I said , here you are beating yourself up one side and down the other……我说，你从这边走到那边、、、Now is it all right for him to ,he thought he might like to take a trip to Maine/他认为他想去缅因州旅行的事情都准备妥当了。
D: /To Maine, yeah /简单的不翻了哦
W: /Yeah? /
D: Sounds fine， as long as you stop the car every hour, let him get out and walk around a bit. Uh, let’s have him get a cardiogram today/听起来不错，只要你一个小时停车一次，让他下车出来走走转转。额，让我们把他今天的心电图给做出来吧
W: /Mmm mmm（语气词）
D: Let me see him again in uh six weeks/我六周后要见到他
W： /Uh huh/（语气词）
D: and uh, let’s plan on say mid-June getting him back, Ok ?......Like to hear from him just about the time he’s ready , it’s time for him to go back to work , just give me a progress report.我们大致约定六月中旬送他回来，好吗？、、、大致是听他说他准备好了的时候，就是让他回到工作岗位上的时候了，只要把他的进度报告给我就可以了。
[to P] I gave your wife a prescription , Mr.__, and uh , and uh so you can go down and get a cardiogram , and uh , I’ll see you in six weeks ,and maybe you can give me a call in about three weeks , let me know how things are going , which would be just about the time you’d be going back to work .我给你妻子开了个药方，**先生，所以你要平静下来，然后我才能得到一个准确的心电图，我们六周内还会再见到的，或者你也可以三个礼拜后打电话给我，好让我知道你一切过得怎么样，那时候也就是你回到工作岗位上的时候了。
I think from the standpoint of what’s going to do more harm to you , it’s going to do more harm to you worrying over those three cigarettes a day than it is smoking them . I think . So I think that this would probably uh three a day , certainly even though you inhale them is not , let’s face it . We can’t get you to the point that we can canonize you , we just want to keep you going .从对你有坏处的立场想想，你一天想三次雪茄比你直接吸它们更有害，我认为，所以我认为一天三次太、、、、、当然了，即使你没有吸！让我们好好面对它，也许你无法做到能让我们都褒奖你，但我们只是希望你可以一直努力前进
P: Yeah , when I do smoke them , I get all nerved up about it , I get so mad at myself /是的，当我吸它的时候，我感到特别紧张焦躁，我对我自己感到恼火
D: /Yeah , you incriminate yourself/是的，你觉得你自己是有罪的
W: /The doctor feels it’s better .医生觉得这个相对好一点
D: Yeah , well I still think that you’re going to be better off to have those few cigarettes , than to sit around and mope and hope and grope around and/是的，我仍然认为你还不如吸这些雪茄，总比你坐在那无聊或者总是想着或者四处乱摸索的好，
W： That’s all he thinks about , that’s all I think about from the time I open my eyes until I close them at night .那些就是他整天想的，是我每天睁眼后和闭眼前所想的
D: Listen , after you get the cardiogram , do me a favor . This will add only a few more minutes to your stay here today . Fill this out if you would . This is a confidential form . There’s a young lady out there with long blond hair , and uh give this to her . She’s uh from the Massachusetts General Hospital . Everything is confidential in this form . It’s just going to go to the study people , and , uh . be very truthful in your anwers .听着，你拿到心电图后，帮我一下，不会很久的，只是稍微加长了你呆在这的时间。如果可以的话把这个填下。这是一个机密的表格，这边有一个金发的年轻女人，把这个给她。她是来自麻省综合医院的医生。这个表格的所有东西都是保密的。这只是用来研究人类的，请如实回答你的问题。
W：Ok .
D： OK . Thank you .
In the encounter expect reduction of smoking . His wife reiterates the patient’s request later and again receives conditional approval(ll.206-212). This couple do not indicate what other activities give them pieasure . The leisure they do seek , however , is subject to medical regulation .在希望戒烟的情况下，他的妻子在重申了病人的要求后，又再次申明了要求保密的请求。这对夫妇没有表明其他活动给他们带来的快乐，他们所寻求的安逸，然而，却是以从药物解放出来为主题。
This encounter also maintains an uncritical stance regarding family relations . 这种遭遇，也主张一个不严厉的立场，在关于家庭关系上（即家庭关系融洽方面）.Participation by the patient’s wife in the encounter is strking but not unusual . 患者妻子共同参与的情况是有显著效果的但不是不平常的，The interaction allows certain inferences about family dynamics and the doctor’s reinforcement of them . 这种相互作用是一定的家庭动力和医生一定的增援加固相融合而产生的。While the patient is the economic breadwinner , he emerges as his wife’s assistance . 如果这个病人是家中经济来源的顶梁柱，当他妻子来援助的时候他会拒绝。
The wife elaborates at length on the patient’s emotional disturbances(ll.34-39,129-135,204-206,239-245)，妻子的煞费苦心最终会因为患者的情绪而白费，
sleep problems(ll.57-68), disability certification(ll. 118-128), and desire for a pleasure trip(ll.206-212). 睡眠问题，残疾证，和期望的那个快乐的旅行都会白费。She and the doctor hold side conversations between themselves , both in and outside the patient’s presence . 她和医生两边夹击，对他进行谈话，让病人参与到这个谈话中来，Although the doctor encourages the patient to become more active by returning to work , 尽管医生鼓励病人用回到工作中的方式来让自己变得更加积极，he subtly colludes with the wife in retaining the patient’s day-to-day helplessness within the family . 他巧妙的和他的妻子串谋用家庭来留住病人日复一日的无助。This collusion extends from agreement about the emotional impact of idleness , to diminishing the patient’s concern about smoking , to instructions about drug dosages(ll.194-206). 这种串谋的扩大是由于失业情绪影响的缘故，为了减弱病人对吸烟的渴望，为了达到药物剂量减少的要求，Further , the patient himself voices no objection to this pattern of communication .进一步的说，病人他自己对这种交流模式没有提出异议， Although the doctor recognizes depression as one of the patient’s two major medical diagnoses , he does not explore the possibility that family life may be part of the problem . 尽管医生很沮丧的意识到病人两种主要药品中的 一种药品的剂量在增加，他不希望认证家庭生活是导致这一现象的缘由To whatever extent that psychological problems in the family exist , the medical encounter reinforces the status quo要加强药物是家庭生活或多少的影响他心理的问题。
Throughout the interaction , technical knowledge occupies a minor place , in comparison to the ideology and symbolism of scientific medicine .通过相互作用，在科学医学中对意识形态和象征主义进行的对比中，技术和知识只占据了一小部分，， The doctor asks a few questions from the standpoint of cardiology(regarding chest pain , ll. 27-32), inquires about the use of a cardiac medication(nitroglycerine , ll.62-66), discusses gauze and nail care(ll.140-155), performs a brief physical exam , and orders an electrocardiogram. 医生从心脏病学的角度问了一些问题，要求使用心脏药物，用论述纱布和指甲修护完成一个简短的身体考试并要求完成心电图，Otherwise , it is difficult to find evidence in this encounter of scientific medicine per se . 否则，要找到这种医学科学的论据会很困难。On the other hand , the doctor offers a series of pronouncements about smoking , work , leisure , and emotional difficulties. 另一方面，医生提供了一系列的关于吸烟，工作，休闲和情感困境的声明。These utterances contain little or no scientific rationale , yet their impact derives from the symbolism of scientific knowledge and technique .Carrying the authority of medical science ,the doctor dominates the interaction .这些声明包含一点活或没有科学原理的阐述，然而它们的影响院子象征主义中的科学知识和技术，带着医学科学的权威性，医生在相互作用中占据了主导地位 In this sense the communication remains distorted ,as the professional assumes control over major areas of life inside and outside the medical realm. 从这层意义上说，交流仍然是受到曲解的，由于专业的假定控制了主要内在生活部分和外在的医疗领域。
