Made available in DSpace on 2016-04-28T18:24:05Z (GMT). No. of bitstreams: 1 Ana Julia Perrotti Garcia.pdf: 821486 bytes, checksum: bee7b666f17ebb799b231741536e2c70 (MD5) Previous issue date: 2009-06-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / In recent years, Brazilian medical journals have increased the number of articles published in English in their issues, in an effort to attract readers from outside Brazil. Little is known about the quality of English language used in these papers, however. Two comparable corpora of approximately 5 million tokens each were collected especially for this study and contain full papers from medical journals. Corpus BRAZIL contains full papers from medical journals published in Brazil and corpus ABROAD contains full papers published in American and European medical journals, both in British English and American English. After analyzing the language used in both corpora, using WordSmith Toos (WordList, clusters; and Concord, and a script in Unix shell language, we detected that the verb submit had 1,111 occurrences in corpus BRAZIL and only 4 in corpus ABROAD. We then looked more closely at the verb submit , a prima facie translation of the Portuguese word submeter , in order to detect which grammatical structures were used in corpus ABROAD to express the same meaning. The strategies found in corpus ABROAD to express the idea studied were: use of verbs (such as undergo; receive; take; have; initiate, start, begin, use, continue, allocate, assign, attend, complete; to be taken, be referred for; perform, do, be considered for, elegible for, to be given, to be subjected to, subject to) in different tenses, voices and modes; use of adjectives; use of prepositions (after, on, with, without) / As revistas médicas brasileiras têm apresentado, nos últimos anos, um número crescente de artigos publicados em inglês, em um esforço para atrair leitores do exterior e dar maior visibilidade aos textos de pesquisadores nacionais. Entretanto, pouco se sabe sobre as características da língua inglesa empregada nesses textos. Dois corpora comparáveis, com aproximadamente cinco milhões de tokens cada foram especialmente coletados para o presente estudo. Ambos contêm artigos de revistas médicas escritos em inglês. O corpus BRAZIL com artigos publicados em revistas médicas brasileiras e o corpus ABROAD com artigos publicados em revistas médicas dos Estados Unidos e Europa, tanto em inglês norte-americano quanto britânico. Após analisar a língua usada em ambos os corpora, usando ferramentas do programa WordSmith (WordList, clusters e o concordanceador Concord) e uma rotina de computador desenvolvida em linguagem Shell, detectamos que o verbo submit teve 1.111 ocorrências no corpus BRAZIL e apenas quatro no corpus ABROAD. O objetivo específico deste estudo foi determinar como os médicos brasileiros usaram o verbo submit, uma tradução prima facie da palavra submeter , e detectar quais estruturas gramaticais foram usadas no corpus ABROAD para expressar o mesmo significado. As estruturas encontradas no corpus ABROAD para expressar a ideia de submeter-se a um exame, teste ou terapia foram: uso de verbos (tais como undergo; receive; take; have; initiate, start, begin, use, continue, allocate, assign, attend, complete; to be taken, be referred for; perform, do, be considered for, elegible for, to be given, to be subjected to, subject to) em diferentes tempos, vozes e modos; uso de adjetivação; uso de preposições (after, on, with, without)

A insatisfação dos médicos está associada ao distanciamento entre sua prática e as imagens idealizadas do médico-sacerdote e do médico-cientista. Investiguei como os ideais de cuidar humanamente dos indivíduos doentes e de conhecer cientificamente os processos de doença e de cura se apresentam na medicina moderna. Para tanto, fiz uma leitura das cinco principais revistas científicas de medicina, de 1990 a 2009. Privilegiei os temas do conhecimento médico e do cuidado relacionados à clínica, e não à saúde pública. Iniciei a leitura por uma amostra sistemática, para aprofundá-la, a seguir, em questões que julguei exemplares, ou especiais. Minhas observações estão entremeadas com citações indiretas de artigos das revistas, para oferecer ao leitor as bases de minhas impressões. Observei que o discurso sobre o conhecimento ocupa maior espaço, é mais complexo e mais elaborado do que o discurso sobre o cuidado. Ao lado de impressionantes avanços da ciência médica e do otimismo positivista da maioria dos artigos, as revistas apresentam incertezas, contradições e limitações dos métodos e das teorias. Há uma tensão entre a fé na ciência, os esforços para tornar a medicina científica, e as dificuldades lógicas e metodológicas de adequar decisões médicas singulares às evidências apresentadas pelas pesquisas. O conhecimento médico se apresenta como um mosaico em permanente reconstrução, incapaz de produzir certezas. E sua produção e divulgação são influenciadas por interesses e crenças de pesquisadores, financiadores e editores. O discurso sobre o cuidado, embora consistente, só ganha proeminência onde falta conhecimento, como em relação ao doente em fase terminal. Os médicos-cientistas, enredados em protocolos e estatísticas, não se ocupam do cuidado. Mas, se adoecem, queixam-se da falta de cuidado. É possível ler propostas de unir evidências científicas e narrativas de doentes e médicos, na construção de uma prática de conhecimento-cuidado curativa para ambos. Mas essas propostas não parecem merecer atenção sequer dos demais autores das próprias revistas. / Dissatisfaction with medical practice is related to the discrepancy between the reality of the practice and the physicians expectations of working like a dedicated priest and like a well-trained scientist. I investigated how the ideals of caring compassionately for the patients and of using all knowledge about disease and cure are presented in modern medicine. In this intent, I read a sample of the Big Five medical journals, from 1990 to 2009. I privileged themes about medical knowledge and care in relation to clinic and not to public health. I began by reading a systematic sample, and then I extended it, studying some points I considered to be special or illustrative. My commentaries are intercalated with citations of articles from the journals, to offer the reader the bases of my impressions. I observed that the discourse on knowledge was given a bigger space, and it is more complex and elaborated than that on care. Beside the impressive advances in medical science, and the optimistic positivism in most papers, the journals show the uncertainties, the contradictions, and the limitations of methods and theories. There is a tension between the faith in science, the efforts to turn medicine into a science, and the logical and methodological difficulties to adequate single medical decisions to the scientific evidence. Medical knowledge appears as a mosaic, permanently reconstructed, and not capable of producing certainties. And the production and divulgation of knowledge are influenced by the beliefs and interests of researchers, supporters and editors. The discourse on care shows consistency; but gains prominence only where knowledge is lacking, as when discussing terminal care. The medical scientists, imprisoned in a labyrinth of guidelines and statistics, do not care about care. But, whenever they get sick, they complain about lack of care. There are also proposals of joining scientific evidence and narratives from patients and doctors in the construction of a knowledge-and-care practice that may be curative for both. But these proposals get no attention, not even from other authors of the same journals.

A insatisfação dos médicos está associada ao distanciamento entre sua prática e as imagens idealizadas do médico-sacerdote e do médico-cientista. Investiguei como os ideais de cuidar humanamente dos indivíduos doentes e de conhecer cientificamente os processos de doença e de cura se apresentam na medicina moderna. Para tanto, fiz uma leitura das cinco principais revistas científicas de medicina, de 1990 a 2009. Privilegiei os temas do conhecimento médico e do cuidado relacionados à clínica, e não à saúde pública. Iniciei a leitura por uma amostra sistemática, para aprofundá-la, a seguir, em questões que julguei exemplares, ou especiais. Minhas observações estão entremeadas com citações indiretas de artigos das revistas, para oferecer ao leitor as bases de minhas impressões. Observei que o discurso sobre o conhecimento ocupa maior espaço, é mais complexo e mais elaborado do que o discurso sobre o cuidado. Ao lado de impressionantes avanços da ciência médica e do otimismo positivista da maioria dos artigos, as revistas apresentam incertezas, contradições e limitações dos métodos e das teorias. Há uma tensão entre a fé na ciência, os esforços para tornar a medicina científica, e as dificuldades lógicas e metodológicas de adequar decisões médicas singulares às evidências apresentadas pelas pesquisas. O conhecimento médico se apresenta como um mosaico em permanente reconstrução, incapaz de produzir certezas. E sua produção e divulgação são influenciadas por interesses e crenças de pesquisadores, financiadores e editores. O discurso sobre o cuidado, embora consistente, só ganha proeminência onde falta conhecimento, como em relação ao doente em fase terminal. Os médicos-cientistas, enredados em protocolos e estatísticas, não se ocupam do cuidado. Mas, se adoecem, queixam-se da falta de cuidado. É possível ler propostas de unir evidências científicas e narrativas de doentes e médicos, na construção de uma prática de conhecimento-cuidado curativa para ambos. Mas essas propostas não parecem merecer atenção sequer dos demais autores das próprias revistas. / Dissatisfaction with medical practice is related to the discrepancy between the reality of the practice and the physicians expectations of working like a dedicated priest and like a well-trained scientist. I investigated how the ideals of caring compassionately for the patients and of using all knowledge about disease and cure are presented in modern medicine. In this intent, I read a sample of the Big Five medical journals, from 1990 to 2009. I privileged themes about medical knowledge and care in relation to clinic and not to public health. I began by reading a systematic sample, and then I extended it, studying some points I considered to be special or illustrative. My commentaries are intercalated with citations of articles from the journals, to offer the reader the bases of my impressions. I observed that the discourse on knowledge was given a bigger space, and it is more complex and elaborated than that on care. Beside the impressive advances in medical science, and the optimistic positivism in most papers, the journals show the uncertainties, the contradictions, and the limitations of methods and theories. There is a tension between the faith in science, the efforts to turn medicine into a science, and the logical and methodological difficulties to adequate single medical decisions to the scientific evidence. Medical knowledge appears as a mosaic, permanently reconstructed, and not capable of producing certainties. And the production and divulgation of knowledge are influenced by the beliefs and interests of researchers, supporters and editors. The discourse on care shows consistency; but gains prominence only where knowledge is lacking, as when discussing terminal care. The medical scientists, imprisoned in a labyrinth of guidelines and statistics, do not care about care. But, whenever they get sick, they complain about lack of care. There are also proposals of joining scientific evidence and narratives from patients and doctors in the construction of a knowledge-and-care practice that may be curative for both. But these proposals get no attention, not even from other authors of the same journals.

<p>This thesis analyse how life-histories are expressed and reformulated in connection to a life crisis of ill health. The study is based on ten interviews with people who in connection with ill health have made use of treatments within both orthodox medicine and complementary medicine and who have also developed various forms of self-treatment. The overall aim is, with a point of departure in the concepts health, healing and trust, to analyse narratives as a practice through which the respondents create identity and a life-context. The signifi cance of constructing the (auto)biography of the healing narrative – a form of narrative and performative act – runs as the main thread through the thesis. This act makes up the practice that is recurrently discussed in several of the thesis’ chapters and is synonymously termed the telling of healing narratives or or to narrate health and healing. The analysis of the narrative’s The analysis of the narrative’s healing main themes is mirrored in the order of the chapters. The study is broadly thematic and structured as a generalised healing process beginning with upheaval, continuing with crisis and social drama, and further to the endeavour of expressing values and judgements in a public context.</p><p>The interview themes of self-treatment and alternative treatment have occasioned the investigation into what an ethno-medical perspective can bring to analyses of people’s experiences of ill health in an everyday medical context. One of the points of having the concept ethno-medicine as a starting point is that every practice or narrative formation is ascribed with a potential for interpretation in its creation of knowledge. Another chapter deals with two themes of identity and life-history construction in the practice of healing narratives – the need for a chronology and reappraised perspectives on body, health and lifestyle. Healing narratives can be understood as a genre of life-historical narratives where life is often described as a linear course of events. A model by the anthropologist Victor Turner on the course and content of social drama is used as a comment to analyses of three respondents’ narratives in another chapter. A drama can be understood as a tragic course of events, based on an accident or an upsetting incident that roughly revolves around event/crisis, chaos and the striving for restoration. The concept of other journals is then used to make visible the everyday medical administrative practice and refers to the documentation used in the form of collected documents, written notes, and diaries. As an unexpected part of healing processes, the necessity of familiarising oneself with rules, laws and health insurance systems in order to be able to claim one’s rights is brought forward.</p><p>The social transformation process of various care practices in society makes up both a context and a commonly occurring theme in the narratives that the thesis is based upon. A modern health culture that gains strength from loosely composed social movements exerts infl uence on all levels of society. With an increased individual responsibility, the need grows to fi nd one’s own healing strategies and to create one’s own life-history in narratives that mirror this transformation in an everyday context. Healing narratives can be seen as a form of evaluation of health-care practices where experiences of treatment and notions of health and cure and healing are concretised.</p>

This thesis analyse how life-histories are expressed and reformulated in connection to a life crisis of ill health. The study is based on ten interviews with people who in connection with ill health have made use of treatments within both orthodox medicine and complementary medicine and who have also developed various forms of self-treatment. The overall aim is, with a point of departure in the concepts health, healing and trust, to analyse narratives as a practice through which the respondents create identity and a life-context. The signifi cance of constructing the (auto)biography of the healing narrative – a form of narrative and performative act – runs as the main thread through the thesis. This act makes up the practice that is recurrently discussed in several of the thesis’ chapters and is synonymously termed the telling of healing narratives or or to narrate health and healing. The analysis of the narrative’s The analysis of the narrative’s healing main themes is mirrored in the order of the chapters. The study is broadly thematic and structured as a generalised healing process beginning with upheaval, continuing with crisis and social drama, and further to the endeavour of expressing values and judgements in a public context. The interview themes of self-treatment and alternative treatment have occasioned the investigation into what an ethno-medical perspective can bring to analyses of people’s experiences of ill health in an everyday medical context. One of the points of having the concept ethno-medicine as a starting point is that every practice or narrative formation is ascribed with a potential for interpretation in its creation of knowledge. Another chapter deals with two themes of identity and life-history construction in the practice of healing narratives – the need for a chronology and reappraised perspectives on body, health and lifestyle. Healing narratives can be understood as a genre of life-historical narratives where life is often described as a linear course of events. A model by the anthropologist Victor Turner on the course and content of social drama is used as a comment to analyses of three respondents’ narratives in another chapter. A drama can be understood as a tragic course of events, based on an accident or an upsetting incident that roughly revolves around event/crisis, chaos and the striving for restoration. The concept of other journals is then used to make visible the everyday medical administrative practice and refers to the documentation used in the form of collected documents, written notes, and diaries. As an unexpected part of healing processes, the necessity of familiarising oneself with rules, laws and health insurance systems in order to be able to claim one’s rights is brought forward. The social transformation process of various care practices in society makes up both a context and a commonly occurring theme in the narratives that the thesis is based upon. A modern health culture that gains strength from loosely composed social movements exerts infl uence on all levels of society. With an increased individual responsibility, the need grows to fi nd one’s own healing strategies and to create one’s own life-history in narratives that mirror this transformation in an everyday context. Healing narratives can be seen as a form of evaluation of health-care practices where experiences of treatment and notions of health and cure and healing are concretised.