Go ask Alice! The voice of medicine and the voice of lifeworld on a website

We know little about the language adolescents use to express their health concerns. Using a mixed-method approach composed of corpus and discourse analysis, this study examines a portion of two and a half million word corpus made up of health questions on different issues and their relative answers. Focussing on these questions and answers posted on the internet resource Go Ask Alice!, the study first delineates patterns of communication and then discusses these as examples of Mishler’s concepts of voice of lifeworld and voice of medicine. According to Mishler the voice of medicine manifests a technical interest and signals a scientific attitude. The voice of lifeworld is characterized by non-technical discourse and directly relates to the patients’ subjective experiences of illness. In particular, the study investigates the ways in which adolescents and health specialists devise their salutations, closings, and pronoun address forms in email. Drawing similar conclusions to those reached by Stommel (2012), the present analysis reveals that health professionals initially use a generic formal recipient design (e.g. Dear Reader) and close emails by giving advice in an authoritative and/or affective stance, whereas adolescents frequently use informal salutations and closings. Furthermore, the pronominal reference in the professionals’ answers can be considered in inclusion (solidarity) and exclusion (power) terms. But the use of third person references in the adolescents’ technical accounts of their own health concerns have a strategic implication for the allocation of blame and responsibility on an external third party. Such linguistic subtleties found in the results suggest that the voice of medicine and the voice of lifeworld are not exclusively employed by doctors and patients respectively. Rather, as health professionals modulate their tone in order to achieve different goals – such as repairing asymmetry in discourse roles – results show how the voice of medicine and the voice of lifeworld categories overlap and adequately describe what actually happens in healthcare discourse.