Laughter as a patient's resource: Dealing with delicate aspects of medical interaction

Abstract

This article presents an analysis of laughter as an interactional device in doctor–patient interaction. The article starts by reporting some findings of a larger study on laughter in Finnish primary care encounters. In the database, it is typically the patients who laugh. Furthermore, they laugh alone, i.e., the doctors do not reciprocate their laughter. The article presents some typical examples of the patients' laughing practices and shows that there are activities that are recurrently done with laughter. For instance, if the patients reject the doctor's candidate understandings with more problematic descriptions, or if the patients problematize the doctor's directives, they recurrently laugh in performing these activities. Through laughter the patients display that the activity at hand is delicate and by showing their awareness of the problem, the laughter also functions as a remedying feature in different kinds of interactional problems. The latter part of the article concentrates on a specific activity environment, the very beginning of the medical agenda where the patients deliver the reason for the visit. The article analyses the cases in which the patients laugh in this slot. In giving the reason for the visit, laughter is used in specific cases: it occurs when the patients present their problem as somewhat ‘untypical’ or ‘strange’. By laughing—and other means—they deal with the delicate interactional business of presenting a problem that is not typical or likely, and thereby may need extra legitimizing as a reason for the visit.