DISCOURSE, ORGANIZATION AND THE SURGICAL WARD ROUND

The surgical ward round is examined as an organisational strategy entered into by surgeons to enable particular claims about the success of surgery to be validated. The paper reports ethnographic data from UK surgical wards which suggest that surgeons organise the discourse of their interactions with patients around three themes: physiology, wound condition and recovery/discharge. These themes are surgeon-centred, and are organised to deny patients access to the agenda of these encounters. Within a post-structuralist and postmodern framework, these strategies of discourse organisation are understood as techniques of power. Surgeons privilege discourses which support their claims to be healers, denying those which focus on the necessary injury which surgical resection causes. The paper argues that the 'ward round' is a mythical structure constituted as an organisational strategy to counter challenges from patients to their hegemonic discourse.