The affective reading of “hao-bu-hao?” in diagnosis delivery

Recent studies in health interaction have shown interest in the issue of affect-in-talk. While prior insights are mainly gained from face-to-face encounters where affect is seen as a gestalt of various modalities (Peräkylä & Sorjonen, 2010), this presentation reports a conversation analytic study of how it is delivered in online environments where multimodal resources are often absent (see Ekberg et al., 2016). We examined the Chinese “hao-bu-hao” (“okay”, “alright”) and its affective import in diagnostic news delivery (Maynard, 2003). Data include 156,104 typed doctor-patient dyads collected online. While HBH is often used to seek agreement, we identified instances where there is some affective import in the doctor’s articulation of HBH. We examined the design features of HBH, its placement in the doctor’s longer turn (what comes before/after its articulation), and patient response. Two designs of diagnostic statements are identified: 1) simple reassurance such as “don’t worry about X, HBH”, and 2) statements incorporating inferential references such as “Your situation seems to be X, HBH”. Patients respond differently by either indicating a reassured state prefaced with “alright” or not responding or pursuing further information regarding the seriousness of the condition. We thus argue that HBH can be heard as either a comfort or a gentle alert.