ABSTRACT
The narratives in the chapter exemplify problems which are clearly a long way from 'communication skills' - but not a long way from 'communication'. The often overlapping categories into which the doctors seem to fit are themselves a mix of symptoms and their causes, of surface and depth. This will often get labeled a 'communication problem' rather than a 'language problem' - a phrase by which specialists might more readily distinguish it. There are three main aspects to this. Firstly, there are problems with communicative competence. Secondly, these problems can be considerably magnified if there are significant cultural barriers. Finally, there are doctors whose command of the language may not appear to be poor, and whose problems go undiagnosed. Indifference to others may also be a by-product of a certain kind of obsession with oneself. In particular, some doctors have a sense of injustice that is confirmed by the referral.
