Talk, Work, and Institutional Order: Discourse in ...

american ethnologist

252 (pp. 92,97,159), or howa person's identity is multiplexthroughconnectiontoalocal parish group as well as connections to other outside groups formed from ancestral links. While Sturzenhofecker does not specifically mention it, the concept of internal externality also captures the manner by which Duna incorporate and transform ideas and practices external to Duna society, whether they are from neighboring local groups or colonial and postcolonial agents. Another feature of the social landscape that Sturzenhofecker captures is the gendered aspect of Duna spatiality. She breaks from a domestic versus public analysis of gendered space and shows instead that Duna male space is collective whereas Duna female space is atomized. A Duna woman is depicted as living in a state of social loneliness, accompanied by her children or one other woman, whether it be in public, in the home, or in the garden. In contrast, Duna men live a collective existence— sitting together in groups morning, noon, and night—dominating the social landscape of gender by the sheer force of their numbers. Sturzenhofecker describes her analysis as looking at a diverse array of topics through a gendered lens that captures historical changes. Her approach is stimulating. If I had one complaint it would be that, given the diversity of topics she covers—cosmology, residence, identity, marriage, history, witchcraft, gender, space, and ritual—the book is much too short. It weighs in at a slim 204 pages of text (not counting 1 7 pages of appendixes and notes). Some of the ethnography seems a bit thin, especially in relation to Stiirzenhofecker's rather remarkable claim that Duna marriage is unlike anything in the highlands or highlands fringe—there is no sister exchange, and bridewealth associated with marriage is a one-time event. In fact, she states that after the initial bride-wealth exchange, when the groom's network gives to the bride's network, a man has no further relations with his affines. I wanted to see a sub-stantial discussion on this exception to every other account of marriage in the highlands, and was disappointed that none was forthcoming. In spite of this, the book is well written and Sturzenhofecker's ambitious approach makes it highly recommendable to those interested in gender, history, or Melanesian ethnography.

Talk, Work, and Institutional Order: Discourse in Medical, Mediation, and Management Settings. Srikant Sarangi and Celia

Roberts,eds. Berlin: MoutondeGruyter, 1999. 529 pp., tables, index. JAMES WILCE

Northern Arizona University Talk, Work, and Institutional Order contains several gems. The authors demonstrate the ethnographic relevance of analyzing talk at work and the role of talk in the (reproduction of institutions. Contributors offer rich ethnographic insights into medical institutions and the discursive structuring of social work and other professions. Several use Erving Goffman's notion of frontstage and backstage (pp. 19-24), as illustrated in shifting analytic attention away from doctors' encounters with patients to the roles played by nurses (Tony Hak) and receptionists (Aaron Cicourel). Transcripts are replete with examples of metacommunicative foregrounding of "categories and boundaries to reinforce . . . institutional realities" (p. 3). Several contributors point out, in contrast with Jurgen Habermas {The Theory of Communicative Action, Beacon Press, 1987), that the lifeworld is very present in institutional discourse. This problematizes the notion of the workplace as distinct, particularly in "the new work order" (p. 9). Still, institutional discourse has unique features, such as maintaining an appearance of neutrality (David Greatbach and Robert Dingwall), the presence of constraints, and a rational or instrumental orientation (David Silverman, p. 406). The volume's argument is well represented by Christopher Candlin, Yon Maley, and Heather Sutch's statement that "changes in discursive practice . . . both reflect and contribute to wider social changes" (p. 234) and by Silverman's assertion that closely analyzing discourse and asking larger theoretical questions are complementary moves (p. 420). The editors have organized the chapters into three sections—"Medical Practices and Health Care Delivery," "Mediation, Management, and Social Care," and "Methodological Debates." They briefly introduce each section. These titles mask the fact that each section includes chapters on medicine: Margareta Bredmar and Per Linell's description oi prenatal encounters, Hak's study of

book reviews the delivery of diagnostic news, and Celia Roberts and Srikant Sarangi's study of the gatekeeping role of oral exams given to British general practitioners. This focus makes the collection particularly valuable to medical anthropologists. In section 1, Paul Atkinson discusses case presentations as collegial discourse during hematology and oncology rounds in an American hospital. Hierarchical relations between senior and junior physicians lead to asymmetrical patterns of interruption, but all collaborate to maintain professional boundaries through different forms of evidential marking. Frederick Erickson describes register shifting as a means of negotiating ambiguities of identity, status, and role between an older white doctor and his African American colleague as they discuss an African American patient. Jenny Cook-Gumperz and Lawrence Messerman's study of medical record keeping and decision making by a team of nurses and allied health professionals at a Veteran's hospital shows how the team orients their written reports toward one audience in particular—their accreditation organization. Cicourel draws from a disparate set of recordings and observations to argue "that structural/organizational, cognitive, and discourse approaches to the study of health care professional and health care delivery systems are mutually interdependent" (p. 193). His most interesting case study highlights the degree to which medical receptionists play a pseudodiagnostic role in busy clinics. These chapters illustrate how accountability shapes discursive practices in and around medicine; those who work in medical institutions must categorize, constantly making judgements about normality. Normality is also the theme of Bredmar and Linell's chapter on "The Constitution of Reassurance in Talks Between Midwives and Expectant Mothers" in Sweden, the first chapter in section 2. Other compelling chapters in section 2 are those by Candlin, Maley, and Sutch, and by Janet Holmes, Maria Stubbe, and Bernadette Vine. Candlin, Maley, and Sutch deal with bargaining between academic union officials and administrators in Australia; this topic will hold the interest of nonunionized American academics! Metadiscursive invocations of different senses of negotiation and bargaining (p. 331) play a key role, indexing Australia's incomplete transition from union militancy to reformed labor relations. Holmes, Stubbe, and Vine present an exemplary bit of discourse

253 analysis that reveals power relations in the often interracial offices of New Zealand government policy units; pronouns, imperatives, and hedges help coworkers establish relations of solidarity or hierarchy. In part 3, David Silverman calls on researchers to seek greater collaboration among conversation analysts (CA), critical discourse analysts, and ethnographers. By contrast, Hak argues that CA has restricted ethnomethodological ethnography to the narrow view of a camcorder lens. While Hak would put ethnography before mechanical recording of any sort, John Gumperz and Silverman agree that it is useful to start with fine-grained transcripts of mechanical recordings for what they reveal about, inter alia, interethnic service encounters (Gumperz). Roberts and Sarangi make several contributions in the volume's last chapter. They demonstrate the viability of conducting research with, and not only on, institutions so that research problems are jointly constructed. Their collaboration with the Royal College of General Practitioners (RCGP), an institution evidently committed to overcoming structural racism in its oral exams, resulted in theoretical insights into discursive hybridity; one problem with the exams' questions was the way they raised both professional and institutional concerns. Of practical relevance to the RCGP was the unexpected finding that oral responses foregrounding one or the other oi these sets of concerns received high scores. This chapter exemplifies how studying up can lead to altering discursive structures that have resulted in the exclusion of ethnic minorities from professions. The volume suffers somewhat from some unfortunate inconsistencies. For example, not all authors who use transcripts reveal their transcription conventions; and some authors number (even long, multiline) turns rather than lines, making it impossible for the author to refer readers to precise bits of the transcript. More substantively, although the notion of entextualization is very useful to studies of institutional discourse—and some contributors did invoke it—not all understood entextualization as it is (I think) commonly used. Entextualization commonly refers to ways that discourse is "fashioned for ease of detachment from situational context"—in other words, howdiscourse is made into text or objectified ("Poetics and Performance as Critical Perspectives on Language and Social Life," Annual Review of

254 Anthropology vol. 19, p. 74). None drew on Joel Kuipers' particular application of the notion to discourse in medical institutions ("'Medical Discourse' in Anthropological Context: Views of Language and Power," Medical Anthropological Quarterly 3(2): 99-123). Overall, the volume will make a very useful text in graduate courses in linguistic, social, and medical anthropology. I recommend it highly.

Women Living Zen: Japanese Soto Buddhist Nuns. Paula Kane Robinson Arai. Oxford: Oxford University Press, 1999. ix + 233 pp., photographs, tables, appendixes, bibliography, endnotes, index. ANNA G RIMS HAW Manchester University In Women Living Zen, Paula Arai examines the lives of Soto Zen nuns in contemporary Japan. Arai writes from the perspective of religious studies; she intends to challenge academic scholars' neglect or denigration of the contributions made by women to Japanese Buddhism. Drawing on ethnographic experience and historical research, Arai argues against the androcentrism of much Buddhist scholarship, seekingtoestablishthedistinctive nature of female monasticism. She tells a story of success as she emphasizes in her account the resilience, determination, and creative adaptation of Soto nuns to changing historical circumstances. Arai begins by exploring the position of women withi n the textua I tradition of Soto Zen Buddhism, founded by Dogen in the 13th century. She first identifies qualities that distinguish the female monastic tradition, suggesting a tangible link between the early nuns and their contemporary counterparts. The author draws attention to the centrality of education and discipline in consolidating women's religious lives. Unlike male monastics, who have progressively shifted from "renunciatory practices" into "liturgical activities" (p. 17), Soto nuns have moved in the opposite direction. Their growing confidence during the 20th century has resulted in a renewed emphasis upon monastic life. The author's account oi Soto nuns in contemporary Japan is built upon her own firsthand experience of living four months in a monastery and submitting to its routine, hierarchy, and discipline. Arai quickly dispels any

american ethnologist notion of tranquillity and harmony, observing that "interpersonal relationships in a monastery are an intensified version of those in the greater society" (p. 83). Her descriptions are detailed and full of insight. Her writing effectively conveys the sheer intensity of monastic life—these very demands are spiritually transformative for women who dedicate themselves to Soto Zen Buddhism. The qualities required for such a commitment are the focus of Arai's inquiry in the final part oi her book. Using interview and survey techniques, she sought to elicit from women their motivations for pursuing monastic life. The material is entirely consistent with the image presented hitherto in the book—that women become Soto nuns as an affirmation, rather than negation, of their personhood. Their decision to follow a religious life stems from a position oi strength rather than weakness. This book is a valuable addition to existing accounts of Buddhist practice and female spirituality. Arai writes in a clear, accessible, and engaging style. The author shows a high degree of reflexive awareness, enhancing the book's potential as a significant teaching resource. There are, however, a number of problems. First of all, Arai's ethnographic perspective seems somewhat dated. Her organizing framework is reminiscent of earlier structural functionalist monographs; and she does not engage much with contemporary debates in anthropology concerning, for example, the body or gender. Arai's account of Soto nuns is also resolutely upbeat, giving a certain predictability to the writing. I began to wonder what had surprised the author. Had she ever been caught unawares or discovered something unexpected? The book read almost as if its final thesis had been known at the outset of the research. Arai wrote her book for an academic audience. Although she introduces herself and her experiences selectively within the text, she refuses to disrupt the conventions of that form. Her use of photographs adds nothing to the account, though the author might have creatively worked withi n this space to evoke a ki nd of experience different from that which she describes through language. The life of Soto Zen nuns is fascinating and deserving of a wider audience. I very much hope that Paula Arai will find a way to write about these women that