t io n fie ld s, a n d t h e h e a lt h c a re system a s a wh ole. He stresses th e sp ecificity of t h e Bra zilia n ca se h e h a s st u d ie d , wh e re su ch sla n g p o in t s t o a kin d o f c r it iq u e o f t h e fu n c -t io n in g o f -t h e h e a l-t h sys-t e m , -t h r o u gh su c h p u n s a s tram biclín icas, p ilan tróp icos, m u lam -bu latórios, a n d Em brom ed. As th e a u th o r h im -se lf h igh ligh t s, t h is cr it iq u e is lin ke d t o p h ysi-cian s’ d iscon ten tm en t toward s th e d ep en d en ce o f p ro fe ssio n a l p ra c t ic e o n d iffe re n t h e a lt h p la n s a n d p u b lic p o licies.
Th u s, a lth ou gh h e p oin ts to th ese con textu a l va ria b les, th e a u th o r sea rch es fo r th e m ea n -in g of p h ysicia n sla n g m ore -in th e etym ologica l
o r igin o f t h e wo rd s fo r m in g t h e p u n s t h a n in t h e p o sit io n t h e se p h ysic ia n s o c c u p y in t h e m e d ica l fie ld . An o th e r co n te xtu a l a sp e ct ove r-looked by th e a u th or, a n d wh ich m igh t h a ve led h is a n a lysis in a d ifferen t d irectio n , p la cin g th e critica l n a tu re o f sla n g in a re la tive ligh t, is th e re cu rre n ce o f t h e t yp e o f b e h a vio r it e xp re sse s in Bra zilia n so cie ty; h e re I a m re m in d e d o f th e wo rk o f Ro b e r t o D a Ma t t a (1983, 1997) c o n -ce r n in g t h e re la t io n sh ip o f Bra zilia n s t o in st i-tu tio n s, n o rm s, a n d la ws. Th e a u th o r’s p ro p o s-a l o f u n d e r st s-a n d in g ‘m e d ic s-a l sls-a n g’ s-a s s-a n e x-p re ssio n (a lb e it in cix-p ie n t ) o f t h e se a rch fo r e i-t h e r a n e w e i-t h ic o r a n a d ju si-t m e n i-t o f m e d ic a l e t h ica l p r in cip le s t o t h e re a lit y co n fro n t e d b y p h ysic ia n s wo u ld t h u s ga in a r gu m e n t a t ive weigh t.
An o th er co n textu a liza tio n wh ich I co n sid er fu n d a m e n t a l, a n d wh ich is la ckin g in t h e a r t i-c le , re fe r s t o m e d ii-c a l i-c u lt u re p e r se , i.e., t h e p la ce a n d ro le o f so -ca lle d m e d ica l ‘sla n g’ a n d m e t a p h o rs in t h e co n st r u ct io n a n d id e n t ifica -tio n o f th e ‘m e d ica l wo rld’. Byra n Go o d (1994), in a n a lyzin g h o w d o c t o r s c o n st r u c t t h e ir o b -jects, sta tes th a t lea rn in g m ed icin e is sim ila r to “learn in g a foreign lan gu age”, n ot on ly b eca u se it in vo lve s le a r n in g sp e c ific sc ie n t ific t e r m s, b u t a b ove a ll in le a r n in g a wa y o f o b se r vin g a n d d escrib in g wh ich is p rop er to th ese p rofes-sio n a ls. In t h is se n se, we m igh t a sk h ow t h e se m e d ica l ‘sla n g’ te rm s a n d m e ta p h o rs e n te r in -t o -t h is le a r n in g p ro c e ss? D o -t h e y e xp re ss -t h is p a r t ic u la r wa y o f vie win g a n d d e sc r ib in g t h e wo r ld o f m e d ic in e ? If so, t h e y sh o u ld n o t b e vie wed o n ly th ro u gh th e etym o lo gica l sen se o f t h e wo rd s t h a t co n st it u t e t h e m . Th e sla n g a n d m eta p h ors u sed to d esign a te rela tion s b etween sp ecia liza tio n field s, th e d ifferen t ‘typ es’ o f p a -tien ts, a n d th e h ea lth p la n s a n d p olicies ca n b e se e n a s wa ys p h ysic ia n s h a ve le a r n e d t o d e a l wit h t h e se sit u a t io n s, re a ffir m in g va lu e s a n d p r in c ip le s p e r t a in in g t o t h e p r o fe ssio n it se lf, a n d t h u s c o n st r u c t in g a p a r t ic u la r re a lit y. In t h is c o n t e xt , t h e h o sp it a l a n d t h e o u t p a t ie n t se r vic e (a lo n g wit h t h e ir re sp e c t ive p a t ie n t s a n d st a ff ) a re a p r im e o b je c t o f c o n st r u c t io n a n d exp ressio n o f su ch rep resen ta tio n s.
DA MATTA, R., 1983. Carn avais, M alan d ros e Heróis: p ara u m a Sociologia d o Dilem a Brasileiro.4th ed ., Rio d e Ja n eiro: Za h a r.
DA MATTA, R., 1997. O qu e Faz o Brasil Brasil.8th ed ., Rio d e Ja n eiro: Rocco.
GOOD, B., 1994. How m ed icin e con stru cts its ob jects. In : M ed icin e, Ra t ion a lit y a n d Ex p erien ce. (B. Go o d , e d .), p p . 65- 87, Ca m b r id ge : Ca m b r id ge Un iversity Press.
