Before making my comments, I should say that I am neither a linguist nor a specialist in jokes and puns. Thus, while my observations reflect my training in social anthropology, they may reflect more of a commonsensical view. They should thus be read as such. Christopher Peterson has published an interesting article on the slang, puns, and jokes used daily by Carioca physicians. The subject, as far as I know, has received little attention in Brazil. The article has the enormous disadvantage of being written in English, which hinders discussion of a theme which is linked to what are so often untranslatable (as culturally impregnated), subtle meanings expressed by slang and jokes.

Contrasting his approach with that of Gordon in an article published in 1983 on hospital jokes for patients in California, the author attempts to distance himself from the sociological or socio-psychological theories according to which the main functions of physician slang and puns are the following: (1) to maintain a physician-patient distance; (2) to reinforce rapport among physicians; and (3) to relax the tension inherent to medical work. Although Peterson does not say so explicitly, such theories derive clearly from symbolic interactionism, as developed by H. Becker and E. Goffmann, among others. Therefore, this is the tradition he criticizes. Although referring indirectly to some of these theories, principally that which views jokes as relieving physician stress, Peterson considers them insufficient for understanding the role of jokes and puns in medical slang. Rather, he states, he attempts to demonstrate that jokes and puns create new meaning for the relations between physicians and patients, among physicians themselves, and between physicians and the health care system. According to the author, this capacity to create new meanings is linked to the fact that jokes and puns operate primarily through metaphors. Based on Richards and Ricoeur, the author incorporates the idea that, beyond illuminating the meaning of a given term by replacing or comparing it with another, metaphor alters the original meaning of both terms when it interrelates them. Rather than a 'substitutive' or 'comparative' view of metaphor, Peterson works with the idea of 'interactive' or 'creative' metaphor, extending this semantic capacity to jokes and puns. In addition, Peterson bases his analysis on Freud's idea that jokes or puns tend to occur in a context of conflictive relations, in which aggressiveness cannot be expressed in its raw, explicit, and direct form. And, as the author shows, there is no lack of conflict in the current Brazilian health scenario. The material comes basically from telephone and face-to-face individual or group interviews.

Having said this, I must confess that, although the article is original and daring, I felt uncomfortable with it on numerous points, on which I ask the author to comment. The first point relates to the lack of explicitness regarding the way the semantic and social planes are articulated. The problem becomes quite evident in the section focusing on jokes and puns for patients, when the author analyzes the expression mulambo. Although recognizing that physician jokes for patients sometimes have other origins, in the case of the expression mulambo the joke is seen as originating from the fact that the patient is perceived "as belonging to a lower socioeconomic class". For some reason, which was not made clear, but which the author derives from Freudian theory, this perception causes an aggressive attitude on the part of physicians. Thus the humorous metaphor. Peterson states that by using the expression mulambo for poor and homeless patients, Carioca physicians are not only 'expressing' the social exclusion to which such individuals are subjected, but by giving in to what appears to be an unconscious class aggressiveness, they are actively creating it. I find the idea reasonable as a hypothesis, but the way by which Peterson derives it from the theory of metaphor he adopts, presenting it to the reader as a conclusion from his study, is problematic, to say the least. Peterson states that, by approaching jokes for patients as a way of promoting rapport among the medical staff and maintaining their distance from patients, Gordon's approach "entails a substitutive view of metaphor..." and not the "creative metaphor" he prefers. What is lacking is a better explanation of why this occurs. Apparently, according to Peterson, since at the semantic level, metaphorical construction is a creative activity, ergo, use of the expression mulambo by Carioca physicians also creates exclusion, but now on a social level. To support this conclusion, Peterson states further that to there is other raw material other than patients to serve the functions Gordon ascribes to jokes. This is true, but it does not help me understand the relationship the author establishes between processes of social exclusion and the interactive theory of metaphor. I do not mean to defend physicians or much less the use of derogatory language for patients or anybody else. My problem is the confusion I see between an analysis performed on the linguistic plane and another occurring on the social plane. If Peterson had kept to the linguistic plane in his analysis of the expression mulambo, he would have to explain, as he did after all in the example "The ICU is a torture room" how the interactive metaphor mulambo changes the sense ascribed to the object mulambo (rag) and the street population metaphorized by it. But the author fails to do so. He changes levels suddenly and explains the creation of social exclusion by the use of mulambo in that the metaphor is creative on the semantic level. I fail to understand. In order to create social exclusion (or racial, as the author insinuates several times), physicians could use non-linguistic or non-metaphorical devices (like spending more time in consultation with wealthier or whiter patients). Linguistic activities like naming and classification, very much present in the diagnostic act, can be equally performative (partially creating that which they are supposed only to designate), without necessarily being metaphorical. Metaphor is creative at the semantic level, I have no doubt, but it can have multiple effects at the social level. In addition, in order to conserve, maintain, or reinforce social hierarchies, privileges, and inequalities, much creativity is needed at the semantic level. I thus fail to see how the premises lead to the conclusion in Peterson's reasoning.

In addition, in my opinion, the performative power of language can only be perceived through the social context of its concrete use (who speaks, why, and to whom). Words have no power in themselves, in fact they do not even exist outside of these contexts. And this leads me to my second area of discomfort: the almost total absence of social context in which these acts of speech occur (the author bases the analysis almost exclusively on interviews), where such observation would have been crucial. As I said above, the author sees in the use of certain jokes by physicians a class effect and also an racist effect, too, as he insinuates several times. I have no doubt that racial and class prejudice exist in Brazilian society as a whole and are manifested among physicians, especially at a moment in history when, as the authors point out quite properly, doctors are losing status and dangerously approaching that of their patients. I even believe that Brazil urgently needs more refined analyses on the way by which racial prejudice, especially, is reflected in medical practice. And Peterson's article has the merit of suggesting such analyses. However, according to the perspective he adopts, he fails to offer us a convincing analysis of the way by which the use of expressions like mulambo create class borders, much less racial ones. In order to achieve this, the author would have to abandon a purely textual analysis to demonstrate more clearly whether mulambo is used to describe poor people in general or only beggars (not that I think it would be more justified morally in the latter case). In fact, the contextual multivocality of the expression is even suggested by one of the physicians he interviewed, who recognizes that the use of the expression mulambulatório to refer to public outpatient clinics is extended improperly (in the interviewee's opinion) to all poor people, and adds, "but not all of them are really mulambos..." So who 'really' are the mulambos? This distinction is crucial, because if the doctors that use the expression are referring more specifically to beggars, then the meaning of the term may be that of criticizing the deplorable state in which a major portion of the Brazilian population lives. In other words, esmulambada [literally 'raggedy', from the same root as mulambo ­ T. n.] without being used metaphorically in this case. With regard to racism, which crops up several times in the article, the author would have to consider the way physicians treat white as compared to black poor people to determine whether the use of verbal language (not to mention the language incorporated into treatment and care) changes according to color or 'ethnicity' (as some would prefer it). The insinuation of racism based on the fact that the word mulambo has Bantu roots is untenable. The words caçula, cafuné, and bamba have the same roots and carry no negative connotation. Closer attention to the context might have led the author to a more interesting analysis of such expressions as pitiático (which, by the way, he should have noted, refers clearly to hysteria), trubufu, and certain jokes referring to obese individuals. They suggest another line of social cleavage, neither that of race nor class, rather that of sex or gender, because they appear to focus primarily on women. In fact, I tried to find an equivalent term for trubufu for men, but could not. White men, even when they are ugly and fat, are not good joking material, contrary to homosexuals, blacks, bald men, and those currently seen as having erectile problems.

In short, the absence of a more sensitive approach to concrete social contexts in the use of speech has led the author to rely too heavily on etymology. And this leads me to my last source of discomfort. The article transpires the supposition of a certain 'etymological consciousness' on the part of speakers of a language. As if we all had an etymological dictionary installed in our brains. Of course the negativity of such Portuguese-language expressions as coitado [meaning the equivalent of "poor thing!" in English and deriving from the Latin coitus, thus reading literally as 'fucked' T.n.] or 'judiar' [deriving from judeu, i.e., 'Jew', meaning the equivalent of 'to torment, harass, etc.' or literally 'to treat as the Jews used to be treated' T.n.] bear the legacy of a chauvinist, racist society that one day placed such words in circulation. Brazilian society may not be much less chauvinist or racist today than it used to be. However, even if it were absolutely egalitarian, many people would continue to help the coitados and judiados without being suspected of vulgar language or anti-Semitism. The words have lost their original meaning. Thus, from my point of view, to find a trampolim in the trambique of the trambiclínicas from which to dive into the deeper meaning such terms have for physicians is risky and dangerous. As an allegory, the gesture is perfect, but as an analysis it is problematic. At any rate, I repeat, the author raises interesting questions which, from my point of view, deserve deeper analysis through other methods and materials. The text is daring, and I also see great merit in this sense. The issue is how not to let intellectual daring slip into analytical temerity.