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Talking about health and illness Australian slang handbook 2009 Edition By Dr Anna Chur-Hansen and students Copyright © 1998 University of Adelaide Department of Psychiatry. Used with permission. This work is copyright. Apart from any use permitted under the Copyright Act 1968, no part may be reproduced by any process without prior written permission from the publisher. Inquiries concerning reproduction and rights should be addressed to the Publications Officer. The 1998 version was contributed to in 2005 by Victoria Cheng, Alison Chew, Chen Kean Choy, Sue Ann Loh, Kelvin Lye & Siew Lee Shu, and in 2006 by Vanessa Tee, Priya, Desmond Ong, Chin Jong Khen and Chua Su Ling This edition adapted with permission. Adapted version published & printed by: Adelaide to Outback GP Training Program Lower Level, 183 Melbourne Street NORTH ADELAIDE 5006 Document: A2O-ED-IG-RE-0004-02 Adapted by: Senior Education Research Officer Editor: Publications Officer Document: A2O-ED-IG-RE-0004-02 Page 2 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009 CONTENTS What is colloquial English?...............................................................................................................................2 Why is it important for GPs to know slang?..................................................................................................3 What can I do if someone uses informal language that I don’t understand?........................................4 A strategy for use in the clinical situation.......................................................................................................4 What strategies are there for learning this sort of language?...................................................................5 What are some common slang words that a patient might use?.............................................................6 Index of Australian slang....................................................................................................................................1 Document: A2O-ED-IG-RE-0004-02 Page 3 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009 WHAT IS COLLOQUIAL ENGLISH? There are different styles of language that a person can use depending upon the situation they are in. Sociolinguistics considers how language reflects not only the meaning of the words, but the speaker’s relationship to the listener, and their age, gender, socio-economic background and so on. ‘Elaborated’ versus ‘restricted’ codes of language are important ways of identifying and thinking about language use. That is, people who are well educated or well read might use longer, more complex sentences and have a greater vocabulary at their disposal (elaborated code), as compared to others, whose speech may be less varied (restricted code). In Australia, most people use informal speech: slang, or ‘colloquial’ English. Some people use it more often than others, but most people use it, especially in informal situations, regardless of whether their usual code is restricted or elaborated. Sociolinguistics shows us how some slang ‘belongs’ to certain age groups, or people with certain educational backgrounds, and so on. Some Australian people use American slang, but certainly we have a great deal of slang and informal speech that is unique to us and is not shared by other English speakers. The specific form of English (with all of its slang included) used in Australia is referred to as Australian English. Slang is shaped by the culture of the people, and its use is contextually dependent. Many things that we say to each other have historical roots, or come from our environment, like sayings based on references to the weather or animals or plants that are from here. Some slang is specific to a particular state or to the country as opposed to the city, and so on. Informal speech makes it difficult to learn a new language because it is often not written down anywhere; if it is written down it is fairly meaningless if taken out of context. Australian slang is often based on rude or vulgar words. However, the meaning may be quite the opposite. To give an example, one man might say to another, ‘you old bastard!’. That would not necessarily mean that the person was elderly, or had parents who were not married to each other. If said with a smile or a slap on the back, it is a term of affection; if said in anger, it means that an argument might be about to happen; if said with a sly grin it might mean that the person is cunning or clever. Nonverbal communication used together with slang is often very important in correctly interpreting what the slang words actually mean. Document: A2O-ED-IG-RE-0004-02 Page 2 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009 WHY IS IT IMPORTANT FOR GPs TO KNOW SLANG? Doctors need to know a great deal of medical terminology that they use when communicating effectively with the colleagues, and must be able to use the correct, educated, ‘elaborated’ code of English. However, this way of speaking is not sufficient if it is the only way in which you know how to speak. You need to be able to interact with Australian colleagues and reception staff, members of the community, your teachers and mentors. If you speak very formally all the time, you may discover that people don’t ‘warm’ to you. They may feel uncomfortable with your interaction. They may also perceive that you don’t understand what they are saying. Therefore, they might restrict their language to a very basic, formal level in response to yours. This is not a good start in building rapport between you and other people, and it is not good for the development of your language skills because you won’t get to hear everyday Australian English. You also need to know slang because you have to talk to patients. You are expected to listen to people, understand them, and be able to accommodate their language level. An important skill for you as the doctor is the ability to engage this such language accommodation, to be able to communicate with a patient so that they understand you; doing so will foster the relationship between you. A GP is expected not only to master the appropriate communication skills to be a doctor, such as rapport, open-ended questions and so on, but also to have a level of English-language proficiency that is adequate for their doctor-patient interactions. Your proficiency must encompass not only technical jargon, but everyday, informal language as well. Patients will often use polite forms of language with the doctor, but their vocabulary may sometimes be limited to slang. During times of emotional distress, patients may revert to speech that they have learned earlier in life, or which they commonly use in their everyday life. This will include slang. Document: A2O-ED-IG-RE-0004-02 Page 3 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009 WHAT CAN I DO IF SOMEONE USES INFORMAL LANGUAGE THAT I DON’T UNDERSTAND? There are probably thousands of examples of slang words. No one could possibly be expected to know them all. People may well say things that don’t seem to make sense to you. The big mistake here is to pretend that you know what they are talking about when you are not sure. Below are two strategies you can use when you don’t understand: 1. Simply ask them what they mean. There is nothing at all wrong with doing this. 2. Use your knowledge of communications skills to summarise what they have said as you understand it. That way, if you are mistaken they can tell you so. A strategy for use in the clinical situation. 1. Ask the patient what they mean. Ensure that you use open ended questions, to facilitate rapport and openness. For example, you might ask, ‘I’m not sure what you mean by that; are you able to explain it for me?’ or, ‘I’m not familiar with that word/phrase, what does it mean?’ Similarly, you could summarise what the patient has said as you have understood it, so that they can tell you if you are mistaken. 2. Write down the word in a notebook dedicated to the purpose. 3. After the consult, or when you have a list of words, take your notebook with you to your mentor, or someone who you trust, and ask them what it means. 4. Ensure you find out who would use the word/phrase; what circumstances the word/phrase is used in; what the word/phrase means; to whom the word/phrase might be used. Document: A2O-ED-IG-RE-0004-02 Page 4 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009 WHAT STRATEGIES ARE THERE FOR LEARNING THIS SORT OF LANGUAGE? You cannot learn a great deal about informal language from a book. The kind of approach to language acquisition you need for informal or slang language is an active rather than a passive one. Certainly you can look at the books for examples and for interest, and there are some books that demonstrate informal Australian English very well, but real people and the spoken word is far more valuable to you here. So, what specifically can you do to gain some idea of our informal language? 1. Talk to people. Talk to your friends and colleagues. This is not as easily done as said, but you will discover that usually the effort in overcoming your fear or nerves will be repaid in many ways. You might find out that there are some people who are quite happy to share their knowledge of informal language with you. 2. Participate actively in your community. If you have time, try to join a sporting club, or a social club or organisation. Not only will it help you become part of your community, it is a good way of finding out about how people speak in your immediate context. Other ways you might find of doing this are by actively participating in activities that your children’s school put together, or by going to the pub for a drink or a meal 3. Notice what people say. Keep an exercise book of words that you hear people, in your immediate context and region, or in the media, which you don’t understand. Then ask someone what the words mean and write the meanings down next to them. Be sure to find out what the term means, who would be most likely to use it, under what circumstances, and to whom. Keep building on the list, and eventually you will have a good resource of informal language specific to your region. We encourage you to share them with other IMGs by forwarding your lists to Adelaide to Outback; we will update the lists in the rear of this handbook, so that the resource continues to be valid and useful. Document: A2O-ED-IG-RE-0004-02 Page 5 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009 WHAT ARE SOME COMMON SLANG WORDS THAT A PATIENT MIGHT USE? There are many different figures of speech that a patient might use to refer to body functions, parts of their anatomy, their state of health, what they have been doing, and so on. Some common ones are listed on the following pages. Remember, this is not an exhaustive list by any means. It is meant to serve as a reference for you. Add colloquialisms of your own where you find that they are not included here. The index, which commences on the next page, will provide you with a list in alphabetical order, which will help you to find the words and phrases that you need with ease. Document: A2O-ED-IG-RE-0004-02 Page 6 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009 Document: A2O-ED-IG-RE-0004-02 Page 7 of 34 Author: Dr Anna Chur-Hansen Approved by: Medical Education Manager Last updated: September 2009