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In:Dialogues of the Clinic: Encounters across medicine and beyond
Edited by Mariaelena Bartesaghi and Shelby Forbes
[Dialogue Studies 36] 2026
► pp. 96–117

Chapter 4
Dialogue as mutual engagement

Working toward shared goals in medical care

 | Old Dominion University
This content is being prepared for publication; it may be subject to changes.
Abstract
In this chapter, I analyze a medical visit between a physician assistant in neurology and a patient with uncontrolled seizures. Focusing on a series of exchanges throughout the visit, I note how the patient shares her concerns and fears about her seizures as well as how the physician assistant responds to these concerns and returns to them, sometimes even reformulating them as her own desires, as they work toward a solution. Through these interactional moments, I argue that engagement in dialogue cannot be fully understood or accomplished in individual sequences of talk; instead, it is the circulation and recurrence of particular topics, themes, and the shared concern and goal orientation that ultimately facilitate a productive medical encounter.
Article outline
  • 1.Introduction
  • 2.Ways of understanding medical encounters
  • 3.Ways of understanding dialogue
  • 4.Fitting dialogue into medical interactions
  • 5.Methods
    • 5.1Analytical approach and framework
    • 5.2Participants and description of the visit
  • 6.Analysis
    • 6.1A triggering narrative
    • 6.2Invoking the narrative and building on prior discourse
    • 6.3Imagining life without seizures
    • 6.4Collectivity and positivity
  • 7.Conclusion
  • Notes
  • References
References (44)
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