Lovers, wrestlers, surgeons: a contextually motivated view of interpersonal engagement and body alignment in surgical interaction
Models for describing how body alignment contributes to the meaning-making of human social contexts have tended to yield elaborate but instance-bound 'thick descriptions'. While this allows for very rich accounts of particular cases, these approaches do not lend themselves to systematic empirical comparison, for instance of how participants in a highly charged endeavour like surgery align their bodies to each other in ways that may construe different meanings under different conditions - e.g., different types of surgery, different phases of surgery, different levels of fatigue, engagement or personal involvement in the procedure at hand, when taking different agentive roles, when working with different teams, or just the effects of working on different days. The need for such empirical analyses in areas like surgery is increasing as we find more and more evidence that a team's sense of engagement is crucial to its capacity to avert and reduce errors (Wilson et al. 2005; Healey et al. 2006; Bezemer et al. 2011; Weldon et al. 2013). Recently, systemically oriented accounts have been emerging which hold promise for dealing with these kinds of empirical analyses. In particular, Martinec (2001) has offered a framework for analyzing the means of construction and expression of interpersonal relations through action, drawing on Hall's (1959, 1966) classic analysis of spatial distance between bodies, and incorporating his own analysis of reciprocal body angle. Yet what is missing from the leading models of body alignment is a systematic account of how the same distance and orientation selections may have quite different meanings even in subtly different contexts; that is, there is no systematic account of the dynamic role of context in the meanings attributed to movement and position. In this chapter, I examine what we can gain by emphasising the stratal rapport between context, semantics and expression choices in multimodal analyses, starting with the issue of how body alignment construes engagement in surgery, and drawing on recent developments within systemic functional linguistics (SFL) by Hasan (1999, 2009) and Butt (2004) regarding the constructs of Field, Tenor and Mode. Although this approach raises further issues (Butt and Wegener 2007; Bowcher 2013), it increases our explanatory power significantly. In the context of surgery, it explains why team members who work at very close distances are not contravening Hall's rules of thumb about appropriate intimacy; rather, they are operating within register- specific relations between context, semantics and expression. Such register-specific accounts of meaning systems at work can make the professional logic of the context more available for scrutiny by institutional members, and can contribute to organisational and professional development.
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