Metaphor and patient communication in Arab culture

Dr. Laeth Nasir MBBS, Dr. Arwa Nasir MBBS, MSc, MPH, Mrs. Nada Al-Antary, Mrs. Aseel Subuh, Mrs. Hana Haimour, Mrs. Mai Ababneh

lnasir@creighton.edu

Metaphor is fundamental to abstract thinking. Operating at a foundational level of cognitive processing, metaphorsallow the structuring of conceptual frameworks, and are central to the creation of meaning.We hypothesized that metaphors common in Western medical discourse differ significantly from those in Arab culture, thereby creating fundamentally mismatched communications, despite accurate linguistic translation. Methods: The authors searched Arabic language popular culture and literary material to locate metaphors around health and disease. Findings: A total of 120 items, that included proverbs, songs, poems, stories, movies and television episodes in Arabic were identified and categorized. Metaphors were identified and analyzed. Although metaphors were identified that were similar to metaphors described to occur frequently in Western studies, such as metaphors referring to disease as an enemy to be defeated, it was noted that the most common metaphors inclined towards social and interpersonal contexts and situations. Most striking were the metaphors around the concept of the “disease as a visitor” Additionally we found metaphors that evoked hunting, trickery, and cunning. These themes tend to be anthropomorphic, differing from those metaphors described in the western medical literature. Implications for patient/physician communication and relationship are discussed.